Are your kids meeting their developmental milestones? The CDC has new guidelines every parent should see.

For the first time in almost 20 years, the Centers for Disease Control and Prevention (CDC) issued a revised list of developmental milestones for babies and young children. Experts say the milestones were updated in order to help parents identify issues such as autism, communication disorders, and developmental delays sooner, so that appropriate interventions could be implemented. Critics, however, argue that the move is an effort to cover up the negative impact COVID-19 may have had on children.

Early childhood benchmarks were released in 2004, and not amended for many years. Last month, the CDC, in conjunction with the American Academy of Pediatrics (AAP), released a revised version of those guidelines. Parents immediately took to Facebook and other social media outlets to express their skepticism about why the guidelines were revised now, claiming the CDC lowered the bar to minimize the negative effects that masking and social distancing may have had on their kids.

The new benchmarks are published in Pediatrics and include a checklist of behaviors and skills for children aged two months to five years. In the past, the guidelines only covered the milestones 50% of children should be achieving in their respective age groups. This created panic for some parents, whose kids may not have reached those milestones in the expected timeframe. The revised guidelines, however, expanded that to 75% or more, so parents now have a broader window for children to achieve benchmarks, and to subsequently receive assistance if their children are falling behind.

So what has changed? Revisions include, but are not limited to:

• Checklists were added at both 15 and 30 months
• Walking was moved from 12 months to 18 months
• Social/emotional milestones, like smiling independently to get an adult’s attention
• Vague language, such as “begins,” was removed
• Recommending open-ended questions, such as “is there anything your child does or does not do that concerns you?” so parents and pediatricians could have improved conversations during pivotal office visits
• Revised activities and tips to promote child development, such as speaking to young children in complete sentences and using “grown up” words.
• The age when children are expected to have a 50-word vocabulary was pushed back from 24 months to 30 months

The claim that the CDC “lowered the bar” for these guidelines in order to diminish the impact masks and other safety measures had on children has largely been debunked. According to Snopes.com, the CDC had already begun making revisions to these guidelines in 2019, prior to the pandemic. No hard evidence has emerged, thus far, to correlate masking and negative effects in children. In fact, the AAP said in a statement, “a key part of learning to communicate for a child is watching the faces, mouths, and expressions of the people closest to them. Babies and young children study faces intently, so the concern about solid masks covering the face is understandable. However, there are no known studies that use of a face mask negatively impacts a child's speech and language development.” While this is based on current data, some experts admit uncertainty about what happens over time when visual cues are not present in a classroom setting. Despite reassurance from most practitioners about children wearing masks in school, many parents and pediatric specialists remain concerned.

Tara Caglione, M.S., CCC-SLP, a North Salem resident and speech-language pathologist for K-5 students, says there was much more to the change in CDC guidelines than the pandemic. “The new guidelines encompass new milestone markers for identifying children with autism (pointing, focusing), social-emotional markers (when a child hugs a doll or a toy, shows affection, or uses words to say ‘look at me’), and fine/gross motor as well as speech and language milestones.”

Caglione said the American Speech-Language-Hearing Association (ASHA), which was not involved in making revisions to the guidelines, wants to work with the CDC to help parents identify developmental problems earlier so that families can “utilize evidence-based criteria in order to make well-informed decisions for their children.” When asked about whether she believes the CDC changed their guidelines because of masks, she said, “currently, the CDC states that revising the guidelines has nothing to do with COVID-19 and/or mask wearing. Personally I believe that time will tell, and like anything else, children will be affected differently by all that has transpired.”

If parents feel something is off with their child developmentally, Caglione recommends talking with their pediatrician and consulting with a speech-language pathologist. The most effective way for parents and caregivers to promote speech and language development, she says, is to “talk to their children, engage in language-rich experiences (zoos, museums, aquariums, nature walks), enroll them in a quality preschool program and, of course, read, read, read.”

Peter Richel, M.D., FAAP, a pediatrician at Westchester Health in Mount Kisco, also weighed in. “The [CDC] recognizes, just as parents and educators do, that masking has had a necessary but negative impact on the educational and social development of our children at all levels and ages,” he said. “This is particularly true for those with special needs requiring support services. Teachers have done an amazing job, even from home initially, and I still don’t know how they did it. We need to continually thank them for their work!”

Richel knows many families who are concerned about their child’s social and emotional development, and several who want to consider repeating a year of school. However, he said, “ I think most children will be fine with time, great teachers, and great family support.”

To learn more about the changes in CDC guidelines/benchmarks for babies and young children, please review these links below:

1. PolitiFact | What to know about the CDC's updated developmental milestones for infants and young children
2. Developmental milestones for children have changed for the first time in nearly 20 years - CNN
3. Did CDC Lower Speech Milestones for Kids Due to Effects of Masking, Lockdowns? | Snopes.com
4. Do Masks Delay Speech and Language Development? - HealthyChildren.org

Elizabeth Malvino, LCSW is a graduate of Skidmore College and Fordham University. She is an executive function coach for Beyond BookSmart where she helps children, teens, and adults understand their ADHD differences and learn strategies to build their confidence. She also has an interest in how school schedules affect the physiological and emotional health of adolescents, and she manages the Northern Westchester County chapter of Start School Later, Inc, a national organization which educates districts about how later start times can improve the lives of students.