8.5: Cognitive Development Concerns

Concerns

The above chart represents averages of when infants and toddlers achieve various cognitive milestones. What about children who do not achieve these milestones by the ages listed? While children can indeed develop different abilities at different times, too great a delay in acquiring specific milestones can be a concern. The information in Figure# is from the Center for Disease Control and Prevention (CDC). The chart adopts a proactive stance--we should take action early when developmental concerns arise rather than the perspective of waiting to see if a child “catches up”. Again, while children do develop at individual paces, being proactive during these critical early years is essential. The chart below lists milestones that, if children are not achieving by specific ages, caregivers should encourage parents to communicate with their family’s pediatrician. Most caregivers are not professionally trained to officially assess the developmental abilities of children; however, caregivers have the ability to track developmental progress and are often the first to notice developmental concerns.

When to encourage parents to communicate with a pediatrician

Age	Encourage parents to communicate with their family’s pediatrician if: ^[1]
By 4 months	● Child doesn’t watch things as they move ● Child doesn’t smile at people
By 6 months	● Child doesn’t try to get things that are in reach ● Child shows no affection for caregivers ● Child has difficulty getting things to mouth ● Child doesn’t respond to sounds around him ● Child doesn’t laugh or make squealing sounds
By 9 months	● Child doesn’t play any games involving back-and-forth play ● Child doesn’t respond to own name ● Child doesn’t seem to recognize familiar people ● Child doesn’t look where you point ● Child doesn’t transfer toys from one hand to the other
By 12 months	● Child doesn’t search for things that she sees you hide ● Child doesn’t say single words like “mama” or “dada” ● Child doesn’t learn gestures like waving or shaking head ● Child doesn’t point to things ● Child loses skills he once had
By 18 months	● Child doesn’t point to show things to others ● Child doesn’t know what familiar things are for ● Child doesn’t copy others ● Child doesn’t gain new words ● Child doesn’t have at least 6 words ● Child doesn’t notice or mind when a caregiver leaves or returns ● Child loses skills he once had
By 24 months	● Child doesn’t use 2-word phrases (for example, “drink milk”) ● Child doesn’t know what to do with common things, like a brush, phone, fork, spoon ● Child doesn’t copy actions and words ● Child doesn’t follow simple instructions ● Child loses skills she once had
By 36 months	● Child drools or has very unclear speech ● Child can’t work simple toys (such as peg boards, simple puzzles, turning handle) ● Child doesn’t speak in sentences ● Child doesn’t understand simple instructions ● Child doesn’t play pretend or make-believe ● Child doesn’t want to play with other children or with toys ● Child doesn’t make eye contact ● Child loses skills he once had

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^[1] CDC’s Developmental Milestones by the Centers for Disease Control and Prevention is in the public domain