FOCUS ON PEDIATRIC MILESTONES
BY CAROL GIBSON, DNP, FNP-BC
Updated Pediatric Milestones The CDC revises its developmental milestones for the first time since 2004 Pediatric specialists and providers have made important progress over the past 15 years to quickly identify and treat children with developmental and behavioral disorders. For the first time since 2004, the American Academy of Pediatrics (AAP) and the Centers for Disease Control (CDC) and Prevention have revised the milestones used to identify developmental delays in the pediatric population.
Early Identification, Better Outcomes In a 2020 clinical report on pediatric development in the AAP journal Pediatrics, the authors wrote: “Early identification and intervention for developmental disorders are critical to the well-being of children.” They went on to explain that said early identification can be achieved through regular developmental surveillance and screening by families and pediatric providers. According to the report, developmental surveillance should take place at every well-child visit and be implemented through use of standardized developmental screening tests. Through use of screening milestone checklists like the ones just revised by the AAP and CDC, children with known high-risk conditions or who have concerning screening results can be referred for early intervention.1 Limitations of Milestone Lists The CDC’s 2004 Learn the Signs, Act Early campaign created developmental surveillance milestone checklists that included warning signs and exhortations for parents and pediatric providers to “act early” when addressing possible delays and concerns.2 The developmental milestone checklists used “average-age” milestones— goals that the 50th percentile (i.e., half) of children were expected to reach at a given time. Many providers and parents using the milestones chose to use a waitand-see approach, which sometimes led to delays in diagnosis and treatment.3
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