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| |    About Language Milestones by Robert Needlman, M.D., F.A.A.P. reviewed by Robert Needlman, M.D., F.A.A.P. Two Kinds of Milestones There are really two ways of looking at language milestones. You might ask, "When should I expect my child to start babbling (or saying her first word, or putting two words together)?" The answer to this question is the usual, or average, age for the particular milestone. The other way of looking at the milestones is to ask, "When should I start to worry, if my child is not babbling (or saying words, etc.)?" The answer to this question is the cutoff age--that is, the age beyond which a child's failure to meet a milestone is likely to be a sign that there is something wrong. A reasonable cutoff is the age at which 90 percent of healthy children are able to meet a particular milestone. A child who has not met the milestone by the cutoff age is slower in developing than 9 out of 10 of her peers. Even so, there is still a good chance that he is healthy, but just developing on a slower timetable. But there is also a reasonable possibility that there is a problem that needs to be sorted out. Why bother with milestones at all? I don't think it's very helpful to measure your child against the average milestones. What's more important is that you know your child well (and no one knows her better!) and help her to progress at her own pace. The fact that she is developing slower or faster than the average isn't really very important. Development is not a race. On the other hand, it is helpful to know the cutoff ages by which roughly 90 percent of children achieve certain milestones. I call these "red-flag" milestones (following the example of Steven Parker, MD, one of my teachers, and co-author of the latest edition of Dr Spock's Baby and Child Care). For example, one month is a red-flag age for a baby paying attention when talked to; 24 months is a reasonable red-flag milestone for saying mini-sentences of two words. Missing a "red-flag" milestone does not mean that your child has a problem; it does mean that it's reasonable to consult a professional to see if a problem exists. Most of the time, you are likely to find that your child has not actually missed a red-flag milestone. If this is the case and you still feel concerned about your child's development, then by all means talk to a doctor or developmental professional. But many times, knowing that your child is not abnormally slow can let you relax and appreciate her individual gifts. If your child has not reached one or more red-flag milestones, knowing the cutoff ages can help you to feel more confident about the need for a complete assessment. You don't need to fear that you are being pushy or overly concerned. If 90 percent of children have attained a skill that your child has not, it is certainly reasonable to find out why, and whether anything needs to be done to help.
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