Milestones and Well Visits
In the first two years of your baby’s life, there are frequent check-ins with your pediatrician. During this time, the doctor checks on all sorts of areas of your child’s health, one of them being milestones of major developmental areas: communication, gross motor, and fine motor. Before I became a mother, I read hundreds of pediatrician notes. Every one has a brief list of milestones the child has met. I imagined what these appointments looked like based off of these notes. I imagined a doctor going through a detailed checklist with families, discussing what amazing stage of development the child had reached, and what parents should look for next.
As a clinician, I am often confused when I walk into a room to meet a family and see a child whose skills do not match those listed on their most recent well-visit note. What I have learned as a mother is that these well visits are very brief; there is simply no way for the pediatrician to have enough time to dive into every single milestone of every single child (the issue of time and efficiency our healthcare system needs its own blog post!). And perhaps most importantly: Children do not act like themselves in the doctor’s office! Even the most verbose child can appear nonverbal in the doctor’s office. And the child who is actually not yet talking may be vocalizing a lot in the office!
So where does the onus lie to ensure children are meeting milestones? Should pediatricians be doing a better job of asking about every single milestone? Perhaps in an ideal world, but in our healthcare system, I do not think many doctors have the time to do this, though I am sure most of them would want to! Caregivers are therefore left with the job to monitor milestones, and we have to remember that if we don’t share what is going on at home, doctors make assumptions off of how our children are acting in this environment — which is often not representative.
But caregivers are not early intervention specialists! How are we supposed to know what to look for? Luckily, many hospital systems have begun providing free webinars on developmental milestones so that parents understand what to look for and how to help facilitate development. Companies such as Lovevery have begun to include little developmental info-packets with their toys so that families can understand how play and development fit together. A quick google search (proceed with caution!) will lead you to an abundance of lists, and there are many reliable resources buried there within (check out ASHA’s milestones for communication here!).
I think the biggest takeaway I have found as a parent is: TRUST YOUR GUT. You are the expert of your child. If you have a concern, bring it to your child’s doctor. Do not wait for your doctor to bring it up with you. And if you don’t feel comfortable when they say “wait and see,” speak up! You have the right to early developmental evaluations. Early intervention is the best thing for children. The worst case scenario of being “overly concerned” is that you get an evaluation and the specialist tells you: “You have nothing to be worried about!”