{"id":153974,"date":"2019-11-20T16:05:37","date_gmt":"2019-11-20T21:05:37","guid":{"rendered":"https:\/\/www.bu.edu\/sph\/?p=153974"},"modified":"2020-09-17T10:32:21","modified_gmt":"2020-09-17T14:32:21","slug":"some-child-development-milestones-may-be-too-early","status":"publish","type":"bu-article","link":"https:\/\/www.bu.edu\/sph\/news\/articles\/2019\/some-child-development-milestones-may-be-too-early\/","title":{"rendered":"Some Child Development Milestones May Be Too Early"},"content":{"rendered":"<div class=\"banner-container banner-has-html\">\n<iframe width=\"855\" height=\"481\" src='\/\/players.brightcove.net\/1327978102001\/rkA3rSifl_default\/index.html?videoId=6090696866001' allowfullscreen frameborder=0><\/iframe>\n<\/div>\n\n<p>\n<div class=\"wp-prepress-component-metabar sphnews-prepress-layout-metabar\">\n\t<div class=\"wp-prepress-component-metabar-wrapper\">\n\t\t\t\t\t<div class=\"wp-prepress-component-metabar-date\">November 20, 2019<\/div>\n\t\t\n\t\t\t\t<div class=\"wp-prepress-component-metabar-credits\">\n\t\t\t\t\t<\/div>\n\t\t<div class=\"wp-prepress-component-metabar-share js-bu-prepress-share-tools\">\n\t\t\t<span class=\"icon-twitter\"><span>Twitter<\/span><\/span>\n\t\t\t<span class=\"icon-facebook\"><span>Facebook<\/span><\/span>\n\t\t\t<span class=\"icon-action\"><\/span>\n\t\t<\/div>\n\t<\/div>\n<\/div>\n<\/p>\n<p>Most nine-month-old babies can sit up by themselves, copy sounds, and play games like peek-a-boo, according to <a href=\"https:\/\/www.cdc.gov\/ncbddd\/actearly\/milestones\/index.html\">developmental milestone guidelines from the Centers for Disease Control and Prevention (CDC)<\/a>. But does \u201cmost children\u201d mean almost all, or just more than half? Does \u201ccan\u201d mean that they demonstrate these abilities often, or every once in a while? Developmental milestones are a key part of pediatric visits for children under five years old, allowing parents and pediatricians to \u201cact early\u201d if a child needs more support, but there is actually little data on what proportion of children reach milestones at different ages.<\/p>\n<p>Now, a new School of Public Health study <a href=\"https:\/\/pediatrics.aappublications.org\/content\/early\/2019\/11\/12\/peds.2019-0374\" target=\"_blank\" rel=\"noopener noreferrer\">published in the journal <em>Pediatrics<\/em><\/a>\u00a0provides more specific data on what is typical behavior at different ages\u2014finding that, for some of the CDC guidelines, \u201cmost children\u201d can mean over 99 percent or barely half.<\/p>\n<p>For example, the study finds that 93 percent of nine-month-olds copy sounds, but only 44 percent demonstrate this ability \u201cvery much.\u201d While the CDC says to \u201cact early\u201d if a nine-month-old doesn\u2019t play games like peek-a-boo, the study finds that as many as one in ten children haven\u2019t reached that milestone at that age, and only 49 percent demonstrate the behavior \u201cvery much.\u201d<\/p>\n<figure id=\"attachment_156518\" aria-describedby=\"caption-attachment-156518\" style=\"width: 380px\" class=\"wp-caption alignright\"><a href=\"https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-%E2%80%94-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data.png\" target=\"_blank\" rel=\"noopener noreferrer\"><img loading=\"lazy\" src=\"\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data.png\" alt=\"\" width=\"370\" height=\"461\" class=\"wp-image-156518\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data.png 1248w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-510x636.png 510w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-822x1024.png 822w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-768x957.png 768w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-1233x1536.png 1233w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-755x941.png 755w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-803x1000.png 803w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-722x900.png 722w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Guidelines-for-Most-Children-and-SWYC-Normative-Data-1200x1495.png 1200w\" sizes=\"(max-width: 370px) 100vw, 370px\" \/><\/a><figcaption id=\"caption-attachment-156518\" class=\"wp-caption-text\">CDC Guidelines for Most Children and SWYC Normative Data (click to expand)<\/figcaption><\/figure>\n<p>\u201cThe CDC guidelines are just that: guidelines,\u201d says study lead author <a href=\"https:\/\/www.bu.edu\/sph\/profile\/radley-sheldrick\/\">R. Christopher Sheldrick<\/a>, research associate professor of health law, policy &amp; management. \u201cParents should know that medical guidelines of all kinds are frequently updated based on new information. In the meantime, parents should consider advice from a range of sources and ask their pediatric providers if they have concerns.\u201d<\/p>\n<p>The researchers used data from 41,465 parent responses to the <a href=\"https:\/\/www.floatinghospital.org\/The-Survey-of-Wellbeing-of-Young-Children\/Overview\" target=\"_blank\" rel=\"noopener noreferrer\">Survey of Wellbeing of Young Children (SWYC)<\/a> in Massachusetts, Rhode Island, and Minnesota. SWYC was created by Sheldrick and study co-author Ellen Perrin of the Tufts University School of Medicine and Medical Center in 2010, and includes 54 questions about developmental milestones over a child\u2019s first five years.<\/p>\n<p>For this study, the researchers compared 31 CDC milestones with 26 corresponding SWYC questions. Unlike the CDC milestones, which only refer to a child doing or not doing something, SWYC asks parents if a child displays a behavior \u201cnot yet,\u201d \u201csomewhat,\u201d or \u201cvery much.\u201d<\/p>\n<figure id=\"attachment_156517\" aria-describedby=\"caption-attachment-156517\" style=\"width: 380px\" class=\"wp-caption alignleft\"><a href=\"https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-%E2%80%94-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data.png\" target=\"_blank\" rel=\"noopener noreferrer\"><img loading=\"lazy\" src=\"\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-532x636.png\" alt=\"\" width=\"370\" height=\"443\" class=\"wp-image-156517\" srcset=\"https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-532x636.png 532w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-856x1024.png 856w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-768x918.png 768w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-755x903.png 755w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-836x1000.png 836w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data-753x900.png 753w, https:\/\/www.bu.edu\/sph\/files\/2019\/11\/Establishing-New-Norms-for-Developmental-Milestones-\u2014-CDC-Act-Early-Recommendations-and-SWYC-Normative-Data.png 1200w\" sizes=\"(max-width: 370px) 100vw, 370px\" \/><\/a><figcaption id=\"caption-attachment-156517\" class=\"wp-caption-text\">CDC Act Early Recommendations and SWYC Normative Data (click to expand)<\/figcaption><\/figure>\n<p>The researchers found that a very high percentage (generally over 90 percent) of children \u201csomewhat\u201d or \u201cvery much\u201d demonstrated behaviors by the ages that the CDC says, and an even higher percentage by the age at which the CDC says parents should \u201cact early.\u201d On the other hand, if only demonstrating a behavior \u201cvery much\u201d counted as a pass, the researchers found that less than half of children reached several of the milestones at the ages that the CDC says \u201cmost\u201d do or at the ages to \u201cact early.\u201d<\/p>\n<p>Consistent with previous studies, the researchers also found that factors such as social determinants of health (such as a family\u2019s Medicaid status and being subject to structural racism, and a child\u2019s exposure to smoking and substance misuse) and premature birth had significant effects on when children reached different milestones.<\/p>\n<p>The study was co-authored by <a href=\"https:\/\/www.bu.edu\/sph\/profile\/pengsheng-ni\/\">Pengsheng Ni<\/a>, research associate professor of health law, policy &amp; management. The other co-authors were Lauren Schlichting and Patrick Vivier of Brown University, and Blythe Berger and Ailis Clyne of the Rhode Island Department of Health.<\/p>\n<p>\u2014<a href=\"mailto:msamu@bu.edu\" target=\"_blank\" rel=\"noopener noreferrer\"><em>Michelle Samuels<\/em><\/a><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>When CDC guidelines say most children reach a milestone by a certain age, \u201cmost\u201d may mean over 99 percent or barely half.<\/p>\n","protected":false},"author":10989,"featured_media":153981,"comment_status":"closed","ping_status":"open","template":"","meta":{"bu_prepress_billboard":"","_bu_prepress_primary_term":"","_bu_prepress_primary_term_manual":""},"tags":[2551,2488],"bu-publication":[3516],"sphnews-article-category":[3519,3531,3535,3540],"sphnews-topic":[],"bu_edition":[],"media_type":[],"profile_tax":[450,2559],"_links":{"self":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/153974"}],"collection":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article"}],"about":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/types\/bu-article"}],"author":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/users\/10989"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/comments?post=153974"}],"version-history":[{"count":17,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/153974\/revisions"}],"predecessor-version":[{"id":175144,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-article\/153974\/revisions\/175144"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media\/153981"}],"wp:attachment":[{"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media?parent=153974"}],"wp:term":[{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/tags?post=153974"},{"taxonomy":"bu-publication","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu-publication?post=153974"},{"taxonomy":"sphnews-article-category","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-article-category?post=153974"},{"taxonomy":"sphnews-topic","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/sphnews-topic?post=153974"},{"taxonomy":"bu_edition","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/bu_edition?post=153974"},{"taxonomy":"media_type","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/media_type?post=153974"},{"taxonomy":"profile_tax","embeddable":true,"href":"https:\/\/www.bu.edu\/sph\/wp-json\/wp\/v2\/profile_tax?post=153974"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}