A common mistake with milestones

A toddler with dark hair is sitting on the floor. She is wearing a fluffy white monster outfit with a hood and rounded horns. She is surrounded by white blankets and two white stuffed sheep.

Let’s talk about milestones, because – let’s be honest – they’re a big deal when you have a mini human! Doctors and specialists toss the word around all the time, but most parents (and even a few medical professionals) misunderstand what it means.

Fair enough – it’s a misleading term so I want to clear up the confusion so you can know exactly what your doctors and therapists are talking about, and whether or not you should be concerned if your child is missing their milestones.

What IS a milestone?

A ‘milestone’ is what MOST children are able to do by that age, it is not an average. Let me repeat that again: IT IS NOT AN AVERAGE! Half of all children are below average, which is not bad or concerning at all! Being below average in a couple of areas is very normal, and most of these kids will never need to come see professionals like me for therapy.

However, only 10% of children do not meet their milestones. If your child misses milestones, they are not meeting the bare minimums expected for typically developing children. A lot of children in this 10% will need to see a speech therapist in order to catch up, and some will have more significant disorders that require therapy for years.

Missing Milestones

Missing milestones is your first clue that something might be going on with your child’s development. They’re like a little red flag that says “Hey, I might need some extra help” and are worthy of a discussion with your doctor or speech-language pathologist (SLP). Although many children who miss milestones catch up, it is something parents should be on top of in case they’re a sign of something more.

Also of note for parents: Family doctors and pediatricians all vary in their opinions on how early to get help when a child is missing their milestones. Some follow a “watch and wait” approach, where they monitor the child and refer after a year or two without improvement, while others refer to early interventionists (like me!) immediately.

Although immediate referral means some children receive therapy who might have improved on their own, it also means those children that DO need therapy are seen earlier, which is hugely beneficial. There is minimal harm to getting speech therapy and getting caught up, and the risk of missing years of early intervention could be high.

Early Intervention

“Early intervention” (aka EI) is the umbrella term for all the therapy services provided to children under the age of five. Little brains develop amazingly fast at this age, so children can learn and grow better right now than when they are older and have more ingrained ways of doing things.

EI therapists also work more closely with our clients’ families, so parents can know how to help their child at home. School-based services do not have that luxury, so home practice is less effective and the children often make slower progress. Have I convinced you about how important parents are in speech therapy yet? You make so much difference, and parent training is one of the main benefits of getting EI services!

When to get help?

Personally, I feel that parents should always be given the option for therapy if their child is delayed. If parents have concerns, those concerns should be heard and early intervention should be provided. If you’re not worried, then you can wait and see. You know best what your little one needs, and can make the best decision for your family right now.

Children all develop at their own pace, and some children who are missing their milestones at age one are caught up by preschool. Meeting milestones depends not only on overall development, but learning experiences, interactions, and interests. Sometimes your child might be a little delayed because you just have not thought to teach them a skill yet, or they just are not interested, or something else entirely.

But parents: trust your instincts. If you think your child needs help right away, refer yourself and do not accept no for an answer! You are the one who has to deal with frustration and tantrums from being misunderstood, you are the one who has to talk for your child, and you are the one who is up at night worrying for your little person.

Early intervention is the most beneficial thing you can do for your child if they end up having a communication delay, so don’t let anyone talk you out of it other than YOU. Now that you have a thorough understanding, it can be helpful to check out all the speech and language milestones for your child’s age. This can help you to decide if your child needs help, or just know what to help them learn next!

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3 year old milestones

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Why do parents need to be involved in therapy?