With the recent changes to the CDC’s milestone checklists, we know that some parents have had questions about what changed, why they changed them, and what it means for their family. We will give you the overview here, but check out our bonus podcast episode to get more in-depth answers and information!

What happened?

• In 2004, the CDC’s Learn the Signs. Act Early. program developed free milestone checklists that included developmental warning signs, messaging to “act early” to addressing concerns; and developmental tips/activities. These materials were developed to help parents recognize typical development, improve conversations between parents and professionals about a child’s development, and support developmental screening at recommended ages and additional screenings when there are concerns. 
• In early 2022, the Center for Disease Control released changes to these long-standing Developmental Milestone Checklists. The purpose of these checklists has always been to help doctors and parents keep an eye on children’s development and to facilitate ongoing conversations between doctor and the families they serve. It’s not an official screening tool that would be used to help determine if a child would qualify for additional services or therapies – it’s a starting point for a conversation between doctors and families!
• The changes made to these checklists were based on research and recommendations of an expert working group from the American Academy of Pediatrics. According to the article that group published in the peer-reviewed journal, Pediatrics, “The goals of the group were to identify evidence-informed milestones to include in CDC checklists, clarify when most children can be expected to reach a milestone (to discourage a wait-and-see approach), and support clinical judgment regarding screening between recommended ages”

What are the changes/updates?

• The updated checklists no longer list a milestone at more the one age (this caused a lot of confusion before)
• Eliminated vague terms like “children may begin to…”
• Removed the “warning signs” section on each checklist
• Direct citations to research studies that support them (yay!)
• Based on more studies that look at development from more diverse and cross-cultural groups
• Added a checklist specifically for the 15- and 30-month ages (as these are common ages for well-child checks in America that previously did not have a milestone list associated with them)
• Suggestions for open-ended questions for doctors to use with families
• Finally, the biggest change – moving the milestones to the age where 75% of children would be expected to achieve the skill. This was a change from the previous standard of 50%. In most cases, this meant moving milestones back to a slightly older age.

Why did they make these changes?

• The change from 50% to 75% has some people confused or frustrated, so let’s start with some of the reasoning provided for this change. According to the article in Pediatrics, there were several justifications for it.

• When the milestone was listed at the age when 50% of kids could do a task, doctors often would tell concerned parents to just wait and see because some kids simply had to be in the later half. This experience often left parents unsure and unheard. On the flip side, pediatricians knew that waiting until the age where 90% of children could do the task would likely delay the opportunity for children who do have a developmental concerns to get a diagnosis or support services. Therefore, the team landed on 75% as a benchmark to balance these two things.
• These new checklists can also prevent worry for children older than the average age of attainment of a milestone but not likely to be at risk for delays (aka late bloomers)
• In a direct quote from the article, authors said “[the previous checklists provided] insight into typical development but [did] not provide clarity for parents, pediatricians, and other early childhood professionals  about when to be concerned or when additional screening might be helpful”

• Another change that people had a lot of questions about was why crawling was removed from the checklists. According to the article in Pediatrics, the age range varies greatly for this milestone, and some typically-developing children never crawl at all.
• A common misconception was that this move was related to the pandemic, but the criticisms, the thought process, and the planning were underway to make these changes long before the COVID-19 pandemic occurred. (Fun fact: I actually wrote a paper in graduate school on developmental milestones, and I read papers criticizing the original milestone checklists that were published in 2007, 2013, and 2019.)

What’s this mean for you and your family?

• Continue to have conversations with your family doctor about your child’s development. If you have concerns, share them with your doctor. Keep trusting your parenting instincts when things don’t feel right. If necessary, build your skills for assertive communication and advocating for your child!
• Download the CDC’s Milestone Tracker app, and answer the questions related to your child’s age. You will answer Yes/Not Sure/Not Yet to specific questions about your child, and then you’ll get follow-up feedback. You can use this tool to communicate with healthcare professionals or therapists you may work with.
• Keep engaging with your child in through conversations, play, and simple daily routines!

The majority of the content referenced in this episode can be found in this American Academy of Pediatrics journal article – they also have a short video abstract from one of the authors you can watch. https://publications.aap.org/pediatrics/article/149/3/e2021052138/184748/Evidence-Informed-Milestones-for-Developmental

Mackenzie Johnson

Parent to a little one with her own quirks. Celebrator of the concept of raising kids “from scratch”. Learner and lover of the parent-child relationship. Translator of research with a dose of reality. Certified Family Life Educator.

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Earlier this spring, when the word “pandemic” was still relatively new to our vocabulary, our team released a bonus episode on Missing Out on the Big Moments. We were hearing about the emotional toll that missing out on events and rites of passage was having on our kids. Now, several months down the road, this concept of missing out because of COVID is a common experience for kids and adults alike.

In the midst of a pandemic and the holiday season, the research around “missing out” and family rituals from this episode is still incredibly relevant. In this episode, you hear our co-hosts define rituals as events that are symbolic, emotionally affective, and having meaning across generations. Many of the holiday traditions families practice meet this definition! We know that tough conversations and emotions can be apart of our family interactions during the holidays in this pandemic as we all try to adjust.

In this episode, you’ll hear about ideas to adjust family rituals. Even if you already heard it this spring, we hope you’ll consider listening with a new perspective. Now that we have been in this pandemic a little longer you may have new insights and questions. Also, you may want to focus more on your own emotions around adjusting these family rituals.

Please join us in revisiting the topic of Missing Out on the Big Moments by examining research around family rituals!

Mackenzie Johnson

Parent to a little one with her own quirks. Celebrator of the concept of raising kids “from scratch”. Learner and lover of the parent-child relationship. Translator of research with a dose of reality. Certified Family Life Educator.

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In the month of February, we are looking at relationships. We’ve looked at our co-parenting relationships, and now we want to look at when our kids are looking at dating! Last week we looked at having realistic expectations, and now we want to know about the age-appropriateness of dating. This is a common question for parents – so let’s look with a Research & Reality lens.

RESEARCH:

• “Kids younger than age 14 years do not have the social skills needed for dating. Early dating often leads to problems. Often kids learn about dating relationships from TV and movies that don’t show appropriate dating relationships. Young people will likely act in ways they see portrayed, rather than develop a healthy relationship with the other person.”
• “Youth spend less time with same-sex friends. Same-sex friendships help kids learn many skills about getting along with others that they may not develop in a dating relationship.”
• “Personal identity is not formed. Most youth do not know themselves well, what they like and dislike, and their own values. Such self-understanding is required in order to relate in a healthy dating relationship. Youth who do not know what they want or should expect in a relationship may be too easily talked into behaviors for which they are not yet ready. Young dating partners may become too close too quickly, which may keep them from maturing emotionally.”

REALITY:

The reality is, every child develops (physically, socially, and emotionally) at different rates. Only you, your co-parent, and your child can make the decision about what’s best for your family! Other factors that may influence your decision could be your family values, your child’s temperament and maturity, and your personal comfort level. Also understand that youth vary greatly in their wishes to be in dating relationships. There is nothing wrong with youth who have no interest in dating.

Here’s a few tips you can use in your own family –

• Encourage group activities. By sixth or seventh grade, it is appropriate for youth to sit with their friends of both sexes at ball games or other events.
• Discuss the reasons for not allowing your child to date. Choose a time when both of you are calm and can listen and discuss wishes, values, and rules.
• Be firm if your child continues to pressure you. You can say, “I love you and the answer is no.”
• Encourage your child to be active in school and community activities and to identify a hobby that interests him or her.
• Stay involved. Know where your child is and what he or she is doing. Unsupervised time can lead to trouble.

Get more information to help inform your conversation about dating in our Parenting in Challenging Moments – Teen section!

Mackenzie Johnson

Parent to a little one with her own quirks. Celebrator of the concept of raising kids “from scratch”. Learner and lover of the parent-child relationship. Translator of research with a dose of reality. Certified Family Life Educator.

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Last week I shared about my own relationship with my partner, and how it can be hard with young kids to find time to focus on the “couple relationship”… And I don’t think I am the only one!

Let’s review this with a Research & Reality lens:

RESEARCH – Well, the research is clear — the quality of adult couple relationships and positive parenting practices are connected to healthy child outcomes. So the relationship I have with my partner affects my parenting and ultimately my kids. Having a relationship that includes good communication and shared decision-making is an important aspect of raising kids together!

REALITY – The reality is; however, I find only enough energy to take care of the next thing on my to do list. Right now it is usually work, play, supper, bath, bed, and repeat. (Now don’t get me wrong, routine can be a good thing, if it comes with intention.)

But we also know this co-parent relationship looks different for every set of parents – maybe you’re dating, married, divorced, separated, in different cities, living together, or somewhere between. Maybe your reality is a challenging relationship with your child’s co-parent.

The good news is that co-parents can intentionally choose to put their kids first – and one way to do that is by working on having a relationship with their co-parent that allows you to communicate and share decision-making in a way that benefits your children!

Join me in planning to do one thing this week to invest in your co-parenting relationship. You, your co-parent, and your kids will benefit!

Mackenzie Johnson

Parent to a little one with her own quirks. Celebrator of the concept of raising kids “from scratch”. Learner and lover of the parent-child relationship. Translator of research with a dose of reality. Certified Family Life Educator.

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We are sneaking up on February, which brings Valentine’s Day! On the Science of Parenting, we talk about our relationships with our kids, and next month we are diving into COUPLE relationships – both kids and adults.

We will explore suggestions for how to navigate when your child is expressing interest in dating and some tips for you and your co-parent. We will also identify a few red flags to be addressed in our own behavior and relationships!

As I’ve shared before, I have two young kiddos at home right now. Other team members have teens who are now dating. As a parent of young children, I still have to intentionally give thought to my relationship with my partner. In the mix of keeping up with an active preschooler and waking at night with an infant, it’s easier than I’d like to admit to forget to dedicate time specifically to my partner. As the chaos of the recent holiday subsides, I am wondering when the last time was that we spent couple time together that didn’t involve the kids, our jobs, or the house? I know that my relationship with my partner can greatly influence my parenting and my children, so it’s time to get back into focus. Join us this month as we look at our relationships and parenting!

Mackenzie Johnson

Parent to a little one with her own quirks. Celebrator of the concept of raising kids “from scratch”. Learner and lover of the parent-child relationship. Translator of research with a dose of reality. Certified Family Life Educator.

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