The first three years of a child’s life is a remarkable time, as we watch our babies evolve from cooing infants into inquisitive, independent toddlers. For parents, it’s human nature to want to know if our kid is hitting their developmental milestones at a healthy rate, especially when it comes to those momentous first steps and words. We spoke with Prachi Edlagan Shah, M.D., pediatric expert at the University of Michigan’s C.S. Mott Children’s Hospital in Ann Arbor, about what to expect during this exciting and ever-changing stage.
Metro Detroit Baby and Beyond: What are the most important developmental milestones for children ages 0-3?
Prachi Edlagan Shah: I frame development in terms of what I call “the Big Three”: walking, talking, stopping. By 1, kids should be walking, by 2 they should be talking, and by 3 they should be stopping — i.e., learning to regulate their impulses.
The big skill we’re looking for by age 1 is gross motor development, which culminates in the ability to begin independent ambulation. When it comes to talking, by age 2, this means the child should be speaking 100 to 200 words and two-word phrases — think “no nap” — and one-half of those phrases should be intelligible. Then by age 3, when I say “stopping,” that’s when children learn to delay gratification, and they learn to pause and wait.
Q: What has to happen before baby is ready to take that first step?
Shah: Gross motor development emerges in a head-to-toe fashion: Babies will have head control before they sit, and they’ll sit before they crawl, and so on. There is a range as to when babies will start to walk. Some take their first step at 9 to 10 months, while others do it at 15 to 16 months. If a baby is not walking independently by 15 or 16 months, I would be concerned with motor delays. But prior to that, there are milestones that we’re looking for that would indicate a potential problem in terms of when a child would begin to walk.
One of the things we look at is if the baby has good head control by 3 months of age. In those first few months of life, giving babies tummy time — that is, supervised periods that they spend on their stomachs — can be really helpful. When the baby is on their belly, they’re forced to lift their head up to explore the world around them, developing that core strength. That’s necessary for learning to sit up independently, and then to walk.
Q: What should parents do if their child isn’t reaching certain milestones by ages 1, 2, and 3?
Shah: There’s a range within which kids can develop skills that are “normal,” so don’t be worried if they’re not doing something immediately on their first birthday. Your pediatrician is another set of eyes and ears for monitoring development. The doctor should be doing routine development screenings at every well-child checkup, so there’s a way to gauge if what the parent is observing is in fact an area of concern.