Early Childhood Development: Baby milestones come quickly
HealthWorks’ editorial staff spoke
with Thomas Collins,
MD, a pediatrician
at Concord Hillside
Medical Associates,
about early childh ood
development.
What are the key development milestones
in a baby’s first six months?
During this period, every day is a new milestone,
but the steps in a baby’s socialization and recognition
abilities are key. When an infant is four months
old, she will give a stranger as big a smile as she
gives her mother. But within a few weeks, they
develop visual memory, and they become more
selective about whom they smile at. In terms of
their motor skills, newborns can’t do much more
than fidget, but at three to four months, they are
reaching out and trying to take command of their
environment. By six months, they are working at
accomplishing goals, such as putting things in their
mouths. Regular well-child visits are a good way
to stay on top of immunizations and to discuss a
child’s development.
What developmental delays should
prompt a visit to the pediatrician?
As a pediatrician, I spend most of my day telling
parents not to compare their baby to other babies.
That said, if a dog barks, and the baby doesn’t jump,
or if a bright light is turned on, and the baby
doesn’t seem startled, it may make sense to see the
pediatrician. Babies should be increasingly engaged
over time—taking in all the sights and changes.
When this is not occurring, the child may need
to be evaluated.
Should i be concerned if my one-year-old
is not attempting to walk?
It depends.The normal range for learning to walk
is between 10 and 15 months, but if a child was a
bit slow in learning to roll over, they may be a bit
late in walking. Motor skill development tends to
happen in quarters, from head to toe. So by three
months, an infant has gained control of his head,
at six months he is sitting up, at nine months he is
crawling, and by 12 months, he is typically trying
to walk.
What about a child whose ability to
talk doesn’t seem to progress?
Communication really begins at around four
months with growling and babbling.This is how a
baby gets someone’s attention. Long before it’s time
to talk, I worry about a child who is not trying to
communicate in this way. Although we expect a
child to have a few words when they are 12 to 15
months old, it’s actually more important to the child
at that age to move than to talk.They don’t really
begin speaking words until they are up on their
feet. At age one, they have six to eight words,
toddlers typically have 20 or so words, and during
the third year, vocabulary skyrockets.
Most toddlers have temper tantrums.
when do they become a behavior
problem?
Tantrums typically begin at around 18 months and
are a very normal sign of frustration. The child has
an agenda—she is probably trying to do something
or wants to communicate—and no one understands
her. Once a child reaches age three and is able to
communicate, yet the temper tantrums continue, it
is a sign of manipulation. It may help to talk with
the pediatrician about the child’s behavior, the parents’
response to that behavior and how to break
the pattern. Discipline is the way we shape a child’s
behavior.
What is a good age to introduce toilet-training?
First of all, children need motor and language
skills before they can be ready to potty-train, and
it should never be about performance. These days,
girls are usually “trained” by age three, and boys
by age four.
For more information on pediatric care at Emerson
Hospital, please call the Physician Referral Service at
978-287-3456 or visit the hospital’s web site at
www.emersonhospital.org.
