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A Doctor’s Guide to Baby Development

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Apr 15, 2015

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The first one to two years of a child’s life can be mystifying to parents — so many baby development stages passing by so quickly. But most children follow the same pattern of development, and knowing what that pattern is can help you ensure your child is developing healthily. Below, I break down the cognitive, emotional and social stages of early childhood development to help you track your baby’s milestones and watch for any delays.

Baby development stages

Baby development at 0-6 months

At 2-3 months, babies start to have reciprocal interactions with parents, differentiating voice tones and facial expressions. Keep track of their responsiveness to voices and noises, as this age is crucial in catching any hearing impairment; if diagnosed in this time window, it’s likely the child can still learn to speak like a fully hearing person.

What you can do: Vary your voice tones when speaking with your child, and coo back to him when he coos at you. This helps him learn to imitate speech.

Baby development at 6-12 months

Babies are generally very responsive and imitative at this age. If your baby doesn’t return warm expressions, doesn’t coo back when you speak, or doesn’t generally interact with you, don’t be alarmed, but be watchful. Try playing peek-a-boo—it’s more than a fun game at this age; it’s also a good development check.

At nine months, an actual, formal growth and development check is recommended, per the American Academy of Pediatrics (AAP). While not all doctors do such a screening as a matter of course in India, parents should request one if their pediatrician doesn’t mention it.

What you can do: Read to your baby, and start early. While she may not be able to understand the plot, looking at pictures with her, or using different voice tones for different characters, will help her develop language skills. It may seem silly, but also be sure to respond to your baby’s babbling, even when it’s nonsense.

Baby development at 12-18 months

By roughly 14-15 months, babies should be speaking meaningful words. If your child isn’t, watch to see if he is communicating non-verbally. For instance, does he point, does he nod, does he reach or use gestures? If there is no or little communication of any kind from the child, this could be an early sign of autism, and parents should consult a doctor.

At 15-18 months, in any case, parents should take their child for another routine screening for language delays and autism, per AAP guidelines. Request one if your pediatrician doesn’t mention it.

Children at this age learn a lot through play. After their first birthday, they enjoy pretend play, often starting by imitating real life. Initially, they will play by doing one action, for example feeding a doll or playmate. At around 18 months, they will begin sequencing actions, e.g., first feeding the doll or playmate, and then brushing their hair.

What you can do: Use short sentences with words meaningful to the child. Describe actions as you and the child do them together, e.g., “We are eating,” or “Now, I am giving you a bath.”

Baby development at 18+ months

Babies are usually starting to talk at this age, and parents should be mindful of how much. Children around two years of age generally speak in small sentences of two words. By three, their vocabulary expands and they speak in slightly longer sentences. Speech delays can lead to later learning disabilities or dyslexia; catching language issues early can head off these issues later.

By two to two-and-a-half years, kids can reenact the day’s events and should be playing with other children to learn skills like sharing and negotiating. The AAP recommends a third screening at 30 months to ensure a child’s growth and development is on course.

By three years, kids are often in preschool, learning about the outside world. They play imaginative imitations of life, reenacting house, school, or doctor scenarios with other children, depending on what they most often experience. From this point onward, a yearly pediatric check-up is the most effective way of monitoring child growth and development.

What you can do: Speak with (not at) your child as much as possible. Also, give her opportunities to use her imagination. Kids become very imaginative at this age and can be more stimulated by an empty box than a flashy toy. Any toy – like the empty box – that allows broad scope for creativity better spurs development.

Common misconceptions about baby development

Misconceptions abound around early childhood development. Don’t let one of these phrases keep you from trusting a gut feeling or an observed developmental delay.

“It runs in the family.”

This may or may not be true. Often, it’s said simply to placate anxious parents. Regardless, with language delays, it’s better to be safe than sorry. Catching a speech or hearing problem early can make all the difference.

“”Boys speak later than girls.”

This colloquial wisdom is just not true. If your son’s language skills are behind, it is cause for concern.

“Everything evens out by five anyway.”

Again, a platitude for concerned parents that can be detrimental: When it comes to developmental delays, it’s all about early detection. Gulfs in language development expand exponentially as the child ages and are more difficult for them to surmount.

“You’ll spoil her if you pick her up every time she cries.”

There is certainly a time to curb your child’s dependence, but not if she’s crying out of pain or frustration. Picking her up to comfort her will not spoil her; rather, it builds important feelings of trust and security and allows her to focus without fear on what she does best: grow, develop, and be adorable.

“Why do you talk/read to him? He can’t even understand you.”

Many people think social and language skills arrive later than they actually do. As mentioned above, children respond to voice tones and can benefit from being read to as early as six months. And responding to your baby – in baby talk or in actual words/sentences – is key to his language development.

Risk factors for delayed baby development

Distress or avoidance is a natural reaction to a delay in baby development. But it is important to keep in mind that early detection, diagnosis, and intervention can make all the difference in either helping  kids catch up or giving them the skills to cope with a disability.

Risk factors for delays in early childhood development can be both biological and environmental. The following children should be monitored closely during the first years of life:

  • Babies born prematurely
  • Babies born with low birth weight
  • Babies who did not cry at birth
  • Babies who spent time in neonatal intensive care
  • Babies born with excessive jaundice
  • Babies whose mothers smoked or drank alcohol during pregnancy

The interaction and environment children experience after birth also figure into how they develop. The following factors can inhibit development:

  • Poor nutrition (apparent in lower than usual weight and height)
  • Few opportunities for back-and-forth communication with caregivers (e.g., parents, nanny, grandparents)
  • History of mental health issues for mother or father
  • Domestic violence
  • Substance abuse by mother or father

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Written By Roopa Srinivasan

Dr Roopa Srinivasan is the Director of Developmental Pediatrics Department and a Senior Management Team member at Ummeed Child Development Centre
She is a Consultant Developmental Paediatrician at Jaslok Hospital and
Research Centre

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