The CDC recently updated their developmental milestones in an at-tempt to ensure that children with delays are identified by doctors and get the referrals they need. They changed the milestones from when 50% of children meet them to 75% of children meet them. The concern among therapist is that early intervention is typically best and shifting the milestones may mean delaying care for our younger population of patients. 

The new changes include moving walking from 12 months to 18 months. Historically, walking has always been considered typical be-tween 12-18 months and as therapist we would consider many factors when making a recommendation for therapy. With the walking milestone shifted to 18 months we may not get the referrals for therapy until the patient has greatly missed the mile-stone. Good head control was shift-ed to 4 months, sitting independently was also shifted to 9 months, and pulling to stand and cruising was shifted to 12 months. This is much delayed compared to the milestones that the therapy world uses and could cause delays in intervention. 

Another concern was that while look-ing throughout the developmental milestones crawling is no longer included as a milestone. Crawling is a highly important milestone as it helps create changes in the spinal column and hips that prepares babies for standing and walking, develops strength and stability in every major muscle group, provides coordination between the opposite sides of the body with the right and left hemispheres of the brain work together, assists in primitive reflex integration, and helps with fine motor development such as handwriting. This is a milestone that needs to be addressed because it has larger impacts on gross motor development. 

The CDC update also vastly impacted speech milestones reducing the number or words required at 12, 15, and 18 months and delaying putting 2-word sentences together from 2 years to 2.5 years. This could delay referrals to Speech Therapy for intervention needed. 

It is our job to continue to provide education to referral sources and families to assist our young patient population in meet-ing their milestones and getting the services that they need.