Dr. Cheryl Tierney : Explaining the New CDC Milestones

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This year, Speech Pathologists, parents, and other professionals have taken to social media with their concerns about the recent changes made to the CDC Developmental Milestones. In this interview with developmental pediatrician, Dr. Cheryl Tierney explains what these changes really mean.

CDC Changes to Developmental Milestones

When discussing the CDC Developmental Milestones, it is important to understand what was actually changed and why. Several years ago, prior to COVID, professionals were tasked with projects to examine current research literature and adapt milestone surveillance as needed. Surveillance is an important word here as it is much different than screening. Surveillance is the questions asked and observations made during child well-checks to assess development. Surveillance, combined with exams, screening, and parental concern work together to create a need for referrals and diagnosis. The changes made with the CDC were to create clear, concrete language and timelines to take the guess work and ambiguity from pediatricians. These new Developmental Milestones Surveillance guides pediatricians with skills measured at 75% where they were previously 50%. This allows less children to slip through the cracks and more children to be referred with evidence of delay.

Motor Milestones in Babies

It’s important to note that the Milestone list was not changed, there was no removal of any skills from any milestone list, only that of the developmental surveillance. Many parents and professionals were concerned about the removal of crawling. Dr. Cheryl Tierney discusses it as a link to delays. There are no delays or disorders directly linked to late presentation or lack of crawling as opposed to other milestones. Additionally, walking was moved from 12 months to 18 months. Does this mean pediatricians will wait for intervention or referral until 18 months. Definitely not. These new surveillance guidance will actually help pediatricians know that they are surveilling the skill and that they should be noting concerns and referring around 15 months if there are no signs of walking or related skills because 75% of children are walking by 18 months.

Expressive Language Development

ASHA was not involved in the changes made to language milestones at the CDC, because of this, speech pathologists were concerned about the low bar set for language skills. Moving the milestone from pointing to two body parts, blowing a kiss, and shaking head, yes and no from 12 months to 24 months, seems worrisome. Dr. Cheryl Tierney shares my concern but notes for parents and professionals that this is still surveillance and not the concrete milestone expectation. Parents with concerns should speak up right away and not wait until well-checks if they have worries about their child’s development.

As professionals, we are always looking for new research and evolution in the field. The goal behind these changes was to provide more clear guidance for pediatricians and hopefully see fewer children slip through these cracks. As professionals voice their concerns, it is proof that more research and more literature is needed so we can continue to update and make the needed changes. If you are a parent with concerns about your child’s development, please do not wait, speak up because that is the most important tool you have.

Dr. Cheryl Tierney : Explaining the New CDC Milestones

Dr. Cheryl Tierney on the Turn Autism Around Podcast

Cheryl Tierney-Aves, MD, MPH is a Board-Certified behavior and developmental pediatrician who has been in practice since 2002. She is a native of Brooklyn, New York, and completed medical school at Tufts University in Boston. Her pediatric residency was at Levine Children’s Hospital at Carolinas Medical Center in Charlotte, North Carolina. She completed Fellowships in Health Services Research, where she received her MPH at Harvard School of Public Health as well as Behavior and Developmental Pediatrics in 2002. After 8 years on faculty at Tuft’s Baystate Children’s Hospital, she was recruited to Penn State Children’s Hospital in 2010. Dr. Tierney-Aves is a Professor of Pediatrics in the Department of Developmental Medicine. She is an active member of The Society for Developmental and Behavioral Pediatrics (SDBP) including its Advocacy Committee. Dr. Tierney is the President and founder of the ABA in PA Initiative, which is a grassroots advocacy group whose mission is to improve access and quality of ABA services in Pennsylvania. Her practice specializes in speech and language disorders to include autism and childhood apraxia of speech as well as pediatric behavioral sleep disorders.

You’ll Learn

  • What does the recent change to the CDC Developmental Milestones mean?
  • Who was involved in the research and change that prompted the update to the CDC Developmental Milestones?
  • What is the difference between surveillance and screening?
  • What pieces go into a well-check visit that lead to a referral?
  • Are COVID restrictions leading to widespread delays in milestones?
  • What changes were made to Motor Milestones?
  • What changes were made to Language Milestones?
  • Why parent concern and speaking up is important.

Resources

Free Workshop

Increase Talking &
Decrease Tantrums

in Young Children with

Autism &/or Speech Delays