The first time a child smiles, talks, crawls, and walks are special memories for families. They’re also important developmental milestones.

As children grow, they reach milestones in actions and behavior — usually by a certain age.

When children don’t achieve certain milestones by the usual time, it’s referred to as a developmental delay. An estimated 15% of children ages 3 to 17 have a developmental delay, according to the American Academy of Family Physicians.

With recognition and support, such as therapy, many developmental delays resolve over time. In other cases, it could be a sign of a developmental disability.

What Are Developmental Milestones?

Your pediatrician should ask questions about your child’s development at each well-child visit.

Developmental milestones measure how your child is growing and developing compared to other children the same age. Milestones fit into several categories:

  • Physical growth
  • Language/vocabulary development
  • Cognitive development
  • Sensory and motor skills
  • Emotional and social development

The Centers for Disease Control and Prevention has a checklist of typical developmental milestones for children.

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What Are Developmental Delays?

If your child does not reach certain milestones by the expected age, it could be a sign of a developmental delay.

Developmental milestones measure the expected age for skills, but they aren’t concrete. Some children develop more slowly in certain areas than others. For example, it’s not necessarily a developmental delay if your child isn’t babbling by 4 months.

But, if your child consistently misses developmental milestones, it can be cause for concern.

The American Academy of Pediatrics (AAP) recommends pediatricians observe a child’s development at each well-child visit. The AAP also recommends developmental screenings at 9, 18, and 30 months and an autism screening at 18 and 24 months.

If you have concerns about your child’s development, talk with your pediatrician and request a developmental screening.

Developmental Delay Risk Factors

Different factors, both genetic and environmental, can lead to developmental delays. Some risk factors include:

  • Genetic disorders
  • Pregnancy/birth complications
  • Use of drugs or toxins (smoking, drinking alcohol) during pregnancy
  • Trauma
  • Infections
  • Stroke
  • Malnutrition

But, there often is not an identifiable cause or reason for a developmental delay or missed milestone.

Developmental Delay Treatment

Developmental delays are treatable when diagnosed early. If your child has a developmental delay, several therapies can help him or her to catch up:

  • Occupational therapy
  • Physical therapy
  • Speech therapy
  • Cognitive/behavioral therapy

Every U.S. state offers early intervention services for children with developmental delays. The Pennsylvania early intervention program covers children from birth through age 5, at no cost to families.

What Are Developmental Disabilities?

If problems persist, it could be a sign of a developmental disability. A developmental disability is a long-term (often lifelong) problem that can cause physical, intellectual, or emotional challenges.

According to the National Association of Councils on Developmental Disabilities, more than 5 million Americans have developmental disabilities. Intellectual disabilities are most common.

Developmental delays can be associated with diagnoses such as:

  • Attention-deficit/hyperactivity disorder
  • Autism spectrum disorder
  • Cerebral palsy
  • Down syndrome
  • Fetal alcohol syndrome
  • Fragile X syndrome
  • Muscular dystrophy
  • Tourette syndrome

They also can be the result of conditions such as :

  • Blindness/vision loss
  • Deafness/hearing loss
  • Intellectual disabilities
  • Language and speech disorders
  • Learning disabilities

If you’re concerned about your child’s development, talk to your pediatrician at the next well-child visit. For more information, visit UPMC Children’s Hospital of Pittsburgh online or call us at 412-692-5325.


American Academy of Pediatrics, Assessing Developmental Delays.

Centers for Disease Control and Prevention, Developmental Disabilities.

Centers for Disease Control and Prevention, Milestone Checklist.

May Institute, Developmental Disabilities.

National Association of Councils on Developmental Disabilities, Learn More About DD.

Pennsylvania Department of Education, Early Intervention.

Kirsten Vitrikas, MD, Dillon Savard, MD, Merima Bucaj, DO, American Family Physician, Developmental Delay: When and How to Screen.

Ying Ying Choo, MD, Pratibha Agarwal, MD, Choon How How, MMed, Sita Padmini Yeleswarapu, Singapore Medical Journal, Developmental Delay: Identification and Management at Primary Care Level.!po=80.7692

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh ranks consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. UPMC Magee-Womens Hospital is a longtime national leader for women and their newborns. We aim to provide the best care for your children, from birth to adulthood and beyond.