August 12, 2019/Children's Health

Does Your Toddler Have a Developmental Delay?

Milestones to watch for between well-child visits

Toddler tries to run from mom

Your firstborn is a Chatty Cathy who spoke in complete sentences by 24 months. Your second kid — not so much. Her vocabulary consists of grunts and groans rather than words.

Advertisement

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy

All kids are different, but this seems off. Should you add “worry about Alice” to your overflowing task list?

Talk, walk and play: Child development milestones to look for

“Development includes motor skills, language skills and social skills,” says pediatrician Minh-Y Canh, DO. “Your child may fall into a wide range of what’s considered normal, but there’s often little reason to be concerned.”

Here’s what to look for in between pediatrician appointments to know if your toddler is on track. Keep in mind: These are averages, so your child may be ahead of or behind the goal.

Language development

Your child’s pediatrician will expect your child to meet these milestones:

  • 2 to 4 months: Starts to smile and laugh.
  • 6 months: Starts to babble.
  • 12 months: Begins to correctly associate words (for example, “Where’s the ball” and the child can look specifically at the ball).
  • 15 months: Has spoken first words, and usually has about 4 to 6 in his or her vocabulary.
  • 18 months: Knows basic body parts and can point to them (and possibly name them).
  • 24 months: Speaks at least 50 words and some two-word phrases.

If your child has a speech delay:

The delay isn’t necessarily developmental: “Impaired hearing can cause a speech delay, so we’ll want to evaluate speech and hearing abilities,” says Dr. Canh.

Advertisement

Delayed speech can result in temper tantrums or behavior issues because kids have difficulty communicating their needs. Dr. Canh says speech therapy can make a big difference for these children.

Social development

Your child’s pediatrician will expect your child to meet these milestones:

  • Before 2 months: May start to smile.
  • 2 to 4 months: Starts to laugh.
  • 6 months: Might smile at themselves in the mirror.
  • 9 months: Might show signs of stranger anxiety.
  • 12 months: Points to things they want.
  • 18 to 24 months: Makes eye contact and plays alongside another child without interacting (parallel play).
  • 24 months and beyond: Plays with other kids and shares (some of the time).

If your child has a social delay:

See the big picture. Dr. Canh urges parents, day care providers and preschool teachers to look at the child holistically: “If a baby was kept at home and didn’t have much exposure to other children, they may not interact much when they enter day care or preschool,” she says. “They’re not lacking social skills — they just haven’t learned how to interact with kids. Or they may have a little anxiety they’ll need to overcome.”

In some cases, a child doesn’t socialize well at day care or preschool because they have delayed speech and can’t effectively communicate. Once again, speech therapy can come to the rescue. “Speech therapy goes a long way to helping children build social skills,” says Dr. Canh.

Motor skills development

Your child’s pediatrician will expect your child to meet these milestones:

Advertisement
  • 6 months: Begins to roll over and sit with support.
  • 9 months: Sits without assistance and begins scooting, reaching or crawling.
  • 15 months: Walks (keep in mind some toddlers have no developmental delays but don’t have enough opportunity to practice their skills because Grandma carries them around all day).

If your child has a motor skills delay:

Your child’s pediatrician will make recommendations to improve motor development — such as encouraging Grandma to let your kiddo explore more with crawling and sitting. Your child may also receive a referral to an occupational or physical therapist to work on fine motor skills (holding a spoon) or gross motor skills (walking).

Early intervention thwarts developmental delays

Early intervention and practice make a remarkable difference in helping kids reach future milestones. If necessary, we can also refer you to a developmental-behavioral pediatrician for an in-depth evaluation.”

When children are young, their brains are pliable so they can learn a lot, very quickly. Pediatricians want to stay ahead of the concern rather than addressing something at a later date when it’s more difficult to catch up.

“At your well visit, your child’s doctor will offer anticipatory guidance, which means we let you know what to look for between now and the next appointment,” says Dr. Canh. “If something worries you before your next visit, reach out to your pediatrician. We want to hear your concerns and talk to you to make a plan.”

Learn more about our editorial process.

Related Articles

Caregiver and child sitting in front of toilet holding toilet paper rolls
April 24, 2024/Children's Health
How To Potty Train: Our Best Tips

Set your child up for potty training success by waiting until they’re ready, keeping the pressure low and going heavy on the praise

Caregiver spoon feeding baby in highchair at the table
April 23, 2024/Children's Health
When Your Baby Can Have Honey

In babies under 12 months, honey may cause a serious illness called infant botulism

Three sick babies crying amidst toys and baby items
April 18, 2024/Children's Health
How To Keep Your Kids Healthy When They Go to Daycare

You can help strengthen your child’s immune system by focusing on hand washing and staying up-to-date on their vaccines

Newborn's tiny hand gripping caregiver's thumb
April 15, 2024/Children's Health
Why Is My Baby Hairy? Newborn Body Hair Explained

Lanugo — the soft, fine hair that develops in utero — is harmless and will shed within a few weeks

Newborn baby with crossing eyes
April 10, 2024/Children's Health
Why Are My Newborn’s Eyes Crossing?

Crossed eyes in a newborn are fairly common, typically harmless and usually go away

Close up of child's chipped teeth
March 29, 2024/Children's Health
What To Do if Your Child Chips a Tooth

A dental emergency, quick action is key to preventing long-term damage

child kneeling down, holding head, with a headache
March 19, 2024/Children's Health
How Serious Are Headaches in Children?

Severe and debilitating headaches can affect the quality of your child’s life

Close up of hand holding a scoop of powder baby formula over container of powder baby formula
February 23, 2024/Children's Health
Feeding Your Baby: How and When to Supplement With Formula

When breastfeeding doesn’t go as planned, you may need to supplement with formula or donor breast milk — and that’s OK

Trending Topics

Person in yellow tshirt and blue jeans relaxing on green couch in living room reading texts on their phone.
Here’s How Many Calories You Naturally Burn in a Day

Your metabolism may torch 1,300 to 2,000 calories daily with no activity

woman snacking on raisins and nuts
52 Foods High In Iron

Pump up your iron intake with foods like tuna, tofu and turkey

Ad