Problem Solving Milestones

This category is one that most parents have some difficulty grasping.  It encompasses the cognitive domain.

By two months a child should be following things with his eyes and getting bored if activities don't change.  At 4 months a child should let you know if she is happy or sad, respond to affection and play peek a boo.  By 6 months a child should enjoy playing with others, recognize strangers and enjoy looking at himself in the mirror.  At 9 months a child should look at things as they fall and look for toys that she's seen you hide.  At 12 months a child should be able to look at a picture of a common object when you name it.

I hope that this has helped to demystify things for you.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta Lane # 101B
Sparks NV 89431
775-359-7111

Social Milestones

Here are some common social milestones.  I hope that this helps you to understand where your baby is.  When in doubt ask your pediatrician to screen your child with one of the validated screening tools that are so widely available:

At 2 months your child should smile at you in response to your smile at 4 months your child should stare at his own hand and smile spontaneously.  At 6 months your child should reach out for a toy.  At 9 months  should be able to feed herself fingerfoods.  at 12 months, most babies can play pat-a-cake.  At 15 months most babies can begin to imitate work around the house and hold a cup.

I hope that this helps you to see what we are looking for with our patients.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta Lane # 101 B
Sparks NV 89431
775-359-7111

Major Speech Milestones

Sorry I've been away for so long.

Many people are conerned about their child's speech.  Here are the major developmental milestones:

Babies should begin to coo at 4 months.  This is a consanant free sound "OOOEEEAAA".
They should be babbling by 4 months "BABBAABAGOO".
They typically have two words by 12 months Mama and one other.
We expect to see 3-5 words by 15 months and 15 words by 18 months.
At two years we hope to see at least 1 two word sentence such as "Mama, NO!" and a 50 word vocabulary.  Typically strangers can understand 1/2 of their speech at two.
By three they should have too many words to count and several prepositions such as over, under, in, out, on and should be understandable by strangers 2/3 of the time.

If your child isn't meeting these milestones, ask your physician for formal screening.

Kevin M. Windisch, MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta Lane #101B
Sparks, NV 89431
775-359-7111

Major Gross Motor Milestones

Following on our last discussion of developmental testing lets look at each category and some of the major milestones we are interested in.

The category of gross motor includes the use of the large muscles of the trunk and extremities.

Children should be able to lift their head off the table for a second by 2 months and look around by 4 months.  Frequently children can roll front to back  by 4 months (but we some times don't see this now that we put children to sleep on their back).  They should be able to sit unsupported for 2-3 seconds or in a tripod position by 6 months.  They should begin to crawl, scoot or roll around by 6 months as well.  By 12 months your child should be able to stand and cruise around holding on to furniture and by 15 months should be able to take 1-2 steps unsupported.  By 18 months your child should be able to go up stairs with one hand held and by 24 months should be able to throw or kick a ball, climb and go up and down stairs without help.

I hope that this has helped

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta Lane # 101 B
Sparks, NV 89431
775-359-7111

Developmental Screening

Developmental screening should take place at the majority of well child/infant visits.  It consists of the usage of various statistically validated tools to monitor child development.  The most common tool that you will hear reference to is the Denver II Developmental Screen.  This tool is fameous because it was the first of it's kind but is not too useful since it has never been shown to be sensitive or specific.

We use a tool called the Ages and Stages Tool.  This tool breaks development up into 5 categories: Gross motor, Fine motor, problem solving, personal/social and speech.  We will discuss each domain in more detail including major milestones in future episodes.

I hope that this has shed some light on the subject of developmental screening and perhaps raised some questions for you.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta ste 101 B
Sparks NV 89431
(775) 359-7111

Hearing Screening

Did you know that hearing loss can be screened for in children too young to talk?  Using a device called an Otoacustic Emissions Screener or OAE screener we can do just that.  Hearing loss can come on at any time in childhood.  If detected early, we can protect the remaining hearing and start with adaptive devices like aids if necessary.  With those simple steps we can maintain improved childhood development.

If your child has not had her hearing checked in the last year, ask that it be done at the next well visit.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta Lane #101B
Sparks NV 89431
775-359-7111

12 month well visit

This is a big one and very important exam not to miss.  We start by addressing ongoing problems, as usual.  We also examine growth and development.  Major milestones at this time include making sure that the child is cruising and saying at least 1-2 words.

As always we conduct a thourough physical exam and address vaccine issues.  At 12 months the children are due for several new vaccines including Measles and Chicken Pox.

At the 12 month visit we also recommend a check for anemia and screening for lead intoxication.

Finally we discuss safety regarding toddlers, introducing whole milk, removal of dietary restrictions and when to change to a forward facing car seat.

I hope that this helps you to see why we do what we do.

Kevin M. Windisch MD, FAAP
Sparks Pediatric and Adolescent Medicine
975 Roberta Lane Suite 101B
Sparks, NV 89431
(775) 359-7111