Could Your Child Be Developmentally Delayed?

The first step in recognizing possible delays in development is to compare your child's abilities with the expectations for the average child at his or her age. The following milestones for social interaction and language skills come from First Signs, Inc., a national non-profit organization dedicated to educating parents and pediatric professionals about the early warning signs of autism and other developmental disorders.

• 4 months: Follows and reacts to bright colors, movement, and objects. Turns toward sounds. Shows interest in watching faces. Returns smiles.
  
  
• 6 months:Smiles when playing. Coos and babbles when happy, and cries if sad.
  
  
• 9 months:Exchanges back-and-forth sounds, smiles, gestures, and expressions.
  
  
• 12 months: Uses a few gestures to get needs met and likes using hands to communicate, share, or point. Will turn to a person speaking or when his name is called. Plays peek-a-boo or other social games. Makes rudimentary mono-syllabic sounds such as "ma," "ba," "da," and "ga."
  
  
• 15 months: Exchanges smiles, vocalizations, and gestures with you. Uses pointing and other motions to draw attention to something, uses voice to get needs met or garner attention. May be able to speak and understand three or four words, such as "momma," "poppa," "bottle," or "bye-bye."
  
  
• 18 months: Uses lots of gestures as well as words to get needs met, like pointing or taking you by the hand and directing you to something. Uses at least four different consonants in babbling or words, shows that he knows the names of familiar people or body parts by pointing to or looking at them when named, and plays simple pretend games (like feeding a doll).
  
  
• 24 months: Engages in complex pretend play (such as feeding a doll then putting it to sleep). Uses and understands at least 50 words and can string words together. Enjoys being with children of the same age and is interested in playing with them and/or sharing toys. Looks for a familiar object out of sight when asked about its whereabouts.
  
  
• 36 months: Enjoys pretend play with different characters and with a story line, enjoys playing with other children, uses thoughts/actions together with speech to communicate and play. Will answer simple "who," "what," and "where" questions easily and talks about things in the past and the future.

It's important for parents to remember that a chart of milestones can't take the place of a screening test performed by a specialist. Rather, the milestones chart will only help parents know whether they should raise their concerns—and also how they can explain those concerns to the doctor.

For parents who want more specific resources before consulting with a doctor, there are screening tools available for order online. The medical testing company Forepath offers its PEDS Child Development Screening Test over the Internet for a small fee. The online test also includes the M-CHAT (Modified Checklist for Autism in Toddlers) for parents whose children are over 18 months but younger than five.