Future Implications, Outlook of New CDC Developmental Milestone Guidelines: Paul Lipkin, MD


The director of medical outpatient services at the Kennedy Krieger Institute discussed the long-term effects of the updated developmental milestone guidelines and the need to judge children based on the 75th percentile. [WATCH TIME: 7 minutes]

WATCH TIME: 7 minutes

"There are 2 major goals here. One is to educate the public. All the work that we did on this paper are now translated into new materials, published by the CDC, in both English and Spanish, and are available to people all throughout the world. Even though it’s a US government organization, the intent is to be available online to everybody anywhere."

In February 2022, the Centers for Disease Prevention and Control (CDC) and American Academy of Pediatrics (AAP) announced they were updating their “Learn the Signs. Act Early.” guidelines for child developmental milestones. These new CDC milestones—which were revisions of the guidelines that were originally released in 2004—are infant development checklists that help determine the need for developmental screenings. After several years of research and discussion, the milestone updates aimed to better reflect the data of when children reach milestones such as crawling, walking, speech, and more.

The AAP Systems of Services for Children and Youth With Special Health Care Needs team identified and convened 8 subject matter experts who settled on 11 criteria for surveillance milestones and tools. Of note, the experts agreed that milestones should be easily observed in natural settings and at least 75%, not 50%, or children would be expected to achieve a milestone at a certain age. Additionally, to reduce confusion about when to be concerned, developmental warning signs were eliminated because not achieving milestones that most children are expected to achieve similarly warrants more in-depth surveillance and consideration for developmental screening.

To learn more about the long-term impact of these new guidelines, and how updated research may better reflect the general population, NeurologyLive® sat down with Paul Lipkin, MD, senior author of the guidelines. Lipkin, director of medical outpatient services at the Kennedy Krieger Institutes, provided commentary on the direction of these guidelines, their impact on society, and how they inform decision-making for clinicians and parents alike.

1. Zubler JM, Wiggins LD, Macias MM, et al. Evidence-informed milestones for developmental surveillance tools. Pediatrics. 2022;149(3):e2021052138. doi:10/1542/peds.2021-052138
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