Weighing Socioeconomic Background, Family Life When Assessing Developmental Milestones: Paul Lipkin, MD


The director of medical outpatient services at the Kennedy Krieger Institute discussed how the clinical community has approached children who fail to reach developmental milestones in part because of poor home lifestyle. [WATCH TIME: 3 minutes]

WATCH TIME: 3 minutes

"We do know that there are influences on brain maturation. For the moment, I’ll call them environmental influences, but it’s the experience we take for granted that children have that probably does modify their development. Does it cause dramatic improvements? We don’t know that. On the other hand, there’s a fundamental foundation for early childhood experience that we hope every child would get."

As infants grow into young children, parents are cognizant that they achieve certain developmental milestones such as standing, walking, and showing excitement, among many others. Failure to do so can prompt further evaluation, clinical testing, and potentially a diagnosis of a neuro-related disease or disorder. Recently, the standard guidelines developed by the Centers for Disease Control and Prevention were updated in collaboration with the American Academy of Pediatrics with the latest evidence-based research.

Otherwise known as the "Learn the Signs. Act Early." Program, these guidelines had not been updated since 2004. These guidelines included one major update, which stated that each milestone is based on the 75th percentile instead of 50th percentile. Although failure to reach milestones may cause a concern, part of the issue may be attributable to living conditions and home lifestyle.

In an interview with NeurologyLive®, Paul Lipkin, MD, senior author of the guidelines, discussed how much living conditions play a role in the development course for a child. Lipkin, director of medical outpatient services at the Kennedy Krieger Institute, also provided insight on how clinicians judge the weight of these issues and whether a wait-and-see approach should still be considered.

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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