#289 - Help! My Child is Behind on Their Milestones- What Do I Do??

by Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC January 03, 2024

#289 - Help! My Child is Behind on Their Milestones- What Do I Do??

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Help! My Child is Behind on Their Milestones- What Do I Do??

Developmental delays can happen for a variety of reasons- there’s no one to blame and you are not doing anything wrong!

We’re going to share some of the typical developmental milestones so you can identify if your little one is on track or a little behind, what you can do to support their development, and who to reach out to and get more help from.

We dive into gross motor, fine motor, oral and feeding, speech, emotional, and social milestones. We also give you 2 activities to add into the daily routine within each category!

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Help My Child Is Behind On Their Milestones What Do I Do

As a parent, you might often be concerned about whether your child is hitting developmental milestones on time, a topic frequently discussed during pediatrician appointments. Understanding these milestones and how to support your child if their progress deviates from typical timelines is crucial. 

Developmental Milestones By Age

When the connection between the brain and body is disrupted, it can lead to deviations from the typical developmental progress. Understanding developmental milestones is crucial for parents and professionals working with young children, as it enables the effective identification and addressing of delays. 

Gross Motor Skills

Essential full-body movements that babies and toddlers should achieve within a month or two for these milestones. 

  • By four months: Rollover. 
  • By six months: Sit with support. 
  • Between 8-10 months: Crawl on all fours before walking.
  • Between 12-16 months: Start walking. 
  • By around 18 months: Running. 
  • By age 2: Able to do two-foot jumps.

Fine Motor Skills

  • By 3-4 months: Use both hands to bring objects to their midline.

  • By six months: Hold a block in each hand and clap them together while seated.

  • By 10-12 months: Start using a pincer grasp with thumb and index finger.

  • Between 13-16 months: Scribbling with markers or crayons and may start clapping.

  • By 17-20 months: Build a tower with six large blocks.

  • By age 2: Start imitating circular strokes, snipping with scissors, and throwing a ball at a target.

  • By age 3: Catch a playground ball with both hands. 

Oral Feeding Skills

  • At birth: Proper latch so they can suck, swallow, and breathe effectively. 
  • By around six months: Introduce solid foods if the child can sit unsupported.
  • By around eight months: Drinking from an open or straw cup.
  • Between 9-12 months: Self-feeding with pincer grasp.
  • By 13-16 months: Self-feed with utensils, though not very skillfully.
  • By age 2: Eating a variety of foods and using utensils well.

Speech, Emotional, And Social Skills

  • By 4-6 months: Laughing and giggling. 

  • By around seven months: Start imitating sounds. 

  • Between 7-9 months: Intentionally look at objects, mimic pointing, repeat words, or imitate sounds. Stranger anxiety may peak with new people.

  • By 10-12 months: Begin using meaningful one- to two-word vocabulary.

  • By around 12 months: Understand basic phrases, follow simple commands, bring toys to share favorites, and show interest in dressing themselves.

  • By 14 months: Engage in interactive games and songs.

  • Between 13-16 months: Expect a vocabulary of 10 to 20 words, start repeating words from conversations, respond to questions, follow instructions efficiently, and engage in activities like pointing and clapping.

  • By age 2: Using two-word phrases and a vocabulary of 50+ words.

  • By age 3: Want strangers to understand about 75% of what the child is saying, ensuring their speech is clear.

Activities To Support Developmental Milestones

Gross Motor Skills

  • Baby: Try tummy time on a therapy ball and engage with eye contact, talking, singing, or playing.
  • Toddler: Encourage crawling through various types of tunnels.

Fine Motor Skills

  • Baby: Stimulate a baby's hands with various tactile experiences, such as a gentle massage, a vibrating ball, or different textures from a washcloth, hairbrush, or carpet.
  • Toddlers: Engage in sensory play with dry and wet materials. Use bins with beans, magnetic letters, shapes, or animal figures. Introduce messy food play, shaving cream, or water tables.

Oral Motor and Feeding Skills

  • Baby: Stimulate inside and outside their mouth, including cheeks and lips. Introduce various textures around and inside their mouth to help them adapt to different sensations.
  • Toddlers: Encourage messy food play by letting them touch and interact with their food during meals and playtime. 

Speech, Emotions, and Social Skills

  • Babies: Narrate by pointing to an item, describing it, speculating on its thoughts, and discussing your observations.
  • Toddlers: Encourage reading emotions from facial expressions using pictures of people with different expressions and discussing their feelings. 

When To Seek Help

If you suspect your child is not reaching developmental milestones, articulate your concerns to a pediatrician or professional. Pay particular attention if you observe any of the following in your baby or toddler:

  • Baby: Consult at any time but particularly in the first three months for gross motor skills like rolling over; by six months for sitting up; nine months if not crawling; and 18 months if not walking.
  • Toddler: Look for red flags during developmental appointments before age two. During preschool years, check language delays, stuttering, hearing loss, behavioral issues like aggression or tantrums, or advanced skills as good reasons to schedule an evaluation.

Remember, every child develops at their own pace, reaching milestones earlier or later than others. The key is to be aware of these milestones and seek help if you have concerns about your child's development. 

Final Thoughts

Understanding and supporting your child's developmental milestones can significantly impact their growth and progress. By engaging in activities that promote gross motor, fine motor, oral feeding, speech, emotional, and social skills, you can help your child reach these milestones more effectively. 

Always trust your instincts as a parent and seek professional help if you have any concerns about your child's development. Children can overcome delays and achieve their full potential with early intervention and support.  






While we make every effort to share correct information, we are still learning. We will double check all of our facts but realize that medicine is a constantly changing science and art. One doctor / therapist may have a different way of doing things from another. We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties and what we have found to be beneficial that will be as evidenced based as possible. By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition in either yourself or your children. Consult your child’s pediatrician/ therapist for any medical issues that he or she may be having. This entire disclaimer also applies to any guests or contributors to the podcast. Under no circumstances shall Rachel Harrington, Harkla, Jessica Hill, or any guests or contributors to the podcast, as well as any employees, associates, or affiliates of Harkla, be responsible for damages arising from use of the podcast.

Keep in mind that we may receive commissions when you click our links and make purchases. However, this does not impact our reviews and comparisons. We try our best to keep things fair and balanced, in order to help you make the best choice for you.

This podcast should not be used in any legal capacity whatsoever, including but not limited to establishing “standard of care” in a legal sense or as a basis for expert witness testimony. No guarantee is given regarding the accuracy of any statements or opinions made on the podcast.

Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC
Jessica Hill, COTA/L & Rachel Harrington, COTA/L, AC

Rachel Harrington, COTA/l, AC, CPRCS, and Jessica Hill, COTA/L, CPRCS are Harkla's in-house Certified Occupational Therapy Assistants (COTA) and Certified Primitive Reflex Clinical Specialists. They have been working with children for over 6 years in outpatient settings. They specialize in creating easy-to-digest, actionable content that families can use to help their child's progress at home. Jessica and Rachel are the in-house experts, content creators, and podcast hosts at Harkla! To learn more about Jessica and Rachel, visit the Harkla About Us Page. Make sure to listen to their weekly podcast, All Things Sensory by Harkla for actionable, fun advice on child development.

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