Speech-language pathologists voice concerns after CDC changes child development guidelines

This is the first time in 20 years the guidelines have changed

For the first time in 20 years, the CDC updated its developmental milestones for children.

The guidelines give details of when most children should be able to accomplish certain behaviors, but it’s the new language guidelines that really caught the attention of speech professionals.

Many parents are concerned about the developmental effects the COVID pandemic has had on their children. That includes Mallory Karadsheh. She said it was obvious to her when her son, Wyatt, turned one that his language skills were delayed. He was placed in speech therapy and now that he’s two and a half years old his language skills are thriving.

According to the new milestones issued by the CDC, there would be no cause for concern until Wyatt turned 15 months old. That change has speech-language pathologists concerned.

Jennifer Rosenthal is the founder and director of Birmingham Speech and Language.

The old guidelines suggested a 24-month-old child would have an average vocabulary of 50 words. The new guidelines say a 30-month-old should have a vocabulary of 50 words.

Speech and language pathologists fear these revised guidelines could slow or inhibit referrals for early intervention. That means the time in which children are eligible for publicly funded programs and services offered for free or at a reduced cost would not be available if the child is too old.

“Early intervention in Michigan is birth to three, so if we are not identifying these kids with language delays until 30 months they don’t have a lot of time left in their early intervention,” Rosenthal said.

Additionally, no speech-language pathologists were involved in the development of the updated milestones and the guidelines don’t line up with those reported by the American Speech-Language-Hearing Association.

The CDC declined a request for an on-camera interview but did answer questions via email.

Local 4 asked why they would lower the language milestones in toddlers at a time like this. They made it clear that they were not “lowered,” but just revised to assign milestones to ages when most children (75% or more) would be expected to exhibit a particular behavior and to improve clarity about when to take action.

Team Lead for CDC’s “Learn the Signs. Act Early” Program Katie Green shared the three reasons with Local 4.

  1. To offer a free milestone checklist for every age at which there is an American Academy of Pediatrics (AAP) recommended well-child health supervision visit between 2 months and 5 years, which meant adding the 15- and 30-month checklists
  2. To assign milestones to ages when most children (75% or more) would be expected to exhibit them to improve clarity about when to take action (e.g. further screening, referral to services) on a missed milestone. Average age milestones (those that 50% would be expected to achieve) can be difficult to interpret when missed and lead to a “wait and see” approach.
  3. To address parents’ and early childhood professionals’ feedback that having very similar milestones across checklist ages was confusing, especially in terms of knowing when to take action on possible developmental concerns

Green writes that the revised guidelines aim to promote developmental monitoring and help encourage conversations between parents, doctors and childhood providers. The revisions of the guidelines were completed in 2019.

They also said the research and revisions were completed in 2019 and were not related to the pandemic.

If you are concerned for your child, you should talk to your pediatrician, reach out to a speech pathologist and make sure to read and talk to your children.

Read: More parenting news coverage

About the Author:

You can watch Kimberly Gill weekdays anchoring Local 4 News at 5 p.m., 6 p.m. and 11 p.m. and streaming live at 10 p.m. on Local 4+. She's an award-winning journalist who finally called Detroit home in 2014. Kim has won Regional Emmy Awards, and was part of the team that won the National Edward R. Murrow Award for Best Newscast in 2022.