Developmental Milestones at 2 Years Old
What Are Developmental Milestones?
Developmental milestones (1) are things most children (75% or more) can do by a certain age. Skills such as taking a first step, waving, or smiling for the first time are examples of developmental milestones.
The most important reason for monitoring your child’s development is to determine whether they are on track. Most children reach developmental milestones at or about the same age. However, some children will reach the milestones sooner and others a bit later. The fact that your child may be reaching a milestone a bit later, does not necessarily mean that there is something wrong.
Developmental Milestones Most Children Reach at 2-Years-Old
Movement and Physical Milestones
- Walks (not climbs) up a few stairs with or without help
- Runs
- Eats with a spoon
- Kicks a ball
Cognitive Milestones (Learning, Thinking, and Problem-Solving)
- Tries to use buttons, knobs, or switches on a toy
- Plays with more than one toy at the same time (e.g., putting toy food on a toy plate)
- Hols something in one hand while using the other hand; for example, holding a cup and taking the lid off
Language and Communication Milestones
- Says at least two words together (e.g., ‘more water’).
- Points to things in a book when you ask (e.g., “Where is the car?”)
- Points at least two body parts when you ask him to show you
- Uses more gestures than just pointing and waving, like nodding yes or waving goodbye
Social and Emotional Milestones
- Looks at your face to see how you react in a new situation
- Notices when others are upset or hurt, like stopping or looking sad when someone is crying
Are You Worried About Your Child’s Development?
If your child is not meeting one or more milestones, has lost skills they once had, or you have any other worries, reach out to your doctor. Have a chat with them and ask for your child to have a developmental screening.
The American Academy of Paediatrics (AAP) recommends that children are screened using standardized validated tools at 9, 18, and 30 months or whenever a parent or provider is worried. It is also recommended that children are screened at 18 and 24 months for autism.
How Common Are Developmental Delays?
Developmental delays (2) are quite common. In the US, it is estimated that one in six children experience a developmental delay. A delay alone does not mean that there is anything wrong with the child. However, when there is an issue, intervening as early as possible can make a big difference.
We generally talk about developmental delays being specific or global:
- Specific: A child may have a delay in only one area, such as motor skills or language.
- Global: A child may have delays in many areas of development, such as motor skills and language at the same time.
The Sooner My Child Hits Developmental Milestones, the Better?
It is important to remember that childhood is not a race. Developmental milestones are designed to be helpful, not anxiety-inducing. Parents should think of developmental milestones as way to get information about their child but not as predictor, or as a competitive indicator of their ability. Childhood is not a competition!
Having said this, children need to be stimulated, receive attention, and love to fulfil their genetic potential. There is some evidence that hitting some developmental milestones early could indicate a high level of academic achievement or intelligence later in life.
What Activities Can You Do with Your 2-Year-Old?
- Involve them in household chores. They usually love to help! They can help setting the table, putting the laundry into the washing machine, and cleaning a floor.
- Help your child to share, take turns and deal with conflicts during playdates or with their siblings.
- Help your child to sounds words correctly.
A Note for Parents of Preterm Babies
Children born prematurely (3) (even those born in the late preterm period) have a higher risk of experiencing developmental delays. They are more likely to experience delays in language, motor, socioemotional, and cognitive domains.
The same tests (4) that are used to test children born to term are used to test children born preterm. The only difference is that when examining performance of preterm children to developmental norms, the age from their due date rather than birth date is generally used.
Many preterm children who experience some delays, catch up by the age of two or three years.
If you have a preterm child is a good idea to keep a close eye on their developmental milestones. Always talk to your doctor if you are concerned.
How Do I Keep Track of my Child’s Development?
The Center for Disease and Control Prevention (CDC) in the US has a very good milestone tracker app that you may find useful. It tracks your child’s milestones from age 2 months to 5 years.
How Are Developmental Milestones Decided?
The CDC, the World Health Organization, and the American Academic of Paediatrics (AAP) develop these guidelines (5) based on scientific research, large-scale studies, and clinical observations of child development.
Every so often, the checklists are reviewed and updated. This is why developmental milestones can change. For example, crawling used to be a developmental milestone at 9 months, but it is no longer considered one because many children never crawl, and it does not affect their development.
Finally…
I hope this information helps. The key message to remember is to keep an eye on your child’s developmental milestones while remembering that childhood is not a race! Milestones are meant to be informative and not to create anxiety. If you think that your child is not hitting a milestone, talk to your doctor.
If you have any questions or comments, do get in touch!
Love,
Ana
References
(1) Scharf, R. J., Scharf, G. J., & Stroustrup, A. (2016). Developmental milestones. Pediatrics in review, 37(1), 25-38.
(2) De Moura, D. R., Costa, J. C., Santos, I. S., Barros, A. J. D., Matijasevich, A., Halpern, R., … & Barros, F. C. (2010). Risk factors for suspected developmental delay at age 2 years in a Brazilian birth cohort. Paediatric and perinatal epidemiology, 24(3), 211-221. DOI: 10.1056/NEJM199402173300708
(3) Bucher, H., Killer, C., Ochsner, Y., Vaihinger, S., & Fauchère, J. C. (2002). Growth, developmental milestones and health problems in the first 2 years in very preterm infants compared with term infants: a population based study. European journal of pediatrics, 161, 151-156. https://doi.org/10.1007/s00431-001-0898-0
(4) Brothers, K. B., Glascoe, F. P., & Robertshaw, N. S. (2008). PEDS: developmental milestones—an accurate brief tool for surveillance and screening. Clinical pediatrics, 47(3), 271-279. https://doi.org/10.1177/0009922807309419
(5) Sheldrick, R. C., Schlichting, L. E., Berger, B., Clyne, A., Ni, P., Perrin, E. C., & Vivier, P. M. (2019). Establishing new norms for developmental milestones. Pediatrics, 144(6). https://doi.org/10.1542/peds.2019-0374
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