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Developmental Milestones and Preemies

Developmental milestones give parents and doctors a gauge to measure how a child is doing in comparison to other children the same age.  Milestones like babbling, crawling or walking are important skills that normally emerge in babies during specific age ranges.  When babies do not develop these skills during the expected time frame, this may indicate that the baby is not developing normally or that she has a developmental delay.  While there is some variation of when milestones are reached, doctors can get an idea of how a child is developing by checking to see when she reaches certain milestones.  


Preemie milestones are based on adjusted age not actual age

With preemies, it is important for parents to understand that preemies are not going to reach milestones at the same time as full term babies.   Developmental milestones are based on the assumption that babies were born around their due dates.  However, since preemies were not born on their due dates, parents need to adjust their baby’s age based on when their baby was due to accurately gauge their development.  A baby that was born two months early, for example, would not be expected to reach two month developmental milestones, like rolling over in one direction, until she was closer to four months old.

How to help your preemie reach developmental milestones

Preemies often need extra help to reach developmental milestones.   In many states, preemies and babies who spent time in the NICU automatically qualify for early intervention services.  Early intervention programs are designed to help at risk babies and children.  Early intervention programs provide parents with support and give at risk children access to services like speech, vision, or physical therapy.  To find out how to get early intervention services for your preemie, you can talk to your pediatrician or you can contact your local school system.

Developmental Services for Preemies – IFSP (Individual Family Service Plan)

Your preemie will be evaluated first to see how she is doing developmentally and where she needs help.  After that, a plan called an IFSP will be developed for your preemie.  An IFSP is similar to an IEP that is used by the school system for older children in that it establishes a plan and goals for your child based on her individual needs.  The IFSP includes the family in the process.  Family members and service providers work as a team to evaluate, plan services, and achieve the goals in the IFSP. 

When do preemies catch up with their peers?

This question is tough to answer.  Most health care providers and professionals stop adjusting a premature child’s age once the child is two years old, but others continue using the adjusted age until the child is three or older.  Adjusting age is most useful for children under three because a few months can make a big difference in reaching developmental milestones in younger children. 
However, just because a child’s age is no longer being adjusted doesn’t mean she has “caught up” with her peers.   Preemies are at higher risk for having disabilities including cerebral palsy, vision and hearing issues, feeding difficulties, and learning disabilities.  With early intervention, many preemies go on to have no long term delays or disabilities.  Still, some preemies, especially those born very early, may struggle with life-long disabilities and may continue to need services and support after age three.


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