The importance of Social milestones in children and detection of delays at the earliest

05 Apr The importance of Social milestones in children and detection of delays at the earliest

Social interaction is important for kids. They learn, develop, and grow a lot from being around others and having social experiences. Allowing your children and encouraging them to be more social and have social interactions can help them to develop these important life skills.

Communication refers to the use of verbal and non-verbal (eye contact, facial expression, gestures) by babies to develop meaningful relationship with the caregivers.

Social skills are the skills your child will use to interact and communicate with everyone in the world around them. One of your baby’s initial social skills is their social smile by around 6 weeks to 4 months.

By 3 months of age, they try to catch your attention by smiling at you.

If your child hasn’t smiled by 4 months of age but maintains eye contact, vocalizes, responds to visual cues, then delay in smiling is rarely the only symptom that a child in Autism spectrum might exhibit in the early stage of development.

A baby should be responding to their name by six or seven months of age. It is concerning if your baby is not showing this skill by seven months.

We need to dig beyond just asking the parent whether they feel like their child responds to their name as sometimes the kids tend to ignore the name call while they are engaged in active play.

The first step when identifying a child is not responding to their name involves a referral to audiology. Ruling out a hearing loss is vital and the first step in the process of evaluation. When a child does not respond to her name by 12 months then we need to be more cautious as it points more towards the diagnosis of autism^.

Babies learn to point by 12 months to 18 months of age.

It is one of the way your child tries to communicate with you even before they have started using actual word. Does your child ever use his or her index finger to point to ask for something? It is one of the developmental milestones by which they build their communication process. Children who lack the finger pointing skill usually use hand on hand communication (hold our hand to point the desired object.

Social Milestones Checklist

0 to 6 months

Calms down when spoken to or picked up

Looks at your face

Smiles at faces

Recognizes parent voices

Cries for attention

Makes eye contact

Knows differences between parents and strangers

Watches your mouth movement

7 to 12 months

Smiling when socially approached

Calming and settling

Playing peek, a boo

Clapping when prompted

Spontaneously lifting arms to parent

13 to 17 months

Establishing good eye contact

Responds to name call

Reacts when you leave (looks, reaches or cries for the caregiver)

Responds to facial expressions

Identifying self in a mirror

Pretend play

Smiles, laughs when you play peek a boo

18 months to 2 years

Points to show you something interesting

Looks at few pages of book with you

Lifts arm up suggesting to carried upon

Notices when others are hurt or upset or get sad when others cry

2 to 3 years

Role play

Spontaneously looking for hidden objects

Verbalizing their drink “I want a drink”

Playing beside other children

Treating toys as if they were alive.

We can use this simple social skills checklist  during the well-baby visits for MMR vaccination by 9 months and for Hepatitis A vaccination by 12 months and use the RBSK  questions as a screener on children between 15 to 18 months of age, where the child shall be referred for further evaluation based on the response obtained.

Reference

RBSK Practical Manual – Screening questionnaire for Autism at the age 15 -18 months

MCHAT-R/F which is the gold standard screening tool widely used, we also need to take into account that on practical grounds, the interpretation of questions in the MCHAT R/F by the caregivers is still difficult.

There is other Infant toddler checklist available but the complexity of the tools does affect the usage in regular basis.

Social milestones and language have emerged as areas in which children with autism are likely to lag behind the typically developing children⁷ and we can use this social milestone checklist to identify the deficit displayed by the children with Autism at the earliest.

To conclude whenever there is regression of attained milestones, there is not much of social smile by 6 months, response to name call by 9 months, pointing by 18 months, the child can be monitored carefully for delay in communication, cognitive skills and also indicate the potential for developing Autism in the future.