At a glance
WIC staff can use this Deskside Reference Guide to help guide conversations about developmental monitoring. Download and print this resource for future use.
Role of WIC staff
At each certification and mid-certification appointment, give parents the opportunity to complete the age-appropriate checklist. The checklist may also be used during other regular appointments and any time a family or WIC staff has a concern or questions about a child's development.
Have the family complete a checklist for each child being certified that day unless the child has known developmental delay or disability; if the child is between checklist ages, use the younger checklist. If the child was born prematurely, use the corrected age.
Refer the family for follow-up if indicated. If allowed by your state, the referral can be noted in the electronic data system. See details in the box below.
Introducing the checklist (sample steps)
- "You may have noticed the pictures on the walls and floor about developmental milestones." [OR "You might remember that I shared the link to an online milestone checklist/CDC's Milestone Tracker app."] "Tracking how (child's name) plays, speaks, learns, acts and moves for his/her age is just as important as measuring his/her height and weight."
- "These checklists help us track your child's development. If you haven't completed it yet, we can do it together now."
- "Let's go through the milestone checklist to see how ______ is doing on his/her milestones. Let's answer these first two questions together. Does ______ (read first item on checklist)? Does ______ (read second item)?"
- "Go through the rest of the checklist and let me know if you have any questions. Be sure to add ______'s name and age, along with today's date."
Be sure the family writes the child’s name, age, and the date on the checklist and completes both columns of the checklist. Provide assistance if needed. Then review the checked boxes to determine next steps:
All boxes checked and no concerns
If all milestone boxes are checked and no concerns noted written or otherwise, this indicates the child is reaching his or her developmental milestones.
"It looks like _________ is on track for meeting these developmental milestones."
“Take this checklist home with you and share it with your family and ____’s doctor so they can see how great _______ is doing.”
"If you have a smart phone, you can download a free app called CDC's Milestone Tracker to keep tracking milestones until your next visit."
“If you ever have any concerns or questions about _________’s development, be sure to talk to the doctor.”
Give the checklist to the family and encourage them to keep tracking milestones. Remind them to download CDC's FREE Milestone Tracker app or find online checklists at www.cdc.gov/Milestones to continue tracking their child's development in between visits.
At least 1 box not checked/any concerns
If one or more milestone box is not checked or any concerns noted, this indicates need for a referral.
“It would be a good idea to talk with your health care provider about this checklist. I really care about what the doctor has to say about ____________’s development.”
“Please call ____________’s health care provider to schedule a follow-up appointment for developmental screening.”
“I am going to turn this checklist over and write ________’s health care provider’s name on it so that he/she knows exactly what you want to talk about.”
“I want to know what the health care provider has to say the next time you come for your (date) WIC appointment.”
Check for understanding and encourage them to follow up. When possible, note the referral in the child's record. If available, an alert can be set as a follow-up reminder for staff. This enables staff to ask the parent about the outcome of this referral at the next visit.
Developmental Monitoring: Getting the Conversation Started
Common questions from parents
About the program
Do I have to do this? No. If you prefer not to, we can just move on.
Why are you asking me these questions? Thinking about how a child plays, speaks, acts and moves is just as important as tracking his or her height and weight. Height and weight can be indicators of healthy growth, just like these milestones can be indicators of healthy development.
I already filled out a checklist (here/at the doctor's office/at daycare). Do I have to do it again? Children grow and change quickly at this early age so it's a great idea to do this kind of checklist frequently. It's a good way to make sure a child is on track. Note: If a child already has been diagnosed with a developmental delay or is receiving specialized services for developmental concerns(e.g.,speech/language therapy, early childhood special education, or other early intervention like speech therapy), there is no need for the parent to complete a checklist or for a referral to the doctor. Often this can be indicated in a child's record so the checklists are not brought up with the parent in the future.
Who is sponsoring this program? WIC provides oversight for this program. [A state would add their identifying information here if appropriate] is also supporting the program. This program was originally developed with the WIC program in Missouri, in partnership with the University of Missouri and the Centers for Disease Control and Prevention, a federal agency interested in the health of children and families.
Where can I go for more information or to comment on this project? Contact [person's name] for more information. You can call or email at [telephone number and e-mail address].
About developmental milestones
What is a developmental milestone? A developmental milestone is a skill that most children can do by a certain age. For example, most children can say "mama"or"dada" by their first birthday. These checklists were developed by the Centers for Disease Control and Prevention's Learn the Signs. Act Early. Program, are informed by research, and were reviewed by development experts.
Where can I go for more information on developmental milestones? Additional sources of information include:
- CDC's "Learn the Signs. Act Early." website is an excellent resource.
- Family Voices. An advocacy group for parents to help them identify resources and support in their state (similar to Parent to Parent).
- Center for Parent Information and Resources. A website with information about parent centers that provide information, support, and resources for children with disabilities and their families.
What do I do if my doctor isn't responsive to my concerns?
- Acting early on concerns is the best way to help your child and you are doing the right thing; you know your childbetter than anyone
- If your doctor tells you to "wait and see" and you feel uneasy about that advice, you can seek a second opinion withanother doctor
- You can also call [insert org name and number here] to find out if your child might qualify for services to help. You do not need a doctor's referral to do so.
How quickly do I need to contact my child's doctor? Is this an emergency? Can it wait until our next well-child visit? While not an emergency, developmental concerns should be addressed promptly. Please see your child's doctor before your next WIC appointment. If your next well-child check-up with the doctor is more than a month away, don't wait. Call and get the soonest appointment available.