The 2022 CDC milestone update: what changed

Why the checklists were revised

CDC's milestone checklists are tools for developmental monitoring: parents, caregivers and clinicians watching how a child plays, learns, speaks, acts and moves over time. ³ Before 2022, it was not always clear what share of children were expected to have reached a listed milestone by the age shown.

CDC funded the American Academy of Pediatrics to convene a working group of subject-matter experts to revise the checklists. The group's stated goals were to identify evidence-informed milestones, to clarify when most children can be expected to reach a milestone, so as to discourage a "wait and see" approach, and to support clinical judgement about screening between the recommended screening ages. ¹

What changed

The working group set 11 criteria for a milestone to be included. Two matter most to parents: a milestone should be something most children (75% or more) are expected to do by the visit age, and it should be easy to observe in everyday settings. ¹

Applying those criteria, and adding checklists for the 15- and 30-month visits, changed the lists substantially. According to the published paper: ¹

• the total number of milestones fell by 26.4%;
• 40.9% of the previous milestones were replaced;
• one-third of the milestones that were kept moved to a different age, and 67.7% of those moved to an older age;
• about 80% of the final milestones had normative data from at least one source; social-emotional and cognitive milestones had the least data.

The revised lists are grouped into four areas on every CDC page: social/emotional, language/communication, cognitive (learning, thinking, problem-solving), and movement/physical development. ²

The 12 checkpoints today

Milestone counts are taken from CDC's checklist pages as mirrored on 2026-10-05. The screening ages are the American Academy of Pediatrics recommendations as published by CDC: general developmental screening at 9, 18 and 30 months and autism screening at 18 and 24 months, or whenever a parent or provider has a concern. ^3,4

What the 75% rule means for you

Under the revised lists, the age on a milestone is roughly the age by which three out of four children can do it. That has two consequences, and both are worth keeping in mind.

Many children do it earlier. A milestone at 9 months is not where most children start; it is where most children have arrived. If your child does something listed for an older age, that is common.

"Not yet" is a reason to ask, not a reason to panic. Because the bar is set where most children have already reached the milestone, a missing milestone is a useful signal to raise with your child's doctor. CDC's advice is direct: if your child is not meeting one or more milestones, has lost skills he or she once had, or you have other concerns, act early, talk with your child's doctor and ask about developmental screening. ^2,4 It is not a diagnosis. About one in four children will not yet have reached any given milestone at that age by definition, and many of them are developing typically.

Checklists are not screening tests

CDC is explicit that its materials "are not a substitute for standardized, validated developmental screening tools." ² A checklist helps you notice and talk about development. A screening tool is a formal, research-based questionnaire, done with your child's clinician or another trained professional, that takes a closer look. ³

That is why childow shows, on each checkpoint page, which screenings AAP recommends at that visit. If a "not yet" comes up at 9, 18 or 30 months, the visit is already the right moment to ask about a developmental screening. If it comes up at another age, you can still ask: CDC notes that children should be screened whenever a parent or provider has a concern. ³

What we show, and how

On childow's milestone pages, every checklist item is quoted word for word from CDC's revised checklist for that age, with "Source: CDC". Each answer is Yes, Not yet or Not sure, and none of them is ever shown in red. A "Not yet" adds a line to your list of questions for the next visit, together with the screening AAP recommends at that visit and your state's early intervention contact.

For babies born before 37 weeks, checkpoint dates are set from the due date (corrected age) up to 24 months, which is how AAP advises reading development in the first two years.

If you are worried now

You do not need to wait for the next checkup. CDC suggests completing the checklist for your child's age, sharing it with the doctor, and asking about screening. At the same time, you can call your state's early intervention program (for children under 3) or your local public school (for children 3 and older) to ask for a free evaluation; a doctor's referral is not required. ⁴ Our guide on requesting an early-intervention evaluation walks through the call.