When were the Learn the Signs. Act Early (LTSAE) milestones updated?
The US Centres for Disease Control and Prevention completed an extensive review process of the LTSAE milestone checklists with revisions published in February 2022. The revised LTSAE milestone checklists have been incorporated in the 2022 edition of the Blue Book.
How have the milestones changed?
The
LTSAE milestone checklists now present the milestones at the ages by which most children (75% or more) are expected to have met them. The old lists were based on what 50% of children were likely to have achieved. A summary of the changes can be found at
Learn the Signs. Act Early- NSW Health website.
Why were the milestones updated?
For the purposes of parent and provider education and to facilitate communication. The new milestones make it clearer that a missing milestone should prompt parent-provider discussion and next steps.
Have all the Learn the Signs. Act Early milestones shifted to new ages?
No. More than two thirds of the LTSAE milestones were retained at the ages at which they were placed in the previous milestone checklists. The wording used to describe the milestone may have changed, primarily to make it easier to understand. Additionally, milestones regarding verbal and nonverbal communication were added across checklists along with parent tips to support language development. Open-ended questions were added to encourage discussion of concerns that milestones may not capture, such as concerns about a child’s clarity of speech.
Why was a particular milestone removed from a checklist or moved to another age?
The updated
LTSAE milestones were chosen to reflect what most children (75% or more) would be expected to do by a specific age to better identify potential concerns as described in the
Paediatrics article (Evidence-Informed Milestones for Developmental Surveillance Tools | Paediatrics | American Academy of Paediatrics (aap.org).
Are these new guidelines/standards for child development?
No. The LTSAE milestone checklists are to promote developmental monitoring/surveillance, ongoing developmental observation, encourage conversations between parents, healthcare providers and early childhood providers about child development.
Where can I go to find out more information?
- A Communications Package is available to support local implementation of revised checklists including :
- For information, refer to
Learn the Signs. Act Early milestones checklists
- To learn more about the process for making the revisions, refer to
Evidence-Informed Milestones for Developmental Surveillance Tools | Paediatrics | American Academy of Paediatrics (aap.org)
