Learn the Signs and Act Early

“Learn The Signs and Act Early” (LTSAE) is a program developed by the National Center for Birth Defects and Developmental Disabilities (NCBDDD) within the Center for Disease Control and Prevention (CDC). It started in 2004 as an Autism awareness campaign regarding the early/warning signs of that condition. As a result of this campaign the US government quickly discovered that parents wanted to know about typical developmental milestones (i.e., what my child should be doing in an age appropriate fashion). LTSAE encourages ongoing, parent-engaged, developmental monitoring and screening and offers free tools to make developmental monitoring practical and easy (see references below).  The goal of the CDC/NCBDDD is to disseminate information and increase understanding about developmental monitoring.  The program is made of three components: a health education campaign  an act early initiative , and research/evaluation.

The Center for Disease Control and Prevention (CDC) states that: “From birth to 5 years, your child should reach milestones in how he plays, learns, speaks, acts, and moves” (https://www.cdc.gov/ncbddd/actearly/index.html).  This is of importance as 1 in every 6 children aged 3-17 years have developmental conditions that affect how the child  engages in these domains.  Unfortunately, many of these children are not identified until after starting school. Early intervention (i.e., before school age) can have a significant impact on a child’s ability to learn new skills and may help reduce the need for future costly interventions. It is for this reason that the American Academy of Pediatrics recommends both developmental monitoring (also called surveillance) and developmental screening for all children.


How your child plays, learns, speaks, and acts offers important clues about your child’s development. Developmental milestones are things that most children (meaning ninety percent of them) do by a certain age.  There are five domains of child development:

  • Communication
  • Gross motor (arms, legs, large muscles used to sit, crawl walk)
  • Fine motor (hand and finger movements. coordination)
  • Problem solving
  • Social-emotional

 Key Points

  • Understanding and tacking/monitoring milestones are important.
  • The CDC has free resources for help.
  • Promoting parent’s active involvement in developmental monitoring promotes optimal development health for their young children.
  • Acting early can make a difference.


  • At what age should a child be referred to a pediatrician if they have not begun to walk?  Answer: 18 months. An infant usually begins to cruise furniture around 10-12 months and can walk alone by 15 months. If walking has not occurred by 18 months the toddler should see a pediatrician.
  • Around what age should a child be able to build a tower of three building blocks?  Answer: 18 months. This increases to around 6 cubes by 2 years and 9 cubes by 3 years.
  • At what age should a child develop a mature pincer grip?  Answer: By 3 months he should be able to swipe at things, develop hand-eye coordination. By 4-8 months he should be able to pick up large objects, and by 9-12 months he should be able to pick up small objects with thumb and forefingers as in holding utensils.

Do you have any concerns about your child’s development, learning, or behavior?  Get help from the following references:

Milestones checklist from ages 0-36 months sorted by age and topic.

Milestones Moments Booklet

Amazing Children’s Books (available in English and Spanish)

Milestone Tracker Mobile App (for iOS and Android devices)

Developmental Screening Passport

For primary health care providers interested in gaining knowledge about how to improve the early identification of children with Autism Spectrum Disorder (ASD), the CDC offers a web-based continuing education course.



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