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What you need to know about the CDC changes to developmental milestones

What you need to know about the CDC changes to developmental milestones

The CDC came out with changes to the developmental milestones for children in early February 2022 and I know a lot of parents and practitioners (including myself) have been surprised by some of these changes. That’s why I wanted to bring on my go-to expert, Dr. Peter Scire on to the podcast to walk us through these latest developments. Dr. Scire is someone I personally trust and have worked with regarding my own child’s health. 

In today’s podcast, we go through some of those changes including the changes to crawling, walking and speech. Dr. Scire takes us through why these changes are concerning and explains why developmental milestones are so important and can affect getting an early diagnosis

Because this is such a big topic and we couldn’t go as in-depth during the episode, Dr. Scire and I will be hosting an Expert Masterclass on September 21, 2022 at 12pm EST/9am PST. The free masterclass, Milestones Matter: How Developmental Milestones from Birth to 3 Years Old Influence Brain Development and What You Can Do When a Milestone is Missed, Skipped or Delayed will include:

  • What are the developmental milestones and how they provide insight into understanding what treatments and therapies are right for your child.
  • How missed, skipped or delayed developmental milestones impact the neurodevelopment of the two hemispheres of your child’s brain and how this explains their symptoms.
  • What tools are commonly used to assess your child’s neurodevelopment and how they translate into what your next steps are to help your child.
  • Why functional medicine and nutritional interventions on their own will often lead to temporary improvements and how combining them with neurorehab is essential for long-term success.

To sign up for for this Masterclass with Dr. Scire on September 21, please sign up here.

In the meantime, I hope you enjoy this podcast episode with Dr. Scire!

Things You Will Learn
  • A synopsis of some of the changes that CDC has made and why people are concerned
  • Why developmental milestones are so important
  • The changes to the crawling and walking milestones and why these could be problematic
  • The CDC’s change to speech and vocabulary
  • The upcoming Masterclass with Dr. Scire on September 21 where we’ll dive into this topic even more.
  • And much more…

Show Notes for this Podcast 

  • Synopsis of the CDC’s changes (4:37)
  • What developmental milestones are and why they’re important (7:13)
  • What it means to remove the milestone of crawling altogether (15:39)
  • Change in the walking milestone (23:50)
  • Change in the speech milestone (27:11)
  • The confusion and concern around these changes. (31:20)
  • Upcoming masterclass on this topic with Dr. Scire. (37:12)

Resources and Links

CDC Developmental Milestone Checklist

Primitive Reflexes Cheat Sheet

Evidence-Informed Milestones for Developmental Surveillance Tools, Journal of Pediatrics

Statement from the American Speech Language Hearing Association

Sign up for the FREE Expert Masterclass with Dr. Scire


Articles Related to What you need to know about the CDC changes to developmental milestones

How Retained Primitive Reflexes Impact Your Child’s Brain Development


More about Dr. Peter Scire

Peter Scire DC is the  owner and clinical Director of Scire Integrative Health Center/Scire Functional Neurology Center and Co-Owner of Brain Balance Centers of Atlanta. As a child, Dr.Scire was diagnosed with a learning disability and Dyslexia. Frustrated with traditional treatment results, his parents brought him to a chiropractor specializing in neurological therapies and functional nutrition.  The combination of traditional academic remediation and these neurological approaches have led to his recovery. Although the process was slow and costly, Dr. Scire went from a struggling student to graduating at the top of his high school class, and became an award winning collegiate scholar. Through his personal struggles and recovery he discovered that helping people was his calling and so made this his vocation. 

While in graduate school he took a special interest in functional neurology which led him to study under Dr. Robert Melillo who developed recovery protocols for children suffering from ADHD, Dyslexia, Learning Disorders, Tourette’s, and autism spectrum disorders. This collaboration has led to Dr. Scire establishing the first three Brain Balance Centers ever built in 2007-2008. Since 2010, Dr. Scire has been a co-instructor with Dr. Melillo in his Childhood & Adult Neurodevelopmental Disorder program. Dr. Scire has over 18 plus years of clinical experience working with children and adults utilizing the developmental neurology applications created by Dr. Melillo.

Ever the learner, Dr. Scire has completed  post-graduate studies in the areas of Traumatic Brain Injury/Concussion Rehabilitation, Vestibular Rehabilitation, Neuroimmunology, Low Level Laser Therapy and Functional Endocrinology. Currently he is enrolled in the three year Clinical Mastership Program at the Kharrazian Institute while simultaneously completing the Functional Immunology program through Cogence.

Dr.Scire has a private practice in Newnan, Georgia where he attends to patients of all ages with complex medical histories. His goal is to provide a personalized integrative clinical approach that incorporates the latest evidence based transitional science.

00:01 Tara Hunkin:
This is My Child Will Thrive and I'm your host, Tara Hunkin, nutritional therapy practitioner, certified GAPS practitioner, restorative wellness practitioner, and mother. I'm thrilled to share with you the latest information, tips, resources, and tools to help you on the path to recovery for your child with ADHD, autism, sensory processing disorder, or learning disabilities.

My own experiences with my daughter combined with as much training as I can get my hands on research I can dig into and conferences I can attend have helped me to develop systems and tools for parents like you who feel overwhelmed, trying to help their children. So sit back as I share another great topic to help you on your journey. A quick disclaimer, before we get started.

My Child Will Thrive is not a substitute for working with a qualified healthcare practitioner. The information provided on this podcast is not intended to diagnose or treat your child. Please consult your healthcare practitioner before implementing any information or treatments that you have learned about on this podcast. There are many gifted, passionate, and knowledgeable practitioners with hundreds if not thousands of hours of study and clinical experience available to help guide you.

Part of our goal is to give you the knowledge and tools you need to effectively advocate for your child so that you don't blindly implement each new treatment that comes along. No one knows your child better than you. No one knows your child's history like you do or can better judge what is normal or abnormal for your child. The greatest success in recovery comes from the parent being informed and asking the right questions and making the best decisions for their child in coordination with a team of qualified practitioners in different areas of specialty. Today's podcast is sponsored by the Autism, ADHD and Sensory Processing Disorder Summit. In order to learn more about the summit and to sign up for free, please go to mychildwillthrive.com/summit.

2:04 Tara Hunkin:
Hi, welcome back to the My Child Will Thrive podcast. I'm Tara Hunkin and I am really excited to have with me today, Dr. Peter Scire. we're going to talk about what you need to know about the CDC changes to the developmental milestones. These are the first changes in almost 20 years and a number of them have taken people by surprise everything from speech language pathologists, occupational therapists, and more are talking about this.

So I wanted to bring on my go-to expert for all things neurodevelopmental, which is Dr. Scire. If you haven't listened to the podcast or one of the many interviews I've done with Dr. Scire over the years, he's here often. Let me just give you a quick synopsis of his background. Dr. Scire is known as the brain doctor and has examined and treated thousands of children with neural developmental disorders since establishing his first practice in 2005, combined with his eight years of running his brain balanced centers.

Dr. Scire received his Doctorate of Chiropractic from Life University in Atlanta and has completed graduate studies in clinical neurology, nutrition, vestibular rehabilitation at the character Institute of graduate studies. He's a board eligible chiropractic neurologist. He's also the past president of the International Association of Functional Neurology and Rehabilitation. And he's a frequent lecturer to healthcare providers, educators, and support groups on functional disconnection syndrome and its applications for adults and children with developmental disorders. Dr. Scire has been co-teaching with his mentor, Dr. Robert Melillo, who's the author of Disconnected Kids if you haven't heard of that before, since 2008. Dr. Scire currently practices at his private practice Scire Integrative Health in Newnan, Georgia, where he uses a multimodal approach to neuro rehab combined with functional medicine to treat patients around the world. Thank you so much once again, for being here.

4:15 Dr. Peter Scire:
Thank you for having me. It's always a pleasure to be here.

4:18 Tara Hunkin:
Yeah. So we're going to dive right into the topic today, which is, as I said before, something that has surprised a number of people in terms of what the changes are, but before we get into those, and we're gonna talk about a few of them in particular, I'm just going to give a quick synopsis of what has happened.

The CDC back in, I guess it was late January announced new guidelines. Some of them they've added some developmental milestones, they've removed, but they did this through a panel of what they say I think there were eight experts that reviewed research over the number of years, the data that they had been collecting and the people involved in that process varied, but they did miss some key elements of others that within that work with children on a regular basis. And I think that's probably where we're going to see the exceptions in terms of what they've decided, because it takes into research data, but not really the clinical knowledge of the people that are working with the kids on a day-to-day basis.

That being said the basis of what they did was they decided to move the benchmark for whether or not when the milestone would happen from typically, it was the average age of when a child would get to that milestone based on the data to when 75{4537a52abafa24f75931b694e3f6d1d9b0beb5896e18e49b3141987b78b41d96} of the children would actually have attained that milestone. And they said the reasoning behind that was for clarity, so that so parents and their healthcare providers wouldn't see so much ambiguity and say, maybe there's a problem, maybe there isn't a problem.

If they aren't meeting that milestone by the new milestone dates, they're saying there's definitely a problem because they're in that bottom 25{4537a52abafa24f75931b694e3f6d1d9b0beb5896e18e49b3141987b78b41d96}. So we'll get into that in just a minute. So that's where we are seeing shifting of milestones that were supposed to be met earlier and now to later.

So, that's the biggest one, that's one big component of the whole overhaul and then the second big component is just some milestones being eliminated altogether. And then the third thing they did was they did add some in and specifically with which we're not going to discuss today, but specifically with respect to milestones that might need to be met, or so people can help identify when a child might be challenged with symptoms of autism.

So that's probably a good thing that they're starting to do that, but let's talk about some of these other changes that don't quite hit the mark from for a lot of people that are working with kids these days. So let's just start with saying, what are developmental milestones and why are they so important?

7:17 Dr. Peter Scire:
Sure. Well, I mean, for me, this was really fascinating when this happened, because I happened to be collaborating with Dr. Melillo this past from January to March, and we were getting ready to be in Dallas a couple of weeks ago, about a month ago. And my whole part of my presentation for the practitioners that we were teaching were the first zero to 36 month milestones.

So when this hit and I was in the process of putting the presentation together, this is really eye-opening for all of us, because I think for the better part of almost 20 years now, my whole clinical attitude towards this, and not only mine, but I think the field of developmental neuroscience, the field of developmental neurology, all of the disciplinary practitioners that I've worked with in the world of development disorders, like your SLPs, your speech language pathologist, or your OTs.

The one thing has always been about early intervention, from a level of understanding where we are now in terms of our diagnostic ability, what we were doing 20 years ago, diagnostically to now is quite different. So the ability to immediately identify when there might be a sign of a developmental immaturity in the brain.

Okay. And there's now a belief that we can see this right away. We have the moment a child is born. I mean, there are certain normal developmental steps that the central nervous system goes through because when we're talking about an infant, we're talking to child at birth, the context of how you and I, or many others would probably describe the brain is really not what the brain looks like anatomically at that moment. Okay. So, when a child is born, most of the activity of the central nervous system is reflective. And so we have these different reflexes that we now, obviously we've been referring to as primitive reflexes, we've known this for decades of neurology.

So there are these reflexes that the brain is going through that are at the brainstem level that are allowing for first and foremost survival. Okay. And the survival, the initiation of the birthing process, a child being born and then within those first couple of days of a child being alive. So we have these reflexes that set the stage for further development.

And so when you looked at, when I was going through all the presentation and looking at all the different developmental assessment tools that are out there, I mean, a lot of these tools we've known very precisely from what happens from zero to three months, three to six months, six to nine months and so on over the first course of 36 months.

And then what I was talking to the practitioners about, but there was about five or six major profiles that are used within the arena, whether it's used in private practice from OTs SLPs to developmental psychologists, to even at the school level five or six major ones. And I've worked with families internationally and they're commonly used throughout the world.

So I think there's been a consensus that we've all worked from for the last 30, 40 years on what are these developmental steps that happen in the area of sensory development of a child, in the area of motor development of a child, cognitive expectations of a child, emotional and social development. And so all of these aspects, and I literally have one of them right here.

That is just a little cool little thing coming from the group called the DAYC snd this is a great way, again, to look at this and say, okay, what are the communication skills of a child throughout that first 24, 36 months of life?

So this is definitely I think, a big slap in the face for most of us that have dedicated our lives to this work to say, okay, here are these very finite points of development that we can look at that we've all agreed upon for a better part of 30, 40 years and we've modified it over time, but these modifications will lead to children, the delay of diagnosis, in our opinion, in that we will look at and say that, Hey, we could actually look at zero to three months and zero to six months, and really begin to know, is there a potential for developmental immaturity, but if parents are being told, well, no, no, that's okay. This is now pushed off to six months or nine months or 12 months. We're going to see an explosion and more developmental disorders.

12:05 Tara Hunkin:

Yeah. I think, I think that's the most alarming part of it.

And I understand the more definitive saying yep, for sure, you've got a problem there. If they're at the 75{4537a52abafa24f75931b694e3f6d1d9b0beb5896e18e49b3141987b78b41d96} of them, have met it at a later milestone. But as I think, you know and I know is that just because we delayed milestones are a problem too, and, you know from the practice and the work that you do when kids aren't meeting them at what were the earlier milestones that we had set, you typically are seeing the early signs of a delay that will kind of cascade over time.

12:42 Dr. Peter Scire:
Yeah. And I think that's the biggest worry. The biggest worry is the fact that if we don't cope, catch this delay immediately, what are the long-term effects? And especially when we're relating it back to these primitive reflexes, okay. If these primitive reflexes are allowed to these developmental steps and not to complicate it, but it's just these automated steps that the central nervous system goes through that allow us to go from a fetal position developmentally to more of a upright position and integrates our eyes, it's integrating our inner ear, our vestibular system.

With our body or appropriate receptive awareness if we kind of keep it on a general term, but that's really what the majority of these reflexes allows us to do is allow us to integrate three major parts of our neurology, our visual centers, our visual system, our auditory system, combining that with our proprioceptive system. And so when we look at these reflexes and if these reflexes are allowed to stick around for longer periods of time, or we're not doing a reflex evaluation on a child, and we're not determining that these reflexes are delayed or present, then yeah, we're going to miss these subtle signs in neurology. And I think the big thing for parents to understand is that these small developmental differences that can happen magnify at a greater date.

And for someone who's evaluated children from birth all the way up to their latter part of their adolescence and into adulthood, it's significant. And it's significant when we look at a developmental milestone at six months, what it might look like, even18 months later. And so these are things that are important for us to realize that we cannot mitigate or minimize the idea of these delays more than anything.

14:46 Tara Hunkin:
So, Yeah. So let's talk about a few of them in particular. And I just, before I do that, I just want to mention that for anybody that's interested in actually looking at what the CDC has said, there are links in the show notes directly to what they've said also to the journal article that is what was published in the journal of pediatrics as to how they determine these change milestones.

So you can read and judge for yourself in terms of whether or not that was the way they went about doing this made a lot of sense. We also have in those links as well, a link to the primitive reflex cheat sheet, that if you aren't as familiar with primitive reflexes, as some people are just so that you can get caught up in some of these terms, but I want to get into some of the milestones that they've moved or removed or changed. I think the biggest one that surprised pretty much everyone was when they removed altogether the milestone of crawling. Can you explain why this is a very big deal and what the implications of a child not crawling are to their further neurodevelopment?

16:08 Dr. Peter Scire:
Sure. Well, we're crawling and creeping again, the idea of lateralization in the brain, the idea of that we developed a sophisticated, asymmetry of brain. It's what makes humans so unique is the relationship of our hemispheres and the differentiation and the lateralization and specialization of the left hemisphere versus the right hemisphere. All that is built on this early development of the brain, going through these very specific motor functions and crawling, and creeping was one of those, okay. The ability of our brain to start developing that integration that begins to exist between these two hemispheres.

And one of the things that we looked at early on for many years was the idea that if a child had a delayed crawl, or they skipped the whole crawling development, or anything is if we watched their crawls and they had have normal crawls. I mean, I have thousands of historical histories on children that I've evaluated where one of the hallmarks of that was very evident to see was the fact that that many of the children would have these at different average seats in their crawling mechanisms or they would skip it entirely. Okay. And then you look at them and say, okay, well now they got language delays, or they have these cognitive deficiencies that are showing up.

So the crawling and creeping aspect is a maturation of the brain shutting down certain reflexes that, that occurred at that time, that occur between, let's say six months and nine months and 12 months, because we go from that early relationship of these permanent reflexes that exists between, let's say zero to 12 months. And then in the upper part of like nine to 12, 15 months, we're developing more sophisticated postural reflex that allow, again, this idea of this integration that exists between your proprioceptive system, your muscles and your joints, and your ligaments hardwired into your vestibular system, which is allowing you to know where you are in space and time, and then your visual system, okay.

Looking at the development of how your eyes are tracking and moving to the environment. And then once your eyes arrive to what they're looking at, the processing of that. So when we do a complex movement like creeping and crawling, it allows for that integration of those areas. And again, the idea that we were able to see so many kids that had various developmental diagnosis when you went back and looked at that sign. And even for patients that would bring me there or parents that would bring me their child when they were 15 or 18 years older or 20, some odd years old. And we have a developmental neurology history form that we have families fill out.

It was always fascinating when you looked at the fact that there was very clear milestones, that they missed in that first 12 months of life to 24 months of life, then you go, huh. And then parents would go, okay, well, yeah, by the time our child was two, two and a half, three, we saw dramatic developmental delays.

19:45 Tara Hunkin:
Yeah. And I think that's what for people that aren't as familiar, they don't realize that these motor skills, or in this case, it's an integration of both the motor skills and obviously the vestibular and the ocular system all together, that that impacts higher function in the long-term. And that's the part that I think a lot of people will like, they just think of, well, my child doesn't crawl, but they walk early, they're advanced. But the impact of that is it's not that it's not that transparent.

20:20 Dr. Peter Scire:
Well, yeah. And I think it's really important that everyone understands that the brain is an organ that is dependent upon sensory input at birth. Okay. Or even in the womb, the idea that the brain receives its sensory bombardment from the visual system. Okay. The auditory system, the vestibular system, the nerve, the cranial nerve that's coming from the inner ear is carrying two important parts. It's carrying auditory input and vestibular input. Okay. Then you have your sense of smell, your sense of taste. Okay.

Combine that with then your muscle system. Okay. So your brain is firing, your sensory system is getting stimulated by the environment, okay. Through these systems then transmit input into the brainstem and input into the upper parts of the brain called your midbrain. And then from there, these sensory inputs hit our relay center in our brain called our thalamus.

And then our thalamus, and all these little hubs in them, these little nuclei, we called them. And from there, they then send that information to very specific regions of the brain. Now here's the trick. The trick is that those particular areas that we may hear about like the frontal lobe or the parietal lobe, or the temporal lobe, or the occipital lobe, the four major lobes of the brain, they do not develop unless there are sensory drive to those areas. Okay. Those areas don't develop that very specific lateralization that very specific specialization that we have as humans, if we don't sensory drive. So that's the problem here.

The problem is that we won't receive that sensory input, the child creeping and crawling on their arms and learning how to create that cross lateral aspect. We're probably going to see very dramatic delays in the differentiation of the hemispheres. Okay. Cause what happens developmentally is that the brain has to go through these stages of where we sensory drive the brain. We activate these pathways. They go up into the higher centers of the brain and you have the right frontal loop, right parietal lobe, the right occipital lobe, the right temporal lobe, but then you have it on the left side of the brain.

And so they're firing independently. The two hemispheres are firing very independently for the first several years of life. And then as we begin to move developmentally and get more complex, we start getting our networks to link up between the two hemispheres and we get this bias of our brain. And so that's what's not going to happen. This is that if we don't allow for this normal sensory motor development trajectory to happen, that we've seen now for many, many decades, we won't see this complexity of functionality happen in my opinion. So

23:41 Tara Hunkin:
Yeah, no, I know it is to understand that better. So a couple of the other things that changes. So walking now moved to 18 months, what do you see is the problem with waiting to see if the child walks till 18 months?

24:00 Dr. Peter Scire:
Again so now we're looking at another window of a six month to eight month window. I mean, again, the idea that a child could have been able to start maybe walking, depending on the whole aspect of walking was looking at when did that creeping and crawling phase happen. Okay. And some children, it happened maybe around that, that 7, 8, 9 month of life. And then from nine to 12 months of life walking became more of a milestone.

For the most part we never, yeah. We always looked at delayed walking, maybe around 13, 14 months of life. Okay. But now to go a year and a half, yeah. Again, it's going to allow us to miss some key milestones that are happening in those moments. And for me, it always goes back to where if a parent has now said, okay, well, my child is, well it's okay. My child's not walking by 18 months, but where they've gone to their practitioners and been able to catch some of the other milestones that were missing. Okay.

Cause they're looking at the big milestone because most people are looking at that really big milestone, which is the walking milestone then combined with the language milestone. Okay. So those have been the two most milestones, unless there was just such a glaring delay that a parent would pick up. Maybe like my child's not making eye contact or my child's not babbling, but unless there was some really true, big evident one, most people are like, okay, well, once I went for my first wellness checkup or whatever, I really don't go back that often as much as I would normally do. And so yeah, I mean, I think that's a big thing, because again, when you look at the fact that what helps drive the lateralization of the human brain is bipedalism.

Okay. Dr. Melillo written textbooks on this. Okay. The idea that what allows the human brain to create this specificity that we see in the hemispheres is the idea of walking and then once we're upright, what the complexity of our motor system at that point. So yeah. That's definitely going to lead to again, the fact that we're going to miss many of these development delays.

26:22 Tara Hunkin:
Yeah Actually, it's really good point when you get rid of the, you skip the crawling creeping crawling milestone altogether, and you push back the walking milestone. There's you're right. There's a huge gap, the red flags, because they think it it's okay for it to not happen by then and there's so much that could be done. And then the beauty of it is as I know you know and again, I have also linked to the response from the speech language pathologists. We're gonna talk about the change in the speech milestones in a moment, but they also have a link on their website to all the evidence and about early intervention. So how important that early intervention is and getting that done because they were pretty taken aback as well.

So let's talk about that. The change in the speech milestones, because as you mentioned, that's really the other one that we're always looking for as parents. So the CDC suggested that has now moved the child speaking 50 words, which used to be at 24 months, they moved it to 30 months. And so that's a huge, huge jump. But at the same time, they've left the milestone of speaking two word phrases to 24 months. And what the speech language pathologists has been pointing out is that in order to speak two word phrases, typically children need to be ha speaking 50 to 60 words. So it's not really congruent with reality in terms of how these things play out clinically. So what are your thoughts on the speech milestones and what are the things earlier that really drives speech development?

28:18 Dr. Peter Scire:
Sure. Well, I mean, first, I mean, just as I was pointing out earlier about our little cheat sheet we have here, but 18 to 24 months, it was expected that 50 words, okay. The child says 50 words, but then really more than anything, the child actually understands over almost 300 words. Okay. And this information has gone back for many years and a child should be able to, like you said, combine two word phrases, use commands such as move possessives like mine or reacts, have reactive words.

So, yeah. I think that what you're going to see here is once again, that we're going to look at a milestone at the parents and I go, well, that's okay, they're within that normative range of what everybody's saying. Okay. This is okay. But in reality, when we don't have verbal development of the brain, okay. Verbal language in the brain, we have to begin to look at what was happening in the non-verbal aspect of the brain. Okay. Because though we speak as humans, much of how we truly communicate is in the nonverbal language.

So did we miss signs developmentally because we weren't looking at some of these other developmental delays to say, okay, well, we have a language delay in nonverbal communication. Because especially in the world of where we think a child may be on the autism spectrum. Okay. Cause really what makes autism so unique is that all the cases of autism is really divided by the nonverbal communication problem.

Most people probably think of autism and say, okay, well, child isn't speaking, but actually in autism, majority of autistic children or adults actually speak and they speak very well. They actually have what we call hyperlexia. They develop a very sophisticated verbal language early on. So I think that that's another sign is that, are we looking for the non-verbal language piece? Okay. Are we looking for the idea that the child is making eye contact? Are they responding to nonverbal gestures of eye contact or facial expressions, or are they making them facial expressions on their own?

So these are things that go back into that early onset of development from the zero to the nine month window of saying, okay, well, I'm seeing signs. Because if I saw those signs then, then yeah, there's a great idea that there would be a delay in say 12 months or 16 months or 18 months or 24 months. But why wait? Why wait for that moment to go, okay, well now it's 24 months old and my child doesn't have 50 words, but I'm okay.

31:20 Tara Hunkin:
Yeah, yeah. It is amazing to me as a parent of a child that had a significant speech delay and at 24 months is when we really, we knew previous to that, but the red flags started to, and I am very grateful for that because, and the speech language pathologists that we worked with early on, even though we were going through different public services, she just, I just asked, if it was your child, what would you do? And she's like, you don't wait. You just don't wait. There's so much you can do early on that will make it easier for your child as well, because when they have an expressive delay, like you said, a lot of it's also about what they understand.

So they can have an expressive delay, but not be delayed in terms of their comprehension. Like they completely understand everything you're saying to them, but they can't express themselves and it's incredibly frustrating to them when they're there like that as well. So it is a little well, more than a little disconcerting that parents may get the impression they're supposed to wait. Now, to be clear, I have read all the different reactions and of course the CDC has responded to the speech language pathologist and everybody's gone back and forth because there was so much upset about it. They're saying that they're not telling people to wait and they don't have to wait and to get services.

The problem is that the communication people say, the CDC says, these are the milestones. Most parents are going to interpret it as there's nothing to worry about unless they don't hit them, the new standard for the milestone. So I think that's what's so disheartening right now, when at a time when we are seeing an increasing rate in all types of neural developmental challenges, I don't think this is going to help us much at all.

33:15 Dr. Peter Scire:
And what's fascinating to me, it always reminds me of when we're looking at like blood labs and we normalize a blood lab. Okay. Everybody thinks that these, that there is these normal lab numbers and the reality, a lot of these lab numbers are based on population norms.

And so as populations throughout the world have gotten actually sicker, we've changed the criteria of labs based on non population norms, as opposed to what is actually truly a functional norm or a developmental norm. And I think that that's coming from the, some of my education being in the functional medicine world is this kind of really looks at it from that angle where, okay, how I may interpret blood glucose from my perspective, in a functional relationship versus a lab relationship.

And I think that that's an important thing here is that when we look at the brain again, what's key. We can expand on these topics, but for the purpose of this conversation right now is let's just keep it very simple in that the brain is a sensory organ. The brain is going to receive this sensory input from their senses, drive that into the lower structures of the brain. What I mean by that is being the brainstem and then the little brain being the cerebellum.

And from there, these particular parts of the brain are then going to then start forming the connections into the midbrain. And then the midbrain is then going to start forming the connections into the higher part of the brain called the cerebral cortex, where the lobes of the brain live. Okay. And what we're looking at from a developmental level is to say, okay, are we getting that sensory drive into the brain?

Because if we are, great, and then we should see the corresponding motor relationships that happen. Okay. And what we've known for many years now is that these motor developmental steps happen at these key junctures, but if for some odd reason, the child's sensory system wasn't developing well, one of the hallmarks to be able to see that would be the inadequacy or the deficit within the motor system.

Okay. Because for especially an infant and especially for a child that isn't speaking over, let's say over that first, the 16, 18 months of life, the best way to assess the child is through their motor responses of their neurology. Okay. Do they have a retained Babinski reflex when we stroke their foot? Do they have a retained rooting reflex when we stroke their mouth? Do they have a retained ATNR reflex? These primitive reflexes, if they're there, then we know that there is immaturity in the brain and that the brain is not going through this normal stair-stepping response that happens.

So, yeah, this is going to be a thing I think we're going to have to overcome as a group of practitioners and parents to make sure that we're constantly saying, no, we're going to get these evaluations done at these very key junctures and look at this information.

36:42 Tara Hunkin:
Yeah. And I think one of the keys here for the parents that are here is that you have to go with your gut. No one knows your child better than you and if you are worried, it is worth pushing through because even if you do early intervention and they didn't need it, it's still going to benefit them, it's not going to hurt them, but it's very likely that if you think there's something that's off, you're accurate in your assessment of your child.

What we're really fortunate about is we are going to dive into this topic even further. Dr. Scire has agreed to do an expert masterclass. It's called Milestones Matter: How Developmental Milestones from Birth to Three Years Old Influence Brain Development and What You Can Do When a Milestone is Missed, Skipped or Delayed. The masterclass is going to go live for free.

So you can sign up for free. It'll be Wednesday, September 21 at noon eastern. There'll be a link in the show notes to this episode, so you can sign up there. During the masterclass, you're going to learn what are the developmental milestones and how they provide insight into understanding what treatments and therapies are right for your child, how miss skipped or delayed developmental milestones impact the neural development of the two hemispheres of your child's brain and how this explains their symptoms.

What tools are commonly used to assess your child's neurodevelopment and how they translate into what your next steps are to help your child and why functional medicine and nutritional interventions on their own will often lead to temporary improvements and how combining them with neuro rehab is essential for long-term success.

So I am very excited about doing that and you sign up and join us live at that event,

you'll be able to also ask questions of Dr. Scire. So come with your questions in hand. It'll be held on zoom so you can join us for that. And again, I want to thank you for doing this with us today and coming back to do that masterclass. This information is so incredibly important and near and dear to my heart. So I really appreciate all the time and energy that you've given to us here today and in a little bit, we'll be joining you again!

39:11 Dr. Peter Scire:
Thank you so much.

39:13 Tara Hunkin:
And so if you're interested in that masterclass, make sure that you check out the link in the show notes, and I look forward to seeing you all there. Bye for now.

So that's a wrap. Thanks for joining me this week on My Child Will Thrive. I'm so passionate about giving you the tools and information you need to help your child recover. And as they say, it takes a village, so join us in the My Child Will Thrive village Facebook group, where you can meet like-minded parents and stay up to date on everything we have going on at My Child Will Thrive. This is Tara Hunkin, and I'll catch you on the next podcast or over at mychildwillthrive.com.

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