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Development

Expert Q&A:
Is something wrong with my child if she is six months behind her peers?

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Suzanne Dixon
Answered by Suzanne Dixon M.D., M.P.H.
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"There is nothing so amazing as the development of a child," says Suzanne Dixon, M.D., a behavioral and developmental pediatrician who was one of the founding members of the Pampers Parenting Network. "Every day is a new adventure when you have a child around you. I never get tired of learning from the children who have been a part of my life, professionally and personally."Suzanne Dixon, M.D., M.P.H., was born and raised in Minnesota and graduated from the University of Minnesota, School of Medicine. She did her pediatric training at Massachusetts General Hospital in Boston and then completed a fellowship in Child Development at Boston's Children's Hospital. Dr. Dixon joined the faculty at the University of California, San Diego, and did patient care, teaching, and research for 20 years. She ran a large newborn service, performed research in early child development, and was involved in many community outreach activities in maternal child health. Throughout her entire professional life she has maintained an interest in cross-cultural activities, living and working in many parts of the world, including Mexico, India, Kenya, Indonesia, and several countries from the former U.S.S.R. Dr. Dixon is the author of numerous research articles, review articles, and textbook chapters in pediatrics, child and family development, and public health. Her textbook, written with Dr. Martin Stein, Encounters With Children: Pediatric Behavior and Development, has become a classic in child health education and is in its fourth edition. She is Editor in Chief of the Journal of Developmental and Behavioral Pediatrics, an international journal of high standing in the professional world. She also has served as an associate editor for Infant Mental Health and currently reviews for several major pediatric journals. Dr. Dixon is a fellow of the American Academy of Pediatrics and served in national positions in that organization. She is a member of the Society for Pediatric Research, the Society for Research in Child Development, the American Public Health Association, and the Executive Council of the Society for Developmental and Behavioral Pediatrics. She serves as consultant to several national and international organizations and has received an award from Healthy Mothers, Healthy Babies.Dr. Dixon continues to lecture and consult worldwide on aspects of maternal, child, and family health. She practices behavioral and developmental pediatrics in Montana and works with local advocacy groups on education and women''s health. Dr. Dixon has been married for over 30 years and has three sons. She and her husband travel frequently, are outdoor enthusiasts, and enjoy being amateur anthropologists.
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Question


My child is now 18 months old. She was born about a month early, but I have never been instructed to see her as a "preemie." She was five pounds at birth. But she seems to be about six months behind all her counterparts. I run a home day care and have really given her a wide berth and freedom to learn on her own. Should I have been more hands-on? Is something wrong? What can I do to help her be more interactive and responsive? I'm so worried I've messed her up.

Answer


I'm quite sure you have not "messed up" your daughter. Children are designed to reach out and learn in a safe environment; they're largely self-propelled if given learning opportunities. But I value your observation that she is behind on development. It's time for her 18-month health supervision visit: Call ahead and tell the office that you are concerned about developmental delay, so the staff can schedule enough time to address this concern. Go to the Well Baby area of this site at the 1-year and 18-month Health Care sections and look under What to Expect and Speak Up. Identify things that your daughter is doing or not doing and bring that list with you for the visit. If she is behind, an early intervention program in your area should be able to point out ways to help your daughter develop without pushing her too much. When looking at development in preemies, we generally correct for the amount of prematurity. We would expect her development to be at about 17 months if she was one month early. We can't explain a six-month delay due to her early birth alone. That's why I suggest that you get a good look at this. You've identified this concern early and that's important to getting things back on track.
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