The first 0-5 years of a child’s life are crucial to the foundations for who a child will be mentally, emotionally, physically, and socially. While no two children are alike, each child must meet developmental milestones through the ages of 0-5 to ensure optimum quality of life. Each developmental stage builds on the previous stages and informs of subsequent stages.

Meeting developmental milestones can be disrupted by genetics or environmental factors. Because of this it is essential to be aware of age appropriate milestones a child needs to meet, the causes of regression in specific areas, and the services available specific to the child’s needs. Examples of environmental factors that could affect a child’s developmental include:

Prenatal - chemical imbalances in mother’s body during pregnancy due to conditions, toxins or direct trauma to mother or fetus
Physical - exposure to conditions such as household’s financial health or overcrowded living spaces that can lead to injury, abuse or neglect
Socio/Cultural - Norms, values, beliefs / standards of behavior that regulate life in child’s cultural group
Learning - degree and type of stimulation / sensory input available in child’s immediate environment to promote cognitive development
Emotional - nature of interpersonal relationships child has, specifically the emotional bond between parents and parents and parents and child; the degree of nurturance available to the child

Progress towards age-appropriate developmental goals is evidence of typical development. If a child is achieving age-appropriate milestones, it is essential to continue to foster their development with appropriate Early Childhood Education.

Examples of Typical Development for a youth 4-years-old include:

Physical - catches a bounced ball most of the time, pour/ cuts/ smashes own food with supervision
Social/ Emotional - becomes increasingly creative with make-believe play, plays “mom” and “dad,” talks about likes and interests, often can’t tell between what is real and what is make believe
Cognitive - names some colors and some numbers, understands the concept of counting, draws a person with 2 or 4 body parts, remember parts of a story, will tell you what they think will happen next in a story, starts to copy capital letters
Language/ Communication - sings a song or poem from memory, knows basic grammatical rules such as a us of pronouns “he” and “she.”

On the other hand, atypical development or developmental regressions is evidenced by a lag in achieving developmental milestones or if a child achieves developmental milestones ahead of their peers. If a child is showing atypical development, it is crucial for Early Intervention services to be implemented in tandem with Early Childhood Education or Preschool Special Education.

Examples of, Atypical Development (usually developmental delays) in a child who is 4 years old can include:

Physical - can’t jump in place, resists dressing/ sleeping/ using the toilet,
Social/ Emotional - shows no interest in interactive play with others or make-believe
Cognitive - cannot scribble, cannot retell a story, does not follow 3-step commands
Language - speaks unclearly, does not follow basic grammatical rules they for example can not use “me” and “you” correctly

NOTE: If a child lives in a bilingual household, learning 2 languages may also affect their language development, which is why it is important for a professional to confirm whether the developmental delays are genetic or environmental.

How to advocate

As an advocate assigned to a youth ages 0-5, It is crucial to understand what developmental milestones youth in this age range need to meet and be aware pay attention for signs that youth may need additional developmental support. Early intervention can provide supports crucial to successful socio-emotional and academic engagement of a child in care. Your first step in determining whether development focused advocacy is necessary in a newly assigned case is to speak with the child’s care team i.e., their PSW and attorney. During this conversation, it will be essential to ask the following:

Is the child in age-appropriate childcare? Early Education Program? OR - Is the child in the process of enrolling into Preschool, TK, or K?
Does the child have active medical insurance?
Does the child have a Pediatrician?
When was the child’s last visit with their pediatrician?
Are there any developmental concerns?
Has the child received a Developmental and Social and Emotional Screening?

As a reminder, an advocate does not diagnose the child assigned to them. Instead, advocates are to learn how to advocate for age-appropriate services for their youth and help connect youth and caregivers to necessary services to support their developmental needs.

For example, for youth ages 0-5, Early education and Early intervention resources can be sought out based on the youth’s academic needs. In addition, the following are resources in San Francisco that provide additional services:

Children’s Council of San Francisco - Children’s Council is an agency that helps families and their children, and will also connect to other community agencies such as: Wu Yee Children’s Services, Children’s Services – Mission Neighborhood Centers and SFUSD Early Education Department.

If a professional has confirmed developmental needs, the following resources can help provide Early Intervention with the help of the youth’s PSW for a referral:

Finally, you will have a brief yet grand opportunity to learn about your CASA youth’s development alongisde their caregivers and can support them in asking questions when talking to a doctor. Once you have built rapport, you can share this guide with the caregiver to help encourage the appropriate conversations with a doctor.

Appropriate Language

As an advocate, you will find yourself needing to develop a CASA youth relationship but also a CASA-Caregiver relationship as well. To build rapport with your youth’s caregiver, the language you use to discuss child development will be crucial to respect and maintain healthy boundaries.

Conversations about a youth’s development is a sensitive topic, and can be difficult. While a CASA may not be a child development professional it is important as an advocate, to know how to approach the conversation with a caregiver, and team members to ensure that the child’s needs are met and avoid the stigmatizations that may be associated with atypical development. It will be important to be mindful of cultural differences and to be aware of your own cultural biases as an advocate, when making decisions about how to communicate with families.

A few tips to help encourage such conversations are:

Talk about development regularly with caregivers about their child’s development, not only when concerns arise.
Provide resources to caregivers to help track milestones from the comfort of their own home.
- CDC’s Milestone Tracker App
- CDC’s Milestone Checklist
Be an active listener.
- Listen closely.
- Make eye contact.
- Nod when appropriate.
- Repeat the caregivers main points so he/ she will know you heard and understood.
- Consider caregiver’s feelings about what they are sharing.
- Watch and listen closely for cues about the caregivers feelings to acknowledge when you respond.
- Probe for more information when necessary.

Tips for when you have concerns to share:

Highlight the child’s strengths – keeping the conversation positive and highlighting the things the child excels at.
Normalize the conversation – take the time to build meaningful relationships with the caregiver and talk about development regularly. Use a milestone checklist to help your comments remain fact based and not on feelings.
Encourage the caregiver to share any concerns with the child’s doctor – advocates are NOT to diagnose, they are to share any concerns with caregivers and qualified professionals in the child’s life.
Hold the team and caregivers accountable - follow up every few weeks to ensure developmental concerns are addressed.

The following terms that will be important to be aware of and/or use while discussing a child’s development:

Cognitive Development – How children think, explore and figure things out. It is the development of knowledge, skills, problem solving and dispositions, that help children to think about and understand the world around them.

Cognitive Milestones – While every child is unique, children develop in certain predictable ways. These are called developmental milestones. Cognitive milestones help you understand how your child learns, thinks, explores and figures things out.

Communication and Language Development – Communication and language development is about more than talking. It means all the different ways a child understands and communicates, only part of which are spoken words. Some children use sign language or other means of communication.

Communication and Language Milestones – While every child is unique, children develop in certain predictable ways. These are called developmental milestones. Communication and language milestones help you understand how your child is learning how to understand and communicate with others.

Developmental Delay – A developmental delay describes a child not reaching one or more development milestones by an expected time period.

Developmental Milestones – While every child is unique, children develop in certain predictable ways. These are called developmental milestones, or simply milestones. They describe the typical skills that a young child acquires by certain ages in the four areas, or domains, of development: motor (physical), communication and language, cognitive, and social and emotional.

Developmental Screening – A comprehensive review of a child’s development completed by medical providers, public health agencies, Head Start, public schools and other qualified professionals. Often developmental screening is part of a well-child checkup and may be done using parent questionnaires.

Early Intervention – A set of services that are provided to eligible children and their families. These services can include special instruction, physical/occupational/speech therapy, family support and service coordination. Early intervention is also known as Infant and Toddler Intervention or Part C.

Motor Development – Motor development means the physical growth and strengthening of a child’s bones, muscles and ability to move and touch his/her surroundings. A child’s motor development falls into two categories: fine and gross. Fine motor skills refer to small movements in the hands, wrists, fingers, feet, toes, lips and tongue. Gross motors skills involve motor development of muscles that enable babies to hold up their heads, sit and crawl, and eventually walk, run, jump and skip.

Motor Milestones – While every child is unique, children develop in predictable ways. Motor or physical milestones help you understand how your child is learning to control muscles and move his or her body.

Preschool Special Education – Services that are provided by school districts that are designed to enable young children with developmental delays, ages three to five, to be active and successful participants during the early childhood years and in the future in a variety of settings. These services are designed to meet the needs of preschool children who meet state education criteria for developmental delay or disability and are experiencing challenges in their learning and development. Children may be eligible if they have a significant delay in development of their ability to learn, speak or play. Services are individually tailored to meet the unique learning needs of each child.

Social and Emotional Development – Social and emotional development means how children start to understand who they are, what they are feeling and what to expect when interacting with others. It is the development of being able to form and sustain positive relationships; experience, manage and express emotions; and explore and engage with the environment.

Social and Emotional Milestones – While every child is unique, children develop in certain predictable ways. These are called developmental milestones. Social and emotional milestones help you understand how your child is learning about feelings, expressing emotions and forming relationships with others.

Social and Emotional Screening – Social and emotional screening is part of the developmental screening process. It focuses on the early identification of possible delays in the expected development of a child’s ability to express and regulate emotions; form close and secure relationships; and explore his/her environment and learn.

NOTE: Other important terms can be found here.