Health Manager Orientation Guide

Social and Emotional Developmental Milestones

Looking over the shoulder of a woman showing a wooden spool to a toddler.

Developmental milestones related to social and emotional development and behavior are inherently relevant to mental health. Some examples of these milestones are:

  • Social smiling, like when they see a loved one
  • Showing interest in others
  • Identifying familiar and unfamiliar adults
  • Pointing to show interest
  • Taking turns
  • Showing empathy
  • Playing with friends

Motor and language milestones are also important to monitor to support identification of neurodevelopmental differences that can impact social and emotional development and learning.

The American Academy of Pediatrics, in partnership with the Centers for Disease Control and Prevention, provide social and emotional milestones from birth to 5 years. Helpful information on developmental milestones is also available in the Head Start Early Learning Outcomes Framework (ELOF). It’s important to have all staff become familiar with developmental milestones for the age group in their care so they can recognize typical behavior and help promote growth and resilience. If staff are not familiar with the social and emotional development milestones, they may misidentify a child as challenging who actually is displaying a developmentally expected behavior. Staff may even fail to identify a child who could benefit from additional developmental services.

For example:

  • A 2-year-old who is doing the opposite of what they have been told to do is behaving in a manner that is typical for this age. Staff would not refer this child for an assessment. Instead, they work with this child in a developmentally appropriate way.
  • A 3-year-old who becomes upset because of a sudden (unavoidable) change in routine and throws a tantrum needs support from staff. Children this age thrive on routine and structure and a sudden change can make them react.

Behavior that can be difficult to handle, such biting or pushing boundaries, is typical for toddlers; however, it still needs to be addressed. Program management should make sure that staff have a basic understanding of these typical behaviors and are supported in managing them appropriately, which in turn supports the child’s overall development. If a child with challenging behavior is not responding to typical developmentally appropriate teaching and redirection, it is often helpful to refer them for a developmental screening or evaluation in your community.

Tips and Strategies for Developmental Milestones Related to Mental Health

  • Make sure to watch for social, emotional, and behavioral milestones as well as physical health and development.
  • Support the development of milestones in formal and informal ways every day by:
    • Acknowledging children’s feelings
    • Modeling what it can look like to express feelings
    • Comforting children when they are upset
    • Offering consistent caregivers and teachers, structure, and routines
  • Decide how you and your management team can make sure staff are familiar with these milestones and can identify the nuances between typical development, typical behaviors that need extra support to address, and behaviors that need mental health assessment and intervention.