Developmental Milestones: Cognitive Development

Abstract

1. Timothy Wilks, MD* 2. R. Jason Gerber, MD† 3. Christine Erdie-Lalena, MD§ 1. *LCDR, USN, Medical Corps; Developmental & Behavioral Pediatrics Fellow, Madigan Army Medical Center, Joint Base Lewis-McChord, Wash. 2. †Major, USAF, Medical Corps, Developmental & Behavioral Pediatrics Fellow, Madigan Army Medical Center, Joint Base Lewis-McChord, Wash. 3. §Lt Col, USAF, Medical Corps, Program Director, Developmental & Behavioral Pediatrics Fellowship, Madigan Army Medical Center, Joint Base Lewis-McChord, Wash. After completing this article, readers should be able to: 1. List the foundational aspects of cognitive development. 2. Characterize object permanence, causality, and symbolic thinking. 3. Discuss the steps of problem-solving development. 4. Describe methods of assessing language development. 5. Review language milestones. This is the second in a series of three articles on normal infant and child development. The previous article covered the acquisition of motor milestones. This article focuses on cognitive development. Social-emotional development will be discussed in the final article. Infant and child development relies on significant interdependence of the developmental streams. The infant who is concentrating on gross motor control while sitting is unlikely to be able to explore an object's detail or advance his or her manipulation of objects. The clinician must appreciate the total developmental progression of a child while also understanding the patterns of development expected within individual developmental streams. Such improved understanding of development can assist in the pediatrician's surveillance of a child's progress but will not substitute for a systematic developmental screening program, as outlined in recent American Academy of Pediatrics (AAP) Practice Guidelines. The complete table of developmental milestones is included in the online version of this article for reference (Table 1). The table is printed in the previous article of this series ( Pediatrics in Review . 2010;31:267–277). Cognitive development is the foundation of intelligence. The dictionary defines intelligence as the ability to learn or understand or to deal with new situations. In reality, intelligence is a broad concept that involves multiple factors and is incompletely understood. The best efforts to quantify this concept come through use of standardized intelligence tests that …