From the Guidelines
At a 9-month well-child check, infants should demonstrate specific developmental milestones, including rolling to both sides, sitting without support, and demonstrating motor symmetry, as recommended by the American Academy of Pediatrics 1.
Developmental Milestones
Key developmental milestones at 9 months include:
- Gross motor skills: rolling over, sitting without support, pulling to stand, and crawling or using alternative methods of mobility
- Fine motor skills: transferring objects between hands, banging objects together, and developing a pincer grasp
- Language and communication: responding to name, understanding "no," and playing interactive games like peek-a-boo
- Social skills: showing stranger anxiety, having favorite toys, and demonstrating emotional attachment to caregivers
Assessment and Screening
Healthcare providers should assess these milestones during the 9-month well-child check, using a standardized developmental screening test, such as the Ages and Stages Questionnaire, as recommended by the American Academy of Family Physicians 1.
Additional Evaluations
If developmental delays are suspected or identified, additional evaluations and referrals should be made, including speech-language evaluation and audiology assessment, as recommended by the American Academy of Pediatrics 1.
Parental Involvement
Parents should be encouraged to read to their child daily, provide opportunities for exploration in a safe environment, and respond consistently to the infant's communication attempts, as these activities support normal development and help identify potential developmental delays early 1.
From the Research
Developmental Milestones at 9 Months
- At 9 months, a well-child check is crucial for assessing a child's development and detecting any potential abnormalities 2
- The American Academy of Pediatrics recommends developmental surveillance at each visit, with formal developmental screening at 9,18, and 30 months 2
- Key developmental milestones at 9 months include:
- Sitting up without support
- Crawling or moving arms and legs to indicate crawling
- Responding to names and familiar words
- Imitating sounds and facial expressions
- Playing with toys and exploring the environment
Immunizations and Safety
- Immunizations should be reviewed and updated as appropriate during the 9-month well-child check 2
- The use of prophylactic acetaminophen or ibuprofen to prevent vaccine-associated adverse reactions is not recommended, except in individuals at high risk for seizures 3
- Combination vaccines, such as DTaP-HepB-IPV, have been shown to be immunogenic and well-tolerated in infants 4, 5
- However, ibuprofen can cause rare but serious side effects, such as hemolytic anemia, in some individuals 6
Additional Recommendations
- Car seats should remain rear-facing until 2 years of age or until the height or weight limit for the seat is reached 2
- Fluoride use, limiting or avoiding juice, and weaning to a cup by 12 months of age may improve dental health 2
- Screen time should be avoided in children younger than 18 months, except for video chatting, and limited to 1 hour per day for children 2-5 years of age 2