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Healthy Growth & Development - School Age

Developmental Milestones

As children grow, we expect them to learn new things at various ages. For example, by 18 months of age, a child is usually able to say five or more words clearly. This is called a "developmental milestone".

One very simple way to check that your child is meeting his or her developmental milestones is by using a series of questionnaires called "Nipissing District Developmental Screen" or "Nipissing Screen" for short.

The Nipissing Screen set of checklists is easy to use. It looks at 13 key developmental stages between infancy and six years of age.

The stages are: one and two months, four months, six months, nine months, 12 months, 15 months, 18 months, two years, 30 months, three years, four years, five years and six years.

The Screen explores a child's skills in the following areas:

Vision Hearing Speech Language Communication

Gross Motor Fine Motor Cognitive Social/Emotional Self-Help

A parent simply answers Yes or No to questions about their child's abilities at a certain age.

The Nipissing Screen is available in English, French, Spanish, Chinese and Vietnamese. It is free of charge at Nipissing District Developmental Screen. If your child has not developed certain skills by the typical age, talk to your doctor or public health nurse.

At Child Health Fairs held in communities throughout Waterloo Region, families can meet with an early child development professional to check their child's progress in areas of learning, social, emotional, language and muscle development.

The Nipissing Screens also have a list of activities that parents and caregivers can do with their children that are appropriate for the age of their child.

School Age 4 - 9 Years

Region of Waterloo Public Health distributes Nipissing Screens to parents at different ages. For school-age children, Region of Waterloo Public Health partnered with the Public and Catholic School Boards to hand out Nipissing Screens to parents at the following times:

• Four-year Nipissing Screen: at JK Parent-Teacher interviews in November.
• Five-year Nipissing Screen: at SK Parent-Teacher interviews in November.
• Six-year Nipissing Screen: at Grade 1 Parent-Teacher interviews in November.

If a parent puts two or more check marks in the "No" column on the Nipissing Screen, he or she is asked to speak to their doctor or call the Healthy Children Info Line, 519-883-2245, to speak to a Public Health Nurse.

Speech, Vision and Hearing

Vision and hearing play a vital role in your child's development. Speech and language difficulties can affect social and emotional development. The Ministry of Health stresses the importance of identifying problems early (before three years of age).

Public Health distributes the Nipissing District Developmental Screens in a mail out to your home when your child turns 18 months and when your child registers for school between the ages of three and six years.

If you would like to receive an age appropriate screen to assess your child's development for vision, hearing and speech and language, contact the Healthy Children Info Line at 519-883-2245

For further information on your child's vision, hearing or speech and language development, contact your family physician or contact a professional agency listed below.

Ontario's Preschool Speech and Language Program

Communication Milestones

Services in Waterloo Region

Vision
University of Waterloo - School of Optometry Paediatric and Special Needs Clinic (Off Columbia Street West, Waterloo) 519-888-4062 or any Optometrist listed in the yellow pages.

Hearing
Canadian Hearing Society 120 Ottawa Street North, Suite 200, Kitchener 519-744-6811
Audiology Services 255 King Street North, Suite 201, Waterloo 519-746-6940
Cambridge Audiology Services 697 Coronation Blvd., Suite #2, Cambridge 519-624-2230
Grand River Hospital - Freeport Health Centre Audiology Department 3570 King Street East, Kitchener 519-749-4300 ext. 7233

Speech / Language
KidsAbility 500 Hallmark Drive, Waterloo 519-886-8886 ext. 214

Physical Growth

A child's growth depends on:

• Family Traits (parents' heights and weights, cultural background)
• Environment
• Nutrition

Children need to eat a variety of healthy foods and to be physically active to grow properly. For more information on nutrition for school aged children visit our Feeding Your School Age Child page.

Four to Nine Years

• Every child grows at a rate that is normal for them.
• Your child will grow taller and should gain weight gradually, but steadily during these years.
• Boys and girls grow at about the same rate during this time.
• Girls may be a little heavier than boys.
• Boys tend to have more muscle; girls tend to have more fat.

How Do I Know If My Child Is Growing Normally?

• Children grow at different rates.
• You and/or your health care provider may keep track of your child's growth by taking the following measurements:  
  • Height 
  • Weight
• Measurements should be plotted on a growth chart to see your child's growth pattern.
• Your health care provider can help you decide if your child's growth pattern is normal for your child.  Don't forget that many factors influence your child's growth and need to be considered, such as family background, how well your child eats and the physical activity level of your child.  

Growth over time is more important than a single measurement.

The resource Is my child growing well? - Questions and Answers for Parents is available in English, French, Spanish, Punjabi, Chinese and Vietnamese at the Dietitians of Canada website.

Growth Charts

If you have any questions about your child's growth, check the information on the Growth Charts page.

More Information

For more information and to speak to a Public Health Nurse, please call the Healthy Children Info Line at 519-883-2245.