#21:Decoding Developmental Milestones with Dr. Sana Smriti | Ananya CDC

1. Introduction

📍 Think back to your childhood—those moments of joy, discovery, and belonging. Now, imagine that experience being different, that the world feels overwhelming, confusing, even hostile at times. That's the reality for many children on the autism spectrum. But what if, instead of focusing on what's "missing," we shifted our perspective to see the unique strengths, the hidden potential within each child? What if we embraced those differences as pathways to new possibilities?

Welcome to the Ananya Child Development Center podcast. I'm Madhavi Adimulam, your host, and today we're embarking on a journey of transformation. Joining me is Dr. Sana Smriti, a developmental pediatrician with over a decade of experience helping children in Hyderabad reach their full potential.

Dr. Sana, welcome to the podcast. We're so glad to have you here.

Dr. Sana Smriti: Thank you so much for having me here today, Madhavi, and for the wonderful introduction. It's my pleasure to be a part of this podcast.

2. A Developmental Pediatrician’s Journey: Beyond the Textbook

Madhavi Adimulam: Dr. Sana, your bio is incredibly impressive. You've trained at some of the most prestigious institutions in India, including Gandhi Medical College and Kasturba Medical College, and you've honed your expertise in neurodevelopmental and behavioral pediatrics through a fellowship at Ummeed Child Development Center, Mumbai.

And for the past two years, you've also been running your own clinic, Oyster CDC, which incorporates family-centered practices and uses eclectic, evidence-based approaches to therapy. That's a remarkable path. Can you tell us about those years of training? What were some of the most valuable lessons you learned—the things that textbooks couldn’t teach you—that have shaped your approach to working with children and families?

Dr. Sana Smriti: One of the most humbling experiences during my training was meeting so many diverse families. Each family had its own unique story, its own cultural influences, and its own way of understanding and supporting their child. It was an incredible learning experience, and it taught me that child development isn’t just about those standard milestones we read about in textbooks.

I realized that parents are often incredibly intuitive. They know their children best, and they have a deep understanding of their needs, even when they don’t have a formal background in child development.

Madhavi Adimulam: That’s so true. Parents are often the first to notice subtle changes in their child’s development.

Dr. Sana Smriti: Yes, they are. And that’s why it’s so important for us, as professionals, to listen to parents, to value their insights, and to work in partnership with them.

Madhavi Adimulam: What were some of the "aha" moments you experienced during your training that really shifted your perspective on child development? Were there any specific experiences that changed the way you approach working with families?

Dr. Sana Smriti: I learned so much about the power of observation and the importance of responding to a child’s cues. I was trained to teach parents how to respond effectively to their children, but I often saw how parents were already doing this instinctively. They knew how to soothe, comfort, and engage their child in ways that felt natural and intuitive.

There were times when simply waiting, observing, and following the child's lead was more powerful than trying to direct or control their behavior. I learned that sometimes, the most effective intervention is simply being present and responsive.

Madhavi Adimulam: So, you’re saying that sometimes it’s about stepping back and letting the child lead the way?

Dr. Sana Smriti: Exactly. It’s about creating space for the child to explore, to experiment, and to communicate their needs in their own way.

And sometimes, the most profound connections happen when we simply observe, listen, and respond authentically, even if a child's behavior or communication seems unconventional or out of context.

Madhavi Adimulam: It’s about meeting the child where they are. Now, you’ve talked about the importance of observation, but parents often turn to developmental milestones as a way to gauge their child's progress.

3. Decoding Developmental Milestones: Beyond the Charts

Madhavi Adimulam: Parents often rely on charts and checklists to track their child's development, but those charts can sometimes be more anxiety-inducing than helpful. What are some of the common misconceptions about developmental milestones that you encounter in your practice? What do you wish more parents understood about the variability of development?

Dr. Sana Smriti: I think those charts and checklists have their place, but they can also create unnecessary anxiety for parents. They often forget that development is not a linear process. It's not about checking boxes on a chart. Every child develops at their own pace, and there’s a wide range of what’s considered "typical."

We see a lot of parents worried about things like tripod grasp or letter reversals, even in very young children. They might panic if their child isn’t walking by 12 months or speaking in full sentences by two years. But these are just averages. There's a wide range of variability, and it’s important to consider the child's individual circumstances, their temperament, and the opportunities they’ve had to develop certain skills.

For example, a child who is more socially engaged might start talking earlier, even if their fine motor skills are developing at a slower pace. Or a child who’s had limited opportunities for outdoor play might take longer to reach gross motor milestones like walking or jumping.

The key is to look at the overall picture, to observe the child's progress over time, and to trust your instincts as a parent. If you have concerns, don’t hesitate to seek professional guidance. But don’t let those checklists become a source of stress or comparison.

Madhavi Adimulam: That's a very important point. Sometimes, those checklists can make parents feel like they're failing or that their child is falling behind. But it's not a race.

Dr. Sana Smriti: Exactly! It’s a journey, and every child takes their own path.

Madhavi Adimulam: Now, at Ananya, we often observe a child's behavior during the assessment, and sometimes there’s a discrepancy between what we see and what the parent tells us. For example, a parent might say that their child can dress themselves independently, but during the assessment, we see that they need help. It’s important for parents to be honest and transparent during the assessment process.

Dr. Sana Smriti: I agree. It's also essential to remember that a single assessment only provides a snapshot of a child's abilities at that specific moment in time. A child might have a “bad day” or might not feel comfortable in the assessment environment. That’s why it’s important to observe the child over time, in different settings, and to gather information from multiple sources – parents, teachers, and other caregivers.

Madhavi Adimulam: So, it’s not about labeling a child based on a single assessment but about gaining a holistic understanding of their strengths and challenges.

Dr. Sana Smriti: Exactly! And we need to be sensitive to the emotional impact of a diagnosis on both the child and the family. It’s about providing support and guidance, not just labels.

Madhavi Adimulam: You’ve touched on a really important ethical dimension of your work, Dr. Sana. It’s a reminder that diagnoses are not just words on paper; they have real-life consequences for families. That’s why it’s so crucial for parents in Hyderabad to consult with highly trained and compassionate professionals like yourself. Now, given your expertise in recognizing subtle signs of developmental challenges, let’s delve a bit deeper into those early indicators.