Red Flags
A child’s failure to reach certain developmental milestones as expected may be a “red flag”, or warning meaning a developmental problem. If your child does not reach developmental milestones on schedule, it does not necessarily mean there is a problem. But he or she should be evaluated by a health professional.
Early diagnosis and treatment for development delays increases the chances of improvement rather than simply “waiting it out” and treating problems later. Treating communication and languages difficulties early on can prevent potencial problems with behavior, learning, reading, and social interaction.
Speech Therapy
The following “red flags” may indicate your child is at risk for a speech and/or language delay and may benefit from an evaluation. If you have any concerns in these areas or are not sure and would like to know more give us a call.
The following are speech/language red flags for referral:
- Decreased eye contact during interactions
- Decreased/absent response to sounds and voices
- Is not babbling by 9 months
- Does not/can not imitate sounds or simple words by 12 months
- Does not imitate simple gestures/actions by 12 months
- Does not point to/identify familiar objects by 15 months
- Demonstrates any “loss” of language/words.
- Does not use 25 words consistently by 18 months
- Does not/can not imitate words regularly by 18 months
- Continues to use more gestures than words at 18 months
- Less than 100 words by 24 months
- No combinations of words into 2-3 word phrases by 24 months
- Not able to follow directions by 24 months
- Family members understand less than 50% at 24 months
- Is not consistently combining words into short sentences by 30 months
- Family members understand less than 85% at 36 months
- Unfamiliar listeners have difficulty understanding child at 42+ months
- Difficulty engaging with peers in pretend/imaginative play at 3-4 years
- Does not develop more complex grammatical concepts between 3-5 years
Occupational Therapy
THE FOLLOWING ARE OCCUPATIONAL THERAPY RED FLAGS FOR REFERRAL:
Delayed Fine Motor Skills (skills requiring use of small muscles in the hand) – has difficulty playing with age-appropriate toys with multiple or small pieces; may have poor handwriting; may have difficulty self-feeding with a utensil; has poor eye-hand coordination
Delayed Gross Motor Skills (skills requiring large-muscle coordination) – is delayed, or has skipped developmental milestones, such as rolling, sitting, crawling, walking, running, jumping, or climbing stairs; has decreased balance (trips easily or is unable to stand on one foot); has difficulty catching or kicking a ball
Lack of Attention – has difficulty maintaining attention in class or to a conversation; is fidgety or has difficulty staying seated for any length of time; has difficulty remembering things mentioned to him/her
Hyperactivity – is impulsive and always seems to be in “turbo speed”; difficulty keeping hands off of nearby people and things (impulsive)
Visual Scanning Problems – has difficulty reading a line of text without skipping to another line; has difficulty copying information from the board at school; slow to find hidden objects in a picture or words in a word search
Visual Scanning Problems – has difficulty reading a line of text without skipping to another line; has difficulty copying information from the board at school; slow to find hidden objects in a picture or words in a word search
Visual-Perception Problems – has difficulty judging spatial distances between self and objects; may not take note of details or distinguishing features of an object; has difficulty with puzzles or copying shape designs
Sensory Concerns – seems to be somewhat excessive in the response (responds too much or too little) to sounds, movement, heights, touching and being touched, types of clothing, food textures, etc (could strongly desire the input or resist it); difficulty following multiple-step instructions
Poor Body Awareness – may be seen as “clumsy”; may run into things often or break things; may appear disheveled with shoes untied, clothing not adjusted properly, food on face or shirt, etc.
Feeding problems – difficulty chewing or swallowing; holds food in cheeks; picky or messy eater; has poor postural control and/or difficulty holding and using eating utensils
Delayed Self-care Skills – has difficulty with age-appropriate dressing, feeding, personal hygiene, or toileting
Poor Social Skills – difficulty making or keeping friends, poor play skills or sportsmanship, aggressive, low frustration tolerance, low self-esteem, has difficulty reading social cues or others’ body language
The following “red flags” may indicate your child is at risk for a fine and/or gross motor delay and may benefit from an occupational therapy evaluation. If you have any concerns in these areas or are not sure and would like to know more give us a call.
Autism Spectrum Disorder
The following “red flags” may indicate your child is at risk for an autism spectrum disorder. If your child exhibits any of the following, please don’t delay in asking your pediatrician or family doctor for an evaluation:
- A person with ASD might:
- Not respond to their name by 12 months of age
- Not point at objects to show interest (point at an airplane flying over) by 14 months
- Not play "pretend" games (pretend to "feed" a doll) by 18 months
- Avoid eye contact and want to be alone
- Have trouble understanding other people's feelings or talking about their own feelings
- Have delayed speech and language skills
- Repeat words or phrases over and over (echolalia)
- Give unrelated answers to questions
- Get upset by minor changes
- Have obsessive interests
- Flap their hands, rock their body, or spin in circles
- Have unusual reactions to the way things sound, smell, taste, look, or feel