Transcript Developmental Red Flags: Birth to 3

August 22, 2011
Jennifer Crookham,
Mental Health & Disabilities Manager
Video
http://youtu.be/KrUNBfyjlBk
Gross Motor Red Flags
 4 months- doesn’t lift head up when on tummy
 Holds head to one side or in one position
 7 months- not rolling over
 8 months- not pushing up on straight arms, lifting his head and
shoulders
 10 months
 not sitting independently
 not “commando” crawling
 12 months
 not crawling on all fours
 not sitting upright in a child-sized chair
 not pulling to stand
Gross Motor Red Flags (cont.)
 Uses only one side of body in crawling or other movement
 14 months- not standing alone
 18 months- not walking alone
 24 months- doesn’t run
 Generally stands or walks on toes and doesn’t put weight on heels
of feet
 30 months
 not jumping
 Not independent on stairs (up and down)
 Trips or falls more than same aged peers; appears more clumsy
than same age peers
Fine Motor Red Flags
 After 6 months- Frequently in a fisted position with both hands
 10 months
 Not bringing both hands to midline
 Not banging objects together
 12 months
 Not clapping their hands
 Not transferring an object from one hand to the other
 Not able to tip and hold their bottle by themselves and keep it up, without
lying down
 18 months
 Still using a fisted grasp to hold a crayon
 Not using a mature pincer grasp (thumb and index finger, pad to pad)
 24 months- Not imitating a drawing of a vertical line
 30 months- Not able to snip with scissors
Cognitive Red Flags
 15 months- Not imitating body action on a doll (ie, kiss the baby,
feed the baby)
 27 months
 Not able to match two sets of objects by item (ie, blocks in one container
and people in another)
 Not able to imitate a model from memory (ie, show me how you brush
your teeth)
 31 months- Not able to match two sets of objects by color
 Having difficulty problem solving during activities in comparison
to his/her peers of about the same or younger age
 Unaware of changes in his/her environment and routine
Sensory Red Flags
 Very busy, always on the go, and has a very short attention to task
 Often lethargic or low arousal (appears to be tired/slow to
respond, all the time, even after a nap)
 Extreme irritability or cries often
 A picky eater
 Not aware of when they get hurt (no crying, startle, or reaction to
injury)
 Under-reactive or overly sensitive to touch, movement, sights, or
sounds
 Afraid of swinging/movement activities; does not like to be picked
up or be upside down
Sensory Red Flags (cont.)
 Showing difficulty learning new activities
 Having a hard time calming themselves down appropriately (self
soothing)
 Has difficulty being comforted by adults
 Appearing to be constantly moving around, even while sitting
 Showing poor or no eye contact
 Has persistent destructive behaviors
 Repetitive behaviors- inappropriately rocks back and forth, makes
hand flapping movements, or repeats words
Sensory Red Flags (cont.)
 Frequently jumping and/or purposely falling to the floor/crashing into
things
 Seeking opportunities to fall without regard to his/her safety or that of
others
 Constantly touching everything they see, including other children
 Hypotonic (floppy body, like a wet noodle)
 Having a difficult time with transitions between activity or location
 Overly upset with change in routine
 Hates bath time or grooming activities such as tooth brushing, hair
brushing, hair cuts, having nails cut, etc.
 Afraid of/aversive to/avoids being messy, or touching different
textures such as grass, sand, carpet, paint, play-doh, etc.
Self-Care Related Red Flags
 Having difficulty biting or chewing food during mealtime
 Needing a prolonged period of time to chew and/or swallow
 Coughing/choking during or after eating on a regular basis
 Demonstrating a change in vocal quality during/after eating (i.e. they
sound gurgled or hoarse when speaking/making sounds)
 14 months- Not feeding him/herself finger foods
 15 months
 Not attempting to use a spoon
 Not picking up and drinking from a regular open cup
 Not able to pull off hat, socks or mittens on request
 19 months- Not attempting to wash own hands or face
 22 months- Not assisting with dressing tasks (excluding clothes fasteners)
 34 months- Not able to deliberately undo large buttons, snaps and
shoelaces
Speech Development Red Flags
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4 months- Not cooing
6 months- Not laughing or squealing
8 months- No babbling
12 months
 Not making mama/dada sounds
 Doesn’t gesture
 18 months- Doesn’t use single words
 20 months- Doesn’t speak 20 different words (with 50% of speech
understood by strangers)
 24 months
 Not using 2 word sentences
 Doesn’t speak 50 words (with 75% of speech understood by
strangers)
 Anytime child who previously mastered a language skill suddenly
stops talking/babbling
Social Emotional Red Flags
 3 months- Not smiling
 Poor, weak, or absent eye contact
 Poor attachment
 12 months
 Not performing for social attention (doesn’t cry, etc)
 Doesn’t show basic emotions
 24 months
 Doesn’t show interest in other children
 Not imitating actions and movements
 Not engaging in pretend play
Social Emotional Red Flags (cont.)
 Not demonstrating appropriate play with an object (i.e. instead of
trying to put objects into a container, the child leaves the objects
in the container and keeps flicking them with his fingers)
 Fixating on objects that spin or turn (i.e. See 'n Say, toy cars, etc.);
also children who are trying to spin things that are not normally
spun
 Having significant difficulty attending to tasks
 Getting overly upset with change or transitions from activity to
activity
 Loss of social skills or social skill regression at any age
Red Flags During Play
 7 months- Does not put toys in mouth
 9 months- Does not act interested in peek-a-boo or patty cake
 12 months- Does not stack items
 24 months
 Does not turn board book pages
 Does not point to eyes, ear, mouth, or nose
General Red Flags
 Growth or development suddenly stops
 Any regression in child’s skill level
 Child drools or has difficulty eating
 Is very underweight or overweight
 Attempts to eat non-food items
 Often stares into space or blanks out
 Lack of eye contact after 3 months
Factors to Keep in Mind…
 Child’s experiences and family environment
 Different cultural expectations for developmental
milestones
 Gender differences
 Health/medical conditions
 All children develop at their own unique rates
What to Expect Handouts
http://www.zerotothree.org/child-development/earlydevelopment/your-babys-development.html
References and Resources
Sensory Processing Disorder:
http://www.sensory-processingdisorder.com/child-developmental-checklist.html
CDC Act Early Campaign: http://cdc.gov/actearly
Birth to Three: http://birthto3.org
Zero to Three: http://www.zerotothree.org/
Early Head Start National Resource Center:
http://www.ehsnrc.org/