August 22, 2011Jennifer Crookham, Mental Health & Disabilities Manager

http://youtu.be/KrUNBfyjlBk

Video

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

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

Gross Motor Red Flags (cont.)

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

Fine Motor 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

Cognitive 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

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.

Sensory Red Flags (cont.)

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 foods15 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 face22 months- Not assisting with dressing tasks (excluding clothes fasteners) 34 months- Not able to deliberately undo large buttons, snaps and shoelaces

Self-Care Related Red Flags

4 months- Not cooing6 months- Not laughing or squealing8 months- No babbling12 months

Not making mama/dada sounds Doesn’t gesture

18 months- Doesn’t use single words20 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

Speech Development 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

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

Social Emotional Red Flags (cont.)

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

Red Flags During Play

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

General Red Flags

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

Factors to Keep in Mind…

http://www.zerotothree.org/child-development/early-development/your-babys-

development.html

What to Expect Handouts

References and ResourcesSensory Processing Disorder: http://www.sensory-processing-disorder.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/