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Red Flags

“Red Flags” are essentially warning signs that an aspect of your child’s development may warrant a referral to a specialist.


•  No babbling by 9 months
•  No first words by 15 months
•   No consistent words by 18 months
  No word combinations by 24 months
   Slowed or stagnant speech development
  Problems understanding your child’s speech at 24 months of age; strangers having problems understanding your child’s speech by 36 months of age
  Not showing an interest in communicating

Also, talk to your health professional anytime you or another caregiver has concerns about your child’s speech and language development or other problem that affects your child’s speech or understanding of language, such as:

• Excessive drooling.
• Problems sucking, chewing, or swallowing
•  Problems with control and coordination of lips, tongue, and jaw
• Stuttering that causes a child embarrassment, frustration, or difficulty with peers.
• Poor memory skills by the time your child reaches kindergarten age (5 to 6 years)
• He or she may have difficulty learning colors, numbers, shapes, or the alphabet

other communication “red flags” include:

•  Failure to respond normally, such as not responding when spoken to. This may include signs that the child does not hear well, such as not reacting to loud noises
•  A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately
•  Not speaking clearly or well by age 3

Developed by Healthwise Staff. Primary Medical Review: Susan C Kim, MD-Pediatrics. Specialist Medical Reviewer: Louis Pellegrino, MD- Developmental Pediatrics. 12/2010. http://www.webmd.com/parenting/tc/speech-and-language-development-red-flags-topic-overview


•  Not rolling by 7 months of age
• Not pushing up on straight arms, lifting his head and shoulders, by 8 months of age
• Not sitting independently by 10 months of age
•  Not crawling (“commando” crawling–moving across the floor on his belly) by 10 months of age
• Not creeping (on all fours, what is typically called “crawling”) by 12 months of age
• Not sitting upright in a child-sized chair by 12 months of age
•  Not pulling to stand by 12 months of age
•  Not standing alone by 14 months of age
• Not walking by 18 months of age
• Not jumping by 30 months of age
• Not independent on stairs (up and down) by 30 months of age

other gross motor “red flags” include:

•  ”Walking” their hands up their bodies to achieve a standing position
only walking on their toes, not the soles of their feet
•  Frequently falling/tripping, for no apparent reason
•  Still “toeing in” at two years of age
•  Unusual creeping patterns
• Any known medical diagnosis can be considered a “red flag”: Down’s syndrome, cerebral palsy, congenital heart condition etc.


• Frequently in a fisted position with both hands after 6 months of age
•  Not bringing both hands to midline (center of body) by 10 months of age
•  Not banging objects together by 10 months of age
• Not clapping their hands by 12 months of age
•  Not deliberately and immediately releasing objects by 12 months of age
• Not able to tip and hold their bottle by themselves and keep it up, without lying down, by 12 months of age
•  Still using a fisted grasp to hold a crayon at 18 months of age
•  Not using a mature pincer grasp (thumb and index finger, pad to pad) by 18 months of age
•  Not imitating a drawing of a vertical line by 24 months of age
•  Not able to snip with scissors by 30 months

other fine motor “red flags” include:

•  Using only one hand to complete tasks
•  Not being able to move/open one hand/arm
•  Drooling during small tasks that require intense concentration
•  Displaying uncoordinated or jerky movements when doing activities
•  Crayon strokes are either too heavy or too light to see
• Any know medical diagnosis can be considered a “red flag”: Down’s Syndrome, cerebral palsy etc.