Red Flags

If a child is….

• not rolling by 7 months of age
• not pushing up on extended arms, lifting his head and shoulders in prone by 8 months of age
• not sitting independently by 10 months of age
• not crawling by 12 months of age
• not sitting upright in a child-size chair by 12 months of age
• not pulling to stand by 12 months of age
• not standing alone by 12 months of age
• not walking by 18 months of age
• not jumping by 30 months of age
• not independent on stairs by 30 months of age
• “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 2 years of age
• unusual creeping patterns
• any known diagnosis:  Down’s Syndrome, Cerebral Palsy, congenital heart condition, etc.

Fine Motor

If a child is…

• frequently in a fisted position with both hands after 6 months of age
• not bringing both hands to midline 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 drawing a vertical line by 24 months of age
• not able to snip with scissors by 30 months of age
• 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:  Down’s Syndrome, Cerebral Palsy, etc.

Cognition/Problem Solving

If a child is…

• not imitating body action on a doll by 15 months of age (kiss the baby, feed the baby)
• not able to match 2 sets of objects by item by 27 months of age (blocks in one container and people in another container)
• not able to imitate a model from memory by 27 months of age (show me how you brush your teeth)
• not able to match 2 sets of objects by color by 31 months of age
• having difficulty problem solving during activities in comparison to his/her peer
• unaware of changes in his/her environment and routine

Sensory

If a child is…

• 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
• a picky eater
• not aware of when they get hurt (no crying, startle, or reaction to injury)
• afraid of swinging/movement activities; does not like to be picked up or be upside down
• showing difficulty learning new activities (motor planning)
• having a hard time calming themselves down appropriately
• appearing to be 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:  brushing teeth, brushing hair, hair cuts, having nails cut, etc.
• afraid of/aversive to/avoids being messy, or touching different textures such as grass, sand, carpet, paint, play dough, etc.

Self-Care

If a child is…

• 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)
• having significant difficulty transitioning between different food stages
• not feeding self finger foods by 14 months of age
• not attempting to use a spoon by 15 months of age
• not picking up and drinking from a regular open cup by 15 months of age
• not able to pull off hat, socks, or mittens on request by 15 months of age
• not attempting to wash own hands or face by 19 months
• not assisting with dressing tasks (excluding clothes fasteners) by 22 months
• not able to deliberately undo large buttons, snaps, and shoelaces by 34 months

Social/Emotional/Play Skills

If a child is…

• not smiling by the age of 4 months
• not making eye contact during activities and interacting with peers and/or adults
• not performing for social attention by the age of 12 months
• not imitating actions and movements by the age of 24 months
• not engaging in pretend play by the age of 24 months
• 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