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Developmental Red Flags
Aka: Developmental Red Flags
- See Also
- Language Milestone Red Flags
- Muscle Weakness in Children (Pediatric Neuromuscular Disorders)
- Red Flags: Birth to three month
- Rolling prior to 3 months
- Evaluate for hypertonia
- Persistent fisting at 3 months
- Evaluate for neuromotor dysfunction
- Failure to alert to environmental stimuli
- Evaluate for sensory Impairment
- Red Flags: 4 to 6 months
- Poor head control
- Evaluate for hypotonia
- Failure to reach for objects by 5 months
- Evaluate for motor, visual or cognitive deficits
- Absent Smile
- Evaluate for visual loss
- Evaluate for attachment problems
- Evaluate maternal Major Depression
- Consider Child Abuse or child neglect in severe cases
- Red Flags: 6 to 12 months
- Persistence of primitive reflexes after 6 months
- Evaluate for neuromuscular disorder
- Absent babbling by 6 months
- Evaluate for Hearing Deficit
- Absent stranger anxiety by 7 months
- May be related to multiple care providers
- W-sitting and bunny hopping at 7 months
- Evaluate for adductor spasticity or hypotonia
- Inability to localize sound by 10 months
- Evaluate for unilateral Hearing Loss
- Persistent mouthing of objects at 12 months
- May indicate lack of intellectual curiosity
- Red Flags: 12 to 24 months
- Lack of consonant production by 15 months
- Evaluate for Mild Hearing Loss
- Lack of imitation by 16 months
- Evaluate for Hearing Deficit
- Evaluate for cognitive or socialization deficit
- Lack of protodeclarative pointing by 18 months
- Problem in social relatedness
- Hand dominance prior to 18 months
- May indicate contralateral weakness with Hemiparesis
- Inability to walk up and down stairs at 24 months
- May lack opportunity rather than motor deficit
- Persistent poor transitions in 21 to 24 months
- May indicate pervasive Developmental Disorder
- Advanced non-communicative speech (e.g. Echolalia)
- Simple commands not understood suggests abnormality
- Evaluate for Autism
- Evaluate for pervasive Developmental Disorder
- Delayed Language Development
- Requires Hearing Loss Evaluation in all children
- Management: Immediate speech therapy evaluation indications
- See Language Milestone Red Flags
- Resources
- Georgetown Bright Futures Provider Guidelines
- http://www.brightfutures.org/bf2/pdf/index.html
- References
- Frankenburg (1990) Denver II Developmental Screening
- Blondis (1999) Pediatr Clin North Am 46:899-913 [PubMed]