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Signs & concerns
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Signs & concerns
When should an ASHA or PHC worker escalate signs of ODD?
Escalate when a child's defiant, hostile behaviour is frequent, lasts six months or more, is severe for the child's age, and harms family, school or friendships — and urgently if there is aggression, self-harm or suspected abuse. Ordinary tantrums do not need escalation. Only a clinician can confirm ODD.
Read the answer AnswerWhen should an ASHA or PHC worker escalate social communication difficulties?
ASHA and PHC workers should escalate when social-communication concerns persist beyond one contact, when red flags appear at any age, or whenever a parent raises worry. Any loss of previously acquired language or social skills warrants same-day referral. Workers screen and route — diagnosis happens only under a clinician.
Read the answer AnswerWhen should I worry about biting in my child?
Biting between 12 and 42 months is usually a normal, passing phase driven by teething, frustration, excitement or sensory seeking, and it fades as language and self-regulation grow. Seek a gentle developmental check if biting is very frequent or intense, regularly breaks skin, is hard to redirect, continues well past age 3, or travels alongside delays in talking, connecting or playing. This is a reason to look early — not a diagnosis — because early support works best.
Read the answer AnswerWhen should I worry about defiance and saying no in my child?
Saying no, tantrums and testing limits are normal and healthy between 18 months and about 5 years — it is how a child learns independence. Seek a developmental check when defiance is intense and frequent for the age, lasts beyond about 6 months, happens across many settings, involves frequent aggression, or comes with delays in talking, play or social connection. This is a reason to look early, not a diagnosis — most strong-willed toddlers are simply doing their developmental job.
Read the answer AnswerWhen should I worry about difficulty sharing in my child?
Difficulty sharing is completely normal for children aged 2–5, who are only just learning that others have their own feelings and wants. Sharing develops gradually, usually settling between 3 and 5 years with gentle practice. A developmental check is wise only when trouble sharing comes with wider patterns — little interest in other children, very limited pretend play, frequent overwhelming meltdowns, or delays in talking and connecting. On its own, not sharing is a sign of a normal, growing child, not a worry.
Read the answer AnswerWhen should I worry about extreme shyness in my child?
Shyness is a normal temperament trait in children aged roughly 18 months to 7 years, and warming up slowly to new people or places is typical. Seek a developmental check when shyness is intense and persistent across many settings, causes real distress, includes consistent silence in certain places, or comes with delays in talking, connecting or play. These are reasons to assess early — not a diagnosis — because early support works best.
Read the answer AnswerWhen should I worry about my child hitting others?
Hitting others is very common and usually typical between 12 months and 5 years, when children have big feelings but few words. Seek a developmental check if the hitting is frequent, intense or harmful, doesn't ease with gentle coaching over a couple of months, happens across many settings, or comes with delays in talking, social connection or play. This is a reason to assess early — not a diagnosis — because early support works best.
Read the answer AnswerWhen to Worry About Limited Eye Contact
Limited eye contact on its own is rarely a worry — babies and toddlers look away to self-soothe, concentrate or follow something more interesting. Seek a developmental check when limited eye contact is consistent across people and settings and travels with other differences: not responding to their name, few or no words for their age, not pointing or sharing, or little back-and-forth smiling. This is a reason to look closely, not a diagnosis, and early support works wonderfully at this age.
Read the answer AnswerWhen should I worry about my child's social development?
Social development grows gradually — from smiles and eye contact to pointing, sharing and playing with others. Seek a developmental check if, by the expected age, your child shows little eye contact or shared smiling, doesn't respond to their name, rarely points to share interest, shows little interest in other children, or loses social skills once present. This isn't a diagnosis — it's a reason to assess early, because early support works best.
Read the answer AnswerWhen should I worry about my child not playing with other children?
Between 2 and 3 years, most children play alongside other children (parallel play) rather than truly with them — this is normal. Cooperative play usually develops closer to 3–4 years. Seek a gentle developmental check if, by around 3, your child shows little interest in other children, doesn't watch or imitate them, or this comes with delays in talking, eye contact or pretend play. This is a reason to look early, not a diagnosis.
Read the answer AnswerWhen should I worry about my child running off in public?
Running off in public is common and usually typical between 18 months and 5 years, when children are impulsive and don't yet grasp danger. Seek a developmental check if the running is frequent, shows no safety awareness, is very hard to redirect, or comes with not responding to their name, few words, little eye contact, or not checking back to you. These are reasons to assess early — not a diagnosis — because impulse, communication and safety-awareness grow well with early support.
Read the answer AnswerWhen should I worry about autism at 12-18 months?
Autism can sometimes be detected by 18 months or younger. Loss of skills or persistent communication concerns warrant pediatric assessment. Autism screening is recommended at 18 and 24 months and when concerns arise; screening is not diagnosis.
Read the answer AnswerWhen to worry about Conduct-Dissocial Disorder at 12–18 months
Conduct-Dissocial Disorder (ICD-11 6C91) cannot be diagnosed in a 12-to-18-month-old — it describes a persistent pattern judged only in older children who understand rules and others' feelings. At this age, tantrums, hitting and biting are normal communication from an immature brain, not warning signs. The right focus now is watching the building blocks of communication and connection, and a general developmental check if anything feels persistently off.
Read the answer AnswerWhen to worry about ODD in a 12–18-month-old
Oppositional Defiant Disorder is not a meaningful diagnosis at 12–18 months — saying "no", tantrums and refusals are expected toddler development as your child discovers they are a separate person. ODD (ICD-11 6C90) is recognised only from the preschool years, once the brain can self-regulate. At this age, watch communication, connection and play rather than "defiance", and seek a gentle check if those foundations seem delayed. Only a Pinnacle clinician can assess — never an online form.
Read the answer AnswerWhen Should I Worry About Social Communication at 12–18 Months?
At 12–18 months, Social Communication Difficulties is not formally diagnosed, but this is a key window to gently observe how your toddler connects — name response, eye contact, pointing, gestures and babble. A persistent pattern of several missed social-communication behaviours, or loss of skills once present, deserves a friendly developmental check rather than waiting. Only a Pinnacle clinician can assess; never an online form.
Read the answer AnswerWhen should I worry about autism at 18–24 months?
From 18 to 24 months, screening for autism becomes reliable and meaningful. A persistent cluster — limited pointing, few words, little response to name, reduced social back-and-forth, or repetitive movements — is worth checking. Worry is a reason to screen, not a diagnosis; only a clinician can confirm.
Read the answer AnswerWhen should I worry about Conduct Disorder in my 18-24 month old?
Conduct-Dissocial Disorder (ICD-11 6C91) is not a meaningful concern at 18-24 months — it describes a sustained, deliberate pattern of rule-violation recognised in older children and adolescents. Toddler hitting, biting, defiance and tantrums are normal developmental behaviour. Watch communication, connection and the ability to be soothed instead; a general developmental check supports those skills. Only a Pinnacle clinician can assess, never an online form.
Read the answer AnswerWhen should I worry about ODD in my 18-to-24-month-old?
Defiance, tantrums and constant "no" are normal, healthy behaviour for an 18-to-24-month-old — not signs of Oppositional Defiant Disorder. ODD is a pattern clinicians recognise in older children, because toddlers haven't yet built the self-control the diagnosis assumes. At this age, watch the wider developmental picture — communication, connection, recovery from upset — and seek a general developmental check, not a behaviour label, if something feels off.
Read the answer AnswerWhen to Worry About Social Communication at 18–24 Months
At 18–24 months, the early signs of Social Communication Difficulties are about connection — sharing attention, pointing, gestures and back-and-forth — more than word count. Worry is reasonable if several of these are consistently absent across settings, or if skills are lost. Check hearing first, then seek a developmental review. Only a Pinnacle clinician can assess — never an online form.
Read the answer AnswerWhen should I worry about autism in my 2-year-old?
At two, worry is reasonable when you see a pattern — few words, no pointing, not responding to name, little pretend-play, or lost skills — rather than one quirk. Two is an ideal age to screen, and only a clinician can confirm anything.
Read the answer AnswerConduct-Dissocial Disorder at age 2: what to know
Conduct-Dissocial Disorder (ICD-11 6C91) is not a meaningful diagnosis at age two. Hitting, biting, defiance and big tantrums are normal toddler development as impulse control and language are still forming. The right focus is supporting communication and emotional skills and monitoring overall development — and only a Pinnacle clinician, never an online form, can assess a child.
Read the answer AnswerWhen should I worry that my 2-year-old might have ODD?
At two, defiance, tantrums and saying "no" are normal, healthy toddler development, not Oppositional Defiant Disorder. ODD is not a meaningful label at this age because its behaviours overlap with ordinary toddler autonomy. Rather than worrying about a diagnosis, watch overall development — communication, connection, ability to be soothed — and seek a general developmental check if something feels off or skills are lost.
Read the answer AnswerWhen should I worry about Social Communication Difficulties at age 2?
At age two, Social Communication Difficulties describe trouble with the back-and-forth of connecting — gestures, eye contact, shared attention and early conversation — not just word counts. A single missed milestone is rarely a worry; a persistent cluster (no pointing to share, limited shared eye contact, not responding to name, little back-and-forth, or any loss of skills) deserves a friendly developmental check. Only a Pinnacle clinician can assess, never an online form.
Read the answer AnswerWhen should I worry about autism in a 3-to-6-month-old?
At 3 to 6 months, autism cannot be diagnosed and there is no reliable signs list this young. Watch your baby's everyday social development — smiling, cooing, turning to sounds — and raise concerns with your paediatrician. Structured autism screening usually begins near 18 months; only a clinician can assess.
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