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Book Assessment
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Signs & concerns
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Signs & concerns
What does it mean if my child isn't yet showing vocabulary comprehension and expression?
Between 12 and 36 months, the range of normal language is very wide, and understanding (comprehension) usually comes before talking (expression). If your toddler isn't yet showing clear vocabulary, it most often means language is still emerging — not that something is wrong. A gentle developmental check, including a hearing check, is wise because early language support works best at this age. This is a reason to look, never a diagnosis.
Read the answer AnswerWhat it means if your child isn't yet showing vocabulary knowledge
If your child isn't yet showing the vocabulary you'd expect, it usually means their language is still building — sometimes more slowly — not that something is wrong. Between 3 and 7, watch for very few words, no short phrases, difficulty naming things or understanding instructions, and check hearing. This is a reason for an early developmental check, not a diagnosis, because language responds strongly to early, playful support.
Read the answer AnswerWhat does it mean if my child isn't showing vocalization development?
If your toddler is not yet showing expected vocalization development, it usually means their sounds and early words need a closer look — not that something is wrong. Between 12 and 36 months the typical range is wide, and many children flourish with gentle, playful support. A developmental check now is a calm, wise step, never a diagnosis, because early support works best.
Read the answer AnswerWhat it means if your child is not yet walking
Most children walk between 12 and 15 months, with a healthy range to about 18 months. A toddler who is not yet walking but pulling to stand, cruising or crawling well is usually just on their own pace. Seek a developmental check if there are no independent steps by 18 months, if one side is favoured or movements look stiff or floppy, or if not-walking comes with other delays. This is a reason to observe early, not a diagnosis.
Read the answer AnswerWhat does it mean if my child is not yet showing word knowledge?
Word knowledge is how many words a child understands and uses, and how they link words to meaning. In a 3-to-7-year-old, not yet showing expected word knowledge usually means language is growing at its own pace — and sometimes that extra support would help. It is not a diagnosis, but a clear, kind reason to arrange a developmental check, because language support works best early.
Read the answer AnswerWhat does it mean if my child is not yet showing working memory?
In toddlers aged 1–3, working memory is only just beginning to emerge and develops gradually and unevenly — so not yet seeing it clearly is usually typical, not a diagnosis. Look for small sparks like following a simple instruction or finding a hidden toy. Seek a general developmental check only if you also notice no words by 18–24 months, no pointing or name response, or loss of skills.
Read the answer AnswerEarly ADHD Indicators for Paediatricians
Watch for age-excessive inattention, hyperactivity and impulsivity that persist for six months and impair function across two or more settings. Diagnosis is rarely secure before age five; first exclude hearing, sleep and developmental contributors, and refer on cross-setting impairment with parent and teacher concern.
Read the answer AnswerWhat early indicators of Attachment Difficulties should a paediatrician watch for?
Watch for limited comfort-seeking when distressed, muted social reciprocity, abnormal stranger response (withdrawn or indiscriminately familiar), and flat or fearful affect with the caregiver — especially with a history of neglect, maltreatment or disrupted care. Signs are meaningful from around 9 months; refer for developmental and psychosocial assessment rather than reassuring alone.
Read the answer AnswerEarly Indicators of Auditory Processing Difficulties
Watch for a mismatch between normal hearing and real-world listening: frequent repetition requests, marked difficulty understanding speech in noise, weak phonological awareness, and slow responses to verbal instructions. Exclude otitis media and hearing loss first. Formal diagnosis is generally deferred until around age 7, but younger children with persistent patterns warrant developmental and speech-language review.
Read the answer AnswerEarly Indicators of Autism Spectrum for Paediatricians
Watch for persistent social-communication differences and restricted, repetitive behaviours across settings, not explained by hearing loss or global delay. Refer most urgently on any skill regression, no babble or gesture by 12 months, no single words by 16 months, or no two-word phrases by 24 months — full ICD-11 criteria are not required for referral.
Read the answer AnswerEarly Indicators of Cerebral Palsy
Watch for delayed or asymmetric motor milestones, persistent abnormal tone, early hand preference before 12 months, retained primitive reflexes and atypical movement quality. The strongest infancy predictor is an abnormal General Movements Assessment plus abnormal neurological exam plus relevant perinatal history — refer promptly rather than waiting.
Read the answer AnswerEarly Indicators of Childhood Anxiety for Paediatricians
Watch for excessive, persistent, impairing fear or worry out of proportion to age — often presenting somatically (recurrent tummy aches, headaches, sleep disturbance), behaviourally (clinging, avoidance, school refusal, irritability), or cognitively (catastrophic worry). Screen when symptoms persist beyond weeks and impair function across settings.
Read the answer AnswerEarly indicators of Childhood Apraxia of Speech a paediatrician should watch for
Watch for inconsistent errors on the same word, articulatory groping, disrupted prosody, vowel distortions, and a marked gap between intact comprehension and effortful, limited expressive speech. Errors increase with word length. Refer to speech-language pathology early — CAS responds to intensive motor-based therapy and should not be managed by wait-and-see.
Read the answer AnswerEarly Indicators of Childhood Epilepsy
Suspect childhood epilepsy with recurrent, stereotyped, unprovoked paroxysmal events — staring spells, focal or generalised jerks, automatisms, myoclonus or infantile spasms — recurring across settings. Refer promptly to paediatric neurology; treat infantile spasms, status, or a first afebrile or focal seizure as urgent.
Read the answer AnswerEarly Indicators of Childhood Sleep Difficulties for Paediatricians
Watch for persistent difficulty initiating or maintaining sleep, frequent age-inappropriate night waking, snoring or witnessed apnoeas, and daytime consequences such as hyperactivity, irritability or inattention. Most is behavioural and modifiable; habitual snoring with pauses or new daytime sleepiness warrants prompt evaluation.
Read the answer AnswerEarly indicators of conduct-dissocial disorder for paediatricians
Watch for a repetitive, persistent pattern that violates others' rights or major age norms — aggression, deceit, destruction, serious rule-breaking — sustained over months across settings, not a single incident. Early onset (under 10) and callous-unemotional traits raise concern; screen for ADHD, trauma and safeguarding in parallel.
Read the answer AnswerEarly Indicators of Developmental Coordination Disorder
Watch for motor skill acquisition and execution markedly below age expectation that interferes with daily life — clumsiness, late milestones, frequent falls, trouble with buttons, cutlery and pencils, and weak motor planning — not explained by intellectual disability or a neurological condition. DCD is reliably judged from around age 5; earlier soft signs warrant monitoring and referral.
Read the answer AnswerEarly Indicators of Developmental Language Disorder
Watch for persistently delayed or atypical language in a child with typical hearing, non-verbal cognition and social reciprocity: no babble by 12 months, fewer than 50 words and no word combinations by 24 months, and ongoing comprehension or grammar difficulty beyond age 3. Confirm hearing first; refer for speech and language therapy when concern persists.
Read the answer AnswerEarly Indicators of Developmental Regression
Developmental regression — loss of previously acquired language, social, motor or self-care skills — always warrants prompt investigation, never watch-and-wait. Treat it as a potential neurological, metabolic or epileptic marker; document the timeline, screen for treatable causes, and refer for paediatric neurology assessment in parallel.
Read the answer AnswerEarly Indicators of Developmental Trauma for Paediatricians
Watch for a persistent, cross-setting pattern of arousal dysregulation (hypervigilance or shut-down), attachment differences (indiscriminate friendliness or extreme withdrawal), developmental regression and unexplained somatic complaints — not better explained by a primary neurodevelopmental or medical cause. Any abuse or neglect concern triggers the safeguarding pathway; persistent signs warrant multidisciplinary, trauma-informed assessment.
Read the answer AnswerEarly Indicators of Down Syndrome for the Paediatrician
Down syndrome is recognised at or near birth from a cluster — hypotonia, flat facial profile, upslanting palpebral fissures, epicanthic folds, single palmar crease, sandal gap — rather than any single sign. When the pattern is present, confirm by karyotype and start the cardiac, hearing and thyroid surveillance bundle with early intervention.
Read the answer AnswerEarly indicators of dyscalculia for paediatricians
Watch for persistent difficulty with number sense — counting, subitising, magnitude comparison and arithmetic-fact retrieval — that sits below age expectation and isn't explained by limited schooling or global delay. A formal dyscalculia label is generally not applied before ~6–8 years, but early markers warrant monitoring and educational support.
Read the answer AnswerEarly indicators of dysgraphia for paediatricians
Watch for written output disproportionately poor for the child's age and intelligence — illegible, laboured handwriting, inconsistent letter formation, spelling worse on paper than orally, and writing avoidance. Dysgraphia is meaningfully identified from around age 6–7 once formal writing instruction is established; only a clinician can confirm.
Read the answer AnswerWhat early indicators of dyslexia should a paediatrician watch for?
Watch for a persistent gap between strong verbal ability and weak phonological skills, letter-sound mapping and word reading — disproportionate to age and effort. Preschool red flags (poor rhyme awareness, slow letter learning, slow rapid naming) and family history raise probability and warrant screening; formal diagnosis firms up around 6–8 years.
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