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Signs & concerns
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Signs & concerns
Prematurity-Related Developmental Risk: Red Flags for Referral
Refer a preterm-born child when corrected-age milestones lag persistently, when tone or movement is asymmetric or abnormal, or when feeding, vision, hearing or behaviour raise concern — most urgently on asymmetric tone, persistent fisting beyond 3 months corrected, early hand preference, or loss of acquired skills. Score milestones against corrected age until 24 months.
Read the answer AnswerRett Syndrome Red Flags Warranting Referral
Refer urgently when a young child shows the Rett pattern: a period of normal early development followed by loss of purposeful hand use, emergence of stereotypic hand movements (wringing, washing, mouthing), deceleration of head growth, and language/social regression — typically 6–18 months. Route to paediatric neurology and clinical genetics for MECP2 testing.
Read the answer AnswerClinical Red Flags for School Readiness Gap
Refer a 4–6-year-old when delays persist across language, pre-academic, motor, attention or self-regulation domains, are out of step with peers, and aren't explained by hearing or sensory deficit. A cross-domain, cross-setting pattern — not a single weak skill — is the referral threshold, especially when parents or preschool staff are concerned.
Read the answer AnswerSelective Mutism red flags warranting referral in young children
Refer when a child consistently fails to speak in specific settings (typically school) despite fluent speech at home, the pattern persists beyond one month of starting school, and it interferes with education or social functioning — and isn't better explained by a language disorder, autism or an unfamiliar language.
Read the answer AnswerSelf-Regulation Difficulties: Red Flags for Referral
Refer a young child for self-regulation difficulties when emotional and physiological dysregulation is pervasive across settings, disproportionate to age, and impairing sleep, feeding, learning or relationships. Act promptly on regression, persistent inconsolability, or co-occurring developmental or medical red flags, and exclude medical mimics such as pain, reflux and seizures.
Read the answer AnswerSensory-Based Feeding Selectivity: red flags for referral
Refer for Sensory-Based Feeding Selectivity when it is severe, persistent and impairing — faltering growth, nutritional deficiency, a narrowing accepted-food range, mealtime distress disrupting family life, or signs of aspiration. Distinguish it from transient toddler neophobia.
Read the answer AnswerSensory Processing Red Flags for Referral in Young Children
Refer a young child for sensory processing assessment when over- or under-responsivity, sensory seeking, or motor-planning and regulatory difficulties are disproportionate, persist across settings, and disrupt feeding, sleep, dressing, play or participation — and are not better explained by autism, ADHD, or hearing/visual impairment.
Read the answer AnswerSeparation Anxiety Disorder red flags warranting referral
Refer when separation-related fear is developmentally excessive, persists four weeks or more, and impairs functioning across settings. Escalate urgently with school refusal, somatic symptoms without medical cause, low mood, or onset after trauma or loss.
Read the answer AnswerSocial Communication Difficulties: Clinical Red Flags for Referral
Refer when social use of language — reciprocity, adjusting to listener, reading inference and context — is impaired across settings, exceeds developmental expectation, and isn't explained by hearing loss, global delay, or autism with restricted/repetitive behaviour. Persistent parent or teacher concern is itself a sufficient trigger.
Read the answer AnswerClinical red flags for Specific Learning Disability referral
Specific Learning Disability is not formally diagnosed before about age 6–8. In younger children, refer when pre-literacy, language and numeracy precursors lag persistently despite adequate instruction, with intact hearing and vision — especially with a family history of learning difficulty.
Read the answer AnswerClinical Red Flags for Speech and Language Delay
Refer when speech or language is meaningfully behind age norms, when acquired words are lost, or when comprehension lags expression — most urgently no babble or gesture by 12 months, no single words by 16 months, no two-word phrases by 24 months. Always rule out hearing loss first.
Read the answer AnswerRed flags for Stereotyped Movement Disorder warranting referral
Refer for Stereotyped Movement Disorder when rhythmic, purposeless movements persist beyond age 3, impair function, cause self-injury, or arise with developmental concern — most urgently with self-injury, regression, abrupt onset, or features suggesting seizure rather than stereotypy.
Read the answer AnswerTourette Syndrome red flags for referral in young children
Refer when multiple motor and at least one vocal tic show a waxing-and-waning course beyond 12 months — most urgently when tics impair function, cause injury, or coexist with ADHD, OCD or anxiety. Atypical or abrupt onset warrants prompt neurology review.
Read the answer AnswerVisual Impairment Red Flags in Young Children
Refer a young child for visual impairment when there is absent fix-and-follow by 3 months, leucocoria (white reflex), persistent or acquired nystagmus, a manifest squint after 4 months, abnormal red reflex, or any regression in visual behaviour. Leucocoria and acquired nystagmus warrant same-day ophthalmology referral.
Read the answer AnswerWhat cognitive milestones should a doctor check at routine visits?
At routine visits track cognition as a trajectory: object permanence and means-end problem-solving in infancy, symbolic play through the second year, and reasoning, attention and pre-academic skills in pre-school years. Use surveillance every visit plus validated screens at 9, 18 and 30 months, escalating on any skill loss or persistent parental concern.
Read the answer AnswerCognitive milestones for your 12-to-18-month-old
Between 12 and 18 months most toddlers begin finding hidden toys, imitating everyday actions, using objects correctly, following simple instructions and starting basic pretend play. These are emerging skills that grow week by week — a band of typical progress, not a strict checklist. If several lag by 18 months, a gentle developmental check is wise.
Read the answer AnswerWhat Cognitive milestones should my 18-to-24-month-old have reached?
Between 18 and 24 months most toddlers begin pretend play, follow one-step instructions, point to name pictures or body parts, and solve simple problems by trial and error. These are guides, not deadlines — a single missing skill is rarely a worry, but persistent gaps deserve a friendly developmental check.
Read the answer AnswerCognitive milestones for your 2-year-old
By age two, most toddlers find hidden toys, sort shapes, stack blocks, follow simple two-step instructions, name familiar pictures and begin pretend play — early signs of growing memory, attention and problem-solving. These are gentle guideposts, not a pass-or-fail test.
Read the answer AnswerCognitive milestones for your 3-to-6-month-old
Between 3 and 6 months, cognitive milestones appear as curiosity: recognising familiar faces, following moving objects, exploring toys by reaching and mouthing, and expecting a response to coos and smiles. Babies develop at different paces, so a few weeks' variation is usually normal — a developmental check brings reassurance if you have concerns.
Read the answer AnswerWhat cognitive milestones should my 3-year-old have reached?
By age 3, most children complete simple puzzles, sort by colour or shape, follow two-step instructions, name a few colours and enjoy pretend play. These cognitive milestones emerge across a healthy range — a gentle developmental check is wise only if pretend play, instruction-following or problem-solving interest seem absent by 3–3½.
Read the answer AnswerWhat cognitive milestones should my 4-year-old have reached?
By four, most children count to ten, name colours, follow two- to three-step instructions, enjoy rich pretend play, and answer simple 'why' questions. These are guides, not a checklist — if several feel well behind, a gentle developmental check is the kind next step.
Read the answer AnswerWhat Cognitive milestones should my 5-year-old have reached?
By age five most children count to ten and beyond, name colours and shapes, follow three-step instructions, enjoy rich pretend play, and answer "why" questions. These are typical signposts within a normal range, not a fixed checklist — steady progress matters most, and a gentle developmental check helps if several are not yet emerging.
Read the answer AnswerWhat Cognitive milestones should my 6-to-9-month-old have reached?
Between 6 and 9 months most babies explore objects with purpose, repeat actions that cause an effect, begin searching for hidden toys (early object permanence), recognise familiar faces and pass objects hand to hand. There is a wide normal range; a developmental check helps if your baby isn't exploring, recognising faces or responding to sounds by 9 months.
Read the answer AnswerWhat Cognitive Milestones Should My 6-Year-Old Have Reached?
By six, most children count and recognise numbers, follow multi-step instructions, focus for about 15 minutes, sort and compare objects, and begin reading simple words. These ICF b1 cognitive milestones span a normal range, and timing varies widely from child to child.
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