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Signs & concerns
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Signs & concerns
When to Refer Sensory-Based Feeding Selectivity
Refer a child with suspected Sensory-Based Feeding Selectivity once the pattern is persistent, narrowing or functionally impairing — fewer foods over time, whole-texture exclusion, or mealtime distress — and after medical red flags (choking, faltering growth, painful swallow) are excluded or co-managed. Earlier referral means a wider repertoire to build on.
Read the answer AnswerWhen should a doctor refer a child with suspected Sensory Processing Differences for developmental therapy?
Refer when sensory differences are functionally impairing — disrupting feeding, sleep, self-care, play, peer participation or classroom function persistently — not for occasional preferences the child self-regulates. Functional impact alone justifies referral; no co-occurring diagnosis is required to act, and earlier is better.
Read the answer AnswerWhen to refer a child with suspected Separation Anxiety Disorder
Refer when separation distress is excessive for the child's developmental age, persists ≥4 weeks (ICD-11 6B05) and impairs function — school refusal, somatic complaints, sleep disruption. First-line is CBT-based psychological therapy; escalate promptly for low mood, self-harm ideation, or a suspected underlying developmental condition.
Read the answer AnswerWhen to Refer Suspected Social Communication Difficulties
Refer when a child shows a persistent pattern of difficulty with the social use of language — reciprocity, pragmatic adjustment, non-verbal cues — that impacts function, after excluding hearing loss. Parental or clinical concern is sufficient grounds; do not adopt watchful waiting past age 4–5. Assessment is how Social Communication Difficulties is differentiated from autism, DLD and intellectual disability.
Read the answer AnswerWhen should a doctor refer a child with suspected SLD for developmental therapy?
Refer when academic skills fall persistently and significantly below age expectation despite adequate instruction, the difficulty lasts at least six months, and other causes (intellectual, sensory, neurological, psychosocial) are excluded. This typically clusters at ages 6–8 once formal instruction begins, but refer at the first persistent gap rather than waiting for failure.
Read the answer AnswerWhen should a doctor refer a child with suspected Speech and Language Delay?
Refer when language delay is persistent rather than transient, when milestone red flags appear at any age, or when there is regression or loss of skills — and run audiology in parallel, not before. Wait-and-see is inappropriate once thresholds are crossed. Diagnosis is confirmed only by a clinician.
Read the answer AnswerWhen to Refer Suspected Stereotyped Movement Disorder
Refer when stereotypies are functionally impairing, self-injurious, or co-occur with developmental delay — not for benign movements alone. Atypical or urgent features need medical work-up first. Therapy targets participation and safety, never mere suppression.
Read the answer AnswerWhen to Refer Suspected Tourette Syndrome for Developmental Therapy
Refer when functional impairment — not tic severity — limits the child, which is most cases given 80–90% comorbidity (ADHD, OCD, anxiety, learning difficulties). Begin supportive therapy at suspicion; CBIT is first-line for disabling tics, with prompt neurology/psychiatry review for red flags.
Read the answer AnswerWhen to Refer a Child with Suspected Visual Impairment for Developmental Therapy
Refer for developmental therapy as soon as visual impairment is confirmed or strongly suspected — in parallel with ophthalmology, not after it. Early habilitation during the plasticity window mitigates secondary motor, cognitive and communication delays. Diagnosis and AbilityScore® are formed only at a Pinnacle centre.
Read the answer AnswerWhen should I worry that my 12–18 month old might have ADHD?
At 12–18 months ADHD cannot be diagnosed, and high energy or short attention is normal toddler behaviour. Rather than ADHD signs, watch milestones — connection, communication, play and movement. A general developmental check, not ADHD screening, is the right next step, and only a clinician can assess.
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 should I worry about Cerebral Palsy at 12–18 months?
Worry between 12 and 18 months is reasonable, but worry is not a diagnosis. Persistent stiffness or floppiness, very early hand preference, fisted hands, or not sitting/standing on time are patterns worth checking. Early therapy works beautifully with the infant brain — only a Pinnacle clinician can confirm anything.
Read the answer AnswerWhen to Worry About Down Syndrome at 12-18 Months
Down syndrome is present from birth and is almost always identified at or soon after birth through examination and genetic testing — not something that newly appears at 12–18 months. At this age, watch general milestones, and see your paediatrician for any delay. Diagnosis is confirmed only by a clinician.
Read the answer AnswerWhen should I worry about Global Developmental Delay at 12–18 months?
Worry is reasonable if your 12-to-18-month-old shows delays in two or more areas — movement, speech, social or thinking skills — or loses skills they once had. A single slow area is often normal; a pattern is the flag to check. Only a clinician can confirm GDD.
Read the answer AnswerWhen should I worry about hearing impairment at 12-18 months?
By 12–18 months, check with your doctor if your child doesn't turn to sounds, isn't babbling or saying any words, or doesn't respond to their name — especially if responsiveness has faded. This needs a hearing check, not panic. Only a clinician can confirm; early checks help enormously.
Read the answer AnswerWhen should I worry about Intellectual Disability at 12–18 months?
At 12–18 months it is too early to diagnose Intellectual Disability — this is a watch-and-support stage, not a labelling one. Track the overall pattern across play, communication and movement; a persistent lag across several areas, or loss of skills, is a reason for a friendly developmental check. Only a clinician can assess, and meaningful assessment comes later.
Read the answer AnswerWhen should I worry that my 12-to-18-month-old might have Sensory Processing Differences?
At 12–18 months, sensory likes and dislikes are normal and we watch patterns rather than diagnose. Worry sooner if intense, lasting distress with sound, touch or movement disrupts eating, sleep or play — and rule out hearing first. Only a Pinnacle clinician can confirm anything.
Read the answer AnswerWhen should I worry about SLD in a 12-to-18-month-old?
Specific Learning Disability is about reading, writing and maths — skills that haven't begun at 12–18 months, so it can't be identified or worried about this early. It usually becomes clear around ages 6–8. For now, watch broad milestones like babbling, pointing, understanding and walking; a persistent pattern of several delays is reason for a general developmental check, not a label.
Read the answer AnswerWhen should I worry about speech delay at 12–18 months?
At 12–18 months, range is wide and one quiet talker is rarely cause for alarm. Worry becomes meaningful with a pattern: no babble or gestures by 12 months, no words by 15–18 months, no understanding of simple requests, or loss of skills once gained. A check — starting with hearing — is the hopeful next step; only a clinician can tell delay from a phase.
Read the answer AnswerWhen should I worry my 18–24-month-old has ADHD?
At 18–24 months, ADHD cannot yet be meaningfully identified — high energy and short attention are normal toddler behaviour. ADHD is reliably assessed only from around age 4–5. Channel any worry into a general developmental check, never a premature label. Only a clinician can assess.
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 that my 18-to-24-month-old might have Cerebral Palsy?
Worry is reasonable, but worry is not a diagnosis. By 18–24 months, persistent patterns — not walking, stiff or floppy tone, strongly favouring one hand, or poor balance — are worth a prompt check. Only a clinician can confirm Cerebral Palsy, and early support works beautifully.
Read the answer AnswerWhen Should I Worry About Down Syndrome at 18–24 Months?
Down syndrome is a genetic condition present from birth and is almost always identified at or soon after birth via physical signs and a blood test — it does not newly appear at 18–24 months. What matters at this age is watching overall development; any delay deserves a general check, not a feared label.
Read the answer AnswerWhen should I worry about Global Developmental Delay at 18–24 months?
At 18–24 months, worry is reasonable if your child is behind in two or more areas at once — movement, words, understanding, play — or has lost skills. One slow area often catches up; a pattern across several is the real flag. Worry is a reason to check, not a diagnosis.
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