{"h1":"Should you refer a child not pointing to show things?","faq":[{"a":"Protodeclarative pointing — pointing to share interest rather than just to request — typically emerges by 12–16 months and is usually well established by 18 months. Persistent absence at or beyond 16–18 months warrants a referral for a developmental check.","q":"By what age should a child point to show things?"},{"a":"No single sign is a diagnosis. Absent sharing-pointing is one recognised early flag for social-communication concern, but a clinician forms any picture by looking at it alongside language, eye contact, response to name, hearing and play. Refer for a structured assessment rather than concluding anything in the field.","q":"Is no pointing on its own a sign of autism?"},{"a":"Confirm the child's age, check whether they share interest in other ways (showing objects, following your point, looking between an object and a face, shared smiling), note any language or response-to-name concerns, and consider hearing. If sharing-pointing is absent at 18 months, refer — when in doubt, refer.","q":"What should I do before referring?"}],"lang":"en","slug":"should-a-frontline-worker-refer-a-child-showing-not-pointing-to-show-things","title":"Should a frontline worker refer a child not pointing to show things?","entity":{"key":"no-pointing","kind":"phenomenon","name":"not pointing to show things","slug":null},"lenses":[{"kind":"stakeholder","label":"Asha Phc","value":"asha_phc"},{"kind":"domain","label":"Communication","value":"communication"},{"kind":"intent","label":"Concern","value":"concern"},{"kind":"lifecycle","label":"Screen","value":"screen"},{"kind":"route","label":"Book-Assessment","value":"book-assessment"},{"kind":"empowerment","label":"Early Clarity","value":"early_clarity"}],"parent":{"key":"behaviours","label":"Behaviours"},"related":[{"lang":"en","slug":"should-a-frontline-worker-refer-a-child-showing-difficulty-sharing","title":"Should a frontline worker refer a child showing difficulty sharing?"},{"lang":"en","slug":"should-a-frontline-worker-refer-a-child-showing-late-talking","title":"Should a frontline worker refer a child showing late talking?"},{"lang":"en","slug":"when-should-i-worry-about-not-pointing-to-show-things-in-my-child","title":"When should I worry about not pointing to show things?"},{"lang":"en","slug":"should-a-frontline-worker-refer-a-child-showing-not-playing-with-other-children","title":"Should a frontline worker refer a child not playing with other children?"},{"lang":"en","slug":"how-should-a-frontline-worker-respond-to-not-pointing-to-show-things-in-a-child","title":"How should a frontline worker respond to a child not pointing to show things?"},{"lang":"en","slug":"when-should-a-doctor-investigate-not-pointing-to-show-things-in-a-young-child","title":"When should a doctor investigate not pointing to show things in a young child?"}],"summary":"If a child is not pointing to show or share things by around 16–18 months, a frontline worker should refer for a developmental check — yes. Sharing-pointing (protodeclarative pointing) is a key early social-communication milestone, and persistent absence is a reliable early flag. Strengthen the picture by checking for other shared-attention behaviours, language, response to name and hearing. This is a reason to assess early, not a diagnosis.","answer_md":"*A child who points to share a moment — \"look at that!\" — is showing one of the earliest, richest signs of social communication; noticing when it's absent is exactly the frontline instinct that changes lives.*\n\n## In short\nYes — if a child is not pointing to show or share things by around 16–18 months, this is a meaningful flag that warrants a referral for a developmental check. Protodeclarative pointing (pointing to share interest, not just to request) is a key early social-communication milestone, and its absence is one of the most reliable early indicators that a closer look is worthwhile. This is a reason to refer for assessment, not a diagnosis — and early routing means early support, which works best.\n\n## What to check before you refer\nAt the PHC or community level, confirm the picture with a few quick, calm observations rather than a single moment:\n\n- **Age** — sharing-pointing typically emerges by 12–16 months and is usually well established by 18 months. Brief absence in a younger infant is not concerning; persistent absence at or beyond 16–18 months is.\n- **Does the child share interest in other ways?** — bringing or showing you objects, following your point, looking back and forth between an object and your face, shared smiling and eye contact. If these are also missing, the flag is stronger.\n- **Travelling signs** — few or no words by 16 months, not responding to name, little eye contact, not engaging in simple back-and-forth play, or loss of a skill once had.\n- **Hearing** — always consider hearing as part of any communication concern, as undetected hearing loss can mimic social-communication delay.\n\nIf sharing-pointing is absent at 18 months — especially alongside any of the above — refer. When in doubt, refer; an unnecessary check costs little, while a missed early window costs much.\n\n## Why this matters\nPointing to share is a window into joint attention — the ability to coordinate attention with another person around a third thing. It is a foundation for language and social learning, which is why its absence features in early screening worldwide. A referral does not label the child; it simply opens the door to a structured clinical look while the developing brain is most responsive.\n\n## The Pinnacle way\nA clinical [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated) and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care — never from a single observation or checklist in the field. Your role as a frontline worker is to notice, reassure the family, and route promptly. Our [speech therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) and developmental teams across [70+ centres](/) then build a full picture of the child's strengths and shape support around play.\n\n## Trusted sources\nCDC \"Learn the Signs, Act Early\" developmental milestones, which list pointing to show interest among 18-month communication milestones; American Academy of Pediatrics (healthychildren.org) guidance on early social-communication monitoring and developmental surveillance; WHO Nurturing Care framework for early childhood development.\n\n**Next step —** Trust the flag. Reassure the family and [refer the child for a developmental assessment](https://www.pinnacleblooms.org/enroll-autism-speech-aba-therapies-india) at the nearest Pinnacle Blooms Network centre for a calm, structured review.","canonical":"https://pinnacleblooms.org/ask/should-a-frontline-worker-refer-a-child-showing-not-pointing-to-show-things","editorial":{"reviewed_at":"2026-06-11T20:12:18.613642+00:00","reviewed_by":null,"developed_by":"SETU Consortium · Pinnacle Blooms Network"},"alternates":[{"href":"https://pinnacleblooms.org/ask/should-a-frontline-worker-refer-a-child-showing-not-pointing-to-show-things","lang":"en","indexable":true}],"dimensions":[{"key":"behaviours","label":"Behaviours"}],"meta_title":"No Pointing to Show: Refer? — Frontline Guide","meta_robots":"index, follow, max-image-preview:large","everyday_tip":"During a home visit, watch for whether the child looks back and forth between an interesting object and the caregiver's face — this 'checking in' is the shared-attention signal that pointing supports.","published_at":"2026-06-10T11:52:00.350809+00:00","reading_paths":[{"key":"signs","items":[{"lang":"en","slug":"should-a-frontline-worker-refer-a-child-showing-difficulty-sharing","title":"Should a frontline worker refer a child showing difficulty sharing?","reason":"Linked from this answer"},{"lang":"en","slug":"when-should-a-doctor-investigate-not-pointing-to-show-things-in-a-young-child","title":"When should a doctor investigate not pointing to show things in a young child?","reason":"Linked from this answer"},{"lang":"en","slug":"should-a-frontline-worker-refer-a-child-showing-late-talking","title":"Should a frontline worker refer a child showing late talking?","reason":"Linked from this answer"},{"lang":"en","slug":"when-should-i-worry-about-not-pointing-to-show-things-in-my-child","title":"When should I worry about not pointing to show things?","reason":"Linked from this 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topic"},{"lang":"en","slug":"what-therapy-techniques-help-a-child-with-not-pointing-to-show-things","title":"Therapy techniques for not pointing to show things","reason":"Same topic"}],"label":"Explore therapy & support","total":10},{"key":"home","items":[{"lang":"en","slug":"how-can-i-help-a-young-child-with-not-pointing-to-show-things","title":"How to Help a Young Child Who Isn't Pointing to Show Things","reason":"Same topic"},{"lang":"en","slug":"how-do-i-handle-not-pointing-to-show-things-in-a-1-year-old","title":"How do I handle not pointing to show things in a 1-year-old?","reason":"Same topic"}],"label":"At home & in everyday life","total":2}],"what_to_watch":"Refer if sharing-pointing is absent at or beyond 16–18 months, especially alongside few or no words by 16 months, not responding to name, little eye contact, not following your point, no shared smiling, or loss of a skill. Always consider hearing as part of any communication concern. When in doubt, refer.","authority_links":[{"url":"https://www.cdc.gov/child-development","label":"CDC — 18-month developmental milestones"},{"url":"https://www.healthychildren.org","label":"AAP HealthyChildren — early social communication"},{"url":"https://nurturing-care.org","label":"WHO Nurturing Care Framework"}],"last_reviewed_at":"2026-06-10T11:52:00.350809+00:00","meta_description":"If a child isn't pointing to share interest by 16–18 months, a frontline worker should refer for a developmental check. A reason to assess early, not a dia","related_materials":[],"related_techniques":[]}