When to Worry About Rett Syndrome at 18–24 Months

If you've noticed your toddler losing skills they once had, your watchfulness matters — and getting answers early is one of the most loving steps you can take.

In short

The single most important sign of Rett Syndrome is regression — a child who was developing typically begins to lose skills she had already gained, especially purposeful use of her hands and sometimes spoken words, often between 12 and 30 months. If your 18-to-24-month-old has lost hand skills she once had, or shows repetitive hand-wringing, hand-washing or mouthing movements, slowing head growth, or loss of words or social engagement, arrange a developmental and paediatric review now. This is a reason to assess promptly — not a diagnosis — and earlier review means earlier support.

What to watch at 18–24 months

Rett Syndrome most often shows itself through a change from what your child could do before. Gentle but important things worth a clinician's eye:

• Loss of hand skills — she stops using her hands to reach, hold or play in the purposeful way she used to.
• Repetitive hand movements — wringing, squeezing, washing-like motions, clapping or bringing hands to the mouth, especially when awake.
• Slowing head growth — a head that was growing on track begins to fall away from its earlier curve.
• Loss of language or social connection — words or babble fading, less eye contact or shared smiling than before.
• Movement changes — unsteady, wide-based walking, stiffness, or trouble with balance she didn't have earlier.
• Any clear regression — losing words, gestures or motor skills she clearly had. This always deserves prompt review.

Rett Syndrome is rare and affects girls far more often than boys. Many other, more common reasons can explain a single delay — so noticing one item is not a verdict. What truly matters is the pattern of losing skills, which deserves a medical and developmental assessment without delay.

When to act

Because Rett Syndrome involves regression and slowing head growth, it warrants prompt paediatric and developmental review — not a wait-and-see approach. If you have seen your child lose hand use, words or social skills, or you notice repetitive hand movements, book a review now. Trust your instinct; a parent who senses a change is giving clinicians vital information.

The Pinnacle way

A clinical AbilityScore® and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care — never from an online list. Our clinicians build a careful developmental baseline, listen closely to the history of any skills lost, and coordinate with your paediatrician on next steps. You can learn more about Rett Syndrome and how our occupational therapy team supports hand use, daily skills and engagement through warm, play-based work.

Trusted sources

WHO ICD-11 classifies Rett Syndrome (LD90.0); the American Academy of Pediatrics (healthychildren.org) and CDC describe developmental regression — losing skills once gained — as a sign that always warrants prompt evaluation; CDC "Learn the Signs, Act Early" milestone guidance supports early developmental review.

Next step — Trust what you've noticed. Book a developmental assessment with a Pinnacle clinician so any change in your child's skills is reviewed promptly, with clarity and care.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.