# When should I worry about Rett Syndrome at 18–24 months?

Canonical: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-18-to-24-month-old-might-have-rett-syndrome
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

Rett Syndrome is rare and shows itself mainly through regression — a toddler losing skills she once had, especially purposeful hand use, often between 12 and 30 months. At 18–24 months, seek prompt paediatric and developmental review if your child has lost hand skills, shows repetitive hand-wringing or washing movements, has slowing head growth, or has lost words or social connection. These are reasons to assess promptly, not a diagnosis — early review means earlier support.

*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®](/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 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](/rett-syndrome) and how our [occupational therapy](https://www.pinnacleblooms.org/best-occupational-therapy-center-india-proven-improvement-rate) 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](https://www.pinnacleblooms.org/enroll-autism-speech-aba-therapies-india) 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.

## Sources
- WHO ICD-11: Rett Syndrome: https://icd.who.int/
- AAP: developmental regression and when to seek review: https://www.healthychildren.org/
- CDC: Learn the Signs, Act Early milestones: https://www.cdc.gov/

## Connected topics and perspectives
- Conditions: https://pinnacleblooms.org/ask/conditions
- Parent: https://pinnacleblooms.org/ask/lens/stakeholder/parent
- Toddler-18-24: https://pinnacleblooms.org/ask/lens/age/toddler-18-24
- Context: https://pinnacleblooms.org/ask/lens/domain/context
- Concern: https://pinnacleblooms.org/ask/lens/intent/concern
- Screen: https://pinnacleblooms.org/ask/lens/lifecycle/screen
- Special Education: https://pinnacleblooms.org/ask/lens/route/special-education
- Early Clarity: https://pinnacleblooms.org/ask/lens/empowerment/early_clarity

## Related question paths

### Understand the subject
- How Rett Syndrome Affects a Child's Daily Life: https://pinnacleblooms.org/ask/how-does-rett-syndrome-affect-a-child-s-daily-life
- Is Rett Syndrome considered a disability?: https://pinnacleblooms.org/ask/is-rett-syndrome-considered-a-disability
- Is Rett Syndrome Genetic or Hereditary?: https://pinnacleblooms.org/ask/is-rett-syndrome-genetic-or-hereditary
- What are common myths about Rett Syndrome?: https://pinnacleblooms.org/ask/what-are-common-myths-about-rett-syndrome
- Types and Stages of Rett Syndrome: https://pinnacleblooms.org/ask/what-are-the-types-or-levels-of-rett-syndrome
- What causes Rett syndrome in children?: https://pinnacleblooms.org/ask/what-causes-rett-syndrome-in-children
- What is Rett Syndrome?: https://pinnacleblooms.org/ask/what-is-rett-syndrome
- What is Rett Syndrome, and what does it look like in early childhood?: https://pinnacleblooms.org/ask/what-is-rett-syndrome-and-what-does-it-look-like-in-early-childhood
- Conditions That Occur Alongside Rett Syndrome: https://pinnacleblooms.org/ask/what-other-conditions-often-occur-alongside-rett-syndrome
- Early Intervention Outcomes in Rett Syndrome (Under 7): https://pinnacleblooms.org/ask/what-does-current-research-show-about-early-intervention-outcomes-for-rett-syndrome-in-children-under-7
- What is Rett Syndrome, and its ICD-11 features in early childhood?: https://pinnacleblooms.org/ask/what-is-rett-syndrome-and-what-are-its-icd-11-features-in-early-childhood
- ICD-11 Classification of Rett Syndrome (LD90.0): https://pinnacleblooms.org/ask/what-is-the-icd-11-classification-for-rett-syndrome

### Recognise signs & concerns
- When to worry about Rett Syndrome at 12–18 months: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-12-to-18-month-old-might-have-rett-syndrome
- When should I worry that my 3-year-old might have Rett Syndrome?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-3-year-old-might-have-rett-syndrome
- When should I worry that my 9-to-12-month-old might have Rett Syndrome?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-9-to-12-month-old-might-have-rett-syndrome
- When should I worry that my 4-year-old might have Rett Syndrome?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-4-year-old-might-have-rett-syndrome
- When should I worry that my 2-year-old might have Rett Syndrome?: https://pinnacleblooms.org/ask/when-should-i-worry-that-my-2-year-old-might-have-rett-syndrome
- Early Signs of Rett Syndrome in an 18-to-24-Month-Old: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-rett-syndrome-in-a-18-to-24-month-old
- Can Rett Syndrome Be Cured?: https://pinnacleblooms.org/ask/can-rett-syndrome-be-cured
- Can Rett Syndrome Be Prevented?: https://pinnacleblooms.org/ask/can-rett-syndrome-be-prevented
- Rett Syndrome in Boys: https://pinnacleblooms.org/ask/do-boys-show-rett-syndrome-differently
- Do girls show Rett Syndrome differently?: https://pinnacleblooms.org/ask/do-girls-show-rett-syndrome-differently
- Should I be worried my child might have Rett Syndrome?: https://pinnacleblooms.org/ask/should-i-be-worried-my-child-might-have-rett-syndrome
- Early Signs of Rett Syndrome: https://pinnacleblooms.org/ask/what-are-the-early-signs-of-rett-syndrome

### Explore causes & influences
- Are boys more likely to have Rett Syndrome?: https://pinnacleblooms.org/ask/are-boys-more-likely-to-have-rett-syndrome
- Are girls more likely to have Rett Syndrome?: https://pinnacleblooms.org/ask/are-girls-more-likely-to-have-rett-syndrome
- What Causes Rett Syndrome in Young Children?: https://pinnacleblooms.org/ask/what-causes-rett-syndrome-in-young-children
- Early Intervention for Rett Syndrome, UNCRPD & the SDGs: https://pinnacleblooms.org/ask/how-does-early-intervention-for-rett-syndrome-advance-un-child-rights-uncrpd-and-the-sdgs
- Known contributing factors for Rett Syndrome: https://pinnacleblooms.org/ask/what-are-the-known-contributing-factors-for-rett-syndrome-in-early-childhood
- Cost-effectiveness of early therapy for Rett Syndrome in young children: https://pinnacleblooms.org/ask/what-is-the-cost-effectiveness-of-early-therapy-for-rett-syndrome-in-young-children
- Prevalence and Public-Health Burden of Rett Syndrome in India: https://pinnacleblooms.org/ask/what-is-the-prevalence-and-public-health-burden-of-rett-syndrome-among-young-children-in-india

### Understand assessment
- How AbilityScore Tracks Progress in a Child with Rett Syndrome: https://pinnacleblooms.org/ask/how-does-abilityscore-track-progress-in-a-child-with-rett-syndrome
- How Rett Syndrome Is Assessed in a Young Child: https://pinnacleblooms.org/ask/how-is-rett-syndrome-assessed-in-a-young-child
- How Rett Syndrome Is Assessed in Children Under 7: https://pinnacleblooms.org/ask/how-is-rett-syndrome-assessed-in-children-under-7
- What an AbilityScore® of 0–100 means for a child with Rett Syndrome: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-0-100-mean-for-a-child-with-rett-syndrome
- What does an AbilityScore of 100–200 mean for a child with Rett Syndrome?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-100-200-mean-for-a-child-with-rett-syndrome
- What does an AbilityScore of 200–300 mean for a child with Rett Syndrome?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-200-300-mean-for-a-child-with-rett-syndrome
- AbilityScore 300–400 in Rett Syndrome: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-300-400-mean-for-a-child-with-rett-syndrome
- What an AbilityScore of 400–500 Means in Rett Syndrome: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-400-500-mean-for-a-child-with-rett-syndrome
- What does an AbilityScore of 500–600 mean for a child with Rett Syndrome?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-500-600-mean-for-a-child-with-rett-syndrome
- What does an AbilityScore of 600–700 mean for a child with Rett Syndrome?: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-600-700-mean-for-a-child-with-rett-syndrome
- What an AbilityScore of 700–800 Means for a Child with Rett Syndrome: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-700-800-mean-for-a-child-with-rett-syndrome
- What an AbilityScore of 800–900 Means for a Child with Rett Syndrome: https://pinnacleblooms.org/ask/what-does-an-abilityscore-of-800-900-mean-for-a-child-with-rett-syndrome

### Explore therapy & support
- Early Signs of Rett Syndrome for Early-Years Workers: https://pinnacleblooms.org/ask/what-early-signs-of-rett-syndrome-might-a-daycare-or-anganwadi-worker-notice
- Can a Child with Rett Syndrome Attend a Mainstream School?: https://pinnacleblooms.org/ask/can-a-child-with-rett-syndrome-attend-a-mainstream-school
- Can a Child with Rett Syndrome Attend a Regular School?: https://pinnacleblooms.org/ask/can-a-child-with-rett-syndrome-attend-a-regular-school
- Can a Child with Rett Syndrome Live Independently?: https://pinnacleblooms.org/ask/can-a-child-with-rett-syndrome-grow-up-to-live-independently
- How is Rett Syndrome diagnosed in a child?: https://pinnacleblooms.org/ask/how-is-rett-syndrome-diagnosed-in-a-child
- How is Rett Syndrome supported through therapy?: https://pinnacleblooms.org/ask/how-is-rett-syndrome-supported-through-therapy
- Rett Syndrome AbilityScore®: What to Do Next: https://pinnacleblooms.org/ask/my-child-with-rett-syndrome-has-an-abilityscore-of-0-100-what-should-we-do-next
- Rett Syndrome with an AbilityScore of 100–200: your next step: https://pinnacleblooms.org/ask/my-child-with-rett-syndrome-has-an-abilityscore-of-100-200-what-should-we-do-next
- Rett Syndrome: AbilityScore 200–300 — what to do next: https://pinnacleblooms.org/ask/my-child-with-rett-syndrome-has-an-abilityscore-of-200-300-what-should-we-do-next
- Rett Syndrome: AbilityScore 300–400 — what to do next: https://pinnacleblooms.org/ask/my-child-with-rett-syndrome-has-an-abilityscore-of-300-400-what-should-we-do-next
- Rett Syndrome with an AbilityScore of 400–500: what to do next: https://pinnacleblooms.org/ask/my-child-with-rett-syndrome-has-an-abilityscore-of-400-500-what-should-we-do-next
- Rett Syndrome and an AbilityScore of 500–600: What To Do Next: https://pinnacleblooms.org/ask/my-child-with-rett-syndrome-has-an-abilityscore-of-500-600-what-should-we-do-next

### At home & in everyday life
- How can I support my child with Rett Syndrome at home?: https://pinnacleblooms.org/ask/how-can-i-support-my-child-with-rett-syndrome-at-home