Red Flags: Signals That Your Child May be Lagging

November 19, 2008

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Red Flags: Signals That Your Child May be Lagging

by Robert Needlman, M.D., F.A.A.P.
reviewed by Robert Needlman, M.D., F.A.A.P.

Development is not a race. Being a little bit ahead or behind on any given milestone means nothing in the long run.

A red flag milestone is different.

The red flag age is the age at which you would expect almost every child to have already mastered a particular skill.

Take walking, for example. Most children walk on their own, without holding on, around their first birthday. By 15 months--the red flag age for walking--a child who has not taken his first independent steps is certainly slower to walk than 90 percent of other children.

Is there something medically or developmentally wrong with this child? Probably not. Most likely he is simply maturing at his own rate. But he is slow enough that a careful examination should be made to rule out any underlying problem, such as weakness in the legs or a hip disorder.

Does the fact that he was slow to walk mean that he will also be academically slow when he goes to school? Not at all!

Red flag milestones are helpful because they put a limit on when you, as a good, concerned parent, should worry.

Here are a few useful red flag milestones at different ages. Many are language milestones because language development relates closely to later elementary school performance, one of the major benchmarks for early development.

Some common milestones, such as crawling, have been left off because they are not very reliable. Some children never crawl, but walk normally. Data for this table are from various developmental tests, as well as the author's clinical experience.

Milestone red flag ages*

Moves both arms and both legs, fairly evenly: Two weeks

Looks at you, at least for a few moments, with both eyes, and follows with his eyes if you move your face slowly from side to side: Six weeks

Smiles, in response to your smiles: 10 weeks

Responds to sounds (looks around, as if to find the sound): Three months

Holds head steady for a few moments when you sit him up: Four months

Grasps a rattle that you put into his palm: Four months

Sits on floor without support: Nine months

Makes interesting noises (for example, ma-da-ba): Nine months

Able to pick up a pea-size object using thumb and forefinger: One year

First word (any sound that your baby uses consistently to refer to one thing, whether or not it is an actual English word): 15 months

Walks without holding on (at least a few steps): 15 months

Says six words, understands more; points to what he wants: 18 months

Makes up two-word sentences by himself (not copied), such as "Baby cookie!"; phrases such as "bye-bye" count as one, not two, words: Two years

Knows one or two body parts, points to a few pictures in books in response to questions, such as "Where's the doggie?" or "Where's the flower?": Two years

Engages in simple make-believe play; for example, feeds doll imaginary food, makes truck sounds for toy truck: 2 1/2 years

Asks questions, uses three-word sentences, understands simple commands: Three years

Can draw a circle with crayons: 3 1/2 years

You can understand nearly everything he says: Four years

Plays cooperatively with a peer, for a short time: Four years

He can say almost anything using simple grammar; uses past, present, and future tenses; distinguishes between singular and plural; can tell a simple story: Five years

*NOTE: If your child has not attained a milestone by the red flag age indicated, ask a medical or child-development professional. Be aware that these red flag milestones apply to full-term infants only. If your child was born more than two weeks early (37 weeks or less gestational), add extra time to these cutoff dates.


RELATED INFORMATION

			Early and Late Talking: 9 to 12 Months
			What Does Normal Development Mean?
			Development: How It Happens
			Concern About Delayed Developmental Milestones

Created May 25, 2000
Reviewed August 15, 2004

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