• Does not respond to loud noises

  • Does not follow moving objects with eyes by 3 months 

  • Doesn’t smile at the sound of your voice by 2 months 

  • Doesn’t grasp and hold objects by 3 months 

  • Doesn’t smile at people by 3 months 

  • Cannot support head well at 3 months 

  • Doesn’t reach for and grasp toys by 4 months

  • Doesn’t bring objects to mouth by 4 months 

  • Doesn’t push down with legs when feet are placed on a firm surface by 4 months 

  • Has trouble moving one or both eyes in all directions 

  • Crosses eyes most of the time (occasional crossing of the eyes is normal in these first months)

This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done. 

Red Flags:  Birth to 3 Months

  • Does not show interest in games like “peek-a-boo” or “patty cake” by 9 months. 

  • Does not engage in turn taking activities with facial expression or eye gaze by 8 month

  • Does not crawl

  • Drags one side of body while crawling (for over one month) 

  • Does not stand when supported 

  • Does not sit steadily by 10 months. 

  • Does not babble by 10 months (dadada, bababa, mamama) 

  • Does not search for objects that are hidden (object permeance) by 10-12 months

  • Does not point and/or use gestures (waving hi/bye, shaking head no/yes, etc) by 12 months 

  • Does not coo or babble during play by 12 months 

  • Does not imitate large motor movements or imitate vocalizations by 12 months 

  • Does not have at least one word (ex. mama) that is used consistently by 13 months

  • Does not understand simple words like “mama” or “juice” by 12 months

  • This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done.

Red Flags:  8 to 12 Months

  • Does not walk by 18 months 

  • Does not use at least 6 words by 18 months

  • Does not follow simple verbal directions such as “Give me the ____” or “Show me your nose” by 21 months 

  • Does not look at you when you are talking or playing 

  • Does not play in close proximity to other children 

  • Prefers gestures to communicate over vocalizations by 18 months

  • Does not point out things of interest (ie. Bird or airplane overhead) by 20 months

  • Does not use at least six consonant sounds (ex. p,b,m,n,w,d) by 20 months 

  • Does not use pretend type play with dolls or self (brush hair, feed, put to bed, etc) by 21 months 

  • Does not appear to know the function of common household objects (ex. toothbrush, phone, fork, etc by 20 months

  •  This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done.

Red Flags:  18 to 23 Months

  • Frequent falling or difficulty climbing stairs 

  • Does not build a tower of more than 4 blocks 

  • Does not manipulate small objects well

  • Does not copy a circle by 36 months/3 yrs

  • Does not easily separate from primary caregiver 

  • Does not answer simple questions such as “who is that?, what do you want?, what is your dolls name?, where is your red truck?” by 36 months/3 yrs

  • Does not use 3-4 word sentences by 3 ½ yrs 

  • Does not accurately answer yes/no questions 

  • Has limited interest in toys 

  • Is not understood at least 75% of the time by adults and peers by 3 years 

  • Does not show interest in playing with other children

  • Has poor eye contact 

  • Does not use “me” or “you” appropriately by 4 yrs

  • Does not consistently use final consonants on words by 3 ½ yrs (ex. says “ca” for “cat”)

  • Is not understood most of the time by 4 yrs

  • Does not respond to people outside their immediate family

  • Does not engage in fantasy play by 4 yrs

  • Does not demonstrate any self-control when angry or upset instead lashes out 

  • Has difficulty scribbling

  • Does not have the ability to jump in place or ride a tricycle

  • Uses gestures or phrases instead of complete sentences by 3 ½ yrs

  • Has difficulty recalling names of common objects and overuses “it, that or thing” 

  • Does not have consistent understanding of basic language such as “in/out, under/over, before/after”, etc

  • Cannot give first and last name 

  • Does not use plurals or past tense (still makes mistakes with irregular past tense                                                 

  • This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done.

Red Flags:  3 to 4 Years

  • Cannot brush teeth efficiently 

  • Has greater academic potential than he/she may be exhibiting in the classroom (6 years) 

  • Poor comprehension skills 

  • Difficulty remembering names and overuses words like “it, thing” 

  • Difficulty paying attention or listening in class 

  • Difficulty sequencing a 4-8 event story 

  • Difficulty sounding out words or knowing sounds based on letter 

  • Difficulty asking for help and repetition when needed 

  • Difficulty following multi-step directions and/or remembering information

Red Flags:  5 to 6 Years

  • Seems very stiff, tight muscles 

  • Seems very floppy, like a rag doll 

  • Head still flops back when body is pulled to sitting position (by 5 months still exhibits head lag) 

  • Shows no affection for the person who cares for them 

  • Doesn’t seem to enjoy being around people 

  • One or both eyes consistently turn in or out 

  • Respond with big smiles by age 5 months? 

  • Turn and look in response to new sounds by age 6 months? 

  • Persistent tearing, eye drainage, or sensitivity to light

  • Does not respond to sounds around them 

  • Has difficulty getting objects to mouth 

  • Does not turn head to locate sounds by 4 months 

  • Doesn’t roll over (stomach to back) by 6 months 

  • Cannot sit with help by 6 months (not by themselves) 

  • Does not laugh or make squealing sounds by 5 months 

  • Does not actively reach for objects by 6 months 

  • Does not follow objects with both eyes 

  • Does not bear some weight on legs by 5 months

 

This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done

Red Flags:  4 to 7 Months

  • Does not have at least one word (ex. mama) that is used consistently by 12 months

  • Does not begin to use single words in addition to “mama/dada” by 14-16 months 

  • Does not respond to name and simple instructions (ex. come here, stop) by 12-16 months

  • Does not point and/or use gestures (waving hi/bye, shaking head no/yes, etc) by 12 months 

  • Does not begin to point to familiar objects/pictures named (ie. Where is the dog?) by 13 months

  • Does not coo or babble during play by 12 months 

  • Does not imitate large motor movements or imitate vocalizations by 12 months 

  • Does not understand simple words like “mama” or “juice” by 12 months

  • Does not use at least a couple of consonants in babble/words like “m,b” (ex. mama, baba), etc 

  • Does not use some form of communication to let you know that s/he needs help by 12 months

  • Does not understand and/or respond to words such as “no, byebye” by 15 months

  • Does not say at least 3 words by 15 months

  • Does not point to simple body parts when asked by 16-17 months

  • Does not attempt to get your attention to show you a toy/object of interest

  • This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done.

Red Flags:  13 to 17 Months

  • Child has limited words to express more than immediate needs=limited vocabulary

  • Has unusual tone of voice (raspy or nasal/sounds like they always have a stuffy nose)

  • Does not follow simple two step directions involving familiar objects (ie. Get the ball and put it on the table)

  • Does not put two words together (ex. hi dada, bye mama, mama go, etc) by 26 months

  • Does not sit to look at high interest books for at least a few minutes at a time

  • Does not point to many pictures of familiar objects in a book as you name them

  • Is not understood by adults and peers at least ½ the time (50%)

  • Does not appear to be having an explosion of new words that they are using spontaneously

  • Does not name at least 3 body parts by 30 months 

  • Does not use pretend play regularly by 30 months

  • Does not consistently use at least 2 word combinations by 30 months

  • Persistent drooling or very unclear speech by 32 months 

  • Uses imitated words more than spontaneously using words to communicate needs

  • Consistently echoes your questions vs. answering them

  • Is not understood by anyone in the family by 30 months

  • Does not show interest in communicating with others 

  • Has difficulty singing fragments of nursery rhymes by 32 months 

  • Does not ask simple questions by 36 months 

  • Does not articulate initial consonants of words by 36 months (ex. says “all” instead of “ball”) 

  • Does not name most common household objects by 36 months

  • Cannot understand two part commands and prepositions (“get the cup and put it on the table, get the ball that’s under the couch”, etc)

  • This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done.

Red Flags:  24 to 36 Months

  • Cannot throw a ball overhand 

  • Does not grasp a crayon between thumb and fingers 

  • Does not engage in fantasy play 

  • Can not differentiate between fantasy and reality 

  • Exhibits extremely aggressive, fearful or timid behavior 

  • Resists dressing, sleeping, using the toilet 

  • Does not use "me" and "you" correctly

  • Shows undue anxiety when presented with new situations (ie. Changes in routines or going to a birthday party) 

  • Seems “off topic” or makes inappropriate remarks to conversation even though she/he is very verbal 

  • Become “out of control” in unstructured settings 

  • Hit rather than using words to work through conflicts 

  • Have a difficult time in social or academic type settings even though he/she appears very bright 

  • Avoids other children or adults 

  • Difficulty cooperating with peers or participating in group activities even though very verbal 

  • Unusually passive 

  • Unable to express wide range of emotions 

  • Appears sad or unhappy most of the time

  • Easily distracted and/or unable to  concentrate on an activity for more than 5 minutes

  • This list is to be used as a resource only. If you have any concerns based on this list, please contact your child’s pediatrician. An evaluation of their development may need to be done.

Red Flags:  4 to 5 Years

 
 
 
 
 
 
 
 
 

3102 S. Church St. Ste 102

Burlington NC 27215

Phone: 336.350.9263

fax: 336.350.9264

info@expressionsspeech.com

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