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Developmental Red Flags: Birth to 3

Developmental Red Flags: Birth to 3. August 22, 2011 Jennifer Crookham , Mental Health & Disabilities Manager. Video. http :// youtu.be/KrUNBfyjlBk. Gross Motor Red Flags. 4 months- doesn’t lift head up when on tummy Holds head to one side or in one position 7 months- not rolling over

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Developmental Red Flags: Birth to 3

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  1. Developmental Red Flags: Birth to 3 August 22, 2011 Jennifer Crookham, Mental Health & Disabilities Manager

  2. Video • http://youtu.be/KrUNBfyjlBk

  3. Gross Motor Red Flags • 4 months- doesn’t lift head up when on tummy • Holds head to one side or in one position • 7 months- not rolling over • 8 months- not pushing up on straight arms, lifting his head and shoulders • 10 months • not sitting independently • not “commando” crawling • 12 months • not crawling on all fours • not sitting upright in a child-sized chair • not pulling to stand

  4. Gross Motor Red Flags (cont.) • Uses only one side of body in crawling or other movement • 14 months- not standing alone • 18 months- not walking alone • 24 months- doesn’t run • Generally stands or walks on toes and doesn’t put weight on heels of feet • 30 months • not jumping • Not independent on stairs (up and down) • Trips or falls more than same aged peers; appears more clumsy than same age peers

  5. Fine Motor Red Flags • After 6 months- Frequently in a fisted position with both hands • 10 months • Not bringing both hands to midline • Not banging objects together • 12 months • Not clapping their hands • Not transferring an object from one hand to the other • Not able to tip and hold their bottle by themselves and keep it up, without lying down • 18 months • Still using a fisted grasp to hold a crayon • Not using a mature pincer grasp (thumb and index finger, pad to pad) • 24 months- Not imitating a drawing of a vertical line • 30 months- Not able to snip with scissors

  6. Cognitive Red Flags • 15 months- Not imitating body action on a doll (ie, kiss the baby, feed the baby) • 27 months • Not able to match two sets of objects by item (ie, blocks in one container and people in another) • Not able to imitate a model from memory (ie, show me how you brush your teeth) • 31 months- Not able to match two sets of objects by color • Having difficulty problem solving during activities in comparison to his/her peers of about the same or younger age • Unaware of changes in his/her environment and routine

  7. Sensory Red Flags • Very busy, always on the go, and has a very short attention to task • Often lethargic or low arousal (appears to be tired/slow to respond, all the time, even after a nap) • Extreme irritability or cries often • A picky eater • Not aware of when they get hurt (no crying, startle, or reaction to injury) • Under-reactive or overly sensitive to touch, movement, sights, or sounds • Afraid of swinging/movement activities; does not like to be picked up or be upside down

  8. Sensory Red Flags (cont.) • Showing difficulty learning new activities • Having a hard time calming themselves down appropriately (self soothing) • Has difficulty being comforted by adults • Appearing to be constantly moving around, even while sitting • Showing poor or no eye contact • Has persistent destructive behaviors • Repetitive behaviors- inappropriately rocks back and forth, makes hand flapping movements, or repeats words

  9. Sensory Red Flags (cont.) • Frequently jumping and/or purposely falling to the floor/crashing into things • Seeking opportunities to fall without regard to his/her safety or that of others • Constantly touching everything they see, including other children • Hypotonic (floppy body, like a wet noodle) • Having a difficult time with transitions between activity or location • Overly upset with change in routine • Hates bath time or grooming activities such as tooth brushing, hair brushing, hair cuts, having nails cut, etc. • Afraid of/aversive to/avoids being messy, or touching different textures such as grass, sand, carpet, paint, play-doh, etc.

  10. Self-Care Related Red Flags • Having difficulty biting or chewing food during mealtime • Needing a prolonged period of time to chew and/or swallow • Coughing/choking during or after eating on a regular basis • Demonstrating a change in vocal quality during/after eating (i.e. they sound gurgled or hoarse when speaking/making sounds) • 14 months- Not feeding him/herself finger foods • 15 months • Not attempting to use a spoon • Not picking up and drinking from a regular open cup • Not able to pull off hat, socks or mittens on request • 19 months- Not attempting to wash own hands or face • 22 months- Not assisting with dressing tasks (excluding clothes fasteners) • 34 months- Not able to deliberately undo large buttons, snaps and shoelaces

  11. Speech Development Red Flags • 4 months- Not cooing • 6 months- Not laughing or squealing • 8 months- No babbling • 12 months • Not making mama/dada sounds • Doesn’t gesture • 18 months- Doesn’t use single words • 20 months- Doesn’t speak 20 different words (with 50% of speech understood by strangers) • 24 months • Not using 2 word sentences • Doesn’t speak 50 words (with 75% of speech understood by strangers) • Anytime child who previously mastered a language skill suddenly stops talking/babbling

  12. Social Emotional Red Flags • 3 months- Not smiling • Poor, weak, or absent eye contact • Poor attachment • 12 months • Not performing for social attention (doesn’t cry, etc) • Doesn’t show basic emotions • 24 months • Doesn’t show interest in other children • Not imitating actions and movements • Not engaging in pretend play

  13. Social Emotional Red Flags (cont.) • Not demonstrating appropriate play with an object (i.e. instead of trying to put objects into a container, the child leaves the objects in the container and keeps flicking them with his fingers) • Fixating on objects that spin or turn (i.e. See 'n Say, toy cars, etc.); also children who are trying to spin things that are not normally spun • Having significant difficulty attending to tasks • Getting overly upset with change or transitions from activity to activity • Loss of social skills or social skill regression at any age

  14. Red Flags During Play • 7 months- Does not put toys in mouth • 9 months- Does not act interested in peek-a-boo or patty cake • 12 months- Does not stack items • 24 months • Does not turn board book pages • Does not point to eyes, ear, mouth, or nose

  15. General Red Flags • Growth or development suddenly stops • Any regression in child’s skill level • Child drools or has difficulty eating • Is very underweight or overweight • Attempts to eat non-food items • Often stares into space or blanks out • Lack of eye contact after 3 months

  16. Factors to Keep in Mind… • Child’s experiences and family environment • Different cultural expectations for developmental milestones • Gender differences • Health/medical conditions • All children develop at their own unique rates

  17. What to Expect Handouts • http://www.zerotothree.org/child-development/early-development/your-babys-development.html

  18. References and Resources • Sensory Processing Disorder: http://www.sensory-processing-disorder.com/child-developmental-checklist.html • CDC Act Early Campaign: http://cdc.gov/actearly • Birth to Three: http://birthto3.org • Zero to Three: http://www.zerotothree.org/ • Early Head Start National Resource Center: http://www.ehsnrc.org/

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