Red Flags
Below you will find a list of milestones and red flags, adapted from a list that was written for the American Academy of Paediatrics by The Early Childhood Direction Center (Shelov, S.P., and Hannemann, R. E. 1994)
Below you will find a list of milestones and red flags, adapted from a list that was written for the American Academy of Paediatrics by The Early Childhood Direction Center (Shelov, S.P., and Hannemann, R. E. 1994)
Please remember - this list is to be used as a guideline for you, as a parent, to make informed decisions. If you feel concerned that your child is delayed or is displaying any 'red flag' behaviours, please consult your nursing practitioner or doctor to discuss this.
How to use this list:
There is a range of time in which individual children could possible achieve a milestone - but the age in brackets at the end of each milestone serves as the 'limit' for typically developing children.
One - Three Months
Movement:
Raises head and cheek when lying on stomach (3 mnths)
Supports upper body with arms when lying on stomach (3 mnths)
Stretches legs out when lying on stomach or back (2-3 mnths)
Opens and shuts hands (2.5-3.5 mnths)
Pushes down on legs when feet are placed on firm surface (3-4 mnths)
Visual:
Watches a face intently (1.5-3 mnths)
Follows moving objects (2 mnths)
Recognises familiar objects and people at a distance (3 mnths)
Starts using hands and eyes in coordination (3-4 mnths)
Hearing and Speech
Smiles at the sound of a voice (1.5-3 mnths)
Cooing noises; vocal play begins at 3 months
Attends to sound (1-3 mnths)
Startles to loud noise (1-3 mnths)
Social and Emotional
Begins to develop a social smile (1.5-2.5 mnths)
Enjoys playing with other people and may cry when playing stops (3-4 mnths)
Becomes more communicative and expressive with face and body (2-3 mnths)
Imitates some movements and facial expressions (3 mnths)
Developmental Red Flags (One - Three Months)
Doesn't seem to respond to loud noises
Doesn't follow moving objects with eyes by 2 months
Doesn't smile at the sound of your voice by 2 months
Doesn't grasp and hold objects by 4 months
Doesn't smile at people by 3 months
Cannot support his head well at 3 months
Doesn't reach for and grasp toys by 4 - 5 months
Doesn't bring objects to her mouth by 4 months
Doesn't push down with legs when his feet are placed on a firm surface by 4 months
Has trouble moving one or both eyes in all directions
Crosses her eyes most of the time (occasional crossing of the eyes is normal in these first months)
Four - Seven Months
Movement
Pushes up on extended arms (5-6 mnths)
Pulls to sitting position with no head lag (5 mnths)
Sits with support of his hands (5-7 mnths)
Sits unsupported for short periods (7-9 mnths)
Supports his/her whole weight on his/her legs (6-8 mnths)
Grasps feet (6 mnths)
Transfers objects from hand to hand (6-7 mnths)
Uses raking grasp (not pincer) (6 mnths)
Visual
Looks for toy beyond tracking range (5-6 mnths)
Tracks moving objects with ease (3-5 mnths)
Grasps objects dangling in front of him (5-6 mnths)
Looks for fallen toys (6-7 mnths)
Language
Distinguishes emotions by tone of voice (3-6 mnths)
Responds to sound by making sounds (4-6 mnths)
Uses voice to express joy and displeasure (4-6 mnths)
Syllable repetition begins (5-7 mnths)
Cognitive
Finds partially hidden objects (6-7 mnths)
Explores with hands and mouth (4-7 mnths)
Works to get objects that are out of reach (5-7 mnths)
Social and Emotional
Enjoys social play (3-6 mnths)
Interested in mirror images (5-7 mnths)
Responds to other people's expression of emotion (3-6 mnths)
Developmental Red Flags (Four - Seven Months)
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 him/her
Doesn't seem to enjoy being around people
One or both eyes consistently turns in or out
Persistent tearing, eye drainage or sensitivity to light
Does not respond to sounds around him
Has difficulty getting objects to her mouth
Does not turn his 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
Eight - Twelve Months
Movement
Gets to sitting position without assistance (8-10 mnths)
Crawls forward on belly (army crawl)
Assumes hand and knee position
Crawls on hands and knees or moves around in some way
Gets from sitting to crawling or prone (lying on stomach) position (10-12 mnths)
Pulls self up to standing position (9-11 mnths)
Walks holding onto furniture (cruising) (10-12 mnths)
Stands momentarily without support (11-12 mnths)
May walk two or three steps without support (10-15 mnths)
Hand and Finger Skills
Uses pincer grasp (9-12 mnths)
Bangs two cubes/blocks together (9-12 mnths)
Puts objects into container (10-12 mnths)
Takes objects out of container (10-12 mnths)
Pokes with index finger (9-12 mnths)
Tries to imitate scribbling (12-14 mnths)
Cognitive
Explores objects in many different ways (shaking, banging, throwing, dropping) (8-10 mnths)
Finds hidden objects easily (10-12 mnths)
Looks at correct picture when image is named (9-12 mnths)
Imitates gestures (9-12 mnths)
Language
Responds to simple verbal requests
Responds to 'no' (10-12 mnths)
Makes simple gestures such as shaking head for no (9-12 mnths)
Babbles with inflection (7-9 mnths)
Babbles 'Dada' and 'Mama' (8-10 mnths)
Says 'Dada' and 'Mama' for specific person (11-12 mnths)
Uses exclamations such as 'Oh-Oh' (11-12 mnths)
Social Emotional
Is shy or cries with strangers (8-12 mnths)
Cries when mother or father leaves (8-12 mnths)
Enjoys imitating people in his play (10-12 mnths)
Shows specific preferences for certain people and toys (8-12 mnths)
Prefers mother and/or regular care provider over all others (8-12 mnths)
Repeats sounds or gestures for attention (10-12 mnths)
Finger Feeds himself (8-12 mnnths)
Extends arms or leg to help when being dressed (11-12 mnths)
Developmental Red Flags (Eight - Twelve Months)
Doesn't crawl or move around over the floor in some way
Drags one side of body while crawling (for over one month)
Cannot stand when supported
Doesn't search for objects that are hidden (10-12 mnths)
Doesn't say single words at 12 months (Mama or Dada)
Doesn't learn to use gestures such as waving or shaking head
Doesn't sit steadily by 10 months
Doesn't show interest in 'peek-a-boo' or 'patty cake' by 8 months
Doesn't babble by 8 months
Doesn't babble 'dada' or 'mama' by 10 months
Twelve to Twenty-Four Months
Movement
Walks alone (12-15 mnths)
Pulls toys behind him while walking (13-16 mnths)
Carries large toy or several toys while waking (13-16 mnths)
Begins to run stiffly (16-18 mnths)
Walks into a ball (18-24 mnths)
Climbs onto and down from furniture unsupported (16-24 mnths)
Walks up and down stairs holding onto support (18-24 mnths)
Hand and Finger Skills
Scribbles spontaneously (14-16 mnths)
Turns over container to pour out contents (12-18 mnths)
Building Tower of four blocks or more (20-24 mnths)
Language
Points to object or picture when it's named for him (18-24 mnths)
Recognises names of familiar people, objects and body parts (15-24 mnths)
Says several single words (15-18 mnths)
Uses two word sentences (18-24 mnths)
Follows simple one-step instructions (12-18 mnths)
Repeats words overheard in conversations (16-18 mnths)
Cognitive
Finds objects even when hidden under 2 or 3 covers
Begins to sort shapes and colours (20-24 mnths)
Begins make-believe play (20-24 mnths)
Social
Imitates behaviour or others, especially adults and older children (12-24 mnths)
Increasingly enthusiastic about company or other children (20-24 mnths)
Demonstrates increasing independence (18-24 mnths)
Begins to show defiant behaviour (18-24 mnths)
Episodes of separation anxiety increase toward midyear and then fade
Developmental Red Flags (Twelve - Twenty-four Months)
Cannot walk by 15-18 months
Fails to develop a mature heel-toe walking pattern after several months of waking, or walks exclusively on his toes
Does not speak at least 10 words by 18 months
Does not use 50 words and put together two word sentences by the age of two
By 15 months, does not seem to know the function of common household objects (brush, telephone, bell, fork, spoon)
Does not imitate actions, speech sounds or words
Does not follow simple two-step instructions by 24 months
Twenty-four to Thirty-six Months
Movement
Climbs well (24-30 mnths)
Walks down stairs alone, placing both feet on each step (26-28 mnths)
Walks up stairs alternating feet with support (24-30 mnths)
Swings leg to kick ball (24-30 mnths)
Runs easily (24-26 mnths)
Pedals tricycle (30-36 mnths)
Bends over easily without falling (24-30 mnths)
Hand and Finger Skills
Makes vertical, horizontal and circular strokes with pencil or crayon (30-36 mnths)
Turns book pages one at a time (24-36 mnths)
Builds a tower of more than six blocks (24-30 mnths)
Holds a pencil in writing position with fingers (30-36 mnths)
Screws and unscrews jar lids, nuts and bolts (24-30 mnths)
Turns rotating handles (24-30 mnths)
Language
Recognises and identifies almost all common objects and pictures (26-32 mnths)
Understands most sentences (24-40 mnths)
Understands physical relationships - on, in, under (30-36 mnths)
Can say name, age and sex (30-36 mnths)
Uses pronouns - I, you, me, we, they (24-30 mnths)
Strangers can understand half of what he says (24 mnths)
Cognitive
Makes mechanical toys work (30-36 mnths)
Matches an object in his hand or room to a picture in a book (24-30 mnths)
Plays make-believe with dolls, animals and people (24-36 mnths)
Sorts objects by colour (30-36 mnths)
Completes puzzles with 3 or 4 pieces (24-36 mnths)
Understands the concept of 'two' (26-32 mnths)
Social and Emotional
By Three, separates easily from parents
Expresses a wide range of emotions (24-36 mnths)
Objects to major changes in routine (24-36 mnths)
Developmental Red Flags (Twenty-four to Thirty-six Months)
Frequent falling and difficulty with stairs
Persistent drooling or very unclear speech
Inability to build a tower of more than four blocks by 24 months
Difficulty manipulating small objects
Inability to copy a circle by three
Inability to communicate in short phrases
No involvement in pretend play
Failure to understand simple instructions
Little interest in other children
Extreme difficulty in separating from primary care giver
Three to Four Years
Movement (by the end of age 3)
Hops and stands on one foot for up to 5 seconds
Goes up stairs and down stairs without support
Kicks ball forward
Throws ball overhead
Catches bounced ball most of the time
Moves forward and backward
Uses riding toys
Hand and Finger Skills (by the end of age 3)
Copies square shapes
Draws a person with 2 or 4 body parts
Uses scissors
Draws circles and squares
Beings to copy some capital letters
Can feed self with spoon by 36 months
Language Milestones (by the end of age 3)
Has mastered some basic rules of grammar
Speaks in sentences of 4 to 5 words
Asks questions
Speaks clearly enough for strangers to understand
Tells stories
Cognitive Milestones (by the end of age 3)
Correctly names some colours
Understands the concept of counting and may know a few numbers
Begins to have a clearer sense of time
Follows three-part commands
Recalls parts of a story
Understands the concepts of 'same' and 'different'
Engages in fantasy play
Understands causality (I can make things happen)
Social Milestones (by the end of age 3)
Interested in new experiences
Cooperates/plays with other children
Plays 'mom' or 'dad'
More inventive in fantasy play
Dresses and undresses
More independent
Emotional Milestones (by the end of age 3)
Often cannot distinguish between fantasy and reality
May have imaginary friends or see monsters
Developmental Red Flags (Three to Four Years)
Cannot jump in place
Cannot ride a tricycle
Cannot grasp a crayon between thumb and fingers
Has difficulty scribbling
Cannot copy a circle
Cannot stack six or more blocks
Still clings or cries when parents leave him
Shows no interest in interactive games
Ignores other children
Doesn't respond to people outside the family
Doesn't engage in fantasy play
Resists dressing, sleeping, using the toilet
Lashes out without any self-control when angry or upset
Doesn't use sentences of more than three words
Doesn't use 'me' or 'you' appropriately
Four to Five Years
Movement (by the end of age 4)
Stands on one foot for 10 seconds or longer
Hops, somersaults
Swings, climbs
May be able to skip
Hand and Finger Skills (by the end of age 4)
Copies triangle and other geometric patterns
Draws person with a body
Prints some letters
Dresses and undresses without assistance
Uses fork and spoon with confidence
Usually cares for own toilet needs
Language Milestones (by the end of age 4)
Recalls parts of a story
Speaks sentences of more than 5 words
Uses future tense
Tells longer stories
Says name and address
Cognitive Milestones (by the end of age 4)
Can count 10 or more objects
Correctly names at least 4 colours
Better understands the concept of time
Knows about things used everyday in the home (money, food etc)
Social Milestones (by the end of age 4)
Wants to please and be with friends
More likely to agree to rules
Likes to sing, dance and act
Shows more independence
Developmental Red Flags (Four to Five Years)
Exhibits extremely aggressive, fearful or timid behaviour
Is unable to separate from parents
Is easily distracted and unable to concentrate on any single activity for more than 10 minutes
Shows little interest in playing with other children
Refuses to respond to people in general
Rarely uses fantasy or imitation play
Seems unhappy or sad much of the time
Avoids or seems aloof with other children or adults
Doesn't express a wide range of emotions
Has trouble eating, sleeping and using the toilet
Can't differentiate between fantasy and reality
Seems unusually passive
Cannot understand two-part commands and prepositions - put the cup 'on' the table, get the ball 'under' the couch
Can't give his first and last name
Doesn't use plurals or past tense
Cannot build a tower of 6-8 blocks
Seems uncomfortable holding a crayon or presses down too hard or too lightly
Has trouble taking off clothing
Cannot brush his teeth or wash and dry his hands
