Developmental Red Flags

Question 1

What is a red flag for developmental delay if a child does not fix and follow by _______ months?

Answer 1

3 months

This indicates potential issues in visual tracking and engagement.

Question 2

What are the milestones at 2 months?

Answer 2

Gross Motor= Baby can hold head up but is unsteady like a bobble-head due to weak neck muscles. They lie on their abdomen

Fine motor: opens hand and follows objects to midline with eyes

Language= coo

Social=smile

Question 3

What are the milestones at 4 months?

Answer 3

Gross Motor= rolls front to back, can hold head steady, sitting with support, palmar grasp briefly

Fine motor: reaches for toys, brings hand to mouth

At 4-6 months Rooting and Moro reflex disappears

Rooting reflex, where stroking child’s cheek causes them to turn heads and open mouth.

Moro reflex, startle reflex where sudden sensation of falling causes extension and abduction of upper extremities with drawing in arms

Language= babbles, turns to voice

Social= laughs

Question 4

What are the milestones at 6 months?

Answer 4

Gross Motor= rolling all around, sitting independently, transferring objects between hands and have raking grasp.

Fine motor: They lose the palmar reflex, where they grasp objects in palm.

Lanaugage= responses to name and makes vowel sounds

Social= Responds to name and recognises people, social

Question 5

What are the milestones at 9 months?

Answer 5

Gross motor Motor: crawling, pulling to stand up and begin cruising.

Fine motor: They will have early pincer grasp and can hold bottle or cup and point with finger,

Language: can sound words mama and dada

Social: , becomes shy and takes everything to mouth

Question 6

What are the milestones at 1 years old?

Answer 6

Gross Motor: stand independently, take first steps, throw a ball, point to object, 2 finger pincer grasp and loss of babinski reflex

Fine motor: precise pincer grip and bangs toys together

Language: 1-2 words spoken, can say no

Social: waves bye-bye, plays pat-a-cake respond to one-step command with gestures and use toys functionally, point at wanted items

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Question 7

What are the milestones at 18months?

Answer 7

Gross motor: squats to pick up toy

Fine motor: scribbling and making 3 block tower

Language: 10-25 words, pointing to 1-3 body parts

Social: plays simple pretend

Question 8

What are the milestones at 2 years old?

Answer 8

Gross motor: running, walk on stairs with rail and kick ball

Fine motor: copy a line, tower of 6

Language: 2-3 word phrases with 50+ vocabulary

social: parallel play, tantrums

Question 9

What are the milestones at 3 years old?

Answer 9

Gross motor: jumping and pedalling tricycle and walks up stairs without rail

Fine motor: copies circle and use a fork

Language: 3-4 word sentences

Social: imaginative play, shares with others, separates easily

Question 10

What are the milestones at 4 years old?

Answer 10

Gross motor: balance on one foot, hopping

Fine motor: copies shapes and uses scissors

Language: speaks in sentences fluently

social: co-operates with peers and plays with others

Question 11

What are the milestones at 5 years old?

Answer 11

Gross motor: skip and catch ball

Fine motor: draw people and copie letter

Language: uses future tense and word play

Social:dress independently and recites alphabet, understands rules and shows empathy

Question 12

A squint present at _______ weeks is a red flag for developmental delay.

Answer 12

8 weeks

This may suggest vision impairment.

Question 13

No social smile at ____, refer at _______ weeks.

Answer 13

6 months

Refer at 10 weeks

This could indicate autism, vision impairment, or attachment issues.

Question 14

When is head lag concerning?

Answer 14

At 4 months and indicates
* NM disorders
* Cerebral palsy
* Hypotonia from Down’s syndrome

This is a sign of potential neurological issues.

Question 15

When is inability to sitting unsupported concerning?

Answer 15

Children should sit without support at 7-8 months. Refer if this is not rpesent at 12 months.

Question 16

No babbling may indicate what conditions?

Answer 16

Absent at 6-9 months=
* Autism
* Hearing impairment
* Global development delay
* Speech and language delay

Babbling is an important milestone in speech development.

Question 17

Not sitting unsupported by _______ months is a red flag for developmental delay.

Answer 17

12 months

This may suggest cerebral palsy, muscular dystrophy, or hypotonia.

Question 18

No pincer grasp at ____ may indicate what conditions?

Answer 18

12 months =
* Autism
* Intellectual disability
* Fine motor delay

The pincer grasp is crucial for fine motor skills.

Question 19

What are the signs of developmental delay if a child is not walking by _____?

Answer 19

• Cerebral palsy
• Duchenne’s
• Developmental dysplasia of hip
• Global developmental delays

Walking is a key milestone in gross motor development.

Question 20

Lack of pretend play by ____ may indicate what?

Answer 20

3 years old=
* Autism
* Intellectual disability
* Neglect

Pretend play is essential for social and cognitive development.

Question 21

What does unintelligible speech at ____ indicate?

Answer 21

4 years old may indicate Potential speech delay

Clear speech is expected by this age.

Question 22

Hand preference before _______ months is abnormal and may indicate ____

Answer 22

12 months and can indicate cerebral palsy

Early hand preference can be a sign of neurological issues.

Question 23

When is lack of pretend play concerning?

Answer 23

By 3 years
Indicates autism, intellectual disability or neglect

Question 24

What does loss of previously acquired skill indicate?

Answer 24

• Neurodegenerative disorder (e.g., Rett’s)
• Autism
• Brain tumor
• Epileptic encephalopathy

This is a concerning sign that requires immediate evaluation.

Question 25

What are the **causes of social, emotional, and behavioral delay**?

Answer 25

* Autism spectrum disorder * Neglect * Genetic disorders (e.g., Down's syndrome) * Hearing impairment ## Footnote These factors can significantly impact a child's development.

Question 26

What are the **causes of speech delay**?

Answer 26

* Global delay (most common) * Hearing impairment * Chronic otitis media with effusion (glue ear) * Environment (lack of stimulus) * Psychiatric issues (e.g., autism) * Bilingual household ## Footnote Speech delays can arise from various factors.

Question 27

What is included in the **management** of developmental delays?

Answer 27

* Comprehensive history and physical exam * MDT evaluation for hearing and speech assessment * Occupational therapy * Pediatric and psychological evaluation * Neuroimaging, MRI, genetic testing, and metabolic screening ## Footnote A multidisciplinary approach is crucial for effective management.

Question 28

Which features should be assessed on physical exam?

Answer 28

look for dystrophic features like single palmar crease or cafe-au-last spots, evidence of systemic illness like hepatospleonegaly

Question 29

What is a **red flag** for developmental delay if a child does not fix and follow by _______ months?

Answer 29

3 months ## Footnote This indicates potential issues in visual tracking and engagement.

Question 30

A **squint** present at _______ weeks is a red flag for developmental delay.

Answer 30

8 weeks ## Footnote This may suggest vision impairment.

Question 31

No **social smile** at 6 months, refer at _______ weeks.

Answer 31

10 weeks ## Footnote This could indicate autism, vision impairment, or attachment issues.

Question 32

What does **head lag** at 4 months indicate?

Answer 32

* NM disorders * Cerebral palsy * Hypotonia from Down’s syndrome ## Footnote This is a sign of potential neurological issues.

Question 33

No **babbling** at 6-9 months may indicate what conditions?

Answer 33

* Autism * Hearing impairment * Global development delay * Speech and language delay ## Footnote Babbling is an important milestone in speech development.

Question 34

Not sitting unsupported by _______ months is a red flag for developmental delay.

Answer 34

12 months ## Footnote This may suggest cerebral palsy, muscular dystrophy, or hypotonia.

Question 35

No **pincer grasp** at 12 months may indicate what conditions?

Answer 35

* Autism * Intellectual disability * Fine motor delay ## Footnote The pincer grasp is crucial for fine motor skills.

Question 36

What are the signs of developmental delay if a child is not **walking** by 18 months?

Answer 36

* Cerebral palsy * Duchenne’s * Developmental dysplasia of hip * Global developmental delays ## Footnote Walking is a key milestone in gross motor development.

Question 37

Lack of **pretend play** by 3 years may indicate what?

Answer 37

* Autism * Intellectual disability * Neglect ## Footnote Pretend play is essential for social and cognitive development.

Question 38

What does **unintelligible speech** at 4 years old indicate?

Answer 38

Potential speech delay ## Footnote Clear speech is expected by this age.

Question 39

Hand preference before _______ months is abnormal and may indicate cerebral palsy.

Answer 39

12 months ## Footnote Early hand preference can be a sign of neurological issues.

Question 40

What does **loss of previously acquired skill** indicate?

Answer 40

* Neurodegenerative disorder (e.g., Rett’s) * Autism * Brain tumor * Epileptic encephalopathy ## Footnote This is a concerning sign that requires immediate evaluation.

Question 41

What are the **causes of social, emotional, and behavioral delay**?

Answer 41

* Autism spectrum disorder * Neglect * Genetic disorders (e.g., Down's syndrome) * Hearing impairment ## Footnote These factors can significantly impact a child's development.

Question 42

What are the **causes of speech delay**?

Answer 42

* Global delay (most common) * Hearing impairment * Chronic otitis media with effusion (glue ear) * Environment (lack of stimulus) * Psychiatric issues (e.g., autism) * Bilingual household ## Footnote Speech delays can arise from various factors.

Question 43

What is included in the **management** of developmental delays?

Answer 43

* Comprehensive history and physical exam * MDT evaluation for hearing and speech assessment * Occupational therapy * Pediatric and psychological evaluation * Neuroimaging, MRI, genetic testing, and metabolic screening ## Footnote A multidisciplinary approach is crucial for effective management.

Question 44

What is a **red flag** for developmental delay if a child does not fix and follow by _______ months?

Answer 44

3 months ## Footnote This indicates potential issues in visual tracking and engagement.

Question 45

A **squint** present at _______ weeks is a red flag for developmental delay.

Answer 45

8 weeks ## Footnote This may suggest vision impairment.

Question 46

No **social smile** at 6 months, refer at _______ weeks.

Answer 46

10 weeks ## Footnote This could indicate autism, vision impairment, or attachment issues.

Question 47

What does **head lag** at 4 months indicate?

Answer 47

* NM disorders * Cerebral palsy * Hypotonia from Down’s syndrome ## Footnote This is a sign of potential neurological issues.

Question 48

No **babbling** at 6-9 months may indicate what conditions?

Answer 48

* Autism * Hearing impairment * Global development delay * Speech and language delay ## Footnote Babbling is an important milestone in speech development.

Question 49

Not sitting unsupported by _______ months is a red flag for developmental delay.

Answer 49

12 months ## Footnote This may suggest cerebral palsy, muscular dystrophy, or hypotonia.

Question 50

No **pincer grasp** at 12 months may indicate what conditions?

Answer 50

* Autism * Intellectual disability * Fine motor delay ## Footnote The pincer grasp is crucial for fine motor skills.

Question 51

What are the signs of developmental delay if a child is not **walking** by 18 months?

Answer 51

* Cerebral palsy * Duchenne’s * Developmental dysplasia of hip * Global developmental delays ## Footnote Walking is a key milestone in gross motor development.

Question 52

Lack of **pretend play** by 3 years may indicate what?

Answer 52

* Autism * Intellectual disability * Neglect ## Footnote Pretend play is essential for social and cognitive development.

Question 53

What does **unintelligible speech** at 4 years old indicate?

Answer 53

Potential speech delay ## Footnote Clear speech is expected by this age.

Question 54

Hand preference before _______ months is abnormal and may indicate cerebral palsy.

Answer 54

12 months ## Footnote Early hand preference can be a sign of neurological issues.

Question 55

What does **loss of previously acquired skill** indicate?

Answer 55

* Neurodegenerative disorder (e.g., Rett’s) * Autism * Brain tumor * Epileptic encephalopathy ## Footnote This is a concerning sign that requires immediate evaluation.

Question 56

What are the **causes of social, emotional, and behavioral delay**?

Answer 56

* Autism spectrum disorder * Neglect * Genetic disorders (e.g., Down's syndrome) * Hearing impairment ## Footnote These factors can significantly impact a child's development.

Question 57

What are the **causes of speech delay**?

Answer 57

* Global delay (most common) * Hearing impairment * Chronic otitis media with effusion (glue ear) * Environment (lack of stimulus) * Psychiatric issues (e.g., autism) * Bilingual household ## Footnote Speech delays can arise from various factors.

Question 58

What is included in the **management** of developmental delays?

Answer 58

* Comprehensive history and physical exam * MDT evaluation for hearing and speech assessment * Occupational therapy * Pediatric and psychological evaluation * Neuroimaging, MRI, genetic testing, and metabolic screening ## Footnote A multidisciplinary approach is crucial for effective management.

Question 62

When does hand preference develop?

Answer 62

2 years old

Question 63

When is not sitting without support worrying?

Answer 63

Past 9 months

Question 64

How many words should an 18 month old have?

Answer 64

6-10 words

Question 65

How many words should an 12 month old have?

Answer 65

1-2 words

Question 66

How does the medial longitudinal arch develop?

Answer 66

Age 6-8 years old

Question 67

What is a normal feature only requiring reassurance for children with flat feet?

Answer 67

*<6 years of age, well, and no red flag features *Flat feet are painless and flexible *Medial arches correct on tip-toe *No limp or interference with daily activities *No pain in legs or joints *Normal Milestones *No blisters or callosities *Flat feet are symmetrical

Question 68

Hen is it a red flag or children to not sit sunsppoirted?

Answer 68

At 12 months

Question 69

When is not smiling a concern?

Answer 69

10 weeks

Question 70

When should babies start crawling?

Answer 70

9 months

Question 71

Which age should children combine words?

Answer 71

2 years old

Question 72

How much vocabulary should children have at 2.5 years old?

Answer 72

200 words

Question 73

When to refer for limited vocabulary below 2 words?

Answer 73

At 18 months

Question 74

When do children achieve no head lag?

Answer 74

3 months