Which of the following would not be considered a red flag in speech and language development?

Topic Overview

A child's failure to reach speech and language milestones as expected may be a "red flag," or warning, meaning a speech and language development problem. If your child does not reach developmental milestones on schedule, it does not necessarily mean there is a problem. But he or she should be evaluated by a health professional.

Language delays include problems understanding what is heard or read (receptive language delays) or problems putting words together to form meaning (expressive language delays). Some children have both speech and language delays.

Red flags for a speech or language delay include:

• No babbling by 9 months.
• No first words by 15 months.
• No consistent words by 18 months.
• No word combinations by 24 months.
• Slowed or stagnant speech development.
• Problems understanding your child's speech at 24 months of age; strangers having problems understanding your child's speech by 36 months of age.
• Not showing an interest in communicating.

Also, talk to your health professional anytime you or another caregiver has concerns about your child's speech and language development or other problem that affects your child's speech or understanding of language, such as:

• Excessive drooling.
• Problems sucking, chewing, or swallowing.
• Problems with control and coordination of lips, tongue, and jaw.
• Stuttering that causes a child embarrassment, frustration, or difficulty with peers.
• Poor memory skills by the time your child reaches kindergarten age (5 to 6 years). He or she may have difficulty learning colours, numbers, shapes, or the alphabet.

Other red flags include:

• Failure to respond normally, such as not responding when spoken to. This may include signs that the child does not hear well, such as not reacting to loud noises.
• A sudden loss of speech and language skills. Loss of abilities at any age should be addressed immediately.
• Not speaking clearly or well by age 3.

References

Other Works Consulted

• Andrews JS, Fieldman HM (2011). Language delay. In CD Rudolph et al., eds., Rudolph's Pediatrics, 22nd ed., pp. 331–334. New York: McGraw-Hill.

Credits

Current as of: September 20, 2021

Author: Healthwise Staff
Medical Review:
Susan C. Kim MD - Pediatrics
Thomas M. Bailey MD - Family Medicine
Kathleen Romito MD - Family Medicine

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Signs and Symptoms of Developmental Delays.

If you have concerns that your child may be showing signs of Autism check out the Red Flags of Autism link.

Developmental Red Flags (1 to 3 months)

• Doesn't seem to respond to loud noises
• Doesn't follow moving objects with eyes by 2 to 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 3 to 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)

Developmental Red Flags (4 to 7 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 5months 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
• 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

Developmental Red Flags (8 to 12 months)

• Does not crawl
• Drags one side of body while crawling (for over one month)
• Cannot stand when supported
• Does not search for objects that are hidden (10-12 mos.)
• Says no single words ("mama" or "dada")
• Does not learn to use gestures such as waving or shaking head
• Does not sit steadily by 10 months
• Does not show interest in "peek-a-boo" or "patty cake" by 8 mos.
• Does not babble by 8 mos. ("dada," "baba," "mama")

Developmental Red Flags (12 to 24 months)

• Cannot walk by 18 months
• Fails to develop a mature heel-toe walking pattern after several months of walking, or walks exclusively on toes
• Does not speak at least 15 words by 18 months
• Does not use two-word sentences by age 2
• By 15 months does not seem to know the function of common household objects (brush, telephone, bell, fork, spoon)
• Does not imitate actions or words by 24 mos.
• Does not follow simple one-step instructions by 24 mos.

Developmental Red Flags (24 to 36 months)

• Frequent falling and difficulty with stairs
• Persistent drooling or very unclear speech
• Inability to build a tower of more than 4 blocks
• Difficulty manipulating small objects
• Inability to copy a circle by 3 years old
• Inability to communicate in short phrases
• No involvement in pretend play
• Failure to understand simple instructions
• Little interest in other children
• Extreme difficulty separating from primary caregiver

Developmental Red Flags (3 to 4 years)

• Cannot jump in place
• Cannot ride a trike
• Cannot grasp a crayon between thumb and fingers
• Has difficulty scribbling
• Cannot copy a circle
• Cannot stack 4 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

(Adapted from The Early Childhood Direction Center's Developmental Checklist)