1. August 22, 2011 Jennifer Crookham, Mental Health & Disabilities Manager

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

3.  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 Gross Motor Red Flags

4.  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 Gross Motor Red Flags (cont.)

5.  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 Fine Motor Red Flags

6.  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 Cognitive Red Flags

7.  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 Sensory Red Flags

8.  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 Sensory Red Flags (cont.)

9.  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. Sensory Red Flags (cont.)

10.  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 Self-Care Related Red Flags

11.  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 Speech Development Red Flags

12.  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 Social Emotional Red Flags

13.  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 Social Emotional Red Flags (cont.)

14.  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 Red Flags During Play

15.  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 General Red Flags

16.  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 Factors to Keep in Mind…

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

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