Parents should keep in mind that development happens on a continuum, and a possible delay in one area of development does not necessarily make for a developmental delay.  However, delays in some developmental areas can be indicative of Autism Spectrum Disorder (ASD), so knowing what the warning signs are can help parents to secure early screening, diagnosis, and treatment if warranted.

According to the US Centers for Disease Control and Prevention, there are warning signs of developmental delay, broken down into 3-month, 7-month, and 1-year of age categories.

At 7 months, some warning signs of a developmental delay include a baby who seems to have tight muscles or who is stiff, or one who seems floppy (his or her head may flop back when you pull baby to a sitting position).  A baby who reaches with just one hand, refuses to cuddle, or shows no affection for his or her caregiver may have a delay.  Lack of response to sounds or a lack of enjoyment for being around people may be indicative of a delay, as may be sensitivity to light or eye drainage or tearing that is persistent.

Babies who do not bear weight on their legs by 7 months may also have a delay.  No interest in “peek-a-boo” games or failure to babble by 8 months may also be signs of developmental delays.  At this, or any age, a dramatic loss of skills once had may be a warning sign of a delay or disorder.

At one year, normally developing babies should crawl and stand when supported.  They should also search for objects that you hide while they are watching, and use gestures such as waving.  Babies at this age who are developing normally should also be able to use single words like “dada” or “mama” and point to pictures or objects.

Between 7 months and 1 year, babies are developing an interest in social play and using their voices to express displeasure and joy.  Babies can tell emotion from the speaker’s tone of voice and are beginning to understand the word “no.”

Although not all delays are indicative of a developmental delay, if your child exhibits any of the following “red flags” for developmental delay around age 6 months, consult your pediatrician right away:

Baby does not try to attract attention through actions by 7 months

Baby does not babble by 8 months

Baby does not learn to use gestures, such as waving or shaking head

Baby does not point to objects or pictures

Baby cannot stand when supported.

While these guidelines are not hard and fast rules, and childhood development happens on a continuum, knowing what behaviors a child should exhibit and what constitutes normal development can help parents to determine if their child is developing normally or has a developmental delay.

Delays in some developmental areas can be indicative of Autism Spectrum Disorder (ASD), so knowing what the warning signs are can help parents to secure early screening, diagnosis, and treatment if warranted.

According to the US Centers for Disease Control and Prevention, there are warning signs of developmental delay, broken down into 3-month, 7-month, and 1-year of age categories.

Some signs of a possible developmental delay at 3 months of age are a baby’s lack of response to loud noises, or failure to notice his or her hands by 2 months.  Not following a moving object with his eyes by 2 or 3 months and not smiling at people by 3 months are also “red flags.”  Three months is also the age at which normally developing babies should support their heads and grasp and hold objects.  Other signs of normal development are reaching for toys and babbling by age 3 to 4 months.

By 6 months, normally developing babies should also be able to move one or both eyes in all directions and only occasionally cross their eyes.  Not trying to imitate sounds a parent or caretaker makes by age 4 months and not paying attention to – or seeming frightened of – new faces, as well as a dramatic loss of skills once mastered are all signs of a possible developmental delay.

Normally developing children smile spontaneously by 5 months, sit alone by 6 months, and reach for objects by 6 or 7 months.  By 6 months, a normally developing baby should laugh or make squealing sounds.

Although not all delays are indicative of a developmental delay, if your child exhibits any of the following “red flags” for developmental delay around age 6 months, consult your pediatrician right away:

Baby seems either very stiff or very floppy;

Baby refuses to cuddle;

Baby shows no affection for those who care for him or her;

Baby does not respond to sounds;

Baby seems inconsolable at night after age 5 months;

Baby cannot roll over either front to back or back to front by five months.

Of course, all children should be watched to determine if they are reaching developmental milestones at the appropriate times, but children who have a sibling or parent with an autism spectrum disorder should be watched more closely.

Autism is treatable, and, like other disorders, early detection is key to obtaining timely and effective treatment.  Since normally developing children aged 2 to 3 are experiencing a marked increase in language use and becoming more adroit in their motor skills, signs such as a delay in or lack of spoken language or repetitive mannerisms such as twirling objects or hand-flapping are “red flags” of autism symptoms at this age.

Normal development at ages 2 to 3 also includes an interest in playing “make believe” games and playing “pretend.”  A lack of this type of play may be a symptom of autism, as may be detachment, such as not maintaining eye contact or appearing not to be aware of being spoken to.

Other possible symptoms of autism at this age include a fixation on objects, a lack of interest in peer relationships, or an inability to adapt to change of routine.  Unwillingness for physical contact is also a possible symptom of autism.

It is important for parents to remember that not all children meet developmental milestones (such as talking) at the prescribed guidelines and that not all signs of autism are necessary to suggest evidence of this disorder need to be present in order to warrant further testing.

What if I Suspect Autism?

The first step in obtaining treatment for autism is to obtain a diagnosis, and you should start with your pediatrician.  He or she may then refer you to a specialist, and you should also educate yourself of the signs and treatment of this disorder.

The American Autism Society’s website, at http://www.autism-society.org, is a great place for starting your research, as is the Centers for Disease Control and Prevention’s autism overview page, located at www.cdc.gov/ncbddd/autism/.

One of the main impairments of people with ASDs is social impairment. This goes beyond just “shyness” and is often combined with other problems, like trouble with communication skills. By age 3, normally developing children should be able to verbalize a range of emotions, and to be largely understood by strangers. People with ASDs may not be interested in other people at all, or have trouble interacting with peers or imitating others. Although it is hard for all children to learn to take turns and to share, children with ASDs have a particularly difficult time with this concept.

By age 4, a normally developing child has experienced a lot of growth in social skills: cooperation and conflict resolution have developed, and language use has developed to the point that children can be easily understood by others. However, children with ASDs exhibit language delays. While some children with ASDs my have only slight delays, about 40% of children with ASDs do not speak at all. Others may have some words and then lose them, or not speak until later in childhood. Some people with ASDs may repeat the same words over and over, and have a hard time understanding body language or tone of voice. They may not be able to participate in a give-and-take conversation, instead talking a great deal about things that interest them.

While normally developing children at ages 3 to 4 can run, kick a ball, climb, and walk forward and backward, those with ASDs may exhibit repetitive motions, such as rocking side to side, flapping the arms, or repeatedly turning a light off and on. Some children with ASDs develop unusual routines, like having to look in every window of a building, and being unable to do these things will elicit frustration. A change in routine can be very upsetting to children with ASDs.

While patterns of development vary somewhat from child to child, children with ASDs develop at different rates; some have delays in language, others with social development. Some may be very good at solving problems, but have trouble making friends.

Some “red flags” for ASDs include not playing “pretend” games; not pointing at objects; having trouble relating to others and avoiding eye contact; appearing unaware when spoken to; repeating or echoing phrases or words; repeating actions over and over; having trouble accepting change in routine; and losing skills once obtained (for instance, ceasing to say words already learned).

If you are concerned that your child exhibits signs of an ASD, your first step should be to schedule an appointment with your pediatrician to address your concerns. He or she may refer you to a specialist who can make additional assessments. Autism is treatable, but, as with any disorder, the sooner you can get a diagnosis and treatment, the better.

Pediatricians may also ask about, or provide information regarding, what developmental milestones a child has reached for his or her age.  Questions about whether a baby is rolling over or feeding himself, or how a toddler is using language or whether a preschooler is dressing herself are all questions designed to determine whether a child is meeting certain milestones of normal childhood development.

Pediatricians use uniform child developmental checklists to determine whether children are reaching developmental milestones in the way they speak, behave, move, learn, and play.  These are used to determine whether a child is functioning at the appropriate developmental level for the child’s age.  They are not used to diagnose a child’s problem, if there is one, but rather as a screening tool to determine if further testing is warranted.

A quick web search will turn up hundreds of hits for developmental checklists such as the one on the US Centers for Disease Control and Prevention site here.

The checklists are broken down into age categories:  3 months, 7 months, 1 year, 2 years, 3 years, 4 years, and 5 years.

It is important for parents to bear in mind that all children develop at various rates and therefore variations in the rate at which children meet developmental milestones is to be expected.  If, for instance, a child is missing a milestone or two out of the many for his or her age, that does not necessarily mean he or she has a developmental delay or disorder.

It is important to be familiar with the milestones, however, so that parents can help their healthcare provider determine if a child has a developmental deficiency or may need further testing and diagnosis in order to determine if a treatment or intervention is necessary.

Children who do not meet certain guidelines may have a developmental delay or disorder. Some delays may be a sign of Autism Spectrum Disorder (ASD), so knowing what the warning signs are can help parents to secure early screening, diagnosis, and treatment, if warranted.

According to the US Centers for Disease Control and Prevention, there are warning signs or “red flags” that may signal a developmental delay for children aged 18 months to 24 months.

Normally developing children walk by age 18 months, and after they have walked for several months, will have developed a heel-toe walking pattern. Children who do not walk in this way or walk only on their toes may have a developmental delay.

Language development takes off during this age range. At 18 to 24 months, toddlers use simple phrases and move on to two and four word sentences. Following simple instructions, repeating overheard words, and pointing to objects when named for them are other milestones. Children who are not using two-word sentences by age two or otherwise fail to meet these language milestones may have a developmental delay.

By age two, normally developing children will have made major strides in movement, fine motor, language, cognitive, and emotional and social development. Two year-olds who are developing normally will be able to push a wheeled toy, run, climb up and down stairs, build towers, scribble with a pen or pencil, and play “make believe” games.

By age two, normally developing children are able to interact with other children and to play alongside them with a sense of “mine” and “yours” and of taking turns. A sense of increasing independence is a hallmark of normal development for two year-olds. Again, not meeting these milestones may be indicative of a developmental delay or disorder.

In this age range, or at any point during your young child’s development, exhibiting a dramatic loss of skills your child once had is also cause for alarm.

Parents should remember that development doesn’t take place overnight and that the range of what is considered normal is a continuum. Some variations in development are completely normal. One delay in meeting a deadline does not a disorder make, but any concerns are absolutely worth mentioning to your child’s healthcare provider.

A dramatic loss of skills (no longer being able to use words once used, or to perform physical tasks previously mastered) can be indicative of a developmental delay or disorder. If you are concerned about any aspect of your child’s development, seek the advice of his or her health care provider right away.

According to the US Centers for Disease Control and Prevention, there are warning signs or “red flags” that may signal a developmental delay for children aged 12 to 18 months.

If, at age 1 year, a child is not crawling, or dragging one side of his body while crawling, doesn’t use single words like “dada” or “mama,” and fails to point at objects or pictures, he or she may have a developmental delay. By age 1, babies should be able to stand when supported if not on their own, and use gestures like waving or shaking one’s head. At this age, babies should search for objects hidden while they watch. Babies and children at any age who display a dramatic loss of skills once mastered may have a developmental delay or disorder.

By 18 months, toddlers should be able to walk; being unable to is a warning sign of a delay. If, after several months of walking, a toddler does not have a heel-toe pattern or walks only on his or her toes, a delay may be present.

Toddlers should use about 15 words by age 2, so if a child at 18 months is not using any words, a delay may be present. If, by age 15 months, a child doesn’t seem to know the function of everyday objects like hairbrushes or silverware, then he or she may have a delay. Children 12 to 18 months should begin to imitate actions or words and be able to do so by age 2. Again, any loss of skills once mastered at this or any stage may be the sign of a delay.

It is important for parents to bear in mind that there are no bright lines for child development; children do not suddenly acquire skills, although it may seem that they have “explosions” of gross motor and language development. Children may seem to focus on development of one area for a while, and then focus on another. Some variations in development, then, are normal. Since behaviors that are measured in developmental assessments necessarily build upon each other, there is leeway in what is considered normal development.

Equally important is the fact that a dramatic loss of skills, such as no longer being able to use words once used, or to perform physical tasks like walking or climbing, can be indicative of a developmental delay or disorder. If you are concerned about any aspect of your child’s development, seek the advice of his or her health care practitioner right away.