How to know when your child needs help?

Children vary a great deal in what they learn to do and when they learn. Below are some general guidelines to follow when observing your child.

THINKING

  • By age one, does not respond to faces and objects, or does not recognize familiar people. Child does not look for hidden object (e.g. peek-a-boo) or does not anticipate return of people.

  • By age two, does not identify simple body parts by pointing, does not match similar objects, or recognize self in a mirror. Cannot say simple words and name familiar objects. 

  • By age three, cannot follow simple directions and commands. Does not imitate adults

  • By age three, does not begin to participate in creative processes; drawing, blocks, or play dough. Cannot match colors and shapes and complete simple puzzles. Unable to pretend or make-believe play. 

  • By age four, does not give correct answers to questions, such as; what do you do when you’re sleepy/hungry? Does not have an active imagination, cannot sit through a short story.

  • By age four, cannot tell the difference between different shapes and colors, does not pretend to read books.

  • By age five to six, does not understand the concepts of today, tomorrow or yesterday. Cannot follow multiple directions. Cannot sort and match according to different qualities (e.g. shape, color, size). Cannot name shapes, colors and some letters.

  • By age five to six, cannot recite 1-10, the child does not understand that numbers represent quantity (e.g. can get three apples, can put one napkin for each child) The child cannot stay with or complete tasks (e.g. finish a puzzle, draw a picture related to a story).

SPEECH

  • Is unusually quiet.

  • By six months, rarely makes sounds like cooing or gurgling.

  • By age one, does not understand first words such as milk, bottle or byebye.

  • By age one, does not say mama or dada.

  • By age two, rarely names family members or common objects.

  • By age two, does not speak in two-word phrases.

  • By age two, does not point to objects or people to express want or need.

  • By age three, does not follow simple directions or speak in sentences of three or four words.

  • By age four, does not tell stories, either real or make-believe, or ask frequent questions.

  • By age four, does not speak in sentences of four or five words and has speech that is not understood by adults.

  • By age five, does not know age and cannot answer, who, what, where, when or why questions or use simple sentences.

MOVING

  • Has stiff arms or legs.

  • Has floppy or limp body posture.

  • By three to six months does not have good control of head, arms, and legs. Does not explore fingers and objects with mouth and has not developed the ability to focus eyes on an object.

  • By one year has not crawled, sat up, picked up objects with thumb and first finger, or stood with support.

  • By two years has not walked or has difficulty walking without help. Cannot kick a large ball or does not need to release energy and use physical skills. Cannot use crayons, spoons or cups.

  • By age three does not walk up or down stairs, frequently falls when running, and cannot turn pages of a book. Does not draw lines and simple shapes, is not active or does not test physical limits.

  • By age four, has difficulty with such activities as standing on one foot, jumping from a bottom step, pedaling a tricycle, catching a large bounced ball, closing a fist, or wiggling a thumb. Cannot kick a ball forward, throw ball overhand, or walk backward.

  • By age five, has difficulty skipping using alternate feet, pumping self on a swing, or cutting with scissors. Cannot string medium size beads. Cannot get dressed with minimal help.

PLAYING

  • By three months does not coo or smile.

  • By age 12 to 24 months, does not play games such as peek-a-boo or pata-cake, or wave bye-bye.

  • By age two, does not show–off occasionally, or shows awareness of being seen by others.

  • By age three, does not imitate parent or caregiver doing routine tasks such as washing dishes, cooking, or going to work.

  • By age three, tends to play alone more than with other children. Does not engage in joint exploration and some peer play.

  • By age three, does not play purposefully or initiates play through pushing or hitting.

  • By age three, does not interact with adults and children outside the family.

  • By age four does not play make-believe games and group games such as hide-and-seek with other children.

  • By age five, does not share and take turns.

  • By age five, does not express concern or compassion, when appropriate. Does not show concern for a child who is crying or in distress.

 

BEHAVIOR

  • Some behaviors may be cause for concern, or they may just be part of the child’s temperament or personality, so observe these behaviors with that in mind.

  • By six months, avoids being held or talked to or resists being soothed or comforted.

  • Does not pay attention or stay focused on an activity for as long as other children of the same age do.

  • Avoids or rarely makes eye contact with others.

  • Gets unusually frustrated when trying to do simple tasks that most children of the same age can do.

  • Often acts out or appears to be very stubborn or aggressive.

  • Acts extremely shy or withdrawn.

  • Does not like being touched.

  • Does not like having certain types of material or clothing next to body.

  • Treats other children, animals or objects cruelly or destructively. 

  • Tends to break things a lot.

  • Displays violent behavior, such as tantrums, fighting, or hitting other children on a daily basis.

  • Stares into space, rocks body, or talks to self more often than other children of the same age.

  • Often bangs head against an object, floor or wall.

  • Does not recognize dangerous situations, such as walking in traffic or jumping from high places.

  • Tends to be sick often, or complains of headaches or stomachaches.

  • Has problems, sleeping, eating, or toileting.

  • Is overly impulsive, active, or distracted.

  • Does not respond to discipline as well as other children of the same age. Has difficulty putting thoughts, actions, and movements together.

  • Does not seek approval from parent or caregiver.

These are just some general guidelines for your child's development. Some children may vary in the amount of time taken to reach these milestones, however, should the child's delay start to concern you or your family members, please do not hesitate to approach us for a consultation

All Children Are Special: How to Know When a Child Needs Help [PDF]. (2005, June). Children’s Inclusive Care Council.

What developmental milestones should my child have?

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