Red Flags to Look for in Your Child

Red Flags for Feeding


  • Ongoing poor weight gain (percentiles falling) or weight loss
  • Ongoing choking, gagging or coughing during meals
  • Ongoing problems with vomiting
  • More than one incident of nasal reflux
  • History of traumatic choking incident
  • History of eating & breathing coordination problems, with ongoing respiratory issues
  • Inability to transition to baby food purees by 10 months of age
  • Inability to accept any table food solids by 12 months of age
  • Inability to transition from breast/bottle to a cup by 16 months of age
  • Has not weaned off baby foods by 16 months of age
  • Aversion or avoidance of all foods in specific texture or food group
  • Food range of less than 20 foods, especially if foods are being dropped over time with no new foods replacing those lost
  • An infant who cries and/or arches at most meals
  • Family is fighting about food and feeding (i.e. meals are battles)
  • Parent repeatedly reports that the child is difficult for everyone to feed
  • Parental history of an eating disorder, with a child not meeting weight goals

Girl eating vegetables

Red Flags for Speech and Language

Under 18 months

  • No big smiles or other warm, joyful expressions by 6 months
  • No back-and-forth sharing of sounds, smiles, or other facial expressions by 9 months or thereafter
  • No babbling by 12 months
  • Does not respond to his/her name by 12 months
  • No sharing/reciprocal interactions like pointing, sharing, reaching or waving by 12 months
  • No pointing at objects of interest by 14 months (pointing at a car driving by)
  • Does not understand simple common words like mama or milk
  • Is not using any words by 16 months
  • Does not imitate gross motor movements like clapping or stomping feet

By 18 Months

  • Does not use at least 8-10 meaningful words
  • Does not follow simple commands like "come here" "stop" "don't" "give me the __________" or "touch your nose"
  • Does not follow your pointing with his gaze
  • Is not playing "pretend" with items (talking on toy phone, feeding a doll)
  • Does not play in proximity to other children

By Age Two

  • No two-word meaningful phrases (without imitating or repeating) by 24 months
  • Does not follow simple two step commands such as "Get the ball and put it on the table"
  • Speech is not at least 50% understandable
  • Cannot point to pictures of items in books when asked

By Three Years

  • Is not using three and four word sentences
  • Speech is not at least 75% or more understandable
  • Child is leaving the beginnings or ends off of most words
  • Cannot accurately answer yes/no questions
  • Cannot answer simple "wh" questions like "who is that" or "where is the truck"
  • Does not play with other children
  • Is experiencing stuttering behavior for more than 6 months

By Four to Five Years

  • Is not 90-100% understandable to strangers despite age appropriate articulation errors (may not be able to say /r, sh, ch, l, or th yet)
  • Is not consistently using 4+ word, complex sentences
  • Is not asking a variety of questions to gain information (who, what, where, why and when)
  • Is having difficulty with grammar or pronoun use
  • Cannot tell a simple story on topic
  • Canot follow simple two step directions
  • Has difficulty answering simple who, what, where and why questions
  • Is not yet able to name a few letters, numbers, and rhyming words

Overall Warning Signs

  • ANY loss of speech or babbling or social skills at ANY age
  • Never gestures or imitates
  • Does not appear to understand speech, or appears to be unable to hear
  • Never develops words beyond repeating others over and over


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