Red Flags that should prompt an evaluation by a Pediatric Physical Therapist or another pediatric specialist

• If baby rolls a lot prior to three months evaluate for high muscle tone
• If baby’s head is observed to rotate or tilt to one side only, evaluate for a condition called Torticollis or visual deficit
• If baby continues to keep hands clenched or fisted after three months evaluate for high muscle tone
• If baby is not alerting to environmental stimuli evaluate for sensory impairment such as hearing loss or visual impairment
• When baby is pulled to sit, if baby head falls behind and baby does not help with maneuver by pulling with arms or pulling head up by four months, evaluate for low muscle tone
• If baby is not reaching for objects by 5 months evaluate for motor, visual or cognitive deficits
• Inability to prop sit by 6 months evaluate for low muscle tone
• If baby is not engaging with caregivers with social smile by 4-6 months evaluate for cognitive or visual concerns
• Persistence of primitive reflexes after 6 months evaluate for neuromuscular disorder
• Absent babbling by 6 months evaluate for hearing deficit
• W sitting and bunny hopping at 7 months à evaluate for high or low muscle tone
• Baby cruises along furniture on toes
• No back and forth sharing of sounds, smiles or other facial expression by age 9 months or thereafter evaluate for autism of pervasive developmental disorder
• Lack of tool use (crayon, spoon) by 12 months evaluate for fine motor or cognitive delay
• Lack of imitative play by 18 months evaluate for hearing deficit or cognitive/socialization deficit, evaluate for autism
• Strong hand dominance prior to 18 months evaluate for hemiplegia or brachial plexus injury
• Lack of pointing by 16 months of age evaluate for autism due to problem in social relatedness
• No first word, other than mama/dada by 18 months evaluate for auditory expressive language delay
• Does not follow simple 1 step commands by 15 months  evaluate for receptive language delay
• Persistent poor transitions by 24 months evaluate for pervasive developmental disorder
• No two word sentences by 2 years evaluate for auditory expressive language delay
• Advanced non-communicative speech (echolalia) by 24 months evaluate for autism or pervasive developmental disorder
• Any loss of speech babbling or social skills at any age, evaluate for autism or pervasive developmental disorder.

(Adapted from Family Practice Notebook, www.fpnotebook.com)