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​Pediatric Developmental
​Red Flags
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Gross Motor:

• ​​Seems weaker than other children his/her age
• Does not have the endurance other children his/her age have for an activity
• ​Difficulty hopping, skipping, or running as compared to other children his/her age
• Appears stiff and awkward in his/her movements
• Clumsy, does not appear to know how body works, bumps into others or objects
• Does not seem to understand concepts such as right, left, front back, as it relates to his/her body
• Shies away from playground equipment.  May only play on one particular item
• Poor posture (always seems to be leaning against something); doesn't sit in chair correctly
• Difficulty initiating movements
• Unusual/unsteady walking, toe walking, or drags feet
• Tires easily
• Passive - avoids recess and/or gym
• Developmental skills below classmates 

Fine Motor:

• Difficulty with drawing, coloring, tracing
• Performs these activities quickly and the result is usually sloppy
• Avoids fine motor activities
• Awkward pencil grip
• Problem holding pencil, grasp may be very loose or very tight
• Printing is too dark, too light, too large, too small
• Does not seem to have a dominant hand, switches hands frequently
• Two hands do not work well together
• Poor desk posture - leans on arms, keeps head close to work
• Written work is slow and labored
• Tires easily when writing
• Does not stabilize paper when writing
• Difficulty manipulating scissors
• Difficulty with buttons, zippers, ties, snaps

Speech-Language-Hearing:

• Repeats sounds, words or phrases over and over
• Does not understand what you're saying
• Does not point to common objects upon request
• Does not follow simple directions
• Does not respond correctly to yes/no questions
• Does not respond correctly to who/what/where/when/why questions
• Communicates through body language, grunting, or one-word utterances
• execution is different from what was asked
• Excessive putting of toys or objects in his mouth

Visual-Perception:

• Trouble discriminating shapes, letters, or numbers
• Cannot complete age-appropriate puzzles
• Difficulty copying designs, letters, or numbers
• Difficulty tracking (i.e. as in reading a book or following the teacher's arm movements)
• Difficulty copying from the blackboard/smart board
• Has a diagnosed visual deficit or receives visual training
• Wears glasses, but issues aren't corrected
• Omits words or phrases, skips lines or loses place while reading and/or copying
• Requires fingers or markers to hold place while reading
• Letter reversal (after first grade)
• Difficulty with spacing and placement of letter/numbers
• Difficulty locating objects/shapes from distracting background (maps, etc)
• Complains of double, blurry vision, and/or closes or squints eyes frequently
• Mis-aligns head or body when working on tabletop tasks
• Has difficulty maintaining eye contact or does not visually regard tasks
• Complains of frequent headaches

Sensory:

• Withdraws from touch
• Touches everything
• Avoids being close to others (doesn't like to be hugged)
• Over-reacts to unexpected touch
• Dislikes removing outer garments, shoes
• Dislikes clothing textures
• Increased dis-tractability to sound
• Overly sensitive to sounds/noise
• Visually distracted
• Over-reacts to smells
• Avoids/craves specific food textures
• Difficulty moving foods around in mouth, avoids working to chew foods
• Fearful of being off the ground
• Floppy, ragdoll like
• Doesn't like playground equipment.
• Can't seem to stop moving, craves swinging, rocking
• Avoids activities that challenge balance
• Seems "earthbound" (i.e. seems unable to jump, move feet off the ground)

Feeding Issues: the more checked off the more daily mealtime restriction it imposes

• Gags easily
• Avoids hot or cold temps
• Avoid/craves mushy, crunchy, chewy, or saucy textures
• Doesn't want foods touching each other
• Eats same three foods every day 
• Considered a yellow food eater
• Not able to entice to try new foods with bribes
• Difficulty accepting baby puree food
• Difficulty transitioning from baby food to solids
• Doesn't like brushing teeth
• Places food at back molars avoiding tongue
• Pocketing food in cheek
• Over stuffs mouth

Emotional/Organizational Behaviors:

• ​Does not like to have routine changed
• Difficulty sequencing a single or multiple tasks from start to finish
• Is easily frustrated.
• Has long meltdowns, cannot self soothe
• Cannot get along with others
• Deals better with a small group situation or one-to-one
• Frequently involves self in other people's activities
• Cannot work independently

• Difficulty problem solving

Executive Functioning:

• Difficulty with organization a plan to achieve a goal
• Struggles with sustaining attention
• Unable to inhibit self to transfer to next task
• Requires multiple cues to initiate tasks
• Requires ongoing cues for completing routine tasks
• Lacks mental flexibility
• Inefficient work process

Academic:

• Easily distracted. restless, short attention span
• Slow worker
• Disorganized, messy desk
• Hyperactive
• Difficulty following directions/sequential steps
• Difficulty completing assignments

Activities of Daily Living:

• Poor control of eating utensils, sloppy hand-to-mouth movements
• Difficulty opening milk or juice cartons, or other containers
• Has trouble manipulating buttons, zippers, snaps
• Unable to tie shoes
• Difficulty with clothing management during toileting
• Difficulty sequencing self-care steps
• Difficulty with organizing personal items 

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