Red Flags by Age for Referral of a Child

All children develop and grow at their own pace, accomplishing certain tasks like beginning to
talk or walk. There are certain concerns at specific ages regarding a young child’s development, often called red flags, that are cause for immediate referral through Help Me Grow. You should also talk with your child’s healthcare provider about your concerns.

Here is one family’s story about their experience with early intervention: “It's obvious that I have found a group of professionals that are dedicated, knowledgeable and incredibly caring. We couldn't be in better hands. For the first time I feel like we have a real advocate in the classroom. It helps me breathe a sigh of relief that someone is there helping him and advocating for him.”  - Metro Parent

Infant and Toddler Intervention (ages birth through two years)

Minnesota´s Infant and Toddler Intervention program provides services for children birth through two years of age. These services are for children who may be experiencing delays in their development for several reasons, or may have a diagnosed condition, such as loss of hearing or Down syndrome, that is likely to result in a developmental delay.  A premature baby born weighing less than three pounds, five ounces, is automatically eligible, however, a referral is still required.

Talk with your child’s healthcare provider and make a referral through Help Me Grow if you have concerns about a diagnosed condition and its potential impact on development and learning.

Looking for age-appropriate red flags can guide you in taking the next step. Select the age of the child below and see reasons to refer a child. Many of these are adapted from the Centers for Disease Control and Prevention’s “Learn the Signs. Act Early.” initiative.

• 1 month
  • Doesn’t startle at loud noises.
  • Doesn’t briefly follow moving object with eyes.
• 2 months
  • Doesn’t respond to loud noises.
  • Doesn’t watch things as they move.
  • Doesn’t bring hands to mouth.
  • Can’t hold head up when pushing up when on tummy.
• 3 months
  • Doesn’t smile at people.
  • Can’t hold head up and push chest up when on tummy.
  • Doesn’t follow movement by turning head.
  • Doesn’t bring hands to mouth.
  • Doesn’t chuckle in response to you.
• 4 months
  • Doesn’t watch things as they move.
  • Doesn’t smile at people.
  • Can’t hold head steady.
  • Doesn’t coo or make sounds.
  • Doesn’t bring things to mouth.
  • Doesn’t push down with legs when feet are placed on a hard surface.
  • Has trouble moving one or both eyes in all directions.
• 6 months
  • Doesn’t try to get things that are in reach.
  • Shows no affection for caregivers.
  • Doesn’t respond to nearby sounds.
  • Has difficulty getting things to mouth.
  • Seems very floppy, like a rag doll.
  • Doesn’t make vowel sounds such as “ah,” “eh,” “oh.”
  • Doesn’t roll over in either direction.
  • Doesn’t laugh or make squealing sounds.
  • Seems very stiff, with tight muscles.
• 9 months
  • Doesn’t bear weight on legs with support.
  • Doesn’t sit with help.
  • Doesn’t babble such as “mama,” “baba,” “dada.”
  • Doesn’t play any games involving back-and-forth play.
  • Doesn’t respond to own name.
  • Doesn’t seem to recognize familiar people.
  • Doesn’t look where you point.
  • Doesn’t transfer toys from one hand to another.
• 12 months or 1 year
  • Doesn’t crawl.
  • Can’t stand when supported.
  • Doesn’t search for things that are hidden from sight while your baby watches.
  • Doesn’t point to things.
  • Doesn’t learn gestures like waving bye-bye or shaking head “no.”
  • Doesn’t say single words like “mama” or “dada.”
  • Loses skills once had.
• 18 months
  • Doesn’t point to show things to others.
  • Can’t walk.
  • Doesn’t know what familiar things are for such as a comb, spoon or cup.
  • Doesn’t copy others.
  • Doesn’t gain new words.
  • Doesn’t say at least six words.
  • Doesn’t notice or mind when a caregiver leaves or returns.
  • Loses skills once had.
• 2 years
  • Doesn’t know what to do with common things, such as a brush, phone, fork or spoon.
  • Doesn’t copy actions and words.
  • Doesn’t follow simple instructions.
  • Doesn’t use two-word phrases such as “drink water.”
  • Doesn’t walk steadily.
  • Loses skills once had.

Ages 3 to 5 years

Minnesota's Preschool Special Education program provides services based on the educational needs of children three to five years of age, or the start of kindergarten. These children meet state eligibility criteria for developmental delay or another disability, and are experiencing challenges in their learning and development. Children may be eligible if they are not able to learn, speak or play like other children who are the same age.

Refer a child through Help Me Grow and talk with your child’s healthcare provider if you have concerns about your child’s development.

Looking for age-appropriate red flags can guide you in taking the next step. Select the age of the child below and see reasons to refer a child. Many of these are adapted from the Centers for Disease Control and Prevention’s “Learn the Signs. Act Early.” program.

• 3 years
  • Falls down a lot or has trouble with stairs.
  • Drools or has very unclear speech.
  • Can't work simple toys such as peg boards, simple puzzles or turning a handle.
  • Doesn’t understand simple instructions.
  • Doesn’t speak in sentences.
  • Doesn’t make eye contact.
  • Doesn’t play pretend or make-believe.
  • Doesn’t want to play with other children or with toys.
  • Loses skills he once had.
• 4 years
  • Can’t jump in place.
  • Has trouble scribbling.
  • Shows no interest in interactive games or make-believe.
  • Ignores other children or doesn’t respond to people outside the family.
  • Resists dressing, sleeping and using the toilet.
  • Doesn’t understand “same” and “different.”
  • Doesn’t use “me” and “you” correctly.
  • Doesn’t follow three-part commands.
• 5 years
  • Doesn’t show a wide range of emotions.
  • Shows extreme behavior such as unusually fearful, aggressive, shy or sad.
  • Unusually withdrawn and not active.
  • Is easily distracted, and has trouble focusing on one activity for more than five minutes.
  • Doesn’t respond to people or responds only superficially.
  • Can't tell what’s real and what’s make-believe.
  • Doesn’t play a variety of games and activities.
  • Can’t give first and last name.
  • Doesn’t draw pictures.