Red Flags and Not-To-Worries by Dr. Patricia Nan Anderson

March 1st, 2018

by Katrina Brooke

Every parent and every teacher wonders “Is this normal?” “Should I be worried?” “How long do I wait?”
No matter how old the child is, these are the questions that will run through your head, usually late at
night when you already are having trouble sleeping. But parents of infants and toddlers think these
thoughts the most.
So how can you tell? What are the red flags you should keep an eye out for? What things that might
seem like red flags are actually things you don’t need to worry about?
First, let’s keep some things in mind: parents have very good imaginations. Your ability to imagine bad
things probably increased hugely as soon as you found out you were pregnant. Try to keep your ability
to imagine the worst under some control.
It’s so easy to imagine scary outcomes that we forget that most children are pretty healthy and most
kids never have anything like a serious issue. We hear about children who have awful problems, not
because those problems are common but because they are uncommon. They’re news. They make a good
story. So keep things in perspective. Watch and wait. Take notes. Avoid jumping to conclusions.
Also, keep in mind that serious issues usually come in bundles. If there is just one thing that seems
delayed, it’s usually okay to wait and see if everything else seems fine. But if you are worried about
several areas of development at the same time, then there might be something going on.
All that being said, here are some things to watch for and things you probably don’t need to worry
0 to 3 months: it’s all about the senses. Does your child seem to see, hear, and react in ways that
match fully functioning sensory equipment? If there seems to be an issue here, be sure to get it checked
out. Sensory impairments are a red flag. But generally it’s not a problem if a child doesn’t seem to sleep
much or cries a good bit. Babies do these things.
4 to 12 months: it’s about emerging social and physical skills. Does your child smile at others, seem to
notice things around him, roll over and sit up? By the end of this period is he at least scooting himself
around and at least trying to pull himself to stand? Lack of interest in people at this age is a red flag that
could indicate autism or some other neurological issue. Lack of interest in moving around is another
concern. But don’t worry if your child at one year isn’t yet walking independently or isn’t talking. This is
part of the normal range.
13 to 24 months: physical abilities take center stage, along with language development. Does your
child pull herself to stand and communicate by gesture and babbling? By two years, is she walking
confidently and does she have a small vocabulary? If not, these could be red flags. Don’t worry too
much, though, if it takes pretty much until she’s two to master walking and talking – for some children,
these things take time. Don’t worry either if she walks before she crawls; this isn’t all that unusual.
Two to Three years: independence should be developing by this point. Does your child walk, talk, and
get along well with other children? Is he a participant in what’s going on? If so, great! But don’t worry if
only family members can understand what your child says or if he throws tantrums, is shy or is a picky
eater. These are all normal for this age.
Four to Five years: a feeling of social competence is what we’re hoping for here. Does your child
seem comfortable with other children, able to manage the ordinary sort of give and take of kid-society
and able to manage his or her affairs in the preschool setting? A certain amount of squirrely behavior is
expected at this age or a certain amount of reserve, depending on the child. But it’s important that a
child at this age knows how to get along in the world and feels comfortable in doing that.
What Should You Do About Red Flags?
Maybe you think there really might be something wrong. Maybe there’s a family history of this or that
and you want to feel reassured. Here’s what to do.
Keep a journal or log. Write down what you see (or what you see instead of what you think you
should see) and be sure to date your entries. See if, after a week or two, things get better or you see
some progress. Is this a problem or just a phase? If it turns out to be a problem, your notes will be
helpful to the professionals you’ll consult.
Tweak your own practice. Infants and toddlers in some households have little opportunity to
explore; they are kept safe, maybe, but not encouraged to develop their abilities. Older preschoolers
too sometimes have too much done for them and become passive or are punished for ordinary kid stuff
and become fearful or angry. Children need opportunities to develop, so check to see if there’s more
you can do.
Talk with your child’s doctor. If you need to, write down your question before you go to the office,
so you remember what you want to say. Write down what the doctor says. If it helps, have someone
else go along with you to take notes. Ask questions if you don’t understand or if you think the doctor
doesn’t understand. If you don’t think you’re getting the right answer, get a second opinion. If there
really is a problem, then early intervention is important. Don’t be obsessive if there truly isn’t a problem
but don’t be in denial either. Avoid delay.
If you consult the Internet, use only reliable sources. The American Academy of Pediatrics is
good. If you conduct a search, look for sources that end in .edu or .gov, then for .org. Avoid most
websites that end in .com – or at least read those with caution.
Keep in mind that most developmental detours are easily corrected and most children grow up with
very few problems. Knowing this should help you feel more confident as a parent or teacher and more
able to relax and enjoy these funny, amazing little people.
© 2018, Patricia Nan Anderson. All rights reserved. Find out more at
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