Developmental red flags by age, birth to 5

A red flag is a prompt, not a diagnosis

Every child grows on their own timeline. A red flag doesn’t mean something is wrong. It means a skill is worth a closer look by someone trained to look.

In 2022, the CDC and the American Academy of Pediatrics updated their milestone lists. Milestones used to describe what half of children could do at a given age. Now they describe what three out of four or more children can do. So when a child isn’t doing something on the list, it’s a good reason to ask, not a reason to wait.

The one red flag at every age: a skill your child had and has lost. If your child stops saying words they used to say, or stops doing something they could do, talk with your pediatrician right away.

How to use this guide

Find your child’s age below. If your child was born early, use their corrected age until their second birthday. Each age lists a few things that are worth bringing up with your pediatrician or with us.

• One item on the list, and everything else on track: mention it at your next well-child visit.
• Several items, or items across different areas (talking, moving, playing): ask for a developmental screening or an evaluation now.
• A lost skill, at any age: call your pediatrician this week.

Red flags by age

By 2 months, talk with your pediatrician or a therapist if your child:

• Doesn’t react to loud sounds
• Doesn’t watch things as they move
• Doesn’t smile at people
• Can’t lift their head during tummy time

By 4 months, talk with your pediatrician or a therapist if your child:

• Doesn’t coo or make sounds
• Can’t hold their head steady
• Doesn’t bring hands or toys to their mouth
• Doesn’t push down with their legs when feet are on a firm surface

By 6 months, talk with your pediatrician or a therapist if your child:

• Doesn’t laugh or squeal
• Doesn’t try to reach for toys
• Doesn’t roll over in either direction
• Seems very stiff or very floppy

By 9 months, talk with your pediatrician or a therapist if your child:

• Doesn’t respond to their name
• Doesn’t babble (“mama,” “baba,” “dada”)
• Doesn’t sit with a little help
• Doesn’t play back-and-forth games like peekaboo

By 12 months, talk with your pediatrician or a therapist if your child:

• Doesn’t point or wave
• Doesn’t say any single words
• Doesn’t crawl or stand with support
• Doesn’t look for things they saw you hide

By 18 months, talk with your pediatrician or a therapist if your child:

• Doesn’t point to show you things
• Isn’t walking
• Says fewer than six words, or isn’t learning new ones
• Doesn’t copy what others do

By 2 years, talk with your pediatrician or a therapist if your child:

• Doesn’t put two words together (“more milk”)
• Doesn’t know what everyday things are for, like a spoon or a phone
• Doesn’t follow simple directions
• Doesn’t walk steadily

By 3 years, talk with your pediatrician or a therapist if your child:

• Doesn’t speak in short sentences
• Is hard for family to understand most of the time
• Falls a lot or has trouble with stairs
• Doesn’t play pretend or show interest in other kids

By 4 years, talk with your pediatrician or a therapist if your child:

• Can’t jump in place
• Has trouble scribbling
• Can’t retell part of a favorite story
• Strongly resists dressing, sleeping or using the toilet

By 5 years, talk with your pediatrician or a therapist if your child:

• Can’t follow two-step directions
• Can’t say their first and last name
• Can’t hop on one foot
• Seems uncomfortable holding a crayon, or can’t wash and dry their hands

What to do this week

1. Write down what you’re seeing. Not “speech is behind,” but the date, what happened, and who noticed.
2. Take a short video. Thirty seconds of the thing you’re worried about. Kids rarely show their tricky moments on demand in an office.
3. Ask your pediatrician for a developmental screening by name. It’s a quick, standard questionnaire.
4. Ask for a referral for a speech, occupational or physical therapy evaluation. Many insurance plans want one before they pay.
5. Start the insurance check at the same time. Our intake team checks your benefits before the first visit, so you know what to expect.

Why acting early helps

The early years are when the brain grows fastest, which is why therapy at this age often moves quickly. A mild delay usually has less ground to make up. And an evaluation is not a label. It’s a clear picture of what your child is doing well, what’s next, and a plan to get there.

If the evaluation shows your child is right on track, that’s a great answer too.

Sometimes it’s something else

• Hearing and vision. Ear infections, fluid in the ears, or a vision problem can look like a speech or motor delay. A hearing check is quick and worth doing first.
• Two languages. Learning two languages does not cause a delay. Count words and skills across every language your child uses.
• Born early. Use corrected age until age two. Our corrected age calculator does the math.
• Young for their grade. A child with a summer birthday can be almost a year younger than classmates.

Free tools to take the next step

• Milestone checklist, ages 1 to 5: 15 yes-or-no questions and a plain answer.
• Speech and language checklist, 12 months to 5 years.
• Corrected age calculator for babies born early.

Find them all at oaklinlane.com/resources. Ready to talk? Start at oaklinlane.com/get-started.

Milestones adapted from the CDC’s “Learn the Signs. Act Early.” program and the American Academy of Pediatrics. This guide is for education, not a diagnosis.