Developmental red flags – when to refer



Developmental Red Flags – When to Refer?At all ages: OFC? > 98 or < 0.4 or rapid change in OFCRegressionSquintParental concern If Red Flag’s present refer to Community Paediatrics6 weeks No visual fixation or following - always referFailure to respond to soundAsymmetrical neonatal reflexesExcessive head legFailure to smile6-8 monthsHand preference, fisting, Squint, not reachingPersistence of primitive reflexesFloppy and poor head controlLack social response/ vocalisation12 monthsUnable to sit or bear weight Absence of saving reactionsPersistence of hand regardPoor communicationNo babble18 monthsNot walking Inability to understand simple commandsNo pointingNo wordsNo pincer gripCasting (throwing) and mouthing2 yearsNot running2 step command 2-3 words togetherBilingual – only have expressive delay 3-6 monthsTop tips:Speech and language development is the most variable domain and sensitive to environmental factors e.g. maternal depressionIf there is delay in more than one domain – gross motor, fine motor and vision, speech and language, social development – it is more likely to be significant.3years4 years5 years 12m 15m 24m 24m18 months2 years3 years 3.5 4 years5 years6 yearsMedian ages for development of skills – bricks and drawing NB pencil grasp by 3 years ................
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