Warning Signs

Warning Signs / Red Flags in Child Development
Disability is a scary word especially when someone uses it about your child. There is always a stigma around pediatric disability, but this is mostly prevalent among people who are ignorant about children with disability and their quality of life.
Many things can go wrong during pregnancy, birth process and a few first years of life of the new born. We are describing a few here

During pregnancy (Prenatal)
All of the following with the mother can be risk factors for developing Neurodevelopmental disorders in the newborn such as

• If there is incidence of birth defects in your family
• If you have had difficulty in conceiving or have had a series of miscarriages, still births, twins, delivery by operation (Caesarean), obstructed labour/prolonged labour (more than 12 hours) and/or severe bleeding in previous pregnancy
• Alcohol intake
• Certain antiepileptic drugs
• Diabetes mellitus
• Folic Acid Deficiency
• Hepatitis B
• HIV/AIDS infections
• Hypothyroidism
• Maternal phenylketonuria (PKU)
• Rubella seronegativity
• Obesity
• Oral anticoagulant
• Sexually transmitted diseases
• Smoking 

  During birth process (Perinatal)

The following conditions can be risk factors in developing developmental disorders or delayed milestones

• Born with HIV
• Born premature
• Born with low birth weight
• Asphyxia / Hypoxia -lack of oxygen during birth
• Heart defect the baby is born with
• Blood disorders such as  sickle cell disease
• Injury to an artery in the brain
• If the baby’s head appears to be abnormally small or large then a physician should be consulted, preferably a pediatrician. The approximate head size for a male child at birth is 35 cm and for female child is 34.5 cm.
• Dehydration
• Genetic disorders

During Post natal period

Risk factors for Hearing Impairment

• Is there anyone in the family with deafness since childhood?
• Did the mother take an abortificient drug or any other medicine in large doses during the first three months of pregnancy?
• Is the birth weight below 1500 gms?
• Did the child have a delayed cry after birth?
• Did the child have significant jaundice (yellowness of eyes) during the first10 days after birth?
• Does the child have a cleft in the lip or palate, or a malformed pinna?
• Does a child turn towards the source of sound which is located either at the back or towards one side of the body?
• Does he/she have discharge from the ear?
• Does he/she turn when called from behind?
• Uses gestures excessively
• The child does not speak nor has a defective speech.
• The child does not understand the spoken language.
• The child has an ear discharge.

Risk factors for Visual Impairment

•  The child does not follow an object moving before his eyes by 1 month’s age.
•  The child does not reach for toys and things held in front of him by 3 months age.
•  One eye moves differently from the other; including squint
•  Eyes are either red or have a yellow discharge or the tears flow continuously.
•   The child has tendency to bring pictures or books very near the eyes.

Risk factors for Intellectual Disability

•  Does the child respond to name/voice by 4th Month?
•  Does the child smiles at others by 6th Month?
•  Does the child hold the head steadily by 6th Month?
•  Does the child sit without support by 12th Month?
•  Can the child stand without support by 18th Month?
• Can the child walk well by 20th Month?
• Can the child talk 2-3 word sentences by 3rd Year?
• Can a child eat/drink by himself by 4th year?
• Can he tell his name by 4th year?
• Does he have toilet control by 4th year?
• Does he avoid simple hazards?
• Does he get fits?

Risk factors for Locomotors Disability

• The child is not able to raise both the arms fully without any difficulties.
• The child is not able to grasp objects without any difficulty.
• The child has absence of any part of the limb.
• The child has a difficulty in walking.

If a child has any of the following disorders

• Erb’s Palsy
• Club feet
• Spina bifida
• Generalized Hypotonia
• Generalized Hypertonia
• Arthrogryposis
• Down syndrome
• Cerebral palsy
• Infantile spasm
• Seizure disorder
• Hearing impairment
• Visual impairment

The list of Red flags is very long, so it is very difficult to put everything here, please ask for developmental screening if you feel there is a concern with your child

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