As a parent or caregiver, if you see any of these behaviors in a child we encourage you to talk with the child’s pediatrician and ask for a referral for an evaluation from one of our physical, occupational, or speech therapists.

Physician referral forms can be found in the Patient Resources section of our website. 


  • Stiff or floppy
  • Difficulty organizing suck, swallow, breath (difficulty feeding)

2 months:

  • Poor visual focus – not interacting with caregiver faces
  • Arches back frequently

4-6 months:

  • Does not bring hands to midline
  • Difficulty moving against gravity
  • Maintains fisting
  • Little to no vocalizations
  • Not initiating some type of rolling movement
  • Not grasping and holding toys
  • Gags or chokes often
  • Unable to lift head up lying on tummy

8 months:

  • Not sitting alone
  • Does not explore toys with hands
  • Will not bear weight on legs
  • Does not respond to or begin social interactions

9 – 12 months:

  • Not crawling on belly or hands and knees
  • Limited sounds, uses mostly vowel sounds
  • Not using pincher grasp (finger and thumb) for self-feeding
  • Does not babble, coo or gesture
  • Unable to walk behind push toy or pull to stand

12-16 months:

  • Not taking steps independently
  • Does not say single words
  • Cannot self feed
  • Does not imitate sounds or movements
  • Walks on tiptoes most of the time

18-24 months:

  • Does not say two word phrases
  • Does not engage in pretend play
  • Difficulty coordinating use of both hands
  • Frequently falls down

2-4 years:

  • Observed to be a “clumsy kid” (tripping over feet)
  • Has difficulty with dressing or having clothes on
  • Does not engage in play with other children
  • Cannot throw or kick a ball
  • Will not scribble when given a crayon or marker
  • Does not use at least 50 words consistently


Any age:

  • Hesitant to interact with others or the environment, appears to be overly sensitive, described as a “fussy baby or child”
  • Overly passive baby, not exploring the environment or toys
  • Perpetual movement, no sit-down time, no balance between movement and rest.
  • Delays in development affecting multiple areas
  • Consistent walking on tip-toes for an extended period of time
  • Has any loss of any language, motor, or social skills
  • Child does not know how to play with toys
  • Child has poor eye contact
  • Child seems to prefer to play alone.
  • Avoids using both sides of his/her body or exhibits a strong one side preference.
  • Not attempting to help with daily skills like washing, dressing, feeding