Developmental Causes for Concern

Consider contacting your pediatrician to learn the benefits of therapy if your child exhibits the following concerns.

Baby’s Motor Development Concerns:

By 3 Months:

  • Has difficulty lifting his head when placed on his belly
  • Holds his legs stiffly with very little movement
  • When lying on his back, he pushes backwards with his head
  • Keeps his hands fisted and doesn’t move his arms around

By 6 Months:

  • When held in sitting, his back is rounded
  • He is unable to lift his head up or hold his head steady
  • When lying on his back, he has difficulty bring his arms forward to reach out or touch his toys
  • He arches his back and stiffens his legs
  • When held in standing, he pulls his arms back and stiffens his legs

By 9 Months:

  • Uses predominately 1 hand
  • Has difficulty using his arms when sitting
  • Sits with a rounded back
  • Has difficulty crawling
  • Only uses one side of his body to move
  • When held in standing, he is unable to straighten his back
  • He can’t take weight through his legs

By 12 months:

  • Difficulty getting to standing because of stiff legs and pointed toes
  • Only uses his arms to get up to standing
  • Sits with his weight to one side (always the same side)
  • Strongly curled or straightened arms
  • Needs to use his hand to maintain sitting

By 15 months:

  • Unable to take steps independently
  • Poor standing balance, falls frequently
  • Walks on his toes most or all of the time
If your child displays concerns in the above areas, discuss with your child’s pediatrician if he/she may benefit from physical therapy.

Baby's Communication Development Concerns:

By 6 months:

  • Cannot focus, easily over-stimulated
  • Seems unaware of sound
  • Cannot find a source of a sound
  • Seems unaware of people and objects in the environment
  • Does not seem to understand or enjoy imitating
  • Lack of connection (eye contact, vocal turntaking)
  • No babbling or babbling with few consonants (e.g., p, b, d)

By 12 months:

  • Easily upset by sounds that will not upset others
  • Doesn’t respond to common words that you use (e.g., up, eat, no)
  • Lack of consistent patterns of babbling
  • Does not clearly indicate desire for objects

By 19 months:

  • Lack of communication gestures (e.g., pointing)
  • Does not attempt to imitate or produce single words
  • Does not persist in communication (may hold up hand for help, but gives up if adult does not respond immediately)
  • Limited comprehension (understands less than 50 words)
  • Lack of new words between the age of 12 and 19 months

By 24 months:

  • Relies on gestures to communicate
  • Limited vocabulary (speaks less than 50 words)
  • Does not use any two word combinations
  • Limited consonant production
  • Mostly unintelligible speech
  • Regresses in language development (stops talking)

By 36 months:

  • Words limited to single syllable and no final consonants
  • Few or no multiword utterances
  • Does not demand a response from a listener
  • Asks no questions
  • Speech difficult to understand
  • Tantrums when frustrated
  • Echoing of speech without communicative intent
If your child displays concerns in the above areas, discuss with your child’s pediatrician if he/she may benefit from speech therapy.

Causes for Concern in Preschool and School-Age Children

Discuss with your child’s pediatrician if he/she may benefit from physical therapy if he/she displays any of the following issues:
  • Uses poor or incorrect posture
  • Falls or trips frequently
  • Unable to hop, skip or jump
  • Moves stiffly or avoids movement
  • Always walks up on his/her toes
  • Unable to keep up with peers in play
  • Frequently complains of neck or back pain
  • Appears clumsy and uncoordinated
  • Motor skills are behind those of his/her peers
Discuss with your child’s pediatrician if he/she may benefit from occupational therapy if he/she displays any of the following issues:
  • Shows no interest in fine motor skills (skills involving coordinated use of his/her hands)
  • Using poor scissor skills
  • Displaying difficulty holding small objects and manipulating tools
  • Unable to complete mazes or dot-to-dots
  • Difficulty copying text from the chalkboard
  • Showing atypical levels of avoidance or motivation to move around
  • Dressing with clothes put on backwards
  • A messy eater
  • Inattentive and distractible to written and/or reading tasks
  • Poor at following instructions
  • Displaying poor eye contact
  • Not tolerating touch, or craving touch
  • Doesn’t like movements or heights


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