Warning Signs of a Toddler's Physical Delay

Children develop at different rates, but most follow a general timeline. If your toddler doesn't seem to be meeting milestones within several weeks of the average, ask his pediatrician about it. It may be nothing — and in fact isolated instances (your child is unable to climb stairs, but does everything else well) usually aren't anything to worry about. If your child does have a delay, however, you'll want to catch it early so you can begin treatment.

As a general rule, trust your instincts. If something seems odd or wrong to you about the way your toddler moves, ask about it. After all, you know your child best. The following are possible warning signs of a problem; print this out and use it as a checklist to keep track of your toddler's development. If your child fails to attain several of these milestones (either in one area or one in each of several areas), call the pediatrician.

Age: 12 to 18 months
Warning Signs:
• At 13 months, has difficulty squatting to play
• At 13 months, has difficulty climbing onto and off of a small chair
• At 13 months, can't eat with fingers
• At 15 months, has difficulty holding a crayon and scribbling spontaneously
• At 15 months, has difficulty rising independently from the floor
• At 15 months, can't climb on a chair to reach things
• At 18 months, can't walk
• At 18 months, is unable to remove his/her socks
• At 18 months, is unable to hold a crayon and imitate a scribble
• At 18 months, does not attempt to kick a large ball
• At 18 months, has difficulty walking down stairs with one hand held
• After several months of walking, does not walk with heel-to-toe steps
• At any age, consistently walks on toes

Age: 19 to 24 months
Warning Signs:
• At 21 months, can't turn the pages of a book with thick pages
• At 21 months, has difficulty walking up or down stairs holding the handrail
• At 21 months, can't kick a large ball following a demonstration
• At 24 months, can't hold a crayon and imitate a vertical line
• At 24 months, does not attempt to stand on one foot
• At 24 months, can't push a toy on wheels
• At 24 months, can't kick a large ball on request
• At 24 months, can't use a spoon well
• At 24 months, does not run well

Age: 25 to 30 months
Warning Signs: • At 30 months, can't walk up steps alone, alternating feet
• At 30 months, can't turn single pages in a book
• At 30 months, can't pedal a tricycle
• At 30 months, can't stand on one foot momentarily


Age: 31 to 36 months
Warning Signs:
• At 36 months, can't walk down stairs alone alternating feet
• At 36 months, can't manipulate scissors or will not attempt to cut with scissors
• At 36 months, can't stand on one foot for 2 seconds
• At 36 months, can't throw a ball overhand
• At 36 months, can't wash and dry hands

Warning Signs of a Language/Communication Developmental Delay

Children learn language at different rates, but most follow a general timeline (though preemies may be off schedule by a few weeks or months). If your child doesn't seem to be meeting communication milestones within several weeks of the average, though, talk to her pediatrician. It may be nothing, but if your child is delayed in some way, recognizing and treating the problem early will benefit her language and learning skills greatly in the long run.

Keep in mind that the timetable for language development is broad, and your child may run into small roadblocks along the way. You may find your toddler repeating a word several times in the middle of a sentence as a way of holding your attention as he formulates the rest of his thought. (This is not the same thing as stuttering.) As long as she can speak clearly by the time she's ready for first grade, your child's on track.

But as a general rule, trust your instincts. If something seems wrong to you, ask your pediatrician about it or call a speech therapist or pathologist or your county's early intervention program for an evaluation. After all, you know your child best. The following are possible warning signs of a language delay. Feel free to print out this form for a handy reference.

Call your child's pediatrician or a speech pathologist if your child:

Age: 12 to 18 months
Warning Signs:
• at 12 months, doesn't use gestures such as waving or shaking her head
• by 12 months, isn't practicing using at least a couple of consonants (p, b, etc.)
• by 12 months, isn't somehow communicating to you when she needs help with something
• at 15 months, doesn't understand and respond to words such as "no" and "bye-bye"
• by 15 months, can't say at least one to three words
• by 15 months, doesn't say "mama" or "dada"
• at 16 months, doesn't point to body parts when asked
• at 18 months, isn't saying at least six to 10 words


Age: 19 to 24 months
Warning Signs:
• by 19 to 20 months, isn't pointing out things of interest, such as a bird or airplane overhead
• by 20 months, isn't making at least six consonant sounds
• at 21 months, doesn't respond to simple directions
• by 21 months, doesn't pretend with her dolls or herself (brushing her hair, feeding her doll, etc.)
• by 24 months, doesn't imitate actions or words of others
• by 24 months, can't point to named pictures in a book
• at 24 months, can't join two words together
• at 24 months, doesn't know the function of common household objects — toothbrush, telephone, fork, etc.


Age: 25 to 36 months
Warning Signs:
• at 26 months, uses no two-word simple sentences
• at 30 months, can't name at least three body parts
• at 30 months, can't be understood by anyone in her family
• by 32 months, has difficulty singing fragments of nursery rhymes
• at 36 months, doesn't ask questions
• at 36 months, can't be understood by strangers at least half the time
• by 36 months, is unable to articulate initial consonants (for example, says "all" instead of "ball"
• by 36 months, is unable to name most common household objects

Age: 3 to 4 years
Warning Signs:
• at 3, can't speak in short phrases
• by 3, is unable to understand short instructions
• at 3, has no interest in interacting with other children
• at 3, has extreme difficulty separating from a parent
• by 3 1/2, consistently fails to add final consonant to words (for example, saying "ca" instead of "cat")
• at 4, still stutters (has true difficulty producing a sound or word) frequently, often accompanied by facial grimacing
• at 4, isn't almost fully understandable

Warning Signs of a Toddler's Hearing Delay

Deafness is the leading cause of delayed language development, according to the American Medical Association's (AMA) Complete Guide to Your Children's Health. Even temporary hearing loss caused by an ear infection — not to mention more permanent damage that can result from frequent infections — can affect how and when your child learns to talk. Your child's doctor should check his hearing regularly, but in the meantime, print this form so you can keep an eye out for any of these warning signs.

Age: 12 to 18 months
Warning Signs:
• Doesn't recognize the names of familiar people, pets, and objects
• Can't follow simple commands such as "Come here"
• Doesn't turn head in response to sounds coming from another room
• Doesn't point to express a desire
• Doesn't imitate simple words
• Doesn't use at least two words
• Doesn't respond to music
• Doesn't babble

Age: 19 to 24 months
Warning Signs:
• Doesn't say more than five words
• Can't point to at least two body parts
• Doesn't respond with "yes" or "no" to a question or command
• Can't identify common objects such as "doll" or "cat"
• Doesn't mix babble with some intelligible speech

Age: 25 to 30 months
Warning Signs:
• Doesn't respond to two-part commands such as "Sit down and drink your milk"
• Can't answer "what" and "who" questions
• Can't understand about half of speech from unfamiliar voices
• Can't form simple two-word sentences such as "I go"
• Isn't interested in simple stories

Age: 30 to 36 months
Warning signs :
• Doesn't understand possessive terms such as "mine" and "yours"
• Can't use basic descriptive terms such as "big" and "little"
• Doesn't use any plurals or verbs
• Doesn't ask "what" and "why" questions

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