Developmental red flags in children: signs and when to seek help

• A child has lost language, movement, social or self-care skills they previously used.
• Progress has stopped for a sustained period or the gap between the child and others of a similar age appears to be widening.
• Difficulties with communication, movement, learning, attention, emotional regulation or everyday tasks are significantly affecting participation and wellbeing.
• There is a marked difference between the two sides of the body, or the child seems unusually stiff or floppy.
• There are ongoing concerns about hearing, vision, feeding or swallowing that may be affecting development.
• A parent, carer, nursery or school has a sustained concern. Concern itself is a valid reason to ask for advice.

Development is not a straight line and milestone ages are not exact deadlines. Some children gain skills earlier, some later and some use a different route. For example, not every baby crawls before walking. A child learning more than one language may use their languages in different settings, but learning more than one language does not cause a language disorder.

A professional will look at the whole child rather than one item on a list. They may consider health, hearing and vision, opportunities to practise skills, communication preferences, family history, sleep, emotional wellbeing, education and whether a child was born prematurely.

For babies born prematurely, the NHS explains that developmental age is calculated from the original due date, rather than the date of birth, until the child is two years old.

• Gross motor skills: head and trunk control, sitting, standing, walking, running, balance and larger body movements.
• Fine motor skills: using the hands and fingers for play, drawing, using cutlery, dressing and other precise movements.
• Communication and language: understanding, gestures, speech, signs, symbols and other ways of expressing needs and ideas.
• Learning and thinking: attention, memory, play, problem-solving and applying new skills.
• Social and emotional development: relationships, shared activities, expressing emotions, regulation and coping with change.
• Everyday independence: eating, dressing, toileting, personal care and taking part in routines at an appropriate level for the child.

The examples below are prompts for discussion, not diagnostic criteria. One sign on its own may have many explanations. Seek advice when a concern is persistent, worsening, present across settings or having a noticeable effect on daily life.

Starting school can make support needs more visible because the environment places new demands on communication, movement, attention and independence. Concerns worth discussing may include:

• persistent difficulty understanding or expressing everyday information, even with appropriate support
• coordination, movement or self-care difficulties that substantially affect classroom, play or personal routines
• attention or emotional regulation needs that repeatedly prevent participation and are seen across more than one setting
• very limited progress in early learning despite appropriate teaching, practice and reasonable adjustments
• a loss of skills or a marked change from the child’s previous development

A five-year-old does not have to read fluently, write neatly or make friends in one particular way to be developing normally. Focus on the child’s progress, access and wellbeing — not comparison with the most advanced child in the class.

By six, a persistent pattern may become clearer as school work and routines become more structured. Consider speaking to the teacher and SENCO, as well as a GP where appropriate, if:

• communication or understanding difficulties consistently interfere with learning and everyday interaction
• movement, handwriting-related motor demands, dressing or other practical tasks remain significantly difficult despite support
• there is sustained difficulty acquiring and using foundational skills across more than one area, despite well-matched teaching
• attention, organisation, sensory needs or emotional distress have a substantial and repeated impact across settings
• progress has stopped, concerns are increasing or the child has lost skills

Reading, spelling or maths difficulty can have many explanations. It may indicate a need for different teaching or SEND support, but it does not by itself diagnose a developmental condition.

For a seven-year-old, the most useful question is whether difficulties form a persistent pattern and affect the child’s access to school, home life, relationships or wellbeing. Examples include:

• ongoing difficulty understanding, organising or expressing information in a way that limits everyday participation
• persistent motor coordination or self-care difficulties that make ordinary activities much harder
• learning needs across reading, writing or maths that remain despite targeted, appropriate support
• significant difficulty with attention, regulation, change or sensory demands across more than one setting
• withdrawal, distress or behaviour that appears to communicate an unmet need and is affecting daily life
• any loss of language, movement, social or independence skills

A “7-year-old milestones red flags” checklist cannot capture differences in teaching, language, disability, neurodiversity or life experience. Use concerns as the start of a conversation, not a label.

Development continues throughout childhood and adolescence. Older children may first be identified when school, relationships or growing independence place new demands on existing skills. Seek advice about persistent difficulties that significantly affect communication, learning, movement, self-care, emotional wellbeing or participation.

A sudden change, loss of skills or serious mental health or safeguarding concern needs a different response from a long-standing developmental difference. Use urgent NHS or safeguarding routes when safety is at risk. If you are concerned about puberty, current NHS guidance says it usually starts between ages 8 and 14 and recommends speaking to a GP if early or delayed puberty is suspected.

None of the following should be used alone to decide that a child has a developmental delay:

• not crawling before walking
• avoiding eye contact or preferring a different style of communication
• preferring solitary play or having a small friendship group
• learning to read, write or use numbers later than some classmates
• growing up with more than one language
• needing movement, quiet, repetition or sensory adjustments to participate

These differences may still be relevant when they form part of a wider pattern or affect wellbeing. The point is that no single behaviour provides a diagnosis.

Ask for advice when you are concerned. You do not have to gather proof or wait for a scheduled review. The right first contact depends on the child’s age and the main concern:

• Under five: contact the health visitor, GP, nursery key person or local speech and language therapy service.
• School age: speak to the class teacher and the school’s special educational needs co-ordinator (SENCO). A GP or school nurse may also be appropriate.
• Hearing or vision: ask a GP, health visitor or school nurse about the appropriate local assessment route.
• Urgent but not life-threatening concern: use NHS 111 for help now.
• Emergency: call 999 if the child is seriously ill, has a life-threatening problem or you think immediate emergency help is needed.

The NHS offers health and development reviews at 9 to 12 months and again at 2 to 2½ years, but parents and carers can contact a health visitor or GP at other times. For school-age children, GOV.UK advises contacting the SENCO when a child may have special educational needs.

1. Write down what you have noticed, when it began and whether it is changing.
2. Use specific examples, such as what happens during dressing, play, classroom tasks or conversation.
3. Note where the concern appears: home, nursery, school, clubs or several settings.
4. Ask the child for their view in a way they can understand and use their preferred way of communicating.
5. Bring the child’s red book, relevant reports and a list of health or family information that may help.
6. Ask what support can start now, who will review progress and when the next discussion will take place.

The process depends on the concern and local services. A professional may ask about pregnancy and birth, health, family history, hearing and vision, development over time, home and education, the child’s strengths and the situations in which support is needed. They may observe play, communication or movement and gather information from nursery or school with consent.

Possible next steps include practical advice, a hearing or vision check, speech and language therapy, physiotherapy, occupational therapy, paediatric or neurodevelopmental assessment, educational support or a period of monitoring. An assessment should consider more than one possible explanation and should not rely on an online checklist alone.

• Use the child’s preferred way of communicating and allow extra processing time.
• Keep routines predictable where this helps, and prepare the child for changes.
• Break tasks into manageable steps and celebrate progress without pressure.
• Offer movement, sensory or quiet-time adjustments that help the child participate.
• Share useful strategies between home, nursery, school and other settings.
• Do not repeatedly test the child or train them to “pass” a milestone checklist. Support should focus on communication, access, comfort, participation and wellbeing.

Understanding development can help parents, carers and professionals notice strengths, describe concerns clearly and make supportive adjustments. It does not qualify someone to diagnose a child.

If you want to develop your knowledge, explore our funded online courses in caring for children and young people, understanding autism, specific learning difficulties and children and young people’s mental health. Courses are available to eligible adults in England and availability depends on location, eligibility and current funding.

General information only. This article should not be used to diagnose a child or replace advice from a qualified health professional. Content reviewed: 21 July 2026. Recommended next review: January 2027, or sooner if NHS, NICE or SEND guidance changes.