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If at any age your child has:

• limited play, self-care, skilled hand or tool use, productive activity, or social participation as expected for age
• sensory preferences or aversions that limit any of the above
• short attention span for age
• limited food repertoire, and/or strong food preferences/aversions
• overly clumsy, jerky movements, apparent weakness, balance problems
• delayed developmental milestones
• poor eye contact and interaction with parents/family

If between Birth and Six months, your child does not:

• have suck/swallow/breathe coordination
• control head and neck as expected for age
• give eye contact or seem "connected"
• form fists
• kick feet when on back
• show interest in different sensations for 3+ seconds
• remain calm and focused for 2+ minutes
• show interest in people (not just objects)
• maintain an alert and regulated state when rocked, held, or swaddled
• smile

If at Six months, your child does not:

• recover from distress and calm with help of a caregiver after 15 minutes
• play with rattles
• watch a parent's/caregiver's face and expect a response during play
• follow a moving object with eyes
• reach towards objects and faces
• turn eyes or head toward sounds, bright colors, and lights
• begin exploring objects with hands and mouth
• begin to anticipate patterns in daily routine
• make cooing sounds or show pleasure when interacting with caregivers

If at Eight months, your child does not:

• sit independently
• accept a variety of textures/types of food
• move toy from one hand to the other
• play with toes
• roll from stomach to back
• recognize familiar faces
• share back-and-forth sounds and facial expressions
• imitate interactions with you
• babble or repeat sounds like "da-da"

If at 12 months, your child does not:

• demonstrate emotions: closeness, pleasure, excitement, assertive curiosity, anger, fear
• calm with help of a caregiver after 10 minutes
• attempt Pat-a-Cake, So Big, etc.
• pick up Cheerios or other small items
• poke or point with finger, and use other communicative signals (eye gaze, reach arms to be picked up)
• crawl on hands and knees and pull self to standing position with support

If at 15 months, your child does not:

• take a few steps independently
• play with a variety of toys or objects
• put objects into containers
• stack at least two blocks
• drink from a cup or sippy cup
• hold arms and legs out while being dressed
• say at least three to five words

If at 24 months, your child does not:

• share 50 back-and-forth interactions (vocal, facial expression, touch, or movement) in a row with you
• point to named body parts
• consistently feed self with a spoon and drink from a cup
• turn one page at a time in books
• push, pull, and dump, following simple directions
• pull off shoes, socks, and mittens
• look at pictures in books
• walk completely unaided
• scribble spontaneously when provided with marking tool

If at three years, your child does not:

• use pretend play
• ride tricycle using pedals
• use fingers and thumb to hold marker or crayon (not fisted grasp)
• open door independently
• build a tower with four blocks
• sing phrases of songs
• use two and three word sentences

If at four years, your child does not:

• play simple group games
• take interest in coloring or drawing
• cut paper in half
• share toys with adult prompting
• use toilet by self
• put on shoes (without tying)

If at five years, your child does not:

• dress self independently
• take turns in play, or play cooperatively with other children
• draw a person with at least five recognizable parts
• eat with a fork and spoon
• count to 10
• attempt to copy letters and numbers (age 5 ½)
• bathe self with minimal assistance

If at six years, your child does not:

• ride a bike with training wheels
• draw recognizable pictures with basic shapes
• consistently print letters of name
• count to 20
• tie shoes

Older Children and Adolescents:

• frustration, anxiety, and undesirable behaviors regarding writing tasks
• muscle aches, pains, fatigue, cramps, or tremors when writing
• immature grasp of writing tool
• discrepancy between cognitive skills and performance
• noticeable difference in speed of completion, or quality of writing as compared to agemates
• increased difficulty with cursive writing and lengthy writing tasks
• lack of independence with self-care activities or play/leisure time
• difficulty with planning, sequencing, and organization
• frustration and/or difficulty with other activities requiring skilled hand/tool use