The “Red Flag”

Early Intervention Referral Guide

for children 0 – 5 years

How to use this resource
This resource is a tool to help you to determine One or more Red Flags (in any area) is a sign
whether a child may have developmental
delays. It will allow you to refer early before the
child begins to struggle to achieve tasks usually
managed by children of the same age.
Step 1:
Find the child’s age across the top of the
table below.
Step 2:
Read through the list and identify if the child is
demonstrating any of the Red Flags at their
age level.
Step 3:
If the child is between age levels (e.g. 2 yrs 5
months) check the lower age level for Red Flags
(ie. 2 yrs)
When to be concerned? Who helps with these Red Flags?
Children aged 0 – 5 years who have a
of delayed development. developmental concern, may benefit from the
services from any of the following:
Who to go to? • Paediatrician
• Speech Pathologist
Parents: • Occupational Therapist
If you have concerns about your child’s • Physiotherapist
development, please contact your • Social Worker
Family Doctor or • Psychologist
Child Health Nurse Phone: (07) 4992 7000
• Dietitian
Health Professionals: Local Child Development Service
If you have screened and identified any Banana Community and Allied Health Services
Red Flags, please contact your local Child Phone (07) 4992 7000
Development Service. Office Hours 8.00 am to 4.30 pm
Monday to Friday
www.health.qld.gov.au/cq/child-development
Developed by: Child Development Program, Children’s Health Services in conjunction with GPpartners.
Adapted by Central Queensland Hospital and Health Service 2015. Print ID P1000 05052015 v1.0

Red Flag referral guidelines

Red Flags at
6 months 9 months 12 months 18 months 2 years 3 years 4 years 5 years
any stage
No interest in
When playing pretend play or
Does not notice
with toys tends other children
someone new
Not sharing to bang, drop,
Does not smile Lacks interest
enjoyment with or throw them Difficulties in Unwilling / Play is different
or squeal in Does not play in playing and
others using eye rather than use noticing and unable to play than their
response to early turn taking interacting with
contact or facial them for their understanding cooperatively friends Not achieving
people games (e.g. others
Social / expression
peekaboo,
purpose (e.g feelings in indicated
cuddle doll, themselves developmental
Emotional rolling a ball)
build blocks) and others (e.g. milestones
happy, sad)

Lack of or limited eye contact Strong parent

Does not have at concerns
No gestures least 50 words Difficulty telling
No babbled No clear words
(e.g. pointing, Speech difficult Speech difficult a parent what is
phrases that Significant loss
showing, Not putting to understand to understand wrong
Not starting sound like Cannot of skills
waving) words together
to babble (e.g talking understand
eg. ‘push car’ Not using simple Unable to follow Cannot answer
adah; oogoo) short requests
Not using 2 part sentences e.g. directions with 2 questions
No response to eg. ‘Where is the Lack of response
babble (e.g. Most of what is big car go steps in a simple
Communication familiar words ball?’ to sound or
gaga, arma) said is not easily conversation
understood visual stimuli
Majority of Concerns from
Difficulty
nutrition still teacher about Poor interaction
helping with
liquid/puree school readiness with adults or
Unable to hold Not holding or self care skills
Not reaching other children
and/or release scribbling with a (e.g. feeding, Not toilet trained
for and holding Cannot chew No interest in Not independent
toys crayon dressing) by day
(grasping) toys solid food self care skills with eating and
eg. feeding, dressing Difference
Cannot move toy Does not Difficulty Unable to draw
Hands frequently Unable to pick dressing between right
from one hand attempt to tower manipulating lines and circles
Fine Motor clenched
to another
up small items
blocks small objects
Cannot draw and left sides of
using index simple pictures
and Cognition finger and
e.g. threading
(e.g. stick
body in strength,
beads movement or
thumb person) tone
Awkward
Not sitting Not running well when walking,
Cannot pedal a
without support Not crawling or running, Loose and floppy
tricycle
bottom shuffling Unable to run Cannot walk up climbing and movements (low
Not rolling Not attempting
Not moving and down stairs using stairs tone) or stiff
to walk without Cannot catch,
eg. creeping or Not pulling to Unable to use and tense (high
Not holding support throw or kick a
crawling motion stand stairs holding on Cannot kick or Ball skills are tone)
head and ball
throw a ball very different to
shoulders up Not standing
Does not take Not standing Unable to throw their peers
when on tummy alone Cannot balance
weight well on holding on to a ball Cannot jump
well standing on
legs when held furniture with 2 feet Unable to hop
Gross Motor by an adult together
one leg
5 times on each
foot

Parents - If there are Red Flags call your Family Doctor or Child Health Nurse
Professionals - REFER EARLY − DO NOT WAIT