Red flags in development and importance of early intervention therapy by Dr. Rafat Trivedi

Dec 29, 2020

Red flags in development and importance of early intervention therapy

The most exciting thing to any parent is watching the child grow, learn, explore and bloom to the fullest potential. The brain of a child undergoes a beautiful and wondrous surge of neural connections during the first few years of life. We understand the worries of the parents if something goes wrong here.

It is very important to know the early developmental milestones so that you seek attention in time if there’s a red flag. First 2-3 years of life are very vital for brain development and if a problem is picked up early there is a tremendous scope of improvement. The brain starts rewiring itself if you stimulate it in a structured manner and that known as neuroplasticity.

It means if you find a lag in development or you notice anything abnormal you should consult your paediatric neurologist or developmental paediatrician early on so that early identification and intervention could be resumed.

Here are a few red flags that should alarm you:

Motor development

Gross motor:

Cannot hold head by 5 months

Cannot sit with support by 6 months

Cannot sit without support by 9 months

Does not crawl by 9 months

Cannot walk by 18 months

Fine motor:

Brings objects to mouth by 5 months

Pincer grasp by 12 months

Difficulty manipulating small objects by 2 years

Connect with your doctor if your child seems stiff or has abnormal postures like arching orthrowing body backwards or if the child seems floppy like a rag doll. If your child uses one hand or limb more than the other it may be a subtle indicator of weakness of the other side. A child should follow objects by 3 months of age and turn to sounds by 5 months, failure to do so could indicate visual or hearing problems.

 Social & Language Milestones

Not smiling back at you by 2 months of age

If he doesn’t enjoy being around people by 5 months

Does not enjoy peek-a-boo by 9 months

Says no single meaningful words like ‘papa’ ‘mama’ by 12 months

Does not wave ‘Bye Bye’ 12 months

Does not point by 15 months

Does not imitate or follow simple commands by 2 years.

It is recommended that you seek medical attention if you notice any of the above red flag signs.

Managing children with neurological impairment involves a multidisciplinary or a group approach involving your pediatrician, pediatric neurologist, physical, occupation, speech & language therapist and psychologist. Some children require visual rehabilitation, nutrition and feeding support. The children with tone problem are prone for developing joint deformities, they may need assistive devices like ankle foot orthosis or splints, some do benefit with botox injections or may need surgery. School going kids may require support in the form special education or remedial therapy.

These children are more prone for infections. Regular vaccinations and a good nutrition should be ensured.

It is vital to work on the preventive aspect, a good maternal nutrition, treatment of systemic diseases and close antenatal follow up is recommended. Vaccination for preventable diseases like MMR is mandatory. Avoid unnecessary medications, alcohol and smoking during pregnancy.

Lastly, if you have a family history of a child with delays or epilepsy or genetic problem,consult a pediatric neurologist who could guide you and do required assessments or tests. This is an era of genetics and we have progressed a lot in this field in the last decade. A genetic diagnosis can help in prenatal counselling and can change lives of many parents and children.

Early intervention therapy is the key to a better development. We at Maatri pledge to strive for preventive, inclusive and comprehensive care for all children and individuals with neurological problems.