REASONS FOR CONCERN IN EIGHTEEN MONTH OLD INFANTS

It is not generally possible to determine what significance delays at this age will have for later development.  However, by noting problems early and providing appropriate services the impact of delays may be minimized, skills may be enhanced, and the level of skills may be maintained.  It is important to remember that an infant’s medical history can be critical in determining whether or not a further evaluation or referral for service is necessary.  A particular delay in development may require different responses depending on the infant’s previous medical and developmental course.  While for children who have no history of health problems, a "wait and see" approach may be appropriate for some delays.  However, developmental delays in high-risk infants generally warrant more immediate attention.

If you notice any of the behaviors listed below speak to your child’s primary care provider about your concerns.  Your child’s primary care provider can help decide if your baby needs an evaluation by a pediatric audiologist, pediatric ophthalmologist, developmental psychologist, physical/ occupational/ speech therapists, or other specialists.

It may be of concern if by eighteen months corrected age an infant:

• is not walking independently.
  
  
• is continuing to walk on her toes.
  
  
• is not responding to verbal requests.  For example, "Show me your shoe," or "Give me the ball."
  
  
• is not developing a language system.  She is not using words and/or holding "conversations" using long strings of jabbering.
  
  
• does not point or try to indicate what she wants.
  
  
• does not have a vocabulary of at least three words that are used in a clear, purposeful way.
  
  
• neglects one hand; uses one hand exclusively.
  
  
• as a rule seems to give up quickly when an age appropriate task is difficult.
  
  
• uses her whole hand in a racking motion to pick up small objects.
  
  
• is unable to throw a ball.  She goes through a throwing motion but does not let go of the ball.
  
  
• usually chokes or gages when eating, or has not transitioned to table foods.