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Children’s Development Milestones & Red Flags for Allied Health Intervention

Children’s Development Milestones & Red Flags for Allied Health Intervention

Every child is different, and it is important to remember that there is a big range of ‘normal’ in children’s development, especially under the 12-month age group. Developmental delay can show up in the way a child moves, communicates, learns, or behaves. It might be short term or might be the sign of a long-term problem. As a general guide, if you notice a child over several months is not developing motor, social or language skills at the same rate as other children the same age, it may be a sign of developmental delay.

For more insights into whether your child might be showing developmental delay, we have put together a guide across 7 key areas.


3 years: A child uses sentences of 3-5 words, or even more. Unfamiliar people understand what the child is saying most of the time, and they label lots of things in the environment and in books.

4 years: A child uses longer sentences of 5-6 words or more and is understood by all people all the time. They understand most things you say, follows 2-3 step instructions about familiar things, understand adjectives like long and small, and uses feeling words like happy and angry.

RED FLAGS for referral: By 3-4 years old, the child is only using 1-2 words together, having difficulty understanding words, only uses language to get needs met as opposed to interacting socially, and does understand simple instructions.


3-4 years: By this age range, children really begin to understand their emotions and know the difference between happy and sad, angry, and afraid. They can also show fear of imaginary things, care about how others act, and show affection for familiar people. They can still have difficulty managing emotions but are able to calm in time with the assistance of an adult.

RED FLAGS for referral: A child is unable to identify emotions in themselves or others and does not display a range of emotions throughout the day, or, the emotion does not match the situations such as having big tantrums over very small things.


3-4 years: At this age range a child is able to walk upstairs, ride a tricycle, throw, catch, kick a ball, run, climb, hop and balance on one foot. Using their hands, they might be able to draw a circle or square, build a tower with blocks, use child-safe scissors, and unscrew a lid for a jar.

RED FLAGS for referral: The child is clumsy. For example, trips over a lot when walking or running, finds it hard to handle small objects, and isn’t drawing simple shapes.


Child Development & red flags for referral - fine motor skills

(Pencil Grasp Development, Erhardt, 1962)


Child Development & red flags for referral - fine motor skills




(Image via


3-4 years: By this age range, a child understands the family and daily routine and enjoys special events like birthdays. They are becoming more independent and are able to feed themselves, put on shoes (not laces), undo buttons, participate and complete much of the dressing routines. Most are also toilet trained and might be able to do some daily hygiene tasks like wiping their bottom and washing their hands and face, but still need supervision with things like bathing and tooth brushing.

RED FLAGS for referral: A child not making progress in toilet training for urination, has difficulty completing any dressing tasks, and does not seem aware of the routines in their day.


3-4 years: By this age range, a child can engage in a range of imaginary play scenarios, such as pretending to be Mum or Dad, play cooperatively with other children and show preferences in developing friendships. They are becoming aware of social norms and rules, such as sitting quietly at circle time.

RED FLAGS for referral: A child shows limited interest in engaging with other children or only engages inappropriately. Strong preference for engaging with adults over children.


If you are noticing your child display any of the red flags for referral, there are different referral options you can take.

  1. NDIS – Early Childhood Intervention (ECI)
    • You can be referred by a parent into a local area coordinator.
    • Does not need a formal diagnosis to be eligible for intervention.
    • Can receive early intervention supports across domains such as Occupational Therapy, Speech Therapy, Physiotherapy and Psychology.
  2. Private referral
    • Use of Medicare or private health insurance.
    • Generally, a GP referral is needed but will be dependent on the service provider.

National 360 offers early intervention (children up to 7 years) and services for older children (7 + years) and teenagers (12 – 18 years). You may be looking for assistance from one service such as occupational therapy, or we can support you with a multidisciplinary approach where you may receive a combination of therapies such as occupational therapyphysiotherapyspeech pathology and behaviour support.

If you feel your child may benefit from the help of our network of skilled and supportive service providers, please get in touch with our friendly team to discuss your child today!

Find out more about our paediatric services, or if you are ready to make a referral fill out our contact form here or simply call 1300 340 440.