5 Developmental Red Flags Your Pediatrician Might Be Missing
At some point during our child’s development, we’ve all asked the same question: Is this normal?
Maybe you’ve been concerned enough to ask a family member, friend and/or your child’s pediatrician to chime in, only to be brushed off with some platitude like, “don’t worry, all kids develop at a different pace.”
Or maybe you yourself have thought, I’m worrying too much, I’m sure everything’s fine, yet you can’t quite shake the nagging feeling that it’s not.
Here’s the thing: “normal” is subjective and kids do develop at a different pace.
But, there are certain developmental red flags that every parent needs to be aware of.
Red flags that your well-meaning family, friends and yes, even your pediatrician, are not privy to, that, when ignored, can have a serious impact on your child’s development.
According to pediatrician and child development expert, Dr. Katiraei of Wholistic Families, “Brain development is incredibly complex, and yet YOU have the ability to identify risk factors early on before they can limit your child's ability to develop to his full potential.”
He goes on to explain that, “sadly, your pediatrician may not be trained to identify sensory processing disorders or how they relate to development, so YOU have to be one who is able to identify these limitations."
It’s not that pediatricians aren’t skilled or highly trained, they are! It’s that western medicine as a whole is lacking education in certain areas, child development and sensory processing being two of them.
That's why it’s important that we educate ourselves and become our child’s developmental advocate.
For starters, here are five possible developmental red flags that are commonly missed/ dismissed by pediatricians.
Disclaimer: Notice the word "possible." Any one of these red flags by itself is most likely not cause for concern. When assessing for developmental red flags, you want to look for patterns and clusters and take everything in context.
Alright, here we go!
Colic is a term commonly used to describe extremely "fussy" babies- babies who cry incessantly for no apparent reason and are impossible to soothe. So, what exactly is cause of their distress? The official definition of colic is: severe, often fluctuating pain in the abdomen caused by intestinal gas or obstruction in the intestines.
Doctors usually diagnose infant colic based on the "rules of three."
Your baby's crying:
- Lasts at least three hours at a stretch
- Occurs at least three days a week
- Persists for at least three weeks in a row.
It typically begins when babies are 2-3 weeks old, peaks around 6 weeks and tapers off around 10-12 weeks, unless your baby is an overacheiver like mine was, in which case it lasted for 9 months!
Most babies outgrow colic without any further complications down. If you had a colicky baby, who outgrew it around 10-12 weeks and otherwise had typical development, colic in and of itself is not a developmental red flag.
However, there are multiple studies that link "infant regulatory problems in the domains of feed, cry-fuss behaviors and sleep with impaired developmental and behavioral outcomes in later childhood. This association is strongest if there is more than one regulatory problem, or if the regulatory problem persists beyond 4-5 months of age."
So, if your baby had colic that lasted much longer than usual AND had additional issues such as feeding and/or sleep issues, colic IS a developmental red flag worth paying attention to. Which leads me to our next red flag...
2. Sleep Issues
There's a reason why the infant sleep industry generates more than $325 million in sales a year. With the exception of the rare few who are "good sleepers," most babies go through some type of "sleep learning" before they're able to sleep soundly.
But, some babies (remember my overacheiver?), no matter how many sleep learning methods they're subjected to (you name it, we tried it!), simply Can. Not. Sleep.
Many doctors dismiss sleep issues and chalk them up to the fault of the parent (inconsistent sleep training, being too permissive etc.). Of course if the sleep issues are the baby's only issue and otherwise he has perfectly normal development, that's fair enough.
But, often babies who have severe sleep issues also have other issues - colic, reflux, feeding issues, extreme separation anxiety, mild motor delays - and when taken in this context, the sleep issues qualify as a developmental red flag.
It's worth noting that nine out of ten families I work with, whose child was later diagnosed with sensory processing issues, report severe sleep issues in infancy and toddlerhood.
3. No Crawl or a “Funky” Crawl
Crawling is a crucial part of a baby's brain development. When a baby doesn't crawl or their crawl is "funky" (belly crawl, crab crawl, scooting on bottom), there's a good chance you'll see reprecussions later on.
The traditional hands and knees crawl stimulates bilateral coordination and crossing the midline, two motor skills that help lay the foundation for higher-level learning. It also stimulates the healthy development of near and far vision, hand-eye coordination and overall muscle strength.
When a baby skips this vital milestone or goes about it in his own unique way, it can be indicative of following underlying sensory issues:
- Lack of core strength and/or shoulder stability
- Difficulty with motor planning
- Lack of body awareness and bilateral integration
- Tactile defensiveness and avoidance of textures to hands and legs
- Vestibular defensiveness and poor balance
If your baby had crawling challenges in conjunction with extreme fussiness, sleep issues, and other "sensitivities," then the "funky" crawl should be considered a developmental red flag.
4. Extreme Picky Eating
Every so often you come across a mom who proudly proclaims, "my baby is such an amazing eater!" But, similar to sleep, at some point in their development, picky eating is something many babies/toddlers/kids have issues with and something doctors often tell parents not to worry about.
And, they're right. Usually it isn't anything to worry about.
Picky eating falls on a spectrum. There's "normal" picky eating, which begins around 1-2 years old, lasts until 3-5 years old, and includes the following traits:
- Will eat at least 30 different foods on a consistent basis
- Eats from a variety of food groups (at least one item from each food group)
- May suddenly stop eating a food they previously liked (but will eat it again in the future)
- Goes through food jags, or only wanting a few select foods on repeat for days or weeks at a time
- Eats inconsistent amounts (i.e. a lot at one meal or on a given day and then only small amounts at the next meal/day)
- Able to handle preferred and non-preferred foods on their plate
- Will gradually add new foods to their list of preferred foods
- Eats with the family, but usually is selective from what’s offered or eats something different from family
This is the type of picky eating that most kids will eventually outgrow.
Then, there's "extreme" picky eating or "problem eating," which is defined as a child who:
- Eats less than 20 different foods
- Does NOT reaquire foods lost due to food jags
- Cries and “falls apart” when presented with new foods
- Refuses entire categories of food textures
- Almost always eats different foods than the family
- Is persistently reported by parent as a “picky eater” across multiple well-child check-ups
While your run of the mill picky eating is nothing to worry about, "extreme" picky eating is and can be indicative of an underlying sensory processing issue.
5. Difficulty Potty Training
For many typically developing kids, potty training is not exaclty smooth sailing. Common issues include:
- Fear of flushing the toilet
- Fear of pooping in the toilet (only wants to poop in a diaper)
- Frequent accidents
- Refusal/ resistence (would rather keep playing than go potty!)
- Bed wetting
Most kids will eventually overcome these issues and parents' frustration will morph into nostalgic tales of potty training woes. However, some kids, like my son, who wasn't fully potty trained until he was 5-years-old, have challenges that last much longer than the norm.
When a child's struggles persist, an underlying sensory processing issue is something to consider and rule out. Kids with sensory processing issues may:
- Not be able to feel when their body has to go
- Be sensitive to wearing big boy/girl underwear
- Have difficulty adjusting to something new
- Have extreme sensitivity to the sound of the toilet flushing
- Have postural insecurity which makes sitting on the toilet difficult
If you've tried everything, and your child still won't pee or poop in the potty AND he has a few other "peculiar" or "challenging" behaviors, consider scheduling and evaluation with a pediatric occupational therapist to assess for an underlying sensory processing issue.
Most of the time, kids do "outgrow" these typical childhood development challenges. But, kids who have sensory processing issues don't.
If you have a child who has struggled with two or more of these developmental red flags, whose "peculiar" behaviors are interfering with his daily functioning and who, despite being repeatedly told by your doctor that there's nothing to worry about, doesn't appear to be "outgrowing" his challenges, trust your instincts and don't give up until you get him the support he needs.
DON'T WAIT until his challenges become a bigger problem. The earlier you intervene, the better to outcome.
If you need someone to run your concerns by, CLICK HERE to schedule a free call.
Please leave your questions and comments below, the Sensory Mom community and I would love to hear from you. And stay tuned for more information on how to spot developmental red flags and what to do if you spot them.