⚠️Red Flags

Developmental Red Flags

When to seek medical review, age-by-age warning signs, and where to get early intervention support in Singapore.

Important: Ranges Are Wide

Developmental ranges are wide. A single missed milestone at a given age is rarely cause for immediate alarm - Babies develop unevenly across domains, and cultural, environmental, and individual variation is significant. Patterns matter more than single data points. But if you are concerned, raise it - Early review is always better than waiting.

Red Flags by Age

By 2 months

⚠Does not smile socially in response to your face
⚠Does not track a moving object with eyes
⚠Does not respond to loud sounds
⚠Does not bring hands to mouth
⚠Limbs seem very stiff or very floppy

By 4 months

⚠Does not hold head steady when held upright
⚠Does not coo, make sounds, or babble
⚠Does not reach for objects
⚠Does not make eye contact or respond to faces
⚠Social smile absent

By 6 months

⚠Does not roll in either direction
⚠Does not laugh, squeal, or make sounds of joy
⚠Does not respond to own name
⚠Does not show affection for caregivers
⚠Cannot sit with minimal support

By 9 months

⚠Does not sit without support
⚠Does not babble (consonant sounds: ba, da, ma)
⚠Does not show interest in other people's faces
⚠Does not point or gesture
⚠No object permanence - No searching for hidden objects

By 12 months

⚠Not standing with support
⚠No meaningful words (including mama/dada used specifically)
⚠Does not point or wave
⚠Does not follow simple one-step instructions
⚠No crawling or other purposeful movement

By 18 months

⚠Not walking independently
⚠Fewer than 10 words
⚠Not using single words purposefully or consistently
⚠No pointing to communicate or to share interest
⚠Does not make eye contact

By 24 months

⚠No 2-word phrases
⚠Fewer than 50 words
⚠Loss of previously acquired language or social skills
⚠Does not engage in any pretend play
⚠Cannot follow 2-step instructions

At any age

⚠Regression - Loss of skills already mastered
⚠Consistent absence of eye contact
⚠Extreme rigidity or distress in response to routine change
⚠Unusual repetitive movements (flapping, spinning)
⚠No interest in people - Prefers objects exclusively

What to Do If You're Concerned

Raise it at your next polyclinic visit

Don't wait for the 'right' appointment. Call your polyclinic and ask for an earlier developmental review if you are concerned. Singapore's Child Health Programme includes developmental screening - Use it.

Ask for a paediatric referral

If the polyclinic doctor shares your concern, they will refer to a paediatrician or developmental specialist. KKH and NUH both have Development & Behavioural Paediatrics departments.

Request a speech-language therapy (SLT) assessment

For language concerns, an SLT assessment can happen via polyclinic referral. Early speech therapy - Even from 18 months - Is highly effective.

Enquire about EIPIC

The Early Intervention Programme for Infants and Children provides centre-based therapy and support for children with developmental delay or disability. Referral via paediatrician or polyclinic.

Trust your instincts

Parents consistently notice something is 'different' before formal screening catches it. If you feel something is wrong, pursue the review. False alarm is far better than late identification.

Developmental Services in Singapore

KKH Development & Behavioural Paediatrics

Specialist assessment for developmental delay, ASD, ADHD, and learning difficulties. Referral via GP or polyclinic.

KKH: 6225 5554

NUH Child Development Unit

Multidisciplinary developmental assessment - Paediatrics, psychology, speech therapy, occupational therapy.

NUH: 6772 2002

EIPIC (Early Intervention Programme for Infants and Children)

Government-subsidised centre-based intervention programme for children aged 0–6 with developmental delay or disability.

Referral via polyclinic or paediatrician

Cerebral Palsy Alliance Singapore (CPAS)

Therapy services for children with cerebral palsy and related motor conditions.

cpas.org.sg

SPARK Centre (SPD)

Early childhood intervention services including sensory integration therapy and speech therapy.

spd.org.sg

Singapore Association for Mental Health (SAMH)

Family support and counselling for families navigating developmental diagnoses.

samh.org.sg

Autism and Developmental Screening in Singapore

The M-CHAT (Modified Checklist for Autism in Toddlers) is a standardised screening questionnaire. In Singapore, it is completed at the 18-month polyclinic developmental check. It asks about eye contact, pointing, interest in other children, pretend play, and communication.

A positive M-CHAT result does not mean your child has autism. It means further assessment is recommended. Many children who screen positive do not receive a diagnosis.

Signs that may indicate autism - see your doctor for assessment

⚠Limited or inconsistent eye contact
⚠Not pointing to share interest in things (e.g. pointing at a dog to show you, not just to request)
⚠Limited interest in other children
⚠Repetitive movements - hand-flapping, spinning, rocking
⚠Very strong attachment to specific objects or routines
⚠Delayed or absent speech beyond expected ages
⚠Loss of words or social skills that were previously present

Vaccines do not cause autism. The 1998 paper by Andrew Wakefield that suggested a link between the MMR vaccine and autism was fully retracted. Wakefield was struck off the medical register. Dozens of large studies involving millions of children have found no connection. Delaying or avoiding vaccination puts your child at real risk of serious diseases.

Early intervention makes a significant difference. Children who begin speech therapy, occupational therapy, or behavioural support before age 3 consistently have better outcomes than those who start later. If you are concerned, do not wait until the next scheduled check. Call your polyclinic today.

Singapore Referral Pathway for Developmental Concerns

See your polyclinic GP or paediatrician

Book an appointment and describe your concerns clearly. Bring examples: a video on your phone of the behaviour that concerns you is often more useful than a verbal description. Ask directly: 'I am worried about my child's development. Can we do a full developmental review?'

Ask for a referral to a specialist

If the GP shares your concern, they will refer you to KKH Child Development Unit or NUH Child Development Programme. These are multidisciplinary teams including paediatricians, psychologists, speech therapists, and occupational therapists.

Speech and language therapy (SLT)

For speech and language concerns specifically, polyclinic SLT referrals are available for children under 18 months. After 18 months, referral is to KKH or NUH Speech Therapy departments. Waiting times vary - request the referral as early as possible.

EIPIC - Early Intervention Programme for Infants and Children

EIPIC provides centre-based therapy and support for children from birth to 6 years with developmental delay or disability. It is government-subsidised. Apply through your hospital or polyclinic. There is often a waiting list - apply early. Centres are located across Singapore.

Development Support (DS) Programme

For children with mild developmental needs who are already attending childcare, the DS programme provides in-centre support from an ECDA-appointed provider. Available through your childcare centre or the ECDA portal.

Financial support: EIPIC is heavily subsidised by the Ministry of Social and Family Development (MSF). Fees are means-tested. Most families pay between $0 and $400 per month. Early intervention is not out of reach for most Singapore families. Ask your case manager about Comcare or MSF assistance if cost is a concern.

Back to Milestones:

Newborn → 1–3 Months → 4–6 Months → 7–9 Months → 10–12 Months → 12–18 Months →

Medical disclaimer: Educational purposes only. This information does not replace professional medical advice. Always consult your paediatrician for concerns about your child's development.