Developmental Red Flags for Children Ages 3-5 (page 3)

By — Pearson Allyn Bacon Prentice Hall
Updated on Jul 20, 2010


Even a mild or temporary hearing loss in a child may interfere with speech, language, or social and academic progress. If more than one of these red flag behaviors is observed, it is likely that a problem exists.

Red Flags

  • Speech and language. Look for the child
    • Whose speech is not easily understood by people outside the family
    • Whose grammar is less accurate than other children of the same age
    • Who does not use speech as much as other children of the same age
    • Who has an unusual voice (hoarseness, stuffy quality, lack of inflection, or voice that is usually too loud or soft)
  • Social behavior (at home and in school). Look for the child who
    • Is shy or hesitant in answering questions or joining in conversation
    • Misunderstands questions or directions; frequently says “huh?” or  “what?” in response to questions
    • Appears to ignore speech; hears “only what he wants to”
    • Is unusually attentive to speaker’s face or unusually inattentive to  speaker, or turns one ear to speaker
    • Has difficulty with listening activities such as storytime and following  directions
    • Has short attention span
    • Is distractible and restless; tends to shift quickly from one activity to  another
    • Is generally lethargic or disinterested in most day-to-day activities
    • Is considered a behavior problem—too active or aggressive, or too  quiet and withdrawn
  • Medical indications. Look for the child who
    • Has frequent or constant upper respiratory tract infections, congestion  that appears related to allergies, or a cold for several weeks or months
    • Has frequent earaches, ear infections, throat infections, or middle ear  problems
    • Has had draining ears on one or more occasions
    • Is mouth breather and snorer
    • Is generally lethargic; has poor color

How to Screen

  1. Observe current behavior related to speech and hearing.
  2. Consult behavioral and medical history.
  3. Consult audiologist or communication disorders specialist.

Vision, Which Includes

  • Skills
  • Acuity (ability to see at a given distance)
  • Disease

Red Flags

  • Eyes
    • Are watery
    • Have discharge
    • Lack coordination in directing gaze of both eyes
    • Are red
    • Are sensitive to light
    • Appear to cross or wander, especially when child is tired
  • Eyelids
    • Have crusts on lids or among lashes
    • Are red
    • Have recurring sties or swelling
  • Behavior and complaints
    • Rubs eyes excessively
    • Experiences dizziness, headaches, nausea on close work
    • Attempts to brush away blur
    • Has itchy, burning, scratchy eyes
    • Contorts face or body when looking at distant objects, or thrusts head forward; squints or widens eyes
    • Blinks eyes excessively; holds book too close or too far; inattentive  during visual tasks
    • Shuts or covers one eye; tilts head

How to Screen

  1. Has child had an eye exam? If not, recommend one.
  2. Screen using a screening tool appropriate for young children, such as the Snellen E chart or Broken Wheel cards.
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