Which of the following lists are common indicators of child or adolescent development concerns that require referral?

• A. Delays in milestones, regression, behavioral problems, academic issues, social withdrawal, and concerns with attachment or bonding
• B. Delays in milestones only
• C. Normal development
• D. No concerns

Answer: (A)

Recognizing when development concerns span multiple areas is key. When a child or teen shows delays in milestones along with regression, behavioral problems, academic struggles, social withdrawal, or attachment or bonding concerns, these patterns suggest that difficulties are affecting functioning across cognitive, emotional, social, and school domains. That breadth of impact typically signals the need for a professional evaluation to identify any underlying developmental, learning, or mental health conditions and to plan appropriate supports.

Delays in milestones by themselves can be a flag, but they don’t capture the full picture of how a child is functioning day to day. Normal development or no concerns would not indicate a need for referral.