Child holding color pencils and drawing acorss from adult

For many parents, the first signs that something may be off in their child’s development are easy to dismiss. A toddler who isn’t talking yet. A baby who avoids eye contact. A preschooler who melts down when routines change. Family reassurances often follow: Every child develops at their own pace.

That’s true, to a point.

“Children do develop on their own timelines,” said Kiti Freier Randall, PhD, a pediatric neurodevelopment psychologist at Loma Linda University Children’s Hospital and co-medical director of the Inland Empire Autism Assessment Center. “But there are still red flags that shouldn’t be ignored.”

Language delays are often the earliest and most overlooked signs. By around 9-12 months, children should be responding to their names and beginning to use words or word approximations with meaning, Freier Randall said. They should also recognize and respond to familiar sounds: a doorbell, a barking dog, the prepping their food. When those responses are missing, it may signal more than a simple delay.

Motor milestones matter, too. Rolling by six months, sitting by nine, crawling by 10-12 months, walking by 15 months. There’s flexibility, but prolonged gaps can warrant concern. Social behaviors are another key indicator: limited eye contact, lack of interest in play, or highly rigid, repetitive behaviors that trigger intense distress when interrupted.

Still, many parents hesitate to speak up.

“People often say, ‘My siblings didn’t talk until later’ or ‘They’ll catch up,’” Freier Randall said. “But asking questions early is never a failure. It’s an act of advocacy.”

One modern factor complicating early development, she added, is screen time. Research shows that excessive exposure, particularly before age 2, can delay expressive language, interfere with sensory development, and worsen behavioral regulation. Screens, she said, can become addictive, replacing real-world interaction.

When concerns do surface, pediatricians often conduct brief screenings. But those tools, while helpful, are only a starting point.

“Screenings can tell us that there’s a concern,” said Vidhya Krishnamurthy, PhD, a pediatric neuropsychologist and co-medical director of the Inland Empire Autism Assessment Center, “What they can’t always tell us is why.”

That distinction is important, she says.

A comprehensive neurodevelopmental evaluation looks beyond symptoms to identify underlying causes. A language delay, for instance, could stem from hearing loss, processing challenges, limited stimulation, broader cognitive delays, or social differences associated with autism. Each possibility points toward a different intervention, and the wrong assumption can delay meaningful progress.

Ideally, evaluations involve multiple disciplines, including medical, psychological, speech-language, and occupational therapy assessments. In-person observation is essential, Krishnamurthy said. Virtual evaluations often miss nuances of behavior, attention, and regulation that only emerge through hands-on interaction.

Equally important is context. Family history can reveal genetic patterns. School and daycare observations offer insight into how a child functions outside the home. Parent interviews capture day-to-day challenges and strengths that tests alone can’t measure.

Once results are in, the work is far from over.

“A diagnosis is emotional,” Krishnamurthy said. “Families may only absorb a fraction of what they’re hearing in that moment. Our responsibility is empathy, meeting them where they are.”

Both Drs. Freier Randall and Krishnamurthy stressed that early labels are not destiny. Young brains are remarkably adaptable, and early intervention: speech therapy, occupational therapy, physical therapy, behavioral supports, can dramatically alter a child’s developmental trajectory.

When delays are identified early, the results can be striking. Freier Randall pointed to decades of research, including studies tied to the Head Start program, showing that early intervention leads to better long-term outcomes.

“Within a few months, you should be able to see a difference,” she said, describing children who become more engaged, less frustrated, and better regulated after starting therapy.

Speech therapy, occupational therapy, physical therapy, and behavioral supports often affect multiple areas of development at once. Both pediatric neuropsychologists emphasized that early support can prevent minor delays from becoming lasting barriers.

Still, access remains a challenge. Many children missed early intervention opportunities during the pandemic, and providers are now working through long waiting lists. “We’re still trying to play catch-up,” Freier Randall said.

That makes awareness and persistence more important than ever.

“For Developmental Disabilities Awareness Month, the message is simple,” Freier Randall said. “Pay attention. Ask questions. Push for comprehensive evaluations, not just checklists.”

And above all, Krishnamurthy added, see children as individuals, not diagnoses.

“Focus on their strengths,” she said. “Support what they need now. Celebrate the small wins. That’s how families build resilience, and how children reach their fullest potential.”