A developmental paediatrician applies the Revised Denver Developmental Screening Test (DDST-II) to screen a 12-month-old. Which of the following is a RED FLAG developmental concern at 12 months that mandates urgent referral?
- A No babbling, no pointing, no single meaningful words, no reciprocal gestures ✓
- B Not walking independently
- C Absence of protective reflexes when tilted laterally
- D Not using a pincer grasp
Correct answer: A. No babbling, no pointing, no single meaningful words, no reciprocal gestures
Explanation
Red flags at 12 months warranting urgent developmental evaluation include: no babbling by 12 months, no pointing or waving by 12 months, no single words by 16 months, and no two-word phrases by 24 months. Absence of all communicative-social behaviours (babbling, pointing, gestures, words) at 12 months is a strong red flag for autism spectrum disorder or global developmental delay. Not walking at 12 months is normal (independent walking expected by 15–18 months). Pincer grasp is expected by 9–10 months but not walking at 12 months is not a red flag per se.
Reference: Ghai Essential Pediatrics, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.