<prompt> Red flag sign in child development if not attained by ___No single word at 18 monthNot able sit with unsuppoed by 12 monthsNot walking alone by 18 month in boysAll of the above  <response>: Red Flags in Developmental Screening and SurveillanceThese indicators suggest that development is seriously disordered and that the child should be promptly referred to a developmental or community pediatrician. Note: Most children do not have red flags and thus require quality screening to detect any problems. POSITIVE INDICATORS THE PRESENCE OF ANY OF THE FOLLOWING Loss of developmental skills at any ageParental or professional concerns about vision, fixing, or following an object or a confirmed visual impairment at any age simultaneous referral to pediatric ophthalmologyHearing loss at any age simultaneous referral for expe audiologic or ear, nose, and throat assessmentPersistently low muscle tone or floppinessNo speech by 18 mo, especially if the child does not try to communicate by other means such as gestures simultaneous referral for urgent hearing testAsymmetry of movements or other features suggestive of cerebral palsy, such as increased muscle tonePersistent toe walkingComplex disabilitiesHead circumference above the 99.6th centile or below 0.4th centile. Also, if circumference has crossed 2 centiles up or down on the appropriate cha or is dispropoionate to parental head circumferenceAn assessing clinician who is unceain about any aspect of assessment but thinks that development may be disordered NEGATIVE INDICATORSACTIVITIES THAT THE CHILD CANNOT DO Sit unsuppoed by 12 months Walk by 18 mo boys or 2 yr girls check creatine kinase urgentlyWalk other than on tiptoes Run by 2.5 yr .Hold object placed in hand by 5 months corrected for gestationReach for objects by 6 mo corrected for gestationPoint at objects to share interest with others by 2 yr Ref.nelson 20th edition pg100 