Warning signs for identifying neurodevelopmental disorders: a systematic literature review.

This review looked at warning signs that might indicate developmental delays in children across several conditions including autism. Key red flags include motor delays (not sitting by 9 months, not walking by 18 months), language delays (no babbling by 12 months, no words by 18 months), social difficulties (poor eye contact, no social smiling), and behavioral concerns like losing skills or repetitive behaviors. Screening tools can help doctors identify these concerns earlier for faster support.

This systematic review synthesized evidence from 54 studies to identify consistent warning signs for neurodevelopmental disorders including autism, cerebral palsy, intellectual disability, language disorders, coordination disorders, ADHD, and global developmental delay. Key early warning signs were organized across developmental domains: motor delays (sitting ≥9 months, walking by 18 months), language delays (no babbling 9-12 months, no words by 15-18 months), social deficits (poor eye contact, absent social smile), and behavioral concerns (skill regression, repetitive behaviors). Screening tools like M-CHAT-R/F, ASQ, Bayley, and HINE improved detection accuracy. The review emphasizes integrating these warning signs into routine pediatric care for earlier identification and intervention.

These findings support implementing systematic screening for neurodevelopmental warning signs in routine pediatric care. Early identification using validated screening tools can reduce delays in referral and intervention, potentially improving developmental outcomes for children with neurodevelopmental disorders.

The abstract does not report sample sizes from individual studies or provide details about methodological quality assessment results. The heterogeneity of included conditions and study designs may limit the strength of conclusions for specific disorders.

To synthesize the most consistent warning signs ("red flags") for NDDs: autism spectrum disorder, cerebral palsy, intellectual disability, language development disorder, coordination developmental disorder, attention deficit hyperactivity disorder, and global developmental delay. Review in PubMed/Medline, Cochrane Library, SciELO, CAPES, and BVS, 2003-2025. Methodological quality was assessed with NOS, CASP, and AMSTAR. 54 studies were included. The most consistent early signs were grouped by NPMD domains: Motor: delay to sit ≥ 9 m, absence of independent walking 18 m, absence of pincer grasp 10 m, and asymmetrical motor patterns 12 m; Language: absence of babbling at 9-12 m, lack of words until 15-18 m, and absence of two-word combination 24 m; Social: absence of social smile, poor eye contact, deficits in shared attention and communicative gestures; Cognitive and behavioral: regression of skills, repetitive behaviors, absence of symbolic play, and irritability or inattention; Others: atypical sensory responses, sleep disturbances, and feeding difficulties.

Instruments such as M-CHAT-R/F, ASQ, Bayley, and HINE increased the accuracy of screening and reduced referral delays. Early recognition of warning signs for NPMD disorder associated with complementary examinations and formal assessment should be integrated into routine pediatric care.