NDIS Early Childhood Approach: Developmental Milestones and Red Flags (0-9)

Written by Bloom Healthcare

Pediatrics

NDIS Early Childhood Approach: Developmental Milestones and Red Flags (0-9) When to Seek Support

If you are wondering whether your child is developing on track, milestones can help you spot what is typical, and what might need support. Early identification and intervention are crucial in supporting a child’s development, as they ensure children receive timely help for their developmental needs. Early identification and support can make a significant difference in a child’s development and long-term outcomes. The clearest “seek support” signals are a loss of skills, limited response to sound or visual cues, persistent difficulty communicating needs, or challenges that affect everyday participation at home, childcare, or school. This guide is for parents and carers of children aged 0-9 who want practical signs to watch for and a simple next-step plan, including how the NDIS early childhood approach may fit. The NDIS Early Childhood Approach supports children aged 0-9 years with developmental delays or disabilities and their families. The NDIS early childhood approach is designed to support families by providing family-centred and strengths-based support, integrating assistance into daily life to enhance family capacity.

What “milestones” actually mean

Developmental milestones are a guide to how children typically learn skills across areas like movement, communication, social interaction, play, thinking, and self-care. Children often develop skills in a similar order, but timing varies. A single late milestone does not always mean a child will need ongoing supports, but patterns, persistence, and functional impact matter.

There are official guidelines and best practice frameworks that help parents and professionals monitor and support children’s development, ensuring quality and consistency in early childhood practices.

A helpful way to think about it is:

• Milestones tell you what to look for.
• Red flags tell you when it is time to act.
• Function tells you how urgent it is (safety, participation, learning, daily routines).

Understanding Developmental Delay

Developmental delay means a child is taking longer than expected to reach certain milestones in areas like movement, communication, learning, or social skills. For families, this can raise questions and concerns about how best to support their child’s development and participation in everyday activities. The early childhood approach is designed to address these concerns, providing children younger than 9 with timely, practical support—especially those with developmental delay or disability.

The NDIS early childhood approach aims to give children the best possible start by connecting families to the right support as early as possible. An NDIS early childhood partner or early childhood coordinator works closely with families and carers to understand each child’s unique needs. Together, they develop a tailored plan that focuses on building the child’s skills, confidence, and capacity to participate in daily routines at home, childcare, and in the community.

Early supports are a key part of this approach. These may include access to child health nurse consultations, early intervention therapies, playgroups, and community or mainstream services. The early childhood partner helps families navigate local services, such as parent support groups, health services, and inclusive community programs, ensuring that children and their families are connected to practical information and resources that make a real difference.

For children younger than 6, the early childhood approach does not require a formal diagnosis to begin support. This means families can access early connections and timely support as soon as developmental concerns are noticed, without waiting for lengthy assessments. The focus is on giving children the opportunity to develop essential skills, engage in everyday activities, and participate fully in mainstream services alongside their peers.

To access the early childhood approach, families can complete a referral form—either online or through their local NDIS early childhood partner. The early childhood coordinator will then work with the family to identify goals, connect them to local services, and provide ongoing guidance as their child grows and develops. This collaborative, evidence-based approach ensures that children with developmental delay or disability, and their families, receive the right support at the right time.

By supporting families and carers with practical information, resources, and early intervention, the early childhood approach helps children achieve the best possible outcomes. It is committed to enabling children with disability and their families to participate fully in community and mainstream services, building the skills and confidence needed for a happy, inclusive life. With the right support, every child has the chance to thrive and reach their full potential.

Red flags at any age (these matter most)

These are “do not wait” signs:

• Loss of skills your child previously had (regression).
• Strong parental concern that something is not right, especially if concerns persist across settings.
• Limited response to sound or visual cues, or concerns about hearing or vision.
• Very limited social engagement, such as minimal eye contact or poor interaction with adults or other children.
• A big mismatch between what your child can do and what daily life requires (mealtimes, toileting, dressing, school readiness, safety).

If you notice regression or safety risk, treat it as urgent and seek medical advice promptly.

Milestones and red flags by age group (0-9)

Below are practical signs to watch for. You do not need to memorise these. Use them as a prompt for action if something stands out. Early identification of concerns allows for timely access to a child’s support, which can be tailored to their individual needs.

0-12 months: connection, movement, early communication

Common “keep an eye on it” signs

• Limited babbling progression or very few vocal sounds.
• Difficulty coordinating feeding, or very stressful feeds.
• Movement that seems unusually stiff or unusually floppy.

Red flags

• Not holding head up by around 3-4 months.
• Not starting to babble by around 6 months.
• Not rolling, not sitting independently, or not moving toward independent mobility as the year progresses.
• Limited social engagement, such as not smiling or interacting with people, or limited shared enjoyment.

12-24 months: gestures, first words, walking, play

Common “keep an eye on it” signs

• Uses fewer gestures than peers (pointing, showing, waving).
• Gets very frustrated because they cannot communicate needs.

Red flags

• Not using gestures (pointing, showing, waving).
• No clear words by around 18 months.
• Not attempting to walk without support around 15 months, or not walking independently when expected for them.
• Difficulty with early turn-taking games and interaction (such as peekaboo).

2-3 years: combining words, following instructions, independence

Common “keep an eye on it” signs

• Speech is hard to understand outside the family.
• Difficulty coping with routine changes.

Red flags

• Not putting words together (for example, “push car”).
• Not understanding short requests or not responding to familiar words.
• No form of independent mobility or major ongoing gross motor difficulty.

3-5 years: school readiness, pretend play, routines

This is a common age for concerns to become clearer because expectations increase.

Common “keep an eye on it” signs

• Avoids fine motor tasks (drawing, scissors, manipulating small objects).
• Emotional meltdowns that consistently block participation.

Red flags

• No interest in pretend play or difficulty interacting with other children.
• Difficulty being understood, or not using simple sentences as expected.
• Not toilet trained by day when development and context suggest it should be emerging.
• Concerns from educators about school readiness or everyday routines (feeding, dressing).

6-9 years: learning, friendships, behaviour, everyday skills

At this age, “red flags” often show up as a participation gap at school and in friendships.

Red flags

• Difficulty following instructions or persistent communication challenges.
• Finds it hard to make friends, shows limited empathy, or avoids school due to distress.
• Ongoing difficulty with everyday independence, such as dressing independently, or ongoing daytime wetting or soiling.
• Gross motor skills significantly behind peers, affecting play and sport participation.

A simple “when to act” checklist (keep this practical)

Seek support when one or more of these are true:

• The concern has lasted more than a few weeks and is not improving.
• The issue shows up in more than one setting (home plus childcare or school).
• It affects daily routines (meals, sleep, toileting, dressing, community outings). Challenges with daily activities are a key focus of early intervention and support planning.
• It affects learning or behaviour at school (attention, instructions, friendships).
• You are seeing escalation (more frequent or intense distress).
• There is regression or safety risk.

Queensland Children’s Health also notes that a single red flag is not always an automatic referral, but the functional impact on everyday participation should guide the decision.

If you notice any of these signs, here’s what you can do next.

What to do next (a clear pathway)

Step 1: Start with your GP or Child and Family Health Nurse

Bring one page of notes:

• what you are noticing
• when it happens
• what makes it better or worse
• what daily life looks like on a hard day

Step 2: Rule out hearing and vision early

Hearing and vision can look like “attention” or “behaviour” issues, and it is important to check them early when concerns exist.

Step 3: Match the support to the need (this is where progress accelerates)

Common matches include:

• Speech Pathology with a Speech Therapist for speech, language, understanding, social communication, and feeding support.
• Occupational Therapy with an Occupational Therapist for daily living skills, fine motor skills, sensory processing, play, and independence routines.
• Psychology/Counselling with a Psychologist for anxiety, emotional regulation, behaviour, and family support strategies.
• Physiotherapy with a Physiotherapist for gross motor development, coordination, balance, and confidence with movement.
• Positive Behaviour Support (PBS) when behaviours of concern impact safety or participation and the support team needs an evidence-based plan.

Where the NDIS fits for children under 9

If your child is under 9, the NDIS early childhood approach may help connect you to the right supports. The NDIS Early Childhood Approach prioritizes timely access to support during the critical early years of development to improve long-term outcomes.

Key points from the NDIS:

• The early childhood approach supports children younger than 6 with developmental delay and younger than 9 with disability.
• Children younger than 6 do not need a diagnosis to get support through this approach when there are developmental concerns.

From 1 July 2023, the NDIS early childhood approach changed to support children younger than 9, instead of the previous age limit of under 7. This change aligns with the World Health Organisation’s definition of young children (zero to 8 years of age) and is part of the recommendations in the ECEI Reset. Children who are currently NDIS participants turning 7 after 1 July 2023 will remain with their early childhood partner until they turn 9 if they require support. Children younger than 9 with a permanent disability who are new to the NDIS from 1 July 2023 will be supported by an early childhood partner.

An Early Childhood Coordinator will be the key contact for families referred to the NDIS Early Childhood Approach. Families work with an Early Childhood Partner to identify their child’s individual needs and the support required. Early supports may include access to information, early intervention strategies, family-based education, and linkages to community services. The Early Childhood Approach provides families with early connections to local community supports to help their child achieve their goals. Support can include short-term interventions and capacity-building strategies for children under 6, lasting from 3 to 12 months.

This matters because early support is often about building skills and confidence before the participation gap widens. The approach aims to reduce future support needs by addressing developmental delays early, potentially minimizing the severity of challenges. Early intervention can lead to improved cognitive, social, and emotional readiness for children transitioning into mainstream education. Families are encouraged to participate in community activities to foster inclusion and reduce social barriers for children with disabilities. The NDIS early childhood approach is designed to support your child’s development by providing guidance, resources, and tailored plans to help families foster their child’s progress.

Practical examples (what support can look like)

Example 1: “My child melts down after childcare every day”

An Occupational Therapist might look at sensory load, transitions, and routines, then build a simple plan for regulation and recovery that parents and educators can implement.

Example 2: “My child is 3 and still not combining words”

A Speech Therapist might assess understanding, expressive language, and interaction skills, then build a home and childcare plan to increase communication quickly and reduce frustration.

Example 3: “My 7 year old cannot keep up socially and is refusing school”

A Psychologist may work on anxiety, confidence, and coping skills, while Speech Pathology supports social communication and Occupational Therapy supports attention and classroom routines.

Who can refer and what to include

Who to refer:

Parents and carers, GPs, Child and Family Health Nurses, Paediatricians, educators, Support Coordinators, and community services.

What to include in the referral:

• Child’s age and main concerns (2-3 clear examples)
• Settings impacted (home, childcare, school, community)
• Any regression or safety concerns
• Relevant medical history, hearing and vision checks (if completed)
• Current supports already in place
• What outcomes you want (for example, independence, communication, participation, school readiness)
• NDIS details if applicable (plan dates, management type, goals)

FAQs

Do I need a diagnosis to seek help for my child under 6?

Not always. The NDIS states children younger than 6 do not need a diagnosis to get support through the early childhood approach where there are concerns about development.

What is the NDIS early childhood approach?

It is how the NDIS supports children younger than 9 and their families, helping connect to the right supports when needed.

What is the biggest red flag to act on quickly?

Loss of skills (regression). It is listed as a red flag and should be treated as urgent.

My child is “late” in one area. Should I worry?

Not necessarily. Milestones vary. The key is whether the issue is persistent, showing up across settings, or affecting everyday participation.

What red flags are common in early communication?

Examples include not starting to babble, not using gestures, no clear words by around 18 months, or not putting words together as expected.

What should I do if school is raising concerns about learning or behaviour?

Treat it as a prompt to investigate, not a label. At primary school age, concerns can relate to communication, behaviour, everyday skills, or anxiety, and the right allied health supports can make school more manageable.

What if my child is under 9 and I am not sure where to start?

Start with your GP or Child and Family Health Nurse, then consider the NDIS early childhood approach as a pathway to connect to the right supports.

How Bloom Healthcare can help

Bloom Healthcare supports children through Paediatrics (0-9 and 10-17) with a practical, family-centred approach and clear goal-setting. Depending on what is going on, support may involve Occupational Therapy, Speech Pathology, Psychology/Counselling, Physiotherapy, and where appropriate Positive Behaviour Support (PBS).

Make a Referral

If you have concerns about developmental milestones or red flags for a child aged 0-9, Bloom Healthcare can help clarify what is happening, set practical goals, and recommend the right therapy pathway.

Make a Referral

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