Warning signs for identifying neurodevelopmental disorders: a systematic literature review

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.