Red-flag screening

The child has lost a skill they already had — sitting, walking, speaking, or using their hands. Critical

Another child in the family died young without a clear cause, or there were repeated pregnancy losses. Critical

The parents were blood relatives before marriage (for example, cousins).

Not gaining weight or height despite feeding; falling below the growth chart line.

Admitted to hospital more than once with vomiting, drowsiness or unconsciousness — often after fever or going without food. Critical

The belly looks unusually large, or the liver or spleen can be felt.

Face, hands or body shape are unlike the rest of the family — heavy features, short fingers, very short or very tall, stiff joints.

Muscles getting weaker over time — trouble climbing stairs, pushes on the thighs to stand up, falls often. Critical

Fits continue despite medicine, or began alongside delayed development.

Losing sight or hearing, or whiteness in the eyes, together with any of the above.