{"h1":"When to refer a child for developmental help","faq":[{"a":"No. You are not expected to diagnose. If milestones are missed, skills are lost, a child does not respond to sound or name, or a parent is worried, that is enough to refer. An early check that turns out fine is far better than a missed delay.","q":"Do I need to be sure something is wrong before I refer?"},{"a":"Yes. Persistent parental concern is one of the most reliable early signals in child development. If a parent feels something is wrong, take it seriously and route them to a developmental check.","q":"Is a parent's worry a good enough reason to refer?"},{"a":"Frame the referral as a positive step — 'a check to help your child do their best' — never as 'something is wrong'. Most families respond well when they feel supported rather than judged.","q":"How should I talk to families so they don't feel frightened?"}],"lang":"en","slug":"as-a-community-health-volunteer-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When to refer a child for developmental help","entity":{"key":"equity-cw-chv-refer","kind":"access_equity","name":"community health worker support","slug":null},"lenses":[{"kind":"stakeholder","label":"Community Health Worker","value":"community_health_worker"},{"kind":"intent","label":"Support","value":"support"},{"kind":"lifecycle","label":"Screen","value":"screen"},{"kind":"route","label":"Book-Assessment","value":"book-assessment"},{"kind":"empowerment","label":"Family Empowerment","value":"family_empowerment"}],"parent":null,"related":[{"lang":"en","slug":"as-an-asha-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When to Refer a Child for Developmental Help — A Guide for ASHA Workers"},{"lang":"en","slug":"as-an-anganwadi-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When should an anganwadi worker refer a child for developmental help?"},{"lang":"en","slug":"what-should-a-community-health-volunteer-do-first-if-a-child-is-not-meeting-milestones","title":"What a community health volunteer should do first for milestone delays"},{"lang":"en","slug":"as-a-phc-nurse-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When to Refer a Child for Developmental Help — A PHC Nurse's Guide"},{"lang":"en","slug":"as-an-anganwadi-worker-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child","title":"Spotting early signs of developmental delay — anganwadi worker guide"},{"lang":"en","slug":"as-a-community-health-volunteer-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child","title":"Spotting early signs of developmental delay: a guide for community health volunteers"}],"summary":"Community health volunteers should refer a child for developmental help when milestones are clearly missed for their age, when a child loses skills they once had, when a child does not respond to name or sound, or when a parent is worried. You never diagnose — you spot the pattern and route the family to a proper developmental check. When in doubt, refer.","answer_md":"*You are often the first trusted face a family sees — and your instinct that 'something needs a closer look' is one of the most powerful tools in early child development.*\n\n## In short\nRefer a child for developmental help when you notice clear missed milestones for their age, any **loss of skills** a child once had, a child who does not respond to sound or to their name, or a parent who is worried — parent concern alone is a valid reason to refer. You do not need to diagnose anything. Your job is simply to spot the pattern and connect the family to a proper developmental check; the assessment and any diagnosis happen later, with clinicians.\n\n## Simple signs that warrant a referral\nUse these as easy-to-remember prompts during home visits or community sessions. Refer if you see any of these:\n\n**Communication & hearing**\n- No babbling or pointing/gesturing by around 12 months\n- No single words by around 16–18 months; no two-word phrases by 2 years\n- Does not respond to their name or to loud sounds\n\n**Movement**\n- Not sitting by ~9 months, not walking by ~18 months\n- Very stiff or very floppy body; strongly favours one side of the body\n\n**Social & play**\n- Little eye contact, smiling back, or interest in other people\n- No pretend play by ~2 years\n\n**Always refer — at any age**\n- Any **loss** of skills the child already had (words, walking, social interest)\n- A parent who feels something is wrong — trust their worry\n- A child who simply seems behind brothers, sisters or peers of the same age\n\nWhen in doubt, refer. An early check that turns out fine is far better than a missed delay. Make sure hearing and vision are also considered, and never frame your message to families as 'something is wrong' — frame it as 'a check to help your child do their best'.\n\n## The Pinnacle way\nAs a community health volunteer, you are the bridge — you notice, you reassure, and you route the family forward. A clinical [AbilityScore®](/ask/what-is-the-abilityscore-and-how-is-it-calculated) and any diagnosis are formed **only at a Pinnacle Blooms Network centre, under qualified clinician care** — never from a checklist, an app, or a home visit. Your referral simply opens the door. Families can begin with a [developmental assessment](/) and reach the right [therapy support](/therapy) close to home, across our 70+ centres in 4 states.\n\n## Trusted sources\nWHO and UNICEF Nurturing Care Framework for early childhood development; CDC developmental milestone guidance for community and frontline use; WHO ICF model of functioning.\n\n**Next step —** Spotted a child who needs a closer look? [Help the family book a developmental assessment](/) at the nearest Pinnacle centre today.\n\nThis is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.","canonical":"https://pinnacleblooms.org/ask/as-a-community-health-volunteer-how-can-i-know-when-to-refer-a-child-for-developmental-help","editorial":{"reviewed_at":"2026-06-11T20:12:18.613642+00:00","reviewed_by":null,"developed_by":"SETU Consortium · Pinnacle Blooms Network"},"alternates":[{"href":"https://pinnacleblooms.org/ask/as-a-community-health-volunteer-how-can-i-know-when-to-refer-a-child-for-developmental-help","lang":"en","indexable":true}],"dimensions":[],"meta_title":"When to Refer a Child for Developmental Help","meta_robots":"index, follow, max-image-preview:large","everyday_tip":"Keep a simple age-and-milestone card in your bag. During home visits, ask the parent one open question: 'Is there anything about how your child plays, moves or talks that worries you?' Their answer alone can justify a referral.","published_at":"2026-06-11T04:00:00.111202+00:00","reading_paths":[{"key":"therapy","items":[{"lang":"en","slug":"as-a-phc-nurse-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When to Refer a Child for Developmental Help — A PHC Nurse's Guide","reason":"Linked from this answer"},{"lang":"en","slug":"as-an-asha-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When to Refer a Child for Developmental Help — A Guide for ASHA Workers","reason":"Linked from this answer"},{"lang":"en","slug":"as-an-anganwadi-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help","title":"When should an anganwadi worker refer a child for developmental help?","reason":"Linked from this answer"},{"lang":"en","slug":"as-a-community-health-volunteer-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child","title":"Spotting early signs of developmental delay: a guide for community health volunteers","reason":"Linked from this answer"},{"lang":"en","slug":"what-should-a-community-health-volunteer-do-first-if-a-child-is-not-meeting-milestones","title":"What a community health volunteer should do first for milestone delays","reason":"Linked from this answer"},{"lang":"en","slug":"as-an-anganwadi-worker-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child","title":"Spotting early signs of developmental delay — anganwadi worker guide","reason":"Linked from this answer"}],"label":"Explore therapy & support","total":6}],"what_to_watch":"Missed milestones for the child's age, any loss of skills the child once had, no response to name or sound, little eye contact or social interest, and — always valid — a worried parent.","authority_links":[{"url":"https://nurturing-care.org","label":"WHO/UNICEF Nurturing Care Framework for early childhood development"},{"url":"https://www.cdc.gov/child-development","label":"CDC developmental milestone guidance"},{"url":"https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health","label":"WHO ICF model of functioning"}],"last_reviewed_at":"2026-06-11T04:00:00.111202+00:00","meta_description":"A simple guide for community health volunteers on the signs that should prompt a referral for a child's developmental check. When in doubt, refer.","related_materials":[],"related_techniques":[]}