# When to refer a child for developmental help

Canonical: https://pinnacleblooms.org/ask/as-a-community-health-volunteer-how-can-i-know-when-to-refer-a-child-for-developmental-help
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

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.

*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.*

## In short
Refer 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.

## Simple signs that warrant a referral
Use these as easy-to-remember prompts during home visits or community sessions. Refer if you see any of these:

**Communication & hearing**
- No babbling or pointing/gesturing by around 12 months
- No single words by around 16–18 months; no two-word phrases by 2 years
- Does not respond to their name or to loud sounds

**Movement**
- Not sitting by ~9 months, not walking by ~18 months
- Very stiff or very floppy body; strongly favours one side of the body

**Social & play**
- Little eye contact, smiling back, or interest in other people
- No pretend play by ~2 years

**Always refer — at any age**
- Any **loss** of skills the child already had (words, walking, social interest)
- A parent who feels something is wrong — trust their worry
- A child who simply seems behind brothers, sisters or peers of the same age

When 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'.

## The Pinnacle way
As 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.

## Trusted sources
WHO and UNICEF Nurturing Care Framework for early childhood development; CDC developmental milestone guidance for community and frontline use; WHO ICF model of functioning.

**Next step —** Spotted a child who needs a closer look? [Help the family book a developmental assessment](/) at the nearest Pinnacle centre today.

This is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.

## Sources
- WHO/UNICEF Nurturing Care Framework for early childhood development: https://nurturing-care.org
- CDC developmental milestone guidance: https://www.cdc.gov/child-development
- WHO ICF model of functioning: https://www.who.int/standards/classifications/international-classification-of-functioning-disability-and-health

## Connected topics and perspectives
- Community Health Worker: https://pinnacleblooms.org/ask/lens/stakeholder/community_health_worker
- Support: https://pinnacleblooms.org/ask/lens/intent/support
- Screen: https://pinnacleblooms.org/ask/lens/lifecycle/screen
- Book Assessment: https://pinnacleblooms.org/ask/lens/route/book-assessment
- Family Empowerment: https://pinnacleblooms.org/ask/lens/empowerment/family_empowerment

## Related question paths

### Explore therapy & support
- When to Refer a Child for Developmental Help — A PHC Nurse's Guide: https://pinnacleblooms.org/ask/as-a-phc-nurse-how-can-i-know-when-to-refer-a-child-for-developmental-help
- When to Refer a Child for Developmental Help — A Guide for ASHA Workers: https://pinnacleblooms.org/ask/as-an-asha-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help
- When should an anganwadi worker refer a child for developmental help?: https://pinnacleblooms.org/ask/as-an-anganwadi-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help
- Spotting early signs of developmental delay: a guide for community health volunteers: https://pinnacleblooms.org/ask/as-a-community-health-volunteer-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child
- What a community health volunteer should do first for milestone delays: https://pinnacleblooms.org/ask/what-should-a-community-health-volunteer-do-first-if-a-child-is-not-meeting-milestones
- Spotting early signs of developmental delay — anganwadi worker guide: https://pinnacleblooms.org/ask/as-an-anganwadi-worker-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child