{"h1":"When should an ASHA worker refer a child for developmental help?","faq":[{"a":"No. Your role is to notice and route, never to diagnose. If milestones are late, a skill is lost, or a parent is worried, refer for a general developmental check — the clinicians will take it from there.","q":"Do I need to know what condition the child has before referring?"},{"a":"Route the family to a doctor urgently. Fits, staring spells, sudden jerks or loss of skills are medical concerns that need prompt medical attention, not therapy first.","q":"What should I do if a child has fits or sudden loss of skills?"},{"a":"A great deal. Persistent parental concern is one of the most reliable early signals of a developmental difference, even when the child seems fine in a short visit. Always take it seriously and refer.","q":"How much should I trust a parent's worry?"}],"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","entity":{"key":"equity-cw-asha-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-spot-the-early-signs-of-developmental-delay-in-a-child","title":"Spotting Early Signs of Developmental Delay: An ASHA Worker's Guide"},{"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"},{"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":"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":"what-should-an-asha-worker-do-first-if-a-child-is-not-meeting-milestones","title":"What an ASHA worker should do first when a child misses milestones"}],"summary":"ASHA workers should refer a child when milestones are clearly late, when a skill is lost, or when a parent is worried — no diagnosis needed. Route delays to a general developmental check, and fits or sudden skill loss to a doctor urgently. Diagnosis and the AbilityScore are formed only at a Pinnacle centre by clinicians.","answer_md":"*You are often the first person to notice when a child is not growing the way they should — and that early eye changes lives.*\n\n## In short\nRefer a child for developmental help when they are clearly **not doing what most children their age can do**, when a milestone is **late or has been lost**, or when a **parent is worried** — you do not need to be certain of any condition. Your job is not to diagnose; it is to **notice and route**. When in doubt, refer for a general developmental check — early support is always safer than waiting.\n\n## Simple things to watch, by age\nUse these as easy household questions during your visits:\n\n**By 6 months** — Does the baby smile back, make sounds, hold the head steady?\n\n**By 12 months** — Does the child babble, respond to their name, point or wave, sit without support?\n\n**By 18 months** — Does the child say a few words, walk, show things to others, copy simple actions?\n\n**By 2 years** — Does the child join two words, follow simple instructions, run, play near other children?\n\n**By 3 years** — Does the child speak in short sentences, play pretend, be understood by family?\n\n**Refer promptly at any age if you see:**\n- Loss of skills the child once had (words, walking, smiling)\n- No eye contact or no response when called\n- Floppy or very stiff body, or not using one side\n- A parent who keeps saying \"something feels different\"\n- Fits, staring spells or sudden jerks — these need a **doctor straight away**, not therapy first\n\nTrust the parent's worry. Parental concern is one of the most reliable early signals there is.\n\n## When and where to route\nFor delays or differences, route the family to a **general developmental check** at the nearest health facility or a Pinnacle Blooms Network centre. For fits, breathing trouble, or sudden loss of skills, route to a **doctor urgently**. You are the bridge — a timely referral from you can open years of opportunity for that child.\n\n## The Pinnacle way\nAbilityScore® is part of Pinnacle’s developmental assessment. Diagnosis, where needed, requires an appropriately qualified healthcare professional — never from a checklist or a home visit. Your role is to spot and refer with confidence. With [70+ centres across 4 states](/) and a [structured clinician-administered assessment](/ask/what-is-the-abilityscore-and-how-is-it-calculated), the families you refer are met with warmth and a clear plan. Many will begin with [speech and developmental therapy](https://www.pinnacleblooms.org/top-speech-therapy-center-india-proven-improvement-rate) once assessed.\n\n## Trusted sources\nWHO and UNICEF Nurturing Care Framework on early childhood development; CDC developmental milestone guidance; 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 a Pinnacle centre.](https://www.pinnacleblooms.org/enroll-autism-speech-aba-therapies-india)\n\nThis is general information, not a diagnosis — individual assessment and diagnosis require an appropriately qualified healthcare professional.","canonical":"https://pinnacleblooms.org/ask/as-an-asha-worker-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-an-asha-worker-how-can-i-know-when-to-refer-a-child-for-developmental-help","lang":"en","indexable":true}],"dimensions":[],"meta_title":"ASHA Guide: When to Refer a Child for Help","meta_robots":"index, follow, max-image-preview:large","everyday_tip":"During home visits, ask the family one simple question for the child's age — like 'Does she point at things she wants?' Their answer often tells you more than any single observation.","published_at":"2026-06-11T04:00:00.111202+00:00","reading_paths":[{"key":"therapy","items":[{"lang":"en","slug":"as-an-asha-worker-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child","title":"Spotting Early Signs of Developmental Delay: An ASHA Worker's Guide","reason":"Linked from this answer"},{"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-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","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":"what-should-an-asha-worker-do-first-if-a-child-is-not-meeting-milestones","title":"What an ASHA worker should do first when a child misses milestones","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":"Late or lost milestones, no response to name or eye contact, floppy or stiff body, one-sided weakness, a worried parent, or fits and staring spells (doctor urgently).","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 milestones"},{"url":"https://www.who.int","label":"WHO ICF model of functioning"}],"last_reviewed_at":"2026-06-11T04:00:00.111202+00:00","meta_description":"A simple guide for ASHA workers: which milestones and signs mean a child should be referred for a developmental check — and when a doctor is needed urgentl","related_materials":[],"related_techniques":[]}