# When to Refer a Child for Developmental Help — A Guide for ASHA Workers

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

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.

*You are often the first person to notice when a child is not growing the way they should — and that early eye changes lives.*

## In short
Refer 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.

## Simple things to watch, by age
Use these as easy household questions during your visits:

**By 6 months** — Does the baby smile back, make sounds, hold the head steady?

**By 12 months** — Does the child babble, respond to their name, point or wave, sit without support?

**By 18 months** — Does the child say a few words, walk, show things to others, copy simple actions?

**By 2 years** — Does the child join two words, follow simple instructions, run, play near other children?

**By 3 years** — Does the child speak in short sentences, play pretend, be understood by family?

**Refer promptly at any age if you see:**
- Loss of skills the child once had (words, walking, smiling)
- No eye contact or no response when called
- Floppy or very stiff body, or not using one side
- A parent who keeps saying "something feels different"
- Fits, staring spells or sudden jerks — these need a **doctor straight away**, not therapy first

Trust the parent's worry. Parental concern is one of the most reliable early signals there is.

## When and where to route
For 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.

## The Pinnacle way
AbilityScore® 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.

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

**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)

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 milestones: https://www.cdc.gov/child-development
- WHO ICF model of functioning: https://www.who.int

## 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
- Spotting Early Signs of Developmental Delay: An ASHA Worker's Guide: https://pinnacleblooms.org/ask/as-an-asha-worker-how-can-i-spot-the-early-signs-of-developmental-delay-in-a-child
- 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: https://pinnacleblooms.org/ask/as-a-community-health-volunteer-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
- What an ASHA worker should do first when a child misses milestones: https://pinnacleblooms.org/ask/what-should-an-asha-worker-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