# How an ASHA worker can use a simple developmental checklist

Canonical: https://pinnacleblooms.org/ask/as-an-asha-worker-how-can-i-use-a-simple-developmental-checklist-in-the-community
Publisher: Pinnacle Blooms Network / Bharath Healthcare Laboratories Private Limited

An ASHA worker uses a simple developmental checklist to observe and ask about age-based milestones during home and immunisation visits — noticing, not diagnosing. Tick 'yes / not yet', always trust the mother's concern, recheck at the next visit, and refer early when gaps persist, a skill is lost, or there are seizures. A clinical AbilityScore® and diagnosis are formed only at a Pinnacle Blooms Network centre.

*You are often the first trusted face a family sees — and a simple checklist in your hands can change a child's whole future.*

## In short
As an ASHA worker, a developmental checklist is your quiet superpower: a short list of age-based milestones you observe and ask about during home visits and immunisation days. You are **not diagnosing** — you are *noticing* whether a child is roughly on track for their age, and gently flagging the few who need a closer look. Use it at every contact, trust a parent's worry, and refer early rather than wait. Early action is the single most powerful thing you can do for these children.

## How to use the checklist, step by step
**1. Use the milestones the child should have by their age band.** For each age, check a few simple things — does the baby smile back and turn to sound, does the one-year-old babble, point and respond to their name, does the two-year-old join words and follow a simple instruction, can the toddler walk, scribble and play near other children. Government tools such as the RBSK/ICDS milestone cards work well; healthychildren.org also has free milestone checklists you can adapt.

**2. Watch *and* ask.** Observe the child for a few minutes, then ask the mother in her own words — *"Does he look at you when you call his name? Does she try to say words?"* Mothers notice first; their concern is reliable and you should always record it.

**3. Use plain "yes / not yet" — never a score or a label.** Tick what the child can do. "Not yet" simply means watch and recheck, not a problem in itself.

**4. Recheck at the next visit.** One "not yet" at one visit is not alarming. The same gaps continuing across visits, or any *loss* of a skill the child once had, means refer now.

**5. Refer kindly and clearly.** Tell the family this is a normal next step to *help* their child grow stronger — never frame it as bad news.

## When to refer without waiting
- No social smile or no response to sound in early infancy
- No babble, pointing or gestures by 12 months
- No single words by 16 months, no two-word phrases by 24 months
- Not walking by 18 months
- **Any loss** of speech, social connection or skills at any age
- Any fits/seizures, or a child who suddenly stops responding — these need a doctor **promptly**, not a wait-and-watch
- Any persistent worry from the mother

## The Pinnacle way
Your checklist is a *screening* aid in the community — a clinical **AbilityScore®** and any diagnosis are formed only at a Pinnacle Blooms Network centre, under qualified clinician care, never from a checklist or an app. When you flag a child, you can route the family confidently. Across [70+ centres in 4 states](/), our [clinician-administered structured assessment](/ask/what-is-the-abilityscore-and-how-is-it-calculated) turns your early notice into a clear plan, and [therapy support](/early-intervention) helps the child catch up. You are the bridge — we take it from there.

## Trusted sources
WHO Nurturing Care Framework on early childhood development and community screening; CDC and healthychildren.org (AAP) developmental milestone checklists; WHO ICD-11 framework for developmental functioning.

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

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

## Sources
- WHO Nurturing Care Framework — early childhood development: https://nurturing-care.org
- AAP HealthyChildren — developmental milestone checklists: https://www.healthychildren.org
- CDC — Developmental milestones and screening: https://www.cdc.gov
- WHO ICD-11: https://icd.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

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- Using a Simple Developmental Checklist in the Community: https://pinnacleblooms.org/ask/as-an-anganwadi-worker-how-can-i-use-a-simple-developmental-checklist-in-the-community
- Using a Simple Developmental Checklist in the Community: https://pinnacleblooms.org/ask/as-a-community-health-volunteer-how-can-i-use-a-simple-developmental-checklist-in-the-community
- How a PHC nurse uses a simple developmental checklist in the community: https://pinnacleblooms.org/ask/as-a-phc-nurse-how-can-i-use-a-simple-developmental-checklist-in-the-community
- How can an ASHA worker raise developmental awareness in the community?: https://pinnacleblooms.org/ask/as-an-asha-worker-how-can-i-raise-developmental-awareness-in-the-community
- 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
- 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