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Cognitive
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Signs & concerns
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Signs & concerns
Memory and Recall on a Home Visit
During a home visit, a frontline worker should observe how a child recognises familiar people and objects, remembers where things are kept, follows simple instructions, finds hidden toys, and recalls songs or names. These are signs to watch and note across visits, not to diagnose. If several areas lag for the child's age, route the family to a general developmental check, ideally after a hearing screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child's memory retention?
On a home visit, observe how a child holds and recalls information: finding a hidden toy, following one- then two-step instructions, repeating short sequences, naming familiar people, and remembering routines, rhymes or small events. These are everyday signs of memory retention to note and monitor, not to diagnose. Concern grows when a child is clearly behind same-age peers, daily routines are affected, or recall does not improve with simple repetition over weeks — a gentle prompt to suggest a developmental check.
Read the answer AnswerWhat to observe about a child's mental effort on a home visit
On a home visit, a frontline worker should observe how a child applies and sustains mental effort — whether they settle on a simple activity, pay attention for an age-appropriate stretch, keep trying when a task is slightly hard, and shift focus when guided. These are observations to note and monitor across visits, not to diagnose. Refer for a developmental screen if engagement is far below age expectations over weeks, or alongside delays in talking, play or understanding.
Read the answer AnswerObserving Multi-Step Task Skills During a Home Visit
During a home visit, observe whether a child can follow and complete tasks with two or more linked steps — remembering the sequence, staying on task, and recovering from mistakes — judged against their age. Note how much repetition or demonstration they need. These are observations to monitor and refer, not to diagnose. Refer for a developmental check (with a hearing check) if the child is clearly behind for age, the pattern persists across visits, or a parent is worried.
Read the answer AnswerObserving Object Matching During a Home Visit
During a home visit, a frontline worker should observe whether the child can bring together objects that belong together — identical items first, then by likeness — and how they explore: looking and comparing, showing interest, and responding to simple words. Object matching emerges through the second year, so this is something to observe and encourage, not diagnose. Note what you see across more than one visit, and recommend a developmental screen if matching is delayed alongside limited words, eye contact or play.
Read the answer AnswerObserving Object Permanence on a Home Visit
During a home visit, a frontline worker should observe whether the child follows a dropped or moving toy with their eyes, looks toward where an object disappeared, lifts a cloth to find a hidden toy by around 8–10 months, and enjoys peek-a-boo. Object permanence usually emerges between 6 and 12 months. These are signs to observe and note, not diagnose — refer onward for a developmental check if searching and playful interaction seem consistently absent or a parent is worried.
Read the answer AnswerObject recognition on a home visit: what to observe
On a home visit, a frontline worker should observe how the child looks at, reaches for and uses familiar everyday objects — a cup, spoon, ball or face. Object recognition means the child shows they know what something is and what it's for, follows moving objects, finds named items and uses them correctly. These are observations to note and discuss, not diagnose. Check hearing and vision first, and if concerns persist across visits, route the family to the PHC for a developmental check.
Read the answer AnswerObserving organization skills during a home visit
On a home visit, a frontline worker should observe how a child manages everyday tasks for their age — gathering items to start an activity, following simple 2–3 step routines, keeping toys roughly in order, tidying with prompts, and coping with transitions. Organization develops gradually, so the worker observes and notes patterns across visits rather than scoring or diagnosing. Where a child is well behind same-age peers across several routines, gently route the family to a general developmental check.
Read the answer AnswerObserving organisation skills on a home visit
On a home visit, observe how the child follows simple routines, puts belongings back, completes tasks, gathers what they need, and moves between activities. Organisation skills grow unevenly in early years, so note patterns rather than label. Mark a referral when difficulties are persistent, marked and seen across many situations — paired with hearing and vision screening.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning pattern recognition?
On a home visit, observe how the child notices and predicts what comes next — matching like objects, sorting by colour or size, continuing simple repeating patterns, completing rhymes, anticipating routines and recalling rules. These are everyday signs of pattern recognition to note over time, not to diagnose. Concern grows when several signs lag clearly behind peers, persist across visits, or a skill is lost — gently route the family to a developmental check.
Read the answer AnswerWhat to Observe About a Child's Problem Solving on a Home Visit
On a home visit, a frontline worker should observe how a child works things out in everyday play — reaching for out-of-grasp toys, fitting shapes, finding hidden objects, using tools, and trying a new approach when the first fails. These show growing problem solving, an early-learning skill. The worker observes and notes patterns over time rather than diagnosing. Persistent very limited exploration or problem solving well behind same-age peers is worth gently referring to the PHC medical officer or a developmental check.
Read the answer AnswerQuantitative reasoning on a home visit: what to observe
On a home visit, observe a child's everyday number sense — noticing more versus less, grouping and sorting objects, sharing items out, and counting touchable things by preschool age. These early quantitative reasoning skills (ICF d1) are observed through ordinary play with home objects, not tested. Worth a closer look: no interest in amounts, inability to count objects by school age, or number play far behind other development. Note kindly for the family and route to a developmental screen — never a home diagnosis.
Read the answer AnswerObserving quantity comparison during a home visit
On a home visit, a frontline worker should watch whether a child can compare two small groups of everyday objects and tell which has more or less, reach for the larger share, and use words like zyada or kam. This is everyday observation to encourage and monitor, not to diagnose. A child who consistently struggles compared with same-age peers should be routed to a friendly developmental check.
Read the answer AnswerObserving sequential memory on a home visit
On a home visit, observe how a child remembers things in order: following two- or three-step instructions, copying a clap or tap pattern, repeating a short series of words or actions, recalling steps in songs or routines, and telling what happened 'first, next, last'. These are observations to note and discuss across visits, not to diagnose at home. If a child consistently lags peers in holding a short order of steps, route the family to a general developmental check.
Read the answer AnswerShape recognition on a home visit: what to observe
On a home visit, a frontline worker should observe how a child plays with everyday shapes — looking, matching, fitting shapes into sorters, and (in older toddlers) pointing to and naming shapes — and how this compares with same-age peers. Shape recognition is a cognitive building block that grows gradually, so the worker observes and notes, never diagnoses. A clear gap behind peers across several play tasks and visits is a reason to route the family for a developmental check.
Read the answer AnswerObserving short-term memory on a home visit
On a home visit, a frontline worker can observe a child's short-term memory through everyday actions: following one- or two-step instructions, finding a hidden toy, recalling familiar names, and remembering routines or song steps. These are things to observe and note against age expectations, not diagnose at home. Always check hearing first. A persistent pattern of struggling compared with peers, or parent worries, is the cue to route the family for a developmental check.
Read the answer AnswerObserving simple planning on a home visit
On a home visit, a frontline worker should observe whether a child can hold a small goal in mind and take a sensible first step towards it — stacking in order, fetching a stool to reach a toy, sequencing two steps, or trying another way when one fails. These are everyday signs to note and monitor against the child's age, never to diagnose at home. Persistent absence of any goal-directed step, inability to hold a two-step idea over weeks, or concerns alongside language or movement delays should be routed to a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning social awareness?
During a home visit, a frontline worker should observe how a child notices and responds to people — eye contact, smiling back, turning to their name, sharing attention by pointing or showing, following others' gaze, and reacting to feelings. These are everyday signs of social awareness to observe and note across visits, not to diagnose. If a child consistently shows little interest in people, gently reassure the family and encourage a developmental check, since early strengths-first support never has to wait for a label.
Read the answer AnswerSorting & categorization on a home visit
On a home visit, a frontline worker should observe how a child notices sameness and difference, matches and groups everyday objects (by colour, shape, size or use), follows a simple sorting instruction, and stays engaged. Many children begin matching around 2–3 years and sort by category by 3–4 years. These are observations to note and route — never a home diagnosis. Refer onward if a child past 3 cannot match or group familiar objects with demonstration, or if wider delays are reported.
Read the answer AnswerSpatial reasoning on a home visit: what to observe
On a home visit, a frontline worker should observe how a child explores space and shape in everyday play — stacking blocks, nesting cups, posting shapes, completing puzzles, navigating around furniture, and using position words like in, on and under. These are skills to watch and encourage, not diagnose at home. A pattern that persists or widens across months, or concerns alongside speech, movement or play, is worth a gentle, planned developmental check and routing to a screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning to story recall?
On a home visit, watch how the child listens to a short familiar story and retells it — noting attention, recall of main characters and events, rough sequencing, and the language they use. A child learning this skill improves with repetition and prompts, so observe growth over several visits rather than one attempt. Persistent low interest, no recall even with picture cues, or retelling far behind peers are observations to share with the team — never a home diagnosis.
Read the answer AnswerObserving sustained attention on a home visit
On a home visit, a frontline worker should observe how long a child stays engaged with one activity, whether they return to it after a distraction, and how this compares to peers of the same age. Attention is naturally short in young children and longer for favoured tasks, so these are points to observe and note across visits — not diagnose at home. Refer for a developmental check when very limited focus persists across settings or when the family raises concern; a hearing check is often a sensible first step.
Read the answer AnswerObserving task completion during a home visit
On a home visit, observe whether the child can begin a simple familiar task, stay focused enough to finish, follow a one- or two-step instruction, cope with a small obstacle, and show pride at completing it. These are observations to note and monitor against the child's age, never to diagnose at home. A pattern that persists across visits, is well behind peers, or comes with attention or comprehension concerns is worth raising for a developmental check.
Read the answer AnswerObserving task initiation during a home visit
During a home visit, a frontline worker should observe how readily a child starts an offered activity — picking up a toy, responding to a simple instruction, or beginning a familiar routine without constant prompting. Task initiation (ICF d1) grows with age, so this is gentle observation and pattern-noting, never home diagnosis. Compare across people and settings, and route consistent difficulty — especially alongside other delays — to a general developmental check.
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