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Cognitive
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Signs & concerns
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Signs & concerns
During a home visit, what should a frontline worker observe about a child learning task management?
On a home visit, observe how a child starts, stays with, and finishes a simple everyday task — understanding a one-step instruction, keeping attention for a minute or two, managing a short sequence of steps, and coping with small frustration. Judge against age and the support given. These are observations to note and monitor, not to diagnose. Flag persistent patterns, or delays alongside language, play or attention, to the supervising health team for a developmental screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning task monitoring?
During a home visit, a frontline worker should observe how a child begins, holds the goal of, sustains and checks a simple everyday task — whether they remember instructions, stay on task, notice and fix their own mistakes, and finish without constant prompting. These are skills to observe and note over several visits, not to diagnose at home. A persistent struggle across many tasks, clearly behind same-age peers, is the cue to suggest a friendly developmental screen.
Read the answer AnswerObserving Task Participation on a Home Visit
During a home visit, a frontline worker should observe how a child engages with a simple, age-appropriate activity — whether they look at it, follow a one-step instruction, stay with it briefly, keep trying and finish a small step. These are strengths to observe and encourage, not to diagnose at home. If a child consistently cannot settle into or complete simple tasks for their age across several weeks, route the family for a gentle general developmental check.
Read the answer AnswerObserving Task Speed During a Home Visit
On a home visit, a frontline worker should observe how a child manages single everyday tasks — starting willingly, keeping going, and finishing at an age-typical pace. This is gentle observation to note and monitor, not to diagnose. Pace varies widely, so what matters is a clear, repeated pattern across several tasks and more than one visit, not one slow moment. Persistent difficulty finishing across tasks should be routed to the PHC for a developmental check.
Read the answer AnswerWhat to observe about a child's transitioning during a home visit
During a home visit, a frontline worker should observe how a child moves between positions (lying to sitting, sitting to standing), shifts between activities and attention, and copes with social changes like a new person or routine. Smooth transitions for the child's age are reassuring; persistent stiffness, floppiness, or extreme distress with change across many settings are signs to note and share with a medical officer. This is observation to monitor, not a home diagnosis.
Read the answer AnswerObserving understanding on a home visit
On a home visit, observe how a child understands everyday words, names and simple requests in their home language — turning to their name, looking at named objects, following a simple instruction, and responding to gesture and tone. Understanding grows ahead of speech, so watch comprehension rather than talking. These are things to observe and note, not diagnose at home; a persisting gap, judged in the home language, is a reason to check hearing first and route the family for a developmental screen.
Read the answer AnswerObserving Visual Motor Integration on a Home Visit
On a home visit, a frontline worker should observe how a child coordinates eyes and hands — reaching accurately, grasping with a finger-thumb pinch, stacking, posting shapes, scribbling and copying for their age. These are observations to monitor and route, not diagnose at home. A persistent gap across several visits, clumsiness affecting daily tasks, or avoiding hand-eye play warrants a gentle developmental check after confirming vision and hearing seem fine.
Read the answer AnswerWhat to observe about a child's visual processing on a home visit
On a home visit, observe how a child uses vision in everyday play: looking at faces, following a moving toy, reaching accurately for objects, and noticing things across the room. Visual processing is how the brain makes sense of what the eyes see. These are signs to note and monitor, not to diagnose at home — and any concern should go first to a vision and hearing check at the primary health centre.
Read the answer AnswerVisual reception: what to observe on a home visit
On a home visit, observe how a child uses their eyes to take in their world: following a face or toy, looking towards movement, reaching for what they see, and recognising familiar faces, objects and pictures as they grow. These are signs to note and monitor, not to diagnose. If a child consistently does not look, track or respond for their age — across weeks or several areas — flag it for a developmental check, starting with a hearing and vision screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about visual recognition?
On a home visit, a frontline worker observes how a child uses their eyes to notice, follow and recognise people and objects — eye contact, smiling at familiar faces, following a moving toy, looking for a dropped object, and reaching for known things. These are observations to note and monitor, not to diagnose. Persistent absence of looking, following or recognising familiar faces for the child's age, or eyes that don't move together, signals a vision and developmental check — vision first, since many causes are treatable.
Read the answer AnswerVisual scanning: what to observe on a home visit
On a home visit, a frontline worker should observe how the child uses their eyes to find and follow things — turning towards faces and moving objects, shifting gaze between toys, tracking a slowly moving object, and searching for dropped or hidden items. Signs worth noting include consistently missing one side, not fixing or following by the expected age, squinting or head-tilting, and little interest in faces. These are patterns to observe and route, not to diagnose; a vision and hearing check comes first.
Read the answer AnswerVisual Spatial Processing on a Home Visit
On a home visit, observe how the child uses eyes and hands together to understand space: accurate looking and reaching, judging distances while moving, stacking and nesting objects, posting shapes, and finding hidden toys. These are everyday signs of growing visual spatial processing. Note patterns rather than diagnose, check for vision concerns first, and route persisting or multi-area difficulties to a general developmental check.
Read the answer AnswerObserving visuospatial skills on a home visit
On a home visit, observe how the child uses eyes and hands together to understand space, shape and position — fitting objects into containers, stacking, simple puzzles, copying shapes, and moving around the home without bumping. These are skills to watch and note over several visits, not to diagnose. Check vision and hearing first, and if a gap persists across visits or affects more than one area, route the family gently to a developmental check.
Read the answer AnswerObserving working memory on a home visit
On a home visit, a frontline worker should observe how a child holds and uses information briefly — following age-appropriate one- or two-step instructions, finding a recently hidden toy, repeating a short rhyme or sequence, and completing familiar routines. These are signs to observe and note, not to diagnose at home. Suggest a developmental check if the child consistently cannot hold instructions expected for their age, struggles across home and play, or shows this alongside other delays.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible ADHD Early
A frontline worker can flag possible ADHD when inattention, overactivity or impulsivity is greater than expected for age, persists 6+ months across home and school, and disrupts daily life. ADHD is reliably recognised from around age 5–6; below this, restlessness is usually normal. Screen to refer, never to diagnose.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Dyscalculia Early
Frontline workers can spot likely dyscalculia from about age 7 when a child shows persistent, specific difficulty with counting, number facts and arithmetic that is out of step with their other abilities and not explained by teaching, effort or general delay. Flag for a developmental and educational assessment; only a clinician can confirm.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Dysgraphia Early
Dysgraphia shows as writing far below a child's spoken ability — laboured, illegible, slow writing, heavy spelling errors and avoidance of writing, not from poor schooling. Watch for a persistent gap from about age 6–7 and refer; only a clinician confirms.
Read the answer AnswerSpotting possible dyslexia early
Spot possible dyslexia by the gap between a child's strong spoken ability and unexpected, persistent difficulty learning letters, sounds and reading — especially with a family history. Early risk markers (late talking, trouble with rhymes and letter names) appear pre-school; refer once reading lags the class despite good teaching, with hearing and vision checked too.
Read the answer AnswerHow a frontline health worker can spot possible Intellectual Disability early
A frontline worker spots possible intellectual disability by watching for delays across several developmental domains at once — motor, language, play and self-help — that persist over visits and lag behind same-age peers. Use a milestone checklist, take parental concern seriously, act urgently on any loss of skills, and refer for a developmental check rather than waiting. A formal label only follows a clinician's structured assessment.
Read the answer AnswerSpotting a possible School Readiness Gap early
A School Readiness Gap is when a child near school-entry age (5–6) has not yet built the language, attention, fine-motor, self-care and social-emotional foundations classrooms assume. Frontline workers can spot it by checking a short cluster of everyday skills during routine contacts and referring any child who lags across two or more areas, or shows regression or hearing concern, for a developmental check.
Read the answer AnswerHow a frontline health worker can spot possible SLD early
Suspect SLD when a school-age child (typically 6+ years) shows persistent, specific, unexpected difficulty with reading, writing or number work — well below age level despite adequate teaching, normal hearing and vision, and no global delay. Frontline workers spot the pattern and refer; only a clinician confirms.
Read the answer AnswerWhen to escalate concerns about achievement orientation
Achievement orientation — the drive to attempt, persist with and take pride in tasks — develops gradually, not on a fixed date. A frontline worker should escalate to a developmental check when a child consistently avoids age-typical tasks, gives up instantly, shows no pride in finishing, or when this travels with language, play or social delays. This is a reason to assess early, never a diagnosis.
Read the answer AnswerWhen to escalate activity-completion delay — guidance for frontline workers
When a 2–3 year old cannot begin and finish a simple familiar task, it is often within the normal range of growing attention, not a diagnosis. A frontline worker should escalate to the Medical Officer or a developmental check when the difficulty is persistent, clearly behind peers, or travels with delays in speech, understanding, social connection or play. Document observations, ask the family what the child manages at home, and route early rather than wait.
Read the answer AnswerWhen should a frontline worker escalate attention and inhibition concerns?
A frontline health worker should escalate when a child's difficulty with attention and inhibition is persistent over weeks, clearly out of step with same-age peers, shows across settings (home, play, preschool), affects safety or learning, or travels with delays in talking or social connection. Attention and self-control mature slowly through the early years, so a single restless day is normal — a steady pattern is the trigger to refer for a developmental check. Referral is early opportunity, not a diagnosis.
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