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Concern
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Signs & concerns
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Signs & concerns
When should a frontline health worker refer a child with possible Intellectual Disability?
Refer when a child shows persistent delay across two or more areas — motor, language, understanding, self-care or social — that is not catching up, or any loss of skills. Frontline workers spot the pattern; only a clinician confirms it.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Motor Planning Difficulties?
Refer when difficulty planning and sequencing movement is persistent, age-inappropriate, and interferes with daily tasks — after ruling out an obvious medical cause. You don't need certainty; a clear pattern is enough. Sudden loss of skills, weakness or asymmetry go to a paediatrician urgently.
Read the answer AnswerWhen to Refer a Non-Verbal or Minimally Verbal Child
Refer when speech milestones are clearly missed — no gestures by 12 months, no words by 18, no two-word phrases by 24 — or whenever a child loses words they once had. Always check hearing first. Minimally verbal is a description, not a diagnosis; only a clinician can find the cause.
Read the answer AnswerWhen should a frontline health worker refer a child with possible ODD?
Refer when defiant, angry behaviour has lasted six months or more, occurs across more than one setting, and is harming relationships, learning or family life — and urgently if there is aggression, self-harm or suspected abuse. ODD is recognised from about age 4; only a clinician confirms it.
Read the answer AnswerWhen should a frontline health worker refer persistent toe-walking?
Occasional tiptoe walking under age three is usually normal and settles with growth. A frontline worker should refer when toe-walking persists beyond three, happens on most steps, is one-sided, comes with tight calves or heel cords, or appears alongside delays in speech, play or motor skills. Loss of a previously gained skill needs prompt medical referral. When unsure, a developmental check reassures the family and catches treatable causes early.
Read the answer AnswerWhen to Refer a Preterm Child for Developmental Risk
Link every preterm baby to specialist follow-up from discharge, and refer promptly on red flags judged by corrected age — stiffness or floppiness, feeding or growth trouble, vision/hearing concerns, delayed babble or words, or any lost skill. When in doubt, refer; field workers screen and route, clinicians diagnose.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Rett Syndrome?
Refer promptly when a girl who was developing normally (typically 6–18 months) slows, stalls, or loses skills — especially loss of purposeful hand use with repetitive hand-wringing, slowing head growth, and lost eye contact. You don't need certainty; recognise and route. Diagnosis is made only by a specialist.
Read the answer AnswerWhen should a frontline health worker refer a child with possible School Readiness Gap to a specialist?
Refer a child aged roughly 4–6 when a school readiness gap persists despite simple support, or sits alongside a developmental red flag — limited language, poor attention, motor or self-care difficulty, or any loss of skills. When in doubt, refer; early assessment is low-risk. Diagnosis is made only by a clinician.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Selective Mutism?
Refer when a child speaks freely at home but stays consistently silent in select settings such as school for more than about a month, and it disrupts learning or friendships — after ruling out a general language delay or a new-language situation. It is anxiety-based and highly treatable; only a clinician confirms it.
Read the answer AnswerWhen to refer a child with self-regulation difficulties
Refer a child with possible self-regulation difficulties when the struggles are frequent, intense and lasting beyond what is typical for the child's age, or when they disrupt sleep, feeding, play, learning or relationships. A single tantrum is normal; a pattern continuing for weeks that interferes with daily life — or persistent parent worry — deserves a developmental check. Sudden skill loss, staring spells or faltering growth need prompt medical review. When in doubt, refer; early support is always safe.
Read the answer AnswerWhen should a frontline health worker refer Sensory-Based Feeding Selectivity?
Refer when feeding selectivity is persistent or narrowing, affects growth, causes mealtime distress, or limits function beyond a normal fussy phase. Any swallowing difficulty or dehydration needs same-day medical review. Frontline workers notice and route; diagnosis happens only at a Pinnacle centre.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Sensory Processing Differences?
Refer a child with possible sensory processing differences when responses are persistent, intense and interfere with feeding, sleep, learning or family life across settings for weeks — not for occasional fussiness. Pair sensory concerns with a general developmental check. Diagnosis is made only by a qualified clinician.
Read the answer AnswerWhen to refer possible Separation Anxiety Disorder
Refer when separation distress is persistent (around 4 weeks or more), out of step with the child's age, and causing real impairment — school refusal, sleep problems, or unexplained physical complaints. Brief clinginess settles; an escalating, impairing pattern needs a specialist. Only a clinician can diagnose.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Social Communication Difficulties?
Refer when a communication concern is persistent, affects everyday social interaction, or keeps being raised by parents or teachers. You needn't confirm anything — notice the pattern, check hearing, and route it. When in doubt, refer; only a clinician diagnoses.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Specific Learning Disability?
Refer once academic difficulty is persistent (6+ months despite help), well below age expectation, and not explained by schooling, hearing, vision or another condition — typically from age 6–7 when formal learning has begun. Rule out simple causes first; only a clinician confirms it.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Speech and Language Delay?
Refer when language milestones are clearly behind for age, when a parent is worried, or at any red flag — especially loss of words already learned. Always check hearing first. When in doubt, refer: early assessment is low-risk and high-benefit. Only a clinician confirms a diagnosis.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Stereotyped Movement Disorder?
Refer a child with possible Stereotyped Movement Disorder when movements cause self-injury, persist past the toddler years, interfere with daily life, or come with developmental concerns. Refer the same day for medical red flags like sudden onset or loss of awareness. Diagnosis is made only by a clinician.
Read the answer AnswerWhen to Refer a Child with Possible Tourette Syndrome
Refer a child with tics that have lasted several weeks or more — especially both movement and sound tics — or that disrupt school, sleep or wellbeing, or distress the family. Frontline workers screen and route; only a specialist diagnoses.
Read the answer AnswerWhen should a frontline health worker refer a child with possible visual impairment?
Refer promptly, never wait and watch. Any white pupil, persistent squint past 3 months, no following of a face/light by 3 months, wobbling eyes, or any preterm baby needs urgent specialist eye referral. Frontline screening flags the concern; only a clinician diagnoses.
Read the answer AnswerWhen should an ASHA or PHC worker escalate a child showing signs of ADHD?
Escalate a school-age child (around 6+) when inattention, hyperactivity or impulsivity persists for 6+ months across two settings (home and school) and disrupts learning or relationships — confirmed by parent and teacher. Refer promptly if red flags suggest another cause. The worker notices and routes; only a clinician diagnoses.
Read the answer AnswerWhen should an ASHA or PHC worker escalate a child showing signs of Attachment Difficulties?
Escalate when a child shows a persistent pattern — not a single episode — of not seeking comfort, emotional withdrawal, or indiscriminate friendliness, especially with neglect, caregiver instability or growth faltering. Escalate urgently if abuse or failure to thrive is suspected. Observe, document, reassure, route — never label.
Read the answer AnswerWhen should an ASHA or PHC worker escalate a child showing signs of Auditory Processing Difficulties?
Escalate when a child hears sound but consistently struggles to understand speech — especially in noise or with multi-step directions — and it persists. Always rule out hearing loss first with an audiology referral. Refer urgent flags (no response to sound, lost skills, ear discharge) promptly; route routine concerns for assessment. The community worker notices and routes; only a clinician confirms.
Read the answer AnswerWhen should an ASHA or PHC worker escalate a child showing signs of Autism Spectrum?
Escalate whenever a child fails a routine developmental check, a parent raises a real concern, or any red flag persists — and treat loss of previously acquired skills as urgent. A community health worker catches and routes; only a clinician diagnoses. When in doubt, refer for a developmental check.
Read the answer AnswerWhen should an ASHA or PHC worker escalate signs of cerebral palsy?
Escalate promptly — do not wait-and-watch — when an infant shows persistent stiff or floppy tone, early hand preference before 12 months, a missed motor milestone, or feeding difficulty, especially with a high-risk birth history. Cerebral palsy is a medical referral; any seizure is an emergency. Early referral is always the safer call.
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