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Concern
Explore explanations, everyday questions and next steps connected with concern.
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Signs & concerns
Does my child need a diagnosis before we can start getting help?
No — a child does not need a formal diagnosis before help can begin. Early intervention is shaped around a child's actual needs, not a label, and a clinician-administered developmental check gives a clear starting point straight away. A diagnosis, if it is needed at all, can follow later; the most important thing is to begin early, when support works best.
Read the answer AnswerDoes my child really need therapy, or is it too early?
It is rarely too early to look — and early looking is a child's biggest advantage. A developmental check is not a one-way door to therapy: sometimes the answer is reassurance, sometimes a little home guidance, and sometimes early support that changes the whole road ahead. Acting on a check means you decide from information, not worry. None of this is a diagnosis.
Read the answer AnswerCan you tell if a 2-year-old has Down syndrome?
Down syndrome is caused by an extra chromosome 21 and is almost always identified at or before birth via a blood test — it does not newly appear at age 2. If your toddler shows delays, the right step is a developmental assessment, not watching for Down syndrome.
Read the answer AnswerCan a newborn have global developmental delay?
Global developmental delay applies to children under 5 who are behind in two or more areas — it is measured against milestones that emerge over months, so it cannot apply to a newborn. Focus now on screening, feeding and routine checks, and track milestones as they arrive.
Read the answer AnswerSigns of hearing loss in a 9–12-month-old
By 9–12 months babies turn to their name, babble, and respond to sound. Hearing loss is easy to miss but highly treatable when caught early. If your baby doesn't react to sound, has reduced babble, or ignores her name, arrange a hearing test now.
Read the answer AnswerHow do I help my child reach their full potential?
Children reach their potential through warm, responsive relationships, daily talk, reading and play, good sleep and nutrition, and timely support when a milestone seems delayed. You do not need to be a therapist — follow your child's lead, respond to their cues, and trust your instincts. Where there is a gap, early and joyful support works best, and a gentle developmental check turns worry into a clear plan.
Read the answer AnswerHow do I know how serious my child's delay is?
You can't grade a delay from a single moment or an online list — seriousness depends on how many areas are affected, how far behind milestones, whether your child is still gaining skills, and whether any skills have been lost. The surest way to know is a structured developmental check with a clinician. Severity is not destiny: early support works best because young brains are most adaptable, so acting on a concern early matters more than diagnosing it yourself.
Read the answer AnswerHow do I know if my child has strong behaviour readiness?
Strong behaviour readiness shows in everyday life: following simple routines, managing transitions and waiting, recovering from upsets with comfort, and connecting through play. There is no single test — readiness grows with age, and tantrums are normal. Seek a calm developmental check if meltdowns are very frequent, intense or hard to soothe, if transitions are very hard, or if behaviour gets in the way of learning and connecting. This is a reason to assess early, not a diagnosis.
Read the answer AnswerHow do I know if my child has strong cognitive readiness?
Strong cognitive readiness shows in everyday play: curiosity and exploration, remembering people and routines, understanding cause and effect, age-appropriate attention, problem-solving, and learning from trying. There's no single home test — readiness is a pattern that grows over months and looks different in every child. If your child rarely explores, attends or learns as you'd expect for their age, especially alongside talking or social delays, a calm developmental check is the kind next step — early support works best.
Read the answer AnswerHow do I know if my child has strong mainstream readiness?
Strong mainstream readiness shows in everyday building blocks: communicating needs, following routines, attending for short stretches, playing alongside other children, basic self-help and recovering from frustration with support. A child strong in most areas and building one or two is showing healthy readiness. It is a profile of strengths, not a pass-or-fail test, and a clinician's structured look gives the clearest picture — so arrange a developmental check if several areas feel consistently hard.
Read the answer AnswerHow do I know if my child has strong motor readiness?
Strong motor readiness shows as smooth, age-appropriate control — steady head and trunk, balanced sitting and standing, willing reaching and grasping, symmetry across both sides, and a happy drive to move and explore. Every child grows at their own pace, so the overall picture matters more than any single milestone. Seek a developmental check if movements seem stiff, floppy, very one-sided, or are clearly behind same-age children — not as alarm, but because early support works best.
Read the answer AnswerHow do I know if my child has strong school readiness?
Strong school readiness is a blend of language, social-emotional skills, attention, independence and fine-motor ability — not early reading. Encouraging signs include following two-step instructions, separating from you without lasting upset, taking turns, sitting for a short activity, and managing basics like the toilet and shoes. Readiness builds gradually through play, talk and warm routines; a calm developmental check helps if a child consistently struggles across several of these areas as school nears.
Read the answer AnswerSigns of Strong Self-Sufficiency Readiness
Strong self-sufficiency readiness shows in everyday moments — wanting to try things, following simple routines, managing age-fitting self-care, and coping with small setbacks with a little help. It grows gradually and looks different at every age, so it is never a single pass-or-fail score. If your child shows little drive to try or leans on you for almost everything peers manage, that is simply a good reason for a gentle developmental check, not a worry to carry alone.
Read the answer AnswerHow do I know if my child has strong speech readiness?
Strong speech readiness shows in the foundations beneath talking: responding to sound and to their name, babbling, sharing attention, pointing and gesturing, understanding simple words, and wanting to connect. These matter more than word count in the early years. Seek a gentle developmental check — and a hearing check — if babbling, gestures, name response or understanding seem quiet for your child's age, or if a skill is lost. This guides support early; it is not a diagnosis.
Read the answer AnswerHow do I know it is time to update my child's therapy plan?
Update your child's therapy plan when goals are met, progress has plateaued for several weeks, a new strength or challenge appears, or life changes (new school, home or routine). Most teams reassess every few months, but your everyday observations can prompt an earlier check any time. Reassessment is a normal, hopeful part of therapy — it keeps support matched to your growing child, never a setback.
Read the answer AnswerHow long will my child need therapy?
There is no fixed timeline — some children need a few focused months, others a year or more, with most stepping down gradually as skills grow. The length depends on your child's starting point, the goals set, how early you begin, and how much practice happens at home. Therapy is a series of milestones to tick off and review, not an open-ended commitment — and good therapy is designed to make itself unnecessary.
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 to escalate a child's difficulty with adaptability
Adaptability (ICF d5) is how a child copes with change — new routines, places and transitions. A frontline health worker should escalate to a developmental check when difficulty adapting is persistent, age-inappropriate, disrupts daily life, or travels with delays in talking, play or social connection. This is a reason to assess early, not a diagnosis, because early support works best.
Read the answer AnswerWhen should a frontline health worker escalate an adaptive-skill delay?
A frontline health worker should escalate when a child clearly lags behind expected age for self-care skills — feeding, dressing, toileting, washing — and especially when the gap is widening, a skill has been lost, or delays appear alongside in speech, movement or social connection. Don't wait indefinitely: refer to the PHC Medical Officer or a developmental service the same month a clear gap or red flag is seen. This signals the need for assessment, not a diagnosis.
Read the answer AnswerWhen should a frontline health worker escalate an adaptive-skill delay?
Adaptive skills are everyday self-care abilities (ICF d5) — feeding, dressing, toileting, washing. A frontline worker should escalate for a developmental check when a child shows a persistent gap behind peers, no progress over 3–6 months, delays across several domains, loss of a learned skill, or clear parent concern. Escalation means a gentle referral, not a diagnosis — early support works best.
Read the answer AnswerWhen to escalate a child's aggression control
Most toddlers and preschoolers cannot fully control anger or aggression — hitting, biting and tantrums are common as self-regulation grows. A frontline health worker should escalate for a developmental check when aggression is frequent and intense, causes real harm, is not fading with age, or comes alongside delays in talking, play or social connection. This is a reason to assess early, not a diagnosis.
Read the answer AnswerAttachment Response: When a Frontline Worker Should Escalate
Attachment response is how a baby seeks and finds comfort in a familiar caregiver — the social smile, calming when held, looking for a parent's face. Frontline workers should escalate for a developmental check when there is no social smile by 3–4 months, no comfort-seeking or settling with the caregiver, very little eye contact or response to a familiar voice, or any clear loss of a connection once present. This is not a diagnosis — it is an early, sensible step, and early support works best.
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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