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Early Signs
Explore explanations, everyday questions and next steps connected with early signs.
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Signs & concerns
Observing Gross Motor on a Home Visit
On a home visit, a frontline worker should observe a child's gross motor skills (ICF d4) by age: head control, rolling, sitting, crawling, standing and walking, plus the quality and symmetry of movement and muscle tone. Watch for persistent stiff or floppy tone, milestone gaps, one-sided preference before 12 months, or loss of a skill. These are signs to observe and refer — never to diagnose at home — routing the child for a developmental check.
Read the answer AnswerObserving Group Participation on a Home Visit
During a home visit, a frontline worker should observe how a child notices and connects with others, joins in play and routines, takes turns and shares, and copes within a group. The focus is on warm back-and-forth and the pattern over time — a child who consistently stays apart, rarely notices others, or is overwhelmed by every group moment across months is worth a gentle developmental check. These are observations to note and route, never to diagnose at home.
Read the answer AnswerObserving group play on a home visit
During a home visit, a frontline worker should observe how a child plays with other children rather than just beside them — interest in others, sharing, turn-taking, joining shared games and following simple group rules. Younger children playing alone or side-by-side is normal; cooperative group play grows gradually. These are developing skills to observe and monitor, not to diagnose at home. Refer for a general developmental check when a child shows little interest in others or marked difficulty joining in, especially alongside speech or behaviour concerns.
Read the answer AnswerObserving gymnastic skill development on a home visit
On a home visit, a frontline worker should observe the motor foundations beneath gymnastic skills (ICF d4): balance and posture, two-sided coordination, motor planning, core strength, body awareness and willingness to move. These are observations to note and monitor — not a diagnosis. A gap that persists across months, affects more than one area, or is clearly harder than for peers should be routed to a general developmental check at a Pinnacle Blooms Network centre.
Read the answer AnswerObserving Head Control During a Home Visit
During a home visit, a frontline worker should observe how steadily a baby holds and balances the head when on the tummy, when pulled to sit, and when held upright. By around 3-4 months the head should stay steady upright, and by 5-6 months it is well-controlled. Persistent floppiness, head that lags far past these ages, constant tilting to one side, or very stiff or very floppy tone should be noted and routed to a developmental screen - never diagnosed at home.
Read the answer AnswerHopping balance on a home visit: what to observe
On a home visit, observe whether the child can balance briefly on one foot, attempt a hop without toppling, and recover steadily after a wobble. Most stand on one leg around 3 years and hop a few times by 4–5 years. Watch for one-sided weakness, persistent unsteadiness or marked stiffness or floppiness. This is to observe and note, never to diagnose at home — a clear gap from same-age peers is a reason for a friendly developmental check.
Read the answer AnswerObserving hopping skills during a home visit
During a home visit, a frontline worker should observe whether a child can balance briefly on one foot, push off and land with control, and hop a few times on a preferred foot — skills that usually emerge between about 3 and 5 years. Watch how the child moves, note any persistent gap, clear left–right difference, or trouble across several motor areas, and gently encourage a general developmental screen. These are observations to monitor, never to diagnose at home.
Read the answer AnswerDuring a Home Visit, What to Observe About Hyperactivity in a Child
On a home visit, a frontline worker should observe and note — never diagnose — how a child manages attention, restlessness and settling for their age. Watch whether the child can sit briefly for play or a meal, follow simple requests, and settle to sleep, and whether restlessness is far beyond same-age peers across several settings. High activity is normal in young children; concern arises only with a strong, persistent, multi-setting pattern that disrupts daily life. Note it, reassure the family, and route any worry to a general developmental check.
Read the answer AnswerObserving imagination during a home visit
On a home visit, observe how a child uses objects and ideas in pretend play — making one object stand for another, 'feeding' a doll, acting out everyday scenes, inventing simple stories, and taking on roles. Imagination (ICF d7) develops gradually, so you watch the richness and pattern of play, not test or diagnose. Gently flag for a developmental check any child whose play stays very limited, fixed or absent over several months, especially alongside delays in talking or playing with peers.
Read the answer AnswerObserving a child learning to imitate imaginative play
During a home visit, a frontline worker should observe how a child of roughly 18 months to 3 years watches, imitates and joins in pretend play — copying a modelled action like feeding a doll, using one object to stand for another, and glancing to share the fun. This is to be observed and noted, not diagnosed at home. A pattern of absent imitation and make-believe beyond about 2.5–3 years, especially with other communication gaps, warrants a gentle, prompt developmental screen.
Read the answer AnswerWhat to observe about imaginative play on a home visit
On a home visit, observe whether the child uses objects to stand in for others (a block as a phone), pretends everyday actions (feeding a doll), takes on simple roles, and shares the play through looks, gestures and words. Pretend play usually emerges between 18 months and 3 years. Note — but do not diagnose — when imaginative play is largely absent past 2.5–3 years, stays repetitive, or is rarely shared, especially alongside limited speech or social connection, and suggest a friendly developmental check.
Read the answer AnswerWhat to observe about imitation during a home visit
At a home visit, a frontline worker should observe whether a child copies simple actions (clapping, waving, banging), sounds and words, and shows interest in copying games. Imitation typically grows from copying actions around 9–12 months to copying words and pretend play around 18–24 months. Gently note any child who rarely imitates by 18 months for a developmental check — this is observation, not diagnosis.
Read the answer AnswerObserving Imitation Skills During a Home Visit
On a home visit, a frontline worker should observe whether the child watches faces and actions and then tries to copy them — waving, clapping, banging a spoon, blowing a kiss, copying chores in play, and echoing sounds and simple words. Imitation grows through everyday play, so look for emerging attempts by the expected windows (e.g. waving and clapping around 9–12 months, pretend-play copying towards 18–24 months). These are observations to note and monitor, not to diagnose, and any persistent pattern should be routed to a developmental check.
Read the answer AnswerObserving imitative behaviour during a home visit
On a home visit, a frontline worker should observe how naturally a child copies facial expressions, gestures (waving, clapping), sounds and everyday actions during ordinary play. Imitation is a key sign of social and learning readiness. Watch for very little spontaneous imitation, no copying by the second year, or skills that seem to have been lost. This is observation to flag for a developmental check — never a home diagnosis.
Read the answer AnswerObserving impulse control on a home visit
On a home visit, observe how the child waits, takes turns, stops an action when asked, and handles frustration — across settings and judged against the child's age. Young children are naturally impulsive; control develops over years. Note only patterns clearly behind same-age peers, persistent across weeks, or causing distress, and route to a developmental check — never diagnose at home.
Read the answer AnswerWhat to observe about a child's impulse regulation on a home visit
On a home visit, observe how a child pauses before acting — waiting briefly for a turn, stopping when gently asked, managing "no" without lasting upset, and recovering after frustration. Impulse regulation (ICF b152) develops gradually and looks different at each age, so watch a pattern over time across settings, not one moment. Note what you see, reassure the family, and route persistent or safety-affecting concerns to a general developmental check — never a diagnosis at the door.
Read the answer AnswerWhat to Observe About Impulsivity on a Home Visit
On a home visit, a frontline worker should observe how a child manages waiting, turn-taking and stopping an action — judged against the child's age, since impulsivity is normal and expected in young children. Watch patterns over many months, not single moments, and note when difficulty is far greater than same-age peers or affects safety. Never label at home; warmly route worried caregivers to a general developmental check.
Read the answer AnswerWhat a frontline worker should observe about a child learning inhibition
On a home visit, observe whether a child can pause before acting, wait a short turn, stop when asked, and settle with adult help — all part of developing inhibition. Bursts of impulsiveness are normal in young children, so watch and note rather than label. Refer for a friendly developmental check if impulsiveness is much stronger than peers, not easing over several months, or linked to safety risks.
Read the answer AnswerWhat to observe about inquiry skills on a home visit
On a home visit, observe a child's inquiry skills (ICF d1) — how they explore and seek to understand their world. In infants this is curiosity in the body: looking towards new things, following a point, reaching and exploring objects, showing things to share, and repeating actions to see what happens. In older children it becomes curiosity in words: asking "what", "why" and "how", experimenting in play, and seeking answers. Note these as everyday strengths to encourage, not to diagnose. A persisting pattern of very little curiosity, or no pointing or sharing by around 18 months, is worth routing for a general developmental check.
Read the answer AnswerInstruction recall on a home visit: what to observe
On a home visit, a frontline worker should observe whether a child can hear, hold and follow simple spoken instructions in their home language — first one-step, then two-step requests — and whether attention or hearing seem to interfere. This is something to observe and note, never to diagnose at home. Look for patterns across visits, check hearing first, and refer any persisting concern for a developmental screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about internalizing behaviours?
During a home visit, a frontline worker should observe how a child manages inward-directed feelings — sadness, worry, fear, withdrawal — rather than only loud behaviours. Watch for persistent fearfulness, clinginess, low mood, reluctance to play, and physical complaints like tummy aches, noting patterns that persist across weeks or settings. These are signs to observe and gently flag, not diagnose at home — route the family for a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning interruption control?
On a home visit, a frontline worker should observe how a child manages interrupting — whether they can pause, wait for a gap in conversation, and let others finish during everyday family talk and play. Frequent interrupting is normal in younger children and matures with age, so this is observe-and-encourage, not diagnose. Note any child whose difficulty is marked, persistent across months and seen in many settings, alongside wider waiting or attention concerns, and route them to a routine developmental check.
Read the answer AnswerWhat a frontline worker should observe about joint attention
On a home visit, observe how the child shares attention with a caregiver: following a point or gaze, looking back to share enjoyment, and showing or pointing to bring others into what interests them. By around 9–14 months these emerge naturally. These are moments to observe and note, not diagnose at home; if sharing is consistently limited across several visits, route the family for a developmental check, starting with a hearing screen.
Read the answer AnswerJump Rope Coordination on a Home Visit
During a home visit, a frontline worker should observe how a child coordinates jumping, timing and turning the rope together — a skill that typically emerges around 6–7 years and develops gradually. Watch steady two-footed jumps, wrist-turning of the rope, rhythm and balance, and whether difficulty spans several motor skills. This is observation and monitoring, not diagnosis. Route persistent or widening motor gaps to a developmental check, where early playful support helps.
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