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Early Signs
Explore explanations, everyday questions and next steps connected with early signs.
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Signs & concerns
What to observe about receptive language on a home visit
On a home visit, a frontline worker should observe how a child responds to language without gestures — turning to their name, quieting to a familiar voice, following simple spoken instructions, and looking at named people or objects. These are everyday signs of receptive language (understanding) growing, and understanding usually develops ahead of speech. The worker observes and notes patterns, not diagnoses; consistently not responding across visits, possible hearing concerns, or lost skills should prompt a gentle referral and a hearing check first.
Read the answer AnswerRelating to People — Home Visit Observation Guide
On a home visit, a frontline worker should observe how a child relates to people (ICF d7): eye contact, smiling back, responding to their name, sharing attention by pointing or showing, joining back-and-forth play, and playing near other children. These are signs to observe and note across the child's age — not to diagnose at home. Where several signs seem delayed or a family is worried, the worker should warmly guide them to a developmental screen at the nearest centre.
Read the answer AnswerWhat to Observe About Relationship Skills on a Home Visit
On a home visit, a frontline worker should observe how a child connects with people — eye contact, social smiling, responding to their name, sharing attention, turn-taking, playing with other children, and seeking comfort when upset. These are observations to note, not diagnose. Signs that persist, appear together, or seem behind age expectations should be gently routed to a general developmental check, where early support can begin.
Read the answer AnswerObserving Repetitive Behaviour on a Home Visit
On a home visit, a frontline worker should observe what a child repeats (movements, sounds, lining up objects), how often and when, and whether it interferes with play, eating, sleep or family life. Some repetition is normal and self-soothing. The worker's role is to watch patterns, note frequency and triggers, and route any concern onward — never to diagnose at home.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child's repetitive behaviours?
During a home visit, a frontline worker should observe how a child uses repetitive movements or routines — whether playful and flexible or so fixed that they crowd out eye contact, communication and play. Many repeated behaviours are typical in toddlers, so these are signs to note and monitor, not to diagnose at home. Frequent, rigid behaviour that is hard to interrupt and paired with limited social back-and-forth across months warrants routing the family to a developmental check.
Read the answer AnswerResponse to name on a home visit — what to observe
On a home visit, observe whether the child looks, turns or makes eye contact when their name is called gently in a quiet moment, tried a few times. Most children respond at least sometimes by 9–12 months and consistently by about 12–15 months. Always rule out a noisy room, deep absorption in play or a hearing concern first. A child who rarely or never responds, especially with limited eye contact or babbling, should be gently flagged for a developmental check — not labelled at home.
Read the answer AnswerObserving responsible decision making on a home visit
During a home visit, observe how a child makes everyday choices: whether they pause before acting, consider others' feelings, follow familiar family rules, and recognise safe from unsafe — noting what they manage with and without adult help. Responsible decision making (ICF d7) grows gradually with age, so frontline workers observe patterns rather than diagnose. A persistent gap across several areas, compared with same-age peers, is worth gently routing to a developmental check.
Read the answer AnswerWhat to observe about restlessness on a home visit
On a home visit, a frontline worker should observe how a child manages stillness, attention and settling during everyday activities — whether they can briefly stay with a meal, story or play, whether constant movement interrupts learning and connection, and whether resting or sleeping is unusually hard for their age. These are signs to note and monitor, not to diagnose. Context matters: hunger, tiredness or a small stimulating space can all increase movement. Persistent patterns across weeks and settings should be shared with the family and routed to the PHC medical officer for a developmental check.
Read the answer AnswerWhat to Observe About Restricted Interests on a Home Visit
On a home visit, a frontline worker should observe whether a child's interests are unusually narrow, intense or hard to interrupt — fixed focus on one object or topic, repetitive lining-up or sorting, distress at small changes, and a need for sameness. These are common alone; what matters is the overall pattern seen alongside how the child communicates, plays and connects. The worker observes and notes patterns — never labels — and refers persistent or interfering patterns for a gentle developmental check.
Read the answer AnswerDuring a home visit, what to observe about a child's rigid behaviours
On a home visit, a frontline worker should observe how a child copes with change — needing fixed routines, becoming very upset at small changes, repeating the same actions, struggling with transitions, and showing strong sameness in food, play or daily steps. A little routine-loving is normal; what matters is how often, how intense, and whether it limits everyday family life. These are signs to note and discuss, not to diagnose at home, and a developmental check is the right next step.
Read the answer AnswerObserving rigid routines on a home visit
During a home visit, observe how strongly a child depends on rigid routines and sameness, and how they cope when routines change. Gentle preferences are typical for toddlers; intense, frequent distress at small changes across several settings — especially alongside communication or social differences — is worth noting and referring for a developmental check. This is to observe and record, not diagnose at home.
Read the answer AnswerWhat to Observe About Risk Awareness on a Home Visit
On a home visit, a frontline worker should observe how the child notices and responds to everyday dangers — pausing near steps or edges, hesitating at hot or sharp objects, looking back at caregivers before trying something new, and reacting to sudden sounds or heights. Risk awareness grows gradually with age and other skills, so the worker is watching whether it is emerging in step, not testing a fixed standard. Note the pattern, reassure the family, and route any clear or persisting concern to a general developmental check — never diagnose at home.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning rotational control?
On a home visit, a frontline worker should observe how a child rolls and turns — rolling both ways, turning head and trunk towards voices and toys, and moving back-to-tummy and tummy-to-back. Watch for smooth, symmetrical, segmental movement with steady tone, and engagement with surroundings. These are observations to note and monitor, not to diagnose. Persistent gaps, strong one-sidedness, or tone that is too stiff or floppy should be routed to a general developmental check.
Read the answer AnswerRoutine adaptability on a home visit
On a home visit, a frontline worker should observe how a child copes with everyday changes in routine — moving between activities, a visitor arriving, or a change in caregiver. Watch whether the child can settle after a small upset, accept gentle prompts, and return to play. These are observations to note and discuss, not to diagnose. Distress that is intense, very frequent, across many situations, or that does not ease with usual comfort over weeks is worth a developmental check.
Read the answer AnswerObserving routine following during a home visit
During a home visit, a frontline worker should observe how the child anticipates and joins familiar daily routines, follows simple step-by-step sequences with prompting, responds to a caregiver's voice or gesture, and copes with small changes. Look for a pattern across visits — a persistent gap, more than one routine affected, or limited eye contact and response to name — rather than a single moment. These are signs to observe and note, not diagnose at home, and any concern is best routed to a general developmental check.
Read the answer AnswerRoutine management: what to observe at a home visit
During a home visit, a frontline worker should observe how a child manages everyday routines (ICF d5) — following familiar steps for washing, dressing, mealtimes and tidying, coping with small changes, and how much prompting they still need compared with peers. The goal is to observe and note, not to diagnose at home. A persisting or widening gap, heavy reliance on prompting, or routines affected alongside speech, play or movement should be routed to a developmental screen.
Read the answer AnswerObserving Routine Participation on a Home Visit
On a home visit, observe how the child joins in and follows everyday routines — anticipating familiar steps, following simple instructions, taking turns, and engaging with the caregiver during meals, dressing and play. Focus on participation (what the child does with and alongside others), not just isolated skills. Note rather than diagnose: refer for a developmental check if participation is consistently much lower than peers, the child rarely responds to caregivers across routines, or distress disrupts most daily activities.
Read the answer AnswerObserving a child learning to run on a home visit
During a home visit, a frontline worker should observe whether a toddler can run with growing speed and control, move both arms and legs evenly, stop and change direction without frequent falls, stay steady on uneven ground, and enjoy moving. Running emerges around 18–24 months and smooths by 3 years. These are observations to note and route — not to diagnose. Delay past the window, one-sided weakness, very stiff or floppy tone, or loss of a skill should be referred promptly for a developmental check.
Read the answer AnswerObserving running skills on a home visit
On a home visit, a frontline worker should observe how a child runs — balance, coordination of arms and legs, ability to start, stop and turn, and whether both legs are used evenly — not just whether they can run. Running usually emerges by 18–24 months and smooths by 3 years. These are observations to note and monitor, not diagnose at home; a persistent gap, clear asymmetry, loss of a skill, or stiffness should be gently flagged for a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning safety awareness?
On a home visit, observe how a child notices and responds to everyday hazards — pausing at steps, reacting to hot or sharp things, looking back to a caregiver, and following warnings like "stop" or "no". Safety awareness grows gradually with age and mobility, so you are watching for responsiveness and learning over time, not testing or labelling. Counsel every family on home safety, and route a developmental check when a clear lack of caution persists across visits or pairs with other delays.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning scissor use?
During a home visit, a frontline worker should observe how a child holds and uses scissors — thumb-up grip, steady wrist, the two hands working together (one cutting, one holding and turning paper), hand strength, and attention to the task. Snipping usually begins around 2–3 years and cutting along a line by 4–5 years, so observations are judged against age. This is a strengths-first observation to note and encourage, not a home diagnosis. If a child past 4 cannot snip, shows one-sided weakness or strong avoidance, suggest a general developmental check.
Read the answer AnswerWhat to Observe About Self-Advocacy Skills on a Home Visit
On a home visit, observe how the child expresses wants and needs, makes choices, says "no", asks for help and seeks comfort — and whether the home offers real choices and waits for the child to respond. These are everyday strengths to nurture, not signs to diagnose. Self-advocacy grows over years and varies by age, so watch the pattern and encourage small steps, suggesting a developmental check if opportunities or responses are consistently missing.
Read the answer AnswerObserving self-awareness on a home visit
On a home visit, a frontline worker should observe how a child shows awareness of being a separate person: responding to their own name, recognising themselves in a mirror (around 18–24 months), using "me", "mine" or their own name, showing clear preferences and feelings, pointing to body parts, and noticing pride or their own mess. These are everyday signs to observe and note, not diagnose. If several signs are clearly absent for the child's age, gently route the family to a general developmental check.
Read the answer AnswerObserving self-care on a home visit
On a home visit, observe how a child manages everyday self-care for their age — feeding, drinking, washing, dressing, toileting and signalling needs — and whether independence is growing over time. Watch how the child does these through natural routines, note family concerns and strengths, and route any persistent gap or delay across more than one area to a general developmental check. These are observations to track and refer early, never a diagnosis.
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