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Early Signs
Explore explanations, everyday questions and next steps connected with early signs.
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Signs & concerns
During a home visit, what should a frontline worker observe about a child learning self-care dexterity?
On a home visit, a frontline worker should observe how a child uses their hands for everyday self-care — pinching small objects, holding a spoon or cup, washing hands, undressing, and managing buttons by age. Watch grip, finger pinch, and both hands working together, and whether skills grow over months. Note stiff or floppy hands, strong early hand preference, or little progress, and refer onward. This is gentle observation to monitor — never a home diagnosis.
Read the answer AnswerObserving self-care skills during a home visit
During a home visit, a frontline worker should observe how a child manages age-appropriate self-care — eating, drinking, washing, dressing and toileting — and how much help a parent provides. Note whether the child attempts tasks, coordinates the movements, follows simple steps and improves over time. These are observations to record and discuss, not to diagnose at home. Difficulty across several areas, no progress over time, or skills well behind same-age children is the cue to route the family for a developmental check.
Read the answer AnswerObserving self-control on a home visit
During a home visit, a frontline worker should observe how a child manages waiting, impulses, frustration and recovery for their age — whether they can pause before grabbing, settle after upset (with or without help), follow a simple 'wait' or 'stop', and shift activities without extreme distress. Self-control grows gradually, so these are patterns to note and support, not to label. Intense, very frequent or prolonged difficulty calming, especially with other delays, warrants a gentle developmental screen.
Read the answer AnswerObserving self-management during a home visit
On a home visit, a frontline worker should observe how a child manages their own day for their age — daily tasks like washing, dressing, eating and toileting, following routines, calming when upset, keeping safe, and asking for help. This is observation and gentle support, not diagnosis. A skill clearly behind peers, not improving, lost, or difficulty across several areas should be routed to a general developmental check.
Read the answer AnswerWhat to observe about self-regulation during a home visit
During a home visit, a frontline worker should observe how a child manages everyday emotions and impulses for their age: settling after upset, waiting briefly, handling transitions, and using a trusted caregiver for comfort. Self-regulation (ICF b152) develops gradually and depends on responsive caregiving, so the parent–child rhythm matters as much as the child. Concerns worth a developmental check are distress that is very frequent, very intense or very hard to settle across several weeks. Nothing observed at home is a diagnosis — it simply signals whether a check would help.
Read the answer AnswerObserving Sensory Responses on a Home Visit
During a home visit, a frontline worker should observe how a child naturally responds to sound, sight, touch, taste, smell and movement — turning to a voice, making eye contact, accepting touch, noticing objects. Watch for responses that are unusually strong, weak or absent across more than one sense, and whether they persist. This is observation and routing, not diagnosis; flag any consistent pattern or family worry for a developmental and hearing/vision check at the PHC.
Read the answer AnswerSensory avoidance: what to observe on a home visit
During a home visit, a frontline worker should observe how a child responds to everyday sensations — sounds, touch, food textures, lights and movement. Note covering ears, refusing certain clothes or foods, avoiding touch, or distress in busy spaces. These are patterns to observe and gently note, not to diagnose at home. Refer for a developmental check when avoidance is frequent, strong, spans several areas, or limits eating, play and family routines.
Read the answer AnswerSensory integration: what to observe on a home visit
During a home visit, a frontline worker should observe — never diagnose — how a child responds to touch, sound, movement, textures and feeding. Watch for responses that are unusually strong, unusually absent, or that disrupt play, feeding and settling, and that persist across weeks. Rule out hearing or vision concerns first, then share observations warmly with the family and route onward for a developmental check so support can begin early.
Read the answer AnswerObserving sensory regulation during a home visit
During a home visit, a frontline worker should observe how a child responds to everyday sensations — sounds, touch, light, movement and textures — and how easily they settle after being upset. Look for a pattern of being very overwhelmed or unusually unbothered across several settings and over time, and whether routines like feeding, sleep and play are disrupted. These are observations to note and share, not to diagnose; a persistent pattern is routed to a general developmental check.
Read the answer AnswerWhat to Observe About Sensory Seeking at Home
During a home visit, a frontline worker should observe how a child seeks sensory input — spinning, jumping, crashing, touching everything, mouthing objects, or loving loud sounds — and whether this helps the child settle or disrupts feeding, sleep, safety and play. This is observing patterns to share, not diagnosing. If the seeking is intense, frequent, affects safety or daily routines, or comes with delays in speech or play, guide the family warmly to a developmental check.
Read the answer AnswerWhat to observe about sensory sensitivity on a home visit
On a home visit, a frontline worker should observe and note — not diagnose — how a child reacts to everyday sounds, lights, textures, tastes and movement. Look for distress, overwhelm or unusual non-reaction that disrupts feeding, sleep, play or family life. Record patterns that are strong, lasting and interfering, and route the family for a developmental check (with a hearing/vision screen first) when concerns persist.
Read the answer AnswerObserving sensory tolerance during a home visit
On a home visit, a frontline worker should observe how the child copes with everyday sensations — touch and texture, loud sounds, bright light, and movement. Note distress, withdrawal or craving patterns that disrupt feeding, sleep, play or family life across several weeks, and what helps the child settle. These are observations to record and route to a developmental check — never a home diagnosis.
Read the answer AnswerObserving Sentence and Phrase Complexity on a Home Visit
During a home visit, a frontline worker should observe how a child combines words into phrases and sentences during natural play — two-word combinations by around 2 years, short three- to four-word sentences by 3, and longer sentences with joining words by 4–5. These are patterns to observe and note, not to diagnose at home. A gap that persists across months or affects daily communication is best routed to a developmental and hearing check, where early support can begin without waiting for a label.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about sentence formation?
On a home visit, a frontline worker should observe how a child naturally combines words during everyday play — from single words to two-word combinations around 18–24 months, to short sentences by 2.5–3 years, and longer sentences with joining words by 3–4 years. Watch what the child does spontaneously, not on command, and check that a familiar caregiver can usually understand them. These are observations to note and discuss, never to diagnose at home. A pattern that persists or does not grow over months, or a worried family, is reason for a gentle developmental and hearing check.
Read the answer AnswerWhat to observe about a child learning sentence repetition
On a home visit, observe how a child copies back short spoken sentences — sentence length, correct word order, whether small joining words are kept, clarity, and whether sentences grow over months. Sentence repetition reflects language and listening memory. Frontline workers observe and note patterns, not diagnose; check hearing first and route any clear or lasting gap to a developmental check.
Read the answer AnswerObserving sequential memory on a home visit
On a home visit, observe how a child remembers things in order: following two- or three-step instructions, copying a clap or tap pattern, repeating a short series of words or actions, recalling steps in songs or routines, and telling what happened 'first, next, last'. These are observations to note and discuss across visits, not to diagnose at home. If a child consistently lags peers in holding a short order of steps, route the family to a general developmental check.
Read the answer AnswerShape Drawing on a Home Visit: What to Observe
During a home visit, a frontline worker should observe how the child holds the crayon, whether they copy simple shapes appropriate to age (line by ~2, circle by ~3, cross by ~4, square by ~5), whether a preferred hand is emerging, and whether the child looks at and tries to copy a model with reasonable attention. These are fine-motor and visual-motor signs to observe and encourage, not diagnose. A clear, persistent gap from peers across several visits — especially with weak hand use or low interest in copying — should be routed to a general developmental check.
Read the answer AnswerShape recognition on a home visit: what to observe
On a home visit, a frontline worker should observe how a child plays with everyday shapes — looking, matching, fitting shapes into sorters, and (in older toddlers) pointing to and naming shapes — and how this compares with same-age peers. Shape recognition is a cognitive building block that grows gradually, so the worker observes and notes, never diagnoses. A clear gap behind peers across several play tasks and visits is a reason to route the family for a developmental check.
Read the answer AnswerObserving short-term memory on a home visit
On a home visit, a frontline worker can observe a child's short-term memory through everyday actions: following one- or two-step instructions, finding a hidden toy, recalling familiar names, and remembering routines or song steps. These are things to observe and note against age expectations, not diagnose at home. Always check hearing first. A persistent pattern of struggling compared with peers, or parent worries, is the cue to route the family for a developmental check.
Read the answer AnswerObserving simple planning on a home visit
On a home visit, a frontline worker should observe whether a child can hold a small goal in mind and take a sensible first step towards it — stacking in order, fetching a stool to reach a toy, sequencing two steps, or trying another way when one fails. These are everyday signs to note and monitor against the child's age, never to diagnose at home. Persistent absence of any goal-directed step, inability to hold a two-step idea over weeks, or concerns alongside language or movement delays should be routed to a developmental check.
Read the answer AnswerObserving sitting balance on a home visit
During a home visit, a frontline worker should observe how steadily the child sits upright, whether they use hands freely to play, whether they make protective arm reactions when nudged, and whether muscle tone is balanced (not too stiff or floppy). Most babies sit with support by ~6 months and alone by ~8–9 months, so judge against a comfortable range. These are observations to note and monitor, not to diagnose — persistent gaps, markedly stiff or floppy tone, or absent protective reactions past 8–9 months should be routed promptly for a developmental check.
Read the answer AnswerWhat to observe about situational factors on a home visit
On a home visit, a frontline worker should observe how situational factors — the setting, people, routine, time of day and the child's comfort — change how a child plays, communicates and responds. A child may speak less with a stranger or struggle when tired. The goal is to notice patterns across familiar and unfamiliar situations, not judge a single moment, and always ask the caregiver if this is the child's usual behaviour.
Read the answer AnswerObserving Sleep and Restlessness During a Home Visit
On a home visit, a frontline worker should observe how a child settles to sleep, total sleep, night waking, snoring or breathing pauses, and restlessness awake and asleep — and ask the family what they notice. Most unsettled sleep is normal and improves with gentle routines. Flag persistent, distressing or worsening patterns, or any breathing concern, for a developmental check rather than diagnosing at home.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning to social?
During a home visit, a frontline worker should observe how a child connects socially: eye contact, social smiling, turn-taking, responding to name, shared attention (pointing, showing), copying gestures and joining play with others. These are observations to note and monitor, not to diagnose at home. Refer for a developmental check when limited connection is seen across several areas and is not growing month on month, or when a parent is worried — with hearing and vision screens first.
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