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Signs
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Signs & concerns
Spotting Possible Gross Motor Delay Early
Spot possible gross motor delay by checking large-movement milestones — head control, rolling, sitting, crawling, standing, walking — against age, and by noticing floppiness, stiffness, asymmetry or loss of a skill. A clear lag or any parental concern justifies referral for a developmental check; only a clinician confirms.
Read the answer AnswerHow a frontline health worker can spot Hearing Impairment early
A frontline worker spots possible hearing impairment by watching responses to sound and voice and the growth of speech: no startle to loud sounds, no head-turn to voice, absent or fading babble, stalled speech, repeated ear discharge, or a failed newborn screen. Caregiver concern and risk factors (NICU, meningitis, family history) always warrant referral. Refer promptly — never wait and see.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Hypotonia Early
A frontline worker can suspect hypotonia in a baby who feels floppy when held, slips through the hands when lifted, drapes over the forearm, has poor head control and late motor milestones, and feeds slowly or tires easily. These are referral signals, not a diagnosis — refer urgently if feeding or breathing is affected.
Read the answer AnswerHow a frontline health worker can spot possible Intellectual Disability early
A frontline worker spots possible intellectual disability by watching for delays across several developmental domains at once — motor, language, play and self-help — that persist over visits and lag behind same-age peers. Use a milestone checklist, take parental concern seriously, act urgently on any loss of skills, and refer for a developmental check rather than waiting. A formal label only follows a clinician's structured assessment.
Read the answer AnswerHow a Frontline Health Worker Can Spot Motor Planning Difficulties Early
Suspect motor planning difficulties when a child knows what they want to do but struggles to organise and sequence the steps — fumbling new or multi-step movements, slow to learn self-care like buttons and spoons, and showing this pattern across settings despite practice. Rule out vision, hearing and age-fit first; persistent signs plus parental concern warrant referral for a structured developmental check.
Read the answer AnswerHow can a frontline health worker spot a possible non-verbal presentation early?
A non-verbal or minimally verbal child uses few or no spoken words for their age — the key early signal is how they communicate instead, through gesture, pointing or gaze. Look for no babble by 12 months, no words by 16–18 months, no two-word phrases by 24 months, and always rule out hearing loss first. Refer for developmental and hearing assessment without waiting.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible ODD Early
Suspect possible ODD when a child shows a persistent (≥6 months) pattern of angry/irritable mood, argumentative and defiant behaviour, and vindictiveness that is beyond age-expected, occurs across home and school, and disrupts daily life. Rule out hearing, anxiety, ADHD, language difficulty and safeguarding concerns first, then refer for structured assessment — never label.
Read the answer AnswerSpotting Persistent Toe-Walking Early
Watch the child walk barefoot: persistent toe-walking is heels rarely touching the floor beyond age 2–3. Most is benign, but refer promptly if it is one-sided, comes with tight or worsening calves, regression, or any developmental delay — only a clinician can confirm the cause.
Read the answer AnswerSpotting Prematurity-Related Developmental Risk Early
Screen preterm children using corrected age (subtract weeks born early up to 24 months) at every contact. Refer when motor, communication, feeding or social milestones lag corrected-age expectations, when tone is unusually stiff or floppy, on any asymmetry or regression, or whenever a parent is worried — alongside hearing and vision checks.
Read the answer AnswerSpotting Possible Rett Syndrome Early
Rett Syndrome shows as a period of normal early development followed by a slowing and loss of acquired skills — especially purposeful hand use — with repetitive hand-wringing movements, slowing head growth and loss of social engagement, often between 6 and 18 months. Frontline workers should recognise any regression and refer promptly; diagnosis is clinical and genetic.
Read the answer AnswerSpotting a possible School Readiness Gap early
A School Readiness Gap is when a child near school-entry age (5–6) has not yet built the language, attention, fine-motor, self-care and social-emotional foundations classrooms assume. Frontline workers can spot it by checking a short cluster of everyday skills during routine contacts and referring any child who lags across two or more areas, or shows regression or hearing concern, for a developmental check.
Read the answer AnswerHow a frontline health worker can spot possible Selective Mutism early
Selective Mutism shows as consistent, situation-specific silence — a child who speaks freely at home but cannot speak at school or clinic for over a month, not explained by an unfamiliar language or hearing loss. It is anxiety-based, not defiance, and is treatable; early, pressure-free referral gives the best outcomes.
Read the answer AnswerSpotting Self-Regulation Difficulties Early
A frontline worker can spot possible self-regulation difficulties when a child shows persistent, intense trouble settling emotions, sleep, feeding or attention — out of proportion to age and present across settings. Rule out hunger, illness, pain and hearing first; refer for a developmental check when patterns persist for weeks and disrupt daily life. These are observations to refer, never a diagnosis.
Read the answer AnswerHow can a frontline health worker spot Sensory-Based Feeding Selectivity early?
Spot possible Sensory-Based Feeding Selectivity when a child's accepted foods are few and shrinking, when textures, smells or colours trigger strong distress, and when mealtimes are a daily battle affecting growth or family life. Refer promptly for any unsafe-swallowing signs or weight faltering; only a clinician can confirm.
Read the answer AnswerSpotting Sensory Processing Differences early
Frontline workers can spot possible Sensory Processing Differences when a child consistently over-reacts (distress at sounds, textures, touch), under-reacts (slow to feel pain, name, heat) or seeks intense input (constant movement, crashing) to a degree that disrupts feeding, dressing, play or settling across settings. Rule out hearing and vision first, weigh real-life impact, and refer for a developmental check rather than waiting.
Read the answer AnswerSpotting Separation Anxiety Disorder Early
Suspect possible Separation Anxiety Disorder when a child's fear of being apart from a caregiver is far stronger and longer-lasting than expected for age — persisting weeks and disrupting school, sleep or daily life. Frontline workers spot the pattern and refer; only a clinician diagnoses.
Read the answer AnswerSpotting Social Communication Difficulties Early
A frontline worker can spot possible social communication difficulties when a child shows little back-and-forth — limited eye contact, few gestures, weak response to name, delayed or odd language — across more than one setting. Two or more persistent signs, or any regression or parental concern, warrant a hearing check and developmental referral. This is screening for concern, never diagnosis.
Read the answer AnswerHow a frontline health worker can spot possible SLD early
Suspect SLD when a school-age child (typically 6+ years) shows persistent, specific, unexpected difficulty with reading, writing or number work — well below age level despite adequate teaching, normal hearing and vision, and no global delay. Frontline workers spot the pattern and refer; only a clinician confirms.
Read the answer AnswerSpotting Speech and Language Delay early
Spot a possible speech and language delay by tracking communication milestones — babbling and gesture by 12 months, single words by 16 months, two-word phrases by 24 months — and by trusting parental concern. Always check hearing first and refer rather than wait when signs persist.
Read the answer AnswerSpotting Stereotyped Movement Disorder early
Suspect Stereotyped Movement Disorder when a child shows repetitive, rhythmic, purposeless movements — hand-flapping, rocking, head-banging, self-biting — that persist past toddlerhood, look the same each time, and interfere with daily life or cause self-injury. Act most urgently on any self-injury, and always rule out seizures with prompt medical referral. A child need not have a diagnosis to be referred for a developmental check.
Read the answer AnswerSpotting Possible Tourette Syndrome Early
Suspect possible Tourette Syndrome when a child (first noticed around ages 4-8) shows repeated involuntary movements plus at least one vocal tic, present on and off for several months, that wax and wane and worsen with stress. Rule out vision problems and seizure mimics, reassure the family, and refer for paediatric or developmental assessment.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Visual Impairment Early
Frontline workers can spot possible visual impairment by checking whether a baby fixes on and follows a face or light, whether the eyes look and align normally, and whether reaching and play match age. Refer urgently for a white or cloudy pupil, persistent squint, eyes not steady by 3 months, or any sudden loss of vision — a medical pathway, not therapy-first.
Read the answer AnswerWhat adaptive difficulties might a teacher notice in a young child?
Teachers may notice a young child needing far more help than peers with dressing, eating, toileting, following multi-step routines and coping with change. Persistent patterns across the day — not one-off difficulties — are worth sharing with the family and a developmental check. Teachers observe; only a clinician assesses.
Read the answer AnswerWhat adaptive warning signs should an ASHA worker act on?
Act when a child's everyday self-care — feeding, dressing, toileting, washing — lags clearly behind age expectations or when a gained skill is lost. Persistent adaptive delay, especially with delay in another domain or any regression, warrants a developmental check. ASHA workers refer, not diagnose.
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