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Signs & concerns
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Signs & concerns
Early indicators of Social Communication Difficulties
Watch for a gap between structural language and its social use — weak joint attention, limited gesture/pointing, poor conversational turn-taking and repair, over-literal interpretation and failure to adjust language to listener. Refer when these persist across settings and aren't explained by hearing loss, global delay or autism's restricted behaviours.
Read the answer AnswerEarly Indicators of Specific Learning Disability
Refer when a child shows persistent, domain-specific difficulty with reading, writing or arithmetic markedly below age expectation despite adequate instruction and intact hearing, vision and intelligence. Diagnosis is meaningful from ~6–8 years; preschool precursors (weak phonological awareness, letter-learning difficulty, family history) warrant monitoring and early support.
Read the answer AnswerWhat early indicators of Speech and Language Delay should a paediatrician watch for?
Watch for absent babble and gesture by 9–12 months, no single words by 16 months, no two-word phrases by 24 months, and speech unintelligible by 36 months — most urgently any loss of acquired words. Refer in parallel for a hearing check; a child need not meet full ICD-11 6A01 criteria to warrant assessment.
Read the answer AnswerEarly Indicators of Stereotyped Movement Disorder
Watch for repetitive, rhythmic, self-driven movements — hand-flapping, rocking, head-banging, self-biting — beginning before age 3, persisting beyond the expected window, suppressible on distraction and rising with stress or excitement. Refer when self-injurious, functionally impairing or developmentally concerning; refer urgently if events are non-suppressible and seizure-like.
Read the answer AnswerEarly indicators of Tourette Syndrome for paediatricians
Watch for sudden, recurrent, non-rhythmic motor tics (eye-blinking, facial grimacing, head jerks) from ages 4–7, followed by vocal tics (throat-clearing, sniffing). Tics wax and wane, migrate, and are briefly suppressible. Tourette per ICD-11 needs multiple motor plus one vocal tic over a year; refer for persistence, functional impact, or to screen comorbid ADHD/OCD.
Read the answer AnswerWhat early indicators of Visual Impairment should a paediatrician watch for?
Watch for absent fixation or following, no social smile by 6–8 weeks, roving eye movements, nystagmus, squint beyond 3–4 months, poor reach, and any abnormal red reflex or loss of visual skills. Abnormal red reflex or leukocoria needs same-day ophthalmology referral; persistent concerns warrant prompt referral plus a parallel developmental review.
Read the answer AnswerEarly signs of ADHD on a home visit
ADHD is not diagnosed on a home visit or in toddlers. From age 4–5, frontline workers should note a persistent pattern of inattention, overactivity and impulsivity that is greater than same-age peers, appears across home and school, and disrupts daily life — then route to a developmental check, never label.
Read the answer AnswerEarly Signs of Attachment Difficulties on a Home Visit
During a home visit, watch how baby and caregiver respond to each other: a baby who rarely seeks or takes comfort, doesn't settle when held, or shows little joy — alongside a caregiver who is flat, harsh or rarely responsive. Look for a persistent pattern, note family stress, reassure, and route to a developmental check — never diagnose on the spot.
Read the answer AnswerEarly Signs of Auditory Processing Difficulties on a Home Visit
Watch for a child who hears the sound but misses the message — frequent "what?", inconsistent response to name, trouble following instructions in noise, and parents saying "he hears when he wants to." First step is a hearing test plus developmental check; only a clinician can confirm.
Read the answer AnswerEarly autism signs on a home visit
On a home visit, watch how the child shares attention, responds to name, communicates and plays, plus repetitive movements or distress at change. No single sign confirms autism — a persistent pattern, or any loss of skills, means guide the family to a developmental check. Trust parental concern.
Read the answer AnswerEarly signs of Cerebral Palsy on a home visit
On a home visit, refer for cerebral palsy assessment when a baby feels unusually stiff or floppy, favours one side, fists hands past 3–4 months, or misses motor milestones such as head control, rolling or sitting. Feeding difficulty and persistent parental concern matter too. These warrant prompt referral, not wait-and-see.
Read the answer AnswerWhat early signs of Childhood Anxiety should a frontline health worker look for during a home visit?
On a home visit, look for fear or worry stronger and longer-lasting than expected for age that disrupts sleep, eating, school or play — unexplained tummy aches, extreme clinging, avoidance and constant reassurance-seeking across settings. Persistent distress for several weeks warrants a gentle referral; only a clinician can confirm.
Read the answer AnswerEarly Signs of Childhood Apraxia of Speech for Frontline Health Workers
On a home visit, look for very limited babble, late and few first words, the same word said differently on each attempt, visible mouth groping, and speech far harder to understand than expected — especially when the child clearly understands language but cannot speak it. Refer to a speech-language pathologist; arrange a hearing check too. Only a clinician can confirm CAS.
Read the answer AnswerEarly signs of childhood epilepsy on a home visit
Refer promptly any child showing repeated unexplained spells — sudden stiffening or jerking, blank staring with no response, infant spasms in clusters, or sudden falls. Epilepsy is medical, not therapy-first: any single observed or clearly reported spell warrants doctor referral, and prolonged convulsions are emergencies.
Read the answer AnswerEarly signs of childhood sleep difficulties for frontline workers
On a home visit, watch for a child who struggles to fall or stay asleep, sleeps too little for age, snores or pauses breathing, or is drowsy and very irritable by day. Persistent patterns across several nights, plus an exhausted parent, are cues to refer — and any breathing pauses need prompt medical review.
Read the answer AnswerEarly Signs of Conduct-Dissocial Disorder on a Home Visit
On a home visit, watch for a persistent, cross-setting pattern over many months — repeated aggression, serious rule-breaking, destruction or dishonesty beyond age expectation — not single incidents. Note family stress kindly, refer for review when the pattern persists or risk exists, and never label the child.
Read the answer AnswerEarly Signs of DCD to Spot During a Home Visit
During a home visit, look for a child who finds everyday movement harder than peers — frequent falls, trouble with spoon, cup, buttons and stairs, and clumsiness that doesn't match effort or intelligence. These are early DCD flags worth a developmental check; only a clinician can confirm.
Read the answer AnswerEarly Signs of Developmental Language Disorder on a Home Visit
On a home visit, watch for a child whose words come late and whose understanding lags peers — few words by 18 months, no two-word phrases by 2 years, hard to understand, or trouble following simple instructions — when hearing and play seem otherwise fine. Rule out hearing loss and route for a developmental and speech check.
Read the answer AnswerEarly signs of developmental regression on a home visit
Developmental regression is the loss of skills a child once had — words, gestures, play, social warmth, walking or hand use. Any clear loss of a previously acquired skill at any age warrants prompt referral, not watch-and-wait. Frontline workers should listen to the family's account, note what was lost and when, and refer quickly — same-day if seizures, drowsiness or illness are present.
Read the answer AnswerEarly Signs of Developmental Trauma on a Home Visit
On a home visit, watch for patterns across visits: a child hard to soothe or oddly withdrawn, frozen watchfulness, disrupted sleep and feeding, stalling milestones, plus an overwhelmed or frightened caregiver. These are signals to support and refer warmly — not to label. Only a qualified clinician can assess.
Read the answer AnswerEarly Signs of Down Syndrome on a Home Visit
Down syndrome is usually recognisable soon after birth from a cluster of features — upward-slanting eyes, flat facial profile, low muscle tone (floppy baby), short neck, single palm crease and feeding difficulty. No single sign confirms it; refer promptly for paediatric review and a confirmatory chromosome test rather than labelling the child.
Read the answer AnswerEarly signs of dyscalculia on a home visit
Dyscalculia is difficulty with numbers and arithmetic well below age expectation, meaningful to flag from about 6–8 years. On a home visit watch for unreliable counting, finger-reliance for simple sums, confusing number symbols and number anxiety — in a child who is otherwise bright. Refer when difficulties persist across home and school.
Read the answer AnswerEarly signs of dysgraphia for frontline health workers
Look for a clear gap between what a child can say and what they can write — awkward pencil grip, poorly formed and uneven letters, inconsistent spelling, leaving out words, and avoiding writing while other learning seems fine. These signs matter most from about 6–8 years; note them and route for a developmental check, as only a clinician can confirm dysgraphia.
Read the answer AnswerEarly signs of dyslexia a frontline health worker should watch for
During a home visit, look for spoken-language and pre-literacy signs rather than reading itself: trouble learning rhymes, muddling word sounds, slow letter learning, and family history. Dyslexia is usually confirmed only at ages 6–8 once reading is taught, so the stance for younger children is watch, support language and route for a developmental check — never label a pre-schooler.
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