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Behaviour Therapy
Explore explanations, everyday questions and next steps connected with behaviour therapy.
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Signs & concerns
Observing 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 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 AnswerWhat to observe about a child's listening skills on a home visit
During a home visit, a frontline worker should observe how a child responds to sound and voice — turning to their name, quietening at a familiar voice, following a simple spoken request, and staying engaged in short back-and-forth exchanges. These are signs of developing listening skills (ICF b152) to observe and note, not diagnose. A consistent lack of response, especially to sound itself, should be flagged for a hearing screen first and a general developmental check.
Read the answer AnswerObserving mood regulation on a home visit
On a home visit, a frontline worker should observe how a child shows and settles feelings — whether they can be comforted by a caregiver, recover from upset within a reasonable time, look to caregivers for reassurance, and show a range of moods. The focus is the pattern across the visit, not one tantrum. Persistent, intense distress seen across situations is worth noting. These are observations to share and route — never a home diagnosis.
Read the answer AnswerWhat to observe about a child's need for sameness
During a home visit, a frontline worker should observe how a child responds to changes in routine, objects or surroundings — noting comfort in repetition and distress when things shift. A little need for sameness is normal in young children, so the worker observes intensity, how long distress lasts and whether it disrupts daily life, watching alongside communication and play. This is monitoring, not diagnosis; persistent, intense distress around change warrants a gentle referral for a developmental screen.
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 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 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 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-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 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 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 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.
Read the answer AnswerWhat a frontline worker should observe about social adaptation on a home visit
During a home visit, a frontline worker should observe how a child responds to people, joins family routines, copies others, plays with siblings, and manages everyday changes. Social adaptation (ICF d7) grows through play and family life, so these are patterns to note over time, not a diagnosis. Weigh observations against the child's age, home language and comfort with a stranger, and route any persisting concern to a developmental check.
Read the answer AnswerDuring a home visit, what to observe about a child's social engagement
During a home visit, a frontline worker should observe how a child connects socially (ICF d7): eye contact, shared smiles, turn-taking, response to their name, pointing or showing to share attention, and interest in people. These are everyday signs to observe and note, not to diagnose at home. A consistent pattern of limited connection across several areas — judged against the child's age — is a reason to route the family for a structured developmental screen, framed warmly and strengths-first.
Read the answer AnswerObserving social function during a home visit
During a home visit, a frontline worker should observe how a child connects socially in their natural setting: eye contact, returning a smile, responding to their name, sharing interest by pointing or showing, taking turns in simple play, and seeking a familiar adult for comfort. These are everyday signs of social function (ICF d7) to observe and note against the child's age — not to diagnose at home. A persistent pattern of limited social response should be recorded and routed for a general developmental check, with hearing and vision considered.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning social interaction?
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 (following a point, pointing to show), turn-taking in play, and showing feelings to a familiar adult. These are observations to note and monitor, not to diagnose at home. If several signs are limited for the child's age, or a parent is worried, reassure in strengths-first language and route the family to a developmental check at the PHC or a developmental centre.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning social language?
On a home visit, a frontline worker should observe how a child connects — eye contact, responding to their name, shared smiles, turn-taking in babble, pointing to show interest, waving and enjoying social games. This is gentle observation and reassurance, not diagnosis. If a child shows little connecting behaviour for their age, or a caregiver is worried, the family is warmly routed to a developmental screen for a closer look.
Read the answer AnswerWhat to Observe About Social Reciprocity on a Home Visit
On a home visit, a frontline worker should observe the child's two-way connection: shared looking and joint attention, returning a smile or copying an action, responding to their name, pointing or showing objects, and taking turns in babble or simple games. Social reciprocity is the back-and-forth flow between child and caregiver. These are observations to note and route, not to diagnose — concerns seen consistently across visits should be sent for a developmental check.
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