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Signs & concerns
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Signs & concerns
What to observe when a child is learning to support
During a home visit, a frontline worker should observe how a child supports their own body — head control when held, pushing up in tummy time, sitting with and without help, and bearing weight on the legs. Watch whether these are emerging steadily for the child's age, whether tone looks too stiff or too floppy, and whether both sides work equally. These are observations to record and refer, never diagnoses. A persistent gap across visits, several areas affected, or asymmetry should prompt a gentle referral.
Read the answer AnswerObserving sustained attention on a home visit
On a home visit, a frontline worker should observe how long a child stays engaged with one activity, whether they return to it after a distraction, and how this compares to peers of the same age. Attention is naturally short in young children and longer for favoured tasks, so these are points to observe and note across visits — not diagnose at home. Refer for a developmental check when very limited focus persists across settings or when the family raises concern; a hearing check is often a sensible first step.
Read the answer AnswerWhat to observe about tactile processing on a home visit
During a home visit, observe how a child responds to everyday touch — clothing textures, messy play, bathing, food and hugs. Note whether the child is over-reactive (distressed by ordinary touch), under-reactive (barely notices touch or pain), or touch-seeking (craves pressure and textures). These are observations to note and share, not to diagnose at home. Refer for a developmental screen when touch responses persist across settings and disrupt eating, dressing, sleep, play or family routines.
Read the answer AnswerObserving task initiation during a home visit
During a home visit, a frontline worker should observe how readily a child starts an offered activity — picking up a toy, responding to a simple instruction, or beginning a familiar routine without constant prompting. Task initiation (ICF d1) grows with age, so this is gentle observation and pattern-noting, never home diagnosis. Compare across people and settings, and route consistent difficulty — especially alongside other delays — to a general developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning task monitoring?
During a home visit, a frontline worker should observe how a child begins, holds the goal of, sustains and checks a simple everyday task — whether they remember instructions, stay on task, notice and fix their own mistakes, and finish without constant prompting. These are skills to observe and note over several visits, not to diagnose at home. A persistent struggle across many tasks, clearly behind same-age peers, is the cue to suggest a friendly developmental screen.
Read the answer AnswerObserving Task Participation on a Home Visit
During a home visit, a frontline worker should observe how a child engages with a simple, age-appropriate activity — whether they look at it, follow a one-step instruction, stay with it briefly, keep trying and finish a small step. These are strengths to observe and encourage, not to diagnose at home. If a child consistently cannot settle into or complete simple tasks for their age across several weeks, route the family for a gentle general developmental check.
Read the answer AnswerObserving Task Speed During a Home Visit
On a home visit, a frontline worker should observe how a child manages single everyday tasks — starting willingly, keeping going, and finishing at an age-typical pace. This is gentle observation to note and monitor, not to diagnose. Pace varies widely, so what matters is a clear, repeated pattern across several tasks and more than one visit, not one slow moment. Persistent difficulty finishing across tasks should be routed to the PHC for a developmental check.
Read the answer AnswerObserving tiptoe walking during a home visit
On a home visit, observe whether the child can put heels flat when standing and walking, whether tiptoe walking is occasional or constant, and whether calves feel stiff or tight. Occasional toe-walking is common and usually harmless in early walkers under 2–3. Flag for a developmental check if it is constant past age 3, only on one side, calves resist flattening, or other milestones are delayed. This is a watch-and-note observation, never a home diagnosis.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about turn-taking skills?
During a home visit, a frontline worker should observe whether the child shows back-and-forth interaction — responding to smiles, joining peek-a-boo or ball games, waiting briefly for a turn, and sharing attention between a toy and the caregiver. These are everyday signs to note and encourage, not to diagnose. Caregiver interaction strongly supports turn-taking. If back-and-forth is persistently absent for the child's age across visits, gently route the family to a general developmental check.
Read the answer AnswerObserving understanding on a home visit
On a home visit, observe how a child understands everyday words, names and simple requests in their home language — turning to their name, looking at named objects, following a simple instruction, and responding to gesture and tone. Understanding grows ahead of speech, so watch comprehension rather than talking. These are things to observe and note, not diagnose at home; a persisting gap, judged in the home language, is a reason to check hearing first and route the family for a developmental screen.
Read the answer AnswerObserving Verbal Communication on a Home Visit
On a home visit, a frontline worker should observe how a child uses voice and words to connect: babbling, pointing, naming, following simple instructions, responding to their name, and taking turns in 'chat'. Match what is seen to age-appropriate milestones and note gaps. These are signs to observe and monitor across visits, not to diagnose at home. A hearing check comes first, and a persisting gap is the cue to route the family for a friendly developmental screen.
Read the answer AnswerVerbal knowledge: what a frontline worker should observe on a home visit
During a home visit, a frontline worker should observe how a child understands and uses language — responding to their name, following simple requests, naming familiar people and objects, and using words to ask, point and share. These are everyday observations to note and discuss, never to diagnose at home. A persistent gap, very few words for age, or little response to speech (with a hearing check first) is reason for a developmental check and prompt, gentle support.
Read the answer AnswerObserving verbal reasoning on a home visit
During a home visit, a frontline worker should observe how a child reasons with language: following one- or two-step instructions, answering simple "why" and "how" questions, comparing or sorting things, explaining wants, and making small guesses in play. This is observing and noting in the child's home language — not testing or diagnosing. If the child persistently struggles to understand or reason with words for their age, and especially across several visits, route the family for a developmental check after ruling out hearing first.
Read the answer AnswerObserving vestibular processing during a home visit
On a home visit, observe how a child responds to movement and body position — swinging, spinning, climbing, being lifted, steps and uneven ground. Watch for strong movement-avoidance (fear, clinging, easy dizziness or car-sickness) or constant movement-craving (endless spinning, jumping, never dizzy), plus balance and posture for age. These are observations to note and share, not to diagnose at home; refer for a developmental and hearing check when the pattern is strong, frequent and disrupts daily play or walking.
Read the answer AnswerWhat to observe about a child's visual processing on a home visit
On a home visit, observe how a child uses vision in everyday play: looking at faces, following a moving toy, reaching accurately for objects, and noticing things across the room. Visual processing is how the brain makes sense of what the eyes see. These are signs to note and monitor, not to diagnose at home — and any concern should go first to a vision and hearing check at the primary health centre.
Read the answer AnswerVisual reception: what to observe on a home visit
On a home visit, observe how a child uses their eyes to take in their world: following a face or toy, looking towards movement, reaching for what they see, and recognising familiar faces, objects and pictures as they grow. These are signs to note and monitor, not to diagnose. If a child consistently does not look, track or respond for their age — across weeks or several areas — flag it for a developmental check, starting with a hearing and vision screen.
Read the answer AnswerVisual Spatial Processing on a Home Visit
On a home visit, observe how the child uses eyes and hands together to understand space: accurate looking and reaching, judging distances while moving, stacking and nesting objects, posting shapes, and finding hidden toys. These are everyday signs of growing visual spatial processing. Note patterns rather than diagnose, check for vision concerns first, and route persisting or multi-area difficulties to a general developmental check.
Read the answer AnswerObserving visuospatial skills on a home visit
On a home visit, observe how the child uses eyes and hands together to understand space, shape and position — fitting objects into containers, stacking, simple puzzles, copying shapes, and moving around the home without bumping. These are skills to watch and note over several visits, not to diagnose. Check vision and hearing first, and if a gap persists across visits or affects more than one area, route the family gently to a developmental check.
Read the answer AnswerObserving vocabulary comprehension and expression on a home visit
On a home visit, a frontline worker should observe how a child understands words (responds to their name, follows simple instructions, points to named objects) and expresses them (babbling, first words, joining words, using gestures) — counting language across all home languages. These are observations to note and discuss, not diagnose. A gap that persists across months, very little understanding for age, or loss of words is a reason to route the family kindly for a developmental check.
Read the answer AnswerObserving vocabulary knowledge on a home visit
On a home visit, a frontline worker should observe how a child understands and uses words in everyday play — recognising familiar names and objects, naming people and things, joining words by age 2, and picking up new words steadily over time. Note the home language too, and watch for steady growth and words used to connect. These are observations to note and route, not to diagnose; a hearing check comes first if words are slow.
Read the answer AnswerWhat to observe about vocalisation on a home visit
During a home visit, a frontline worker should observe how the child makes and uses sound for their age — cooing and chuckling early on, babbling with repeated sounds like "ba-ba" by 6–9 months, and first words plus pointing near a year. Note whether the baby responds to voices and takes turns making sounds. These are signs to observe and record, not diagnose, with hearing checks first and a warm route to a developmental screen for any concern.
Read the answer AnswerWhat to Observe About a Child Learning to Walk
During a home visit, observe how a child moves, not just when they walk. Watch for pulling to stand and cruising by 9–12 months, independent steps by 12–18 months, and even, symmetric leg use. Concern signs include no standing with support by 12 months, no steps by 18 months, stiffness or scissoring, one-sided weakness, or lost skills. These are signs to observe and route for a check — never to diagnose at home.
Read the answer AnswerObserving word knowledge during a home visit
During a home visit, a frontline worker should observe how the child understands and uses everyday words — responding to their name, following simple instructions, pointing, naming familiar objects, and joining words together as they grow. These are observations to note and monitor, not to diagnose. Check that hearing is fine first. If word knowledge seems clearly behind others of the same age, or the family is worried, gently route the child to the PHC medical officer or a developmental check. Early support never waits for a label.
Read the answer AnswerObserving working memory on a home visit
On a home visit, a frontline worker should observe how a child holds and uses information briefly — following age-appropriate one- or two-step instructions, finding a recently hidden toy, repeating a short rhyme or sequence, and completing familiar routines. These are signs to observe and note, not to diagnose at home. Suggest a developmental check if the child consistently cannot hold instructions expected for their age, struggles across home and play, or shows this alongside other delays.
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