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Signs & concerns
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Signs & concerns
Auditory processing on a home visit: what to observe
On a home visit, a frontline worker should observe how a child responds to and understands sound — turning to their name, following simple spoken instructions, reacting to everyday noises, and coping in a noisy room. These are signs to observe and note, never diagnose at home, and a hearing check always comes first to rule out true hearing loss. A consistent pattern across several areas, or understanding clearly behind age, warrants a hearing screen and a general developmental check; formal auditory-processing assessment is meaningful only from around school age.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning to balance?
On a home visit, a frontline worker should observe a child's balance against age — steady sitting without propping by about 8–9 months, pulling to stand and standing alone near 12 months, and independent walking by 15–18 months. Watch for frequent unexplained falls, a wide or staggering gait, marked stiffness or floppiness, and reliance on one side. This is to observe and monitor, not diagnose. Flag a clear lag across several visits, balance that is regressing, or tone concerns for a developmental check, with hearing and vision checked first.
Read the answer AnswerBehavioural observation during a home visit
During a home visit, a frontline worker should observe how a child behaves naturally — responses to their name and to people, attention and engagement in play, social smiling and eye contact, comfort-seeking, and self-regulation. Look for patterns seen more than once or behaviour clearly out of step with same-age children. Behavioural observation screens and flags concerns early — it never diagnoses. Refer to the PHC medical officer or a developmental check if several areas seem off or a parent is worried.
Read the answer AnswerWhat to Observe About Cause-and-Effect on a Home Visit
During a home visit, observe how the child links an action to a result — pressing buttons, banging, shaking or dropping toys, and repeating actions on purpose to make something happen. By 6–12 months babies repeat actions intentionally; by 9–18 months they explore with purpose and watch for results, including social games like peek-a-boo. Note kindly, encourage play, and route to a developmental check if several signs persist — never diagnose in the home.
Read the answer AnswerHome visit: what to observe about a child's characteristics
During a home visit, a frontline worker should observe how the child moves, communicates, plays, eats and interacts — judged against age expectations. Watch head control, posture and muscle tone, response to voices and faces, babbling and first words, eye contact, social smiling, play interest, and caregiver–child connection. These are signs to observe and note, never to diagnose at home. A pattern that persists, widens, or affects more than one area should be referred promptly for a developmental check, with hearing and vision screened first.
Read the answer AnswerObserving climbing on a home visit
On a home visit, observe how a child attempts to climb low furniture or steps — looking at leg and arm strength, balance, both sides working together, safety awareness and confidence to try. Climbing is normal gross-motor play (ICF d4). Note, don't diagnose: flag anything that persists over months, affects one side only, or shows clearly stiff or floppy tone, and route the family for a developmental check.
Read the answer AnswerWhat to observe about a child's cognitive learning on a home visit
During a home visit, a frontline worker should observe how a child notices, explores, remembers and problem-solves — looking for a hidden toy, copying simple actions, recognising familiar people and routines, following a simple instruction, and playing in an age-appropriate way. These are everyday cognitive signs to observe and note, not to diagnose. A persistent gap across visits, several areas affected, or loss of a skill is reason to gently encourage a developmental check, with hearing and vision reviewed first.
Read the answer AnswerObserving cognitive flexibility on a home visit
During a home visit, a frontline worker should observe how a child shifts between activities, copes with small changes to routine or rules, and tries a new approach when the first fails. A child building cognitive flexibility switches tasks without intense lasting distress, sorts items more than one way, and accepts a changed plan in play. Rigidity is normal in young children, so these are observations to note and monitor — not to diagnose at home. A strong, frequent pattern of distress at change across many settings is worth routing to a general developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning cohesion?
On a home visit, observe how the child links ideas in talk — using connecting words like "and", "then", "because", staying on a topic across a few turns, retelling a simple event in order, and using "he"/"she"/"it" clearly. These are observe-and-note signs, not a home diagnosis. A child who consistently cannot link ideas well past age 4 should be routed for a gentle developmental and speech check, with hearing checked first.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning to communicate?
During a home visit, a frontline worker should observe how the child listens and responds to voices and their name, makes sounds, babbles or uses words for their age, and connects through eye contact, gestures and shared attention with a caregiver. These are signs to observe and note, not diagnose. A persistent pattern of limited communication, or any loss of skills, should be routed for a developmental and hearing check — early support never waits for a label.
Read the answer AnswerWhat to Observe About Communication Pragmatics on a Home Visit
On a home visit, a frontline worker should observe how a child uses communication socially — eye contact, joint attention, turn-taking, gesturing, pointing to share, and responding to their name — rather than only counting words. These are observations to note and monitor, not to diagnose at home. If several social-communication patterns seem limited for the child's age, route the family to a general developmental check, often starting with a hearing screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about concept formation?
On a home visit, observe how a child sorts, matches and understands simple ideas — big/small, same/different, colours, shapes, more/less, and grouping things that belong together (ICF d1, concept formation). These emerge through everyday play. The frontline worker observes and notes patterns worth a closer look, never diagnoses, and routes families with persisting gaps across several areas to a friendly developmental check.
Read the answer AnswerConceptual Thinking on a Home Visit: What to Observe
On a home visit, a frontline worker should observe how a child sorts and matches objects, grasps size and quantity (big/small, more/less), follows simple cause-and-effect, pretends in play, and talks about things not present. These are observations to note and monitor, never a home diagnosis. A persistent gap across several areas compared with same-age peers, or no change over months, should be gently routed to a developmental check at the PHC or a Pinnacle centre.
Read the answer AnswerWhat to Observe About a Child Learning to Manage Conflict
During a home visit, a frontline worker should observe how a child handles everyday disagreements — over toys, turns or rules — with family or other children. Watch whether the child expresses upset with words or gestures rather than only hitting, can wait, share and take turns with gentle support, and can recover and reconnect after a squabble. These social skills grow with age and coaching, so observations are a picture to support, not a home diagnosis. Persistent, intense or always-physical conflict over months warrants a friendly developmental check.
Read the answer AnswerObserving contextual language use during a home visit
During a home visit, a frontline worker should observe how the child uses language to fit the situation — requesting, greeting, naming, commenting, taking turns and adjusting to who is present — and whether this grows across visits in the home language. These are observations to note and route onward, not a home diagnosis. Hearing is checked first. If communication is weak across several areas or not growing, encourage a developmental screen.
Read the answer AnswerConversation skills on a home visit: what a frontline worker should observe
On a home visit, a frontline worker should observe how a child takes turns, responds to their name, makes eye contact, gestures, shares attention and replies to simple talk — the back-and-forth of conversation, watched in everyday play. These are signs to note and route onward, not to diagnose at home. A consistent lack of turn-taking or shared attention for the child's age warrants a developmental screen, with hearing checked first.
Read the answer AnswerObserving conversational skills during a home visit
On a home visit, a frontline worker should observe how a child starts and responds in back-and-forth talk, takes turns, stays on topic with a familiar person, and uses eye contact, gestures and words together. These are everyday things to watch and note — not to diagnose. Check that hearing has been screened. Where a pattern persists, widens or affects several areas, reassure the family and route them to a general developmental check.
Read the answer AnswerWhat to Observe About Cooperative Play on a Home Visit
During a home visit, a frontline worker should observe whether a child plays with other children toward a shared goal — sharing, taking turns, following simple rules and resolving small conflicts with words — rather than only playing alone or alongside others. Cooperative play typically emerges around 4–5 years, building on earlier parallel play. Persistent lack of interest in other children, or inability to share or take turns across settings (especially with speech delays), is worth flagging for a developmental check. These are observations to note and discuss, never to diagnose at home.
Read the answer AnswerWhat to Observe About Coordination on a Home Visit
On a home visit, a frontline worker should observe how a child combines hands and body for everyday play — reaching, grasping, passing toys between hands, stacking, scribbling, sitting, walking, climbing and kicking. The aim is to notice, not diagnose: flag anything clearly behind for age, very one-sided, or unusually stiff, floppy or clumsy across visits, and route the family to a developmental check. Compare against milestone guidance, never against other children.
Read the answer AnswerWhat to Observe About Counting Ability on a Home Visit
During a home visit, a frontline worker should observe whether a child counts with meaning — saying number words in order, touching each object once while counting, and knowing the last number answers "how many?". Watch how counting appears in daily play and routines like sharing food or counting fingers. These are observations to note and monitor, not to diagnose at home; a gap that persists across several visits, or counting that stays a chant with no link to objects, is worth a gentle developmental check.
Read the answer AnswerObserving counting skills during a home visit
During a home visit, a frontline worker should observe how a child uses counting in everyday play: reciting number words in order, touching each object once as they count, knowing the last number means "how many", recognising and comparing small groups, and counting spontaneously during routines. These skills grow with age and home support, so the worker observes and encourages rather than tests. Record concerns and route to a developmental check if a child shows little number sense alongside wider delays.
Read the answer AnswerCraft participation: what a frontline worker should observe at home
On a home visit, a frontline worker should observe how willingly and fully a child joins a craft activity — engaging with materials, sharing attention, taking turns, following simple steps and showing pleasure — rather than judging the finished product. This maps to ICF domain d7 (participation). It is an observation across several visits, not a one-off test or a diagnosis; a consistently limited pattern compared with same-age peers warrants a developmental screen.
Read the answer AnswerObserving daily living skills on a home visit
On a home visit, observe how a child manages age-appropriate self-care — eating, drinking, dressing, washing, toileting and small chores (ICF d5) — and how much help the parent gives. Note what the child does alone, with help, and cannot yet attempt. The aim is to observe and record, not diagnose. A clear gap from peers across several areas, or one not closing over months, signals a referral for a gentle developmental check.
Read the answer AnswerWhat to observe about a child's dressing skills on a home visit
On a home visit, a frontline worker should observe how a child manages dressing for their age — pulling clothes on and off, finding armholes, simple fastenings — alongside hand control, balance while dressing, and whether they follow simple instructions. These are points to note and monitor, not diagnose. If a child is clearly behind peers across several self-care areas or has slipped back, gently suggest a developmental screen, since early support never waits for a label.
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