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Signs & concerns
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Signs & concerns
Observing early words during a home visit
During a home visit, a frontline worker should observe how a child uses sounds, words and gestures to connect: babbling, a few meaningful words by 12–15 months, pointing and waving, turning to their name, and back-and-forth exchanges with a caregiver. Flag gently if there is no babbling by 12 months, no words by 16–18 months, no gestures, or loss of skills — and route the family to a developmental check. These are observations to note, never diagnoses made at home.
Read the answer AnswerEmotional development on a home visit: what to observe
During a home visit, a frontline worker should observe how a child connects with familiar caregivers, the range and fit of their emotions, and how they settle when upset. Watch whether the child smiles back, seeks comfort, recovers after distress, and shows feelings that match the situation. These are observations to note and share with the family, not a home diagnosis. A pattern that persists across visits or worries the caregiver is reason to suggest a friendly developmental check.
Read the answer AnswerObserving Emotional Inference During a Home Visit
On a home visit, a frontline worker should observe whether a child notices and responds to others' feelings — looking at faces, reacting to a parent's tone, comforting someone upset, sharing attention, and naming simple emotions in play. A consistent lack of interest in faces or feelings across several visits, very little shared attention, or a gap alongside language and play delays is worth a closer developmental check. This is observation to share with the family and PHC team, not a diagnosis.
Read the answer AnswerObserving Emotional Understanding on a Home Visit
On a home visit, a frontline worker should observe how a child reads and responds to feelings: noticing a caregiver's smile or frown, looking to a trusted face when unsure, showing concern for others, expressing and naming their own feelings, and seeking comfort when upset. These are everyday observations to note and discuss with the family, not to diagnose at home. A persistent pattern across several visits — little response to others' feelings or hard-to-settle distress — is worth routing to a general developmental check.
Read the answer AnswerObserving empathy in a child during a home visit
During a home visit, a frontline worker should observe how a child responds to others' feelings — looking towards someone upset, checking a parent's face, offering comfort, sharing, copying smiles, and taking simple turns in play. Empathy (ICF d7) is a slowly-developing social skill, so the worker notes the overall pattern across natural play rather than testing or labelling. These are observations to share with the family and PHC and to route to a developmental check if several signs are consistently missing for the child's age.
Read the answer AnswerEmpathy development on a home visit
On a home visit, a frontline worker should observe how a child notices and responds to others' feelings — looking towards someone upset, offering comfort, sharing, taking turns, and showing warmth in play. Empathy grows gradually, so the aim is to observe and encourage, not to test or diagnose. Route the family to a general developmental check only if a child consistently shows little interest in or response to others across several months, especially alongside other delays.
Read the answer AnswerEvent description on a home visit: what to observe
On a home visit, a frontline worker should observe whether the child can describe a simple recent event in their own words — what happened, who was involved and roughly in what order — using short sentences that join ideas, with a growing vocabulary and clear-enough speech. Watch for staying on topic and answering simple what/who/where questions. These are everyday observations to note and monitor, not to diagnose; check hearing first, and route persistent or multi-area concerns to a developmental screen.
Read the answer AnswerObserving Executive Functioning on a Home Visit
On a home visit, a frontline worker should observe how a child holds a simple plan, follows two-step instructions, waits a turn, remembers a step and copes when something goes wrong — the everyday roots of executive functioning. This is observation and gentle noting, never diagnosis. What matters is a pattern seen across visits and across more than one situation; persistent or clearly age-inappropriate difficulty should be routed for a developmental check at the PHC or a Pinnacle centre.
Read the answer AnswerObserving Eye Contact During a Home Visit
During a home visit, a frontline worker should observe whether the child looks towards faces and voices, briefly meets a familiar adult's eyes during play or feeding, shares glances to enjoy a moment, and follows where a parent looks or points. These are everyday social-connection signs (ICF d7) to watch gently across visits — never to diagnose at home. A shy child on one day is not a concern; it is the pattern that matters. If eye contact stays consistently very limited for the child's age, route the family to a friendly developmental check.
Read the answer AnswerWhat to observe about a child learning family values
On a home visit, a frontline worker should observe how a child learns family values through everyday interactions — showing affection, looking to caregivers for comfort, beginning to share and help, imitating household routines, and responding warmly to family. These are social-emotional skills that grow with age, so the aim is to observe and encourage, not test. A connected, engaged child is developing well; persistent lack of eye contact or response to name by 18–24 months is worth a friendly developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning fine motor?
During a home visit, a frontline worker should observe how a child uses hands and fingers — reaching, grasping, pincer grip, transferring objects, using both hands together, and managing tools like spoons or crayons. Note whether grasp matches age, whether both hands cooperate, and whether any hand is fisted, stiff, floppy or barely used. These are observations to note and monitor, not to diagnose; persistent concerns should be routed for a developmental check.
Read the answer AnswerDuring a home visit, what to observe about a child learning fluid reasoning
On a home visit, a frontline worker should observe how a child solves new, unfamiliar little problems in play — sorting and matching, copying or continuing patterns, working out cause-and-effect, trying a different approach when one fails, and following new instructions or answering simple 'why' questions. These show fluid reasoning, the ability to think on the spot. The worker observes and notes, never diagnoses, and gently suggests a developmental screen if concerns repeat or parents are worried.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about following directions?
On a home visit, observe how a child responds to everyday spoken requests — turning to their name, looking where you point, fetching a familiar object, or doing a simple action like 'give me'. Watch whether understanding grows with age and whether words and gestures are understood together. These are observations to note and monitor, not to diagnose at home; a hearing check comes first, and a persisting gap is a reason to suggest a friendly developmental screen.
Read the answer AnswerWhat to observe about a child learning foot control on a home visit
On a home visit, a frontline worker should observe how a child uses their feet in everyday movement — standing flat with even weight on both feet, smooth alternating steps, kicking a ball, stepping over low objects, and beginning to balance on one foot with age. These are everyday skills to observe and note, not to diagnose. Watch for clear asymmetry, persistent toe-walking, loss of a skill, or being well behind peers across areas — and route the family to a developmental check when a concern persists or widens.
Read the answer AnswerFriendship seeking: what to observe on a home visit
On a home visit, a frontline worker should observe how a child notices, approaches and engages other children and familiar people — looking towards them, moving closer, offering or sharing a toy, exchanging smiles and simple turn-taking. Friendship seeking (ICF d7) develops gradually, so observations are judged against age and framed by strengths. Persistent low interest in others, little shared attention, or solitary play across several months is worth a gentle referral for a general developmental check — never a home diagnosis.
Read the answer AnswerObserving Friendship Skills on a Home Visit
On a home visit, a frontline worker should observe how a child connects with others — interest in peers, eye contact, taking turns, sharing, responding to others' feelings, and seeking company. Friendship skills (ICF d7) develop gradually, so note patterns over visits rather than judging one moment. Where a child shows little interest in other children, cannot share or take turns far beyond peers, or is distressed by most social situations, flag it for a general developmental check — observe and monitor, never diagnose at home.
Read the answer AnswerObserving Game Rule Understanding on a Home Visit
During a home visit, a frontline worker should observe how a child takes turns, waits, follows a simple game instruction, remembers the rule across rounds, and handles winning or losing in a familiar game. These are everyday signs of growing attention, memory and social understanding — to observe and note, never to diagnose at home. Suggest a friendly developmental check only when several signs are consistently behind same-age children.
Read the answer AnswerObserving general knowledge on a home visit
On a home visit, a frontline worker should observe how a child shows general knowledge for their age — recognising familiar people, objects and routines, pointing to or naming everyday things, following simple instructions, showing curiosity and meaningful play. These are observations to note and monitor, not to diagnose. A persistent gap across several areas, judged against the family's language and daily life, is the cue to reassure the family and route them to a PHC medical officer or developmental check, with hearing and vision screens first.
Read the answer AnswerObserving Gross Motor on a Home Visit
On a home visit, a frontline worker should observe a child's gross motor skills (ICF d4) by age: head control, rolling, sitting, crawling, standing and walking, plus the quality and symmetry of movement and muscle tone. Watch for persistent stiff or floppy tone, milestone gaps, one-sided preference before 12 months, or loss of a skill. These are signs to observe and refer — never to diagnose at home — routing the child for a developmental check.
Read the answer AnswerObserving Group Participation on a Home Visit
During a home visit, a frontline worker should observe how a child notices and connects with others, joins in play and routines, takes turns and shares, and copes within a group. The focus is on warm back-and-forth and the pattern over time — a child who consistently stays apart, rarely notices others, or is overwhelmed by every group moment across months is worth a gentle developmental check. These are observations to note and route, never to diagnose at home.
Read the answer AnswerObserving group play on a home visit
During a home visit, a frontline worker should observe how a child plays with other children rather than just beside them — interest in others, sharing, turn-taking, joining shared games and following simple group rules. Younger children playing alone or side-by-side is normal; cooperative group play grows gradually. These are developing skills to observe and monitor, not to diagnose at home. Refer for a general developmental check when a child shows little interest in others or marked difficulty joining in, especially alongside speech or behaviour concerns.
Read the answer AnswerObserving gymnastic skill development on a home visit
On a home visit, a frontline worker should observe the motor foundations beneath gymnastic skills (ICF d4): balance and posture, two-sided coordination, motor planning, core strength, body awareness and willingness to move. These are observations to note and monitor — not a diagnosis. A gap that persists across months, affects more than one area, or is clearly harder than for peers should be routed to a general developmental check at a Pinnacle Blooms Network centre.
Read the answer AnswerObserving Head Control During a Home Visit
During a home visit, a frontline worker should observe how steadily a baby holds and balances the head when on the tummy, when pulled to sit, and when held upright. By around 3-4 months the head should stay steady upright, and by 5-6 months it is well-controlled. Persistent floppiness, head that lags far past these ages, constant tilting to one side, or very stiff or very floppy tone should be noted and routed to a developmental screen - never diagnosed at home.
Read the answer AnswerDuring a Home Visit, What to Observe About Hyperactivity in a Child
On a home visit, a frontline worker should observe and note — never diagnose — how a child manages attention, restlessness and settling for their age. Watch whether the child can sit briefly for play or a meal, follow simple requests, and settle to sleep, and whether restlessness is far beyond same-age peers across several settings. High activity is normal in young children; concern arises only with a strong, persistent, multi-setting pattern that disrupts daily life. Note it, reassure the family, and route any worry to a general developmental check.
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