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Signs & concerns
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Signs & concerns
Sensory integration: what to observe on a home visit
During a home visit, a frontline worker should observe — never diagnose — how a child responds to touch, sound, movement, textures and feeding. Watch for responses that are unusually strong, unusually absent, or that disrupt play, feeding and settling, and that persist across weeks. Rule out hearing or vision concerns first, then share observations warmly with the family and route onward for a developmental check so support can begin early.
Read the answer AnswerObserving sensory regulation during a home visit
During a home visit, a frontline worker should observe how a child responds to everyday sensations — sounds, touch, light, movement and textures — and how easily they settle after being upset. Look for a pattern of being very overwhelmed or unusually unbothered across several settings and over time, and whether routines like feeding, sleep and play are disrupted. These are observations to note and share, not to diagnose; a persistent pattern is routed to a general developmental check.
Read the answer AnswerObserving Sentence and Phrase Complexity on a Home Visit
During a home visit, a frontline worker should observe how a child combines words into phrases and sentences during natural play — two-word combinations by around 2 years, short three- to four-word sentences by 3, and longer sentences with joining words by 4–5. These are patterns to observe and note, not to diagnose at home. A gap that persists across months or affects daily communication is best routed to a developmental and hearing check, where early support can begin without waiting for a label.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about sentence formation?
On a home visit, a frontline worker should observe how a child naturally combines words during everyday play — from single words to two-word combinations around 18–24 months, to short sentences by 2.5–3 years, and longer sentences with joining words by 3–4 years. Watch what the child does spontaneously, not on command, and check that a familiar caregiver can usually understand them. These are observations to note and discuss, never to diagnose at home. A pattern that persists or does not grow over months, or a worried family, is reason for a gentle developmental and hearing check.
Read the answer AnswerObserving simple planning on a home visit
On a home visit, a frontline worker should observe whether a child can hold a small goal in mind and take a sensible first step towards it — stacking in order, fetching a stool to reach a toy, sequencing two steps, or trying another way when one fails. These are everyday signs to note and monitor against the child's age, never to diagnose at home. Persistent absence of any goal-directed step, inability to hold a two-step idea over weeks, or concerns alongside language or movement delays should be routed to a developmental check.
Read the answer AnswerObserving sitting balance on a home visit
During a home visit, a frontline worker should observe how steadily the child sits upright, whether they use hands freely to play, whether they make protective arm reactions when nudged, and whether muscle tone is balanced (not too stiff or floppy). Most babies sit with support by ~6 months and alone by ~8–9 months, so judge against a comfortable range. These are observations to note and monitor, not to diagnose — persistent gaps, markedly stiff or floppy tone, or absent protective reactions past 8–9 months should be routed promptly for a developmental check.
Read the answer AnswerWhat to observe about situational factors on a home visit
On a home visit, a frontline worker should observe how situational factors — the setting, people, routine, time of day and the child's comfort — change how a child plays, communicates and responds. A child may speak less with a stranger or struggle when tired. The goal is to notice patterns across familiar and unfamiliar situations, not judge a single moment, and always ask the caregiver if this is the child's usual behaviour.
Read the answer AnswerObserving Sleep and Restlessness During a Home Visit
On a home visit, a frontline worker should observe how a child settles to sleep, total sleep, night waking, snoring or breathing pauses, and restlessness awake and asleep — and ask the family what they notice. Most unsettled sleep is normal and improves with gentle routines. Flag persistent, distressing or worsening patterns, or any breathing concern, for a developmental check rather than diagnosing at home.
Read the answer AnswerWhat a frontline worker should observe about social-emotional development on a home visit
During a home visit, a frontline worker should observe how a child connects emotionally — social smiling, eye contact, responding to their name, seeking comfort, and pointing or showing to share interest with a familiar caregiver. These are signs to note and monitor, not to diagnose. A pattern of several missing or fading social-emotional signals for the child's age warrants a friendly developmental check rather than alarm.
Read the answer AnswerObserving social-emotional understanding on a home visit
During a home visit, a frontline worker should observe how a child shares and reads emotions: eye contact, social smiling, turning to familiar voices, showing or pointing to share interest, seeking comfort when upset, and noticing others' feelings as they grow. These are everyday things to observe and note over several visits, judged by the child's age — never to diagnose at home. When several signs seem limited for age, or a skill has faded, gently route the family to a general developmental check.
Read the answer AnswerSocial Greeting: What to Observe on a Home Visit
On a home visit, a frontline worker should watch how a child responds to being greeted — turning towards a voice or face, sharing eye contact and a social smile, responding to their name, waving, imitating greeting actions like namaste, and using greeting words as language grows. Take-turns matter: greet, pause, and wait for a response. These are signs to observe and note, not to diagnose at home. Refer to a general developmental check if greetings, eye contact and name-response are repeatedly absent across several months or if parents share worries.
Read the answer AnswerSocial imagination: what to observe on a home visit
On a home visit, observe how a child uses pretend and imagination in everyday play — using objects symbolically, role-playing, and inviting others into make-believe. Social imagination (ICF d7) typically grows between 18 months and 4 years. Note what the child can do, watch for play that stays only repetitive or solitary, and share concerns with the family and clinician — this is observation, not diagnosis.
Read the answer AnswerObserving Social Initiation on a Home Visit
On a home visit, observe how readily the child starts social moments on their own — eye contact, sharing a smile, pointing or showing things, coming over to play, and calling out — not only how they respond when others lead. Note whether reaching out happens just to share enjoyment, not only to meet needs. These are observations to monitor, not diagnose; a persistent or wide gap across visits should prompt a gentle developmental check.
Read the answer AnswerObserving Social Initiative During a Home Visit
During a home visit, a frontline worker should observe how a child starts social moments themselves — seeking out a familiar adult, pointing or showing to share interest, offering toys, making eye contact, calling for attention, and joining back-and-forth play. These are everyday signs of growing social initiative (ICF d7). The worker observes patterns to share with the family, not to diagnose. If a child consistently makes very few attempts to start social contact, encourage a gentle general developmental check.
Read the answer AnswerWhat to Observe About a Child's Social Interest at Home
On a home visit, a frontline worker should observe how a child notices and responds to people: looking at faces, smiling back, turning to a familiar voice or name, sharing attention by following or making a point, taking simple turns in play, and seeking caregivers for comfort or play. This is observation, not diagnosis — a single quiet day means little. A pattern of limited social interest across several visits, or social responses that have faded, is worth noting kindly and routing to a general developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about social play?
On a home visit, observe how a child plays with others, not just near them: eye contact, shared attention, smiling back, responding to their name, simple turn-taking, imitation, and beginnings of pretend play. Increasingly back-and-forth, social play is a healthy sign; play that stays solitary, fleeting or hard to join across several visits is worth noting and routing to a developmental check. Frontline workers observe and record patterns — never diagnose at home.
Read the answer AnswerObserving Social Pragmatics on a Home Visit
During a home visit, a frontline worker should observe how a child uses communication to connect — eye contact, pointing to share, following another's gaze, back-and-forth turn-taking, and using gestures and sounds for many reasons (requesting, greeting, sharing). Watch how the child communicates with familiar people in natural play, judged against age, family and language. These are observations to note and route for a developmental check — never a doorstep diagnosis. Early support never waits for a label.
Read the answer AnswerWhat to observe about social referencing on a home visit
Social referencing is when a child looks to a trusted adult's face, voice or gesture to judge how to feel or act in an uncertain moment, typically emerging between 8 and 14 months. On a home visit, a frontline worker should observe whether the child checks in with the caregiver, follows a point or gaze, and adjusts behaviour to the adult's reaction — and whether the caregiver offers warm, readable cues. These are observations to note and route, never to diagnose at home.
Read the answer AnswerObserving Social Sharing During a Home Visit
During a home visit, a frontline worker should observe how a child gives and takes turns, offers or shows toys, looks to caregivers to share a moment, and responds to others' feelings. Sharing develops gradually, so reluctance is normal in young children. The role is to observe patterns over time and gently flag persistent differences to the family and referral team — never to diagnose.
Read the answer AnswerObserving social understanding during a home visit
During a home visit, a frontline worker should observe how a child connects with people: eye contact, sharing smiles, responding to their name, following a point, taking simple turns in play, imitating actions, and reading a parent's mood. These are signs to observe and note — never to diagnose at home. A persistent gap across several areas, judged for the child's age, is a reason to gently suggest a developmental screen and a hearing check, with early support starting without waiting for a label.
Read the answer AnswerSprinting Ability — Home Visit Observation Guide
On a home visit, a frontline worker should observe how a child runs at pace — whether running looks smooth and balanced, whether arms and legs coordinate, and whether the child can stop, start and change direction without frequent falls. Confident running emerges around 2.5–3 years and refines through 4–5. These are points to observe and note, not diagnose at home — persistent lag, asymmetry or not running by 3 years should be routed for a developmental check.
Read the answer AnswerSquatting balance: what to observe on a home visit
On a home visit, observe whether the child can lower into a squat to reach the floor, hold it steadily for a few seconds, and rise without using hands or furniture. Squatting balance usually appears between about 14 and 24 months, so judge against age. Watch for heels lifting and wobbling, one-sided weakness, or skills that have regressed. This is a skill to observe and encourage, not diagnose at home — route persistent delay, one-sidedness or regression to a developmental check.
Read the answer AnswerObserving standing balance during a home visit
On a home visit, observe whether the child can pull to stand, hold standing with support, then stand briefly alone, with feet flat and apart, even weight on both legs, and a steady trunk. Pulling to stand and cruising usually appear by 9–12 months; standing alone by about 11–13 months. These are signs to observe and note, not to diagnose at home. No weight-bearing by 12 months, constant tiptoeing, stiff or scissoring legs, or one-sided weakness should be raised gently with the family for a developmental check.
Read the answer AnswerObserving Storytelling Skills on a Home Visit
On a home visit, a frontline worker should observe how a child sequences events, uses descriptive and linking words, recalls a simple story, and stays socially connected while telling it. By 4–5 years a child should manage a rough beginning–middle–end with linking words; by 5–6 a clear sequence with reasons and feelings. Watch-points include only single words past age 4, no sequencing, or poor shared attention. These are observations to note and share with families, not home diagnoses — refer for a developmental check if storytelling stays well behind peers.
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