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Special Education
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Signs & concerns
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Signs & concerns
Observing organisation skills on a home visit
On a home visit, observe how the child follows simple routines, puts belongings back, completes tasks, gathers what they need, and moves between activities. Organisation skills grow unevenly in early years, so note patterns rather than label. Mark a referral when difficulties are persistent, marked and seen across many situations — paired with hearing and vision screening.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning pattern recognition?
On a home visit, observe how the child notices and predicts what comes next — matching like objects, sorting by colour or size, continuing simple repeating patterns, completing rhymes, anticipating routines and recalling rules. These are everyday signs of pattern recognition to note over time, not to diagnose. Concern grows when several signs lag clearly behind peers, persist across visits, or a skill is lost — gently route the family to a developmental check.
Read the answer AnswerObserving sequential memory on a home visit
On a home visit, observe how a child remembers things in order: following two- or three-step instructions, copying a clap or tap pattern, repeating a short series of words or actions, recalling steps in songs or routines, and telling what happened 'first, next, last'. These are observations to note and discuss across visits, not to diagnose at home. If a child consistently lags peers in holding a short order of steps, route the family to a general developmental check.
Read the answer AnswerShape recognition on a home visit: what to observe
On a home visit, a frontline worker should observe how a child plays with everyday shapes — looking, matching, fitting shapes into sorters, and (in older toddlers) pointing to and naming shapes — and how this compares with same-age peers. Shape recognition is a cognitive building block that grows gradually, so the worker observes and notes, never diagnoses. A clear gap behind peers across several play tasks and visits is a reason to route the family for a developmental check.
Read the answer AnswerObserving short-term memory on a home visit
On a home visit, a frontline worker can observe a child's short-term memory through everyday actions: following one- or two-step instructions, finding a hidden toy, recalling familiar names, and remembering routines or song steps. These are things to observe and note against age expectations, not diagnose at home. Always check hearing first. A persistent pattern of struggling compared with peers, or parent worries, is the cue to route the family for a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning social awareness?
During a home visit, a frontline worker should observe how a child notices and responds to people — eye contact, smiling back, turning to their name, sharing attention by pointing or showing, following others' gaze, and reacting to feelings. These are everyday signs of social awareness to observe and note across visits, not to diagnose. If a child consistently shows little interest in people, gently reassure the family and encourage a developmental check, since early strengths-first support never has to wait for a label.
Read the answer AnswerSorting & categorization on a home visit
On a home visit, a frontline worker should observe how a child notices sameness and difference, matches and groups everyday objects (by colour, shape, size or use), follows a simple sorting instruction, and stays engaged. Many children begin matching around 2–3 years and sort by category by 3–4 years. These are observations to note and route — never a home diagnosis. Refer onward if a child past 3 cannot match or group familiar objects with demonstration, or if wider delays are reported.
Read the answer AnswerSpatial reasoning on a home visit: what to observe
On a home visit, a frontline worker should observe how a child explores space and shape in everyday play — stacking blocks, nesting cups, posting shapes, completing puzzles, navigating around furniture, and using position words like in, on and under. These are skills to watch and encourage, not diagnose at home. A pattern that persists or widens across months, or concerns alongside speech, movement or play, is worth a gentle, planned developmental check and routing to a screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning to story recall?
On a home visit, watch how the child listens to a short familiar story and retells it — noting attention, recall of main characters and events, rough sequencing, and the language they use. A child learning this skill improves with repetition and prompts, so observe growth over several visits rather than one attempt. Persistent low interest, no recall even with picture cues, or retelling far behind peers are observations to share with the team — never a home diagnosis.
Read the answer AnswerObserving task completion during a home visit
On a home visit, observe whether the child can begin a simple familiar task, stay focused enough to finish, follow a one- or two-step instruction, cope with a small obstacle, and show pride at completing it. These are observations to note and monitor against the child's age, never to diagnose at home. A pattern that persists across visits, is well behind peers, or comes with attention or comprehension concerns is worth raising for a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning task management?
On a home visit, observe how a child starts, stays with, and finishes a simple everyday task — understanding a one-step instruction, keeping attention for a minute or two, managing a short sequence of steps, and coping with small frustration. Judge against age and the support given. These are observations to note and monitor, not to diagnose. Flag persistent patterns, or delays alongside language, play or attention, to the supervising health team for a developmental screen.
Read the answer AnswerWhat to observe about a child's transitioning during a home visit
During a home visit, a frontline worker should observe how a child moves between positions (lying to sitting, sitting to standing), shifts between activities and attention, and copes with social changes like a new person or routine. Smooth transitions for the child's age are reassuring; persistent stiffness, floppiness, or extreme distress with change across many settings are signs to note and share with a medical officer. This is observation to monitor, not a home diagnosis.
Read the answer AnswerObserving Visual Motor Integration on a Home Visit
On a home visit, a frontline worker should observe how a child coordinates eyes and hands — reaching accurately, grasping with a finger-thumb pinch, stacking, posting shapes, scribbling and copying for their age. These are observations to monitor and route, not diagnose at home. A persistent gap across several visits, clumsiness affecting daily tasks, or avoiding hand-eye play warrants a gentle developmental check after confirming vision and hearing seem fine.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about visual recognition?
On a home visit, a frontline worker observes how a child uses their eyes to notice, follow and recognise people and objects — eye contact, smiling at familiar faces, following a moving toy, looking for a dropped object, and reaching for known things. These are observations to note and monitor, not to diagnose. Persistent absence of looking, following or recognising familiar faces for the child's age, or eyes that don't move together, signals a vision and developmental check — vision first, since many causes are treatable.
Read the answer AnswerVisual scanning: what to observe on a home visit
On a home visit, a frontline worker should observe how the child uses their eyes to find and follow things — turning towards faces and moving objects, shifting gaze between toys, tracking a slowly moving object, and searching for dropped or hidden items. Signs worth noting include consistently missing one side, not fixing or following by the expected age, squinting or head-tilting, and little interest in faces. These are patterns to observe and route, not to diagnose; a vision and hearing check comes first.
Read the answer AnswerCan a newborn have global developmental delay?
Global developmental delay applies to children under 5 who are behind in two or more areas — it is measured against milestones that emerge over months, so it cannot apply to a newborn. Focus now on screening, feeding and routine checks, and track milestones as they arrive.
Read the answer AnswerHow do I know if my child has strong cognitive readiness?
Strong cognitive readiness shows in everyday play: curiosity and exploration, remembering people and routines, understanding cause and effect, age-appropriate attention, problem-solving, and learning from trying. There's no single home test — readiness is a pattern that grows over months and looks different in every child. If your child rarely explores, attends or learns as you'd expect for their age, especially alongside talking or social delays, a calm developmental check is the kind next step — early support works best.
Read the answer AnswerHow do I know if my child has strong mainstream readiness?
Strong mainstream readiness shows in everyday building blocks: communicating needs, following routines, attending for short stretches, playing alongside other children, basic self-help and recovering from frustration with support. A child strong in most areas and building one or two is showing healthy readiness. It is a profile of strengths, not a pass-or-fail test, and a clinician's structured look gives the clearest picture — so arrange a developmental check if several areas feel consistently hard.
Read the answer AnswerHow do I know if my child has strong school readiness?
Strong school readiness is a blend of language, social-emotional skills, attention, independence and fine-motor ability — not early reading. Encouraging signs include following two-step instructions, separating from you without lasting upset, taking turns, sitting for a short activity, and managing basics like the toilet and shoes. Readiness builds gradually through play, talk and warm routines; a calm developmental check helps if a child consistently struggles across several of these areas as school nears.
Read the answer AnswerWhen to escalate concerns about achievement orientation
Achievement orientation — the drive to attempt, persist with and take pride in tasks — develops gradually, not on a fixed date. A frontline worker should escalate to a developmental check when a child consistently avoids age-typical tasks, gives up instantly, shows no pride in finishing, or when this travels with language, play or social delays. This is a reason to assess early, never a diagnosis.
Read the answer AnswerWhen to escalate activity-completion delay — guidance for frontline workers
When a 2–3 year old cannot begin and finish a simple familiar task, it is often within the normal range of growing attention, not a diagnosis. A frontline worker should escalate to the Medical Officer or a developmental check when the difficulty is persistent, clearly behind peers, or travels with delays in speech, understanding, social connection or play. Document observations, ask the family what the child manages at home, and route early rather than wait.
Read the answer AnswerWhen should a frontline worker escalate an attention-to-detail concern?
Attention to detail develops gradually, and young children are naturally distractible, so judge against the child's own stage. A frontline worker should escalate to a Medical Officer or developmental check when the difficulty is persistent, clearly behind peers, affects daily play or learning, or travels with delays in talking, understanding, hearing, vision or motor skills. Always check hearing, vision, nutrition and recent illness first. This is a referral signal, not a diagnosis — early review opens early support.
Read the answer AnswerBehaviour awareness: when frontline workers should escalate
Behaviour awareness — noticing one's own actions and adjusting to a caregiver's cue — develops through the toddler years. A frontline health worker should escalate to the PHC medical officer or a developmental check when a child consistently does not respond to their name, shows no shared attention, cannot follow a simple one-step request by age 2, or has lost a skill once held. Escalation means routing for review, not diagnosing; parent concern alone is reason enough to refer early.
Read the answer AnswerWhen to Escalate a Cognitive Milestone Concern
Escalate when a child consistently misses cognitive milestones for their age, when the gap from peers is widening, when a skill is lost, when cognitive delay travels with communication or motor concerns, or whenever a caregiver is worried. Frontline escalation is not a diagnosis — it opens a door to early support, which works best when started young. The guiding rule for any health worker is: when in doubt, refer for a developmental check.
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