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Asha Phc
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Signs & concerns
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Signs & concerns
Early Signs of Down Syndrome on a Home Visit
Down syndrome is usually recognisable soon after birth from a cluster of features — upward-slanting eyes, flat facial profile, low muscle tone (floppy baby), short neck, single palm crease and feeding difficulty. No single sign confirms it; refer promptly for paediatric review and a confirmatory chromosome test rather than labelling the child.
Read the answer AnswerEarly signs of dyscalculia on a home visit
Dyscalculia is difficulty with numbers and arithmetic well below age expectation, meaningful to flag from about 6–8 years. On a home visit watch for unreliable counting, finger-reliance for simple sums, confusing number symbols and number anxiety — in a child who is otherwise bright. Refer when difficulties persist across home and school.
Read the answer AnswerEarly signs of dysgraphia for frontline health workers
Look for a clear gap between what a child can say and what they can write — awkward pencil grip, poorly formed and uneven letters, inconsistent spelling, leaving out words, and avoiding writing while other learning seems fine. These signs matter most from about 6–8 years; note them and route for a developmental check, as only a clinician can confirm dysgraphia.
Read the answer AnswerEarly signs of dyslexia a frontline health worker should watch for
During a home visit, look for spoken-language and pre-literacy signs rather than reading itself: trouble learning rhymes, muddling word sounds, slow letter learning, and family history. Dyslexia is usually confirmed only at ages 6–8 once reading is taught, so the stance for younger children is watch, support language and route for a developmental check — never label a pre-schooler.
Read the answer AnswerEarly Signs of Emotional & Behavioural Difficulties During a Home Visit
During a home visit, watch for emotional and behavioural patterns that are more intense, longer-lasting, or earlier than expected for age, and that appear across more than one setting. These signal a gentle referral, never a diagnosis. Persistent parental worry is itself an important early indicator.
Read the answer AnswerWhat early signs of Feeding & Eating Difficulties should a frontline health worker look for during a home visit?
On a home visit, watch for feeds over 30–40 minutes, coughing or choking with feeds, refusal or arching, eating only a few foods, gagging on textures, stressful mealtimes and poor weight gain. Breathing distress or weight loss needs prompt medical review; persistent difficulty warrants a developmental and feeding assessment.
Read the answer AnswerEarly signs of FASD on a home visit
On a home visit, look for clusters rather than one sign: low birth weight or growth faltering, poor feeding and weak suck, small head size, subtle facial features (smooth philtrum, thin upper lip), irritability or poor sleep, and developmental delays — alongside any history of alcohol use in pregnancy, asked sensitively. Route clusters to the PHC medical officer; FASD is confirmed only by clinical assessment.
Read the answer AnswerEarly signs of Fine Motor Delay for frontline health workers
On a home visit, watch how the child uses hands for their age: reaching and grasping in infancy, then pincer grasp, stacking, scribbling and self-feeding. A clear lag behind age-expected hand skills, or any loss of a skill, warrants a developmental check — you screen, a clinician confirms.
Read the answer AnswerEarly signs of genetic & chromosomal syndromes on a home visit
On a home visit, look for clusters of signs rather than one alone — low muscle tone, feeding difficulty, distinctive facial features, slow growth, delayed milestones, or a worried parent. You are not diagnosing; you are noticing a pattern and routing the family to a doctor for examination and early intervention.
Read the answer AnswerEarly signs of Global Developmental Delay on a home visit
On a home visit, screen for Global Developmental Delay using the RBSK 4 Ds — delay or difficulty across movement, speech, social skills and daily thinking. Refer promptly when a child is behind in two or more areas, or has lost any skill once held, alongside a hearing and vision check.
Read the answer AnswerEarly Signs of Gross Motor Delay for Frontline Health Workers
Refer a child for gross motor assessment when they miss movement milestones for their age — no steady head control by 4 months, not sitting by 9 months, not standing or walking with support by 18 months — or show floppiness, stiffness, one-sided weakness or loss of a skill. Frontline observation and parent concern are what get a child seen in time.
Read the answer AnswerEarly Signs of Hearing Impairment on Home Visits
On a home visit, refer any baby who doesn't startle to loud sound, doesn't turn to a voice, has absent or fading babble, or doesn't respond to their name. Family concern about hearing is itself a strong signal. Don't wait — hearing loss found early is far easier to support, and only a clinician confirms it.
Read the answer AnswerEarly Signs of Hypotonia (Low Muscle Tone) on a Home Visit
On a home visit, watch for a baby who feels floppy or limp, has poor head control, slips through your hands when lifted, has a weak suck or feeding difficulty, and lags on motor milestones. These are early signs of hypotonia — a reason to refer for a developmental check, not to diagnose.
Read the answer AnswerWhat early signs of Intellectual Disability should a frontline health worker look for during a home visit?
On a home visit, look for a child consistently slower than peers across several areas at once — motor milestones, babble and words, understanding instructions, play and self-help. Intellectual development disorder (ICD-11 6A00) is suspected when delay is broad and persistent, not a single skill. You don't diagnose — you spot the pattern and route promptly to a developmental check.
Read the answer AnswerWhat early signs of Motor Planning Difficulties should a frontline health worker look for during a home visit?
Motor planning difficulties show as a child struggling to figure out and carry out new movements despite normal strength — clumsiness, late milestones, trouble copying actions, and difficulty with buttons or cutlery. A persistent cluster across tasks warrants referral; only a clinician can confirm.
Read the answer AnswerEarly Signs of a Non-Verbal or Minimally Verbal Child
During a home visit, watch how a child communicates beyond speech — pointing, gestures, eye contact, response to name — not just word count. Few or no words by the expected age with limited gesture, or any loss of skills, warrants referral for a developmental check and a parallel hearing test. A clinician confirms; the frontline worker's job is timely referral.
Read the answer AnswerEarly signs of Oppositional Defiant Disorder on a home visit
On a home visit, look for a persistent pattern (6+ months) of angry/irritable mood, argumentative defiance and occasional spitefulness that is frequent for the child's age, shows across settings, and strains family or school life — not ordinary toddler testing. Screen and refer; only a clinician can diagnose.
Read the answer AnswerEarly Signs of Persistent Toe-Walking on a Home Visit
On a home visit, watch for a child over age 2 who walks on toes or balls of the feet most of the time, on both legs, with tight calves or heels that can't reach the floor. Occasional toe-walking in new walkers is normal; persistent toe-walking — or toe-walking with speech, social, stiffness or weakness concerns — warrants a developmental and medical check.
Read the answer AnswerEarly Signs of Prematurity-Related Developmental Risk on a Home Visit
Born-preterm babies face higher developmental risk, so during a home visit track milestones by corrected age, watch feeding and growth, and note unusual stiffness or floppiness. These are watch-and-monitor signs — persistent concern warrants a prompt developmental check, not waiting.
Read the answer AnswerEarly signs of Rett Syndrome for frontline health workers
Watch for regression in a baby girl who was developing normally — loss of purposeful hand use and babble after 6–18 months, repetitive hand-wringing or washing movements, slowing head growth, and breathing irregularities. Any loss of acquired skills needs prompt medical referral; only a clinician can confirm.
Read the answer AnswerEarly Signs of a School Readiness Gap on a Home Visit
During a home visit, look for clusters of difficulty in a child near school age — trouble following simple instructions, unclear speech, very short attention, little pretend play, no pencil control, and difficulty playing with others or managing self-care. These point to a school readiness gap and warrant a developmental check, not a label.
Read the answer AnswerEarly Signs of Selective Mutism on a Home Visit
On a home visit, look for a child who speaks freely with family but consistently cannot speak to you — freezing, whispering or going silent — with the pattern lasting beyond a month and affecting school or friendships. It is anxiety-based, not shyness or hearing loss; refer when the pattern is clear.
Read the answer AnswerEarly signs of self-regulation difficulties on a home visit
On a home visit, watch for a child who melts down intensely and recovers slowly, is very hard to soothe, can't settle their body or attention, reacts strongly to everyday sensations, and a parent who feels drained. Persistent cross-setting patterns deserve a gentle developmental check — only a clinician can assess, never a doorstep label.
Read the answer AnswerEarly signs of Sensory-Based Feeding Selectivity at a home visit
Flag a child for assessment when food refusal is persistent and narrowing: very few accepted foods, refusal of whole textures or groups, gagging or distress at new foods, and any concern about growth. These are early signs of Sensory-Based Feeding Selectivity worth a developmental check — only a clinician can confirm the cause.
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