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Asha Phc
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Signs & concerns
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Signs & concerns
When should a frontline health worker refer a child with possible Developmental Trauma?
Refer whenever a child shows a persistent change in relating, feeling or developing — especially after a known adversity — or any safety concern. You needn't be certain; recognising the pattern and routing it onward is your role. When in doubt, refer early.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Down syndrome?
Refer promptly: any newborn or infant with a cluster of recognisable features — low tone, single palmar crease, upward-slanting eyes, flat nasal bridge, feeding difficulty — needs paediatric referral within days. Confirmation is by clinical exam and karyotype only. Escalate same-day for breathing or heart concerns.
Read the answer AnswerWhen should a frontline health worker refer a child with possible dyscalculia?
Refer a school-age child (usually 7–8+) when number difficulty is persistent for six months or more, markedly below grade level, specific to maths, and not explained by schooling gaps, vision/hearing problems, or another condition. Rule out those first, then route for structured assessment — diagnosis is made only by a clinician.
Read the answer AnswerWhen should a frontline worker refer a child with possible Dysgraphia?
Refer a child for possible Dysgraphia when written-output difficulty is persistent, age-inappropriate and unexplained by other causes — clearly from age 7–8, once formal writing instruction has had time to work. Before that, monitor and support. Refer promptly for any sudden skill loss, hand weakness or vision concern.
Read the answer AnswerWhen should a frontline health worker refer a child with possible dyslexia?
Refer a school-age child (around 6–7+) when reading stays slow and effortful despite proper instruction, once hearing, vision, schooling and language barriers are ruled out. Look for a persistent cluster of signs, not one bad day. The frontline worker opens the door; only a clinician confirms dyslexia.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Emotional & Behavioural Difficulties?
Refer a child with possible emotional & behavioural difficulties when the problem is persistent (beyond 4-6 weeks), pervasive (across home and school), and interfering with learning, relationships or daily life. Refer promptly for any self-harm risk or sudden regression. Frontline workers route, not diagnose.
Read the answer AnswerWhen should a frontline health worker refer a child with feeding difficulties?
Refer a child for specialist feeding assessment when feeding is unsafe (choking, coughing, noisy breathing), when growth is faltering, or when refusal persists for weeks. Aspiration and poor weight gain are urgent triggers. When in doubt, refer early.
Read the answer AnswerWhen to Refer a Child with Possible FASD
Refer when prenatal alcohol exposure is confirmed or suspected alongside growth, developmental or behavioural concerns — or when unexplained delay and learning or behaviour difficulties appear. You needn't be certain; suspicion plus concern is enough. Confirmation and diagnosis are the specialist's role.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Fine Motor Delay?
Refer a child with possible Fine Motor Delay when hand-and-finger skills clearly lag age milestones, when a skill is lost, or when the family is worried. A pattern across visits matters more than one slow milestone. When in doubt, refer — only a clinician can assess and diagnose.
Read the answer AnswerWhen to refer a child with a possible genetic or chromosomal syndrome
Refer when you see a cluster of unusual features, or any feature alongside developmental delay — you don't need to name the syndrome. Same-day medical referral for breathing, feeding crises or seizures. When in doubt, refer; only a clinician diagnoses.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Global Developmental Delay?
Refer when a child shows significant delay in two or more developmental domains, when a previously gained skill is lost (regression), or when delay comes with red flags like seizures, abnormal tone, or hearing/vision concerns. When in doubt, refer — early referral never harms.
Read the answer AnswerWhen should a frontline health worker refer a child with possible gross motor delay?
Refer a child for specialist assessment when gross motor milestones are clearly delayed — not sitting by 9 months, not walking by 18 months — or sooner if you see loss of skills, stiffness, floppiness, or one-sided weakness. A single late milestone is often normal; a pattern, a regression or a red flag warrants prompt referral.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Hearing Impairment to a specialist?
Refer immediately on failed newborn screening, parental concern, missed listening milestones, recurrent ear discharge, or high-risk history. Never wait-and-watch for hearing — prompt audiology/ENT referral protects spoken language. Diagnosis is made only by a qualified clinician.
Read the answer AnswerWhen should a frontline health worker refer a child with possible hypotonia?
Refer a child with possible hypotonia when floppiness persists, motor milestones are clearly delayed, skills are lost, or there is feeding/breathing difficulty — and same-day for a limp newborn. Isolated mild tone in a thriving baby can be monitored and re-checked. Hypotonia is a sign, not a diagnosis.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Intellectual Disability?
Refer when a child shows persistent delay across two or more areas — motor, language, understanding, self-care or social — that is not catching up, or any loss of skills. Frontline workers spot the pattern; only a clinician confirms it.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Motor Planning Difficulties?
Refer when difficulty planning and sequencing movement is persistent, age-inappropriate, and interferes with daily tasks — after ruling out an obvious medical cause. You don't need certainty; a clear pattern is enough. Sudden loss of skills, weakness or asymmetry go to a paediatrician urgently.
Read the answer AnswerWhen to Refer a Non-Verbal or Minimally Verbal Child
Refer when speech milestones are clearly missed — no gestures by 12 months, no words by 18, no two-word phrases by 24 — or whenever a child loses words they once had. Always check hearing first. Minimally verbal is a description, not a diagnosis; only a clinician can find the cause.
Read the answer AnswerWhen should a frontline health worker refer a child with possible ODD?
Refer when defiant, angry behaviour has lasted six months or more, occurs across more than one setting, and is harming relationships, learning or family life — and urgently if there is aggression, self-harm or suspected abuse. ODD is recognised from about age 4; only a clinician confirms it.
Read the answer AnswerWhen should a frontline health worker refer persistent toe-walking?
Occasional tiptoe walking under age three is usually normal and settles with growth. A frontline worker should refer when toe-walking persists beyond three, happens on most steps, is one-sided, comes with tight calves or heel cords, or appears alongside delays in speech, play or motor skills. Loss of a previously gained skill needs prompt medical referral. When unsure, a developmental check reassures the family and catches treatable causes early.
Read the answer AnswerWhen to Refer a Preterm Child for Developmental Risk
Link every preterm baby to specialist follow-up from discharge, and refer promptly on red flags judged by corrected age — stiffness or floppiness, feeding or growth trouble, vision/hearing concerns, delayed babble or words, or any lost skill. When in doubt, refer; field workers screen and route, clinicians diagnose.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Rett Syndrome?
Refer promptly when a girl who was developing normally (typically 6–18 months) slows, stalls, or loses skills — especially loss of purposeful hand use with repetitive hand-wringing, slowing head growth, and lost eye contact. You don't need certainty; recognise and route. Diagnosis is made only by a specialist.
Read the answer AnswerWhen should a frontline health worker refer a child with possible School Readiness Gap to a specialist?
Refer a child aged roughly 4–6 when a school readiness gap persists despite simple support, or sits alongside a developmental red flag — limited language, poor attention, motor or self-care difficulty, or any loss of skills. When in doubt, refer; early assessment is low-risk. Diagnosis is made only by a clinician.
Read the answer AnswerWhen should a frontline health worker refer a child with possible Selective Mutism?
Refer when a child speaks freely at home but stays consistently silent in select settings such as school for more than about a month, and it disrupts learning or friendships — after ruling out a general language delay or a new-language situation. It is anxiety-based and highly treatable; only a clinician confirms it.
Read the answer AnswerWhen to refer a child with self-regulation difficulties
Refer a child with possible self-regulation difficulties when the struggles are frequent, intense and lasting beyond what is typical for the child's age, or when they disrupt sleep, feeding, play, learning or relationships. A single tantrum is normal; a pattern continuing for weeks that interferes with daily life — or persistent parent worry — deserves a developmental check. Sudden skill loss, staring spells or faltering growth need prompt medical review. When in doubt, refer; early support is always safe.
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