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Asha Phc
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Signs & concerns
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Signs & concerns
When should an ASHA or PHC worker escalate Separation Anxiety Disorder?
Escalate when separation distress is excessive for the child's age, lasts four weeks or more, and disrupts school, sleep or eating. Escalate urgently for panic with breathing difficulty, self-harm talk, or refusal of food. The ASHA/PHC role is to notice, reassure and route on time — diagnosis happens only at a Pinnacle centre.
Read the answer AnswerWhen should an ASHA or PHC worker escalate social communication difficulties?
ASHA and PHC workers should escalate when social-communication concerns persist beyond one contact, when red flags appear at any age, or whenever a parent raises worry. Any loss of previously acquired language or social skills warrants same-day referral. Workers screen and route — diagnosis happens only under a clinician.
Read the answer AnswerWhen should an ASHA or PHC worker escalate suspected SLD?
ASHA/PHC workers should escalate when a school-age child (about 6+) shows persistent, unexplained difficulty with reading, writing or maths despite adequate schooling and normal effort — after first ruling out vision, hearing and attendance issues. Refer to the Medical Officer or DEIC; SLD is not diagnosed before formal schooling, and never at community level.
Read the answer AnswerWhen to escalate Speech and Language Delay — ASHA & PHC guidance
Escalate any child who misses an age-appropriate language milestone, shows regression or suspected hearing loss, or whose parent raises a concern. Screen at every contact, refer on any concern, and pair every referral with a hearing check. Referral is for assessment, never diagnosis.
Read the answer AnswerEscalation guidance: Stereotyped Movement Disorder for ASHA & PHC workers
Most repetitive movements in young children are harmless and self-soothing. An ASHA or PHC worker should escalate when there is self-injury, interference with daily function, persistence past 3–4 years, co-occurring developmental delay or regression, or any sign suggesting seizures. When in doubt, refer — assessment reassures.
Read the answer AnswerWhen should an ASHA or PHC worker escalate suspected Tourette Syndrome?
ASHA/PHC workers should observe and document repeated involuntary movements or sounds lasting more than a few weeks, then escalate to the Medical Officer — urgently if there is altered awareness, whole-body jerking or sudden behaviour change. Frontline workers refer, never diagnose.
Read the answer AnswerWhen should an ASHA or PHC worker escalate a child showing signs of Visual Impairment?
Escalate same-day for any infant with a white or cloudy pupil, absent red reflex, watering or light-sensitive eyes, or enlarged hazy corneas. Refer promptly if a baby does not fix-and-follow by 3 months, has constant squint or roving eyes, or if an older child holds things close, tilts the head or bumps into objects. When in doubt, refer through the RBSK pathway — early eye care changes outcomes.
Read the answer AnswerWhen should I worry that my 12–18 month old might have ADHD?
At 12–18 months ADHD cannot be diagnosed, and high energy or short attention is normal toddler behaviour. Rather than ADHD signs, watch milestones — connection, communication, play and movement. A general developmental check, not ADHD screening, is the right next step, and only a clinician can assess.
Read the answer AnswerWhen should I worry about autism at 12-18 months?
Autism can sometimes be detected by 18 months or younger. Loss of skills or persistent communication concerns warrant pediatric assessment. Autism screening is recommended at 18 and 24 months and when concerns arise; screening is not diagnosis.
Read the answer AnswerWhen should I worry about Cerebral Palsy at 12–18 months?
Worry between 12 and 18 months is reasonable, but worry is not a diagnosis. Persistent stiffness or floppiness, very early hand preference, fisted hands, or not sitting/standing on time are patterns worth checking. Early therapy works beautifully with the infant brain — only a Pinnacle clinician can confirm anything.
Read the answer AnswerWhen to Worry About Down Syndrome at 12-18 Months
Down syndrome is present from birth and is almost always identified at or soon after birth through examination and genetic testing — not something that newly appears at 12–18 months. At this age, watch general milestones, and see your paediatrician for any delay. Diagnosis is confirmed only by a clinician.
Read the answer AnswerWhen should I worry about Global Developmental Delay at 12–18 months?
Worry is reasonable if your 12-to-18-month-old shows delays in two or more areas — movement, speech, social or thinking skills — or loses skills they once had. A single slow area is often normal; a pattern is the flag to check. Only a clinician can confirm GDD.
Read the answer AnswerWhen should I worry about hearing impairment at 12-18 months?
By 12–18 months, check with your doctor if your child doesn't turn to sounds, isn't babbling or saying any words, or doesn't respond to their name — especially if responsiveness has faded. This needs a hearing check, not panic. Only a clinician can confirm; early checks help enormously.
Read the answer AnswerWhen should I worry about Intellectual Disability at 12–18 months?
At 12–18 months it is too early to diagnose Intellectual Disability — this is a watch-and-support stage, not a labelling one. Track the overall pattern across play, communication and movement; a persistent lag across several areas, or loss of skills, is a reason for a friendly developmental check. Only a clinician can assess, and meaningful assessment comes later.
Read the answer AnswerWhen should I worry that my 12-to-18-month-old might have Sensory Processing Differences?
At 12–18 months, sensory likes and dislikes are normal and we watch patterns rather than diagnose. Worry sooner if intense, lasting distress with sound, touch or movement disrupts eating, sleep or play — and rule out hearing first. Only a Pinnacle clinician can confirm anything.
Read the answer AnswerWhen should I worry about SLD in a 12-to-18-month-old?
Specific Learning Disability is about reading, writing and maths — skills that haven't begun at 12–18 months, so it can't be identified or worried about this early. It usually becomes clear around ages 6–8. For now, watch broad milestones like babbling, pointing, understanding and walking; a persistent pattern of several delays is reason for a general developmental check, not a label.
Read the answer AnswerWhen should I worry about speech delay at 12–18 months?
At 12–18 months, range is wide and one quiet talker is rarely cause for alarm. Worry becomes meaningful with a pattern: no babble or gestures by 12 months, no words by 15–18 months, no understanding of simple requests, or loss of skills once gained. A check — starting with hearing — is the hopeful next step; only a clinician can tell delay from a phase.
Read the answer AnswerWhen should I worry my 18–24-month-old has ADHD?
At 18–24 months, ADHD cannot yet be meaningfully identified — high energy and short attention are normal toddler behaviour. ADHD is reliably assessed only from around age 4–5. Channel any worry into a general developmental check, never a premature label. Only a clinician can assess.
Read the answer AnswerWhen should I worry about autism at 18–24 months?
From 18 to 24 months, screening for autism becomes reliable and meaningful. A persistent cluster — limited pointing, few words, little response to name, reduced social back-and-forth, or repetitive movements — is worth checking. Worry is a reason to screen, not a diagnosis; only a clinician can confirm.
Read the answer AnswerWhen should I worry that my 18-to-24-month-old might have Cerebral Palsy?
Worry is reasonable, but worry is not a diagnosis. By 18–24 months, persistent patterns — not walking, stiff or floppy tone, strongly favouring one hand, or poor balance — are worth a prompt check. Only a clinician can confirm Cerebral Palsy, and early support works beautifully.
Read the answer AnswerWhen Should I Worry About Down Syndrome at 18–24 Months?
Down syndrome is a genetic condition present from birth and is almost always identified at or soon after birth via physical signs and a blood test — it does not newly appear at 18–24 months. What matters at this age is watching overall development; any delay deserves a general check, not a feared label.
Read the answer AnswerWhen should I worry about Global Developmental Delay at 18–24 months?
At 18–24 months, worry is reasonable if your child is behind in two or more areas at once — movement, words, understanding, play — or has lost skills. One slow area often catches up; a pattern across several is the real flag. Worry is a reason to check, not a diagnosis.
Read the answer AnswerWhen should I worry about hearing in my 18–24-month-old?
By 18–24 months a child should turn to your voice, respond to their name and use a few growing words. If your toddler misses everyday sounds, follows only gestures, or has very few words, ask for a hearing check — a fresh test is always reasonable, even after a newborn screen. Only a clinician can confirm anything.
Read the answer AnswerWhen to worry about SLD in an 18–24-month-old
At 18–24 months it isn't clinically meaningful to look for Specific Learning Disability — it concerns reading, writing and maths skills your toddler hasn't begun yet, and is usually recognised only around ages 6–8. For now, watch broader development — talking, understanding, play and movement — and route any concern to a general developmental check.
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