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Asha Phc
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Signs & concerns
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Signs & concerns
Instruction recall on a home visit: what to observe
On a home visit, a frontline worker should observe whether a child can hear, hold and follow simple spoken instructions in their home language — first one-step, then two-step requests — and whether attention or hearing seem to interfere. This is something to observe and note, never to diagnose at home. Look for patterns across visits, check hearing first, and refer any persisting concern for a developmental screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about internalizing behaviours?
During a home visit, a frontline worker should observe how a child manages inward-directed feelings — sadness, worry, fear, withdrawal — rather than only loud behaviours. Watch for persistent fearfulness, clinginess, low mood, reluctance to play, and physical complaints like tummy aches, noting patterns that persist across weeks or settings. These are signs to observe and gently flag, not diagnose at home — route the family for a developmental check.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child learning interruption control?
On a home visit, a frontline worker should observe how a child manages interrupting — whether they can pause, wait for a gap in conversation, and let others finish during everyday family talk and play. Frequent interrupting is normal in younger children and matures with age, so this is observe-and-encourage, not diagnose. Note any child whose difficulty is marked, persistent across months and seen in many settings, alongside wider waiting or attention concerns, and route them to a routine developmental check.
Read the answer AnswerWhat a frontline worker should observe about joint attention
On a home visit, observe how the child shares attention with a caregiver: following a point or gaze, looking back to share enjoyment, and showing or pointing to bring others into what interests them. By around 9–14 months these emerge naturally. These are moments to observe and note, not diagnose at home; if sharing is consistently limited across several visits, route the family for a developmental check, starting with a hearing screen.
Read the answer AnswerJump Rope Coordination on a Home Visit
During a home visit, a frontline worker should observe how a child coordinates jumping, timing and turning the rope together — a skill that typically emerges around 6–7 years and develops gradually. Watch steady two-footed jumps, wrist-turning of the rope, rhythm and balance, and whether difficulty spans several motor skills. This is observation and monitoring, not diagnosis. Route persistent or widening motor gaps to a developmental check, where early playful support helps.
Read the answer AnswerWhat to observe about a child learning to jump
During a home visit, a frontline worker should observe a child's gross-motor readiness for jumping: knee bending and bouncing, stepping and jumping down from a low step, and (around 2–2.5 years) getting both feet off the ground together, landing steadily and using both legs evenly. These are skills to observe and encourage, not diagnose. Refer to a general developmental check if a child past 3 years cannot get both feet off the ground, shows unusual tone, has lost a skill, or if a parent is worried.
Read the answer AnswerObserving jumping skills during a home visit
On a home visit, observe whether a child can bend the knees, push off and lift both feet off the ground together — emerging around 2 years and steadier by 2½–3 years. Watch jumping in place, forward and off a low step, balance on landing, and confidence to try. These are everyday observations to note and encourage, not to diagnose at home; a persistent gap, stiff or floppy tone, or lost skills merits a gentle developmental check.
Read the answer AnswerObserving Language Development on a Home Visit
During a home visit, a frontline worker should observe how a child understands and uses communication for their age — responding to sounds and their name, babbling or words, pointing and gestures, eye contact, and back-and-forth play in any home language. These are signs to note and discuss, not to diagnose. Refer for a developmental and hearing check when a skill is clearly behind age expectations, has plateaued, or has regressed, since early support works best.
Read the answer AnswerLanguage processing on a home visit: what to observe
During a home visit, a frontline worker should observe how a child receives and understands spoken language — turning to their name, following simple requests, looking towards named objects, and responding to familiar voices and routines. These are observations to note and monitor, not to diagnose at home. A hearing check comes first, since undetected hearing concerns are common. When understanding seems consistently behind a child's age across visits, the family should be guided to a developmental and hearing check.
Read the answer AnswerWhat to observe about a child's language structure on a home visit
On a home visit, a frontline worker should observe how a child combines words into phrases and sentences — moving from single words to two- and three-word combinations, using simple grammar and word order, and understanding short instructions for their age. These are things to observe and note, not diagnose at home. Consider the family's mother tongue, since bilingual children may mix languages normally. If language structure seems markedly behind, route the family for a hearing screen and a developmental check.
Read the answer AnswerWhat to observe about lateral movement on a home visit
During a home visit, a frontline worker should observe how a child learning lateral (sideways) movement shifts weight between legs, cruises along furniture, keeps balance, and uses both sides of the body equally. These are signs to observe and note, not to diagnose. A delay, strong one-sidedness, or stiff/floppy tone should be gently flagged for a developmental check at a primary health centre.
Read the answer AnswerWhat to Observe in a Child Learning Line Tracing
On a home visit, observe how the child holds the crayon, whether marks stay roughly along the line, hand steadiness, eye-hand coordination, and willingness to try. Line tracing is an early fine-motor and visual-motor skill emerging around 2.5–4 years, so observe and note rather than label. A child who struggles well past age 4 or avoids all mark-making is best routed gently for a developmental check.
Read the answer AnswerWhat to observe about a child's listening skills on a home visit
During a home visit, a frontline worker should observe how a child responds to sound and voice — turning to their name, quietening at a familiar voice, following a simple spoken request, and staying engaged in short back-and-forth exchanges. These are signs of developing listening skills (ICF b152) to observe and note, not diagnose. A consistent lack of response, especially to sound itself, should be flagged for a hearing screen first and a general developmental check.
Read the answer AnswerObserving Long-Term Memory at a Home Visit
At a home visit, a frontline worker should observe whether a child recalls and uses earlier learning — recognising familiar faces and places, finding hidden objects, following known routines, and remembering songs or instructions after a gap. These are signs to observe and note, not to diagnose at home. If recall is consistently weak across several months and settings, gently route the family to a developmental check through the PHC pathway.
Read the answer AnswerObserving manual dexterity during a home visit
On a home visit, a frontline worker should watch how the child reaches, grasps, transfers, holds and releases objects during natural play, and compare this to age expectations. Note hands kept fisted past 3–4 months, a strong hand preference before 18 months, or stiff/floppy hands. These are observations to note and follow up, not to diagnose at home — refer worrying or persistent patterns to a developmental check.
Read the answer AnswerMemory and Recall on a Home Visit
During a home visit, a frontline worker should observe how a child recognises familiar people and objects, remembers where things are kept, follows simple instructions, finds hidden toys, and recalls songs or names. These are signs to watch and note across visits, not to diagnose. If several areas lag for the child's age, route the family to a general developmental check, ideally after a hearing screen.
Read the answer AnswerDuring a home visit, what should a frontline worker observe about a child's memory retention?
On a home visit, observe how a child holds and recalls information: finding a hidden toy, following one- then two-step instructions, repeating short sequences, naming familiar people, and remembering routines, rhymes or small events. These are everyday signs of memory retention to note and monitor, not to diagnose. Concern grows when a child is clearly behind same-age peers, daily routines are affected, or recall does not improve with simple repetition over weeks — a gentle prompt to suggest a developmental check.
Read the answer AnswerWhat to observe about a child's mental effort on a home visit
On a home visit, a frontline worker should observe how a child applies and sustains mental effort — whether they settle on a simple activity, pay attention for an age-appropriate stretch, keep trying when a task is slightly hard, and shift focus when guided. These are observations to note and monitor across visits, not to diagnose. Refer for a developmental screen if engagement is far below age expectations over weeks, or alongside delays in talking, play or understanding.
Read the answer AnswerObserving mobility during a home visit
During a home visit, a frontline worker should observe how a child moves naturally — rolling, sitting, crawling, pulling to stand and walking — judged against age, plus muscle tone, symmetry (both sides used equally) and confidence in exploring their home space. These are observations to note and route, never to diagnose. A pattern that persists, affects one side, or shows markedly stiff or floppy tone should prompt a prompt, gentle referral for a developmental check.
Read the answer AnswerObserving mood regulation on a home visit
On a home visit, a frontline worker should observe how a child shows and settles feelings — whether they can be comforted by a caregiver, recover from upset within a reasonable time, look to caregivers for reassurance, and show a range of moods. The focus is the pattern across the visit, not one tantrum. Persistent, intense distress seen across situations is worth noting. These are observations to share and route — never a home diagnosis.
Read the answer AnswerObserving Motor Skills on a Home Visit
During a home visit, a frontline worker should observe a child's gross motor skills (head control, sitting, crawling, standing, walking) and fine motor skills (reaching, grasping, passing objects), checking that movement is symmetrical and tone is neither too stiff nor too floppy, and that skills are appearing roughly on time. These are observations to note and refer, not to diagnose at home — clear delays, one-sided movement, or unusual tone should be referred promptly to a PHC officer or developmental check.
Read the answer AnswerObserving Multi-Step Task Skills During a Home Visit
During a home visit, observe whether a child can follow and complete tasks with two or more linked steps — remembering the sequence, staying on task, and recovering from mistakes — judged against their age. Note how much repetition or demonstration they need. These are observations to monitor and refer, not to diagnose. Refer for a developmental check (with a hearing check) if the child is clearly behind for age, the pattern persists across visits, or a parent is worried.
Read the answer AnswerObserving naming speed during a home visit
On a home visit, observe how quickly and smoothly a child names familiar things they clearly know — objects, people, colours — not whether they are perfect. Slow, hesitant or effortful naming with long pauses or repeated 'that thing' can be an early clue worth noting, after checking home language, shyness, tiredness, hearing and vision. This is to observe and note, never to diagnose at home; route persistent patterns to a general developmental and speech check.
Read the answer AnswerWhat to observe about a child's need for sameness
During a home visit, a frontline worker should observe how a child responds to changes in routine, objects or surroundings — noting comfort in repetition and distress when things shift. A little need for sameness is normal in young children, so the worker observes intensity, how long distress lasts and whether it disrupts daily life, watching alongside communication and play. This is monitoring, not diagnosis; persistent, intense distress around change warrants a gentle referral for a developmental screen.
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