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Asha Phc
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Signs & concerns
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Signs & concerns
Visual Spatial Processing on a Home Visit
On a home visit, observe how the child uses eyes and hands together to understand space: accurate looking and reaching, judging distances while moving, stacking and nesting objects, posting shapes, and finding hidden toys. These are everyday signs of growing visual spatial processing. Note patterns rather than diagnose, check for vision concerns first, and route persisting or multi-area difficulties to a general developmental check.
Read the answer AnswerObserving visuospatial skills on a home visit
On a home visit, observe how the child uses eyes and hands together to understand space, shape and position — fitting objects into containers, stacking, simple puzzles, copying shapes, and moving around the home without bumping. These are skills to watch and note over several visits, not to diagnose. Check vision and hearing first, and if a gap persists across visits or affects more than one area, route the family gently to a developmental check.
Read the answer AnswerObserving vocabulary on a home visit
On a home visit, a frontline worker should observe how a child understands and uses words for their age — responding to their name, following simple instructions, pointing and gesturing, saying clear words, and imitating sounds in play. These are things to note across visits, not to diagnose at home. Check that hearing has been screened, and gently route any concern to a PHC or developmental check.
Read the answer AnswerObserving vocabulary comprehension and expression on a home visit
On a home visit, a frontline worker should observe how a child understands words (responds to their name, follows simple instructions, points to named objects) and expresses them (babbling, first words, joining words, using gestures) — counting language across all home languages. These are observations to note and discuss, not diagnose. A gap that persists across months, very little understanding for age, or loss of words is a reason to route the family kindly for a developmental check.
Read the answer AnswerObserving vocabulary knowledge on a home visit
On a home visit, a frontline worker should observe how a child understands and uses words in everyday play — recognising familiar names and objects, naming people and things, joining words by age 2, and picking up new words steadily over time. Note the home language too, and watch for steady growth and words used to connect. These are observations to note and route, not to diagnose; a hearing check comes first if words are slow.
Read the answer AnswerWhat to observe about vocalisation on a home visit
During a home visit, a frontline worker should observe how the child makes and uses sound for their age — cooing and chuckling early on, babbling with repeated sounds like "ba-ba" by 6–9 months, and first words plus pointing near a year. Note whether the baby responds to voices and takes turns making sounds. These are signs to observe and record, not diagnose, with hearing checks first and a warm route to a developmental screen for any concern.
Read the answer AnswerWhat to Observe About a Child Learning to Walk
During a home visit, observe how a child moves, not just when they walk. Watch for pulling to stand and cruising by 9–12 months, independent steps by 12–18 months, and even, symmetric leg use. Concern signs include no standing with support by 12 months, no steps by 18 months, stiffness or scissoring, one-sided weakness, or lost skills. These are signs to observe and route for a check — never to diagnose at home.
Read the answer AnswerObserving Walking Balance During a Home Visit
During a home visit, a frontline worker should observe how steadily a child stands, pulls to stand, cruises and takes independent steps, and how they recover from wobbles. Most children walk independently between 12 and 18 months, with wide normal variation. Watch during natural play and note what the child can do. Flag delays past 18 months, clear one-sided weakness, persistent tiptoe or stiff gait, or loss of a skill — these warrant a closer look, not a home diagnosis.
Read the answer AnswerObserving word knowledge during a home visit
During a home visit, a frontline worker should observe how the child understands and uses everyday words — responding to their name, following simple instructions, pointing, naming familiar objects, and joining words together as they grow. These are observations to note and monitor, not to diagnose. Check that hearing is fine first. If word knowledge seems clearly behind others of the same age, or the family is worried, gently route the child to the PHC medical officer or a developmental check. Early support never waits for a label.
Read the answer AnswerObserving working memory on a home visit
On a home visit, a frontline worker should observe how a child holds and uses information briefly — following age-appropriate one- or two-step instructions, finding a recently hidden toy, repeating a short rhyme or sequence, and completing familiar routines. These are signs to observe and note, not to diagnose at home. Suggest a developmental check if the child consistently cannot hold instructions expected for their age, struggles across home and play, or shows this alongside other delays.
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 AnswerSigns of hearing loss in a 9–12-month-old
By 9–12 months babies turn to their name, babble, and respond to sound. Hearing loss is easy to miss but highly treatable when caught early. If your baby doesn't react to sound, has reduced babble, or ignores her name, arrange a hearing test now.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible ADHD Early
A frontline worker can flag possible ADHD when inattention, overactivity or impulsivity is greater than expected for age, persists 6+ months across home and school, and disrupts daily life. ADHD is reliably recognised from around age 5–6; below this, restlessness is usually normal. Screen to refer, never to diagnose.
Read the answer AnswerHow a frontline health worker can spot possible attachment difficulties early
Possible attachment difficulties show as a child who rarely seeks or accepts comfort from a caregiver, is withdrawn and flat, or is indiscriminately over-friendly with strangers — set against disrupted or insufficient care. Watch for a pattern across visits, support the caregiver without blame, and refer for a hearing check and relationship-focused assessment.
Read the answer AnswerHow a Health Worker Can Spot Auditory Processing Difficulties Early
Suspect Auditory Processing Difficulties when a child with normal basic hearing repeatedly mishears, needs repetition, can't follow spoken instructions in noise, or listens inconsistently. Rule out ear infection and hearing loss first, then refer for speech-language and audiological assessment — formal testing matures from around age 7.
Read the answer AnswerHow a frontline health worker can spot possible autism early
Frontline workers spot possible autism by watching how a child shares attention, responds to name, points, plays and communicates — plus repetitive behaviour and need for sameness — when these persist across settings. Refer urgently on any regression, no babble or gesture by 12 months, no words by 16 months, or no two-word phrases by 24 months. Workers refer; only clinicians diagnose.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Cerebral Palsy Early
Suspect possible Cerebral Palsy when a child shows a persistent pattern of abnormal tone (too stiff or too floppy), asymmetry such as early hand preference before 12 months, or delayed motor milestones that do not improve. These are signals to refer promptly, not to diagnose — and prematurity, birth asphyxia or NICU history raises risk.
Read the answer AnswerHow a Frontline Health Worker Can Spot Childhood Anxiety Early
Spot childhood anxiety when worry, fear or avoidance is out of proportion, lasts weeks, and disrupts school, sleep, play or eating. Children often show it physically — tummy aches, headaches, clinging — rather than in words. Persistent signs across home and school justify a developmental check and referral; treat any hopelessness or self-harm mention as urgent.
Read the answer AnswerSpotting Childhood Apraxia of Speech early at the frontline
Suspect Childhood Apraxia of Speech when a child clearly understands but speaks very little, says the same word inconsistently, shows groping mouth movements, and speech worsens with effort. Frontline workers should screen and refer — alongside a hearing check — to a speech-language pathologist; only a clinician can confirm CAS.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Childhood Epilepsy Early
Suspect childhood epilepsy when a child has recurrent unprovoked episodes — staring spells, sudden jerks, stiffening or collapse — that recur in a stereotyped pattern. Epilepsy is a medical condition, so any suspected seizure warrants prompt referral to a doctor, not therapy-first or wait-and-watch.
Read the answer AnswerHow a Health Worker Can Spot Childhood Sleep Difficulties Early
Spot possible childhood sleep difficulties by asking about settling time, night waking, loud snoring or breathing pauses, and daytime irritability or poor attention. Refer loud snoring with pauses promptly; refer persistent difficulties after basic sleep-hygiene advice — only a clinician can confirm.
Read the answer AnswerSpotting Conduct-Dissocial Disorder early
Refer when a child shows a persistent, pervasive pattern of aggression, deceit, destruction or serious rule-breaking across home, school and community — not one-off lapses or normal tantrums. Frontline workers should always screen for abuse, neglect, learning or hearing difficulty first, and refer urgently on any risk of harm. Diagnosis is a clinical decision, never a screen.
Read the answer AnswerSpotting Possible DCD Early at a Community Visit
Frontline workers can spot possible DCD when a child's movement skills — balance, dressing, pencil and cup use — are clearly below age expectation, persistent across settings, and not explained by vision, hearing, neurological or intellectual causes. Rule out the obvious, check persistence and impact, then refer. Only a clinician can confirm.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible DLD Early
Suspect Developmental Language Disorder when a child's understanding or use of language is clearly behind age expectations and persists despite normal hearing, and isn't explained by another condition. Key early flags: no gestures by 12 months, no single words by 16–18 months, no two-word phrases by 24 months, or hard-to-understand speech by 3 years. The frontline worker spots the pattern, checks hearing, and refers — diagnosis stays with a clinician.
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