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Asha Phc
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Signs & concerns
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Signs & concerns
Spotting Self-Regulation Difficulties Early
A frontline worker can spot possible self-regulation difficulties when a child shows persistent, intense trouble settling emotions, sleep, feeding or attention — out of proportion to age and present across settings. Rule out hunger, illness, pain and hearing first; refer for a developmental check when patterns persist for weeks and disrupt daily life. These are observations to refer, never a diagnosis.
Read the answer AnswerHow can a frontline health worker spot Sensory-Based Feeding Selectivity early?
Spot possible Sensory-Based Feeding Selectivity when a child's accepted foods are few and shrinking, when textures, smells or colours trigger strong distress, and when mealtimes are a daily battle affecting growth or family life. Refer promptly for any unsafe-swallowing signs or weight faltering; only a clinician can confirm.
Read the answer AnswerSpotting Sensory Processing Differences early
Frontline workers can spot possible Sensory Processing Differences when a child consistently over-reacts (distress at sounds, textures, touch), under-reacts (slow to feel pain, name, heat) or seeks intense input (constant movement, crashing) to a degree that disrupts feeding, dressing, play or settling across settings. Rule out hearing and vision first, weigh real-life impact, and refer for a developmental check rather than waiting.
Read the answer AnswerSpotting Separation Anxiety Disorder Early
Suspect possible Separation Anxiety Disorder when a child's fear of being apart from a caregiver is far stronger and longer-lasting than expected for age — persisting weeks and disrupting school, sleep or daily life. Frontline workers spot the pattern and refer; only a clinician diagnoses.
Read the answer AnswerSpotting Social Communication Difficulties Early
A frontline worker can spot possible social communication difficulties when a child shows little back-and-forth — limited eye contact, few gestures, weak response to name, delayed or odd language — across more than one setting. Two or more persistent signs, or any regression or parental concern, warrant a hearing check and developmental referral. This is screening for concern, never diagnosis.
Read the answer AnswerHow a frontline health worker can spot possible SLD early
Suspect SLD when a school-age child (typically 6+ years) shows persistent, specific, unexpected difficulty with reading, writing or number work — well below age level despite adequate teaching, normal hearing and vision, and no global delay. Frontline workers spot the pattern and refer; only a clinician confirms.
Read the answer AnswerSpotting Speech and Language Delay early
Spot a possible speech and language delay by tracking communication milestones — babbling and gesture by 12 months, single words by 16 months, two-word phrases by 24 months — and by trusting parental concern. Always check hearing first and refer rather than wait when signs persist.
Read the answer AnswerSpotting Stereotyped Movement Disorder early
Suspect Stereotyped Movement Disorder when a child shows repetitive, rhythmic, purposeless movements — hand-flapping, rocking, head-banging, self-biting — that persist past toddlerhood, look the same each time, and interfere with daily life or cause self-injury. Act most urgently on any self-injury, and always rule out seizures with prompt medical referral. A child need not have a diagnosis to be referred for a developmental check.
Read the answer AnswerSpotting Possible Tourette Syndrome Early
Suspect possible Tourette Syndrome when a child (first noticed around ages 4-8) shows repeated involuntary movements plus at least one vocal tic, present on and off for several months, that wax and wane and worsen with stress. Rule out vision problems and seizure mimics, reassure the family, and refer for paediatric or developmental assessment.
Read the answer AnswerHow a Frontline Health Worker Can Spot Possible Visual Impairment Early
Frontline workers can spot possible visual impairment by checking whether a baby fixes on and follows a face or light, whether the eyes look and align normally, and whether reaching and play match age. Refer urgently for a white or cloudy pupil, persistent squint, eyes not steady by 3 months, or any sudden loss of vision — a medical pathway, not therapy-first.
Read the answer AnswerWhen to escalate concerns about achievement orientation
Achievement orientation — the drive to attempt, persist with and take pride in tasks — develops gradually, not on a fixed date. A frontline worker should escalate to a developmental check when a child consistently avoids age-typical tasks, gives up instantly, shows no pride in finishing, or when this travels with language, play or social delays. This is a reason to assess early, never a diagnosis.
Read the answer AnswerWhen to escalate activity-completion delay — guidance for frontline workers
When a 2–3 year old cannot begin and finish a simple familiar task, it is often within the normal range of growing attention, not a diagnosis. A frontline worker should escalate to the Medical Officer or a developmental check when the difficulty is persistent, clearly behind peers, or travels with delays in speech, understanding, social connection or play. Document observations, ask the family what the child manages at home, and route early rather than wait.
Read the answer AnswerWhen to escalate a child's difficulty with adaptability
Adaptability (ICF d5) is how a child copes with change — new routines, places and transitions. A frontline health worker should escalate to a developmental check when difficulty adapting is persistent, age-inappropriate, disrupts daily life, or travels with delays in talking, play or social connection. This is a reason to assess early, not a diagnosis, because early support works best.
Read the answer AnswerWhen should a frontline health worker escalate an adaptive-skill delay?
A frontline health worker should escalate when a child clearly lags behind expected age for self-care skills — feeding, dressing, toileting, washing — and especially when the gap is widening, a skill has been lost, or delays appear alongside in speech, movement or social connection. Don't wait indefinitely: refer to the PHC Medical Officer or a developmental service the same month a clear gap or red flag is seen. This signals the need for assessment, not a diagnosis.
Read the answer AnswerWhen should a frontline health worker escalate an adaptive-skill delay?
Adaptive skills are everyday self-care abilities (ICF d5) — feeding, dressing, toileting, washing. A frontline worker should escalate for a developmental check when a child shows a persistent gap behind peers, no progress over 3–6 months, delays across several domains, loss of a learned skill, or clear parent concern. Escalation means a gentle referral, not a diagnosis — early support works best.
Read the answer AnswerWhen to escalate a child's aggression control
Most toddlers and preschoolers cannot fully control anger or aggression — hitting, biting and tantrums are common as self-regulation grows. A frontline health worker should escalate for a developmental check when aggression is frequent and intense, causes real harm, is not fading with age, or comes alongside delays in talking, play or social connection. This is a reason to assess early, not a diagnosis.
Read the answer AnswerAttachment Response: When a Frontline Worker Should Escalate
Attachment response is how a baby seeks and finds comfort in a familiar caregiver — the social smile, calming when held, looking for a parent's face. Frontline workers should escalate for a developmental check when there is no social smile by 3–4 months, no comfort-seeking or settling with the caregiver, very little eye contact or response to a familiar voice, or any clear loss of a connection once present. This is not a diagnosis — it is an early, sensible step, and early support works best.
Read the answer AnswerWhen should a frontline worker escalate attention and inhibition concerns?
A frontline health worker should escalate when a child's difficulty with attention and inhibition is persistent over weeks, clearly out of step with same-age peers, shows across settings (home, play, preschool), affects safety or learning, or travels with delays in talking or social connection. Attention and self-control mature slowly through the early years, so a single restless day is normal — a steady pattern is the trigger to refer for a developmental check. Referral is early opportunity, not a diagnosis.
Read the answer AnswerWhen to escalate a child's attention concern
A child's attention span grows with age, so a frontline worker should escalate when attention is clearly below the expected level for the child's age, is not improving across a few visits, or travels with delays in speech, social connection or learning. Loss of a skill, staring spells or sudden behaviour change need prompt medical review. Escalation is for assessment, not diagnosis, and early action works best.
Read the answer AnswerWhen should a frontline worker escalate an attention-to-detail concern?
Attention to detail develops gradually, and young children are naturally distractible, so judge against the child's own stage. A frontline worker should escalate to a Medical Officer or developmental check when the difficulty is persistent, clearly behind peers, affects daily play or learning, or travels with delays in talking, understanding, hearing, vision or motor skills. Always check hearing, vision, nutrition and recent illness first. This is a referral signal, not a diagnosis — early review opens early support.
Read the answer AnswerAttention to Others: When a Frontline Worker Should Escalate
Attention to others — responding to name, eye contact, shared smiles, following a point and joint attention — develops across the first two years. A frontline health worker should escalate when a child consistently does not respond to their name, makes little eye contact, does not share smiles or follow a point, or shows no joint attention by around 12–18 months, especially with language delay or regression. Parental concern and clustered flags both warrant prompt referral for a structured developmental check — a reason to assess early, not a diagnosis.
Read the answer AnswerWhen to escalate auditory memory concerns
Auditory memory develops gradually, so occasional forgetting is normal. A frontline worker should escalate when difficulty holding and recalling spoken information is consistent across settings, the child cannot follow age-expected simple instructions, or it travels with delays in talking, attention or possible hearing loss. Rule out hearing first. This is a reason to assess early, not a diagnosis.
Read the answer AnswerIf a child struggles with auditory processing, when should a frontline health worker escalate?
A frontline worker should escalate when a child hears but consistently struggles to understand, follow or respond to spoken language at the expected age. The first, essential step is a hearing test and ENT review to rule out hearing loss or ear infection — auditory processing (ICF b156) is only considered once hearing is confirmed clear. Escalate promptly when difficulties persist across settings, do not improve over weeks, or come with speech-language delay. This is a referral decision, not a diagnosis.
Read the answer AnswerWhen to escalate delayed self-care autonomy
Autonomy in self-care (ICF d5) — feeding, dressing, washing, toileting, simple choices — develops gradually, so one missed step rarely worries. A frontline worker should escalate to the Medical Officer when self-care lags well behind peers across several areas, when a gained skill is lost, or when delay travels with concerns in speech, motor, hearing or social connection. This is early routing, not a diagnosis.
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