PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

1211dd8a-afbb-4bfd-968c-8f1abef3facc

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Vidushi Pal

Age

3 Year 1 Month 24 Days

Gender

Female

DOB

2023-07-14

Mother’s age (years)

45 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

45 years

Father’s education

Father’s occupation

Wendy School

Type of family

Nuclear

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

Address

Vinay Nagar

Contact

7415456389

Referred By

Doctor

Informant

Parents

Chief concerns

Poor response to name call

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Hand flapping, loooking from corner of eyesw

Patterned behavior or activities

If yes- Details

Others

Details:

Sniffs objects, arranges objects in que

Impression

? ASD

Hopes from the consultation