PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 3/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

Hypersensitive

PatientId

751f4b36-015d-4a11-9742-acc98ca7f6fb

FollowUpId

e1585bf6-3d08-4c04-99b1-79478e2db5b8

Child's Name

Nitya Tripathi

Age

3 Year 3 Month 9 Days

Gender

Female

DOB

2023-07-12

Mother’s age (years)

33 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

37 years

Father’s education

Father’s occupation

Air force

Type of family

Nuclear

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

10 year old female

Address

Hashimara

Contact

8602448008

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Handflapping

Patterned behavior or activities

If yes- Details

Others

Details:

Spitting

Impression

Social communication delay

Hopes from the consultation