PatientInfo

Is child enrolled in school

No

Intervention plan

IDP + PT/ Home Based Program

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

851e537b-2853-4acf-9e06-f22957b14df0

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Saksham Choubey

Age

3 Year 8 Month 15 Days

Gender

Male

DOB

2023-01-21

Mother’s age (years)

22

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

28

Father’s education

Father’s occupation

Private job

Type of family

Joint

Number of family members

5

Number of siblings

0

Details of siblings (Age and sex)

Address

Tikamgarh

Contact

7999882384

Referred By

Doctor

Informant

Father, grandfather

Chief concerns

Hyperactivity, inattention

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Interaction

Eye contact

Sustained

Interaction

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

Poor self regulation.

Hopes from the consultation