PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hyposensitive

PatientId

cddddc94-846c-447d-bed5-c611b8adb98e

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Aurav Gupta

Age

3 Year

Gender

Male

DOB

2023-07-20

Mother’s age (years)

Mother’s education

Mother’s occupation

Private job

Father’s age (years)

Father’s education

Father’s occupation

Private job

Type of family

Joint

Number of family members

6

Number of siblings

1

Details of siblings (Age and sex)

1.5 years male

Address

Lohiya Bazar

Contact

8867185958

Referred By

Informant

Parents

Chief concerns

Behavioral concerns, separation anxiety

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Sustained

Interaction

Quality of Interaction

avoids

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Self hitting

Impression

Behavioral concerns

Hopes from the consultation