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

Hypersensitive

PatientId

7e8d38a6-3acb-4f86-96a2-679682401b4e

FollowUpId

56ed9ae4-b67d-4a8f-9ba5-c0795ad0bfbd

Child's Name

Ekagra Agrawal

Age

2 Year

Gender

Male

DOB

2024-09-22

Mother’s age (years)

Mother’s education

Mother’s occupation

Father’s age (years)

Father’s education

Father’s occupation

Type of family

Joint

Number of family members

6

Number of siblings

0

Details of siblings (Age and sex)

Address

City centre

Contact

7987683472

Referred By

Healthcare worker

Informant

Parents

Chief concerns

Poor response to name call

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

running to and fro, closing ears, eyes flapping

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

? ASD

Hopes from the consultation