PatientInfo

Is child enrolled in school

No

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

PatientId

83e32bd2-80cd-4f6b-8fa4-a41c88bc0e61

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Atharva Pathak

Age

6 Year 1 Month 9 Days

Gender

Male

DOB

2020-08-12

Mother’s age (years)

35 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

36 years

Father’s education

Father’s occupation

Government job

Type of family

Nuclear

Number of family members

Number of siblings

1

Details of siblings (Age and sex)

10 year old female

Address

Contact

8114420516

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay, behavioral concerns

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

Looking from corner pf eyes

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

ASD

Hopes from the consultation