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Patient Details


OPD : 29-Aug-2026 12:07PM Demographic Details Child's Name: Tanush Shakya Age: 2 Year 1 Month 13 Days Gender: Male DOB: 2024-07-16 Contact: 9893349857 Current Improvements: Eye contact, interaction improved Current concerns: Stubborness Interaction history: Eye contact: Suboptimal Interaction: Improved with known people Quality of Interaction: limited Behavioral history: Repetitive behaviors (RRBs): Reduced Patterned behavior or activities: Sensory Concerns: Visual: Seeks visuals Details:: Reduced Birth & Perinatal History: Antenatal History Natal and Postnatal History: Past history: Investigations done- Family history: Developmental History: Gross Motor Fine Motor Language Expressive:- Communication & Language Assessment Non-Verbal Communication Grading:- Need-based communication: Inconsistent Drag for needs: Inconsistent Joint attention: Emerging Pointing: Absent Understanding gestures: Absent Following commands (gesture + verbal): 1-step Answering Questions:- Echolalia: Present Social Response to Name Call Details: 8/10 Sitting tolerance- (in minutes) For interaction: 5 minutes For tasks: 10 minutes ADL Skills (Age-appropriate)- Eating: 1. Dependent Bathing: 2. Started attempting Toilet training: 1. Dependent Dressing: 1. Dependent Undressing: 1. Dependent Type of Play : 3. Onlooker Academic History: Is child enrolled in school: No Diet History: Food preferences: Prefers mashed food Food allergies: No Junk food intake: Nil Sleep History Total sleep duration (night): 10 hours Afternoon nap: Yes Duration of Afternoon nap: 2 hours Daily Screen Time Duration: Zero Examination a. Vitals: b. Anthropometry: Height: 90 cm Head circumference: 49 cm c. General Examination d. CNS: Higher Mental Functions Sensory Examination Cranial Nerves (1â€“12) Neuromuscular Concerns Oromotor Examination CVS examination: NAD Respiratory System examination: NAD Per abdomen examination: NAD Impression: ? ASD Advice Intervention plan: HBP 1/week Medications: Syp Autinorm 5 ml OD Follow up plan: Next month General recommendation- Zero Screen Time Physical interactive play No Junk food

OPD : 29-Aug-2026 12:07PM Demographic Details

Child's Name: Tanush Shakya
Age: 2 Year 1 Month 13 Days
Gender: Male
DOB: 2024-07-16
Contact: 9893349857
Current Improvements: Eye contact, interaction improved
Current concerns: Stubborness

Interaction history:

Eye contact: Suboptimal
Interaction: Improved with known people
Quality of Interaction: limited

Behavioral history:

Repetitive behaviors (RRBs): Reduced Patterned behavior or activities:
Sensory Concerns:

Visual: Seeks visuals

Details:: Reduced

Birth & Perinatal History: Antenatal History

Natal and Postnatal History:

Past history:

Investigations done-

Family history:

Developmental History:

Gross Motor

Fine Motor

Language

Expressive:-

Communication & Language Assessment

Non-Verbal Communication Grading:-

Need-based communication: Inconsistent
Drag for needs: Inconsistent
Joint attention: Emerging
Pointing: Absent
Understanding gestures: Absent
Following commands (gesture + verbal): 1-step

Answering Questions:-

Echolalia: Present

Social

Response to Name Call

Details: 8/10

Sitting tolerance- (in minutes)

For interaction: 5 minutes
For tasks: 10 minutes

ADL Skills (Age-appropriate)-

Eating: 1. Dependent
Bathing: 2. Started attempting
Toilet training: 1. Dependent
Dressing: 1. Dependent
Undressing: 1. Dependent

Type of Play : 3. Onlooker Academic History:

Is child enrolled in school: No

Diet History:

Food preferences: Prefers mashed food
Food allergies: No
Junk food intake: Nil

Sleep History

Total sleep duration (night): 10 hours
Afternoon nap: Yes
Duration of Afternoon nap: 2 hours

Daily Screen Time

Duration: Zero

Examination

a. Vitals:

b. Anthropometry:

Height: 90 cm Head circumference: 49 cm

c. General Examination

d. CNS: Higher Mental Functions

Sensory Examination

Cranial Nerves (1â€“12)

Neuromuscular Concerns

Oromotor Examination

CVS examination: NAD
Respiratory System examination: NAD
Per abdomen examination: NAD

Impression: ? ASD

Advice

Intervention plan: HBP 1/week
Medications: Syp Autinorm 5 ml OD
Follow up plan: Next month
General recommendation-
1. Zero Screen Time
2. Physical interactive play
3. No Junk food

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