PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

Yes

Tactile

PatientId

8ad197bb-f2fc-46f4-8fe7-7b2d9d5196a9

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Shivansh Dwivedi

Age

7 Year 2 Month 9 Days

Gender

Male

DOB

2018-12-19

Mother’s age (years)

36 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

37 year

Father’s education

Father’s occupation

Service (Airforce)

Type of family

Nuclear

Number of family members

3

Number of siblings

0

Details of siblings (Age and sex)

Address

DD Nagar

Contact

8285208935

Referred By

Relative

Informant

Parents

Chief concerns

Poor understanding, behavioral issues, speech delay

Duration of symptoms

Realized speech delay since 1 year

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Task oriented

Impression

Hopes from the consultation