PatientInfo

Is child enrolled in school

Yes

Intervention plan

IEP 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

00ce14af-90c9-4384-af3f-192fa09de06b

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Bhavishya Verma

Age

15 Year 9 Month 27 Days

Gender

Male

DOB

2010-08-10

Mother’s age (years)

37 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

44 years

Father’s education

Father’s occupation

Government teacher

Type of family

Nuclear

Number of family members

5

Number of siblings

1

Details of siblings (Age and sex)

6 year old male

Address

Shivpuri

Contact

9755128868

Referred By

Doctor

Informant

Father, uncle

Chief concerns

Understanding not age appropriate

Duration of symptoms

Noticed since 3rd grade

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Fidgetiness+

Impression

ID

Hopes from the consultation