PatientInfo

Is child enrolled in school

No

Intervention plan

Home based program

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed: sugar cravings

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hyposensitive

PatientId

24a4b436-18a6-4127-be66-f3d725c41d15

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Ilham Khan

Age

4 Year 1 Month 2 Days

Gender

Male

DOB

2022-05-07

Mother’s age (years)

33 years

Mother’s education

Mother’s occupation

Teacher

Father’s age (years)

39 years

Father’s education

Father’s occupation

Business

Type of family

Joint

Number of family members

5

Number of siblings

1

Details of siblings (Age and sex)

8.5 years

Address

Etawah

Contact

9149210209

Referred By

Doctor

Informant

Parents

Chief concerns

Hyperactivity

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

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

ASD

Hopes from the consultation