PatientInfo

Is child enrolled in school

Yes

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

b561f7a2-f9d5-4228-933d-e90d1dd56995

FollowUpId

cc416532-2aba-42b3-89c4-cc7f489b3a4f

Child's Name

Avyan Maheshwari

Age

3 Year 10 Month 14 Days

Gender

Male

DOB

2022-07-26

Mother’s age (years)

36 years

Mother’s education

Mother’s occupation

Dentist

Father’s age (years)

39 years

Father’s education

Father’s occupation

Dentist

Type of family

Joint

Number of family members

5

Number of siblings

0

Details of siblings (Age and sex)

Address

Contact

8087893556

Referred By

Doctor

Informant

Chief concerns

Distractability, poor self control, stubborness

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

age-appropriate

Repetitive behaviors (RRBs)

If yes- Details

Patterned behavior or activities

If yes- Details

Others

Details:

Hitting behavior

Impression

Poor self regulation

Hopes from the consultation