PatientInfo

Is child enrolled in school

Yes

Intervention plan

IDP 2/week +PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater. Craving for sweets

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

f53aeea3-e684-4dc0-a36d-bdb80d2d79ee

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Mishita sen

Age

3 Year 11 Month 28 Days

Gender

Female

DOB

2022-04-13

Mother’s age (years)

29 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

31 years

Father’s education

Father’s occupation

Private job

Type of family

Joint

Number of family members

5

Number of siblings

1

Details of siblings (Age and sex)

8 months male

Address

Kampoo

Contact

8959899819

Referred By

Doctor

Informant

Parents

Chief concerns

Poor eye contact, speech delay, hyperactivity

Duration of symptoms

Since

Concerns noticed by school (if any)

Strengths of child

Eye contact

Fleeting

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Jumping, to and fro

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

ASD

Hopes from the consultation