PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week +PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed diet. Bottlefeeding 3-4 times

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

3f8af7dd-82d7-4239-b241-65470fe12e04

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Shivansh Singh Tomar

Age

2 Year 3 Month 2 Days

Gender

Male

DOB

2024-02-02

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

IT (Work from home)

Type of family

Joint

Number of family members

5

Number of siblings

6

Details of siblings (Age and sex)

Address

Adarshpuram

Contact

9806709042

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay, poor response to name call

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

running to and fro, toe walking

Patterned behavior or activities

If yes- Details

Others

Details:

Scratching when not allowed for something, spins wheels of toys

Impression

M chat r score- 16 (High risk)

Hopes from the consultation