PatientInfo

Is child enrolled in school

Yes

Intervention plan

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hyposensitive

PatientId

3ee2bd17-ff89-4a7f-8b53-6ddefd135efa

FollowUpId

d663bb43-6c90-47d1-838b-fb07a181b2e9

Child's Name

Samarth Shrivastava

Age

8 Year 7 Month 9 Days

Gender

Male

DOB

2017-10-03

Mother’s age (years)

36 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

43 years

Father’s education

Father’s occupation

Business

Type of family

Joint

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

12 years female

Address

Lahar

Contact

7987839162

Referred By

Doctor

Informant

Mother, Paternal aunt

Chief concerns

Poor understanding, social behavior not age appropriate

Duration of symptoms

From early infancy

Concerns noticed by school (if any)

Strengths of child

Eye contact

Suboptimal

Interaction

Quality of Interaction

Repetitive behaviors (RRBs)

If yes- Details

Toe walking

Patterned behavior or activities

If yes- Details

Plays with rope and twigs

Others

Details:

Licking hands, walls, his soles

Impression

ID

Hopes from the consultation