PatientInfo

Is child enrolled in school

No

Intervention plan

IDP 2/week + PMT 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Picky eater. Bottlefeeding+

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hypersensitive

PatientId

a21b064d-9ce4-44d2-9f67-a3f0c54cabed

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Parth Jadon

Age

2 Year 5 Month 19 Days

Gender

Male

DOB

2024-01-03

Mother’s age (years)

27 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

30 years

Father’s education

Father’s occupation

Business

Type of family

Nuclear

Number of family members

Number of siblings

1

Details of siblings (Age and sex)

3.5 year old female

Address

Joura

Contact

8516026921

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay, poor interaction

Duration of symptoms

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

Handflapping, spinning, stimming

Patterned behavior or activities

If yes- Details

Others

Details:

Pica

Impression

M chat R score-16 (High risk)

Hopes from the consultation