PatientInfo

Is child enrolled in school

No

Intervention plan

Home Based Program 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

HR

Neuropsychiatric condition

Yes

Place of Birth

Institutional

Hospitalization

No

Tactile

PatientId

edfbe1a6-0cc6-4930-8e2a-3ec6ffca9330

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

AKSHAT TIWARI

Age

3 Year 9 Month 10 Days

Gender

Male

DOB

2022-06-20

Mother’s age (years)

34 years

Mother’s education

Mother’s occupation

Homemaker

Father’s age (years)

38 years

Father’s education

Father’s occupation

In IAF (Srinagar)

Type of family

Nuclear

Number of family members

4

Number of siblings

1

Details of siblings (Age and sex)

1- 7 years male

Address

Srinagar

Contact

8168354045

Referred By

Doctor

Informant

Parents

Chief concerns

Speech delay, behavioral issues

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

Puts things in line

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

?ASD

Hopes from the consultation