PatientInfo

Is child enrolled in school

No

Intervention plan

Home Based program 1/week

Consanguinity

No

Neck holding

Achieved

Food preferences

Mixed

HR

Neuropsychiatric condition

No

Place of Birth

Institutional

Hospitalization

No

Tactile

Hypersensitive

PatientId

da98405c-5159-4eff-9aa6-d0a7bc68c3a6

FollowUpId

00000000-0000-0000-0000-000000000000

Child's Name

Mayank Dhurve

Age

4 Year 4 Month 1 Days

Gender

Male

DOB

2022-02-22

Mother’s age (years)

31 years

Mother’s education

Mother’s occupation

homemaker

Father’s age (years)

36 years

Father’s education

Father’s occupation

Private job

Type of family

Nuclear

Number of family members

5

Number of siblings

2

Details of siblings (Age and sex)

1- 11year female, 2- 7 year female

Address

Betul

Contact

9009105687

Referred By

Doctor

Informant

Parents

Chief concerns

Duration of symptoms

Noticed 13 month age

Concerns noticed by school (if any)

Strengths of child

Eye contact

Poor

Interaction

Quality of Interaction

limited

Repetitive behaviors (RRBs)

If yes- Details

running to and fro, jumping

Patterned behavior or activities

If yes- Details

Others

Details:

Impression

? ASD

Hopes from the consultation