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OPD : 02-Jun-2026 11:35AM Demographic Details Child's Name: Rudra Pratap Singh Age: 5 Year 1 Month 26 Days Gender: Male DOB: 2021-04-07 Mother’s age (years): 38 years Mother’s occupation: Homemaker Father’s age (years): 40 years Father’s occupation: Bank Type of family: Joint Number of family members: 4 Number of siblings: 1 Details of siblings (Age and sex): 9 year old female Address: Sikandar Kampoo Contact: 7987174700 Referred By: Doctor Informant: Mother Presenting Concerns Chief concerns: Speech delay, object obsession Interaction history: Eye contact: Fleeting Quality of Interaction: limited Behavioral history: Inattention Object obsession Temper tantrums Stubbornness Others Emotional History Details: Irrelevant laughing episodes sometime Sensory Concerns: Auditory: Hyposensitive Vestibular: Avoids swings Birth & Perinatal History: Antenatal History Consanguinity: No Type of conception: Natural Natal and Postnatal History: Place of Birth: Institutional Mode of Delivery: LSCS Indication for LSCS (if applicable): Previous LSCS Gestational Age: FT Birth Weight: 2.5 Kg Cry at birth: Cried immediately after birth Resuscitation required: No NICU stay: No Past history: Hospitalization: Yes Seizures: No Others: At 1.5 year age- admitted for pneumonia Investigations done- Hearing assessment: Done Details: BERa- normal Vision assessment: Not done Family history: Neuropsychiatric condition: No Developmental History: Gross Motor Neck holding: Achieved Age of attainment: 4 months Roll over: Achieved Age of attainment: 5 months Sitting without support: Achieved Age of attainment: 7 months Standing without support: Achieved Age of attainment: 10 months Walking without support: Achieved Age of attainment: 13 months Running: Achieved Age of attainment: Climbing upstairs: Achieved Age of attainment: Climbing downstairs: Achieved Age of attainment: Fine Motor Bidextrous grasp: Achieved Age of attainment: 4 months Unidextrous grasp: Achieved Age of attainment: 6 months Pincer grasp: Achieved Age of attainment: 12 months Scribbling: Achieved Age of attainment: Drinking from cup: Achieved Age of attainment: Language Receptive:- Joint attention: Achieved Age of attainment: Pointing: Achieved Age of attainment: Understanding gestures: Achieved Age of attainment: Following commands: 1-step Expressive:- Cooing: Achieved Age of attainment: 4 months Babbling: Achieved Age of attainment: 6 months Meaningful words: Not achieved Expressive:- Cooing: Achieved Age of attainment: 4 months Babbling: Achieved Age of attainment: 6 months Meaningful words: Not achieved Communication & Language Assessment Non-Verbal Communication Grading:- Need-based communication: Inconsistent Drag for needs: Inconsistent Joint attention: Inconsistent Pointing: Attempts Answering Questions:- Echolalia: Present Social Social smile: Achieved Age of attainment: 2 months Stranger anxiety: Achieved Age of attainment: 8 months Waving bye bye: Not achieved Comes when called: Achieved Age of attainment: Response to Name Call Sitting tolerance- (in minutes) For interaction: Doesnt sit For tasks: Better for tasks ADL Skills (Age-appropriate)- Eating: 4. Needs minimal assistance Bathing: 2. Started attempting Toilet training: 2. Started attempting Dressing: 2. Started attempting Undressing: 2. Started attempting Type of Play : 3. Onlooker Academic History: Is child enrolled in school: Yes Additional information: Going to start from July Diet History: Food preferences: Mixed Food allergies: No Junk food intake: Alternate days Sleep History Total sleep duration (night): 9 hours Afternoon nap: Yes Duration of Afternoon nap: 2-3 hours Daily Screen Time Duration: Zero Examination a. Vitals: b. Anthropometry: Weight: 17.2 kg Height: 104 cm Head circumference: 50 cm c. General Examination Dysmorphology: Ab Neurocutaneous markers: Ab d. CNS: Higher Mental Functions Sensory Examination Cranial Nerves (1–12) Neuromuscular Concerns Oromotor Examination Drooling: No Chewing: Proper Swallowing: Proper Blowing: Proper Sucking: Proper CVS examination: NAD Respiratory System examination: NAD Per abdomen examination: NAD Impression: ?ASD Advice Intervention plan: IDP 2/week +PMT 1/week Follow up plan: every month General recommendation- Zero Screen Time Physical interactive play No Junk food

OPD : 02-Jun-2026 11:35AM Demographic Details

Child's Name: Rudra Pratap Singh
Age: 5 Year 1 Month 26 Days
Gender: Male
DOB: 2021-04-07
Mother’s age (years): 38 years
Mother’s occupation: Homemaker
Father’s age (years): 40 years
Father’s occupation: Bank
Type of family: Joint
Number of family members: 4
Number of siblings: 1
Details of siblings (Age and sex): 9 year old female
Address: Sikandar Kampoo
Contact: 7987174700
Referred By: Doctor
Informant: Mother

Presenting Concerns

Chief concerns: Speech delay, object obsession

Interaction history:

Eye contact: Fleeting
Quality of Interaction: limited

Behavioral history:

Inattention Object obsession Temper tantrums Stubbornness Others Emotional History Details: Irrelevant laughing episodes sometime
Sensory Concerns:

Auditory: Hyposensitive
Vestibular: Avoids swings

Birth & Perinatal History: Antenatal History

Consanguinity: No
Type of conception: Natural

Natal and Postnatal History:

Place of Birth: Institutional
Mode of Delivery: LSCS
Indication for LSCS (if applicable): Previous LSCS
Gestational Age: FT
Birth Weight: 2.5 Kg
Cry at birth: Cried immediately after birth
Resuscitation required: No
NICU stay: No

Past history:

Hospitalization: Yes Seizures: No Others: At 1.5 year age- admitted for pneumonia

Investigations done-

Hearing assessment: Done Details: BERa- normal Vision assessment: Not done

Family history:

Neuropsychiatric condition: No

Developmental History:

Gross Motor

Neck holding: Achieved

Age of attainment: 4 months
Roll over: Achieved

Age of attainment: 5 months
Sitting without support: Achieved

Age of attainment: 7 months
Standing without support: Achieved

Age of attainment: 10 months
Walking without support: Achieved

Age of attainment: 13 months
Running: Achieved

Age of attainment:
Climbing upstairs: Achieved

Age of attainment:
Climbing downstairs: Achieved

Age of attainment:

Fine Motor

Bidextrous grasp: Achieved

Age of attainment: 4 months

Unidextrous grasp: Achieved

Age of attainment: 6 months

Pincer grasp: Achieved

Age of attainment: 12 months

Scribbling: Achieved

Age of attainment:

Drinking from cup: Achieved

Age of attainment:

Language

Receptive:-

Joint attention: Achieved

Age of attainment:
Pointing: Achieved

Age of attainment:
Understanding gestures: Achieved

Age of attainment:
Following commands: 1-step

Expressive:-

Cooing: Achieved

Age of attainment: 4 months

Babbling: Achieved

Age of attainment: 6 months

Meaningful words: Not achieved

Expressive:-

Cooing: Achieved

Age of attainment: 4 months

Babbling: Achieved

Age of attainment: 6 months

Meaningful words: Not achieved

Communication & Language Assessment

Non-Verbal Communication Grading:-

Need-based communication: Inconsistent
Drag for needs: Inconsistent
Joint attention: Inconsistent
Pointing: Attempts

Answering Questions:-

Echolalia: Present

Social

Social smile: Achieved

Age of attainment: 2 months
Stranger anxiety: Achieved

Age of attainment: 8 months
Waving bye bye: Not achieved
Comes when called: Achieved

Age of attainment:

Response to Name Call

Sitting tolerance- (in minutes)

For interaction: Doesnt sit
For tasks: Better for tasks

ADL Skills (Age-appropriate)-

Eating: 4. Needs minimal assistance
Bathing: 2. Started attempting
Toilet training: 2. Started attempting
Dressing: 2. Started attempting
Undressing: 2. Started attempting

Type of Play : 3. Onlooker Academic History:

Is child enrolled in school: Yes
Additional information: Going to start from July

Diet History:

Food preferences: Mixed
Food allergies: No
Junk food intake: Alternate days

Sleep History

Total sleep duration (night): 9 hours
Afternoon nap: Yes
Duration of Afternoon nap: 2-3 hours

Daily Screen Time

Duration: Zero

Examination

a. Vitals:

b. Anthropometry:

Weight: 17.2 kg Height: 104 cm Head circumference: 50 cm

c. General Examination

Dysmorphology: Ab Neurocutaneous markers: Ab

d. CNS: Higher Mental Functions

Sensory Examination

Cranial Nerves (1–12)

Neuromuscular Concerns

Oromotor Examination

Drooling: No
Chewing: Proper
Swallowing: Proper
Blowing: Proper
Sucking: Proper

CVS examination: NAD
Respiratory System examination: NAD
Per abdomen examination: NAD

Impression: ?ASD

Advice

Intervention plan: IDP 2/week +PMT 1/week
Follow up plan: every month
General recommendation-
1. Zero Screen Time
2. Physical interactive play
3. No Junk food

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