A 4-year-old boy is brought to the physician because of non-fluent speech. His mother worries that his vocabulary is limited for his age and because he cannot use simple sentences to communicate. She says he enjoys playing with his peers and parents, but he has always lagged behind in his speaking and communication. His speech is frequently not understood by strangers. He physically appears normal. His height and weight are within the normal range for his age. He responds to his name, makes eye contact, and enjoys the company of his mother. Which of the following is the most appropriate next step in management?
AReferral to speech therapist
BEvaluate response to methylphenidate
CPsychiatric evaluation
DAudiology testing
EThyroid-stimulating hormone
A 13-month-old girl is brought to the physician for a well-child examination. She was born at 38 weeks' gestation. There is no family history of any serious illnesses. She cannot pull herself to stand from a sitting position. She can pick an object between her thumb and index finger but cannot drink from a cup or feed herself using a spoon. She comes when called by name and is willing to play with a ball. She cries if she does not see her parents in the same room as her. She coos “ma” and “ba.” She is at the 50th percentile for height and weight. Physical examination including neurologic examination shows no abnormalities. Which of the following is the most appropriate assessment of her development?
AFine motor: normal | Gross motor: delayed | Language: normal | Social skills: delayed
BFine motor: normal | Gross motor: delayed | Language: delayed | Social skills: normal
CFine motor: delayed | Gross motor: normal | Language: delayed | Social skills: normal
DFine motor: delayed | Gross motor: delayed | Language: normal | Social skills: normal
EFine motor: delayed | Gross motor: normal | Language: normal | Social skills: delayed
A 6-year-old boy presents to the pediatrician with his parents. He is fully vaccinated and met most developmental milestones. His fine motor milestones are delayed; at present, he cannot eat by himself and has difficulty in self-dressing. His intelligence quotient (IQ) is 65. He listens quietly while spoken to and engages in play with his classmates. He neither talks excessively nor remains mute, but engages in normal social conversation. There is no history of seizures and he is not on any long-term medical treatment. On his physical examination, his vital signs are stable. His height and weight are normal for his age and sex, but his occipitofrontal circumference is less than the 3rd percentile for his age and sex. His neurologic examination is also normal. Which of the following is the most likely diagnosis?
AAttention deficit hyperactivity disorder
BAutism
CIntellectual disability
DObsessive-compulsive disorder
ETic disorder
+ 7 more in the PDF
Browse all chapters