Match each pediatric clinical presentation to the most appropriate next step in management based on developmental guidelines and red flags.
- An 18-month-old boy who brings objects to parents for help but does not point to share interest, has poor eye contact, and inconsistently responds to his name.Administer an autism-specific screening tool
- A 24-month-old girl who speaks in 2-word phrases and runs, but persistently walks on her toes and exhibits increased bilateral calf tone.Refer for a formal neurological evaluation
- A 15-month-old boy who walks independently and follows 1-step commands with gestures, but does not use any recognizable words and rarely babbles.Refer for a formal audiology evaluation
- A 4-year-old boy who copies a cross, hops on one foot, and plays cooperatively, but occasionally repeats the first syllables of words when excited.Provide reassurance and continue routine observation
Answer
The presentations match as follows: The 18-month-old requires an autism-specific screening tool, the 24-month-old requires a neurological evaluation, the 15-month-old requires an audiology evaluation, and the 4-year-old requires reassurance and observation.
Each matching correctly pairs a specific developmental presentation with its evidence-based next step. The 18-month-old demonstrates impaired joint attention and social reciprocity, which are hallmark signs of autism spectrum disorder (requiring screening). The 24-month-old displays motor red flags indicative of spasticity (requiring neurology). The 15-month-old exhibits delayed expressive language without other global delays (requiring audiology). The 4-year-old presents with benign developmental stuttering (requiring reassurance).
Step-by-Step Solution
Key Concept
Distinguishing normal developmental variations from pathological delays to determine the appropriate next step in pediatric management.