A couple consults a family physician during a community health fair regarding their son, who recently turned 36 months of age. The father reports that the child confidently pedals a tricycle around their driveway and walks up the playground steps using alternating feet. However, he is concerned because the child cannot yet hop on one foot and struggles to draw a cross with a crayon. The mother adds that while the family understands everything the child says, strangers seem to comprehend his speech about 75% of the time. The parents are worried about potential developmental delays because an older sibling was already performing these missing tasks at this age. Which of the following is the most appropriate action?
- ASuggest an occupational therapy evaluation for fine motor deficits
- BRecommend audiometry to investigate for hearing-related speech delay
- Explain that the child is demonstrating typical milestones for his ageAnswer
- DAdvise a physical therapy consultation to address gross motor function
- ERefer the child to a developmental-behavioral pediatrician
Answer
Explain that the child is demonstrating typical milestones for his age
The correct answer is to explain that the child is demonstrating typical milestones for his age. A healthy 3-year-old (36 months) is expected to ride a tricycle, ascend stairs with alternating feet, copy a circle, speak in 3-word sentences, and be about 75% intelligible to strangers. The parents are concerned because he cannot yet hop on one foot or draw a cross, but these are firmly established 4-year-old (48 months) milestones. Since his development is entirely age-appropriate, providing routine anticipatory guidance without further testing or referrals is the most appropriate action.
Step-by-Step Solution
Key Concept
Normal pediatric developmental milestones at 3 years versus 4 years of age.