A mother brings her 12-month-old boy to the clinic for a routine well-child visit. He was born at 28 weeks of gestation via emergency cesarean delivery due to severe maternal preeclampsia. He spent 6 weeks in the neonatal intensive care unit primarily for respiratory distress syndrome but was discharged on room air and has since done well. Today, the mother expresses deep concern regarding his neurodevelopment. She notes that her older daughter was walking independently and saying specific words like 'dog' and 'milk' by her first birthday. In contrast, her son currently only pulls himself up to a standing position while holding onto furniture and babbles 'mamama' and 'bababa' without directing it at anyone specifically. On physical examination, the infant sits steadily without support and transitions smoothly from lying down to a seated position. He transfers a wooden block from one hand to the other and picks up a small piece of cereal using his thumb along with his index and middle fingers. When the physician covers a small toy with a towel, the infant immediately pulls the towel away to retrieve it. Muscle tone and deep tendon reflexes are normal throughout. Which of the following is the most appropriate next step in the management of this patient?
- AReferral to an early intervention program for developmental delay
- BMagnetic resonance imaging of the brain
- Reassurance and schedule the next routine well-child visitCevap
- DChromosomal microarray and metabolic screening
- EReferral for a comprehensive audiological evaluation