You Are Conducting a Preparticipation Physical Examination for a 10-Year-Old

You are conducting a preparticipation physical examination for a 10-year-old girl with Down syndrome who will be playing soccer. She has increased deep tendon reflexes, ankle clonus, and a positive Babinski sign. What would be your next course of action?

A) Cervical spine radiograph
B) Immediate referral to a neurosurgeon
C) Mini-Mental State Examination
D) Nerve conduction studies
E) Visual acuity