A 3-year-old boy is brought to the office for a well-child visit. His mother reports that, apart from an ear infection last year, he is in good health. The child started preschool this year. He plays alongside other children and often copies what they are doing but does not play cooperatively with them. The patient knows his age and gender and speaks in 3-word sentences. He can ride a tricycle. The patient cannot use a spoon or fork but enjoys eating with his hands. He scribbles spontaneously but cannot copy a circle. He weighs 14.5 kg (32 lb) and is 96.5 cm (3 ft 2 in) tall. Head circumference is 50.8 cm (20 in). Which of the following developmental milestones is likely delayed in this patient?

Question

A 3-year-old boy is brought to the office for a well-child visit.  His mother reports that, apart from an ear infection last year, he is in good health.  The child started preschool this year.  He plays alongside other children and often copies what they are doing but does not play cooperatively with them.  The patient knows his age and gender and speaks in 3-word sentences.  He can ride a tricycle.  The patient cannot use a spoon or fork but enjoys eating with his hands.  He scribbles spontaneously but cannot copy a circle.  He weighs 14.5 kg (32 lb) and is 96.5 cm (3 ft 2 in) tall.  Head circumference is 50.8 cm (20 in).  Which of the following developmental milestones is likely delayed in this patient?

Quizplus · Accepted Answer

Developmental milestones during toddlerhood must be thoroughly assessed by practitioners during routine well-child examinations. Milestones are divided into categories, including cognitive/academic, gross motor control, fine motor control, social behavior, and language. Because each child is different, milestones should be used as a guideline. For instance, one child may be able to kick a ball at 18 months and another at 24 months. A child who is deficient in a single task is unlikely to have developmental delay, but failure to reach several milestones by the appropriate age, or a marked delay in one area, requires further evaluation. Three-year-olds should have the fine motor skills to copy a circle and use utensils; this patient has not reached his expected fine motor milestones and should undergo additional evaluation. (Choices A, C, D, and E) This patient's cognitive, gross motor, language, and social development are within the expected range. By age 3, children are expected to describe their age and gender and follow simple directions (cognitive). They are able to climb stairs with alternating feet and ride a tricycle by operating the pedals (gross motor) and speak in simple sentences (language). In addition, 3-year-olds engage in imaginative play and play in parallel but not cooperatively with others (social). Toilet training often begins at age 2 or 3. Educational objective: By age 3, a child is expected to play imaginatively in parallel with others, speak in simple sentences, copy a circle, use utensils, and ride a tricycle. __________ References: Developmental delay: when and how to screen. (http://www.ncbi.nlm.nih.gov/pubmed/28671370)

A 3-Year-Old Boy Is Brought to the Office for a Well-Child