A 2 year old child is in for her well visit. She is up to date...

A 2 year old child is in for her well visit. She is up to date with all vaccinations. Born full term, 7 pounds and 5 ounces. No allergies and not on any medications. Breast fed for six months. Mother is anxious because she is not far along in language development as her brother was at this age. She cries when getting a hair cut and is not consolable. Only eats noodles and toast. Is not a good sleeper.

1. The mothers asks, "are these things related?" How do you reply?

2. What are some online tools to screen for assessing language delays?

3. What should be included in the health history?

4. What should the focused physical examination include?

Expert Solution

1) THESE FINDING ARE RELATED WITH DELAYED LANGUAGE DEVELOPMENT. MANY REASONS BEHIND IT. EXACT REASON IS IDENTIFIED BY PHYSICAL EXAMINATION AND DIAGNOSTIC TESTS. ( MENTAL RETARDATION, AUTISM, HEARING LOSS, CEREBRAL PALSY, EXPRESSIVE LANGUAGE DISORDER , ORAL IMPAIRMENT ETC) 2) _COMMUNICATION MATRIX _ M_ CHAT _ TIGERS TALE 3) HEALTH HISTORY MUST INCLUDING ANTENATAL HISTORY AND FAMILY HISTORY. * ANTENATAL HISTORY-ANY MATERNAL ILLNESS DURING PREGNANCY LIKE RUBELLA, TOXOPLASMOSIS, CYTOMEGALO VIRUS LEADS TO HEARING LOSS. * FAMILY HISTORY OF DELAYED SPEECH DEVELOPMENT AND CHROMOSOMAL ABNORMALITIES. 4) PHYSICAL EXAMINATION * ANTHROPOMETRIC MEASUREMENTS , MICROCEPHALY, AND MACROCEPHALY * AUDIOMETRY * DEFORMITIES OF EXTERNAL EAR CANAL OR AURICLE , PINNA ENLARGED * UPWARD SLANTING EYES , LACK OF EYE CONTACT * ASSESS FOR GOITER * ORAL IMPAIRMENT LIKE DISORDER OF PALATES AND TONGUE * ATAXIA AND DYSARTHRIA * SPASTICITY AND HYPER REFLEXIA.

Nightingale answered 1 year ago

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