Case Study Part I

A happy toddler boy

It’s a busy morning in the Neonatal Intensive Care Unit and you think about the lunch you won’t be able to have as you quickly sign out your patients.

You hurry over to your community clinic, arriving a few minutes late. Your first patient for the afternoon is a baby you have been following since birth. You first met the family in the newborn nursery and have enjoyed seeing little Matthew learn to roll over, sit, cruise, and walk.

Toddler boy in a jacket

Matthew is now 18 months old and is coming in for a routine health care maintenance visit. As you enter the room, you smile at Matthew and ask his mother and father how he’s doing. “Great,” they reply. “He loves to explore our apartment and laughs like crazy when we play peek-a-boo. We have started taking him to the park, and he enjoys playing with blocks.”

You do a physical exam on Matthew and note that he has said very few words during the assessment. His eye contact is variable. When you ask about his language, Matthew’s parents indicate that, although they have noticed he’s not saying as many words as they had anticipated at his age, they attribute this to his being raised in a bilingual household. They indicate he only has a couple of words.

A toddler boy waving

Although Matthew is a quiet and sweet boy, you remain concerned about his language and variable eye contact. Given his age, Matthew should have an ASD-specific screening as well as a general developmental screening as part of his 18-month checkup.

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