A 3-year-old boy is brought to your office because his daycare teachers are concerned about...

A limited vocabulary (fewer than 50 words by age 2–3 years) and reduced social interaction (limited interest in peers) raise concern for autism spectrum disorder (ASD). Screening for ASD is the most appropriate next step.

Toronto Notes 2023 – Pediatrics, Development and Behaviour:

“Red flags for autism include delayed language, limited social reciprocity, and poor peer interaction. Screening should be initiated early when clinical signs are present.”

MCCQE1 Objectives – Pediatrics > Developmental Disorders:

“Candidates must identify key signs of ASD and initiate appropriate screening and early intervention.”

Multilingual households do not typically cause such delays (E is incorrect). ADHD (B) presents with attention/hyperactivity issues, not language/social delay. Reassurance (A) is inappropriate. Neurology referral (C) may follow but is not first-line.

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