Speech and play concern in a toddler
AMC Clinical practice station

The task

You are a doctor in a general practice. Mrs Rachel Dunn has brought her son Oliver, aged two years and five months, because she is worried about his talking. Oliver is playing with toy cars in the corner of the room and is not taking part. Take a developmental history from Mrs Dunn. Then explain your impression and next steps and answer her questions. Examination findings and what you can see of Oliver will be given if you ask for them. The examiner will not take part in the conversation.

What this station tests

• Ask directly about loss of words or skills: regression changes the urgency of assessment.
• Always exclude hearing loss in a child with speech delay.
• Early intervention can start before a diagnosis; do not recommend waiting.
• Address guilt and family doubts without blaming and without a premature label.
• Observe the child during the consultation; behaviour in the room is data.

Sources for the clinical content

• Autism CRC: National guideline for autism assessment and diagnosis
• Royal Children’s Hospital Melbourne: Kids Health Info on autism
• Medical Board of Australia: Good medical practice, a code of conduct for doctors in Australia

An original practice scenario with invented patients. Not an exam question.

Practise next

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• Vaginal bleeding and lower abdominal pain