Paeds Cases · growth-development-and-behaviour
Lost words at 20 months — regression OSCE
OSCE on history, threat triage, counselling and urgent plan for developmental regression.
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Study tools
Target exams
MRCPCH ClinicalRACP DCE
Prompt
20-month-old with loss of words and pointing over 10 weeks; worried caregiver.
Objectives
- Confirm true developmental regression with a skill timeline. [1]
- Triage threat and progressive red flags. [1] [9]
- Explain an urgent plan including hearing assessment and parallel referrals. [1] [3]
- Safety-net and close loops with teach-back. [14] [17]
References8ShowHide
- [1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
- [3]Moeschler JB Comprehensive evaluation of the child with intellectual disability or global developmental delays. Pediatrics, 2014.PMID 25157020
- [7]Pickles A Loss of language in early development of autism and specific language impairment. Journal of child psychology and psychiatry, and allied disciplines, 2009.PMID 19527315
- [9]Loo KK Diagnostic Overshadowing: Insidious Neuroregression Mimicking Presentation of Autism Spectrum Disorder. Journal of developmental and behavioral pediatrics : JDBP, 2022.PMID 35943376
- [11]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
- [13]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
- [14]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
- [17]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428