Paeds SAQs · growth-development-and-behaviour
Social communication concerns and autism recognition — formative SAQs
Formative SAQs on autism red flags, screening limits and early referral.
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Study tools
Target exams
RACP General PaediatricsMRCPCH ClinicalABP General Pediatrics
Prompt
Social communication concern
SAQ 1 (10 marks)
A father of an 18-month-old says: “He does not point or look when I call his name.” [1]
- List four bedside observations that help discriminate autism concern from isolated speech delay. (4) [1] [4]
- Explain the role and limits of M-CHAT-R/F in this age band. (3) [2]
- Outline your immediate management steps after a positive screen or strong clinical concern. (3) [1] [3]
Model answer
Observe joint attention, pointing/showing, response to name, social use of any words, imitation and play quality — not word count alone. [1] [4] M-CHAT-R/F risk-stratifies with follow-up interview; it does not diagnose ASD. [2] Check hearing, refer early to developmental pathways, start interim supports, counsel that screen ≠ diagnosis, and safety-net the wait. [1] [3]
References10ShowHide
- [1]Hyman SL Identification, Evaluation, and Management of Children With Autism Spectrum Disorder. Pediatrics, 2020.PMID 31843864
- [2]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
- [3]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
- [4]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
- [5]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
- [6]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
- [7]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
- [8]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
- [9]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
- [10]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088