Toddler health supervision: 1 to 3 years — formative SAQs

SAQ 1 (10 marks)

An 18-month-old attends for a toddler well-child visit. The caregiver mainly wants “the needles done.” ^[1]

1. List the essential domains you will cover beyond immunisation status. (4) ^{[1] [2]}
2. How will you approach developmental and autism-risk assessment at the bedside? (3) ^{[2] [3] [4]}
3. Outline your safety-net if you refer after a positive developmental or autism screen. (3) ^[21]

Model answer

Domains: growth trajectory (weight, length/height, WHO plotting); developmental surveillance; autism-specific screening at recommended ages; oral health/lift-the-lip and fluoride; injury prevention matched to motor skills (including passenger safety); feeding, iron-rich diet and bottle weaning; sleep; media limits; positive discipline; iron and lead risk assessment; social determinants and safeguarding. ^{[1] [2] [5] [6] [8] [9] [10] [12]}

Bedside approach: open caregiver concerns; observe gait, joint attention, words/phrases, pointing and play; use evidence-informed milestones; deploy validated general screens and M-CHAT-R/F with follow-up where indicated; document domains and sources. ^{[2] [3] [4]}

Safety-net: written plan, red-flag symptoms for earlier return, how to chase appointments, interim communication strategies, and clear review timing if waitlists are long. ^[21]