Social communication concerns — branching viva

Stem

You are in clinic with a toddler and caregiver who is worried about social communication. [1]

Examiner: What history and observations matter most in the first five minutes? [1] [4]

Strong answer: Caregiver concern narrative; response to name; joint attention; pointing/showing; imitation; play quality; any loss of skills; hearing clues. [1] [4]

Examiner: Positive M-CHAT-R pathway — what does it mean? [2]

Strong answer: Elevated autism risk needing follow-up interview and likely referral; not a diagnosis alone. [2]

Examiner: Family declines the tool but clinical concern is high. [1] [3]

Strong answer: Clinical concern can still justify referral and interim supports; document and counsel without coercing a score. [1] [3]

Examiner: Mother has limited English. [5]

Strong answer: Professional interpreter for screening and counselling; not child interpreters. [5]

Examiner: Waitlist is long. [7]

Strong answer: Safety-net with interim early intervention, written plan, return precautions and chase pathway. [7]