A 2-year-old child does not point at objects of interest, does not engage in pretend play, does not use two-word phrases, does not follow a two-step command, and makes minimal eye contact. What is the most likely diagnosis?
- A Intellectual disability (global developmental delay)
- B Attention-deficit/hyperactivity disorder (ADHD)
- C Autism spectrum disorder (ASD) ✓
- D Selective mutism
Explanation
The triad of impaired social communication (absent pointing, poor eye contact), restricted social interaction, and absence of pretend play are the core diagnostic features of autism spectrum disorder (ASD). The DSM-5 criteria include deficits in social communication/interaction AND restricted, repetitive behaviours/interests. Red flags at 18–24 months include: no pointing by 12 months, no babbling by 12 months, no two-word phrases by 24 months, and any loss of previously acquired language/social skills. Global developmental delay affects all domains but without the specific social-communication profile of ASD. ADHD and selective mutism do not explain the full constellation.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.