A child can walk independently at 18 months, build a tower of 3 cubes, use a spoon, and has a vocabulary of 10–15 meaningful words. Which single developmental milestone is MOST concerning at this age?
- A Tower of 3 cubes
- B Independent walking
- C Vocabulary of 10–15 words ✓
- D Spoon use
Correct answer: C. Vocabulary of 10–15 words
Explanation
At 18 months, the expected language milestone is at least 10 meaningful single words (some references cite 10–20 words). A vocabulary of only 10–15 words is borderline and warrants monitoring, but the most concerning finding at this age that would trigger immediate evaluation is fewer than 10 words. By 18 months, children should also be pointing and demonstrating joint attention. Independent walking by 18 months and tower of 3–4 cubes at 18 months are both within normal limits.
Reference: Ghai Essential Pediatrics, 10th ed.
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Written and medically reviewed by the StethoPrep medical team.