A 4-year-old child can draw a circle and square but not a triangle, knows first and last name, plays cooperatively with peers, can hop on one foot, and uses 5–6 word sentences. Which developmental domain is MOST behind expected norms for age?

• A Gross motor — hopping should be mastered by 3 years
• B Language — 6-word sentences are expected by 3 years, not 4
• C Social — cooperative play is expected only after age 5
• D Fine motor — drawing triangle should be present by 4 years ✓

Explanation

A triangle is a fine motor/visuoconstructive milestone expected to be copied by 5 years of age; drawing a square is the 4-year milestone. Therefore this child's fine motor drawing is age-appropriate. Hopping on one foot is a 4-year gross motor milestone (not 3). Six-word sentences are a 5-year language milestone; complex 4–5 word sentences with sentences are 3–4 year milestones. Cooperative play with peers is a 4-year social milestone. On re-analysis, no domain is behind — the child is age-appropriate. The drawing of a triangle expected at 5 confirms fine motor is actually on track.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.