A 24-month-old child uses only 5–6 single words, does not combine two words, does not point to pictures, but maintains good eye contact, plays symbolically (feeds a doll), and follows 2-step commands. Hearing test is normal. This pattern suggests delay in which domain of development?
- A Language development with expressive delay predominating ✓
- B Gross motor development
- C Autism spectrum disorder given the lack of two-word phrases
- D Global developmental delay affecting all domains
Explanation
At 24 months, expected milestones include 50+ words and two-word combinations. This child has only 5–6 words with no word combinations — indicating significant expressive language delay. However, receptive language (follows 2-step commands), social cognition (symbolic play, eye contact, pointing preserved), and other domains appear intact. This pattern (expressive > receptive delay, intact social skills) is characteristic of specific language impairment/expressive language delay, NOT autism spectrum disorder. ASD would be characterised by reduced eye contact, absent pointing, and impaired social reciprocity.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.