A 14-month-old child can walk independently, says 3 meaningful words, uses a pincer grasp, and stacks 2 blocks. He waves bye-bye and points to a desired object. He does not yet respond to his name consistently when called. Which developmental assessment is most important at this visit?
- A Hearing evaluation — rule out conductive hearing loss from otitis media
- B M-CHAT-R/F screening for autism spectrum disorder ✓
- C Vision screening for amblyopia using Snellen chart
- D Bayley-IV formal developmental evaluation for intellectual disability
Explanation
Failure to consistently respond to one's own name by 12–14 months is a red flag for autism spectrum disorder (ASD). The M-CHAT-R/F (Modified Checklist for Autism in Toddlers, Revised with Follow-up) is the recommended validated autism screening tool at 18 months (and 24 months) per AAP, but should also be applied whenever a red flag is present. While the child has appropriate social gestures (waving, pointing), inconsistent name response is a significant ASD red flag. Hearing evaluation is also important to rule out conductive loss, but M-CHAT screening is the specific developmental priority for this behavioral concern. Snellen chart requires cooperation and is inappropriate at 14 months.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.