A 3-year-old child does not respond to his name consistently, avoids eye contact, has no pretend play, and makes repetitive hand-flapping movements. He speaks only 5 words and has lost 3 words he previously used at age 2. Parents note he lines up toys in rows obsessively. Which of the following is the BEST first-line intervention for this child's core social communication deficits?

• A Risperidone to reduce stereotypies and improve social engagement
• B Applied Behavior Analysis (ABA) therapy as the most evidence-based behavioral intervention for ASD ✓
• C Sensory integration therapy as the gold standard for treating core ASD symptoms
• D Speech therapy alone, as language delay is the primary deficit

Explanation

This child has classic features of Autism Spectrum Disorder (ASD)—social communication deficits, restricted/repetitive behaviors, and regression of language. Applied Behavior Analysis (ABA) is the most extensively studied and evidence-based behavioral intervention for ASD, targeting communication, social skills, and adaptive behaviors through structured reinforcement techniques. Risperidone is approved for irritability associated with ASD (not core social deficits). Sensory integration therapy lacks robust evidence for core symptoms. Speech therapy alone is insufficient—ASD requires a multimodal approach with ABA as the cornerstone behavioral therapy.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.