April 2026 – Question of the Month
April 7, 2026
A 3-year-old boy is brought to the clinic by his parents due to concerns about his social behavior. They report that he prefers to play alone, only talks about firetrucks, and becomes very upset when his routine changes. He rarely engages in back-and-forth conversation and does not consistently respond to his name. On exam, he avoids eye contact and engages in repetitive hand movements.
Which of the following is the most appropriate next step in management?
Correct!
Wrong!
EXPLANATION
This child demonstrates core features of autism spectrum disorder (ASD), including:
• Impaired social communication (limited reciprocity, poor eye contact)
• Restricted interests (fixation on firetrucks)
• Repetitive behaviors
• Difficulty with routine changes
Screening should occur at 18 and 24 months using tools like M-CHAT-R/F
If concerns arise at any age, prompt screening and referral are indicated
Early intervention (<3 years) is critical and should not be delayed
Early identification and intervention are critical and a 'wait and see' approach should be avoided.