Problem
You are seeing Ethan Scott for his 2-year-old well child visit. His mother, Anne, who brought him in today reports, he has been well since his last check-up. He is not taking any medications, nor is he allergic to any medications. He is up-to-date on all previous immunizations. Ethan has been in pre-school since six months old as both parents work. His only sister is 4-years-old and is also healthy. His birth weight was 7 pounds 5 ounces, vaginal birth- no complications at 40 weeks gestation. He was breast fed for six months. His father is a computer engineer. His mother is a chemist and teaches at the local junior college in the biology department. She appears anxious. She tells you that Ethan does not seem to have as many words as his sister did at his age. He cries intensely when getting his haircut and often cannot be consoled. He only eats cheese noodles or toast. He has never been a good sleeper and she is at her wits end with these new issues.
A. What is normal speech development for a 2 year old?
B. Anne asks you, "Are these things related?" How do you respond?
C. What is expressive language?
D. What is Pragmatic language delay?
E. What are some red flags that indicate a need for referral?
F. What are some online screening tools for assessing language delay?
G. What should be included in the history?
H. What should the focused physical examination include?