The clinic nurse is assessing an infant. What are early signs of cognitive impairment the nurse should discuss with the health care provider? (Select all that apply.)
a. Head lag at 11 months of age
b. No pincer grasp at 4 months of age
c. Colicky incidents at 3 months of age
d. Unable to speak two to three words at 24 months of age
e. Unresponsiveness to the environment at 12 months of age
ANS: A, D, E
Early signs of cognitive impairment include gross motor delay (head lag should be established by 6 months, and head lag still present at 11 months is a delay), language delay (normal language development is speaking two to three words by age 12 months; if unable to speak two to three words at 24 months, that is a delay), and unresponsiveness to the environment at 12 months. No pincer grasp at 4 months of age is normal (palmar grasp is the expected finding), and colicky incidents at 3 months of age is a normal finding.
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