A mother brings her 18-month-old son to the pediatrician for a routine well-child visit. She is concerned about her child's speech. He has been babbling and cooing since 6 months of age but is not yet saying any words
Which response by the nurse would be the most appropriate? a. "Don't worry, he should catch up soon. Boys are always slower at speaking than girls.".
b. "The doctor will want to refer your son to an audiologist and speech pathologist.".
c. "This is normal speech development for an 18-month-old child.".
d. "Your son has an expressive language disorder and will need a referral for further evaluation.".
B
An appropriate response is one in which the doctor refers the son to an audiologist and speech pathologist. By 18 months children should have a three-word vocabulary. Adequate hearing is essential for the development of speech. Hearing and language should be tested and a referral to an audiologist and speech pathologist is indicated. The nurse should not provide inappropriate reassurance that her son will be fine. He needs to be referred for further evaluation as this is not normal speech development for an 18-month-old child. The nurse is not qualified to offer a diagnosis to the mother of this patient on the basis of the limited information provided. Further tested and a referral are indicated for this patient.
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