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 is 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."
Answer is B
A This is offering the parent inappropriate reassurance that her son will be fine. He
needs to be referred for further evaluation.
B This is an appropriate response. 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.
C This is not normal speech development for an 18-month-old child.
D The nurse is not qualified to offer a diagnosis to the mother of this patient on the
basis of the limited information provided. Further testing and a referral are
indicated for this patient.
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