Page 2 of 2: Peds

doctorkarim · Credits: 78299 My Scrapbook

HI Dr. Maryana

b. reassure and regular follow up.

If you follow the question above you will see normal child development as question said at Started cruising at 12 months and walking at 15 months (Toronto notes 2007). In addition He seems to understand everything his mother says to him. He waves bye bye when she leaves. About the milestone of child developement language is that chils could say 2 words in comination from 18 month till 21 month of his , her age . ("*-18 months Runs Feeds self (messily) Points to body parts Plays around (not with)
with utensils when asked other children
*-21 months Squats and recovers Builds 5-block tower Two-word combinations") -blue print pediatric 3rd edition 2004

doctorkarim · Credits: 78299 My Scrapbook

What mention in side bar of toronto notes 2007 it said red flag means child need to be follow up as in our choice B reassure and regular follow up.

bloater · Credits: 800 My Scrapbook

If there is an evidence for the child to hear, we should wait some more months waiting for him to say something. If he won't say anything even we wait enough time, the child should be examined for the dumb. Is there any chromosomal or congenital viral illness making child hear but say nothing ???

Marzoukrz · Credits: 2496 My Scrapbook

This child suffers expressive language problem,saying no word by 18 months is abnormal need further assesment.normal gross motor development does not exclude abnormality in other area of development.

bloater · Credits: 800 My Scrapbook

Then what kind of assessment will be neccessary for this 18Mo child ? If verbal expression is out of normal expectation what diagnoses should we suspect and investigate for ? Brain C-T for the ischemia of frontal cortex ? Psychiatric evaluation ? Certain unknown genetic or chromosomal abnormalities ? If,of course, there is any suspiciousness, we should earnestly recommend further assessment and investigation to the child's parent. But when all of the investigation made such an enormous expense and the child begins to speak after then, there would be such a criticism. When we consider diagnosis, if it is not an urgency or emergency and we feel we are too hurried for the accurate diagnosis, waiting for the spontaneous success of the child patient in his milestone's ultimate border, hesitancy might be the best diagnostic strategy...

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