Question
A 3-year old boy is brought with complaints of staying aloof. He also has delayed speech. Rest of the developmental milestones were attained normally. The most likely diagnosis is:
The correct answer is
Autism
Diagnosis for Aloof 3-Year-Old Boy with Delayed Speech
The primary symptoms presented are a child staying aloof (indicating social difficulties) and having delayed speech. These symptoms must be evaluated against the provided options.
Symptom Analysis
- Aloofness: Suggests difficulty with social interaction or withdrawal.
- Delayed Speech: Indicates a lag in language development.
- Other Milestones Normal: This is crucial, ruling out global developmental delay.
Evaluating Diagnostic Options
- Selective Mutism: Characterized by an inability to speak in specific social situations, not typically pervasive aloofness or general speech delay.
- Attention Deficit Hyperactivity Disorder (ADHD): Primarily involves inattention, hyperactivity, and impulsivity. While social issues can co-occur, aloofness and primary speech delay are not core features.
- Autism (Autism Spectrum Disorder - ASD): Core diagnostic criteria include persistent deficits in social communication and social interaction (matching aloofness) and may include delayed speech or language impairments (matching delayed speech). This diagnosis aligns well, especially when other milestones are normal.
- Phonological Disorder: Involves difficulties with the sound system of language, affecting pronunciation. It does not typically explain pervasive social withdrawal or aloofness.
Conclusion
Considering the combination of persistent social withdrawal (staying aloof) and delayed speech in a 3-year-old, with other developmental milestones achieved normally, Autism Spectrum Disorder is the most likely diagnosis among the choices.
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Important Questions from Autism and Counselling
Which of the following drugs is NOT included in the management of Attention Deficit Hyperactivity disorder?
- A 3-year-old boy presents with parental concerns regarding delayed development, especially speech. On observation, the clinician notes decreased eye contact, inattentiveness, unresponsive to being called and toe walking. What is the most likely diagnosis ?
- Atomoxetine is prescribed to children with Autism Spectrum Disorder to control symptoms of :
- What is the diagnosis of Autism Spectrum Disorder primarily based upon ?
- Autism Spectrum Disorder is characterised by which of the following ?
1. Onset before 3 years of age
2. Impaired verbal and gestural communication
3. Stereotypic and restrictive behavioural patterns
4. Tangential speech
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