Language Regression Workup — RACP Paediatrics MCQ

Instant feedback + full explanation. One question, done properly.

ModerateNeurology & DevelopmentLanguage Regression WorkupRACP Paediatrics

A 4-year-old has regression of language skills. He was speaking in sentences at age 3 but now only uses single words. He has also developed stereotypic hand movements and unsteady gait. Brain MRI is normal. What investigation is most important?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: E — EEG (including sleep EEG)

Language regression with stereotypies should prompt EEG to evaluate for epileptic encephalopathies (Landau-Kleffner, CSWS) and metabolic screen to exclude neurometabolic disorders. ASD regression is also possible but typically occurs earlier (18-24 months). A comprehensive evaluation including EEG, metabolic screen, and genetic testing is warranted.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Developmental Regression