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Autism spectrum disorder — MCCQE Part 1 MCQ

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ModerateDevelopmental DelayAutism spectrum disorderMCCQE Part 1

2-year-old boy presents with delayed speech and limited social interaction. He does not point to share interest and has repetitive lining up of toys. Which of the following is the most appropriate next step?

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Correct answer: E — Arrange developmental assessment, hearing evaluation and early intervention referral

Arrange developmental assessment, hearing evaluation and early intervention referral is best because social-communication delay with restricted behaviours suggests autism. Provide only reassurance without clear follow-up or safety-netting is suboptimal because children can deteriorate quickly and follow-up must be explicit; Use adult dosing or adult pathways without paediatric adjustment is suboptimal because children require age- and weight-appropriate care; Delay assessment until the next routine visit is suboptimal because developmental, infectious and neonatal red flags require timely assessment; Give antibiotics, steroids or investigations routinely despite no indication is suboptimal because over-treatment can cause harm when supportive or targeted care is indicated. Early intervention should start before diagnostic certainty is perfect.

Reference: Canadian Paediatric Society ASD guidance