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Speech delay — DCH MCQ

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HardDevelopmentSpeech delayDCH

An 18-month-old girl has no spoken words, does not point to request objects, and rarely turns when her name is called. Her hearing screen at birth was normal, and examination is otherwise unremarkable. What is the most appropriate investigation?

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Correct answer: A — Formal hearing assessment

Speech delay and poor response to name require formal hearing assessment even when the newborn screen was passed. Autism assessment may also be needed, but hearing impairment must be excluded early because it is common and treatable. The clinical pearl is that a normal newborn hearing screen does not rule out later conductive or sensorineural loss.

Reference: NICE CG128; RCPCH DCH syllabus