Ms. Hernandez brought in her son Matthew for his 2-year-old well-child visit. The mother is concerned because although Matthew says “Ma” for mom and “ba” for bottle, he mostly gestures and points when he tries to communicate his needs.

1. Ms. Hernandez brought in her son Matthew for his 2-year-old well-child visit. The mother is concerned because although Matthew says “Ma” for mom and “ba” for bottle, he mostly gestures and points when he tries to communicate his needs.

What type of screening tool(s) should the APRN use to assess Matthew’s language and social delay and why?

What potential risk factors (e.g., prenatal, pregnancy, neonatal) could place Matthew at risk for language/social delay?

What type of anticipatory guidance should the APRN provide to support Matthew’s communication and language development?

2.  Mr. Jones has brought in his son Johnny for a 15-month-old well-child visit, and his biggest concern is that his son does not walk yet. You note that in his electronic medical record, he was born at 35 weeks’ gestation via emergency C-section and was discharged 2 weeks later.

What fine motor and gross motor skills should the APRN expect a 15-month-old toddler to perform? Should Matthew be able to perform those skills as well? Why or why not?

What type of screening test(s) should the APRN utilize to assess Matthew’s current motor skills?

What type of anticipatory guidance and support should the APRN provide to monitor and encourage Matthew’s continued physical development?

 3. Rebecca is 7 years old and has refused to go to school for the past 3 days. Rebecca’s mother has brought her in to be evaluated. You note on her medical record that Rebecca had to repeat the first grade.

What additional history does the APRN need to gain a better understanding of Rebecca’s school refusal?

What testing should the APRN perform/order and why?

What should the APRN consider as developmental red flags for Rebecca?