Review the toddler's developmental surveillance timeline and determine the appropriate screening and referral response.
Trend
Choose your responses, then check the answer.
Explanation
Developmental monitoring follows how a child plays, learns, communicates, acts, and moves over time. By 18 months, most children point to show something interesting and try at least three words besides 'mama' or 'dada.' A loss of a previously acquired skill is especially concerning. A milestone checklist supports surveillance but does not diagnose a disorder or replace a validated screening tool. The nurse should acknowledge the caregiver's observations, communicate them to the clinician, obtain recommended developmental and autism screening, and facilitate referral for further evaluation and early intervention rather than recommending a passive wait-and-see approach.
Trend to recognize Communication and social milestones are not advancing, and a previously used gesture has been lost. The longitudinal change matters more than a single office impression.
Next health-promotion step Validate the caregiver's concern, use standardized developmental and autism screening at the appropriate visit, and initiate evaluation and early-intervention referral when concerns persist.
Scope rule A milestone checklist is surveillance, not a diagnosis. The nurse should not label the child with autism from these observations alone.
Why the alternatives fail Waiting several months can postpone services during a key developmental period. Reassurance based only on normal height and weight does not address communication or social development.
Sources
1CDC Milestones by 18 Months
2CDC Developmental Monitoring and Screening
32026 NCLEX-RN Test Plan
Well-child careThe nurse compares caregiver observations across visits for an 18-month-old child. The caregiver is increasingly concerned about communication and social interaction.