BSF Staff Nurse - 2015
Child Health Nursing (Pediatrics)
Easy
Autism can usually be diagnosed when the child is about?
Appeared in: BSF Staff Nurse - 2015
Explanation
- A reliable clinical diagnosis of Autism Spectrum Disorder (ASD) can usually be made by the age of 2 years (24 months).
- The American Academy of Pediatrics (AAP) reinforces this by recommending universal screening for ASD for all children at both 18 months and 24 months of age.
- While parental concerns about developmental delays, particularly in language and social interaction, often arise between 12 to 18 months, the 2-year mark is when symptoms are typically evident enough for a formal diagnosis.
- Screening tools like the Modified Checklist for Autism in Toddlers, Revised (M-CHAT-R) are designed for use between 16 and 30 months, centering on this diagnostic window.
Why Other Options Were Wrong
- Option A: At 1 month, an infant's behavioral and social repertoire is extremely limited. Key diagnostic indicators for ASD, such as joint attention, response to name, and complex social interactions, have not yet developed, making diagnosis impossible.
- Option B: Similar to 1 month, a 2-month-old is only beginning to develop foundational social skills like the social smile. The complex deficits in social communication required for an ASD diagnosis cannot be assessed at this age.
- Option D: This is considered a late diagnosis. While it can occur, especially in individuals with milder symptoms (formerly Asperger's), it is not the typical age. ASD is a neurodevelopmental disorder with symptoms that must be present in the early developmental period, even if they are not fully recognized until later.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Developmental screening and diagnosis of Autism Spectrum Disorder (ASD) as background academic context rather than a clinical decision trigger.
- Nurses in pediatric and community settings are at the forefront of developmental surveillance. They are responsible for administering standardized screening tools, such as the M-CHAT-R, at the recommended 18- and 24-month well-child visits.
- Early diagnosis is directly linked to early intervention. Initiating therapies like Applied Behavior Analysis (ABA) or speech therapy at a younger age significantly improves long-term outcomes in communication, social skills, and adaptive behavior.
- What if? If a parent expresses concern about autism at a 12-month visit but the child is meeting most milestones, the nurse should not dismiss the concern. The correct action is to validate the parent's feelings, provide education on red flags to watch for, and ensure a follow-up screening is scheduled for the 18-month visit.
How to Approach the Question
- First, identify the question type. This is a factual recall question asking for a specific time frame related to a developmental disorder.
- Recall knowledge of standard pediatric health screening guidelines. The American Academy of Pediatrics (AAP) provides recommendations for various conditions, including autism.
- Analyze the options based on a child's developmental timeline. Consider when key social and communication skills emerge and when their absence would become a significant concern.
- Eliminate options that are clearly too early. A diagnosis at 1 or 2 months is not feasible as the necessary developmental milestones have not occurred.
- Eliminate the option that is too late. While a late diagnosis is possible, the question asks when it can usually be diagnosed. Age 14 is an outlier, not the norm.
- Select the remaining option, which aligns with the official screening recommendations (18 and 24 months) and the period when developmental delays become diagnostically significant.
Concept Tested & Keywords
- Concept Tested: Developmental screening and diagnosis of Autism Spectrum Disorder (ASD).
- Stem keywords: Autism, diagnosed, child, age
- Lead-in keywords: when
- Clinical cues: Age/sex group narrows the expected diagnosis, intervention, or normal reference range.
Question ID
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Reference Book
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 391-393
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 12071-12073
E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 424-426
Practise the full BSF Staff Nurse - 2015
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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