The child at 15 months shows the following language development, EXCEPT?

AIIMS Raipur - 2017 (shift-2)

Child Health Nursing (Pediatrics)

Easy

Appeared in: AIIMS Raipur - 2017 (shift-2)

Explanation

the milestone that is not expected at 15 months.
According to developmental charts, the ability to follow a one-step command without an accompanying gesture is a milestone for an 18-month-old child.
At 15 months, a child is expected to be able to follow a command only when it is given with a gesture (e.g., pointing to the object).
Therefore, this option is the exception for a 15-month-old's typical development.

Option A: This is a normal social-communicative behavior for a 15-month-old. It demonstrates joint attention, where the child shares focus on an object or event with another person.
Option B: Enjoying simple stories and looking at books is a typical cognitive and language-promoting activity for a 15-month-old. At this age, they begin to use things like books in the correct way.
Option D: This is a typical milestone for receptive language (understanding words). A child's receptive vocabulary grows rapidly, and understanding 100-150 words by 15-18 months is within the normal range. By 18 months, a child can understand up to 150 words.

Visual 1: Chart - A comparative chart showing language, cognitive, and motor milestones for children at 12, 15, 18, and 24 months. This would visually highlight that following commands without gestures occurs at 18 months.
Visual 2: Infographic - An infographic illustrating the concept of 'receptive' vs. 'expressive' language, showing how a child's understanding of words (receptive) far exceeds their ability to speak them (expressive) in the toddler years.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Language and cognitive developmental milestones in toddlers as background academic context rather than a clinical decision trigger.
Developmental screening is a core nursing responsibility in pediatric care. Using standardized tools like the Ages and Stages Questionnaires (ASQ) helps identify potential delays.
Nurses must educate parents about what to expect at each stage and encourage activities that promote development, such as reading books, talking to the child, and playing interactive games.
What if? If a child at their 18-month check-up is still unable to follow a one-step command without a gesture, it would be a red flag. The nurse should perform a more detailed developmental screening and consider a referral for a hearing evaluation and to an early intervention program.

How to Approach the Question

First, identify the key elements of the question: the child's age (15 months), the developmental domain (language), and the negative framing ('EXCEPT').
The word 'EXCEPT' means you are looking for the one option that is NOT true for a 15-month-old.
Recall or look up the typical language milestones for a 15-month-old child.
Evaluate each option against these milestones.
Option A (looks at adults), B (enjoys stories), and D (understands many words) are all typical behaviors.
Option C describes following a command without a gesture. Recall that this skill develops later, around 18 months. At 15 months, a gesture is usually still required.

Concept Tested & Keywords

Concept Tested: Language and cognitive developmental milestones in toddlers.
Stem keywords: child, 15 months, language development
Lead-in keywords: EXCEPT
Clinical cues: Age: 15 months - This specific age is critical for comparing developmental milestones.
Negative lead-in flag: Question asks for the exception

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