The parent brings their 4 year old child to your clinic with concerns about possible developmental delays. The parent reports that the child is not speaking in full sentences, struggles with social interactions with peers, and has difficulty following instructions at home and preschool. The parent also mentions that he child often seems frustrated when unable to communicate effectively.
Objective: On exam, the 4 year old appears alert and curious. Vital sings are within normal limits. During the visit, the child speaks in short phrases but does not engage in extended conversations. the child demonstrates difficulty with fine motor tasks, such as holding a pencil and cutting with scissors. Socially, the child displays limited eye contact and struggles to to initiate play with others.
What is your approach to assessing and managing this 4 year old, what will you include in your history? What are specific milestones this child should be exhibiting. What are appropriate screening tools or assessments, referral considerations.