Toddler speech concern — developmental assessment OSCE

Objectives

1. Elicit developmental concerns. [1]
2. Perform age-adapted observation and examination planning. [2]
3. Choose screening/referral appropriately without over-claiming. [3]
4. Counsel with teach-back, hearing pathway and safety-net. [1] [9]

Candidate brief

12-minute station. Caregiver and toddler present for speech concern. [1]

Expected actions

• Open concern-focused history. [1]
• Observe joint attention, gesture, words, gait; plan neurology/growth exam. [2]
• Explain screening versus diagnostic evaluation in plain language. [1]
• Plan validated general screen and autism-specific tool if indicated, with limits of interpretation. [3]
• Prioritise hearing; refer early; safety-net wait time. [1] [4]
• Offer interpreter if language barrier arises. [8]

Parent actor prompts

• “He only says two words. His cousin talks much more.” [1]
• If asked about social skills: “He doesn’t always look when we call his name.” [3]
• If candidate over-reassures: “So you’re saying nothing is wrong?” [1]
• If candidate orders random genetics first: “Will that help him talk sooner?” [4]

Model communication lines

“I take your concern seriously. Today I will watch how he plays, examine him, and use a validated screening tool if appropriate. Screens help us decide who needs more assessment — they are not a final diagnosis. We should also check hearing. I will refer early for support and tell you exactly what to watch for while we wait.” [1] [3]

Marking

Pass: structured assessment plan, correct tool limits, hearing, early referral, clear counselling. [1] [3]
Fail: pure wait-and-see despite concern; screen treated as diagnosis; walks used as false reassurance; child used as interpreter. [1] [3] [8]