Developmental surveillance and milestone assessment — formative SAQs · Paeds SAQs

Prompt

Developmental surveillance

SAQ 1 (10 marks)

A mother of an 18-month-old says he is “not talking like his brother did.” [1]

Define surveillance vs screening in this visit. (3) [1]
Outline your bedside assessment steps. (4) [1] [2]
When would you use an autism-specific screen and what must you not claim from it? (3) [3]

Model answer

Surveillance is continuous concern elicitation, observation and documentation; screening is a validated tool at key ages or on concern. [1] Assess caregiver concern, observe joint attention/gesture/words/motor, use evidence-informed milestones, document domains. [2] Autism-specific tools such as M-CHAT-R/F risk-stratify with follow-up; they do not alone diagnose. [3]

SAQ 2 (10 marks)

A child loses words at 22 months after previously using several. [1] [3]

Why is this not routine “wait and see”? (4) [1]
Immediate actions and referrals. (4) [1] [3]
Safety-net while awaiting services. (2) [10]

Model answer

Regression is a red flag for serious developmental/neurological problems and needs prompt evaluation. [1] Urgent structured pathway, hearing assessment, autism/neurodevelopmental referral as indicated. [3] Concrete return precautions and chase plan for appointments. [10]

References

[1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
[2]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
[3]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
[4]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
[5]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
[6]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
[7]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
[8]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
[9]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
[10]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428

SAQ 1 (10 marks)

A mother of an 18-month-old says he is “not talking like his brother did.” [1]

Define surveillance vs screening in this visit. (3) [1]

Outline your bedside assessment steps. (4) [1] [2]

When would you use an autism-specific screen and what must you not claim from it? (3) [3]

Model answer

SAQ 2 (10 marks)

A child loses words at 22 months after previously using several. [1] [3]

Why is this not routine “wait and see”? (4) [1]

Immediate actions and referrals. (4) [1] [3]

Safety-net while awaiting services. (2) [10]

Model answer

References

[1]Lipkin PH Promoting Optimal Development: Identifying Infants and Young Children With Developmental Disorders Through Developmental Surveillance and Screening. Pediatrics, 2020.PMID 31843861
[2]Zubler JM Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics, 2022.PMID 35132439
[3]Robins DL Validation of the modified checklist for Autism in toddlers, revised with follow-up (M-CHAT-R/F). Pediatrics, 2014.PMID 24366990
[4]Kuo DZ Recognition and Management of Medical Complexity. Pediatrics, 2016.PMID 27940731
[5]Mills E Association between caregiver concern for clinical deterioration and critical illness in children presenting to hospital: a prospective cohort study. The Lancet. Child & adolescent health, 2025.PMID 40451224
[6]Boylen S Impact of professional interpreters on outcomes for hospitalized children from migrant and refugee families with limited English proficiency: a systematic review. JBI evidence synthesis, 2020.PMID 32813387
[7]Starmer AJ Changes in medical errors after implementation of a handoff program. The New England journal of medicine, 2014.PMID 25372088
[8]Katz AL Informed Consent in Decision-Making in Pediatric Practice. Pediatrics, 2016.PMID 27456510
[9]Forkey H Trauma-Informed Care. Pediatrics, 2021.PMID 34312292
[10]Burvenich R Effectiveness of safety-netting approaches for acutely ill children: a network meta-analysis. The British journal of general practice : the journal of the Royal College of General Practitioners, 2025.PMID 39117428