Social communication concerns and autism recognition — formative SAQs

SAQ 1 (10 marks)

A father of an 18-month-old says: “He does not point or look when I call his name.” [1]

1. List four bedside observations that help discriminate autism concern from isolated speech delay. (4) [1] [4]
2. Explain the role and limits of M-CHAT-R/F in this age band. (3) [2]
3. Outline your immediate management steps after a positive screen or strong clinical concern. (3) [1] [3]

Model answer

Observe joint attention, pointing/showing, response to name, social use of any words, imitation and play quality — not word count alone. [1] [4] M-CHAT-R/F risk-stratifies with follow-up interview; it does not diagnose ASD. [2] Check hearing, refer early to developmental pathways, start interim supports, counsel that screen ≠ diagnosis, and safety-net the wait. [1] [3]

SAQ 2 (10 marks)

A child loses words at 21 months after previously using several meaningfully. [1] [3]

1. Why is “wait and see until preschool” unsafe? (3) [1]
2. Immediate actions and differential considerations. (4) [1] [3]
3. Safety-net and communication points for the family. (3) [7] [8]

Model answer

Regression is a red flag for serious developmental or neurological problems and needs prompt evaluation. [1] Urgent structured pathway, hearing assessment, autism/neurodevelopmental referral; consider neurological red flags. [3] Explain next steps with consent, give written plan, return precautions and chase plan for appointments. [7] [8]