Growth and development: evaluation of speech delay: practice question

A Pediatrics question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Pediatrics · Growth and development: evaluation of speech delay

Sample item

A 30-month-old has about ten single words and no two-word phrases. He points, imitates, plays pretend games and makes good eye contact. Motor milestones are normal. What is the most appropriate first step?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Formal hearing assessment

Isolated expressive speech delay in a socially engaged child must first be assessed for hearing loss, because even mild hearing impairment delays language. Speech therapy is begun alongside, and wider genetic or imaging studies are used only if other features appear.

Option by option

  • A. Chromosomal microarray

    Genetic testing is reserved for global delay or dysmorphism, which are absent here.

  • B. Formal hearing assessment (correct)

    Correct. Hearing loss is a common and treatable cause of speech delay and must be excluded first.

  • C. Review after the fourth birthday

    Waiting until four years wastes a critical period for language and is inappropriate.

  • D. MRI of the brain

    Imaging is not indicated without focal signs, regression or an abnormal examination.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Pediatrics question

What is the answer to this Pediatrics question?

The best answer is B, Formal hearing assessment. Isolated expressive speech delay in a socially engaged child must first be assessed for hearing loss, because even mild hearing impairment delays language.

Why is "Chromosomal microarray" not the answer?

Genetic testing is reserved for global delay or dysmorphism, which are absent here.

Why is "Review after the fourth birthday" not the answer?

Waiting until four years wastes a critical period for language and is inappropriate.

Why is "MRI of the brain" not the answer?

Imaging is not indicated without focal signs, regression or an abnormal examination.

What concept does this question test?

It tests Growth and development: evaluation of speech delay in Pediatrics. Speech therapy is begun alongside, and wider genetic or imaging studies are used only if other features appear.

How hard is this question?

We tag it as an application question: it asks you to use a fact on a patient or a finding. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Growth and development: evaluation of speech delay?

Memorise milestones and the vaccine schedule as tables and revise them often. Then use the flashcards and the other Pediatrics questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.