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Psychiatry · Child and adolescent psychiatry: evaluating delayed speech
Sample itemA 2-year-old speaks only a few words and does not respond when called, though he plays well and has good eye contact. What should be done first?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Formal hearing assessment
Hearing loss must be excluded in every child with delayed speech, using audiometry or brainstem evoked response audiometry. Early detection prevents long-term language and learning problems.
Option by option
A. Start methylphenidate
Methylphenidate does not treat speech delay.
B. Start an antipsychotic
Antipsychotics have no role in speech delay.
C. Reassure with no further action
Waiting risks missing hearing loss during a critical period.
D. Formal hearing assessment (correct)
Correct. Hearing impairment is a treatable cause that must be excluded first.
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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