Comprehensive Pediatric Developmental
Assessment NRNP 6541 – Social Interaction
Concerns in a 22-Month Old Female ] My daughter
doesn’t interact with other children and
prefers to play alone.” in an outpatient clinic
With Laboratory Capabilities:(full S
Patient Introduction
, • Patient Name: [Redacted for privacy]
• Age/Sex: 22 months, female
• Accompanied by: Mother
• Presenting Concern: “My daughter doesn’t interact with other children and prefers to play
alone.”
• Setting: Outpatient clinic with laboratory capabilities
• Date of Assessment: [Insert Date]
History of Present Illness (HPI)
The patient is a 22-month-old female, brought in by her mother due to concerns about delayed social
interaction. According to her mother:
• She prefers to play alone and rarely engages with peers.
• She does not imitate other children’s play and shows limited joint attention (e.g., following the
gaze of others or pointing to share interest).
• There is minimal verbal communication beyond single words and occasional gestures.
• She does not respond consistently to her name or to social cues from adults or peers.
• No history of regression; milestones in gross motor and self-help skills are reportedly on track.
• No known history of hearing or vision deficits.
• Appetite and sleep patterns are normal.
• No history of seizures or significant illnesses.
Duration of symptoms: Since infancy, with increasing parental concern over the past 3–6 months.
Past Medical History:
• Full-term birth, no complications.
• Routine vaccinations up to date.
• No hospitalizations or chronic illnesses.
Family History:
• No known history of autism spectrum disorder (ASD), developmental delays, or genetic
conditions.
• Siblings are neurotypical.
Social History:
, • Lives with parents, no daycare attendance yet.
• Minimal exposure to peer groups.
Review of Systems (Focused)
System Findings
General No fevers, weight gain normal
Growth/Nutrition Eating well, normal growth per pediatric charts
HEENT No vision or hearing complaints reported
Neuro No seizures, no loss of milestones
Behavioral / Limited social interaction, reduced verbal communication, prefers solitary
Developmental play, repetitive movements not observed
GI / GU / Cardiac / Resp No complaints
Developmental Screening
Domain Observation / Parent Report Notes
Gross Motor Walks independently, climbs stairs with support Age-appropriate
Fine Motor Picks up small objects, stacks 2–3 blocks Age-appropriate
Slight delay for age in expressive
Language Uses 2–3 words, minimal gestures
language
Limited eye contact, does not engage in pretend Concerning for ASD or social
Social/Emotional
play, prefers solitary play communication delay
Explores objects, problem solving with toys
Cognition Age-appropriate
appropriate
Screening Tools Suggested:
• M-CHAT-R/F (Modified Checklist for Autism in Toddlers – Revised, with Follow-Up)
• Ages & Stages Questionnaire: Social-Emotional (ASQ:SE)
Physical Examination
Assessment NRNP 6541 – Social Interaction
Concerns in a 22-Month Old Female ] My daughter
doesn’t interact with other children and
prefers to play alone.” in an outpatient clinic
With Laboratory Capabilities:(full S
Patient Introduction
, • Patient Name: [Redacted for privacy]
• Age/Sex: 22 months, female
• Accompanied by: Mother
• Presenting Concern: “My daughter doesn’t interact with other children and prefers to play
alone.”
• Setting: Outpatient clinic with laboratory capabilities
• Date of Assessment: [Insert Date]
History of Present Illness (HPI)
The patient is a 22-month-old female, brought in by her mother due to concerns about delayed social
interaction. According to her mother:
• She prefers to play alone and rarely engages with peers.
• She does not imitate other children’s play and shows limited joint attention (e.g., following the
gaze of others or pointing to share interest).
• There is minimal verbal communication beyond single words and occasional gestures.
• She does not respond consistently to her name or to social cues from adults or peers.
• No history of regression; milestones in gross motor and self-help skills are reportedly on track.
• No known history of hearing or vision deficits.
• Appetite and sleep patterns are normal.
• No history of seizures or significant illnesses.
Duration of symptoms: Since infancy, with increasing parental concern over the past 3–6 months.
Past Medical History:
• Full-term birth, no complications.
• Routine vaccinations up to date.
• No hospitalizations or chronic illnesses.
Family History:
• No known history of autism spectrum disorder (ASD), developmental delays, or genetic
conditions.
• Siblings are neurotypical.
Social History:
, • Lives with parents, no daycare attendance yet.
• Minimal exposure to peer groups.
Review of Systems (Focused)
System Findings
General No fevers, weight gain normal
Growth/Nutrition Eating well, normal growth per pediatric charts
HEENT No vision or hearing complaints reported
Neuro No seizures, no loss of milestones
Behavioral / Limited social interaction, reduced verbal communication, prefers solitary
Developmental play, repetitive movements not observed
GI / GU / Cardiac / Resp No complaints
Developmental Screening
Domain Observation / Parent Report Notes
Gross Motor Walks independently, climbs stairs with support Age-appropriate
Fine Motor Picks up small objects, stacks 2–3 blocks Age-appropriate
Slight delay for age in expressive
Language Uses 2–3 words, minimal gestures
language
Limited eye contact, does not engage in pretend Concerning for ASD or social
Social/Emotional
play, prefers solitary play communication delay
Explores objects, problem solving with toys
Cognition Age-appropriate
appropriate
Screening Tools Suggested:
• M-CHAT-R/F (Modified Checklist for Autism in Toddlers – Revised, with Follow-Up)
• Ages & Stages Questionnaire: Social-Emotional (ASQ:SE)
Physical Examination
