What is the diagnosis for a 3-year-old female presenting with self-soothing behaviors, including head banging and body rocking, repetitive humming and verbalizations, and significant speech delay with limited vocabulary and impaired pronunciation?

Differential Diagnosis for 3-year-old Female with Developmental Delays

• Single most likely diagnosis: + Autism Spectrum Disorder (ASD): The patient's repetitive behaviors (rocking, head hitting, and body rocking), speech delay, and limited vocabulary are consistent with ASD. The repetition of words in a humming manner and the presence of self-soothing behaviors also support this diagnosis.
• Other Likely diagnoses: + Developmental Language Disorder: The patient's significant speech delay, trouble with pronunciation, and limited vocabulary suggest a developmental language disorder. However, the presence of other symptoms such as repetitive behaviors and self-soothing actions make ASD a more comprehensive diagnosis. + Sensory Processing Disorder: The patient's self-soothing behaviors, such as rocking and humming, may indicate sensory processing difficulties. However, this diagnosis alone does not account for the speech delay and other developmental concerns. + Global Developmental Delay: The patient's delays in speech and language development, combined with repetitive behaviors, could be indicative of a global developmental delay. However, a more specific diagnosis like ASD may be more appropriate.
• Do Not Miss diagnoses: + Traumatic Brain Injury or Abuse: Although the patient's head hitting behavior appears to be self-soothing, it is essential to rule out any possibility of traumatic brain injury or abuse, which could have severe consequences if missed. + Hearing Impairment: A hearing impairment could contribute to the patient's speech delay and limited vocabulary. It is crucial to assess the patient's hearing to rule out any underlying auditory issues. + Metabolic or Genetic Disorders: Certain metabolic or genetic disorders, such as phenylketonuria (PKU) or fragile X syndrome, can present with developmental delays and speech difficulties. Although less likely, these conditions should be considered and ruled out through appropriate testing.
• Rare diagnoses: + Rett Syndrome: A rare genetic disorder characterized by developmental regression, speech loss, and repetitive hand movements. Although the patient's symptoms do not perfectly align with Rett syndrome, it is essential to consider this diagnosis due to its severe consequences. + Landau-Kleffner Syndrome: A rare neurological disorder characterized by sudden or gradual loss of language skills, often accompanied by seizures. This diagnosis is less likely but should be considered due to the patient's significant speech delay and repetition of words.