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Differential Diagnosis for a 3-year-old who can't pronounce words correctly

Single most likely diagnosis

  • F80.9 - Speech and language development disorder, unspecified: This is the most likely diagnosis because at 3 years old, children are still developing their speech and language skills, and difficulties with pronunciation can be a normal part of this process. However, if these difficulties persist, they could indicate a speech and language development disorder.

Other Likely diagnoses

  • F80.0 - Phonological disorder: This diagnosis is likely because phonological disorders involve difficulties with the sound system of language, which could manifest as an inability to pronounce words correctly.
  • F80.1 - Expressive language disorder: Although primarily involving difficulties with expressing language, some aspects of expressive language disorders can include pronunciation issues.
  • R47.0 - Speech disturbance, unspecified: This is a broader category that could encompass a range of speech difficulties, including pronunciation problems.

Do Not Miss (ddxs that may not be likely, but would be deadly if missed)

  • G40.4 - Landau-Kleffner syndrome: A rare condition characterized by the sudden or gradual development of aphasia (the inability to understand or use language) in children. Early diagnosis is crucial for intervention.
  • F84.0 - Autistic disorder: While not primarily a speech disorder, autism spectrum disorders can include significant difficulties with verbal and nonverbal communication, which might initially present as pronunciation issues.

Rare diagnoses

  • F80.2 - Mixed receptive-expressive language disorder: This involves both difficulties in understanding (receptive) and using (expressive) language, which could include pronunciation issues.
  • G31.88 - Other specified diseases of the nervous system, including developmental disorders of speech and language: This category includes a range of less common neurological conditions that could affect speech and language development.
  • Q35.0 - Cleft palate: A congenital condition that can affect speech, including pronunciation, due to anatomical abnormalities in the palate.

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