What is the most likely diagnosis for an 18-month-old boy with a 12-15 word vocabulary, limited intelligible speech, and delayed gross motor skills, who pulls to stand and walks while holding onto furniture?

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Differential Diagnosis

  • Single most likely diagnosis:
    • E. Language delay (13%): The patient has a limited vocabulary, and strangers can only understand a few of his words. He also babbles gibberish most of the time and does not combine words into 2-word phrases, indicating a significant delay in language development.
  • Other Likely diagnoses:
    • D. Gross motor delay (39%): Although the patient can pull to stand and walk while holding on to furniture, his gross motor skills may be slightly delayed, as most children can walk independently by 12-14 months.
    • B. Autism spectrum disorder (3%): The patient's limited vocabulary, babbling gibberish, and not combining words into phrases, along with his behavior of crying when the physician tries to play with him, may raise concerns for autism spectrum disorder. However, a more comprehensive evaluation would be needed to confirm this diagnosis.
  • Do Not Miss:
    • C. Cognitive delay (4%): Although the patient's growth has been consistent, and he can perform some tasks like scribbling with a crayon, cognitive delay should be considered, especially if his language and gross motor delays are significant. Early identification of cognitive delay is crucial for providing appropriate interventions.
  • Rare diagnoses:
    • A. Articulation disorder (3%): While the patient's vocabulary is limited, and strangers can only understand a few words, an articulation disorder typically presents with difficulties in pronouncing specific sounds, which is not the primary concern in this case.
    • F. Normal development (34%): Given the patient's significant delays in language and possible gross motor development, it is unlikely that his development is entirely normal.

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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