Meet Jai Chandra, an 18-month-old, here for

Meet Jai Chandra, an 18-month-old, here for his pediatric wellness visit. You have seen him once or twice for acute illness, but this is your first time seeing him for a wellness visit. Mom stated Jai is brilliant, has already mastered the alphabet, and gets upset when they are not in the right order. Jai only has two words and only repeats everything I say. He still walks on his toes. He does not look at you when you are talking to him and does not respond to his name when called. Jai gets frustrated if he wants something and his mom can’t figure out what he wants because of his limited use of words. Jai does not like when mom vacuums, has temper tantrums, and is so hard to console. Mom stated Jai is UpToDate on vaccines apart from MMR. Mom is hesitant about MMR because her sister’s daughter’s baby got the vaccine and is autistic. MCHAT is 17. Assessment Jai is following his growth curve normally. Jai is up to date with his shots except for the MMR. Hepatitis B: Birth, 2, and 6 months Rotavirus: 2, 4, 6 months Pentacel (diphtheria, haemophilus influenzae type B, pertussis, polio and tetanus): 2, 4, 6, and 15 months Prevnar 13 (pneumococcal 13 valent ): 2, 4, 6, and 12 months Influenza: yearly Varicella: 15 months Hepatitis A: 15 months Jai does not say anything during the visit. Jai will not look at your directly or what you point at even though you have one of his favorite toys. You also notice he does not seem to look at his mother for any cues. Jai is walking just fine and has good hand eye coordination and movement. Jai’s teeth are coming in with no signs of decay although you do see some white spot lesions. You try to varnish his teeth, but he becomes very upset and his mom has a really hard time consoling him. Evaluation What developmental delays are present? What is the MCHAT score? Are you concerned about autism? Why or why not? List your primary and secondary health recommendations. How would you handle the situation if Jai’s mother is hesitant to do the vaccinations? How would you protect yourself legally if she refused them? What anticipatory guidance will you give based on Jai’s age (refer to Bright Futures)? Image transcription text Developmental Delays Meet Jai Chandra, an 18-month-old here for his pediatric wellness visit. You have seen him once or twice for acute illness, but this is your first time seeing him for a wellness visit. What developmental delays are pres… Show more

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