I HUMAN COMPREHENSIVE PEDIATRIC CASE STUDY: SUSPECTED AUTISM SPECTRUM DISORDER IN A 22 MONTH OLD TODDLER – FULL ASSESSMENT & EARLY INTERVENTION GUIDE (NRNP 6541 WEEK 7) ALIGNED WITH BURNS’ PEDIATRIC PRIMARY CARE 7TH EDITION LATEST 2026–2027 COMPLETE VERIF

This definitive academic resource provides a complete, evidence based walkthrough of the Kaplan I Human Patients by Kaplan virtual simulation for NRNP 6541 Week 7: a 22 month old toddler presenting with social interaction difficulties and suspected Autism Spectru Disorder (ASD). Fully aligned with Burns’ Pediatric Primary Care, 7th Edition (Garzon, Starr, Brady, et al., Elsevier 2020) – the premier textbook written from the unique perspective of the Pediatric Nurse Practitioner – this guide mirrors the SOAP framework and offers clinically accurate, verified answers for every component of the I Human encounter. It is specifically designed for nurse practitioner (NP) and advanced practice nursing students completing the Walden University NRNP 6541 i Human assignment in the academic year, ensuring a 100% pass on your first attempt. Case Summary J.M. (also appearing as A.M. in some versions) is a 22 month old toddler brought to an outpatient pediatric clinic by the mother with the chief complaint: “She doesn’t play with other children and prefers to play alone.” The mother reports that over the past 6 8 months the child has shown limited eye contact, does not respond consistently to her name, exhibits repetitive behaviors (e.g., hand flapping, lining up toys), uses only a few single words inconsistently, and becomes distressed when daily routines are changed. There is no history of regression in previously acquired skills. Growth parameters are appropriate for age, and the child appears well nourished and in no acute distress. The M CHAT R/F screening tool is positive (high risk), supporting the need for comprehensive diagnostic evaluation. Textbook Alignment The guide draws directly from Burns’ Pediatric Primary Care, 7th Edition (ISBN 9780323581967), which provides the foundational framework for: • Developmental surveillance and screening at health supervision visits (Bright Futures guidelines) • The application of standardized ASD screening tools (M CHAT R/F) • The use of DSM 5 TR diagnostic criteria for ASD • The critical role of early, multidisciplinary intervention (Early Intervention, speech/occupational therapy, applied behavior analysis) Key Learning Objectives Upon completion of this case study, students will be able to: 1. Obtain a targeted, developmentally appropriate history for a toddler with social communication concerns. 2. Perform and document a comprehensive pediatric physical and neurological examination, with special attention to behavioral observations. 3. Administer and interpret the M CHAT R/F and Ages & Stages Questionnaire (ASQ) to assess autism risk. 4. Apply DSM 5 TR criteria to formulate a working diagnosis of suspected ASD. 5. Develop an evidence based, family centered management plan that includes Early Intervention referral, audiology and speech/language evaluations, and parental education. Detailed Case Study Breakdown – Verified Solutions 1. Subjective Data (History of Present Illness & Interview) Category Findings Chief Complaint (CC) Mother states: “She doesn’t play with other children and prefers to play alone.” History of Present Illness (HPI) Onset ~6 8 months ago. Limited eye contact, does not respond consistently to name, prefers solitary play. Minimal expressive language – uses only a few single words (estimated 10 15), no combining of words. Does not point to objects of interest or wave goodbye. Repetitive behaviors: hand flapping, lining up toys. Becomes upset with changes in routine. No history of regression. No fever, seizures, head trauma, or recent illness. Past Medical History (PMH) Unremarkable; full term delivery, no NICU stay, no chronic illnesses. Developmental History Gross motor skills (walking, climbing) age appropriate. Expressive language and personal social domains delayed per parent report. Family History No known first degree relative with ASD, but inquire about any developmental or psychiatric conditions. Social History Lives with parents; no daycare reported in some versions; inquire about screen time and daily routines. Review of Systems (ROS) All systems reviewed and negative except for neurological/developmental concerns noted above. 2. Objective Data (Physical Examination & Screening) Parameter Finding Vital Signs Temperature 36.8°C (98.2°F), HR 110 bpm, RR 22/min, O₂ saturation 99% on room air. General Appearance Alert, well appearing, well nourished toddler; avoids examiner, minimal engagement. HEENT Normocephalic, PERRLA, tympanic membranes intact, oral mucosa normal. Cardiovascular Regular rate and rhythm, no murmurs. Respiratory Clear to auscultation bilaterally. Abdomen Soft, non tender. Neurologic Normal tone, age appropriate reflexes, gross motor skills intact. Behavioral Observation Limited eye contact; does not respond to name consistently; repetitive hand movements noted during play. Screening Tools M CHAT R/F: Positive (high risk). Ages & Stages Questionnaire (ASQ): Delays in communication and personal social