Clinical Vignette

BD is 2 years old and 3 months, male who was brought in to your clinic for a medical
consult. While he was at your clinic, you observe that he was constantly moving – climbing
the furniture, walking around and opening doors. He did not turn to name calling nor did
he stop when told to do so. His mother raised concerns that BD vocalized and babbled
loudly but would pull on her hands when he wanted something. He enjoyed watching
videos and playing with toys – balls and cars at home.

1. What are the milestones expected for his age? Tabulate per domain.
2. What will you have advised BD’s mother?

You saw BD again in your clinic at 3 years old. The previously observed behaviors of
walking around, climbing furniture and no response to name calling was still seen. His
mother states that BD can now utter a few single words like “no”, “dog” and “car”. He is
heard to recite the alphabet, count from 1 to 10 and identify colors. He prefers to play on
his own – lining up objects and spinning the wheels of his toy cars. BD would jump and flap
his hands when excited, squint and flick his fingers towards any light source and bite his
fingers for no apparent reason.

3-6. List the symptoms that you see based on the DSM-5 criteria.
7-8. Give the possible causes of his developmental condition.
9-10. Give possible treatment options.