MCQ – 100680

Correct Answer » C Explanation

A 9-month-old infant is expected to achieve several developmental milestones:

• Sits without support by 8–9 months
• Rolls over by 5–6 months
• Babbles using “mama” and “dada” nonspecifically by 8–9 months
• Stranger anxiety develops around 6–9 months

In this child:

• Rolling over is appropriate.
• Stranger anxiety is appropriate.
• Saying “mama” and “dada” is appropriate.
• Failure to sit even with support at 9 months is abnormal and represents a gross motor developmental delay.

This warrants a formal developmental assessment to identify the underlying cause and initiate early intervention.

Explanation of the Correct Answer

Option C. Refer the child to a neurologist/developmental pediatrician for developmental assessment

• Correct.
• Failure to achieve an expected gross motor milestone at 9 months is a developmental red flag.
• The child requires detailed neurological examination, developmental assessment, and further investigations if indicated.
• Early diagnosis allows timely intervention and improves long-term outcomes.

Why the Other Options are Incorrect

Option A. Order an immediate MRI

• Incorrect.
• MRI is not the first step in every child with isolated developmental delay.
• A detailed developmental and neurological assessment should precede neuroimaging.
• MRI is indicated if there are focal neurological deficits, abnormal head size, seizures, regression, or suspicion of structural brain abnormalities.

Option B. Reassure the parents that this is normal development

• Incorrect.
• A 9-month-old should be able to sit without support.
• Failure to sit even with support is abnormal and should not be considered normal variation.

Option D. Advise the parents to start exercises

• Incorrect.
• Although physiotherapy may eventually be required, the child should first undergo a comprehensive developmental evaluation to determine the cause of the delay and guide management.