Paediatricsmiddle twist
A 2-year-old boy attends with his mother after his childcare educator commented that he "plays on his own". He walks and runs well, uses about sixty single words and joins two of them together, feeds himself and pulls off his shoes. He lines his toy cars up in a row and likes to spin their wheels. He plays beside other children with his own toys rather than with them. He does not point at aeroplanes, does not bring things over to show her and does not follow her gaze. Which one of the following features most strongly indicates the need for referral for formal developmental assessment?