It was a pleasure to see Daniel (age 4 years 2 months) in clinic on January 9, 2014 as part of his ongoing developmental evaluation. Developmental tests were performed to evaluate his social communication, behavior and interactions and to identify any restrictive interests or repetitive behaviors. A physical examination and some brief cognitive measures were also obtained. Daniel's father accompanied him on this visit. Daniel was first seen in the Developmental Clinic on December 19, 2013. At that time, his family's concerns were related to his overall development: they wondered if he was behind. Daniel's parents also raise concerns about his social communication and how he interacts with others; they notice that he is often not as engaged with others. Meanwhile, Daniel continued to attend kindergarten. He also continued to receive early intervention services with Vimmi from Adventure Place. Vimmi observed Daniel at school and noticed that he engaged in prolonged, reciprocal play with other children in his class. He seemed more reserved with adults, but reportedly fits into the classroom routine. Adventure Place continued to work with her family on community resources and behavioral strategies for the home environment. ADOS-2: For today's assessment we administered the Autism Diagnostic Observation Schedule - Second Edition. The ADOS-2 is a standardized semi-structural assessment of language, social interactions, and play, or imaginative use of materials in individuals who have been referred due to a possible autism spectrum diagnosis. The ADOS is designed to elicit behaviors relevant to the diagnosis of autism spectrum disorder. The form used is determin...... middle of paper ......ng steps and is a good runner, age equivalent to 3 years and 2 months. With his fine motor skills, Daniel can unwrap a small wrapper and write some of his own letters and numbers. Holds pencil appropriately, age equivalent to 4 years and 5 months. The total motor skills composite was at the 42nd percentile for age. IMPRESSION AND PLAN: In summary, Daniel is a 4 year, 2 month old boy undergoing developmental assessment. Today's test results showed that Daniel has many strengths but has difficulties in some areas related to social communication. Information from all sources will be examined. I will meet with Daniel's parents again and we will review our test results and discuss Daniel's overall clinical picture, as well as make recommendations for future plans. I will plan to send a note at that time. Thank you for involving me in Daniel's care.