Pediagogy™

Key points: -Bronchiolitis is seen in kids under the age of 2 and caused by RSV -Treatment is supportive including fluids, oxygen, and suction -Learn about palivizumab and other new preventive therapies against bronchiolitis Supplemental Information: AAP 2014 guidelines: https://pediatrics.aappublications.org/content/134/5/e1474 Day of Illness and Outcomes in Bronchiolitis Hospitalizations: https://publications.aap.org/pediatrics/article/146/5/e20201537/75296/Day-of-Illness-and-Outcomes-in-Bronchiolitis

Key points: -Brief, resolved, unexplained events in patients

Key points: -DKA presents with hyperglycemia, ketosis, and anion gap metabolic acidosis, which if severe can cause cerebral edema and CNS dysfunction -Initial management includes fluid resuscitation and IV insulin -Learn about the 2 bag system for DKA -There is a rule to correct for hyponatremia in hyperglycemia -Learn about how to manage potassium, bicarbonate, and phosphorus in DKA Supplemental information: Pediatrics in Review 2019 DKA: https://publications.aap.org/pediatricsinreview/article-abstract/40/8/412/35321/Diabetic-Ketoacidosis?redirectedFrom=fulltext

Key points: -Remember the 4-2-1 rule for calculating maintenance fluids in children -Use of hypotonic fluids is based on historical data in healthy children -Data now supports use of isotonic fluids like NS or LR to reduce risk of hyponatremia and SIADH -Newer data may support LR over NS Supplemental information AAP 2018 Maintenance Fluid Guidelines: https://publications.aap.org/pediatrics/article/142/6/e20183083/37529/Clinical-Practice-Guideline-Maintenance

Key points: -There are specific clinical criteria for diabetes -There are some differences to help distinguish between type 1 versus type 2 diabetes -Learn about how to manage diabetes on the inpatient floor, including how to calculate total daily insulin dose, correction factors, and carbohydrate ratios. Supplemental information: Pediatrics in Review 2013: https://publications.aap.org/pediatricsinreview/article-abstract/34/5/203/34790/Type-1-Diabetes-Mellitus?redirectedFrom=fulltext American Diabetes Association 2018 Position Statement: https://diabetesjournals.org/care/article/41/9/2026/40739/Type-1-Diabetes-in-Children-and-Adolescents-A

Key points: -First line management is insulin when in DKA -First line management is lifestyle modification and metformin when not in DKA -Consider adding insulin and GLP-1 agonists if still in poor control Supplemental Information AAP guidelines 2013: https://publications.aap.org/pediatrics/article/131/2/364/31847/Management-of-Newly-Diagnosed-Type-2-Diabetes AAFP guidelines 2018: https://www.aafp.org/afp/2018/1101/p590.html ISPAD guidelines 2018: https://www.ispad.org/page/ISPADGuidelines2018

Key points: -New strategies for management of febrile infants depending on age (1-3 weeks, 3-4 weeks, or 4-8 weeks) -Inflammatory markers like CRP and procalcitonin help to determine if LP is needed in older patients. -Learn about common bugs that cause infection in infants and the antibiotics we use to treat them -Observation of febrile infants is now reduced from 48 hours to 24-36 hours Supplemental information: AAP guidelines 2020: https://pediatrics.aappublications.org/content/148/2/e2021052228 Yale Observation Scale Score in febrile infants 60 days and younger: https://publications.aap.org/pediatrics/article/140/1/e20170695/37958/The-Yale-Observation-Scale-Score-and-the-Risk-of

Key points: -Ask about common triggers for asthma like smoke or allergens as well as medication adherence -Asthma is a clinical diagnosis but ancillary tests like PFTs may help -Symptom frequency and severity can help you classify the asthma as intermittent versus persistent -Learn about controller/maintenance therapy, including the new SMART therapy -Learn about steroid use for acute exacerbations as well as next line medications like magnesium, ipratropium, and epinephrine Supplemental information: NIH 2020 guideline updates: https://pediatrics.aappublications.org/content/147/6/e2021050286 Peds in review 2019: https://pedsinreview.aappublications.org/content/40/11/549 Asthma control test: https://www.greenhillspeds.com/wp-content/uploads/2015/12/Asthma-Control-Test-4-to-11-years.pdf GINA 2020 Pocket Guide: https://ginasthma.org/wp-content/uploads/2020/04/Main-pocket-guide_2020_04_03-final-wms.pdf NIH Guidelines 2007: https://www.nhlbi.nih.gov/health-topics/guidelines-for-diagnosis-management-of-asthma JAMA 2021 guideline update summary: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2780356

We're back with journal club to review a study evaluating the PECARN guidelines on febrile infants under 28 days of age and serious bacterial infections like meningitis. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Magana (pediatric emergency medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Urinalysis, absolute neutrophil count, and procalcitonin are useful predictors of serious bacterial infectionIn this study, using urine studies, absolute neutrophil count, and procalcitonin were able to risk stratify patients into risk for meningitis and no cases of meningitis were missedSources:Burstein B, Waterfield T, Umana E, Xie J, Kuppermann N. Prediction of Bacteremia andBacterial Meningitis Among Febrile Infants Aged 28 Days or Younger. JAMA. Publishedonline December 8, 2025. doi:10.1001/jama.2025.21454Kuppermann N, Dayan PS, Levine DA, et al. A Clinical Prediction Rule to IdentifyFebrile Infants 60 Days and Younger at Low Risk for Serious Bacterial Infections. JAMAPediatr. 2019;173(4):342-351. doi:10.1001/jamapediatrics.2018.5501

Dealing with a crying and moving child who needs sedation for a laceration repair? Intranasal midazolam is a good sedative option but what dose do you choose? Learn more in this journal club episode where we talk about a recent study that evaluated the most effective dosing of intranasal midazolam.This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Marlow (pediatric hospitalist). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Intranasal midazolam is a good non-invasive sedative option. It has similar plasma concentrations as intravenous administration because it bypasses first pass metabolism unlike oral administration. Onset of action is 20-30 minutes and can last 30-60 minutes.Dosing of intranasal midazalam for children is 0.2 - 0.5 mg/kgBased on the results of this study, 0.4 - 0.5 mg/kg of midazolam was found to provide more effective sedation without increased adverse events for the studied patient population (6 months - 7 years old with simple laceration)Always critically think through studies! This study had limitations including the narrow patient population (did not include children with autism or developmental delay, did not include children less than 6 months old, and had a small study sample size with n = 101)Sources:Tsze DS, Woodward HA, McLaren SH, et al. Optimal Dose of Intranasal Midazolam for Procedural Sedation in Children: A Randomized Clinical Trial. JAMA Pediatr. Published online July 28, 2025. doi:10.1001/jamapediatrics.2025.2181 UpToDate “Pediatric procedural sedation: pharmacological agents”

Sometimes kids are FOS - full of stool! In today's episode, we talk about how to diagnose and treat functional constipation which is a common cause of abdominal pain in pediatrics and can be a pain in the butt, literally!This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Kelly Haas (pediatric gastroenterology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Functional constipation is constipation not due to any other underlying conditions such as Hirschsprungs, spinal cord dysphraphism, or other disease. Functional constipation is defined as having at least 1 month of symptoms in kids younger than 4 years old (or) symptoms at least once per week for at least 2 months in kids older than 4 years old who do not meet IBS criteria. Symptoms include 2 or fewer stools per week, at least 1 episode of incontinence per week after toilet training is established, a history of excessive stool retention/retentive posturing/excessive volitional stool retention, a history of hard or painful bowel movements, the presence of large fecal mass in rectum, or a history of large diameter stools that may obstruct the toiletEncopresis is liquid stool that goes around large stool balls and is indicative of constipation rather than diarrheaPolyethylene glycol (PEG, miralax), lactulose, and enemas are all good treatment options for constipationSources:Evaluation and treatment of functional constipation in infants and children: evidence-based recommendations from ESPGHAN and NASPGHAN. Tabbers MM, et al. J Pediatr Gastroenterol Nutr. 2014;58(2):258-274. doi:10.1097/MPG.0000000000000266 Constipation. Neal S. LeLeiko, et al. Pediatr Rev (2020) 41 (8): 379–392. https://doi.org/10.1542/pir.2018-033

Tripoding and a thumb print sign on X-ray are your buzz words for epiglottitis that you don't want to miss as it can cause very rapid respiratory compromise requiring ICU care. We'll go over what to look out for and how to treat epiglottitis in this week's episodeThis episode was written by pediatricians Tammy Yau and Lidia Park with content support from Zachary Chaffin (pediatric critical care). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Epiglottitis can present with rapid onset fever, sore throat, difficulty breathing, and drooling. On exam, you might see stridor, retractions, and tripoding which is when the patient is leaning forward with their head tilted upward.Epiglottitis can lead to respiratory failure and may require intubationThe most common causes of epiglottitis are Staph aureus, Streptococcus pneumonoiae, and Haemophilus influenzae though the latter has decreased due to vaccination with the Hib vaccineTreatment for epiglottitis includes antibiotics like ceftriaxone and vancomycin for 7-10 days. Steroids and racemic epinephrine have not been shown to improve outcomes for epiglottitis. Sources:Croup and Epiglottitis. Mark Shlomovich, et al. Pediatr Rev (2025) 46 (7): 366–372. https://doi.org/10.1542/pir.2024-006420Epiglottitis Associated With Intermittent E-cigarette Use: The Vagaries of Vaping Toxicity. Pediatrics (2020) 145 (3): e20192399. https://doi.org/10.1542/peds.2019-2399Croup (laryngitis, laryngotracheitis, spasmodic croup, laryngotracheobronchitis, bacterial tracheitis, and laryngotracheobronchopneumonitis) and epiglottitis (supraglottitis). In: Feigin and Cherry's Textbook of Pediatric Infectious Diseases, 8th edition, Tovar Padua LJ, Cherry JD, Harrison GJ, Kaplan SL, Steinbach WJ, Hotez PJ (Eds), Elsevier, Philadelphia 2019. Vol 1, p.175.Up to Date: Epiglottitis: Management, Clinical Features and Diagnosis

Wondering how to best protect your patients or your own baby this winter from RSV? We'll go over the different preventative options against RSV in today's episode!This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Kenneth Yau (general pediatrics). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:RSV immunizations can stimulate an immune response to create antibodies against RSV or can directly give antibodies to an individualThe RSV vaccine (Abrysvo) for adults can be given to pregnant individuals to provide passive immunity to infants after birth. It should be given at 32-36 weeks of gestational and 2 weeks prior to deliveryAfter birth, infants can be given an RSV immunization, either nirsevimab (Beyfortus) or clesrovimab (Enflonsia), which are RSV antibodies. These can be given to all infants less than 8 months old if the pregnant parent did not receive Abrysvo. High risk infants 8-19 months should also receive RSV immunization.Sources:CDC: https://www.cdc.gov/rsv/hcp/vaccine-clinical-guidance/pregnant-people.htmlAAP Oct 2025: https://doi.org/10.1542/peds.2025-073923 AAP Patient Care: https://www.aap.org/en/patient-care/respiratory-syncytial-virus-rsv-prevention/rsv-frequently-asked-questions/?srsltid=AfmBOopMfpneGvJVfI8lZGHlZg5gtqU7AtrR2NbqYzVh9OINyVnrXqT- 

Measles cases are rising world-wide so now's the time to brush up on this previously rare life threatening and vaccine preventable illness.This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Ritu Cheema (pediatric infectious disease). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Measles is a highly contagious vaccine preventable viral infection. From 1 single person infected with measles, an average of 18 people can be infected compared to an average of 10 for Ebola and an average of 6 for COVID.2 doses of the live attenuated measles vaccine is 97% effective at preventing measles infectionHerd immunity prevents wide-spread measles outbreaks. The threshold needed to prevent large scale measles outbreaks is 95%. Only 92.7% of kindergarteners in the US received both MMR shots for the 2023-2024.Symptoms of measles includes cough, conjunctivitis, coryza (rhinorrhea), Koplik spots (white spots in the mouth), and rash spreading from the face down, Serious complications include death (1-3 deaths per 1000 cases), encephalitis (20% mortality), and subacute sclerosing panencephalitis (SSPE) which is almost universally fatal.Sources:“What’s Old is New Again: Measles”. Pediatrics (2025) 155 (6): e2025071332. https://doi.org/10.1542/peds.2025-071332“CDC Confirms Worst Year for Measles since 1992”. AAP News. Sean Stangland. Jul 9 2025.“Vaccines Matter: Measles and Its Complications”. Pediatrics (2025) 156 (1): e2025071622. https://doi.org/10.1542/peds.2025-071622Mina MJ, Metcalf CJE, de Swart RL, Osterhaus ADME, Grenfell BT. Long-term measles-induced immunomodulation increases overall childhood infectious disease mortality. Science. 2015;348(6235):694–699. PubMed doi: 10.1126/science.aaa3662Mina MJ, Kula T, Leng Y, et al. Measles virus infection diminishes preexisting antibodies that offer protection from other pathogens. Science. 2019;366(6465):599–606. PubMed doi: 10.1126/science.aay6485Lin WH, Kouyos RD, Adams RJ, Grenfell BT, Griffin DE. Prolonged persistence of measles virus RNA is characteristic of primary infection dynamics. Proc Natl Acad Sci U S A. 2012;109(37):14989-14994. doi:10.1073/pnas.1211138109AAP Red Book: Measles Medical vs Nonmedical Immunization Exemptions for Child Care and School Attendance: Policy Statement. Pediatrics (2025) 156 (2): e2025072714. https://doi.org/10.1542/peds.2025-072714

Ever wonder what if the cafe au lait macule on your patient might be something more than just a benign birth mark? Learn more about neurofibromatosis 1 and other genetic disorders associated with cafe au lait macules in today’s episode. This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Suma Shankar (pediatric genomic medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Neurofibromatosis type 1 (NF1) is an autosomal dominant disorder with complete penetrance but variable expression.NF1 can be diagnosed clinically if a patient has the following features and meets the specific clinical criteria: cafe au lait macules, neurofibromas, freckling, optic gliomas, iris hamartomas, an osseous lesion, and/or a first degree relative with NF1Sources:Pediatrics, Miller et al (2019) 143 (5): e20190660. https://doi.org/10.1542/peds.2019-0660

Have you ever wondered if your patient pausing to breathe in their sleep is concerning or not? Learn about the signs of central sleep apnea and which medical conditions it is often associated with in pediatric patients in this episode.This episode was written by pediatricians Tammy Yau, Lidia Park, and Jessica Ahn, with content support from Ambika Chidambaram (UCD pediatric pulmonology). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.com Key PointsCentral sleep apnea (CSA) occurs when the brain’s central respiratory drive can’t send proper signals to the muscles that are part of breathing.CSA is diagnosed by a polysomnogram if there are apneic episodes that last 20 seconds or longer or if they are associated with oxygen desaturations, arousals, or heart rate changes (specific criteria in footnote).Central apneas are considered normal during certain stages of sleep (onset, during REM, after arousal), in premature infants less than 37 weeks corrected gestational age, and when ascending to altitudes greater than 3500 m above sea level.Common pediatric conditions associated with CSA include congenital central hypoventilation syndrome, achondroplasia, and Arnold-Chiari malformations. Diagnostic Criteria for CSAApneic episodes last 20 seconds or longer ORThe apnea lasts at least the duration of two breaths during baseline breathing and is associated with an arousal or at least a 3% oxygen desaturation ORIf the event occurs in an infant younger than 1 years old, it has to last at least the duration of two breaths during baseline breathing AND be associated with a decrease in heart rate to less than 50 beats per minute for at least 5 seconds OR less than 60 beats per minute for 15 secondsDiagnostic Criteria for Periodic BreathingAt least three episodes of central pauses lasting for at least 3 seconds interspersed by less than 20 seconds of normal breathing. ReferencesGipson K, Lu M, Kinane TB. Sleep-Disordered breathing in children. Pediatrics in Review. 2019;40(1):3-13. doi:10.1542/pir.2018-0142McLaren AT, Bin-Hasan S, Narang I. Diagnosis, management and pathophysiology of central sleep apnea in children. Paediatric Respiratory Reviews. 2018;30:49-57. doi:10.1016/j.prrv.2018.07.005Berry RB, Budhiraja R, Gottlieb DJ, et al. Rules for scoring respiratory events in sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Journal of Clinical Sleep Medicine. 2012;08(05):597-619. doi:10.5664/jcsm.2172Javaheri S, Dempsey JA. Central sleep apnea. Comprehensive Physiology. Published online December 10, 2012:141-163. doi:10.1002/cphy.c110057Selim BJ, Somers V, Caples SM. Central sleep apnea, hypoventilation syndrome, and sleep in high altitude. In: Springer eBooks. ; 2017:597-618. doi:10.1007/978-1-4939-6578-6_33Fauroux B, AlSayed M, Ben-Omran T, et al. Management of sleep-disordered breathing in achondroplasia: guiding principles of the European Achondroplasia Forum. Orphanet Journal of Rare Diseases. 2025;20(1). doi:10.1186/s13023-025-03717-0

Wondering how you describe the rash of measles, molluscum contagiosum, hand foot mouth, or chickenpox? Learn how in today’s episode!This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Aruna Venkatesan and Gabriel Molina (dermatologists at Santa Clara Valley Medical Center). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:When describing a rash, include the basic morphology, size, color, location, distribution and configuration, and any secondary morphologyWhen taking photos, try to have natural light and make sure the rash is in focus. If taking a close up photo, make sure to have a photo further away so that the location of the rash is clear.Sources:Stanford Medicine: https://stanfordmedicine25.stanford.edu/the25/dermatology.htmlAllmon A, Deane K, Martin KL. Common skin rashes in children. American family physician. 2015 Aug 1;92(3):211-6. CDC Measles: https://www.cdc.gov/measles/data-research/index.html 

How do you know when a head injury can be observed or if more work-up needs to be done? Find out in this episode!This episode was written by pediatricians Tammy Yau and Lidia Park with content support from Julia Magana (pediatric emergency medicine). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comKey Points:Low risk head injuries do not need head imaging. The criteria for low risk head injuries are those where the patient’s GCS is 15 without altered mental status and do not have signs of skull fracture. If any of these signs are present, head imaging with a head CT is recommendedIf the head injury includes history of loss of consciousness or vomiting, a non-frontal scalp hematoma (ie parietal, temporal, or occipital), a severe mechanism of injury, or a severe headache, then generally observation is still recommended but a head CT can be obtained based on clinical decision making. Sources:Stat Pearls. Pediatric Head Trauma. Micelle J, et al. February 2024: https://www.ncbi.nlm.nih.gov/books/NBK537029/Pediatrics. Abusive Head Trauma in Infants and Children: Technical Report. Sandeep Narang, et all. February 2025: https://publications.aap.org/pediatrics/article/155/3/e2024070457/201049/Abusive-Head-Trauma-in-Infants-and-Children 

Opioid use disorders affect babies and children in all ways. In newborns, it can present as neonatal opioid withdrawal syndrome (also known as NOWS). Learn how hospital systems are managing infants with NOWS with the Eat, Sleep, Console protocol in our episdoe today!Key Points:Eat Sleep Console (ESC) focuses on non-pharmacological intervention first before initiating medication. This includes limiting excessive stimulation, keeping the room dark and quiet, swaddling, rocking, swaying, and giving babies a pacifier or feeding.Compared to using the Finnegan scoring system, ESC results in shorter or equal length of hospital stay for infants with NOWS. However, some critics of ESC raise the concern for undertreating infants with NOWS.Morphine, clonidine, and phenobarbital are common agents used to treat infant with NOWSSources:Neoreviews (2025) 26 (4): e223–e232. https://doi.org/10.1542/neo.26-4-010Hosp Pediatr (2025) 15 (3): e121–e125. https://doi.org/10.1542/hpeds.2024-008094Hosp Pediatr (2025) 15 (3): e99–e101. https://doi.org/10.1542/hpeds.2025-008332Kaltenbach K, O'Grady KE, Heil SH, et al. Prenatal exposure to methadone or buprenorphine: Early childhood developmental outcomes. Drug Alcohol Depend. 2018;185:40-49.  https://doi.org/10.1016/j.drugalcdep.2017.11.030 Rees P, Stilwell PA, Bolton C, et al. Childhood Health and Educational Outcomes After Neonatal Abstinence Syndrome: A Systematic Review and Meta-analysis. J Pediatr. 2020;226:149-156.e16.  https://doi.org/10.1016/j.jpeds.2020.07.013 

Learn about language and speech development, potential etiologies of speech delay, and early interventions for speech delay.Follow us on Twitter/X @Pediagogypod, Instagram/Threads @pediagogy, Bluesky @pediagogypodcast.bluesky.social, and connect with us at pediagogypod@gmail.comThis episode was written by pediatricians Lidia Park and Tammy Yau as well as UCD pediatrics resident Elaine Ho, with content support from Anisha Srinivasan (UCD child development and behavioral pediatrician). Pediatricians Tammy and Lidia take full responsibility for any errors or misinformation. Key PointsCDC and AAP have created updated 2022 developmental guidelines that includes changes in speech and language milestones for childrens and have added guidelines forage ages 15 months and 30 months Differential for speech delay is broad and includes hearing loss, global developmental delay, autism, and isolated language disorders Interventions include speech therapy services and exercises at homePediatricians play critical role in surveillance, evaluation, and management of speech delays to allow for earlier intervention and improved outcomes Sources  Jennifer M. Zubler, Lisa D. Wiggins, Michelle M. Macias, Toni M. Whitaker, Judith S. Shaw, Jane K. Squires, Julie A. Pajek, Rebecca B. Wolf, Karnesha S. Slaughter, Amber S. Broughton, Krysta L. Gerndt, Bethany J. Mlodoch, Paul H. Lipkin; Evidence-Informed Milestones for Developmental Surveillance Tools. Pediatrics March 2022; 149 (3): e2021052138. 10.1542/peds.2021-052138Maris Rosenberg, MD, Nancy Tarshis, MA, MS, 2016. "Speech and Language Concerns (Chapter 195)", American Academy of Pediatrics Textbook of Pediatric Care, Thomas K. McInerny, MD, FAAP, Henry M. Adam, MD, FAAP, Deborah E. Campbell, MD, FAAP, Thomas G. DeWitt, MD, FAAP, Jane Meschan Foy, MD, FAAP, Deepak M. Kamat, MD, PhD, FAAP, Rebecca Baum, MD, FAAP, Kelly J. Kelleher, MD, MPH, FAAPHeidi M. Feldman; Evaluation and Management of Language and Speech Disorders in Preschool Children. Pediatr Rev April 2005; 26 (4): 131–142. https://doi.org/10.1542/pir.26-4-131Henry Adam; Speech and Language Concerns. Quick References 2022; 10.1542/aap.ppcqr.396455ASHA Communication Milestones and Age Ranges https://www.asha.org/public/developmental-milestones/communication-milestones/ Audio Clips: From Youtube Channel “Pathways”The 4 to 6 Month Baby Communication Milestones to Look For: https://www.youtube.com/watch?v=d0FGHFrMRXI10-12 month Old Communication Milestones https://www.youtube.com/watch?v=zYHpjZC2qCA19-24 Month Communication Milestones: https://www.youtube.com/watch?v=-2C--4gay2c