Ariel is a 7 month old infant, born at 40 weeks gestation, with Apgar scores of 9 and 10. The baby is up-to-date for well child care and immunizations and has had 2 minor episodic illnesses at aged 4 and 6 months with full recovery.  Ariel rolled tummy to back, started to purposely bring hands together, and babble at around age 4 months, and has had a social smile since age 2 months. Ariel is the youngest of three children, and today, parents mention that they are concerned that, “She’s not sitting up by herself yet. Our older kids were all sitting by now. She tries but then falls over.” Physical exam reveals a highly interactive healthy appearing infant with excellent muscle tone, who age appropriately resists exam. The NP considers which of the following? 

A.  Refer the infant to an early intervention program for additional evaluation. 

B.  Discuss a referral for genetic counseling with the child’s parents. 

C.  Advise that the child’s clinical presentation is consistent with normal parameters for an infant of this age. 

D.  Order testing for plumbism and iron-deficiency anemia. 

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