A 16-month-old child is attending a well-child visit at a pediatric clinic.
Which assessment would indicate the biggest cause for concern?

Choice A rationale:

Educationally oriented play might be suitable for some children, but for a child with moderate intellectual deficiency, focusing on education may not be the most appropriate choice. These children often have developmental delays, so it's important to consider their mental age rather than chronological age when planning activities. Tailoring play to their cognitive abilities can be more effective in promoting their development.

Choice B rationale:

Exercise for leg and arm muscles is a beneficial form of physical activity, but it may not be the most appropriate choice when caring for a child with moderate intellectual deficiency. While physical activity is essential for overall health, it should be combined with play that stimulates cognitive and social development, which is better achieved through age-appropriate play adjusted to their mental age.

Choice D rationale:

Involving a child with moderate intellectual deficiency in contact sports and aggressive physical activities with other children can be unsafe and may not suit their cognitive and physical abilities. These activities may lead to injuries or frustration for the child. It's crucial to focus on play that matches their cognitive level and promotes social and emotional development.

Choice A rationale:

The fear of death is a more abstract and complex concept that is not typically unique to the preschool period. While children may start to understand the concept of death during this time, it is not a fear that is unique to this developmental stage.

Choice B rationale:

Fear of animals is unique to the preschool period and is a common developmental fear during this stage. Children often exhibit fear or anxiety towards unfamiliar animals, which is considered a normal part of their emotional and cognitive development.

Choice C rationale:

Fear of bodily harm is not unique to the preschool period and can be present at various stages of development. It is a general fear that can occur at any age, depending on the child's experiences and exposure to potential harm.

Choice D rationale:

Fear of water is not unique to the preschool period. While some children may have a fear of water, it is not a specific fear that is characteristic of this age group. Water fears can develop at any stage and may be influenced by individual experiences.