A mother brought her 3 year-old daughter for her health examination. Mother reports that the child is ‘always in her own world’, not showing interest in things around her, not playing much and not making eye contact when being held. The mother works two jobs and keeps the child with the family of her boyfriend, who attends a suboxone clinic for his opioid dependence and leaves the child with his dad whenever he has to attend drug and alcohol counseling. When the patient was brought to your office 6 months ago, you advised the mother on providing proper physical, emotional and nutritional care to the patient. At that time, you informed her that her daughter’s growth and development is abnormal compared to other children of the same age. Mother reports ‘I am doing everything I can to feed my baby, but she sleeps too much and does not show interest to eat’. Today, in the physical examination, you noticed that this child is 20% below the ideal weight for her height. She is irritable and does not make eye contact with you. What is the most appropriate next step in the management of this child?
