A 4-year-old child still has unclear speech (~50% intelligible) and cannot participate in pretend or cooperative play. The nurse recognises that this may indicate:

1. A normal, expected variation in development
2. A possible developmental delay needing further evaluation
3. A sign of advanced, above-age development
4. A temporary lag caused by the child's temperament

Practice all 18 Pediatric Growth and Development Milestones questions