What finding indicates a child is obtunded?

The indication of a child being obtunded is best represented by the scenario where there is limited spontaneous movement and sluggish speech. Obtunded refers to a state of reduced alertness and awareness, where the individual is less responsive than usual.

In this case, the presence of sluggish speech and limited spontaneous movement accurately describes a state where the child is not fully alert but can still be roused with some stimulation. It denotes a level of consciousness that lies between being fully aware and being in a more deeply altered state, such as stupor or coma. This level of responsiveness signifies that while the child is not fully engaged with their environment, they are still capable of reaction when stimulus is applied.

The other described states imply different levels of consciousness that do not fit the definition of obtunded. For instance, remaining in deep sleep but only responsive to vigorous stimulation suggests a deeper degree of unresponsiveness than obtunded presents. No motor or verbal response to painful stimuli indicates a comatose state rather than obtunded. Hence, the description of sluggish speech and limited movement aligns with the concept of being obtunded, capturing the nuances of reduced responsiveness without complete unresponsiveness.