i-Human Case Week #7 A 22 months old
female girl is having Difficulty in making
friends Pediatric Primary Care Clinical
Case Analysis
Patient Identification
Age: 22 months
Sex: Male
Source of History: Mother (reliable historian)
Visit Type: Initial developmental concern evaluation
, Clinical Setting: Outpatient pediatric clinic with laboratory and referral
capabilities
Chief Complaint (CC)
“My child has difficulty making friends and does not interact well with other
children.”
History of Present Illness (HPI)
(Extensive clinician–parent interview reflecting real clinical reasoning)
Clinician: What made you decide to bring your child in today?
Mother: I’m concerned that he doesn’t play with other children. He doesn’t seem
interested in them at all.
Clinician: How long have you had these concerns?
Mother: Since he was about 18 months old.
Clinician: What made you start noticing it at that time?
Mother: We started attending playgroups, and I noticed other kids his age were
interacting, but he wasn’t.
Clinician: What does he do instead during playtime?
Mother: He usually sits by himself and plays with toys alone.
Clinician: Does he try to share toys or show things to others?
Mother: No, he doesn’t bring toys to show us.
Clinician: How does he respond when another child approaches him?
Mother: He usually ignores them or walks away.
Clinician: Does he engage in pretend play, such as feeding a doll or talking on a
toy phone?
Mother: No, I haven’t seen him do that.
Clinician: How does he communicate his needs?
Mother: He pulls my hand or points to things.
female girl is having Difficulty in making
friends Pediatric Primary Care Clinical
Case Analysis
Patient Identification
Age: 22 months
Sex: Male
Source of History: Mother (reliable historian)
Visit Type: Initial developmental concern evaluation
, Clinical Setting: Outpatient pediatric clinic with laboratory and referral
capabilities
Chief Complaint (CC)
“My child has difficulty making friends and does not interact well with other
children.”
History of Present Illness (HPI)
(Extensive clinician–parent interview reflecting real clinical reasoning)
Clinician: What made you decide to bring your child in today?
Mother: I’m concerned that he doesn’t play with other children. He doesn’t seem
interested in them at all.
Clinician: How long have you had these concerns?
Mother: Since he was about 18 months old.
Clinician: What made you start noticing it at that time?
Mother: We started attending playgroups, and I noticed other kids his age were
interacting, but he wasn’t.
Clinician: What does he do instead during playtime?
Mother: He usually sits by himself and plays with toys alone.
Clinician: Does he try to share toys or show things to others?
Mother: No, he doesn’t bring toys to show us.
Clinician: How does he respond when another child approaches him?
Mother: He usually ignores them or walks away.
Clinician: Does he engage in pretend play, such as feeding a doll or talking on a
toy phone?
Mother: No, I haven’t seen him do that.
Clinician: How does he communicate his needs?
Mother: He pulls my hand or points to things.
