Physical Exam:

Normal growth and vital signs. 

Healthy appearing 8 year old.

No dysmorphic features. 

Physical exam and neurologic exam are completely normal.

Observations:

Ben is fidgeting on the chair during the interview and plays with the blood pressure cuff and other instruments while being examined.

He interrupts, saying “Mom, look at me!” as he tries to jump off the exam table.

During the exam, his mother is firm and consistent with redirecting Ben; he obeys, but is quick to resume his activities.

Physical Exam:

Normal growth and vital signs. 

Healthy appearing 4.5 year old.

No dysmorphic features. 

Physical exam and neurologic exam are completely normal.

Observations:

Oliver is constantly moving around the exam room. Oliver is somewhat interested in coloring with provided crayons and paper but quickly loses interest. He climbs up on the exam table and begins to pull on the cord attached to the ophthalmoscope. The ophthalmoscope falls from the wall onto the exam table. Oliver then climbs off and begins tapping on various keys on the computer keyboard located in the room.

During the exam, his mother frequently apologizes for his Oliver’s behavior and reports she “doesn’t know what to do with him” at times.

Physical Exam:

Growth parameters who weight, height, and head circumference measurements between the 5th and 10th percentiles. 

Vision and hearing screens, and complete physical exam are normal.

Observations:

Jill presented as a petite girl, who was initially shy, but could be engaged in conversation.  Her speech was clear and intelligible, although she answered questions with short phrases.  She sometimes needed to have questions repeated. She was not hyperactive.