Today you note that Kayla is back with Jo for behavioral issues.

Week 5: PBL Case Discussion: Issues in Growth and Behavior Part One
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Today you note that Kayla is back with Jo for behavioral issues.

HPI: Kayla (mom) is back to visit with Jo, the 5 & 8/12 year-old female child. She is here for complaints of behavioral difficulties and poor performance in school. Mother reports since moving back in with her parents that Jo has become increasingly emotional and ‘clingy’. The mother reports that she has always been needier than her siblings. However, since the move and starting kindergarten, others have commented on difficulties in behavior, difficulty leaving her at school, and the inability of the mother to leave without Jo when she goes out because she refuses to stay with her grandparents.

PMH: No change in diet; no fever; no communicable disease symptoms; continues children’s chewable multivitamin with iron daily; sleep includes going to bed around 11 when Kayla does because she refuses to sleep in her own bed and hand has been sleeping with Kayla every night. She is waking for school at 6:30 am.

Discussion Questions Part One:

What additional OLDCART and ROS information would you like? Why?

Differential diagnoses with rationale?
Jo has become increasingly emotional and ‘clingy’. The mother reports that she has always been needier than her siblings.

Further history and ROS needed to more fully develop your differential diagnoses?