i-Human Pediatrics Case Study: Avery
Brook – 10-Year-Old Female Experiencing
Academic Decline and Slipping Grades
- **Name:** Avery Brook
- **Age:** 10 years old (Grade: 4th or 5th)
- **Chief Complaint (CC):** "My grades have been getting
worse/slipping".
- **Source:** Patient and mother (reliable historians).
### 2. History of Present Illness (HPI)
Avery presents with a gradual decline in academic performance over
the past 6–12 months. Prior to this period, she was an average-to-
above-average student. Her mother reports significant difficulty with
attention and task completion both at school and home.
**Onset & Duration:** Gradual worsening over approximately one
school year.
, **Specific Behaviors (School & Home):**
- **School:** Teachers report incomplete assignments, careless
mistakes, and frequent "daydreaming." She is easily distracted by
surrounding activities and often loses school supplies (jackets,
homework folders).
- **Home:** Homework takes excessive time. Avery frequently forgets
assignments, requires constant redirection, and struggles with multi-
step instructions.
**Pertinent Negatives (Critical Rule-Outs):**
- **Sleep:** No loud snoring, witnessed apneas, or restless sleep
reported.
- **Neurologic:** No staring spells (absence seizures), headaches, or
tics.
- **Psychiatric:** No anxiety, depression, or social withdrawal.
- **General:** No recent illness, trauma, or vision changes.
### 3. Review of Systems (ROS)
- **General:** Denies fever, weight loss, or significant fatigue.
- **HEENT:** Denies vision changes (though no recent exam), hearing
loss, or sore throat.
- **Neurologic:** **Positive for poor concentration and
distractibility.** Negative for seizures, staring spells, or head trauma.
- **Psychiatric:** **Positive for forgetfulness and frustration.**
Negative for anhedonia, suicidal ideation, or excessive worry.
Brook – 10-Year-Old Female Experiencing
Academic Decline and Slipping Grades
- **Name:** Avery Brook
- **Age:** 10 years old (Grade: 4th or 5th)
- **Chief Complaint (CC):** "My grades have been getting
worse/slipping".
- **Source:** Patient and mother (reliable historians).
### 2. History of Present Illness (HPI)
Avery presents with a gradual decline in academic performance over
the past 6–12 months. Prior to this period, she was an average-to-
above-average student. Her mother reports significant difficulty with
attention and task completion both at school and home.
**Onset & Duration:** Gradual worsening over approximately one
school year.
, **Specific Behaviors (School & Home):**
- **School:** Teachers report incomplete assignments, careless
mistakes, and frequent "daydreaming." She is easily distracted by
surrounding activities and often loses school supplies (jackets,
homework folders).
- **Home:** Homework takes excessive time. Avery frequently forgets
assignments, requires constant redirection, and struggles with multi-
step instructions.
**Pertinent Negatives (Critical Rule-Outs):**
- **Sleep:** No loud snoring, witnessed apneas, or restless sleep
reported.
- **Neurologic:** No staring spells (absence seizures), headaches, or
tics.
- **Psychiatric:** No anxiety, depression, or social withdrawal.
- **General:** No recent illness, trauma, or vision changes.
### 3. Review of Systems (ROS)
- **General:** Denies fever, weight loss, or significant fatigue.
- **HEENT:** Denies vision changes (though no recent exam), hearing
loss, or sore throat.
- **Neurologic:** **Positive for poor concentration and
distractibility.** Negative for seizures, staring spells, or head trauma.
- **Psychiatric:** **Positive for forgetfulness and frustration.**
Negative for anhedonia, suicidal ideation, or excessive worry.
