1. INTRODUCTION TO THE
PEDIATRIC INTERVIEW
Stephanie Kay
PGY2 Pediatrics
McMaster University
April 28, 2012

2. OBJECTIVES
 Review questions to ask on a pediatric history,
including neonates and adolescents
ACKNOWLEDGEMENTS
 Mohammed Zubairi, PGY3

3. THINGS TO REMEMBER
 Most babies don’t talk
 Caregivers are right (majority of the time)
 Language and culture play a role in child
upbringing

4. THINGS TO REMEMBER
 Lay eyes on the child first*
 Focus your history in complex situations
 Confidentiality

5. LAYING EYES ON A CHILD: SICK OR
NOT
SICK?
 Look at their level of activity
 Look at their breathing
 Look at their color

6. BUILDING RAPPORT
 Ignore young children at first
 Ask non-threatening questions
 Comment on t-shirt/toy
 Bring toys/stickers
 Stay calm

7. HISTORY OF PRESENTING ILLNESS?
 Location
 Onset (activity at symptom onset, environment)
 Duration
 Precipitating/Palliating
 Quality
 Radiation
 Severity
 Timing
 Happened before?
 What do you think?

8. PAST MEDICAL HISTORY
 Illnesses?
 Surgeries?
 Hospitalizations?
 ER visits?

9. PAST MEDICAL HISTORY
 Accidents/Injuries?
 Immunization?
 Medications?
 Allergies?
 *Pubertal changes*

10. PREGNANCY HISTORY
 GTPAL
 Maternal serology and blood type*
 Infection, fever, antibiotics
 Medications
 U/S
 IVF

11. BIRTH HISTORY
 Vaginal delivery vs C/S
 ROM
 APGAR
 Birth weight
 Need for oxygen, resus

12. NEWBORN PERIOD
 Feeding
 Respiratory problems
 Jaundice
 Stay in hospital

13. NUTRITION, SLEEP, AND TOILETING
 Breast fed or not?
 How long?
 Present intake
 G-tube?
 # of meals, # of snacks
 Bed time? Anxiety?
 Toileting?

14. BEHAVIOUR & DEVELOPMENT
More than one setting…
 Cognitive/Language
 Television/Computer/Videogaming
 Adaptive Skills/Fine Motor
 Gross Motor
 Social/Emotional/Behavioral

15. FAMILY & SOCIAL HISTORY
 Parents (ages/occupations/medical conditions)
 Consanguinity?
 Siblings (ages/medical conditions)
 Extended family?
 Supports? Housing?
 Recent travel?

16. HEADDSSS INTERVIEW IN
ADOLESCENTS
 H=home
 E=education
 A=activity
 D=drugs
 D=disordered eating
 S=safety
 S=sexual activity
 S=suicidality
*confidentiality

17. REVIEW OF SYSTEMS
 Head
 Toe
 Constitutional symptoms

18. CLINICAL PEARLS
 Which hand do you pick your nose with?
 ADHD: how long can you focus on something you
like that doesn’t involve a screen
 Constipation: characterize the poop. Large logs
are constipation too!

19. THANKS!
stephanie.kay@medportal.ca