University of Hawaii
Integrated Pediatric Residency Program
Case 4
A 5 year old girl with cerebral palsy recently moved from the mainland and is seeing you as a new patient in clinic. On physical exam, you note that she is unable to ambulate or eat independently, and has a tracheostomy in place. You estimate her language development to be equivalent to a 15 month old, with gross motor skills at the level of a 10 month old. Her parents both work and are interested in enrolling her and her healthy, normal twin bother into Kindergarten.
Questions to think about/discuss:
1. What are the problems in this case?
2. What medical home principles need to be addressed in this case?
3. What elements of the health care and educational systems need to be involved in this patient’s care?
4. How would coordinate care for this patient?
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