Background Information: Mrs. Sarah Smith, mother of John. History form completed by Mrs. Sarah Smith. Persons attending the current assessment John and both parents live together full time. Parents and living situation Biological father: Mr. Jim Smith, 33 years old. Biological mother: Mrs. Sarah Smith, 31 years old. English. Languages spoken within the home John's family has twice in his life, with the most recent Moves within John's lifetime move occurring when he was 4 years old, which he adjusted to with great difficulty. Birth: 25 years old. Maternal age at birth John's mother began receiving prenatal care within the second Prenatal care trimester. Mrs. Smith reported "I might have had a beer and sushi before I Exposure to illicit or realized I was pregnant, but neither in excess." substances while pregnant None reported by Mrs. Smith. Difficulties with pregnancy Not completed. Amniocentesis completed 40 weeks (full term). Gestation Mrs. Smith reported that John was born by emergency cesarean Delivery section and complications included: "the labor failed to progress and fetal distress was detected and they decided to do a 7 lb 5 oz and 19 inches long. Birth weight and length Unknown by Mrs. APGAR scores None reported by Mrs. Smith. Significant postnatal issues Medical: John’s overall health is good although he has mild allergies, Overall health asthma, and a mild astigmatism. Mrs. Smith reported, "John has had three episodes of significant Significant illnesses vomiting. We didn't know what caused it and took him to the emergency room each time. Doctors gave him fluids through an IV and he recovered quickly." None reported by Mrs. Significant injuries None reported by Mrs. Smith. Hospitalizations None reported by Mrs. Smith. Surgeries None reported by Mrs. Smith. Signs of seizures John has never had an ear infection. Chronic ear infections Mrs. Smith reported John is allergic to the following: "whole Allergies to environment, food, eggs, but [he] can tolerate products with eggs in it." or medications Mrs. indicated John has asthma and he utilized an Asthma difficulties “mild”
Background Information: History form completed by Mrs. Sarah Smith, mother of John. Persons attending the current assessment Mrs. Sarah Smith. Parents and living situation John and both parents live together full time. Biological father: Mr. Jim Smith, 33 years old. Biological mother: Mrs. Sarah Smith, 31 years old. Languages spoken within the home English. Moves within John's lifetime John's family has twice in his life, with the most recent move occurring when he was 4 years old, which he adjusted to with great difficulty. Birth: Maternal age at birth 25 years old. Prenatal care John's mother began receiving prenatal care within the second trimester. Exposure to illicit or substances while pregnant Mrs. Smith reported "I might have had a beer and sushi before I realized I was pregnant, but neither in excess." Difficulties with pregnancy None reported by Mrs. Smith. Amniocentesis completed Not completed. Gestation 40 weeks (full term). Delivery Mrs. Smith reported that John was born by emergency cesarean section and complications included: "the labor failed to progress and fetal distress was detected and they decided to do a Birth weight and length 7 lb 5 oz and 19 inches long. APGAR scores Unknown by Mrs. Significant postnatal issues None reported by Mrs. Smith. Medical: Overall health John’s overall health is good although he has mild allergies, asthma, and a mild astigmatism. Significant illnesses Mrs. Smith reported, "John has had three episodes of significant vomiting. We didn't know what caused it and took him to the emergency room each time. Doctors gave him fluids through an IV and he recovered quickly." Significant injuries None reported by Mrs. Hospitalizations None reported by Mrs. Smith. Surgeries None reported by Mrs. Smith. Signs of seizures None reported by Mrs. Smith. Chronic ear infections John has never had an ear infection. Allergies to environment, food, or medications Mrs. Smith reported John is allergic to the following: "whole eggs, but [he] can tolerate products with eggs in it." Asthma difficulties Mrs. indicated John has “mild” asthma and he utilized an
Part-3_Demo-report.docx