A 2-year-old with cerebral palsy, seizure disorder, developmental delay, and gastroesophageal reflux disease is seen by you for the first time. The family just moved to your city and has been referred to you from the child’s former physician. The mother has brought a copy of the child’s medical records for your review. The child is current with his preventive medicine visits and vaccines. His mother states that the child is having increased difficulty swallowing with frequent choking episodes and seizures.

A comprehensive history is taken including a detailed history of present illness, review of 10 systems, and past, family, and social history. A comprehensive physical examination is performed. You spend 40 minutes talking with the mother to discuss a change in the child’s medication and the need for a consultation with a neurologist and nutritionist. The conversation includes a discussion of the coordination of care with a physical, occupational,...

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