We discussed increased visit to accident and emergency for convulsions in a seven year old girl with developmental delay.

Learning points were:

• Think of a differential while reading the information outside

• This will guide you in your questioning but be open to change track if the information provided so demand.

• Remember the broad headings for history and try and cover them all, this may limit your ability to go in great depth in all.

• Check the current issues and the social impact on the child and family.

• Social history is very important and usually has the clues to how to proceed

• Be empathic, do not use jargon

• A brief summary at nine minutes with the open question of is there anything you would like to tell me that I have missed.

SOCIAL HISTORY IS VERY IMPORTANT IN CHRONIC DISEASE AND IT’S MANAGEMENT.

TAKE IT AFTER PRESENTING ISSUES.