James Binder

2013

Learning Through Role Play

A 10-year-old boy with high-functioning autism presents to the primary care clinic with a history of intermittent LUQ abdominal pain, present for several months. His mother, who suffers from a cognitive impairment, loudly demands an x-ray and an immediate referral to a specialist. After evaluating the child, the fi rst-year resident presents the situation to the attending. The resident feels frustrated. The child has no red fl ags in the history or physical exam and he thinks an x-ray and referral are not warranted; yet, the mother is insistent.