Child Health 10 - Jackson

The Case

A few years later...

Once Jackson’s parents have removed the TV, and he has had a course of iron therapy,  he starts falling asleep at 8.30pm. School report his learning has improved markedly and his attention span is much better. Parents report that his behaviour at home is much better and they are starting to be able to persuade him to eat a greater range of healthier foods.


3 years later, he is re-referred. This time the referral is from the GP. His sleep is an issue again as is his learning, and the parents say that the team were so helpful last time, they are keen for him to be reviewed.


This time the history is a bit different. He is falling asleep ok at around 8.30pm. He is very hard to wake in the mornings though and often complains of a headache and is sweaty when he wakes. His parents joke that his snoring probably wakes the neighbours. Sometimes they think he has stopped snoring as it goes very quiet but then he starts again with a loud snort.


His school work is falling behind again, and his current class teacher has again raised concerns about his attention span.


He is now 10 years 3months. On examination his weight is 60kg and his height is 146cm.

Attachment: Boys 2-18yrs Growth Chart.pdf
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Relevant Growth Chart for boys aged between 2-18 years.

Open Question

Plot this on the chart. What is his BMI and BMI centile?

Multiple Choice Question

What is the most likely cause of his sleep symptoms?

Open Question

What investigations would you order and what is the management?