Neurodevelopmental disorders (ADHD, autism) — MCQs

Q: A 7-year-old boy is brought to the clinic by his mother due to poor academic performance. His teacher reports that he frequently leaves his seat, interrupts others, and fails to complete assignments. At home, he has difficulty waiting his turn during games and often loses his belongings. His mother notes these behaviors have been present since age 4 and occur both at school and home. Physical examination is unremarkable. What is the most appropriate initial pharmacological treatment?

Methylphenidate. ***Methylphenidate*** - **Methylphenidate** and other **stimulants** are considered the first-line pharmacological treatment for **ADHD** due to their high efficacy and superior response rates in children aged 6 years and older. - It works by increasing the levels of **synaptic dopamine** and **norepinephrine** in the prefrontal cortex, helping to regulate attention and behavior. *Risperidone* - This is an **atypical antipsychotic** primarily used for the management of **irritable behavior** in autism or **conduct disorder**, rather than core ADHD symptoms. - High side-effect profile, including **weight gain** and **metabolic changes**, makes it inappropriate as an initial treatment for uncomplicated ADHD. *Atomoxetine* - While it is a **non-stimulant** medication approved for ADHD, it is generally considered a second-line option when **stimulants** are ineffective or contraindicated. - It has a **slower onset of action** (weeks) compared to the rapid effect of methylphenidate. *Clonidine* - This is an **alpha-2 adrenergic agonist** typically used as an adjunct or second-line treatment, especially for patients with comorbid **tics** or significant **sleep disturbances**. - It is less effective for **inattentive symptoms** compared to stimulants and can cause significant **sedation** and hypotension. *Fluoxetine* - This is a **Selective Serotonin Reuptake Inhibitor (SSRI)** indicated for **Major Depressive Disorder** or **Anxiety**, which are not the primary issues described here. - It has no proven efficacy in treating the core symptoms of **hyperactivity**, **impulsivity**, or **inattention** seen in ADHD.

Neurodevelopmental disorders (ADHD, autism) — MCQs

A 7-year-old boy is brought to the clinic by his mother due to poor academic performance. His teacher reports that he frequently leaves his seat, interrupts others, and fails to complete assignments. At home, he has difficulty waiting his turn during games and often loses his belongings. His mother notes these behaviors have been present since age 4 and occur both at school and home. Physical examination is unremarkable. What is the most appropriate initial pharmacological treatment?

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ADHD subtypes and diagnostic criteria

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Neurobiology of ADHD

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Stimulant medications

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Non-stimulant ADHD treatments

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Autism spectrum disorder diagnostic criteria

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Autism assessment tools

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Early intervention in ASD

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Applied behavior analysis

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Intellectual disability classification

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Learning disorders

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Communication disorders

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Motor disorders (tic disorders, stereotypic movement)

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Transition to adult care

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