Pediatrics · Developmental and Behavioral Pediatrics (Detailed)

An 8-year-old is failing academically despite normal intelligence (IQ 95). He has significant difficulty reading (confuses b/d, reads slowly, poor phonological awareness) despite being in a stimulating environment with no sensory deficits. The MOST effective evidence-based intervention is:

  • A Ritalin (methylphenidate) for presumed co-existing ADHD
  • B Visual tracking therapy and colored overlays
  • C Intensive phonics-based reading instruction (Orton-Gillingham approach)
  • D Occupational therapy for fine motor difficulties
Correct answer: C. Intensive phonics-based reading instruction (Orton-Gillingham approach)

Explanation

This presentation is classic for dyslexia (specific reading disorder) — poor phonological processing, letter reversals, slow reading, and normal intelligence. Intensive structured literacy (phonics-based) instruction such as the Orton-Gillingham method, which systematically teaches sound-symbol correspondences, is the gold-standard evidence-based intervention. Phonological awareness training improves reading outcomes significantly. Visual tracking therapy has not been validated by controlled trials. Methylphenidate is for ADHD (which can co-occur) but does not treat the reading disorder itself. Occupational therapy addresses handwriting/dysgraphia but not the core phonological deficit.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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