A 7-year-old boy has been failing school for two years. Teachers report he is easily distracted, frequently loses his pencil and books, forgets homework daily, and struggles to follow multi-step instructions but can sit quietly. He has no hyperactivity or impulsivity. What subtype of ADHD does he most likely have, and which DSM-5 criterion helps establish chronicity?

• A ADHD, predominantly inattentive presentation; symptoms present in ≥2 settings for ≥6 months before age 12 ✓
• B ADHD, hyperactive-impulsive presentation; symptoms present for ≥3 months
• C ADHD, combined presentation; symptoms present for ≥12 months before age 7
• D ADHD, predominantly inattentive; symptoms present in at least one setting for ≥6 months

Explanation

The child demonstrates exclusively inattentive features (distractibility, forgetfulness, losing items, difficulty following instructions) without hyperactivity/impulsivity, consistent with ADHD predominantly inattentive presentation. DSM-5 requires: ≥6 inattentive symptoms for ≥6 months, present in ≥2 settings (home and school here), with onset of several symptoms before age 12 (replacing the earlier DSM-IV cut-off of age 7). Option C incorrectly states the age cut-off as 7 (DSM-IV criterion); DSM-5 uses age 12.

Reference: Ghai Essential Pediatrics, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.