A 6-year-old boy has difficulty sustaining attention in class, is easily distracted, frequently loses belongings, and cannot wait for his turn in games. His teacher reports he frequently interrupts others and blurts out answers. He performs normally on individual academic testing in a quiet room. His IQ is 95. Which of the following regarding the diagnosis of ADHD is MOST ACCURATE per DSM-5 criteria?
- A Symptoms must be present only in school as this is the primary impairment setting for ADHD
- B A neurological EEG is required to confirm ADHD before initiating treatment
- C Symptoms must be present in at least two settings (e.g., home and school) and have been present before age 12 years ✓
- D Symptoms must have been present since birth (before age 3 years) for a formal ADHD diagnosis
Explanation
DSM-5 criteria for ADHD require: (1) ≥6 symptoms of inattention and/or hyperactivity-impulsivity for ≥6 months to a degree inconsistent with developmental level; (2) onset of symptoms before age 12 years; (3) symptoms present in at least two settings (e.g., home AND school); and (4) symptoms cause functional impairment. Presence in only one setting argues against ADHD. There is no requirement for EEG—ADHD is a clinical diagnosis based on history and observation. Symptoms need not be present from birth or before age 3. This child's symptoms in both school and home settings, with impairment, meet criteria.
Reference: Ghai Essential Pediatrics, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.