Child Psychiatry (ADHD, Autism, Intellectual Disability, Learning Disorders) MCQs

Psychiatry · 22 free questions with answers & explanations.

1. An 8-year-old boy is referred because he often cannot sustain attention during schoolwork, loses belongings, is easily distracted by external stimuli, and frequently does not follow through on instructions. His teacher reports the same behaviour at school. His parents note these problems began around age 5. He has no features of autism spectrum disorder. What minimum duration of symptom presence is required to diagnose ADHD under DSM-5-TR?
2. A 3-year-old girl is brought by her parents because she does not speak, avoids eye contact, engages in repetitive hand-flapping, lines up toys in precise rows, and becomes extremely distressed when her routine is changed. Hearing is normal. What is the most characteristic diagnostic feature of autism spectrum disorder that differentiates it from language disorder?
3. A 9-year-old boy is diagnosed with ADHD (combined presentation). His parents refuse stimulants. Which non-stimulant medication has FDA approval for ADHD as monotherapy?
4. In DSM-5, Autism Spectrum Disorder (ASD) requires deficits in social communication/interaction AND restricted repetitive behaviors. Which of the following is included in the restricted/repetitive behaviors domain?
5. A 7-year-old girl has difficulty reading despite normal intelligence, adequate educational exposure, and no sensory deficits. She makes letter reversals (b/d), struggles with phonological decoding, and reads slowly. What is the most likely diagnosis and the core deficit?
6. A 9-year-old boy has ADHD predominantly inattentive presentation. He has a tic disorder and his parents are concerned about worsening tics. Among the following, the agent LEAST likely to worsen tics while effectively treating ADHD is:
7. In DSM-5, Autism Spectrum Disorder (ASD) diagnosis requires deficits in TWO domains. Which two domains are specified?
8. A 9-year-old boy is brought by his parents for failing grades, inability to sit still in class, and frequent interrupting. His teacher confirms the same behavior at school. Symptoms have been present since age 5. His IQ testing is normal. According to DSM-5, how many symptoms of inattention AND/OR hyperactivity-impulsivity are required for an ADHD diagnosis in children under 17?
9. A 4-year-old child fails to respond to his name, makes no eye contact, has not developed any words, engages in repetitive hand-flapping, and insists on rigid routines. There is no history of regression after normal development. He scores in the severe range on the Autism Diagnostic Observation Schedule (ADOS-2). Which DSM-5 change is MOST relevant to this case?
10. A 7-year-old child with ADHD, combined presentation, is started on methylphenidate. His parents ask about the mechanism. Methylphenidate primarily acts by:
11. A 9-year-old boy presents with inattention, impulsivity, and hyperactivity across school and home. He was started on methylphenidate. Which mechanism explains methylphenidate's therapeutic action in ADHD?
12. DSM-5 consolidated autism spectrum disorder (ASD) from DSM-IV's separate diagnoses. Which DSM-IV diagnosis is no longer a separate diagnosis in DSM-5, and what are the two core symptom domains now required?
13. According to DSM-5, Autism Spectrum Disorder (ASD) collapses previous subtypes from DSM-IV. Which of the following DSM-IV diagnoses was subsumed into ASD in DSM-5, alongside Autistic Disorder, PDD-NOS, and Childhood Disintegrative Disorder?
14. A 9-year-old boy with ADHD has been on methylphenidate for 6 months with good symptom control but now shows decreased appetite and poor weight gain (5th percentile). The most appropriate management strategy is:
15. A 7-year-old child with ADHD does not respond adequately to methylphenidate despite two dose optimisation trials. The non-stimulant option with the best evidence as an alternative in children and a specific FDA approval for ADHD is:
16. A 7-year-old boy shows social communication deficits (difficulty with back-and-forth conversation, poor eye contact), restricted interests (preoccupied exclusively with trains for 2 years), and repetitive motor mannerisms (hand-flapping when excited). Symptoms were present from early development. He uses full sentences. IQ on WISC-V is 84. Per DSM-5, the diagnosis is:
17. A 7-year-old boy has fidgetiness, inability to remain seated, running in inappropriate situations, blurting out answers, and difficulty waiting his turn, along with difficulty sustaining attention in class since age 4. These symptoms are present both at home and school. What is the recommended first-line pharmacotherapy for ADHD in this age group according to current guidelines?
18. In ASD (autism spectrum disorder), the DSM-5 requires deficits in social communication AND restricted, repetitive patterns of behaviour. Which specifier is used to indicate the level of support needed, and what does 'Level 3' indicate?
19. A 7-year-old boy has been diagnosed with ADHD (combined presentation). His parents refuse stimulant medication. Which non-pharmacological intervention has the STRONGEST evidence base as monotherapy in this age group?
20. In Autism Spectrum Disorder (ASD), which core diagnostic feature was ADDED in DSM-5 that was NOT a separate domain in DSM-IV autism criteria?
21. A 7-year-old boy is brought for being disruptive in class, unable to sit still, frequently interrupting others, and making careless mistakes despite apparently good intelligence. Symptoms occur across home and school settings for >6 months. DSM-5 criteria for ADHD require symptoms in how many settings, for what duration, and before what age of onset?
22. A 3-year-old does not speak, avoids eye contact, lines up toys repetitively, and becomes severely distressed when his routine is changed. His pediatrician suspects ASD. The single most important standardized diagnostic screening tool validated for this age in primary care is: