A 10 yr old child is always restless, inattentive to study and always wants to play outside. Parents are extremely distressed. What would you advise?
Correct Answer: Behaviour therapy
Description: Behaviour therapy [Ref: Nelson 18thie p. 1481 First, Look at the DSM criteteria for ADHD The American Academy of Child Adolescent Psychiatry (AACAP) considers it necessary that the following be present before attaching the label of ADHD to a child. The behaviors must appear before age 7. They must continue foe at least six months. The symptoms must also create a real handicap in at least two of the following areas of the child's life : ? In the classrrom On the playground At home In the community, or In social settings The information provided in the question is not enough to diagnose it as a case of attention deficit hyperactivity disorder. Most of the parents will complain that their child is always restless and wants to play outside, It is not mentioned that the child suffers from some handicap while playing. The DSM criteria states that behaviour problem must began before age 7 years and must be present for at least 6 months. These features have not been mentioned in the question and without these we cannot diagnose AMID. The behaviour of the child may be problematic to his parents but he falls sho of meeting the full criteria for diagnosis of ADHD. DSM-IV criteria Either A or B A. Six or more of the following symptoms of inattention have been present for at least 6 months to a point that is disruptive and inappropriate for development level. I. Often does not give close attention to details or makes careless mistakes in schoolwork. work, or other activities. Often has trouble keeping attention on tasks or play activities. Often does not seem to listen when spoken to directly. Often does not follow instructions and fails to finish schoolwork, chores, or duties in the workplace (not due to oppositional behavior or failure to understand instructions). Often has trouble organizing activities. Often avoids, dislikes, or doesn't want to things that take a lot of mental effo for a long period of time (such as schoolwork or homework). Often loses things needed for tasks and activities (e.g., toys, school assignments. pencils, books or tools). Is often easily distracted. Often foretful in daily activities. B. Six or more of the following symptoms of hyperactivity-impulsivity have been present for at least 6 months to an extent that is disruptive and inappropriate for developmental level : ? Hyperactivity Often fidgets with hands or feet or squirms in seat. Often gets up from seat when remaining in seat is expected. Often runs about or climbs when and where it is not appropriate (adolescents or adults may feel very restless). Often has trouble playing or injoying leisure activities quietly. Is often "on the go" or often acts as if "driven by a motor". Often talks excessively Impulsiveness Often blus out answers before questions have been finished. Often has trouble waiting one's turn. Often interrupts or intrudes on others (e.g., butts into conversations or games).
Category:
Pediatrics
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