Vignette Number CAP 017
Speciality:
Child & Adolescent Psychiatry
Date:
10 October 2001
Vignette:
8 year old boy is referred by GP. Parents complain that he will
not do as he is told. He is very bright. School complains that he
will not sit still, is always moving about. He cannot stay doing
one thing and moves from one task to another. Parents say he has no
sense of danger - has tried to get out of a moving car. He has no
friends - no one will play with him because he is too rough and
bossy.
Discuss the child's assessment and management.
Suggested Probes:
- What are the key criteria for ADHD?
- Who would you involve in behaviour management?
- What other problems/disorders would you look for?
- Must mention Attention Deficit Hyperkinetic
Disorder/Hyperkinetic disorder (overactivity, short attention span
and impulsivity).
- Features are seen in 2 out of 3 situations, (home, school,
interview).
- Know role of medication, e.g., stimulants e.g., Methylphenidate
- dosage, investigations and common side effects.
- Involve family and school, educational psychologist - behaviour
management.
- Impact of co-morbidity especially conduct disorder, anxiety,
developmental disorders, e.g., Asperger's, co-ordination.