MEDizzy - A 7-year-old boy attends the assessment clinic accompanied

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Child & Adolescent Psychiatry

A 7-year-old boy attends the assessment clinic accompanied by his parents. He was referred by his GP for an assessment for ADHD, after his teacher raised concerns with his parents about his poor attention in class. All the following are core features of ADHD except:

ExplanationADHD is the most frequently occurring neurobiological disorder in childhood and is characterised by inattention, impulsivity and hyperactivity that are excessive when compared with other individuals at the same developmental level and that have an onset before 12 years of age (DSM-5; < 7 years of age in the ICD-10 diagnostic criteria). The symptoms should be present for more than 6 months, in multiple settings (for example, home and school or a healthcare setting), and cause functional impairment for the child. The worldwide prevalence of ADHD is estimated to be 5.9–7.1% in children and adolescents and 5.0% in adults (based on DSM-IV criteria). On the basis of the narrower criteria of ICD-10, hyperkinetic disorder (equivalent to severe ADHD and describing the occurrence of all three hyperactivity, impulsivity and inattention symptoms) is estimated to occur in about 1–2% of children and young people in the UK. There is a male preponderance, with a male : female ratio of 3:1. See Feldman & Reiff (2014) and Hill (2015).