Attention-deficit hyperactivity disorder — formative SAQs

SAQ 1 (10)

A 7-year-old is referred because the teacher says “ADHD tablets please.” Homework is unfinished. Nightly sleep is about 8 hours with a tablet in bed. Vision has not been checked for two years. Parent reports the child is “fine at weekends.” ^[1]

1. Define ADHD using multi-setting and impairment criteria. (2) ^[1]
2. List four reversible or alternative contributors you must assess before labelling. (2) ^{[1] [20]}
3. Outline your multi-informant assessment plan. (3) ^[1]
4. State two reasons a same-day stimulant prescription is unsafe here. (3) ^{[1] [12] [20]}

Model answer

Definition. Neurodevelopmental pattern of impairing inattention and/or hyperactivity-impulsivity inconsistent with developmental level, present ≥6 months, onset before age 12, in ≥2 settings, with clear functional interference and not better explained by another condition. ^[1]

Contributors. Short sleep/screen-related sleep debt; uncorrected vision; learning disorder; hearing problem; anxiety/trauma; normal high activity without multi-setting impairment. ^{[1] [20]}

Assessment plan. Child voice; parent developmental history; teacher scales/report; sleep and sensory screens; growth/BP/HR baselines; comorbidity and safeguarding screen; synthesis meeting. ^[1]

Why not same-day stimulant. Diagnosis incomplete (single setting claim, no teacher instrument yet); sleep opportunity inadequate; vision unchecked; risk of overdiagnosis from pressure without multi-informant evidence. ^{[1] [12] [20]}