Attention-deficit hyperactivity disorder — viva

Stem

Examiner-led viva on paediatric ADHD. ^[1]

Examiner: How do you open this “medication today” visit? ^[1]

Strong answer: I greet the child first, set a joint agenda, and reframe the request as a full multi-setting assessment: developmental history, function, mimics, comorbidity, school information and shared decision-making — not a same-day label from one complaint. ^[1]

Examiner: What age-of-onset number do you use? ^[1]

Strong answer: Onset of symptoms before age 12 in DSM-5-TR style criteria — not the old DSM-IV before-7 rule. ^[1]

Examiner: Sleep is 8 hours with screens. Why does that matter? ^[20]

Strong answer: School-age children often need roughly 9–12 hours’ sleep opportunity per AASM consensus. Short sleep is a reversible driver of ADHD-like behaviour and must be addressed before or alongside diagnostic labelling. ^[20]

Examiner: Diagnosis is confirmed moderate-severe combined ADHD. First-line plan? ^[1]

Strong answer: Psychoeducation, parent behavioural strategies and classroom supports plus carefully monitored stimulant medication for moderate-severe impairment, with growth, BP, HR, appetite, sleep, mood/tics and diversion review. ^{[1] [3] [15]}

Examiner: What did MTA show at 14 months? ^[4]

Strong answer: Carefully managed medication management and combined medication-plus-behavioural treatment were superior to behavioural treatment alone and community care for core ADHD symptoms. ^[4]

Examiner: Parent fears stimulants cause later drug abuse. Your reply? ^[17]

Strong answer: Meta-analytic evidence does not support stimulant therapy causing later substance abuse; untreated ADHD raises substance-use risk, and diversion is managed with long-acting formulations and monitoring. ^[17]