Autism spectrum disorder — structured clinical viva

"Tablet for autism?" No medication treats core social-communication deficits as a primary indication. Foundations are educational supports, speech/OT, behavioural and parent-mediated interventions (name ESDM, PACT, parent training). Medicines treat comorbidities and severe irritability only.^[1][4]

Dangerous aggression. Functional analysis and medical pain screen first. If severe irritability persists, discuss risperidone (RUPP evidence) or aripiprazole (Owen evidence): low start, slow titration, baseline and serial metabolic monitoring, EPS/prolactin (risperidone) or akathisia (aripiprazole), time-limited goals and review for dose reduction when safe.^[2][3]

ADHD or anxiety? Both commonly co-occur; dual diagnosis is allowed when criteria are met. Discriminate social interest and developmental RRB pattern from pure inattention or fear-of-scrutiny anxiety. Treat each problem that meets threshold with adapted approaches.^[1]

Age 18. Plan transition early: written care plan, adult service handover, education/employment, capacity is decision-specific with support, safeguarding for exploitation, and mental health follow-up — premature mortality and suicide risk mean physical and mental health cannot be ignored across the lifespan.^[5][6]

Name evidence. Hyman AAP; McCracken RUPP; Owen aripiprazole; Dawson ESDM; Hirvikoski mortality; Cassidy suicide framing.^{[1][2][3][4][5][6]}