USMLE Forums banner
1 - 11 of 11 Posts

·
Registered
Joined
·
4,342 Posts
Discussion Starter · #1 ·
A 5 year old boy brought to the office because his mother said that he has problems with "inattentivity". His school teacher said that "he does not stand still and just does not listen". He rarely completes his school assignments in time. When asked to run errands at home, he appears not to listen and continues to do with what's he's engaged in. He makes poor eye contact and has limited language skills compared to his peers. He usually prefers to play by himself. What is the most likely diagnosis?

A) Selective mutism
B) Attention deficit hyperactivity disorder
C) Autism
D) Hearing impairment
E) Oppositional defiant disorder
 

·
Registered
Joined
·
2 Posts
Poor eye contact & limited language skills are more than sufficient to make diagnosis. moreover the child doesn't listen to the command & keep on doing the activity he was engaged in. so, Autism is the answer.
 

·
Registered
Joined
·
244 Posts
interesting... he "appears" not to listen..... so hes choosing to remain silent?

selective mutism ? although if this were usmle id click ADHD :p
 

·
Registered
Joined
·
4 Posts
D presentation describes a picture most likely 2 b Autism.I mean..a Pt with just selective mutism is not likely to hv problems with eye contact and d apparent hyperactivity and defiance present in dis pt...same goes for hearing impairment..i honestly don't knw much abt Oppostitional defiant disorder(i'd appreciate help with that)..so..
 

·
Registered
Joined
·
23 Posts
autism

:) Answer is autism: poor eye to eye contact, social interaction, language delay all dignositic of autism( inattention also present as most cases of autism associated with cognitive delay(MR). ON THE OTHER HAND ADHD NOT ASSOCIATED WITH THIS, WE NOT DIGNOSE BY A SYMPTOM BUT CONSTELLATION OF SYMPTOM(DIGNOSITIC CRITERIA).​
 

·
Registered
Joined
·
1 Posts
hi ,it is nice q ,am going with c for 2 reasons the child has poor eye contact and prefers to play by himself although it is confusing with hearing impairment but i think those with hearing impairment are socialized and they like to play with thier peers beside they r having good eye contact...correct me if i am wrong thnx
 

·
Registered
Joined
·
4,342 Posts
Discussion Starter · #10 ·
The correct answer

Autism is not the correct answer because this child does not feature the typical repetitive stereotypic patterns of behavior and also autism usually diagnosed at an earlier age.
ADHD is also not correct because poor social interaction and impaired language are not typical features of ADHD. The child does have inattention and some hyperactivity but it's not enough for the diagnosis and does not fit the scenario.
Selective mutism is also wrong because such children have failure to speak in certain social situations but they speak normally in other situations such as home.
An undiagnosed hearing impairment (Choice D) will lead to poor language development and social skills and as a result such children will be frustrated and develop poor self-esteem and isolate themselves. This child's inattentivity and refusal to listen and poor eye contact can all be explained by hearing impairment. Of course further diagnostic work up is needed to rule other diagnoses but at this point an undiagnosed hearing impairment is the best answer.
 

·
Registered
Joined
·
167 Posts
Autism is not the correct answer because this child does not feature the typical repetitive stereotypic patterns of behavior and also autism usually diagnosed at an earlier age.
ADHD is also not correct because poor social interaction and impaired language are not typical features of ADHD. The child does have inattention and some hyperactivity but it's not enough for the diagnosis and does not fit the scenario.
Selective mutism is also wrong because such children have failure to speak in certain social situations but they speak normally in other situations such as home.
An undiagnosed hearing impairment (Choice D) will lead to poor language development and social skills and as a result such children will be frustrated and develop poor self-esteem and isolate themselves. This child's inattentivity and refusal to listen and poor eye contact can all be explained by hearing impairment. Of course further diagnostic work up is needed to rule other diagnoses but at this point an undiagnosed hearing impairment is the best answer.
Thanks YALLAH for such nice explanation of the answer it s very complicated question!!!!!!!!!:)
 
1 - 11 of 11 Posts
Top