ADHD Under-5s Treatment — MRCPsych Paper B MCQ

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EasyChild & Adolescent PsychiatryADHD Under-5s TreatmentMRCPsych Paper B

A 4-year-old boy has been diagnosed with attention deficit hyperactivity disorder (ADHD). According to NICE NG87, which treatment should be offered first-line?

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Correct answer: C — Offer an ADHD-focused group parent-training programme

The correct answer is C. NICE recommends an ADHD-focused group parent-training programme as first-line treatment for children under 5 with ADHD. This reflects evidence of benefit from parent training and the limited evidence concerning medication efficacy and long-term effects on growth and development in very young children. If significant impairment persists across settings after parent training and reviewed environmental modifications, advice should be obtained from a specialist ADHD service with expertise in young children. Medication must not be offered to a child under 5 without a second specialist opinion. Methylphenidate, atomoxetine, lisdexamfetamine and guanfacine are therefore not routine first-line options in this age group.

Reference: NICE. Attention deficit hyperactivity disorder: diagnosis and management (NG87), recommendations 1.5.7–1.5.9, 2018 (updated 2019). https://www.nice.org.uk/guidance/ng87/chapter/recommendations