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ADHD — CCFP MCQ

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ModeratePaediatrics and adolescentADHDCCFP

A 9‑year‑old boy has persistent inattention and impulsivity at home and school. Teacher and parent rating scales support ADHD, and hearing and vision are normal. He has no tics, blood pressure is normal, and there is no substance use exposure. What is the most appropriate next step in management?

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Correct answer: B — Discuss behavioural interventions and consider initiating stimulant medication, providing monitoring of appetite, sleep, blood pressure, and growth

Option B is correct. Canadian Paediatric Society guidance emphasizes a combination of behavioural supports and stimulant medication (for children ≥6 years) as first‑line treatment, with appropriate monitoring of side effects and growth ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/30681665/?utm_source=openai)). A thorough baseline history and physical exam are sufficient before starting stimulants; ECG or EEG are not routinely indicated in the absence of red flags ([pubmed.ncbi.nlm.nih.gov](https://pubmed.ncbi.nlm.nih.gov/21037835/?utm_source=openai)). Antipsychotics are reserved for severe aggression unresponsive to first‑line therapies and carry significant risks. Elimination diets lack robust evidence as primary ADHD treatment, and delaying evidenced‑based care into adolescence risks allowing impairments to worsen.

Reference: Canadian Paediatric Society. “ADHD in children and youth: Part 2‑Treatment.” Paediatr Child Health, 2018 Nov. https://pubmed.ncbi.nlm.nih.gov/30681665/