[ Psychiatric ] Child Psychiatry 2

ADHD management (Stimulants) side effects: Common and psychiatric

Insomnia (MC), agitation, anxiety, anorexia.

ADHD management (Stimulants) side effects: Cardiovascular

Tachycardia, hypertension, affects the heart.

ADHD management (Stimulants) side effects: Somatic and neurological

Weight loss, tics, bruxism.

ADHD management (Amphetamines): Mechanism of action

Increase DA & NE release.

ADHD management (Amphetamines): Pharmacokinetics benefit

Slow release = improve focus & attention.

ADHD management (Pharmacological): Second-line agents

2nd line: atomoxetine, guanfacine XR.

ADHD management (Pharmacological): Third-line agents

3rd line: clonidine, bupropion, imipramine.

ADHD management clinical notes: First-line approach for age ≥6 years

Psychosocial therapy + meds = first-line in ≥6 years.

ADHD management clinical notes: First-line approach for age <6 years

Psychosocial alone = first-line in <6 years.

ADHD management clinical notes: Comorbidity management

Comorbid disorders often need separate treatment (SSRIs, antipsychotics).

Autism Spectrum Disorder epidemiology: Prevalence rate

Prevalence: 1%.

Autism Spectrum Disorder epidemiology: Gender predominance

Male > female.

Autism Spectrum Disorder epidemiology: Typical age of recognition

Recognized between 12–24 months (variable severity).

Autism Spectrum Disorder diagnostic criteria: Core domain 1

Persistent deficits in social communication & interaction.

Autism Spectrum Disorder diagnostic criteria (Social communication): Social-emotional reciprocity deficits

Abnormal social approach, Reduced back-and-forth conversation, Reduced sharing of interests/emotions.

Autism Spectrum Disorder diagnostic criteria (Social communication): Nonverbal communicative deficits

Poor eye contact, Abnormal body language/gestures, Reduced facial expressions, Poor integration of verbal + nonverbal communication.

Autism Spectrum Disorder diagnostic criteria (Social communication): Relationship deficits

Difficulty adjusting behavior to context, Difficulty making friends, Lack of interest in peers, Reduced imaginative play.

Autism Spectrum Disorder diagnostic criteria: Core domain 2 (with threshold)

Restricted, repetitive behaviors (≥2 required).

Autism Spectrum Disorder diagnostic criteria (Repetitive behaviors): Specific clinical features

Stereotyped movements (e.g., hand flapping), Insistence on sameness / routines, Highly restricted or fixated interests, Sensory abnormalities (hyper- or hypo-reactivity).

Autism Spectrum Disorder diagnostic criteria: Onset timeline requirement

Symptoms present in early developmental period.

Autism Spectrum Disorder diagnostic criteria: Functional requirement

Cause clinically significant impairment.

Autism Spectrum Disorder diagnostic criteria: Diagnostic exclusion

Not better explained by intellectual disability alone.

Autism Spectrum Disorder clinical features: Associated cognitive profiles

May coexist with: Intellectual disability, High abilities in specific areas (savant skills).

Autism Spectrum Disorder etiology (Biological/prenatal): Risk factors

Prenatal infections or toxins, Low birth weight, Advanced paternal age.