Match each clinical presentation to the most appropriate neurodevelopmental or behavioral psychiatric diagnosis.
- Parents of a 3-year-old boy note that he rarely makes eye contact, does not engage in pretend play, and becomes extremely distressed if his daily routine is altered.Autism spectrum disorder
- A 10-year-old boy is evaluated after school suspension. He frequently initiates physical fights, was caught stealing from lockers, and recently set fire to a trash can on school property.Conduct disorder
- A 7-year-old girl is often touchy and easily annoyed by others. She frequently argues with her teachers and actively defies their requests, but she has never been physically aggressive or destroyed property.Oppositional defiant disorder
- A 5-year-old girl who met all early developmental milestones began to experience a regression in spoken language and purposeful hand use around 18 months of age, now demonstrating constant hand-wringing movements.Rett syndrome
Answer
The correct matches align the 3-year-old boy with autism spectrum disorder, the 10-year-old boy with conduct disorder, the 7-year-old girl with oppositional defiant disorder, and the 5-year-old girl with Rett syndrome.
Each vignette provides pathognomonic or highly characteristic features for its respective disorder: autism spectrum disorder (social deficits and rigid routines), conduct disorder (severe rights violations like fire-setting), oppositional defiant disorder (defiance without severe aggression), and Rett syndrome (developmental regression with characteristic hand-wringing).
Step-by-Step Solution
Key Concept
Accurate diagnosis of childhood behavioral and neurodevelopmental disorders requires distinguishing between specific symptom domains, severity of rule violations, and the presence or absence of developmental regression.