Growth and Development

Question 1

Hi there 🫵 سمِّي الله

Answer 1

بسم الله الرّحمن الرّحيم 💡

Question 2

🧠What are the four major domains of developmental assessment in pediatrics ⁉️

Answer 2

1. Gross motor.
2. Vision and Fine motor.
3. Hearing and speech
4. Social behavior.

Question 3

🧠 What is the expected gross motor milestone at 3 months of age ⁉️

Answer 3

✅ Neck holding
##footnote
💡 At 3 months, the infant should be able to hold their neck upright while in a supported sitting position.

Question 4

🧠 At what age should a baby be able to roll over from front to back and back to front ⁉️

Answer 4

✅ 4–6 months
##footnote
💡 Rolling front to back : ~4 months
Rolling back to front : ~5–7 months

Question 5

🧠 When should an infant be able to sit with support (tripod sitting) ⁉️

Answer 5

✅ 6 months
##footnote
💡 Sitting with support is an important transitional posture before independent sitting.

Question 6

🧠 What is the expected gross motor milestone at 8 months of age ⁉️

Answer 6

✅ Sit without support and crawl (chest & abdomen touching ground)

F>B done at 4-5-6 m B>F done 5-6-7 m

💡 By 8 months , the baby can sit independently and begin crawling with belly contact on the floor.

Question 7

🧠 What is the difference between crawling and creeping, and when does creeping develop ⁉️

Answer 7

✅ Creeping: 10 months (chest & abdomen not touching the ground)

💡 Crawling: belly on the ground
Creeping: more mature, all fours

Question 8

🧠 At what age does a baby typically begin standing with support ⁉️

Answer 8

✅ 10 months
##footnote
💡 Babies can pull to stand and maintain balance with support.

Question 9

🧠 What is the milestone known as “cruising” and when does it occur ⁉️

Answer 9

✅ Cruising: 11 months

💡 Cruising is walking sideways while holding on to furniture .

Question 10

🧠 When should a baby be able to stand without support and walk with support ⁉️

Answer 10

✅ 12 months
##footnote
💡 A 1-year-old typically stands unaided and begins assisted walking.

Question 11

🧠 At what age should a child walk independently without support ⁉️

Answer 11

✅ 15 months

💡 Independent walking is expected by 15 months .

Question 12

🧠 When does running usually develop in toddlers ⁉️

Answer 12

✅ 18 months
##footnote
💡 Toddlers begin to run after mastering walking.

Question 13

🧠 At what age should a child walk upstairs using two feet per step ⁉️

Answer 13

✅ 2 years
##footnote
💡 Two feet per step is a common beginner stair-climbing pattern .

Question 14

🧠 What gross motor skills are expected by 3 years of age ⁉️

Answer 14

✅ 1 foot per step (upstairs) and ride a tricycle
##footnote
💡 Coordination improves by this age, enabling alternating steps and tricycle use.

Question 15

🧠 At what age should a child be able to go downstairs using 1 foot per step ⁉️

Answer 15

✅ 4 years
##footnote
💡 Descending stairs with alternate feet requires balance and strength, developed by age 4.

Question 16

🧠 What is the fine motor milestone from 0–3 months ⁉️

Answer 16

✅ Palmar grasp
##footnote
💡 The infant uses all fingers and the palm to grasp an object reflexively.

Question 17

🧠 What is the expected fine motor skill at 4 months ⁉️

Answer 17

✅ Bidextrous grasp
##footnote
💡 The baby begins reaching for objects with both hands.

Question 18

🧠 What is the expected fine motor skill at 5 months ⁉️

Answer 18

✅ Unidextrous grasp
##footnote
💡 The infant starts reaching with one hand, showing hand preference.

Question 19

🧠 What is the expected fine motor milestone at 12 months ⁉️

Answer 19

✅ Mature pincer grasp
##footnote
💡 The child uses index finger and thumb to pick up small objects (like crumbs).

Question 20

🧠 Which fine motor skills are expected by 15 months ⁉️

Answer 20

✅ Scribbling and 2-cube tower
##footnote
💡 Early signs of drawing and object stacking begin .

Question 21

🧠 What fine motor skills are expected by 2 years ⁉️

Answer 21

✅ Draws horizontal line, builds 6-cube tower, undresses

Question 22

🧠 What are the fine motor skills at 3 years ⁉️

Answer 22

✅ Draws a circle, builds 9-cube tower, dresses & undresses (needs help with buttons)
##footnote
💡 Shape drawing begins, and the child develops basic dressing skills.

Question 23

🧠 What should a child be able to draw by 4 years ⁉️

Answer 23

✅ Plus sign (+)
##footnote
💡 Drawing shapes becomes more refined with the cross or plus sign.

Question 24

🧠 What are the fine motor skills by 5 years ⁉️

Answer 24

✅ Draws triangle, dresses & undresses completely, ties shoelaces
##footnote
💡 This reflects full dressing independence and advanced shape drawing .

Question 25

🧠 **What is the expected drawing skill by 6 years of age** ⁉️

Answer 25

✅ **Draws a diamond** ##footnote 💡 Diamond drawing reflects **complete visual-motor integration** expected by school age.

Question 26

🧠 **What is the expected language milestone at 3 months of age** ⁉️

Answer 26

✅ **Cooing** ##footnote 💡 Early vocalization with **soft vowel-like sounds** (e.g., “ooo,” “ahh”).

Question 27

🧠 **What type of speech appears at 6 months** ⁉️

Answer 27

✅ **Monosyllables** (e.g., “ma,” “pa”) ##footnote 💡 First clear consonant-vowel combinations begin.

Question 28

🧠 **When do bisyllables like “mama” and “papa” typically emerge** ⁉️

Answer 28

✅ **9 months** ## Footnote 💡 More complex repetition of sounds signals **speech pattern formation** .

Question 29

🧠 **At what age should a child begin to say 1–2 real words** ⁉️

Answer 29

✅ 1 year ## Footnote 💡 Often includes meaningful use of “mama” or “dada.”

Question 30

🧠 **What is “jargon speech,” and when does it appear** ⁉️

Answer 30

✅ **15 months** ##footnote 💡 Jargon speech = **many babbled words** without clear meaning — sounds like speech but not understandable.

Question 31

🧠 **How many words should an 18-month-old child speak** ⁉️

Answer 31

✅ **8–10 words** ##footnote 💡 Includes simple everyday words like “milk,” “bye,” “ball.”

Question 32

🧠 **What language milestone is expected at 2 years** ⁉️

Answer 32

✅ **2-word sentences** ##footnote 💡 Example: “Come play,” “Want juice” — combining words to convey basic needs.

Question 33

🧠 **At what age should a child state their age, name, and gender** ⁉️

Answer 33

✅ **3 years** ##footnote 💡 Also begins answering simple identity questions.

Question 34

🧠 **What verbal skill is expected at 4 years** ⁉️

Answer 34

✅ **Telling a story or poem** ##footnote 💡 Language becomes **structured and expressive** , often reciting short rhymes.

Question 35

🧠 **By what age should a child be able to ask the meaning of words** ⁉️

Answer 35

✅ **5 years** ##footnote 💡 Reflects **language comprehension and curiosity** , important for school readiness.

Question 36

😊 **What is the first major social milestone seen in infants, and when does it appear** ⁉️

Answer 36

✅ **Social smile at 2 months** ##footnote 💡 The infant smiles at any human face — a key sign of early social interaction.

Question 37

😳 **When does stranger anxiety typically begin to appear in infants** ⁉️

Answer 37

✅ **6 months** ##footnote 💡 Babies may become distressed around unfamiliar people and start to smile at their **own mirror image** .

Question 38

👋 **When should a child be able to wave “bye-bye”** ⁉️

Answer 38

✅ 9 months ## Footnote 💡 This milestone reflects **intentional social communication** .

Question 39

🏀 **What social behaviors are expected at 12 months of age** ⁉️

Answer 39

✅ **Plays a simple ball game and comes when called** ##footnote 💡 These indicate **cooperative play** and **responsive interaction**.

Question 40

🏡 **What is a typical social milestone at 18 months** ⁉️

Answer 40

✅ **Domestic mimicry** ## Footnote 💡 The child imitates household activities — e.g., sweeping, pretending to cook, copying parents’ routines.

Question 41

🧠 **What is the expected gross motor posture of a neonate** ⁉️

Answer 41

👉🏼 **Limbs are flexed**

Question 42

🧠 **What gross motor sign indicates good neck control by 3 months in the pull-to-sit maneuver** ⁉️

Answer 42

👉🏼 **No head lag** ## Footnote ✅ Indicates head control

Question 43

🚨 **What developmental red flags require immediate concern at any age** ⁉️

Answer 43

1️⃣ Loss of previously acquired skills 2️⃣ Concerns about vision or confirmed visual impairment 3️⃣ Hearing loss or concerns 4️⃣ Persistent low muscle tone or floppiness

Question 44

🚩 **What is a red flag for speech development by 18 months** ⁉️

Answer 44

✅ **No speech by 18 months** ##footnote 💡 Suggests possible **language delay** or neurodevelopmental disorder.

Question 45

📏 **What head circumference red flags suggest concern** ⁉️

Answer 45

✅ **Above 97th percentile or below 5th percentile** ##footnote 💡 Indicates possible **macrocephaly or microcephaly** needing evaluation.

Question 46

🚷 **Which gait-related findings are considered red flags** ⁉️

Answer 46

✅ **Persistent toe-walking** ##footnote 💡 May indicate motor dysfunction or neurological disorder.

Question 47

🧠 **What are examples of complex developmental disabilities** ⁉️

Answer 47

✅ **Co-occurrence of multiple delays (motor, language, cognition)** ##footnote 💡 Suggests **global developmental delay** or syndromic disorder.

Question 48

🧒 **By what age should a child sit unsupported — and what if they can’t** ⁉️

Answer 48

✅ **By 8months** ##footnote ⛔ Inability after 9-10 months is a red flag for gross motor delay.

Question 49

🚶**By what age should a child walk — and what delay is a red flag** ⁉️

Answer 49

Walk without support at 15 months Red flag: 🔸 **Boys** : not walk by **18 months** 🔸 **Girls** :not walk by **2 years** ##footnote ⛔ Delay beyond these points warrants further assessment.

Question 50

👣 **What red flag is noted if a child can only walk on tiptoes** ⁉️

Answer 50

✅ **Walking other than tiptoes is expected** ##footnote ⛔ Persistent tiptoe walking may indicate neuromuscular issues.

Question 51

🏃‍♂️ **By what age should a child be running — and what if they can’t** ⁉️

Answer 51

✅ **Running by 18 months** ##footnote ⛔ Delay suggests motor developmental issue.

Question 52

🤲 **What if a child cannot hold an object placed in their hand by 5 months** ⁉️

Answer 52

✅ **Red flag** ##footnote 💡 Expected milestone = **grasp reflex and purposeful holding**

Question 53

👐 **What if a child cannot reach for objects by 6 months**⁉️

Answer 53

✅ **Red flag for fine motor delay** ##footnote 💡 Indicates abnormal upper limb coordination or weakness.

Question 54

❓ **What is the fastest period of growth in a child’s life and what does it depend on** ⁉️

Answer 54

✅ **Fetal Phase** — contributes ~30% of adult height ➡️ Depends on: ▪️ Size of the mother ▪️ Placental nutrient supply ##footnote ⚠️ Problem: Severe intrauterine growth restriction (IUGR), prematurity → short stature

Question 55

❓ **What are the features and key determinants of growth during the infantile phase (birth to ~2 years)** ⁉️

Answer 55

✅ **Rapid but decelerating growth** , ~15% of adult height ➡️ Depends on: ▪️ Good nutrition ▪️ Good health ▪️ Normal thyroid function and growth hormone ▪️ Genetic size ##footnote ⚠️ Problem: Failure to thrive due to inadequate weight gain

Question 56

❓ **What factors influence the childhood phase of growth, and how much adult height is gained during this phase** ⁉️

Answer 56

✅ **Slow but steady growth** , ~40% of adult height ➡️ Depends on: ▪️ Good nutrition ▪️ Good health ▪️ Growth hormone and T3 ##footnote ⚠️ Problem: Chronic stress or unhappiness may suppress growth hormone secretion

Question 57

❓ **What controls the pubertal growth phase and how much adult height is gained during it** ⁉️

Answer 57

✅ **Rapid growth spurt** , ~15% of adult height ➡️ Depends on: ▪️ Sex hormones (estrogen/testosterone) ▪️ Growth hormone ##footnote ⚠️ Problem: Early puberty → early epiphyseal fusion → shorter final height

Question 58

❓ **Which phases of growth contribute the highest % of adult height** ⁉️

Answer 58

✅ **Childhood Phase** : ~40% ➡️ Followed by Fetal (30%), Infantile (15%), and Pubertal (15%)

Question 59

❓ **What is the expected physiological weight loss in a newborn during the first few days of life** ⁉️

Answer 59

✅ Up to 10% of birth weight in the first **3–4 days** ➡️ Due to poor suckling, passage of meconium, and diluted urine 🧠 **Regained by day 10**

Question 60

❓ **How does an infant’s weight change during the first year of life** ⁉️

Answer 60

✅ 📈 **Weight milestones** : • **Double** birth weight by **4–6 months** • **Triple** birth weight by **12 months** • **Quadruple** birth weight by **2 years**

Question 61

❓ **What is the average monthly weight gain during the first year of life** ⁉️

Answer 61

• **First 4 months** :750 g/month (¾ kg) • **Next 4 months** : 500 g/month (½ kg) • **Last 4 months** : 250 g/month (¼ kg)

Question 62

❓ **What is the expected weight of a child between 1–6 years** ⁉️

Answer 62

✅ Formula: **Weight = (Age in years × 2) + 8**

Question 63

❓ **What is the correct method for measuring length and height in children based on age** ⁉️

Answer 63

• **< 2 years** ➡️ Supine length using an **infantometer** • **> 2 years** ➡️ Standing height using a **stadiometer**

Question 64

❓ **What are the normal height milestones at birth, 1 year, and 4 years** ⁉️

Answer 64

• 📏 **At birth** : ~50 cm • 📏 **At 1 year** : ~75 cm • 📏 **At 4 years** : ~100 cm ##footnote 🧠 Helpful rule: Gain ~25 cm in 1st year, ~25 cm from 1 to 4 years

Question 65

❓ **How do you estimate expected height in children older than 2 years** ⁉️

Answer 65

✅ Formula: **Height (cm) = (Age in years × 5) + 80**

Question 66

❓ **What is the most important tool in early detection of abnormal growth** ⁉️

Answer 66

✅ **Growth velocity** ##footnote 💡 Regular measurement every **6 months** helps track trends early.

Question 67

❓ **What does “crossing percentiles” on a growth chart suggest** ⁉️

Answer 67

✅ It indicates **possible growth abnormalities** even if the child’s height is still within the normal range. ##footnote 🧠 Requires further evaluation!

Question 68

❓ **What is the definition of short stature** ⁉️

Answer 68

• Height **< 5th percentile** , or • Height **< -2 SD below the mean** (2.5th percentile)

Question 69

❓ **What is the average growth velocity in different age phases** ⁉️

Answer 69

• 🍼 **Birth–1 year** : ~25 cm/year • 👶🏼 **1–2 years** : ~12.5 cm/year • 👧🏽 **2–3 years** : ~8 cm/year • 🧒🏻 **3 years–puberty** : ~5–6 cm/year • 🧑🏽‍🦱 **Adolescence** : up to ~15 cm/year ##footnote 📉 Note: Growth decelerates after infancy until puberty

Question 70

❓ **What are the key clinical uses of measuring OFC (Occipitofrontal Circumference) in infants** ⁉️

Answer 70

1. Assessment of brain growth 🧠 2. Diagnosis & monitoring of small/large head 🧠 3. Monitoring hydrocephalus treatment 💧

Question 71

❓ **What is the normal OFC at birth** ⁉️

Answer 71

✅ **35 ± 2 cm**

Question 72

❓ **What is the total OFC increase in the first year of life** ⁉️

Answer 72

✅ **≈12 cm** ➡️ From ~35 cm at birth to ~47 cm at 1 year of age

Question 73

❓ **What is the rate of increase of OFC in the first year** ⁉️

Answer 73

• 1st 3months ➡️ +2cm/m • 2nd 3 months ➡️ +1 cm/m • 3rd 3 months ➡️ +0.5cm/m

Question 74

❓ **What head size abnormalities can be detected with OFC measurement** ⁉️

Answer 74

✅ **Microcephaly** and **Macrocephaly**

Question 75

❓ **What is the definition of macrocephaly** ⁉️

Answer 75

✅ Head circumference **above the 95th percentile** for age and sex

Question 76

❓ **What are the cranial causes of macrocephaly** ⁉️

Answer 76

• Familial large head 👨‍👩‍👧 • Chronic hemolytic anemia 🩸 • Rickets 💀

Question 77

❓ **What are the intracranial causes of macrocephaly due to increased intracranial pressure (ICP)** ⁉️

Answer 77

• **Hydrocephalus** 💧 • **Subdural hematoma / effusion** 🧠 • **Brain tumors** 🎯 • **Neurofibromatosis** 🧬 • **Cerebral gigantism (Sotos syndrome)**📈 • **CNS storage diseases** (e.g., Hurler syndrome) 🧪

Question 78

❓ **What are the four phases of growth and their contribution to adult height** ⁉️

Answer 78

🚼 **Fetal phase** – ~30% of adult height ➡️ Depends on: maternal size & placental nutrition ⚠️ Problem: IUGR, prematurity ➡️ short stature 👶🏼 **Infantile phase** – ~15% ➡️ Depends on: nutrition, thyroid, GH, genetics ⚠️ Problem: FTT (Failure to Thrive) 🧒🏼 **Childhood phase** – ~40% ➡️ Depends on: nutrition, GH, T3 ⚠️ Problem: decreased GH secretion 🧑🏼‍🦱 **Pubertal phase** – ~15% ➡️ Depends on: sex hormones, GH ⚠️ Problem: Early puberty ➡️ early epiphyseal closure

Question 79

**What is the normal pattern of weight changes in infancy** ⁉️

Answer 79

🧼 Weight loss: Up to 10% in first 3–4 days (regained by day 10) ⏫ Double birthweight by 4–6 months ⏫ Triple by 12 months ⏫ Quadruple by 2 years

Question 80

**What are the average lengths at birth, 1 year, and 4 years** ⁉️

Answer 80

📍 **At birth ➡️ 50 cm** 📍 **At 1 year ➡️ 75 cm** 📍 **At 4 years ➡️ 100 cm**

Question 81

**What is the importance of growth velocity**⁉️

Answer 81

🧠 **Most sensitive tool for detecting abnormal growth** ##footnote 🚨 Crossing percentiles = red flag

Question 82

**What are causes of a bulging fontanelle** ⁉️

Answer 82

💦 **Crying, coughing, vomiting** ##footnote 🚨 ↑ICP → Hydrocephalus, meningitis, hemorrhage, tumors

Question 83

**What are causes of a sunken fontanelle** ⁉️

Answer 83

💧 **Dehydration**

Question 84

**What are causes of a large/delayed-closing fontanelle** ⁉️

Answer 84

⏳ **Hypothyroidism, Rickets, Trisomy 21, Achondroplasia, ↑ICP**

Question 85

**What is the definition of puberty** ⁉️

Answer 85

🧬 Puberty is the time at which a child develops: 🔹 **Secondary sexual characteristics** 🔹 **Reproductive function**

Question 86

**What biological processes drive the onset of puberty** ⁉️

Answer 86

🧠 A complex sequence of events mediated by: 🔹 **Genetic factors** 🔹 **Hormonal regulation** 🔹 **Environmental influences** ➡️ Leading to maturation of gametogenesis and secretion of gonadal hormones

Question 87

**How is adolescence different from puberty** ⁉️

Answer 87

📍 Adolescence is a **broader stage** that includes: ✅ **Puberty** ✅ **Cognitive development** ✅ **Psychological changes** ✅ **Social transitions**

Question 88

**What is gonadarche and what triggers it** ⁉️

Answer 88

🧬 **Gonadarche is the onset of sex hormone production by the ovaries or testes** ➡️ Triggered by **pituitary secretion** of:  ▪️ Luteinizing hormone **(LH)**  ▪️ Follicle-stimulating hormone **(FSH)**

Question 89

**What is adrenarche and what are its effects** ⁉️

Answer 89

💥 **Adrenarche is increased adrenal androgen production** ➡️ Leads to:  ▪️ **Pubic hair** (pubarche)  ▪️ **Axillary hair**  ▪️ **Acne** (via sebaceous glands)  ▪️ **Sweating & body odor** (via apocrine glands)

Question 90

**What is thelarche** ⁉️

Answer 90

🌸 Thelarche is the **onset of breast development** 👉🏼 Marked by appearance of breast buds

Question 91

**What is menarche** ⁉️

Answer 91

🩸 Menarche is the **onset of menstrual cycles in females**

Question 92

**At what age does puberty typically begin in girls and boys** ⁉️

Answer 92

👧🏼 **Girls** : Between **8 and 13 years** 👦🏼 **Boys** : Between **9 and 14 years** 🧠 Average age for boys = **11.5 years**

Question 93

**What is the first sign of puberty in girls** ⁉️

Answer 93

🌸 **Thelarche** (breast bud development)

Question 94

**What is the sequence of puberty milestones in girls** ⁉️

Answer 94

1️⃣ **Thelarche** ➡️ 2️⃣ **Pubarche** (pubic hair) ~6–12 months later ➡️ 3️⃣ **Menarche** (onset of menses) ~2 years later

Question 95

**What is the first sign of puberty in boys** ⁉️

Answer 95

**Testicular enlargement** (>2.5 cm in length or >4 mL volume)

Question 96

**What is the sequence of puberty in boys** ⁉️

Answer 96

1️⃣ **Testicular enlargement** ➡️ 2️⃣ **Pubic hair** ➡️ 3️⃣ **Penis enlargement**

Question 97

**When does the male growth spurt occur compared to females** ⁉️

Answer 97

📈 About **2 years** later than in females 🧍🏽‍♂️ Growth may continue beyond age **18 years**

Question 98

**What is the definition of precocious puberty** ⁉️

Answer 98

📍 Onset of **secondary sexual characteristics** : 👧🏼 **Before age 8 in females** 👦🏼 **Before age 9 in males**

Question 99

**What is the first sign of precocious puberty in girls and boys** ⁉️

Answer 99

👧🏼 Girls: **Breast buds** (Thelarche) 👦🏼 Boys: **Growth of the testes**

Question 100

**What are the two main types of precocious puberty** ⁉️

Answer 100

1️⃣ **Central (gonadotropin-dependent)** 2️⃣ **Peripheral (gonadotropin-independent)**

Question 101

**What causes central precocious puberty (gonadotropin-dependent)** ⁉️

Answer 101

🔻 **Premature activation of GnRH pulse generator** 🚩 Causes include: • **Idiopathic** (common in girls) • **CNS tumors** : astrocytoma, glioma, hamartoma • **CNS injury** : trauma, surgery, irradiation • **Congenital anomalies** : septo-optic dysplasia, neurofibromatosis

Question 102

**What are the causes of peripheral precocious puberty (gonadotropin-independent)** ⁉️

Answer 102

• **McCune-Albright syndrome** • **Testotoxicosis** • **Tumors (adrenal, gonadal)** • Late-onset **Congenital Adrenal Hyperplasia (CAH)**

Question 103

**What are the evaluations and treatments for precocious puberty** ⁉️

Answer 103

🔍 **Investigations** : • **Brain MRI, LHRH test** (central) • **Abdominal/pelvic imaging** (peripheral) 💊 **Treatments** : • Central: **GnRH analogues** • Peripheral: **Cyproterone (♂)** , **Tamoxifen (♀)**

Question 104

**What is ADHD and in whom is it most common** ⁉️

Answer 104

🧠 ADHD is a **behavioral disorder seen mostly in children** , characterized by: • **Inattention** • **Difficulty controlling impulses** • **Motor hyperactivity** 🧠 It is the **most common neurobehavioral disorder in school-age children** .

Question 105

**Does ADHD have a genetic component** ⁉️

Answer 105

✅ Yes, ADHD has a **strong genetic component** .

Question 106

**How do the clinical features of ADHD vary with age** ⁉️

Answer 106

📍 **Preschool children**: • **Motor restlessness** • **Aggressive, troublesome behavior** 📍 **Older adolescents & adults** : • **Disorganization** • **Distractibility** • **Inattentiveness**

Question 107

**What is the role of the TOVA test in ADHD** ⁉️

Answer 107

🧪 The **TOVA (Test of Variables of Attention)** can help evaluate symptoms ⚠️ But it is **not a diagnostic tool**

Question 108

**What are the diagnostic criteria for ADHD** ⁉️

Answer 108

✅ At least **6 symptoms** of: • **Inattention** and • **Hyperactivity** 🕒 Symptoms must: • **Persist ≥ 6 months** • **Be present in ≥ 2 settings** (e.g., school, home)

Question 109

**What are the main treatment components for ADHD** ⁉️

Answer 109

🧠 **Pharmacotherapy ➕ Behavioral therapy**

Question 110

**Which treatment is considered more effective than behavioral therapy for ADHD** ⁉️

Answer 110

💊 **Stimulants** like: • **Methylphenidate** • **Dextroamphetamine**

Question 111

**What is the first-line treatment for ADHD in preschool-aged children** ⁉️

Answer 111

🧠 **Behavioral therapy** is first-line (medications are not first choice)

Question 112

🧠 **What are the DSM-5 diagnostic criteria for Autism Spectrum Disorder (ASD)** ⁉️

Answer 112

✅ **Persistent deficits in social communication and interaction across contexts** 🔁 **Restricted, repetitive patterns of behavior, interests, or activities** 🕒 **Symptoms present in early developmental period** 📉 **Symptoms cause clinically significant impairment** ⛔ **Not better explained by intellectual disability or global developmental delay** ##footnote ❌ **No diagnostic biomarker** — clinical diagnosis only

Question 113

🧠 **What are common comorbid conditions in children with Autism Spectrum Disorder (ASD)** ⁉️

Answer 113

✅ **Intellectual disability** ✅ **Language disturbances** ✅ **Gastrointestinal problems** (e.g., GERD, constipation, esophagitis) ✅ **Epilepsy** (in ~1/3 of children) ⚠️ Risk of abuse, anxiety, and depression

Question 114

🧬 **What genetic recommendation is made for children with Autism Spectrum Disorder (ASD)** ⁉️

Answer 114

✅ **All children with autism should undergo genetic work-up** 🧪 **All males with autism should be evaluated for Fragile X syndrome**

Question 115

تعبت؟ 😵‍💫

Answer 115

إلى هُنا تنتهي رحلتنا لهذا الشابتر 😌 والسلام عليكم ورحمة الله وبركاته!