A 7-year-old child prefers to arrange toys in a fixed, orderly pattern, has limited social interaction and poor eye contact, and frequently exhibits severe temper tantrums whenever this routine or arrangement is disturbed. Which condition is most likely?

1. A

   Attention-deficit hyperactivity disorder

2. B

   Autism spectrum disorder

3. C

   Conduct disorder

4. D

   Oppositional defiant disorder

Appeared in: NORCET-11 Prelims

Explanation

• Autism spectrum disorder involves persistent deficits in social communication and interaction, including poor eye contact and limited social interaction.
• Restricted, repetitive patterns of behavior such as arranging toys in a fixed, orderly pattern and insistence on sameness are hallmark features.
• Severe temper tantrums when routines are disturbed are common due to inflexibility and distress with change.
• The combination of social deficits and repetitive, ritualistic behaviors differentiates autism spectrum disorder from other childhood behavioral disorders.

Why Other Options Were Wrong

• Option A: Attention-deficit hyperactivity disorder (ADHD) is marked by inattention, hyperactivity, and impulsivity, but does not typically involve restricted, repetitive behaviors or insistence on sameness.
• Option C: Conduct disorder involves persistent patterns of violating societal norms or the rights of others, such as aggression or property destruction, not repetitive routines or social withdrawal.
• Option D: Oppositional defiant disorder is characterized by defiant, disobedient, and hostile behavior toward authority figures, but does not include restricted, repetitive behaviors or poor social interaction as core features.

Related Visual

Clinical Relevance

• Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Diagnosis of autism spectrum disorder based on behavioral features as background academic context rather than a clinical decision trigger.
• Early identification of autism spectrum disorder allows for timely intervention and support for social and communication skills.
• Nurses play a key role in observing and reporting behavioral patterns that may indicate autism spectrum disorder in pediatric settings.
• What if? If the child only had hyperactivity and impulsivity without repetitive behaviors or social withdrawal, ADHD would be more likely.

How to Approach the Question

• Identify the key behavioral features described in the stem (repetitive patterns, poor social interaction, poor eye contact, distress with change).
• Recall the diagnostic criteria for common childhood behavioral and neurodevelopmental disorders.
• Match the described features to the disorder that includes both social deficits and repetitive behaviors.
• Rule out options that do not fit the full pattern of symptoms.

Concept Tested & Keywords

• Concept Tested: Diagnosis of autism spectrum disorder based on behavioral features
• Stem keywords: 7-year-old child, arrange toys in fixed pattern, limited social interaction, poor eye contact, severe temper tantrums, routine disturbed
• Lead-in keywords: most likely
• Clinical cues: Fixed, repetitive behaviors and poor social interaction are classic for autism spectrum disorder

Question ID

QNZJVqtYYv5Lq8osLWd_2E

Copy ID

Reference Book

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) pp. 393-395, 397-399

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 15507-15510