A 5-Year-Old Boy Is Brought to the Office Due to Behavioral

A 5-year-old boy is brought to the office due to behavioral difficulties at school.  His grandmother says, "This past year has not been easy for him, but he's been hitting other kids and breaking their toys."  The patient was adopted by his grandmother a year ago after his parents died in a motor vehicle collision.  He attends the same school but no longer wants to play with his friends or join group activities.  The patient wakes up a few times a week, crying about monsters and asking to sleep in his grandmother's room.  He can ride a bike and draw complex shapes.  Vital signs are within normal limits, and he is tracking adequately on growth curves.  Physical examination is unremarkable.  The patient is restless and rams a toy truck into a stuffed animal repeatedly while his grandmother speaks.  He makes poor eye contact and answers most questions by saying "I don't know" despite his grandmother's encouragement.  Which of the following is the most likely diagnosis?

A) Age-appropriate behavior
B) Attention deficit hyperactivity disorder
C) Autism spectrum disorder
D) Oppositional defiant disorder
E) Posttraumatic stress disorder
F) Reactive attachment disorder

Correct Answer:

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