Attention-deficit hyperactivity disorder — OSCE

Objectives

1. Open with child voice and reframe “medication today” into structured assessment. [1]
2. Screen sleep, senses, multi-setting function and comorbidity. [1] [20]
3. Explain diagnosis criteria without stigma and without over-promising. [1] [12]
4. Agree a multimodal plan and monitoring if medication is later indicated. [1] [3] [15]

Candidate brief

12-minute station. Parent and child present after a teacher email. Parent says “just write the ADHD tablet.” Sleep is about 8 hours with screens. No cardiac symptoms on history cards provided after you ask. Teacher report forms are not yet returned. [1]

Expected actions

• Greet the child by name; ask school/friends/sleep before parent monologue. [1]
• Explain multi-setting diagnosis needs parent, child and teacher information. [1]
• Address sleep opportunity toward school-age AASM needs; reduce bedtime screens. [20]
• Plan vision check and teacher scales before labelling. [1]
• Avoid same-day stimulant without completed assessment and baselines. [1] [12]
• If diagnosis later confirmed moderate-severe: psychoeducation, school supports, stimulant option with growth/BP/HR monitoring. [1] [3] [15]
• Safety-net: earlier review if mood drops, school exclusion risk, or suicidal talk. [1]

Examiner prompts

• “Parent: just write the script.” → Reframe assessment quality. [1] [12]
• “Is my child naughty?” → Neurodevelopmental framing without blame. [1]
• “Will tablets fix school forever?” → Multimodal care and functional goals. [1] [3]

Marking foci

• Child-centred communication [1]
• Multi-setting diagnostic standards [1]
• Sleep and mimic screening [20]
• Safe medication counselling when appropriate [3] [15]
• Clear follow-up plan [1]