​Attention Deficit Hyperactivity Disorder (ADHD)

• Attention deficit hyperactivity disorder - ADHD (CKS), Attention deficit hyperactivity disorder - ADHD (NHS Choices)​, ADHD information services (addiss.co.uk)

Autism Spectrum Disorder (ASD)

• Autism spectrum disorder (ASD) (NHS Choices), Autistic spectrum disorders (patient.info), Autism and related problems (patient.info), Autism in children (CKS)

Conduct disorders

• Conduct disorders in children and young people (CKS)

Attachment difficulties

A grandmother brings a 3-year-old boy to see you, worried that he always seems to ignore her or turn away when he is told off and does not tend to express any need for attachment to her. The grandmother comments that the boy’s mother is inconsistent in her response when he gets distressed or upset.

What is the SINGLE MOST likely diagnosis?

1. Reactive attachment disorder

2. Disorganised insecure attachment

3. Disinhibited attachment disorder

4. Resistant insecure attachment

5. Avoidant insecure attachment

Children displaying insecure attachment have learnt that their caregiver is not reliably responsive at times of distress. Avoidant behaviour is shown by the child being closed off and distant when they are alarmed. There is a tendency to minimize expression of attachment needs.

Reference

• Turner M, Beckwith H, Duschinsky R, et al. Attachment difficulties and disorders. InnovAiT 2019; 12(4): 173–179.