A 6-year-old boy presents with his foster carer. The boy immediately approaches the physician and is over familiar. He wants to sit on his knee and is keen to engage in rough and tumble type play. He has been with his foster carer for 6 weeks having been removed from his family because of ongoing child protection concerns. The foster carer reports that in some ways he is an easy child to manage as he seems to take things in his stride but his poor concentration and attention may make it difficult for him to learn basic skills.
Mental state examination He is an overactive lad and struggles to sit still. He cannot focus on anything for more than a few minutes. He is physically inappropriate wanting to hug and other staff and patients that he has only just met. He has no qualms about approaching strangers and talking to them. He is cheerful and joins in other people’s activities without…
