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NBME Psychiatry Test

A 3-year-old girl is brought to the physician by her parents because they are concerned about her behavior.
They describe their daughter as stubborn and always on the go.

She can rarely sit still for more than 10 minutes.

She often refuses to comply with their requests and sometimes throws 3- to 5-minute temper tantrums.

They report that she dawdles at bedtime and requires frequent direction and assistance in preparing for bed.

Her preschool teacher notes that she is active and talkative without being disruptive and is beginning to demonstrate more interactive play with her peers.

She generally sleeps through the night and occasionally wets the bed.

Her appetite is good.

Her first word was at the age of 11 months, and she began walking without assistance at the age of 14 months.

Physical examination shows no abnormalities.

On mental status examination, she initially hides behind her mother but warms to the interviewer after a few minutes and begins playing with toys in the office.

Her speech is 90% intelligible, and her vocabulary is large for her age.

Which of the following is the most appropriate next step in management?

Select your answer