Pharmaceutical choice and initial dose selection is crucial in children with neurodevelopmental disabilities for whom CYP2D6 substrates, such as aripiprazole, atomoxetine, citalopram, fluoxetine, fluvoxamine and risperidone, are commonly prescribed.27 Children with developmental disabilities are uniquely vulnerable to the limitations of subjectively guided medication management, the mainstay of current practice, screening for side effects and assessment of target symptoms such as anxiety and irritability. The gene discussed is CYP2D6; the disease is Neurodevelopmental abnormality.