Attention wanders in ordinary life. People lose track of a conversation, postpone unpleasant work, misplace a phone, or reach for another browser tab when a task becomes difficult. Attention-deficit/hyperactivity disorder (ADHD) is considered when inattentive and/or hyperactive-impulsive symptoms form a persistent developmental pattern, extend across meaningful settings, and interfere with functioning. The clinical question is therefore about the organization, history, severity, and consequences of difficulties rather than the mere presence of distraction. CDC clinical criteria and NIMH guidance specify this distinction.
Someone who has become distracted during a stressful week may benefit from sleep, changed workload, or a quieter environment. Someone who has struggled since childhood with persistent disorganization, missed instructions, unfinished responsibilities, and recurring impairment at home and in education or employment deserves a comprehensive ADHD assessment. Both examples require an individualized understanding of circumstances. Even when ADHD is present, fatigue, anxiety, depression, learning difficulties, and environmental overload can intensify the symptoms. NICE NG87.
What Separates Ordinary Distraction From ADHD?
The most informative distinction is a pattern with several dimensions considered together: symptom frequency and persistence, developmental onset, behavior across settings, functional interference, and the extent to which another condition or circumstance explains the experience. A single recognizable behavior has low diagnostic specificity. Difficulty paying attention is shared by people with ADHD, people under intense stress, people experiencing insufficient sleep, and people facing tasks that exceed their current resources.
In the DSM-5 diagnostic framework summarized by the CDC, ADHD involves at least six months of multiple symptoms inappropriate for developmental level. Several symptoms must have been present before age 12, several must occur in at least two settings, and clear evidence must show interference with, or reduced quality of, social, academic, or occupational functioning. Symptoms must not be better explained by another mental disorder. These conditions are assessed together through a clinical process. CDC, Clinical Care of ADHD in Children.
ADHD can manifest predominantly through inattention, through hyperactivity-impulsivity, or through a combined presentation. A person who is quiet, reads for pleasure, or achieves excellent grades may still meet the criteria. Conversely, intense restlessness or several neglected deadlines do not establish ADHD without the broader developmental and functional picture. Recognition is an evidence-gathering process, not a visual judgment about who appears distracted.
The First Dimension: Persistence Over Time
Repeated behavior matters more than an isolated lapse
Ordinary distractibility commonly changes in response to circumstances. A person may become preoccupied during a major deadline, have difficulty following a lecture after a sleepless night, or forget appointments during an unusually demanding month. The history points toward a situational cause when symptoms arise alongside an identifiable change and substantially remit as the conditions improve.
ADHD involves repeated symptoms across extended periods. This persistence does not require someone to feel equally distracted every minute. Symptom intensity varies with sleep, physical and mental health, external structure, task novelty, interest, rewards, and environmental demands. A long history may contain periods of high achievement, effective compensation, and relatively manageable functioning alongside periods of significant difficulty. Faraone et al., 2021; Kooij et al., 2019.
The diagnostic threshold of six months helps separate persistent patterns from brief periods of difficulty; it is a minimum duration criterion, not proof of the disorder by itself. A clinical interview therefore reconstructs the course of symptoms across years, asks whether there were earlier periods of similar difficulty, and examines whether improvement reflects recovery from a temporary condition or the availability of unusually strong external supports.
How frequency is interpreted
Expressions such as “often loses things” or “often has difficulty sustaining attention” imply repeated tendencies judged relative to developmental expectations and context. Counting every instance without considering the circumstances would be misleading. A warehouse worker repeatedly interrupted by urgent instructions and a student working in a noisy classroom may experience many attention shifts for reasons built into their environments. A clinician asks what is typical for a comparable situation, whether difficulties are disproportionate, and how they affect real responsibilities.
The Second Dimension: Childhood Onset and Developmental History
ADHD is classified as a neurodevelopmental disorder. It can be diagnosed for the first time in adulthood, but the diagnostic history must support symptoms beginning in childhood. DSM-5 requires several symptoms before age 12 rather than a documented childhood diagnosis, and those symptoms may have gone unrecognized. CDC diagnostic criteria; NIMH.
A person who began missing deadlines only after a recent depressive episode needs a different examination from someone who can recall unfinished homework, lost school materials, chronic lateness, and forgotten instructions extending back through school years. Adult stress, depression, sleep disorders, substance effects, illness, and changing responsibilities can create new difficulties or reveal older ones. A careful clinician distinguishes the onset of symptoms from the moment when consequences became impossible to ignore.
Childhood evidence can come from the person's recollections, school reports, caregiver accounts, previous evaluations, and descriptions of recurring routines. These sources are sometimes incomplete, particularly for older adults, people who moved frequently, those who were educated in different systems, or those without available family informants. Clinicians assess the quality and coherence of the available evidence rather than requiring a childhood report card as a universal prerequisite. Kooij et al., 2019.
For children, developmental expectations are central. Many young children move frequently, have difficulty waiting, or need reminders to finish work. The relevant question is whether the intensity, frequency, and functional cost are markedly beyond what would be expected at that developmental stage. The American Academy of Pediatrics recommends evaluation for children and adolescents aged four through eighteen who present with academic or behavioral problems and relevant ADHD symptoms, using information from several observers and investigating alternative or coexisting conditions. AAP guideline.
The Third Dimension: More Than One Important Setting
A recurrent difficulty limited to a single setting may reflect a mismatch between task demands, the social environment, available supports, sleep schedule, learning needs, or stressors. ADHD criteria require symptoms in two or more important settings. The settings need not look identical, and the same symptom does not have to appear in precisely the same way everywhere. NICE NG87.
At school, a child may lose worksheets and overlook instructions. At home, the same child may routinely fail to complete age-appropriate chores, misplace needed items, and need repeated prompts to prepare for the next day. An adult might appear competent in highly structured employment but experience severe problems with household bills, appointments, relationships, or independent study. A good interview maps the underlying regulation difficulties onto the actual expectations of each context.
Apparently successful performance in one context deserves explanation rather than automatic dismissal. Tight schedules, external deadlines, supportive colleagues, detailed checklists, or intense personal interest may temporarily reduce observable difficulties. The clinician examines the effort required to maintain that performance, whether symptoms persist elsewhere, and whether the supports are themselves compensating for impairing difficulties.
The requirement for more than one setting prevents narrow evidence from being generalized into a lifelong diagnosis. It also protects people whose concentration is disrupted by a specific classroom environment, an unsafe workplace, a demanding relationship, or circumstances that call for environmental change.
The Fourth Dimension: Functional Impairment
The key clinical question is what happens in a person's life because of the symptoms. Functional impairment can include repeated academic problems, chronic difficulty meeting work responsibilities, unsafe impulsive actions, breakdowns in routine self-management, recurrent conflict over forgotten commitments, and difficulty maintaining appropriate organization despite sustained effort.
Impairment must be assessed with care. Missing one payment or forgetting a birthday can happen to anyone. More informative evidence includes a sustained pattern of consequences: recurring late fees despite repeated attempts to prevent them, avoidable workplace errors, repeated school interventions, persistently missed medical appointments, or exhaustion caused by disproportionate effort to keep obligations from collapsing.
Distress and impairment overlap, but they are distinct. Someone may feel intense frustration about ordinary mistakes without meeting ADHD criteria. Another person may minimize distress while repeatedly experiencing serious practical consequences. Clinicians therefore examine concrete functioning in education, work, relationships, household management, and safety, and ask whether appropriate supports have been available. NICE NG87.
Successful outcomes do not erase the assessment of costs. A high-performing student may need substantially more time than peers to complete straightforward administrative tasks. An adult may rely on a partner to manage nearly all appointments or continuously work late into the night to compensate for inconsistent task initiation. Clinical relevance depends on whether the history meets established diagnostic criteria and whether the difficulties materially reduce functioning or its quality, not merely on outward achievement.
The Fifth Dimension: Inattention, Hyperactivity, and Impulsivity
Inattention is broader than getting distracted
The ADHD inattentive symptom domain includes problems sustaining attention, following through on instructions, organizing tasks, handling sustained mental effort, tracking necessary objects, remembering everyday obligations, and maintaining attention to details. Distractibility is one component. A person can have significant inattentive difficulties without constantly looking around the room. CDC symptom criteria.
Behavior gains meaning when several symptoms cluster together. Someone who struggles to read dense material only when tired may simply be fatigued. Someone who repeatedly loses essential tools, overlooks steps in familiar procedures, cannot organize multistage responsibilities, and forgets obligations across years presents a broader pattern requiring assessment.
Hyperactivity changes across development
In young children, hyperactivity may appear as excessive running, climbing, leaving a seat, or difficulty engaging quietly. In adolescents and adults it may become internal restlessness, constant fidgeting, difficulty relaxing, or a strong need for activity. These features are interpreted relative to age, expectations, and cultural context. The absence of conspicuous physical hyperactivity does not exclude an inattentive presentation. NIMH overview.
Impulsivity is not a universal personality judgment
Impulsive symptoms include interrupting, blurting responses, struggling to wait, or intruding on others. Impulsivity also has many other psychological and situational causes. A person who makes an occasional hasty decision, seeks novelty, or dislikes a slow process has not thereby demonstrated ADHD. Clinical assessment looks at persistent patterns of developmentally inappropriate behavior and their consequences, while distinguishing symptom descriptions from moral evaluations of character.
A Practical Comparison: Two Patterns That May Look Similar
Consider a university student who became distracted during examinations after several weeks of disrupted sleep, long work shifts, and high anxiety. Earlier years show steady classroom attention and manageable routines. Difficulties began during the stressful period and improve after sleep and workload are addressed. The concentration problem is real; the history does not, on those facts, demonstrate a developmental ADHD pattern.
Now consider a student with a longstanding history of losing materials, forgetting instructions, needing unusual amounts of supervision, repeatedly failing to organize schoolwork, and struggling at home as well as in class. In college, external structure disappears and the same difficulties intensify. The pattern warrants a clinical ADHD evaluation because onset, persistence, setting breadth, and functioning align with core diagnostic questions.
These vignettes illustrate diagnostic reasoning rather than substitute for assessment. Either student could have another condition, both could have ADHD, and information not contained in the vignette could change the conclusion. Clinicians evaluate the whole person and test competing explanations rather than applying a quick label to a short narrative.
Why Task Interest and Good Concentration Do Not Settle the Question
A person who can spend hours on an absorbing hobby may still struggle with repetitive, delayed-reward tasks. Motivation, salience, novelty, and immediate feedback influence attention in everyone, and differences in regulation may matter clinically for people with ADHD. Intense engagement in a preferred activity is therefore insufficient either to confirm or exclude the diagnosis. Faraone et al., 2021.
The popular word “hyperfocus” describes episodes of concentrated absorption, but its definitions and measurement are less standardized than formal diagnostic criteria. It is not an independent DSM symptom or a diagnostic test. “Time blindness” is likewise a useful informal description for difficulty estimating or managing time in some contexts, while underlying time-perception and executive-function processes are subjects of empirical research. “Rejection sensitive dysphoria” is a popular label with no independent ADHD diagnostic status. These terms should prompt careful questions rather than settle the diagnosis.
Executive dysfunction also describes a family of difficulties in planning, inhibitory control, working memory, organization, and goal-directed behavior. It can be relevant to ADHD and many other conditions. Laboratory executive-function test performance varies within ADHD populations and overlaps with performance in people without ADHD. An executive-function difficulty alone cannot identify its clinical cause. For general cognitive foundations, see Executive Functions: Inhibition, Working Memory, and Flexibility.
How Sleep and Stress Can Mimic or Intensify ADHD
Sleep insufficiency, irregular circadian timing, sleep apnea, and other sleep problems can impair attention, processing speed, working memory, emotional regulation, and impulse control. Sleep questions belong early in a comprehensive evaluation because a patient may experience these impairments as chronic distractibility. ADHD and sleep disorders can also coexist; identifying a sleep problem does not automatically settle the status of ADHD.
Stress produces competition for cognitive resources. Persistent demands can fragment attention, increase prospective-memory errors, and make routine organization difficult. Environmental factors such as constant interruptions or unpredictable scheduling can create repeated concentration lapses even when a person's broader developmental history is unremarkable.
Clinical reasoning asks whether difficulties predate sleep or stress changes, whether they extend across settings and years, and whether they remain significant when those conditions improve. A clinician may treat or investigate a suspected medical or psychiatric cause while maintaining an open, evidence-based assessment of ADHD. CDC, Diagnosing ADHD; NICE NG87.
Anxiety, Depression, Trauma, and Other Explanations
Anxiety can draw attention toward threats, predictions, and repetitive worry, leaving fewer resources for the immediate task. Depressive episodes can reduce concentration, initiative, speed, and memory while also changing sleep and energy. Trauma-related symptoms may involve hypervigilance, avoidance, intrusive memories, or dissociative experiences that disrupt concentration. The timing and content of these experiences help a clinician interpret apparently similar outward behavior.
Anxiety and ADHD can occur together. A person whose longstanding ADHD difficulties create repeated mistakes may develop anxiety about future failure, and anxiety can then worsen concentration. Assessing one condition does not automatically explain the other. The published Anxiety and ADHD: Comorbidity, Restlessness, Attention, and Differential Diagnosis explores that distinction in greater depth.
A clinician also considers learning disorders, autism, tic disorders, substance use, medication effects, pain, neurological conditions, and sensory or medical problems when relevant. They ask whether the pattern reflects difficulties in acquiring a particular skill, understanding instructions, sustaining adequate sleep, regulating mood, or managing attention across everyday tasks. The differential process is guided by the history, relevant examination, and presenting concerns rather than indiscriminate testing.
Episodic changes in mood, energy, sleep need, and activity deserve particular attention because bipolar mood episodes can produce distractibility or agitation and may require a distinct assessment and urgent care when severe. A person with enduring childhood-onset attention difficulties can also develop a separate mood disorder. See Bipolar Disorder vs ADHD: Mood Episodes and Persistent Attention Symptoms.
Children and Adolescents: Development Changes the Interpretation
Children's attention and self-management capacities develop rapidly, and the expectations placed on them change with age. Long periods of unstructured sitting, developmentally inappropriate instructions, limited opportunities for movement, bullying, unmet learning needs, or an unsettled home environment can contribute to behaviors that resemble ADHD symptoms. The child still deserves support, whether or not ADHD is diagnosed.
School reports are useful when they describe specific behavior and consequences. A statement such as “sometimes distracted” is much less informative than a record of frequent failures to complete classroom tasks, repeated loss of materials, or a pattern persisting despite age-appropriate instruction and support. Parent and caregiver accounts matter because behavior at home may reveal difficulties in preparing, following routines, waiting, and completing daily responsibilities.
AAP guidance calls for information from teachers, parents, and other involved adults and evaluation for coexisting emotional, developmental, and physical conditions. The goal is to understand the child's functioning and select age-appropriate interventions rather than treating every active or inattentive behavior as a medical symptom. Wolraich et al., 2019.
Adolescence increases demands for independent planning, sustained work, time management, and emotional self-regulation. Someone previously supported by detailed parental supervision may experience greater impairment once these scaffolds are removed. Clinicians distinguish a newly visible problem from genuinely new symptom onset, examine sleep and mood changes, and gather developmentally appropriate collateral information.
Adults: Late Recognition, Compensation, and Context
Adults often seek evaluation when promotions, parenthood, college, or independent living increase demands on organization and self-direction. The pressures may expose long-standing vulnerabilities that were partially compensated for by family routines, school structure, or unusually high effort. Recognition in adulthood and onset in adulthood are separate questions. Kooij et al., 2019.
An adult presentation may center on disorganization, chronic procrastination, forgetfulness, mental restlessness, and difficulty following through. Clinicians examine whether these patterns were present in developmentally meaningful forms before age twelve and whether they produce impairment across settings now. A successful career, an advanced degree, or a polished social presentation does not provide sufficient evidence either for or against ADHD.
Women and girls may be overlooked when symptoms are relatively quiet or when compensatory strategies obscure their costs. The research on sex and gender differences is complex and affected by referral pathways, measurement, social expectations, and ascertainment. The relevant standard remains an individual, criterion-based evaluation of symptoms, history, impairment, and alternative explanations. Young et al., 2020.
For older adults, evaluation may also require particular attention to sleep, medications, medical illness, sensory losses, mood symptoms, and age-related cognitive changes. Historical evidence can be especially difficult to reconstruct. The clinical task is to account for multiple possible influences without assuming that lifelong ADHD becomes impossible after a particular birthday.
Screening Questionnaires: Useful Signals, Limited Conclusions
Rating scales and screening instruments provide structured descriptions of experiences, frequencies, and sometimes observed behaviors. For adults, questionnaires such as the Adult ADHD Self-Report Scale can identify people who may benefit from further evaluation. For children, parent and teacher scales can summarize observed patterns across environments. A positive screen means that additional assessment may be appropriate; it does not mean that the diagnostic criteria have been established.
The predictive meaning of a score changes with the population, the threshold used, coexisting conditions, and the underlying prevalence of ADHD. People seeking information online may be stressed, sleep-deprived, depressed, or worried about attention and may therefore endorse several items. Some people with ADHD underreport longstanding symptoms because they have normalized them. A score is one piece of information, to be interpreted with the history and impairment evidence.
NICE guidance explicitly states that diagnosis should not be made solely from rating scales or observational data. Likewise, the World Federation consensus emphasizes clinician evaluation instead of stand-alone cognitive tests or brain imaging. An online quiz, a social media checklist, a wearable measurement, or a brief concentration task cannot settle the diagnosis.
What a Comprehensive Clinical Evaluation Examines
A structured developmental and psychosocial history
A clinician establishes what brought the person for assessment, which problems interfere with life, when they first appeared, how they changed over time, and what supports or circumstances modify them. The inquiry covers school and work history, daily routines, relationships, current stresses, medical and psychiatric history, sleep, substance use, and relevant family history. It examines inattentive and hyperactive-impulsive symptom domains against an accepted diagnostic classification.
Corroboration across settings
With appropriate consent, clinicians may seek observations from parents, partners, teachers, or others who know the person's functioning. They may examine school records or prior assessments when available. Contradictory accounts are interpreted rather than mechanically averaged: people see behavior in different environments and may have different expectations, opportunities to observe, or biases.
Functional consequences and alternative explanations
The assessment describes concrete and meaningful consequences, evaluates psychiatric and developmental co-occurrence, and considers physical conditions and medications when indicated. It may use standardized interviews, rating scales, and targeted additional tests. Neuropsychological tests can clarify particular cognitive or learning questions but do not on their own confirm ADHD. NICE diagnostic recommendations; NICE digital assessment evidence.
Age-specific diagnostic thresholds
Under DSM-5 criteria, children through age sixteen need at least six symptoms in the relevant domain, while people aged seventeen and older need at least five, alongside other requirements. These thresholds apply to symptoms in the inattention or hyperactivity-impulsivity domains, with corresponding rules for presentations. Counts are clinically interpreted together with developmental appropriateness, duration, onset, setting breadth, impairment, and differential diagnosis. CDC.
How to Prepare for an Assessment
A useful account focuses on specific recurring situations. Instead of writing “I have ADHD,” record what happens: appointments missed despite reminders, tasks repeatedly abandoned, instructions forgotten, essential materials lost, or work not completed despite understanding its requirements. Record when the pattern started, what the consequences were, and which settings reveal it.
Examples from school, employment, home, relationships, and independent responsibilities help establish breadth. Earlier reports, where available, can support the developmental history. It is also useful to mention sleep quality, shift work, caffeine and other substance use, medications, mood changes, anxiety, medical conditions, and recent disruptions. Information that suggests another explanation is valuable clinical evidence rather than a reason to conceal it.
A qualified clinician can use this history to decide whether formal ADHD criteria are met, whether another diagnosis or coexisting condition deserves care, and which interventions are appropriate. Evaluation is especially useful when difficulties recur and cause sustained impairment, regardless of whether the final diagnosis is ADHD.
What Helps While the Cause Is Being Clarified?
Environmental and organizational measures can be useful whenever attention and follow-through are under strain. A person may externalize reminders, reduce avoidable interruptions, break complex tasks into visible steps, schedule deliberate recovery time, improve sleep regularity, and discuss realistic workload adjustments. These strategies can reduce friction while assessment proceeds; a favorable response does not establish an ADHD diagnosis.
Interventions are matched to the underlying needs. ADHD-specific treatment, when indicated, may involve psychoeducation, age-appropriate behavioral interventions, parent training, school supports, medication, or structured psychological therapy. Treatment decisions depend on age, severity, preferences, coexisting conditions, adverse-effect monitoring, and local clinical guidance. A short period of being distracted does not justify self-directed use of prescription ADHD medications. AAP; NICE.
When sleep deprivation, depression, anxiety, substance problems, environmental overload, or a medical condition is a major contributor, addressing that contributor can substantially improve concentration and well-being. Coexisting ADHD may still require care. The practical objective is a credible explanation and support that improves functioning.
Common Misinterpretations
“Everyone gets distracted, so ADHD is just a normal trait.”
Normal variation and clinical ADHD share surface behaviors. The syndrome is established through a validated constellation of developmentally inappropriate symptoms, persistence, setting breadth, and functional impact. Research supports ADHD as a clinically meaningful neurodevelopmental disorder, while individual diagnosis still demands careful evaluation. Faraone et al., 2021.
“I can focus on something interesting, so it cannot be ADHD.”
Sustained engagement on an absorbing activity does not test whether the person meets criteria across other tasks and settings. The balance of demands, supports, and consequences matters more than any one moment of concentration.
“I feel distracted every day, so it must be ADHD.”
Daily symptoms deserve attention, particularly when they disrupt functioning. They can also reflect chronic sleep loss, ongoing anxiety, depression, medication effects, environmental stress, or overlapping conditions. The history and differential assessment decide what the pattern means.
“A brain scan, online test, or executive-function score can prove it.”
Current clinical guidance does not support any one of those measurements as an individual diagnostic arbiter. Research findings about brain networks or average cognitive performance are not interchangeable with a person-level clinical diagnosis. NICE; Faraone et al., 2021.
“A good student or organized employee cannot have ADHD.”
Achievement is an outcome shaped by abilities, support, effort, opportunity, and context. A competent performance in one area cannot substitute for investigating other settings, the costs of compensation, symptom history, and clinically significant impairment.
Research Strengths, Limitations, and Clinical Uncertainty
ADHD's diagnostic validity is supported by converging evidence from clinical course, family and genetic research, population studies, functional associations, and treatment trials. The World Federation of ADHD consensus statement summarizes large-scale evidence while recognizing that no single biomarker serves as a diagnostic test. The strongest conclusion for a particular person arises from criteria-based assessment rather than a laboratory signature.
Evidence also has limits. Self-report is influenced by recall, current distress, expectations, and health literacy. Observer accounts can be incomplete or colored by context. Research samples may overrepresent referred, treated, or more severely impaired individuals. Differences between age groups and between clinical and community samples complicate direct comparisons.
Criteria have necessary categorical thresholds, while attention and executive functioning vary dimensionally across populations. Near-threshold difficulties may still be consequential and warrant support. A clinical evaluation can conclude that a person experiences genuine impairing attention problems while the evidence does not meet full ADHD criteria. The appropriate response remains to identify causes, address needs, and document uncertainties accurately.
Questions Readers Frequently Ask
How do I know whether my distractibility is normal?
Consider the duration, age of onset, repetition across significant settings, and actual effects on functioning. A newly emerging problem tied closely to sleep or an identifiable life change calls for evaluation of that contributor. Recurrent developmental difficulties accompanied by impairment across settings make ADHD assessment appropriate. The conclusion comes from an individualized clinical history.
Is it possible to have ADHD without hyperactivity?
Yes. ADHD includes a predominantly inattentive presentation. Persistent and impairing symptoms may include organization, follow-through, forgetfulness, sustained effort, and distractibility without conspicuous physical overactivity. CDC symptom criteria.
Can someone develop ADHD as an adult?
An adult can first receive a diagnosis long after childhood; the diagnostic model requires evidence of childhood symptoms. New adult-onset attention difficulties prompt assessment for other or additional causes as well as reconstruction of earlier patterns. Kooij et al., 2019.
Does ADHD require problems in every situation?
No. The criteria require symptoms in two or more important settings. Their form and visibility may change with task demands, personal interest, external structure, and available accommodations. Clinical interpretation looks for a coherent pattern rather than identical behavior everywhere. NICE.
Can ADHD and ordinary situational distraction occur together?
Yes. People with ADHD can also experience fatigue, emotional stress, distracting environments, and ordinary lapses. Those influences may exacerbate existing symptoms and deserve attention in their own right. Diagnosticians distinguish chronic underlying patterns from their temporary amplification.
Should I take a screening test before seeing a clinician?
A validated screening questionnaire may help organize concerns and encourage discussion, provided its result is treated as preliminary. It can neither confirm nor exclude ADHD by itself. A clinical assessment integrates developmental history, symptoms, impairment, setting breadth, and possible alternative explanations.
Clinical Conclusion
ADHD becomes a diagnostic consideration when distractibility belongs to a sustained developmental pattern of inattentive and/or hyperactive-impulsive symptoms that is clinically disproportionate, appears across multiple important settings, and measurably interferes with functioning. Symptoms, history, context, and consequences are examined together. Ordinary distraction and clinically significant attention difficulties deserve equally serious explanation, and a comprehensive assessment provides the basis for care appropriate to the person's actual needs.
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