- It is obvious that in multiple milieu (school, play, home) it appears impossible for your child to sit and focus without becoming easily distracted and inattentive within even just a few minutes
- The child has much difficulty following directions, and playing by the rules – for example, when “quiet play” is required
- The child is shunned and possibly is being treated like a pariah by teachers, peers and even family members because he or she is so difficult to be around
- The child has never done well academically and is consistently failing
- The child is spending an inordinate amount of time in “time-outs” (mostly for younger kids) or in some type of “punish hall” for older children
- The child is not responding to multiple attempts at redirection
- The child’s distractibility and impulse control problems don’t lead to marked maliciousness, meanness, or attempts to perpetrate harm on others. If these ramifications are present, it’s likely something else
- A trial of stimulants has resulted in objective, measurable positive changes in ability to focus and behave more appropriately without excessive movement