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Answer 2
  1. Impairment observed in 2 or more settings. In order to diagnose ADHD, some impairment from its symptoms must be observed in 2 or more settings (eg, at school and at home). The symptoms of inattention and/or hyperactivity-impulsivity must persist for at least 6 months to a degree that is maladaptive and inconsistent with the child’s developmental level. In early childhood, it may be difficult to distinguish symptoms of ADHD from age-appropriate behaviors in active children. Some hyperactive-impulsive or inattentive symptoms that caused impairment in the case patient were present before age 7 years but not age 5 years. Behaviors such as violating rules or the rights of others suggest conduct disorder. Behaviors such as enuresis, fire setting, and cruelty to animals may exist as comorbid conditions, but these behaviors are not diagnostic of ADHD.

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