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Many people argue that genuine ADHD appears during the pre-school years and that the related symptoms are objective, meaning that any observer would come to the same conclusion. This perspective is often, but not always true.

Although in preschool-age children, diagnosing the disorder is left to specialists, in their daily settings, parents are the experts when it comes to their child. If they perceive that their child is restless, inattentive or impulsive, that he has difficulty controlling his reactions, needs to move or has difficulty to wait his turn, then caregivers ought to listen carefully.

In ideal circumstances, the specialist will work with the parents to observe the child’s behaviour in various settings and also evaluate if the problem might lie elsewhere (e.g., in parental expectations, coping strategies, stress level or socio-economic situation).

In some cases, ADHD can also become symptomatic much later in development, after starting school or even later in the school-age period.

In all cases, the ultimate arbiter of the diagnosis is the presence of impairment, whether it be at the social, academic or emotional level.