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Severity of Symptoms are relative
Although the symptoms appeared before 7 years of age is necessary, the reality of how symptoms "appear" is relative.
(Before anyone gets to technical, "signs" mean what others can observe, see, measure and "symptoms" mean the individual perception. Blood Pressure is a sign. Nausea is a symptom. I will use them interchangeably.)
This is especially true for the inattentive type.
For example, you have to compare the severity of the ADHD with the other coping skills, supports, and assets to help with the demands on the child at the time.
A smart-kid, with mild-ADHD in a highly-structured environment will low stress will not be very obvious... until of course demands and independence rise.
An average kid with moderate-to-sever ADHD in a chaotic environment will be very obvious.
With that said, ADHD is a diagnosis of exclusion.
These means that you really need to look at other possible explanations and Dx until ADHD is the only reasonable explanation that remains.
http://askdreric-schoolpsychologist.blogspot.com/
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