What symptom may prompt evaluation for ADHD in school-age children?

• A. Oppositional defiant behavior
• B. Speech delay
• C. Inattention and hyperactivity that impairs functioning for a sustained period (e.g., >6 months)
• D. Enuresis

Answer: (C)

ADHD evaluation is prompted when a child shows a persistent pattern of inattention and/or hyperactivity-impulsivity that causes clear impairment in daily functioning and lasts for a substantial period, typically at least six months. In school-age kids, this often shows up as difficulty sustaining attention on tasks, organized work, or following through on instructions, along with restlessness or being unusually impulsive, which can interfere with school performance and social interactions. The combination of duration, pervasiveness across settings (often noticed at home and at school), and resulting impairment is what differentiates ADHD from typical misbehavior or developmental variations. The other options describe problems that may occur in children but do not define ADHD criteria: oppositional behaviors, while potentially present, are not the defining pattern; speech delay and enuresis are separate issues unrelated to the core ADHD diagnosis.