How do you differentiate ADHD from typical high energy in adolescence, and what assessment strategies support this differentiation?

• A. ADHD is diagnosed based solely on mood symptoms.
• B. ADHD can be diagnosed after a single teacher report.
• C. ADHD symptoms must be present in all settings from birth.
• D. ADHD requires impairment across multiple settings for at least six months, with onset before age 12, and evidence from multiple informants.

Answer: (D)

ADHD is best understood as a persistent pattern of inattention and/or hyperactivity-impulsivity that leads to clear impairment across multiple settings and begins in childhood, with symptoms lasting at least six months and starting before age 12. Differentiating it from typical high energy in adolescence relies on three things: the behavior shows up in more than one setting (for example, home and school), it causes meaningful problems in daily functioning (academic, social, or family), and there is a documented onset in childhood (before age 12) with information gathered from several sources. In practice, assessment strategies combine a developmental history with reports from multiple informants—parents, teachers, and sometimes the adolescent—collected via structured interviews and standardized rating scales. Clinicians corroborate symptom presence and impairment across settings using school records, observations, and collateral information, while also ruling out other conditions such as mood or anxiety disorders that could imitate some symptoms. By integrating cross-situational evidence, duration, onset timing, and multi-informant data, clinicians can distinguish ADHD from normative high energy and other issues.