A 7-year-old boy presents with his mother to his pediatrician. The mother describes the boy's inability to concentrate and impulsivity. In his spare time, he enjoys being with his friends and participating in physical activities, such as swimming, running, and skating. He also enjoys participating in social events and is often invited to play dates and birthday parties. He interacts well with his peers, but his parents note that he can be easily led and influenced by others. They also report that he gets upset when he does not receive recognition or feels that he has been ignored. His teacher notes that he sometimes acts socially immature and often demonstrates attention-seeking behavior. He also interrupts other students in the classroom and on the playground.

He often forgets his lunch. He has difficulty focusing and sitting still in class. He can "hyper-focus" on activities of interest but often cannot sustain his attention at school. The boy is restless and often requires reminders to help him stay on task. He is described as "constantly running around" and has trouble listening and following instructions. His teacher says that he often blurts out answers and interrupts other students in the classroom. He recognizes this but says that he can't stop.

He has difficulty falling asleep and sometimes wakes up in the middle of the night, and then has difficulty getting back to sleep. His mother reports that at home he has trouble following routines and remembering instructions. He is easily frustrated and emotionally impulsive and has had several incidents of hitting, crying outbursts, and inappropriate behavior.