The familiar picture does not include everyone

• ADHD is often associated with a visibly restless child who interrupts or has obvious school difficulties.

• The New Zealand Clinical Principles Framework also describes less visible inattentive features, including distractibility, forgetfulness and organisational difficulties.

• Good grades, qualifications or professional success do not rule out ADHD.

Read more: ADHD symptoms in adults →

External structure may provide support

Earlier in life, difficulties may be partly managed through:

• family support;

• school timetables and clear routines;

• regular reminders;

• clearly defined deadlines;

• help with planning and organisation.

The pattern may become more noticeable when work, study, household responsibilities, finances and relationships require greater independence.


Compensation can make difficulties less visible

The Australian ADHD guideline notes that some people develop compensation strategies that may mask ADHD features. Detailed lists, several reminders, arriving very early, over-preparing or relying on urgency can help, but may require considerable time and mental effort.


Other explanations may also be relevant

Concentration, memory or restlessness difficulties may also occur with anxiety, depression, sleep problems or prolonged stress, and more than one condition may be present. An earlier explanation should not automatically be replaced with ADHD. Assessment considers the full developmental and clinical picture.


Recognition may differ between groups

NICE notes that ADHD is thought to be under-recognised in girls and women. They may be referred for assessment less often, or their difficulties may initially be attributed to another mental health or neurodevelopmental condition. There is no single presentation shared by all women.

Read more: ADHD in women →