Paediatricsmiddle twist
A 9-year-old boy is brought by his mother, who has completed a standardised parent rating scale scoring highly for inattention and hyperactivity. She says he cannot sit through dinner, loses his hat and lunchbox weekly and never finishes homework, and that the same behaviour was obvious at six. He was born at term, his hearing and vision screens are normal, and he has lost no skills. She asks the general practitioner to start medication today. Which one of the following must be established before a diagnosis of attention deficit hyperactivity disorder can be made?