Physical illness (most common)  Anxiety and depression  Deliberately kept home by parents  Truancy Miserable conditions at school e.g. Bullying 

Summary of Treatment Guidelines   for ADHD       AAP Treatment Recommendations Nov 2019         First-line    Second line    Preschool children (4-5 years)    Behaviour therapy    Methylphenidate        Methylphenidate, if no significant improvement and moderate-to- severe functional impairment    Elementary school (6–11 years)    Behaviour therapy or medication, preferably both .     Evidence      stimulants > atomoxetine > guanfacine ER > Clonidine ER    Summary, NICE Treatment Recommendations 2018        First-line    Second line    Children under 5 years    Discussion    Group parent-training program    (ADHD-Focused)    Medication     (Only a specialist can start)    Start medications only after seeking...