When might symptoms of ADHD in my school-age child appear?

More severe symptoms may surface in first and second grade when a child is unable to follow directions and complete only small quantities of work. Milder attention problems may not surface until third or fourth grade when kids are expected to function more independently. Symptoms are most likely to be seen at school where the child has greater difficulty completing class work and at home where homework can take several hours to finish.  About three to five percent of school-age kids are diagnosed with ADD/ADHD especially boys (by a 1:5 ratio) who tend to have more difficulty focusing.