In order for a student to be diagnosed with ADHD, symptoms must appear before age 12 and be exhibited across at least two settings. They must also have adverse effects on academic performance, occupational success, or social-emotional development (APA, 2013).    To add to the complexity of the diagnosis, children with ADHD are likely to have co-existing emotional, behavioral, developmental, learning, or physical conditions (Wolraich & DuPaul, 2010).    As a result of the behaviors listed above, students with ADHD are at greater risk of academicdifficulties, social/emotional issues, and limited educational outcomes. The degree to which attention impacts a student’s academic and social performance is related to the interactions between the student’s academic and behavioral needs and the environmentaldemands.    Therefore, it is not unusual for the student to perform differently across settings.  For example, a student with ADHD may experience academic success in elementary school;however, when he enters middle school, the increased academic and organizational demandsmay increase his need for additional academic and behavioral supports.