Which of the following is a necessary criterion for diagnosing Attention Deficit/Hyperactivity Disorder?

The diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) according to the DSM-5-TR requires that symptoms must have been present before the age of 12. This criterion is essential for several reasons. First, ADHD is a neurodevelopmental disorder, and evidence suggests that its symptoms typically emerge in early childhood. By identifying the onset of symptoms during this critical developmental period, clinicians can differentiate ADHD from other disorders that may present later and avoid misdiagnosis.

Additionally, the requirement for symptoms to be evident before age 12 helps reinforce the understanding that ADHD is not simply a consequence of environmental factors or situational challenges that arise later in life, such as failure in coping with academic or social demands. This criterion establishes a clear timeline that supports the understanding of ADHD as a persistent pattern of behavior that is developmentally inappropriate.

The other options do not accurately reflect the DSM-5-TR criteria. For instance, symptoms must be present in various settings (not exclusively academic), and a diagnosis does not hinge on hyperactivity alone, as ADHD can manifest with inattentive symptoms that do not involve hyperactive behavior at all.