ADHD symptom onset is generally in childhood. According to a 2014 national survey, the median age of diagnosis is seven years. Most children with ADHD will continue to have symptoms and impairment through adolescence and into adulthood. In complex ADHD onset can be before the age of four- or after 12-years. Apart from the SDBP, the American Paediatric Association (APA), and the National Institute for Health and Care Excellence (NICE) updated their guidelines recently.