The child’s mood and behavior problems get distinctly worse or more intense for days at a time, but then return to the child’s usual behavior.

The child has difficult behaviors (such as impulsivity and hyperactivity) that are fairly consistent.

Mood swings and strange behaviors occur unpredictably. The child may be withdrawn or irritable one moment and extremely happy or giddy the next.

The child’s moods can change quickly but are not extreme. These changes in mood are usually in response to something.

The child’s response to external events is prolonged and out of proportion to the event.

The child’s reaction to external events is not extreme and is resolved in a normal amount of time.

The child shows signs of hypersexuality (talking or thinking about sex, having sex, or using sexual language).

The child can show some signs of sexually inappropriate behavior. But the behavior is usually not severe or the child can be distracted from this behavior.

Sleep disturbances and inability to sleep occur periodically. The child often has plenty of energy despite not getting much sleep.

Sleep disturbances and inability to sleep are long-term (chronic). The child is usually tired when he or she does not get enough sleep.