Kwame: "he never listens"

The case (fictional)

Kwame is seven and attends a private primary school in Accra. His teacher writes that he "never listens", leaves his seat, rarely finishes his work and often seems to daydream. She has suggested to his parents that he may have ADHD and should see someone.

At home his mother, a nurse, says he is lively but can sit with his building bricks for an hour. His father says he was "exactly the same" as a boy. Kwame snores loudly, sleeps with his mouth open and is very hard to wake; his teacher has seen him yawning in class. He had many ear infections as a toddler, often says "what?" when spoken to, and his speech is a little unclear for his age.

This year the school moved to teaching only in English. At home the family speaks Twi and English. His reading is behind the class, while his maths is about average. The teacher says the problems are worst in the afternoon and during whole-class teaching, and better when she works with him one to one.

He has a group of friends and is not aggressive. There have been no recent upheavals at home.