At what point do you suggest a formal ADHD assessment for a child rather than ‘wait and see’?

If symptoms are persistent across settings and causing functional impairment, I recommend assessment sooner rather than later. Struggling to sit still or focus occasionally is normal. But if a child is consistently having difficulty at school, at home, or socially, and it is affecting learning or self esteem, that is meaningful. Early identification can prevent years of frustration and negative self beliefs. Waiting is reasonable if symptoms are mild and not impairing. But if teachers and parents are both concerned, it is worth exploring formally.