Attention deficit hyperactivity disorder (ADHD or AD/HD or ADD) is a developmental disorder. It is primarily characterised by "the co-existence of attentional problems and hyperactivity, with each behavior occurring infrequently alone" and symptoms starting before seven years of age. ADHD management usually involves some combination of medications, behaviour modifications, lifestyle changes, and counselling. Its symptoms can be difficult to differentiate from other disorders, increasing the likelihood that the diagnosis of ADHD will be missed. Most clinicians have not received formal training in the assessment and treatment of ADHD, particularly in adult patients. However herbal medicine, nutritional supplementation, dietary and lifestyle approaches can treat this condition naturally, without the use of pharmacological drugs.