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Biological and physical contributors
Lifelong attention, learning, communication, sensory or executive-function differences and their environmental fit.
Fit, function and alternatives
A contextual factor earns a place in the formulation when case evidence links it to the presentation, not because it is present.
Check alternatives
Do not infer the process from a label, search phrase or diagnosis alone. Assess actual circumstances and source-specific population limits.
Next steps
Elicit case evidence, examine alternatives, discuss the hypothesis with the person, and revise when relevant evidence changes.
Qualification
Establish developmental baseline. Do not infer resistance, dependency or personality pathology where support or accommodation is needed.
Caveats for this record