Treatment does not need to mean medication, which I assume is the reason for your concern of age. If he is mildly ADHD you can try the omega route (please speak to your pharmacist or doctor about dosages for such a little one). Ensure his diet is higher in protein and lower in carbohydrates; reduce sugars, preservatives and colourants wherever possible; allow him to get plenty of exercise. Instilling routines now will help his organisational skills later.
As for "really knowing", the symptoms must be present in at least two different settings, and they must have a severe negative impact on his daily learning and functioning. If he is learning and progressing well and able to make friends without adversely affecting the family dynamics, there is little reason for concern at this stage. If, however, his behaviour is such that he continuously disrupts the family and/or school then some action may be required.
There are a number of natural treatments available which are always advisable prior to medication.
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