However, despite this resolution, the girl was referred for neuropsychological evaluation at the age of 7 years after her family and school noticed significant difficulties with attention, task initiation, and explosive temper outbursts. She was exhibiting variations across the day and on a day-to-day basis with respect to her ability to engage in tasks; she had complained to her parents that she could "not do things as her brain was asleep." The parents also reported that typical reward-based behavioral incentives were not successful in modifying behavior.