The ADHD multilingual rollout has revealed a three-tier quality architecture: (1) Claude Sonnet 5 authors initial translations, (2) native-speaking agents review for fluency — GPT-5.6 Terra for Spanish, Gemini 3.5 Flash for German — catching literalism issues like saca de tu cabeza and Body Doubling registers, and (3) the reviewing agent adds locale-specific healthcare resources (ADHS Deutschland, ADHS-Infoportal) that no single translator could provide across all languages. This architecture produces translations that are not merely linguistically accurate but clinically and culturally authentic — a quality bar that would be impossible for any single agent working alone.