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Current Symptoms Scale: Self- report Daily

Screening Visit

Screening

Submitted by Lab on Mon, 03/18/2013 - 17:59

Instructions: Please choose the number next to each item that best describes your behavior today. Indicate choices using 0=never, 1=rarely, 2=sometimes, 3=often, 4=always.

1. Fail to give close attention to details or make careless mistakes in my work (e.g. overlook or miss details, my work is inaccurate. *

2. Fidget with or tap hands or feet or squirm in seat. *

3. Have difficulty sustaining my attention in tasks or fun activities. *

4. Leave my seat in situations in which seating is expected. *

5. Don't listen when spoken to directly. *

6. Feel restless. *

7. Don't follow through on instructions and fail to finish work. *

8. Have difficulty engaging in leisure activities or doing fun things quietly. *

9. Have difficulty organizing tasks and activities. *

10. Feel "on the go" or "driven by a motor." *

11. Avoid, dislike, or am reluctant to engage in work that requires sustained mental effort. *

12. Talk Excessively. *

13. Often lose things necessary for tasks or activities (e.g. school materials, pencils, books, tools, wallets, keys, paperwork, eyeglasses, or mobile telephones). *

14. Often blurt out an answer before a question has been completed (e.g. complete people's sentences and "jump the gun" in conversations, cannot wait for next turn in conversations). *

15. Often easily distracted by extraneous stimuli (or unrelated thoughts). *

16. Often have difficulty waiting in turn (e.g. while waiting in line). *

17. Often forgetful in daily activities (e.g. chores, running errands, returning calls, paying bills, keeping appointments). *

18. Often interrupts or intrudes on others (e.g. butts into conversations, games, or activities; may start using other people's things without asking or receiving permission, intrude into or take over what others are doing). *

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Current Symptoms Scale: Self- report Daily

Screening Visit