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Submitted by Lab on Sun, 03/24/2013 - 22:46

Instructions: Please circle the number next to each item that best describes the individual's behavior during the past 6 months.

0=Never or Rarely
1=Sometimes
2=Often
3=Very often

1. Fails to give close attention to details or makes careless mistakes in their work (e.g. overlook or miss details, my work is inaccurate).

2. Fidgets with or taps hands or feet or squirms in seat.

3. Has difficulty sustaining attention in tasks or fun activities.

4. Leaves seat in situations in which seating is expected.

5. Doesn't listen when spoken to directly.

6. Feels restless.

7. Doesn't follow through on instructions and fails to finish work.

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

9. Has difficulty organizing tasks and activities.

10. Feels "on the go" or "driven by a motor".

11. Avoids, dislikes, or is reluctant to engage in work that requires sustained mental effort.

12. Talks excessively.

13. Often looses things necessary for tasks or activities.

14. Often blurts out an answer before a question has been completed (e.g. "jumps the gun" in conversation).

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

16. Often has difficulty waiting for turn (e.g. while waiting in line).

17. Often forgetful in daily activities (e.g. chores, running errands, paying bills).

18. Often interrupts or intrudes on others (e.g. butts into conversations, games, or, activities).

How old was the individual when these problems with attention, impulsiveness, or hyperactivity first begin to occur? years old