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Attention-Deficit/Hyperactivity Disorder (ADHD) Evaluation Tool

Does your child have problems paying attention?
Do they fidget, talk a lot, or run around with seemingly endless energy?
Do they have trouble waiting their turn, and 'butt into' games or conversations?

If the answer to any of these is yes, you might want to find out whether your child is exhibiting symptoms of Attention-Deficit/Hyperactivity Disorder (ADHD). All children at some time or another will tend to be inattentive, hyperactive or impulsive. However some children will exhibit these qualities most of the time, and more than their peers.

Please complete the survey below to find out if you need to consult your GP about these symptoms. It is important to keep in mind that symptoms of ADHD are often common in many energetic children; therefore it might help to compare your child to other children in the same age group.

  1. Does your child fail to pay attention to details during tasks? For example, a teacher may have reported careless errors in schoolwork.
    1. Yes
    2. Not more than other children of the same age
  2. Does your child have trouble sustaining attention during tasks or games? For example they appear to easily lose interest and become distracted.
    1. Yes
    2. Not more than other children of the same age
  3. Do they have trouble following through on instructions, and often fail to finish schoolwork, homework or chores?
    1. Yes
    2. Not more than other children of the same age
  4. Do they have trouble listening, even when spoken to directly?
    1. Yes
    2. Not more than other children of the same age
  5. Could your child be described using the following three words: forgetful; disorganised; or easily distracted?
    1. Yes, to all three
    2. Yes, to two only
    3. Yes, to one only
    4. None of these words could describe my child
  6. Does your child avoid or dislike activities that require sustained mental attention such as schoolwork or homework?
    1. Yes
    2. Not more than other children of the same age
  7. Does your child fidget, squirm in their seat, or get up from their seat in situations where sitting still or remaining seated are expected?
    1. Yes
    2. Not more than any other child of the same age
  8. Does your child have difficulty 'playing quietly'?
    1. Yes
    2. Not more than any other child of the same age
  9. Does your child act as if driven by a motor, often running or climbing excessively, and in situations where it is inappropriate?
    1. Yes
    2. Not more than any other child of the same age
  10.  Does your child talk excessively and/or blurt out answers before questions have been completed?
    1. Yes, to both
    2. Yes, to one only
    3. Not compared to children of the same age
  11.  Does your child have difficulty waiting their turn and/or interrupt or intrude on the conversations or games of others?
    1. Yes, to both
    2. Yes, to one only
    3. Not compared to children of the same age
  12.  On the scale below, please indicate how much you feel these symptoms impact on your child's quality and enjoyment of their social and academic life
    (1 indicates that their life is not affected by the symptoms and 10 indicates their life is severely affected).
    12345678910

Reference: Diagnostic and Statistical Manual of Mental Disorders. 4th Ed, Text Revision (DSM-IV-TR). Washington, D.C.: American Psychiatric Association 2000.

Evaluation

Your child is unlikely to be experiencing symptoms of ADHD. You probably dont need to be concerned.

Evaluation

Your child is unlikely to be experiencing symptoms of ADHD. However, if you are concerned, you should show this survey to your GP at your next consult.

Evaluation

Your child may be experiencing some of the symptoms of ADHD. These symptoms may be able to be managed by your doctor. You should book an appointment with your GP and take this survey with you for further discussion.

Evaluation

Your child may be experiencing some of the symptoms of ADHD. These symptoms may be able to be managed by your doctor. You should book an appointment with your GP as soon as possible and take this survey with you for further discussion.

This information will be collected for educational purposes, however it will remain anonymous.



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if you want advice please see your treating physician.

Information on this site must be discussed with your treating doctor.

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