Adult ADHD Self Questionnaire

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Personal Details
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Adult ADHD Self-Report Scale

Please answer the following questions, rating yourself on each of the criteria shown

  • For each question, select the answer that best describes how you have felt and conducted yourself over the past 6 months.
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? : *
2. How often do you have difficulty getting things in order when you have to do a task that requires organization?: *
3. How often do you have problems remembering appointments or obligations?: *
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?: *
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?: *
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?: *
7. How often do you make careless mistakes when you have to work on a boring or difficult project?: *
8. How often do you have difficulty keeping your attention when you are doing boring or repetitive work?: *
9. How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?: *
10. How often do you misplace or have difficulty finding things at home or at work?: *
11. How often are you distracted by activity or noise around you?: *
12. How often do you leave your seat in meetings or other situations in which you are expected to remain seated?: *
13. How often do you feel restless or fidgety?: *
14. How often do you have difficulty unwinding and relaxing when you have time to yourself?: *
15. How often do you find yourself talking too much when you are in social situations?: *
16. When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?: *
17. How often do you have difficulty waiting your turn in situations when turn taking is required?: *
18. How often do you interrupt others when they are busy?: *
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Childhood Behaviour Scale

Please answer the questions below, rating yourself on each of the criteria shown.

  • For each question, select the answer that best describes how you felt and conducted yourself when you were a child between 7 and 12 years of age
20. Failed to give close attention to details or made careless mistakes in work: *
21. Fidgeted with hands or feet or squirmed in seat: *
22. Had difficulty sustaining attention in tasks or fun activities: *
23. Left seat in classroom or other situations in which sitting was expected: *
24. Didn’t listen when spoken to directly: *
25. Restless in the "squirmy" sense: *
26. Didn’t follow through on instructions and failed to finish work: *
27. Had difficulty engaging in leisure activities or doing fun things quietly: *
28. Had difficulty organising tasks and activities: *
29. Felt “on the go” or acted as if “driven by a motor”: *
30. Avoided, disliked, or was reluctant to engage in work that required sustained mental effort: *
31. Talked excessively: *
32. Lost things necessary for tasks or activities: *
33. Blurted out answers before questions had been completed: *
34. Easily distracted: *
35. Had difficulty awaiting turn: *
36. Forgetful in daily activities: *
37. Interrupted or intruded on others: *

To what extent did the problems you may have indicated on the previous page, interfere with your ability to function in each of these areas of life activities when you were a child between 7 and 12 years of age?

38. In your home life with their immediate family: *
39. In your social interactions with other children: *
40. In your activities or dealings in the community: *
41. In school: *
42. In sports, clubs, or other organisations: *
43. In learning to take care of yourself: *
44. In your play, leisure or recreational activities: *
45. In your handling of daily chores or other responsibilities: *
 

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