Quiz

Child ADD Quiz

This is a screening test designed to give a preliminary "Indication" of traits that may be associated with Attention Deficit Disorder. It can not replace an evaluation by a Doctor to determine the presence or absence of a ADD/ADHD. The test requires that each question be answered

Age Gender

At Home Behavior

Does this child present problems with compliance to instructions, commands or rules in any of the following "at Home"situations?

	ADD/ADHD	Never/Rarely	Sometimes	Often	Very Often
1	Playing alone
2	Playing with other children
3	At mealtimes
4	Getting dressed
5	Washing and bathing
6	While you are on the telephone
7	Watching television
8	In the car
9	In the mornings
10	When others are visiting in your home
11	When you are visiting someone else's home
12	In public places (restaurants, stores, church, etc)
13	When father is home
14	When father is not home
15	When with a babysitter
16	When asked to do chores
17	When asked to do homework
18	At bedtime

School Situations

Does this child present problems with compliance to instructions, commands or rules during the following "at School" situations?

	ADD/ADHD	Never/Rarely	Sometimes	Often	Very Often
1	When arriving at school
2	During individual desk work
3	During small group activities
4	During free playtime in class
5	During lectures to the class
6	At recess
7	At lunch
8	In the hallways
9	In the bathroom
10	On field trips
11	During special assemblies
12	On the bus

Classroom Behavior

Does this child exhibit any of the following behaviors while in a classroom setting?

	ADD/ADHD	Never/Rarely	Sometimes	Often	Very Often
1	Fidgets with hands or feet
2	Squirms in seat
3	Doesn't listen when spoken to directly
4	Seems restless
5	Talks excessively
6	Loses things necessary for tasks or activities
7	Is easily distracted
8	Fails to give close attention to details or makes careless mistakes in his/her work
9	Leaves his/her seat in classroom or in other situations in which seating is expected
10	Doesn't follow through on instructions and fails to finish work
11	Has difficulty engaging in leisure activities or doing fun things quietly
12	Avoids, dislikes, or is reluctant to engage in work that requires sustained mental effort
13	Blurts out answers before questions have been completed

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