Not At All
Just A Little
Quite A Bit
Very Much
1. Often fails to give close attention to details or makes careless mistakes in schoolwork or tasks
2. Often has difficulty sustaining attention in tasks or play activities
3. Often does not seem to listen when spoken to directly
4. Often does not follow through on instructions and fails to finish schoolwork, chores, or duties
5. Often has difficulty organizing tasks and activities
6. Often avoids, dislikes, or reluctantly engages in tasks requiring sustained mental effort
7. Often loses things necessary for activities (e.g., toys, school assignments, pencils, or books)
8. Often is distracted by extraneous stimuli
9. Often is forgetful in daily activities
10. Often has difficulty maintaining alertness, orienting to requests, or executing directions
11. Often fidgets with hands or feet or squirms in seat
12. Often leaves seat in classroom or in other situations in which remaining seated is expected
13. Often runs about or climbs excessively in situations in which it is inappropriate
14. Often has difficulty playing or engaging in leisure activities quietly
15. Often is “on the go” or often acts as if “driven by a motor”
16. Often talks excessively
17. Often blurts out answers before questions have been completed
18. Often has difficulty awaiting turn
19. Often interrupts or intrudes on others (e.g., butts into conversations/games)
20. Often has difficulty sitting still, being quiet, or inhibiting impulses in the classroom or at home
22. Often argues with adults
23. Often actively defies or refuses adult requests or rules
24. Often deliberately does things that annoy other people
25. Often blames others for his or her mistakes or misbehavior
26. Often touchy or easily annoyed by others
27 Often is angry and resentful
28. Often is spiteful or vindictive
30. Often is negative, defiant, disobedient, or hostile toward authority figures
31. Often makes noises (e.g., humming or odd sounds) ______ ______ ______ ______
32. Often is excitable, impulsive
34. Often is uncooperative
36. Often is restless or overactive
37. Often disturbs other children
38. Often changes mood quickly and drastically
39. Often easily frustrated if demand are not met immediately
40. Often teases other children and interferes with their activities
41. Often is aggressive to other children (e.g., picks fights or bullies)
42. Often is destructive with property of others (e.g., vandalism)
43. Often is deceitful (e.g., steals, lies, forges, copies the work of others, or “cons” others)
44. Often and seriously violates rules (e.g., is truant, runs away, or completely ignores class rules)
45. Has persistent pattern of violating the basic rights of others or major societal norms
46. Has episodes of failure to resist aggressive impulses (to assault others or to destroy property)
47. Has motor or verbal tics (sudden, rapid, recurrent, nonrhythmic motor or verbal activity)
48. Has repetitive motor behavior (e.g., hand waving, body rocking, or picking at skin)
49. Has obsessions (persistent and intrusive inappropriate ideas, thoughts, or impulses)
50. Has compulsions (repetitive behaviors or mental acts to reduce anxiety or distress)
51. Often is restless or seems keyed up or on edge
52. Often is easily fatigued
53. Often has difficulty concentrating (mind goes blank)
55. Often has muscle tension
56. Often has excessive anxiety and worry (e.g., apprehensive expectation)
57. Often has daytime sleepiness (unintended sleeping in inappropriate situations)
58. Often has excessive emotionality and attention-seeking behavior
59. Often has need for undue admiration, grandiose behavior, or lack of empathy
60. Often has instability in relationships with others, reactive mood, and impulsivity
61 Sometimes for at least a week has inflated self esteem or grandiosity
62. Sometimes for at least a week is more talkative than usual or seems pressured to keep talking
63. Sometimes for at least a week has flight of ideas or says that thoughts are racing
64. Sometimes for at least a week has elevated, expansive or euphoric mood
65. Sometimes for at least a week is excessively involved in pleasurable but risky activities
66. Sometimes for at least 2 weeks has depressed mood (sad, hopeless, discouraged)
67. Sometimes for at least 2 weeks has irritable or cranky mood (not just when frustrated)
68. Sometimes for at least 2 weeks has markedly diminished interest or pleasure in most activities
69. Sometimes for at least 2 weeks has psychomotor agitation (even more active than usual)
70. Sometimes for at least 2 weeks has psychomotor retardation (slowed down in most activities)
71. Sometimes for at least 2 weeks is fatigued or has loss of energy
72. Sometimes for at least 2 weeks has feelings of worthlessness or excessive, inappropriate guilt
73. Sometimes for at least 2 weeks has diminished ability to think or concentrate
74. Chronic low self-esteem most of the time for at least a year
75. Chronic poor concentration or difficulty making decisions most of the time for at least a year
76. Chronic feelings of hopelessness most of the time for at least a year
77. Currently is hypervigilant (overly watchful or alert) or has exaggerated startle response
78. Currently is irritable, has anger outbursts, or has difficulty concentrating
79. Currently has an emotional (e.g., nervous, worried, hopeless, tearful) response to stress
80. Currently has a behavioral (e.g., fighting, vandalism, truancy) response to stress
81. Has difficulty getting started on classroom assignments
82. Has difficulty staying on task for an entire classroom period
83. Has problems in completion of work on classroom assignments
84. Has problems in accuracy or neatness of written work in the classroom
85. Has difficulty attending to a group classroom activity or discussion
86. Has difficulty making transitions to the next topic or classroom period
87. Has problems in interactions with peers in the classroom
88. Has problems in interactions with staff (teacher or aide)
89. Has difficulty remaining quiet according to classroom rules
90. Has difficulty staying seated according to classroom rules
