ADHDRS with PROMPTS
Note: Not all prompts will be present for each symptom listed. Use as a guide to access whether the participant experiences the specified ADHD symptom.
Participant Name:
Rater:
1. Fails to give close attention to details or makes careless mistakes in schoolwork.
None (0)
Mild (1)
Moderate (2)
Severe (3)
2. Fidgets with hands or feet or squirms in seat.
None (0)
Mild (1)
Moderate (2)
Severe (3)
3. Has difficulty sustaining attention in tasks or play activities
None (0)
Mild (1)
Moderate (2)
Severe (3)
4. Leaves seat in classroom in other situations in which seating is expected.
None (0)
Mild (1)
Moderate (2)
Severe (3)
5. Does not seem to listen when spoken directly.
None (0)
Mild (1)
Moderate (2)
Severe (3)
6. Runs about or climbs excessively in situations in which it is inappropriate.
None (0)
Mild (1)
Moderate (2)
Severe (3)
7. Does your child not follow through on instructions and fails to finish work.
None (0)
Mild (1)
Moderate (2)
Severe (3)
8. Has difficulty playing or engaging in leisure activities quietly
None (0)
Mild (1)
Moderate (2)
Severe (3)
9. Has difficulty organizing tasks and activities
None (0)
Mild (1)
Moderate (2)
Severe (3)
10. Is “on the go” or acts if “driven by a motor.”
None (0)
Mild (1)
Moderate (2)
Severe (3)
11. Avoids tasks (e.g., work) that require sustained mental effort
None (0)
Mild (1)
Moderate (2)
Severe (3)
12. Talks excessively.
None (0)
Mild (1)
Moderate (2)
Severe (3)
13. Loses things necessary for tasks or activities.
None (0)
Mild (1)
Moderate (2)
Severe (3)
14. Blurt out answers before questions have been completed.
None (0)
Mild (1)
Moderate (2)
Severe (3)
15. Is easily distracted.
None (0)
Mild (1)
Moderate (2)
Severe (3)
16. Has difficulty awaiting turn.
None (0)
Mild (1)
Moderate (2)
Severe (3)
17. Is forgetful in daily activities.
None (0)
Mild (1)
Moderate (2)
Severe (3)
18. Interrupts or intrudes others
None (0)
Mild (1)
Moderate (2)
Severe (3)
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