Attention Deficit Disorder Survey
The Attention Deficit Disorder Survey is a tool that can be used to help diagnose attention deficit disorder. It is a self-report measure that asks questions about symptoms of inattention, hyperactivity, and impulsivity. The survey can be used by parents, teachers, or mental health professionals to help identify individuals who may have attention deficit disorder.
Time to complete
2 minutes
Eligibility
There is no particular eligibility criterion to fill the Attention Deficit Disorder Survey. Any individual can fill out this form.
Questions for Attention Deficit Disorder Survey
1.
Full Name
The answer should be a text input.
2.
Age
The answer should be a single choice:
- Under 18
- 18-24 years old
- 25-34 years old
- 35-44 years old
- 45-54 years old
- Over 55
3.
Gender
The answer should be a single choice:
- Male
- Female
- Other
- Prefer not to say
4.
Phone Number
The answer should be a phone number.
5.
Do you have difficulty sustaining attention in tasks or activities?
The answer should be a single choice:
- Yes
- No
6.
Do you have difficulty completing tasks or activities?
The answer should be a single choice:
- Yes
- No
7.
Do you have difficulty following through on instructions?
The answer should be a single choice:
- Yes
- No
8.
Do you have difficulty sustaining focus on tasks or activities?
The answer should be a single choice:
- Yes
- No
9.
Do you often avoid or procrastinate tasks that require sustained mental effort?
The answer should be a single choice:
- Yes
- No
10.
Do you often lose things necessary for tasks or activities?
The answer should be a single choice:
- Yes
- No
11.
Do you often become easily distracted by irrelevant stimuli?
The answer should be a single choice:
- Yes
- No
12.
Do you often have difficulty starting tasks or activities?
The answer should be a single choice:
- Yes
- No
Similar Ideas
- The Adult ADHD Self-Report Scale (ASRS)
- The Attention Deficit Disorder Evaluation Scale
- The Conners' Adult ADHD Rating Scales
- The Adult Self-Report Scale
Here are some FAQs and additional information
on Attention Deficit Disorder Survey
What is Attention Deficit Disorder?
Attention Deficit Disorder (ADD) is a medical condition that is characterized by problems with focus, hyperactivity, and impulsiveness. Symptoms of ADD can vary from person to person, and they may also change over time.
What causes Attention Deficit Disorder?
The exact cause of ADD is unknown, but it is believed to be caused by a combination of genetic and environmental factors.
Who is at risk of developing Attention Deficit Disorder?
ADD is more common in males than females, and it is also more common in children who have a family history of the condition.
What are the symptoms of Attention Deficit Disorder?
Symptoms of ADD can vary from person to person, but they may include problems with focus, hyperactivity, and impulsiveness.
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