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ADD/ADHD Screening
Access Center 1.800.777.5722 24 hrs day/7 days
Adult ADHD/ADD Screening This educational material is made available courtesy of Dr. Daniel Amen and ADDult Support of Washington for Adults with ADD, a non-profit organization based in Tacoma , whose purpose if to educate adults and the professionals who treat them about Attention Deficit Disorder. Our address is PO Box 7804 , Tacoma , WA , 98407 . Telephone 253-759-5085, E-mail: adult@addult.org and website: www.ADDult.org . We suggest you print this page to complete and score the checklist. Read this list of behaviors and rate yourself (or the person who has asked you to rate him or her) on each behavior listed. Use the following scale and place the appropriate number next to the item. For purposes of this questionnaire, both ADD and ADHD are lumped into the single term ADD. 0 = Never 1 = Rarely 2 = Occasionally 3 = Frequently 4 = Very Frequently
Past History
*History of ADD symptoms in childhood, such as distractibility, short attention span, impulsivity or restlessness. ADD doesn't start at age 30.
History of not living up to potential in school or work (report cards with comments such as "not living up to potential")
History of frequent behavior problems in school (mostly for males)
History of bedwetting past age 5
Family history of ADD, learning problems, mood disorders or substance abuse problems
Short Attention Span / Distractibility
*Short attention span, unless very interested in something
*Easily distracted, tendency to drift away (although at times can be hyperfocused)
Lacks attention to detail, due to distractibility
Trouble listening carefully to directions
Frequently misplaces things
Skips around while reading, or goes to the end first, trouble staying on track
Difficulty learning new games, because it is hard to stay on track during directions
Easily distracted during sex, causing frequent breaks or turn-offs during lovemaking
Poor listening skills
Tendency to be easily bored (tunes out)
Restlessness
Restlessness, constant motion, legs moving, fidgeting
Has to be moving in order to think
Trouble sitting still, such as trouble sitting in one place for too long, sitting at a desk job for long periods, sitting through a movie
An internal sense of anxiety or nervousness
Impulsivity
Impulsive, in words and/or actions (spending)
Say just what comes to mind without considering its impact (tactless)
Trouble going through established channels, trouble following proper procedure, an attitude of "read the directions when all else fails"
Impatient, low frustration tolerance
A prisoner of the moment
Frequent traffic violations
Frequent, impulsive job changes
Tendency to embarrass others
Lying or stealing on impulse
Poor Organization
Poor organization and planning, trouble maintaining an organized work/living area
Chronically late or chronically in a hurry
Often have piles of stuff
Easily overwhelmed by tasks of daily living
Poor financial management (late bills, check book a mess, spending unnecessary money on late fees)
Problems Getting Started and Following Through
Chronic procrastination or trouble getting started
Starting projects but not finishing them, poor follow through
Enthusiastic beginnings but poor endings
Spends excessive time at work because of inefficiencies
Inconsistent work performance
Negative Internal Feelings
Chronic sense of under achievement, feeling you should be much further along in your life than you are
Chronic problems with self-esteem
Sense of impending doom
Mood swings
Negativity
Frequent feeling of demoralization or that things won't work out for you
Relational Difficulties
Trouble sustaining friendships or intimate relationships, promiscuity
Trouble with intimacy
Tendency to be immature
Self-centered; immature interests
Failure to see others' needs or activities as important
Lack of talking in a relationship
Verbally abusive to others
Prone to hysterical outburst
Avoids group activities
Trouble with authority
Short Fuse
Quick responses to slights that are real or imagined
Rage outbursts, short fuse
Frequent Search For High Stimulation
Frequent search for high stimulation (bungee jumping, gambling, race track, high stress jobs, ER doctors, doing many things at once, etc.)
Tendency to seek conflict, be argumentative or to start disagreements for the fun of it
Tendency To Get Stuck (thoughts or behaviors)
Tendency to worry needlessly and endlessly
Tendency toward addictions (food, alcohol, drugs, work)
Switches Things Around
Switches around numbers, letters or words
Turn words around in conversations
Writing/Fine Motor Coordination Difficulties
Poor writing skills (hard to get information from brain to pen)
Poor handwriting, often prints
Coordination difficulties
The Harder I Try The Worse It Gets
Performance becomes worse under pressure.
Test anxiety, or during tests your mind tends to go blank
The harder you try, the worse it gets
Work or schoolwork deteriorates under pressure
Tendency to turn off or become stuck when asked questions in social situations
Falls asleep or becomes tired while reading
Sleep/Wake Difficulties
Difficulty falling asleep, may be due to too many thoughts at night
Difficulty coming awake (may need coffee or other stimulant or activity before feeling fully awake)
Low Energy
Periods of low energy, especially early in the morning and in the afternoon
Frequently feeling tired
Sensitive To Noise Or Touch
Startles easily
Sensitive to touch, clothes, noise and light
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