PEDIATRIC PEOPLE
A few questions about focus & attention
Rate how you have felt and conducted yourself over the past 6 months. There are 18 short questions.
First name
Last name
1/18
Part A
How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done?
Part A
How often do you have difficulty getting things in order when you have to do a task that requires organisation?
Part A
How often do you have problems remembering appointments or obligations?
Part A
When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
Part A
How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
Part A
How often do you feel overly active and compelled to do things, like you were driven by a motor?
Part B
How often do you make careless mistakes when you have to work on a boring or difficult project?
Part B
How often do you have difficulty keeping your attention when you are doing boring or repetitive work?
Part B
How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?
Part B
How often do you misplace or have difficulty finding things at home or at work?
Part B
How often are you distracted by activity or noise around you?
Part B
How often do you leave your seat in meetings or other situations in which you are expected to remain seated?
Part B
How often do you feel restless or fidgety?
Part B
How often do you have difficulty unwinding and relaxing when you have time to yourself?
Part B
How often do you find yourself talking too much when you are in social situations?
Part B
When you’re in a conversation, how often do you find yourself finishing the sentences of the people you are talking to, before they can finish them themselves?
Part B
How often do you have difficulty waiting your turn in situations when turn taking is required?
Part B
How often do you interrupt others when they are busy?
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Scoring your responses…
All done
Your responses have been recorded and shared with your clinician.