Adult ADHD Self-Report Scale

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Personal Details

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Answer the questions below, rating yourself on each of the criteria shown using the scale.

As you answer each question, choose the option that best describes how you have felt and conducted yourself over the past 6 months.

How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? : *

How often do you have difficulty getting things in order when you have to do a task that requires organization?: *

How often do you have problems remembering appointments or obligations?: *

When you have a task that requires a lot of thought, how often do you avoid or delay getting started?: *

How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?: *

How often do you feel overly active and compelled to do things, like you were driven by a motor?: *

How often do you make careless mistakes when you have to work on a boring or difficult project?: *

How often do you have difficulty keeping your attention when you are doing boring or repetitive work?: *

How often do you have difficulty concentrating on what people say to you, even when they are speaking to you directly?: *

How often do you misplace or have difficulty finding things at home or at work?: *

How often are you distracted by activity or noise around you?: *

How often do you leave your seat in meetings or other situations in which you are expected to remain seated?: *

How often do you feel restless or fidgety?: *

How often do you have difficulty unwinding and relaxing when you have time to yourself?: *

How often do you find yourself talking too much when you are in social situations?: *

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?: *

How often do you have difficulty waiting your turn in situations when turn taking is required?: *

How often do you interrupt others when they are busy?: *

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Childhood Behaviour Scale

Please do not complete this section yourself

Ask a relative or someone to complete it who knew you between the ages of 7 to 12 years

Failed to give close attention to details or made careless mistakes in work: *

Fidgeted with hands or feet or squirmed in seat: *

Had difficulty sustaining attention in tasks or fun activities: *

Left seat in classroom or other situations in which sitting was expected: *

Didn’t listen when spoken to directly: *

Restless in the “squirmy” sense: *

Didn’t follow through on instructions and failed to finish work: *

Had difficulty engaging in leisure activities or doing fun things quietly: *

Had difficulty organising tasks and activities: *

Felt “on the go” or acted as if “driven by a motor”: *

Avoided, disliked, or was reluctant to engage in work that required sustained mental effort: *

Talked excessively: *

Lost things necessary for tasks or activities: *

Blurted out answers before questions had been completed: *

Easily distracted: *

Had difficulty awaiting turn: *

Forgetful in daily activities: *

Interrupted or intruded on others: *

To what extent did the problems, mentioned above, interfere with their ability to function in each of these areas of life activities when they were a child between 7 and 12 years of age?

In their home life with their immediate family: *

In their social interactions with other children: *

In their activities or dealings in the community: *

In school: *

In sports, clubs, or other organisations: *

In learning to take care of themselves: *

In their play, leisure or recreational activities: *

In their handling of daily chores or other responsibilities: *

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Adult ADHD Self-Report Scale

Answer the questions below, rating yourself on each of the criteria shown using the scale.

Please do not complete this section yourself

Privacy Consent

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