Adult ADHD Questionnaire

Name of person being rated *

Name of rater if different to above (& relationship to person being rated)

1. Fails to give attention to details or makes careless mistakes in work or activities *

2. Has difficulty sustaining attention to tasks or activities *

3. Struggles to listen when spoken to directly *

4. Does not follow through on instruction and fails to finish work (not due to motivation or not understanding instructions) *

5. Has difficulty organising tasks and activities *

6. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort *

7. Loses belongings (eg. keys, phone, bag, glasses etc.) *

8. Is easily distracted by extraneous stimuli *

9. Is forgetful in daily activities *

10. Fidgets with hands or feet, or squirms in seat *

11. Leaves seat in situations in which remaining seated is expected *

12. Runs about in situations in which it is inappropriate or feels very restless when required to remain still *

13. Has difficulty engaging in activities quietly *

14. Is 'on the go' or acts as if 'driven by a motor' *

15. Talks excessively *

16. Blurts out answers before questions have been completed *

17. Has difficulty waiting in line *

18. Interrupts or intrudes on others (eg. butts into conversations) *

19. Loses temper *

20. Is touchy or easily annoyed *

21. Fearful, anxious or worried *

22. Sad, unhappy or depressed *