ADHD Rating Scale

ADHD Rating Scale

Patient name
Date:
Age:
Sex:

Home Version

School Version

	Never or rarely (0)	Sometimes (1)	Often (2)	Very often (3)
1. Fails to give close attention to details or makes careless mistakes in schoolwork.
2. Fidgets with hands or feet or squirms in seat.
3. Has difficulty sustaining attention in tasks or play activities.
4. Leaves seat in classroom or in other situations in which remaining seated is expected.
5. Does not seem to listen when spoken to directly.
6. Runs about or climbs excessively in situations in which it is inappropriate.
7. does not follow through on instructions and fails to finish work.
8. Has difficulty playing or engaging in leisure activities quietly.
9. Has difficulty organizing tasks and activities.
10. Is "on the go" or acts as if "driven by a motor".
11. Avoids tasks (e.g. schoolwork, homework) that require sustained mental effort.
12. Talks excessively.
13. Loses things necessary for tasks or activities.
14. Blurts out answers before questions have been completed.
15. Is easily distracted.
16. Has difficulty awaiting turn.
17. Is forgetful in daily activities.
18. Interrupts or intrudes on others.

	Age 5-7 yr		Age 8-10 yr		Age 11-13 yr		Age 14-18 yr
	Male		Female

Percentile for Inattention
<90%
90%-93%
93%-98%
>98%
Percentile for Hyperactivity
<90%
90%-93%
93%-98%
>98%

Diagnostic criteria for ADHD
A. Six or more of each Inattention Symptoms (odd numbers) and/or Hyperactivity-Impulsivity symptoms (even numbers) present for 6 months (rated "often" or "very often")
B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 yrs.
C. Some impairment from the symptoms is present in two or more settings(eg school and home)
D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning.
E.The symptoms are not part of another mental disorder (eg depression or personality disorder).
Codes:
314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type
314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type
314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type

Subject: