STEP 1: FILL OUT THE A.D.D.-Q. CHECK LIST. It is impossible to compose a one-size-fits-all checklist for A.D.D., which may be why there are many types of questionnaires and checklists in use. What the A.D.D.-Q does best is help you organize your thinking about the problem and give the professional you choose information at a glance and a summary of your own insights into your child. Keep in mind that A.D.D. traits are qualities found in most children from time to time; this questionnaire looks at the degree to which these traits are present, as well as the traits themselves. Unlike most questionnaires, which confuse behavior problems with A.D.D. symptoms, this questionnaire focuses only on A.D.D. It is based on our understanding of A.D.D. gained through our clinical experience.
Child’s name: ______________________ Date: __________
Grade: ______ Date of Birth ________ Age:_____.
QUESTIONS: (Place a check ‘?’ in the appropriate column for each item) Never or very rarely Some-times A great deal Almost always
- ATTENTION SPAN1. When my child is deeply interested in an activity I have difficulty dragging her away.
2. My child does pay attention to things he wants to do.
3. My child has difficulty paying attention to things I want her to do.
4. My child has difficulty paying attention to things others (e.g., teachers) want him to do (e.g. instructions).
5. My child daydreams, drifts into her own little world, oblivious to what’s going on.
6. My child notes unimportant details, which interest him, yet misses the main idea.
7. My child doesn’t pay attention to important details and often makes careless mistakes in schoolwork. (e.g., + and – signs in math)
8. My child’s school grades do not reflect her true ability – she underachieves.
9. My child is inconsistent in his work and behavior. He is fine one day but not the next.
10. It is hard for my child to follow routines, such as getting ready for school or getting ready for bed.
11. My child gets easily sidetracked from a task someone else asks her to do. (For example, she stops to examine a bug on the wall and forgets she was on her way to brush her teeth.)
12. My child honestly “forgets” to bring her assignments home. (“Forgetting” is NOT done in an angry or oppositional manner most of the time.)
13. My child needs a lot of supervision to complete assignments (school work, chores), which require sustained attention.
14. My child’s attention span is getting worse relative to other children the same age.
- SPONTANEITY15. My child fails to think through what he is about to do or say; that is, leaps without looking.
16. My child has difficulty waiting for a turn, (for example, interrupts others, blurts out answers before a question is completed.)
17. My child has difficulty waiting in line, sharing, and cooperating.
18. My child often gets into potentially dangerous situations.
19. My child has difficulty waiting for rewards, delaying gratification. (She wants the toy now!)
20. My child’s ability to control impulses is not improving with age.
- ORGANIZATION21. My child’s schoolwork, belongings, time-management and personal functioning seem very disorganized.
22. When my child is working on his own hobbies or creating his own projects he is extremely organized.
- EMOTIONAL23. My child overreacts to minor disturbances
24. My child is easily bored.
25. My child shows rapid mood swings.
26. My child has difficulty adjusting to sudden changes in routines.
- ACTIVITY LEVEL27. My child’s activity level is inappropriate for the situation, for example, she has difficulty sitting still in class, church, during meals.
28. My child is restless, fidgets, and squirms.
29. My child seems always on the go as if driven by a motor.
30. My child seems sluggish, lethargic and unmotivated,
TOTAL CHECKS FOR EACH COLUMN
SCORE: (the total number of checks in each column multiplied by 0, 1, 2, and 3)
x 0 = 0x 1= x 2= x 3 =TOTAL = _________ Interpretation:
This questionnaire is designed to help you organize your thinking about your child. You can use the total score to track your child’s symptoms over time. If you have checks only in the “often” and “almost always” columns for positive items such as numbers 1, 2 and 22, then A.D.D. is probably not a problem. On the other hand, if you have a great many of the other items marked in the “often and “almost always” columns, then it may be advisable for you to take this questionnaire and discuss your observations with a professional. (Hyperactive children will have higher scores than children who don’t have hyperactivity.) Remember, too, that your child’s age may affect the score. Younger children usually have higher scores.
Why are there more items under the first two topics?”Attention Span” and “Spontaneity” cover the major symptoms of A.D.D. It becomes increasingly difficult to separate other behavior disorders from A.D.D. when we ask questions about organization and emotions. Activity level can be average or at either extreme, hyperactive or lethargic.
What about angry, defiant behavior?A.D.D. is a very different problem from Conduct Disorder and Oppositional Defiant Disorder. In the A.D.D.-Q, we want to emphasize A.D.D. but also recognize that your child’s scores can be higher if your child is angry and has other behavioral difficulties. Some parents will want to rate their child on the degree to which the symptoms of A.D.D. are accompanied by an angry, defiant, and oppositional attitude or behavior. That is something more complex than A.D.D. alone, and behavior management becomes extremely important. These children are the ones who are at risk for getting into trouble with the law, especially if they grow up in difficult family situations. One frustrated parent opened a counseling session with Dr. Bill, pleading, “I just want to keep him out of jail.”
(From The A.D.D. Book by Drs. William Sears and Lynda Thompson)
STEP 2: ASSESS THE SEVERITY OF THE PROBLEM. In addition to describing your child by completing the checklist, you should also think about how the problem behavior affects your child, you, and the rest of the family. Does it cause occasional inconvenience, or are the child and family under constant stress? Perhaps the child’s differences are a minor problem that time and maturity will resolve. Or perhaps the child is an average kid, but he is in an academic setting that is a poor match for his abilities or learning style, making the difficulties really a situational problem. To help you assess whether this problem is a “biggie” or a “smallie” and to pinpoint where the child is having the most difficulty (home, school, play), complete the A.D.D.-Q Supplement.
THE A.D.D.-Q SUPPLEMENT: THE EFFECTS OF MY CHILD’S BEHAVIOR. The next section gives you an opportunity to think about your child’s and your family’s need to change things. How severe is the problem?Never or very rarelySome-timesA great dealAlmost always
1. My child’s behavior keeps me from liking him.
2. My child’s behavior is causing family problems
3. My child’s behavior is interfering with our marriage.
4. My child’s inattention is keeping her from learning.
5. My child’s behavior makes it hard for him to keep friends.
6. My child seems to be bothered by her behavior
7. Underachievement is resulting in lower self-esteem
TOTAL CHECKS FOR EACH COLUMN
SCORE: (The total number of checks for each column multiplied by 0, 1, 2, and 3
x 0 = 0x 1= x 2= x 3 =
STEP 3: GET INFORMATION FROM SIGNIFICANT OTHERS. While parents are undoubtedly the experts on their child’s behavior, they may find it hard to be objective. Love and constant proximity make parents more accepting of their child’s quirks; yet the child has to function in a society that will be less tolerant. Some children function well at home but fall apart at school. Some children learn well with one teacher yet clash with another. Children with A.D.D. have cross-situational problems, that is, the difficulties occur at home, at school, and with peers. If problems occur in only one area or situation then it makes sense to change that situation rather than change the child. To get a broader perspective, ask for observations from your child’s teachers, caregivers and any other person who spends time with your child and whose observations you value.
My child’s teacher observes:
My child’s caregiver and/or other adults observe:
My child’s friends observe:
STEP 4: DISCOVER YOUR CHILD’S SPECIAL SOMETHING. If you have read and enjoyed Calvin and Hobbes comic strip, you’ll agree that A.D.H.D. boys have a certain charm, even though they are a handful. If you haven’t met Calvin and his stuffed tiger toy, we highly recommend you purchase one of the anthologies. This cartoon will teach you more about the imaginative and energetic side of A.D.D., as well as the challenges it presents at home and school than you would learn in the same time spent with a specialist. And laughter is, in our view, your most valuable survival tool!
Remember that A.D.D. is only a description of a difference. A child who has this difference needs to be recognized and helped before it becomes a disability. There are two sides of the coin for each special trait found in children with A.D.D. Each trait can be an asset or a liability; it can work to the child’s advantage or disadvantage. A child’s personality is like a flower. Parents and teachers are like the gardeners. They cannot change the color of the flower or when it blooms, but they can prune the plant so that it blossoms more beautifully.
What qualities make your child special, valuable and delightful? What positive things do you have to say about your child? Is she creative, enthusiastic, persistent or artistic? List the qualities in your child you don’t want to change.
Recognizing the positive side of your child’s personality lessens the chances of him being over treated, inappropriately treated, or simply drugged for a caregiver or teacher’s convenience rather than for his own well-being. Consider the following example of a child who was medicated for A.D.D. with hyperactivity.
Billy’s parents were divorced, and Billy lived with his mother during the week and with his father on weekends. During the week Billy’s behavior was made tolerable by drugs. On weekends, his Dad refused to give his son the prescribed medication. A social worker doing a home visit found dozens of magnificent drawings that Billy had done at his father’s house, when not under the influence of medication. His creativity had been masked by medication. At his mother’s home he behaved “better” but was less creative.
The fundamental question that parents, teachers and professionals must ask, especially when considering medication, is whether the treatment is for the convenience of the caregivers or the well-being of the child. By looking at both sides of your child’s personality you and your child’s helpers, like gardeners, are more likely to focus on providing the right soil and careful training of the vines rather than on using heavy artificial fertilizers.
I could better accept my son’s behavior once I began looking for progress, not perfection.”
QUALITIES I DON’T WANT TO CHANGE 1. 2. 3. 4. 5.
STEP 5: ANALYZE HOW THE PROBLEM IS PROGRESSING. Is your child’s learning or behavior problem getting better, worse, or staying the same? This is an important piece of the puzzle only you can provide. Is your child growing out of the problem, or is your child growing into worse problems? Pick out the problems that seem to cause the most difficulty for you and your child and chart the progression. Problem Getting Better Staying the Same Getting Worse
STEP 6: SELECT THE RIGHT PROFESSIONAL HELP. Some parents may decide that they need assistance from an A.D.D. specialist as they are working through the previous steps. A professional can help in the process of assessing your child’s difficulties as well as in deciding what to do about them. Many A.D.D. specialists will have their own checklists or questionnaires for you to complete.
Management of a child with A.D.D. requires a multidisciplinary approach. Your child may visit a variety of specialists (psychologist, learning specialist, behavior therapist, neurologist, ears-nose-throat specialist, etc.) during the process of diagnosing and treating his difficulties. Yet you must have one team quarterback who looks at what’s happening all over the field and decides on an overall plan of attack for your child, the teachers, and the family. In many cases, parents become the quarterback.