William H. Reading, MD
Adult ADD Screen
Score each item as follows:
0 = never
1 = rarely
2 = occasionally
3 = frequently
4 = very frequently
1) History of ADD symptoms in childhood
2) Short attention span, unless very interested in something
3) Easily distracted, tendency for thoughts to drift
4) Starting projects but not finishing them, poor follow through
5) Is easily bored (tunes out)
6) History of not living up to potential in school or work
7) Poor listening skills
8) Lacks attention to detail
9) Trouble listening carefully to directions
10) Frequently misplaces things
11) Enthusiastic beginnings but poor endings
12) Difficulty learning new games; hard to stay on track during directions
13) Easily distracted during sex, causing frequent breaks or turn-offs during lovemaking
14) Family history of ADD, learning problems, mood disorders or substance abuse
15) History of frequent behavior problems in school
16) Restlessness, fidgetiness
17) Has to be moving in order to think
18) Trouble sitting still
19) Sense of anxiety or nervousness
20) Impulsive, in words or actions (spending)
21) Say just what comes to mind without considering its impact (tactless)
22) Trouble following procedure; "read the directions when all else fails"
23) Impatient, low frustration tolerance
24) A prisoner of the moment
25) Frequent traffic violations
26) Frequent, impulsive job changes
27) Tendency to embarrass others
28) Lying or stealing on impulse
29) Poor organization and planning, trouble maintaining an organized work/living area
30) Chronically late or in a hurry
31) Often have piles of stuff
32) Easily overwhelmed by tasks of daily living
33) Poor financial management (late bills, check book a mess, late fees)
34) Surrounding self with people who will organize
35) Chronic procrastination or trouble getting started
36) History of bed wetting past age 5
37) Skips around while reading, or goes to the end first, trouble staying on track
38) Spends excessive time at work because of inefficiencies
39) Inconsistent work performance
40) Feeling you should be much further along in your life than you are
41) Chronic problems with self-esteem
42) Sense of impending doom
43) Mood swings
44) Negativity
45) Frequent feeling of demoralization or that things won't work out
46) Trouble sustaining friendships or intimate relationships, promiscuity
47) Tendency to be immature
48) Self-centered; immature interests
49) Failure to see others' needs or activities as important
50) Lack of talking in a relationship
51) Verbally abusive to others
52) Proneness to hysterical outburst
53) Avoids group activities
54) Trouble with authority
55) Quick responses to slights that are real or imagined
56) Rage outbursts, short fuse
57) Frequent search for high stimulation (e.g. bungee jumping, gambling, etc.)
58) Tendency to seek conflict, be argumentative or to start disagreements
59) Tendency to worry needlessly
60) Switches around numbers, letters or words
61) Turn words around in conversations
62) Poor writing skills
63) Coordination difficulties
64) Performance becomes worse under pressure.
65) Test anxiety, or during tests the mind tends to go blank
66) The harder you try, the worse it gets
67) Work or schoolwork deteriorates under pressure
68) Tendency to turn off or become stuck when asked questions in social situations
69) Falls asleep or becomes tired while reading
70) Difficulties falling asleep, may be due to too many thoughts at night
71) Difficulty awakening
72) Periods of low energy, especially early in the morning and in the afternoon
73) Frequently feeling tired
74) Startles easily
75) Sensitive to touch, clothes, noise and light
Scoring:
1. Total Score: _____
2. Total 3 & 4: _____
3. Score #1: _____
4. Score #2: _____
5. Score #3: _____
There is a high probability of ADD as a factor if:
a) The total score is greater than 160 or
b) There are 20+ answers with a score of 3 and 4 or
c) #1, #2, and #3 are all 4.