Dr Leigh Martens

Self-Assessments

Please answer every question.

Which of the following statements apply to your child?

Question	Almost Never	Sometimes	Often	Very Often
1: My child fails to pay close attention to the finer details and tends to make careless mistakes
2: Has difficulty sustaining his/her attention for prolonged periods
3: Does not listen when spoken to directly
4: Does not follow through on instructions or orders
5: Has difficulty in organising or executing multiple tasks
6: Avoids or is reluctant to engage in tasks that require sustained mental effort or concentration
7: Tends to lose personal items such as clothing, books, toys, etc.
8: Is easily distracted by external stimuli, disruptions or outside influences
9: Appears restless, on the go and twitchy
10: Tends to interrupt other people when they are speaking
11: Has difficulty in waiting for their turn
12: Runs, climbs or displays disruptive behaviour in situations when it’s inappropriate