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Children ADHD) Assessment -Conners
Assessment 1 of 100
Form Instructions & Things to Know
How to fill this form:
Read each question carefully before selecting an answer.
Select the most accurate option based on your observations.
Do not skip questions; every response helps in the assessment.
Things to know:
10-15 Mins
Estimated completion time.
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Your data is fully encrypted.
Note:
This is a screening and assessment tool, not clinical (medical).
First, please provide your contact information.
Your Full Name
Email Address
Phone Number
Information about the individual being assessed.
Who are you filing for?
Choose relationship...
Self
Child
Partner
Family Member
Friend
Caretaker
Guardian
Teacher/Tutor
Name of Individual Being Assessed
Date of Birth
Age
Gender
*
Select Gender
Male
Female
School Grade (Optional)
Assessment Reasons / Reason for Assessment
1. Is forgetful in daily activities
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
2. Avoids or dislikes things that take a lot of effort and are not fun.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
3. Has trouble getting started on tasks or projects.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
4. Is easily distracted.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
5. Gets a headache when they have to pay attention for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
6. Doesn't seem to listen to what people are saying to them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
7. Doesn't know what their homework is or where they put it.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
8. Has trouble getting back on task after being interrupted.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
9. It's impossible for them to pay attention to things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
10. Fails to follow through on instructions.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
11. Forgets to turn in completed work.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
12. Has difficulty managing their time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
13. Has trouble concentrating.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
14. Has trouble organizing tasks or activities.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
15. Fails to pay close attention to details
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
16. Makes careless mistakes in schoolwork or other activities.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
17. Has trouble planning ahead.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
18. Hands in incomplete work or tests.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
19. There is nothing they can pay attention to for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
20. Loses or misplaces things that they need.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
21. Gets so focused on something that they lose track of what is going on around them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
22. Has a hard time prioritizing tasks.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
23. Has a short attention span.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
24. Has trouble changing from one task to another.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
25. Has trouble staying focused on work or play for a long time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
26. Checks their work for mistakes.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
27. Leaves their seat when they should stay seated.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
28. Needs to be moving around.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
29. Isn't aware that they are being loud.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
30. Talks too much.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
31. Runs or climbs when they are not supposed to.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
32. Is unable to be quiet when playing or using free time.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
33. Gets overly excited.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
34. Has trouble sitting still.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
35. Acts as if driven by a motor.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
36. Fidgets or squirms in their seat.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
37. Is restless.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
38. Blurts out the first thing that comes to mind
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
39. Makes impulsive decisions.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
40. Has difficulty waiting for their turn.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
41. Interrupts other people's conversations, games, or activities.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
42. Intrudes on or takes over what others are doing.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
43. Acts before thinking.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
44. Talks out of turn.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
45. Blurts out answers before the question has been completed.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
46. He/she Is impulsive.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
47. Loses temper.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
48. Has trouble controlling their emotions.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
49. Has trouble calming down when upset.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
50. Is irritable or easily annoyed by others.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
51. Says or does things they don't mean to because they are angry.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
52. Gets really angry all of a sudden.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
53. Overreacts when they get upset.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
54. Mood changes quickly and drastically.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
55. He/she Is impossible to please.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
56. Has trouble controlling their anger.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
57. Is sad, gloomy, or irritable.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
58. Seems hopeless about the future.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
59. Feels worthless.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
60. Seems tired
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
61. Has at least one happy memory.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
62. Doesn't enjoy things like they used to.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
63. Feels helpless.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
64. Has trouble falling or staying asleep
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
65. Has trouble controlling their worries.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
66. Gets tired or worn out from worrying.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
67. Worries too much about many different things.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
68. Appears tense, nervous, or jumpy.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
69. Writes reminders that they don't remember writing.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
70. Fears they will act in a way that could lead to embarrassment or rejection.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
71. Doesn't finish schoolwork, work, or other tasks
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
72. Hands things in late (submitting class work, assignments, documents, or items after use)
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
73. Gets invited to play or go out with others.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
74. Is annoying to peers.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
75. Peers complain about their behavior.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
76. Interacts well with peers.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
77. People don't want to be friends with them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
78. Has trouble making or keeping friends.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
79. Disrupts family activities.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
80. Creates stress for the family.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
81. Makes it hard for the family to have fun together.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
82. Causes the family to be late for appointments or activities.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
83. Argues with family members.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
84. Doesn't get along well with family members.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
85. Creates a chaotic family life.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
86. Uses other people's things without asking permission.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
87. Tries to get revenge with people.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
88. Upsets or offends others on purpose.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
89. Actively refuses to follow the rules.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
90. Is angry and resentful.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
91. Argues with family members.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
92. Annoys other people on purpose.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
93. Actively refuses to do what adults tell them to do.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
94. Blames their mistakes or misbehavior on others.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
95. Argues with adults.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
96. He/she wants good things to happen to them.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
97. Enjoys doing his/her favorite activity.
Not true at all (Never/Rarely)
Just a little true (Occasionally)
Pretty much true (Often/Quite a bit)
Completely true (Very often/Always)
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