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Current Scale

The document is a self-report questionnaire designed to assess current behaviors related to attention, impulsiveness, and hyperactivity over the past six months. It includes a series of items for individuals to rate their behaviors and the extent to which these behaviors interfere with various life activities. Respondents are also prompted to indicate the age at which they first experienced these problems.

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jacopo.tubini
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33 views3 pages

Current Scale

The document is a self-report questionnaire designed to assess current behaviors related to attention, impulsiveness, and hyperactivity over the past six months. It includes a series of items for individuals to rate their behaviors and the extent to which these behaviors interfere with various life activities. Respondents are also prompted to indicate the age at which they first experienced these problems.

Uploaded by

jacopo.tubini
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOC, PDF, TXT or read online on Scribd

Current self-report

CURRENT BEHAVIOUR SCALE – SELF-REPORT

Instructions
Please circle the number next to each item that best describes your
behaviour
DURING THE PAST 6 MONTHS

Items: Never or
Rarely Sometim Often Very
es Often

1. Fail to give close attention to 0 1 2 3


details or make careless mistakes
in my work

2. Fidget with hands or feet or 0 1 2 3


squirm in seat

3. Have difficulty sustaining my 0 1 2 3


attention in tasks or fun activities

4. Leave my seat in situations in 0 1 2 3


which sitting is expected

5. Don’t listen when spoken to 0 1 2 3


directly

6. Feel restless 0 1 2 3

7. Don’t follow through on 0 1 2 3


instructions and fail to finish work

8. Have difficulty engaging in leisure 0 1 2 3


activities or doing fun things
quietly

9. Have difficulty organising tasks 0 1 2 3


and activities

10. Feel “on the go” or “driven by a 0 1 2 3


motor”

11. Avoid, dislike, or am reluctant to 0 1 2 3


engage in work that requires
sustained mental effort

12. Talk excessively 0 1 2 3

13. Lose things necessary for tasks or 0 1 2 3


activities

Please Turn Over


Current self-report

14. Blurt out answers before questions 0 1 2 3


have been completed

15. Easily distracted 0 1 2 3

16. Have difficulty awaiting turn 0 1 2 3

17. Forgetful in daily activities 0 1 2 3

18. Interrupt or intrude on others 0 1 2 3

If you indicated that you experienced any of the problems with attention,
concentration, impulsiveness, or hyperactivity on the first page, please
fill in the blank below indicating as precisely as you can recall at what
age these problems began to occur for you:

I was approximately ________ years old.

To what extent do the problems you may have circled on the previous
page interfere with your ability to function in each of these areas of life
activities?

Areas: Never Someti Often Very


or mes Often
Rarely

In your home life with your immediate 0 1 2 3


family

In your work or occupation 0 1 2 3

In your social interactions with others 0 1 2 3

In your activities or dealings in the 0 1 2 3


community

In any educational activities 0 1 2 3

In your dating or marital relationship 0 1 2 3

In your management of money 0 1 2 3

In your driving of a motor vehicle 0 1 2 3

In your leisure or recreational activities 0 1 2 3

In your management of your daily 0 1 2 3


Please Turn Over
Current self-report

responsibilities

Please Turn Over

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