|
The Adult ADD Screener
|
|
Your Screener Results
This questionnaire, though not a substitute for a clinical evaluation, is designed to help you recognize if you may have symptoms of ADD and would benefit from further assessment by a physician.
Your responses do not indicate a likelihood of Adult ADD.
Only your doctor can make a definite diagnosis. If you have concerns or questions regarding ADD, discuss your results and any concerns with your physician and/or other healthcare professional.
Use the print button below to print out your responses to the questionnaire and take it to your doctor.
Your screener responses: |
||
|
||
|
|
||
Only your doctor can make a definite diagnosis. If you have concerns or questions regarding ADD, discuss your results and any concerns with your physician and/or other healthcare professional.
Use the print button below to print out your responses to the questionnaire and take it to your doctor.
Message to the Physician: This questionnaire can be found on http://www.adhd.com/. For more information on Adult ADD please visit LillyConnect.com, Eli Lilly and Company's private physician resource dedicated to providing Answers that Matter to Physicians about Lilly's products and specific disease states. For the latest Adult ADHD information created specifically for healthcare professionals, visit Medscape at http://www.medscape.com/resource/adultadhd.
Your Screener Results
The responses you have provided indicate that your symptoms may be consistent with Adult ADD. Only your healthcare professional can make a definite diagnosis. If you have concerns or questions regarding ADD, please discuss your results with a physician and/or healthcare professional.
|
|
||||||||||||||
| Print your responses to the questionnaire and take it to your doctor. | ||||||||||||||
NEXT STEPS |
||||||||||||||
|
||||||||||||||
Your Screener Responses: |
||||||||||||||
|
||||||||||||||
|
|
||||||||||||||
Only your doctor can make a definite diagnosis. If you have concerns or questions regarding ADD, discuss your results and any concerns with your physician and/or other healthcare professional.
Use the print button below to print out your responses to the questionnaire and take it to your doctor.
Are you living with Adult ADD?
The questions below can help you find out.
Many adults have been living with Adult Attention Deficit Disorder (Adult ADD) and don't recognize it. Why? Because its symptoms are often mistaken for a stressful life. If you've felt this type of frustration most of your life, you may have Adult ADD; a condition your doctor can help diagnose and treat.
The following questionnaire can be used as a starting point to help you recognize the signs and symptoms of Adult ADD, but is not meant to replace consultation with a trained healthcare professional. An accurate diagnosis can only be made through a clinical evaluation. Regardless of the questionnaire results, if you have concerns about diagnosis and treatment of ADD, please discuss your concerns with your physician. This Adult Self-Report Scale-V1.1 (ASRS-V1.1) Screener is intended for visitors age 18 years or older.
Instructions: Please click on the appropriate description for each question below, based on an assessment of yourself and then hit the submit button to see your results. You can clear your answers and start over by clicking on the reset button.
|
||||||
|
||||||
|
||||||
|
|
|
|
| 1. | How often do you have trouble wrapping up the final details of a project, once the challenging parts have been done? | - |
| ||
| 2. | How often do you have difficulty getting things in order when you have to do a task that requires organization? | - |
| ||
| 3. | How often do you have problems remembering appointments or obligations? | - |
| ||
| 4. | When you have a task that requires a lot of thought, how often do you avoid or delay getting started? | - |
| ||
| 5. | How often do you fidget or squirm with your hands or your feet when you have to sit down for a long time? | - |
| ||
| 6. | How often do you feel overly active and compelled to do things, like you were driven by a motor? | - |
| ||
|
The 6-question Adult Self-Report Scale - V 1.1 (ASRS - V 1.1) Screener is a subset of the WHO's 18-question Adult Self-Report Scale - V 1.1 (ASRS - V 1.1) Symptom Checklist. ASRS - V 1.1 Screener COPYRIGHT © 2003 World Health Organization (WHO). Reprinted with permission of WHO. All rights reserved. |
||
| ||
