Childhood Observer Assessment - ADHD Treatment Australia

Your unique perspective and memories of the patient’s behavior and characteristics up to the age of 12 are invaluable to us. By providing your observations, you are playing a pivotal role in helping us understand the patient’s developmental history and behavioral patterns, which is an essential component of the ADHD assessment.

The assessment includes a series of multiple choice questions that revolve around various aspects of behavior, attention, and activity levels that the patient may have displayed during childhood.

Please rest assured that your responses will be kept confidential and are solely for the purpose of this assessment. Your time and effort in helping us are deeply appreciated.

This colateral history is provided by:

The patients relationship to me:

Their primary school report cards comments included
(select all that apply)

Easily distracted Needs to pay attention Disruptive to other children They Would get good results if he/she applied himself/herself

The patient struggled to pay attention

The patient made careless errors in homework/schoolwork

The patient seemed to be daydreaming

The patient didn’t seem to listen when spoken to

The patient was disorganised

The patient would avoid doing homework

The patient would lose things

The patient was easily distracted

The patient was forgetful

The patient couldn’t sit still

The patient would fidget

The patient couldn’t stay seated (dinner table, classroom, cinema, church service)

The patient seemed to have trouble getting comfortable (sitting in a chair, or in bed)

The patient was disorganised

The patient had trouble relaxing

The patient could play quietly

The patient was very talkative

The patient would blurt out answers before the question was completed

The patient was impatient – struggled to wait for his/her turn

The patient would frequently interrupt

The patient was very sensitive to teasing or criticism

The patient had sudden temper outbursts

The patient tended to stay up late at night (was a night-owl)

The patient struggled to wake up and get going in the morning (not a morning person)

The patient's body would move around a lot during sleep

The patient had a tendency to hyper-focus

The patient was often unable or unwilling to do chores at home

Childhood Observer: Behavioural Assessment Form

Childhood Observer:

Behavioural Assessment Form

This free ADHD screening test is designed for individuals who believe they might benefit from a more detailed ADHD evaluation.

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