Instructions: Please indicate how much each statement reflects your child.

Please circle the number indicating how much your child is like the given statement in school, at home, or around other children. Please note that the male and female gender are used alternately purely for convenience and ease of reading. All questions apply equally to females and males.

1 = My child is nothing like that.
2 = My child is sometimes like that, but it’s not a problem.
3 = There are times when that describes my child, but I don’t know if it’s a problem.
4 = That describes my child much of the time.
5 = That is a perfect statement to describe my child.

 

1. If he is watching TV or playing his favorite video game, it’s as if he has gone deaf. I will have to call his name over and over, and I still might not get his attention until I tap his shoulder.

I would rate my child a:

2. She loses things all the time like books, a pencil, her glasses, toys, clothes, her shoes, etc.

I would rate my child a:

3. He forgets to do things often unless I remind him over and over again. This happens even if it’s something he wants to do like picking out a new video game from a catalog.

I would rate my child a:

4. She has a lot of difficulty playing quietly, whether alone or with other children. She will either get loud or get up a lot while her friends will sit still and play or talk quietly.

I would rate my child a:

5. He is very fidgety, and it doesn’t matter if he is sitting at the table eating dinner, watching television, sitting in the car or in the classroom.

I would rate my child a:

6. She has to be pushed to do anything that requires a lot of concentration like home- work or even playing a child’s game like Memory. Trying to give her even a short list of chores to do seems to overwhelm her.

I would rate my child a:

7. He does not finish homework, chores, or other tasks. He will just stop at some random time in the middle and go on to something else like a switch was just turned off.

I would rate my child a:

8. She seems to have too much energy to the point where she cannot sit still for very long without getting up, running around, or going for a walk at inappropriate times (e.g., during class, in the middle of dinner, or while playing a board/card game).

I would rate my child a:

9. He tends to say whatever comes into his head right away. There seems to be no filter to prevent him from blurting things out like answers to questions posed in the classroom or when seeing a person in a store.

I would rate my child a:

10. She is often much too talkative and has trouble being quiet and listening. This is true whether she is with an adult (parent/teacher) or a friend of hers. Her listening skills seem weak, almost as if she is unaware other people want to speak too.

I would rate my child a:

11. He has a lot of trouble waiting in lines (even relatively short ones like at a store), waiting his turn when playing a game, or even waiting to talk to a relative who is on the phone.

I would rate my child a:

12.She has difficulty making and keeping friends because many of her peers do not like how she acts. They tend to lose patience with her. I think they view her as selfish or self-centered.

I would rate my child a:

13. He frequently interrupts people when they are speaking despite being told over and over how rude it is. He seems to understand and apologizes, but then he does it again. It’s like he is unable to control himself whenever something enters his head.

I would rate my child a:

14. She tends to be disorganized. Every night she has trouble figuring out what her homework assignments are, and every morning she has to search for what she needs to take to school that day. Her life seems to be a constant mess.

I would rate my child a:

15. He can be in the middle of a serious conversation or watching a movie he is enjoying on TV, and suddenly he forgets everything and becomes totally focused on something else – a random person walking by, a noise somewhere, even a random thought that enters his head.

I would rate my child a:

16. Her teachers have told me she is a real challenge in the classroom. Not only is her behavior a problem, but she is not reaching her academic potential because of problems with inattention, hyperactivity, fidgetiness, or distractibility.

I would rate my child a:


To help ensure the accuracy of the information that will be provided to you at the end of this quiz, please answer whether the following statements are True or False about your child.

1. My child’s moods are all over the place. He goes from being happy to angry to sad and crying so quickly that I never really know what is going on.

2. My child has a lot of anxiety. She tends to worry too much about different things or just a few things. But the worrying takes up a lot of her time.

3. I have been told that my child has a learning disorder (e.g., dyslexia, reading problems, delayed development, etc.) which requires the services of special education teachers and/or specialized classrooms.


Please complete the following general questions.

1) Child’s Name:

2) Child’s Email:

3) Child’s Age:

4) Child’s Gender:

5) Zip Code:

6) What grade is your child currently in or will be in when school resumes:

7) Please list the gender and age of all of your child’s:

Brothers

Sisters

Half/Step-Brothers

Half/Step-Sisters



Hi Thanks for completing the quiz!

Here is your quiz Score:

The result is based on a point-based system to the answers you have submitted for the questions.

Disclaimer: This quiz is not a diagnostic assessment. A mental health diagnosis can only be given by a licensed mental health professional. If you have concerns about your mental health, please speak to your doctor.

Child Contrarian

Media Recognition