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Diagnostic Criteria* for Attention-Deficit/Hyperactivity Disorder (ADHD) |
Patient Name__________________________ Date________________Patient Age________ Evaluated by___________________________ Relationship to Patient__________________ |
| Check the applicable symptoms in each section. | |
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_____ Often does not give close attention to details or makes careless mistakes in schoolwork, work, or other activities |
_____ Often fidgets with hands or feet or squirms in seat |
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_____ Often blurts out answers before questions are completed |
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| ______ Total number of inattention items checked | _______ Total number of hyperactivity & impulsivity items checked |