Child Name
Item
Child Name
text
C1299487 (UMLS CUI [1])
Age
Item
Age
text
C0001779 (UMLS CUI [1])
Grade
Item
Grade
text
C3244287 (UMLS CUI [1])
Item
Sex
text
C0079399 (UMLS CUI [1])
Today's Date
Item
Today's Date
date
C1549507 (UMLS CUI [1])
Your Name
Item
Your Name
text
C0027365 (UMLS CUI [1])
Relationship to child
Item
Relationship to child
text
C0021797 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
Item
1. Interrupts others (e.g., butts into conversations or games)
integer
C1820712 (UMLS CUI [1])
Code List
1. Interrupts others (e.g., butts into conversations or games)
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
2. Talks too much
integer
C1820711 (UMLS CUI [1])
Code List
2. Talks too much
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
3. Fidgets with hands or feet or squirms in seat
integer
C0424235 (UMLS CUI [1])
C0424234 (UMLS CUI [2])
Code List
3. Fidgets with hands or feet or squirms in seat
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
4. Blurts out answers before questions have been finished
integer
C1706817 (UMLS CUI [1,1])
C4018905 (UMLS CUI [1,2])
Code List
4. Blurts out answers before questions have been finished
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
5. Has difficulty playing or engaging in leisure activities quietly
integer
C1820704 (UMLS CUI [1])
Code List
5. Has difficulty playing or engaging in leisure activities quietly
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
6. Leaves seat in situations in which remaining seated is expected
integer
C1706081 (UMLS CUI [1,1])
C0179847 (UMLS CUI [1,2])
C0233522 (UMLS CUI [1,3])
Code List
6. Leaves seat in situations in which remaining seated is expected
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
7. Has difficulty awaiting turn
integer
C1820700 (UMLS CUI [1])
Code List
7. Has difficulty awaiting turn
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
8. Is 'on the go' or acts as if 'driven by a motor'
integer
C3842459 (UMLS CUI [1])
Code List
8. Is 'on the go' or acts as if 'driven by a motor'
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
9. Runs about or climbs excessively in situations in which it is not appropriate
integer
C0235012 (UMLS CUI [1,1])
C0233522 (UMLS CUI [1,2])
Code List
9. Runs about or climbs excessively in situations in which it is not appropriate
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
10. How much of a problem do the above behaviours (items 1 to 9) cause this child in school?
text
C0580094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0004927 (UMLS CUI [1,3])
Code List
10. How much of a problem do the above behaviours (items 1 to 9) cause this child in school?
CL Item
No problems (No problems)
CL Item
Mild problems (Mild problems)
CL Item
Moderate problems (Moderate problems)
CL Item
Severe problems (Severe problems)
CL Item
Very severe problems (Very severe problems)
Item
11. Is easily distracted
integer
C0424102 (UMLS CUI [1])
Code List
11. Is easily distracted
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
12. Does not seem to listen when spoken to directly
integer
C4716255 (UMLS CUI [1])
Code List
12. Does not seem to listen when spoken to directly
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
13. Fails to give close attention to details or makes careless mistakes in schoolwork or other activities
integer
C1821931 (UMLS CUI [1])
C1820693 (UMLS CUI [2])
Code List
13. Fails to give close attention to details or makes careless mistakes in schoolwork or other activities
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
14. Does not follow through on instructions and fails to finish homework or chores (not because of stubborness or oppositional behaviour or failure to understand instructions)
integer
C3175109 (UMLS CUI [1])
Code List
14. Does not follow through on instructions and fails to finish homework or chores (not because of stubborness or oppositional behaviour or failure to understand instructions)
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
15. Has difficulty sustaining attention in tasks or play activities
integer
C0424099 (UMLS CUI [1])
Code List
15. Has difficulty sustaining attention in tasks or play activities
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
16. Loses things that are needed for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
integer
C2702624 (UMLS CUI [1])
Code List
16. Loses things that are needed for tasks or activities (e.g., toys, school assignments, pencils, books, or tools)
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
17. Avoids, dislikes, or is reluctant to take part in tasks that require sustained mental effort (such as schoolwork or homework)
integer
C0178494 (UMLS CUI [1,1])
C3540678 (UMLS CUI [1,2])
C0589099 (UMLS CUI [1,3])
C0870431 (UMLS CUI [2,1])
C3540678 (UMLS CUI [2,2])
C0589099 (UMLS CUI [2,3])
C2347948 (UMLS CUI [3,1])
C3540678 (UMLS CUI [3,2])
C0589099 (UMLS CUI [3,3])
Code List
17. Avoids, dislikes, or is reluctant to take part in tasks that require sustained mental effort (such as schoolwork or homework)
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
18. Has difficulty organizing tasks and activities
integer
C1820701 (UMLS CUI [1])
C1299586 (UMLS CUI [2,1])
C1300196 (UMLS CUI [2,2])
C0441655 (UMLS CUI [2,3])
Code List
18. Has difficulty organizing tasks and activities
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
19. Is forgetful in daily activities
integer
C0542476 (UMLS CUI [1,1])
C0001288 (UMLS CUI [1,2])
Code List
19. Is forgetful in daily activities
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
20. How much of a problem do the above behaviours (items 11 to 20) cause this child in school?
text
C0580094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0004927 (UMLS CUI [1,3])
Code List
20. How much of a problem do the above behaviours (items 11 to 20) cause this child in school?
CL Item
No problems (No problems)
CL Item
Mild problems (Mild problems)
CL Item
Moderate problems (Moderate problems)
CL Item
Severe problems (Severe problems)
CL Item
Very severe problems (Very severe problems)
Item
21. Argues with adults
integer
C0001675 (UMLS CUI [1,1])
C0680226 (UMLS CUI [1,2])
Code List
21. Argues with adults
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
22. Is spiteful or vindictive
integer
C0679111 (UMLS CUI [1])
C0871267 (UMLS CUI [2])
Code List
22. Is spiteful or vindictive
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
23. Blames others for his or her mistakes or misbehaviour
integer
C1822304 (UMLS CUI [1])
Code List
23. Blames others for his or her mistakes or misbehaviour
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
24. Actively defies or refuses to comply with or obey adults' requests or rules
integer
C0457432 (UMLS CUI [1,1])
C1272683 (UMLS CUI [1,2])
Code List
24. Actively defies or refuses to comply with or obey adults' requests or rules
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
25. Is angry and resentful
integer
C0002957 (UMLS CUI [1,1])
C0679111 (UMLS CUI [1,2])
Code List
25. Is angry and resentful
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
26. Is touchy or easily annoyed by others
integer
C3831378 (UMLS CUI [1])
Code List
26. Is touchy or easily annoyed by others
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
27. Loses temper
integer
C0424331 (UMLS CUI [1])
Code List
27. Loses temper
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
28. Deliberately annoys people
integer
C2700617 (UMLS CUI [1,1])
C1283828 (UMLS CUI [1,2])
C0021797 (UMLS CUI [1,3])
Code List
28. Deliberately annoys people
CL Item
Much less than others (0)
CL Item
Less than others (1)
CL Item
Same as others (2)
CL Item
More than others (3)
CL Item
Much more than others (4)
Item
29. How much of a problem do any of the above behaviours (items 21 to 29) cause this child in school?
text
C0580094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0004927 (UMLS CUI [1,3])
Code List
29. How much of a problem do any of the above behaviours (items 21 to 29) cause this child in school?
CL Item
No problems (No problems)
CL Item
Mild problems (Mild problems)
CL Item
Moderate problems (Moderate problems)
CL Item
Severe problems (Severe problems)
CL Item
Very severe problems (Very severe problems)