ADHD Rating Scale
ADHD Rating Scale. Contributed by Dr. David Page. Cosmetic modifications by Dr. John Yap (Mar13/11).
ADHDRatingScaleUpdate.html
—
HTML,
62Kb
File contents
<html>
<head>
<title>ADHD Rating Scale</title>
<style type="text/css">
p.title{
text-transform: uppercase;
font-size: 16;
font-family: Arial;
font-weight: bolder;
text-align: left;
color: black;
}
p.heading{
font-size: 12;
font-family: Arial;
font-weight: bolder;
text-align: left;
vertical-align: top;
color: black;
}
p.normaltext{
font-size: 12;
font-family: Arial;
font-weight: normal;
text-align: left;
vertical-align: top;
color: black;
}
td.heading1{
font-size: 12;
font-family: Arial;
font-weight: bold;
text-align: left;
vertical-align: top;
color: white;
background-color:black ;
border-width: 1;
}
td.QuestionHeading{
font-size: 12;
font-family: Arial;
font-weight: bold;
text-align: left;
vertical-align: top;
color: white;
background-color: #505050;
border-width: 1;
}
td.AnswerHeading{
font-size: 12;
font-family: Arial;
font-weight: bold;
text-align: center;
vertical-align: top;
color: white;
background-color: #505050;
border-width: 1;
}
tr.odd{
background-color: #ffffff;
}
tr.even{
background-color: #dddddd;
}
td.question{
font-size: 12;
font-family: Arial;
font-weight: normal;
text-align: left;
vertical-align: top;
color: black;
border-width: 1;
}
td.answer{
font-size: 12;
font-family: Arial;
font-weight: normal;
text-align: center;
vertical-align: middle;
color: black;
border-width: 1;
}
td.normaltext{
width: 100%;
font-size: 12;
font-family: Arial;
font-weight: normal;
text-align: left;
vertical-align: top;
color: black;
background-color: white;
border-width: 0;
}
input.formtext{
width: 100%;
height: 100%;
font-size: 12;
font-family: Arial;
font-weight: normal;
text-align: left;
vertical-align: top;
color: black;
background-color: white;
border-width: 1;
border-style: solid;
}
textarea.formtext{
width: 100%;
height: auto;
font-size: 12;
font-family: Arial;
font-weight: normal;
text-align: left;
vertical-align: top;
color: black;
background-color: white;
border-width: 1;
border-style: solid;
}
</style>
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background: transparent;
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textarea.noborder {
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background: transparent;
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</style>
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function TotalScoreEven(){
var k = 0;
k += getCheckedValue(document.FormName.P1);
var l = 0;
l += getCheckedValue(document.FormName.P3);
var n = 0;
n += getCheckedValue(document.FormName.P2);
var j = 0;
j += getCheckedValue(document.FormName.Q2);
j += getCheckedValue(document.FormName.Q4);
j += getCheckedValue(document.FormName.Q6);
j += getCheckedValue(document.FormName.Q8);
j += getCheckedValue(document.FormName.Q10);
j += getCheckedValue(document.FormName.Q12);
j += getCheckedValue(document.FormName.Q14);
j += getCheckedValue(document.FormName.Q16);
j += getCheckedValue(document.FormName.Q18);
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</head>
<body onload="passAge();passGender();">
<form method="post" action="" name="FormName">
<p class="title">
ADHD Rating Scale
</p>
<div name="demographics">
<table width="100%">
<tr>
<td class="heading1" width=25%>Patient name</td>
<td class="formtext"><input class="formtext" name="PatientName" type="text" oscarDB=patient_name>
</tr>
<tr>
<td class="heading1">Date:</td>
<td class="formtext"><input class="formtext" name="TodaysDate" type="text" oscarDB=today>
</tr>
<tr>
<td class="heading1">Age:</td>
<td class="formtext"><input class="formtext" name="Age" id="Age" type="text" oscarDB=age>
</tr>
<tr>
<td class="heading1">Sex:</td>
<td class="formtext"><input class="formtext" name="Gender" id="Gender" type="text" oscarDB=sex>
</tr>
</table>
</div>
<br>
<table>
<td class="question"><p class="heading">Home Version</p></td>
<td class="answer"><input type="radio" name="P2" value="1"checked></td>
<td class="question"><p class="heading">School Version</p></td>
<td class="answer"><input type="radio" name="P2" value="2"></td>
</table>
<div name="Questionnaire">
<table width="100%">
<tr>
<td class="QuestionHeading" width=60%></u></td>
<td class="AnswerHeading" width=10%>Never or rarely (0)</td>
<td class="AnswerHeading" width=10%>Sometimes (1)</td>
<td class="AnswerHeading" width=10%>Often (2)</td>
<td class="AnswerHeading" width=10%>Very often (3) </td>
</tr>
<tr class="odd">
<td class="question"><p class="heading">1. Fails to give close attention to details or makes careless mistakes in schoolwork.</p></td>
<td class="answer"><input type="radio" name="Q1" value="0"></td>
<td class="answer"><input type="radio" name="Q1" value="1"></td>
<td class="answer"><input type="radio" name="Q1" value="2"></td>
<td class="answer"><input type="radio" name="Q1" value="3"></td>
</tr>
<tr class="even">
<td class="question"><p class="heading">2. Fidgets with hands or feet or squirms in seat.</p></td>
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<td class="answer"><input type="radio" name="Q2" value="1"></td>
<td class="answer"><input type="radio" name="Q2" value="2"></td>
<td class="answer"><input type="radio" name="Q2" value="3"></td>
</tr>
<tr class="odd">
<td class="question"><p class="heading">3. Has difficulty sustaining attention in tasks or play activities.</p></td>
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<td class="answer"><input type="radio" name="Q3" value="1"></td>
<td class="answer"><input type="radio" name="Q3" value="2"></td>
<td class="answer"><input type="radio" name="Q3" value="3"></td>
</tr>
<tr class="even">
<td class="question"><p class="heading">4. Leaves seat in classroom or in other situations in which remaining seated is expected.</p></td>
<td class="answer"><input type="radio" name="Q4" value="0"></td>
<td class="answer"><input type="radio" name="Q4" value="1"></td>
<td class="answer"><input type="radio" name="Q4" value="2"></td>
<td class="answer"><input type="radio" name="Q4" value="3"></td>
</tr>
<tr class="odd">
<td class="question"><p class="heading">5. Does not seem to listen when spoken to directly.</p></td>
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<td class="answer"><input type="radio" name="Q5" value="1"></td>
<td class="answer"><input type="radio" name="Q5" value="2"></td>
<td class="answer"><input type="radio" name="Q5" value="3"></td>
</tr>
<tr class="even">
<td class="question"><p class="heading">6. Runs about or climbs excessively in situations in which it is inappropriate.</p></td>
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<td class="answer"><input type="radio" name="Q6" value="1"></td>
<td class="answer"><input type="radio" name="Q6" value="2"></td>
<td class="answer"><input type="radio" name="Q6" value="3"></td>
</tr>
<tr class="odd">
<td class="question"><p class="heading">7. does not follow through on instructions and fails to finish work.</p></td>
<td class="answer"><input type="radio" name="Q7" value="0"></td>
<td class="answer"><input type="radio" name="Q7" value="1"></td>
<td class="answer"><input type="radio" name="Q7" value="2"></td>
<td class="answer"><input type="radio" name="Q7" value="3"></td>
</tr>
<tr class="even">
<td class="question"><p class="heading">8. Has difficulty playing or engaging in leisure activities quietly.</p></td>
<td class="answer"><input type="radio" name="Q8" value="0"></td>
<td class="answer"><input type="radio" name="Q8" value="1"></td>
<td class="answer"><input type="radio" name="Q8" value="2"></td>
<td class="answer"><input type="radio" name="Q8" value="3"></td>
</tr>
<tr class="odd">
<td class="question"><p class="heading">9. Has difficulty organizing tasks and activities.</p></td>
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<td class="question"><p class="heading">10. Is "on the go" or acts as if "driven by a motor".</p></td>
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<tr class="odd">
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<tr class="even">
<td class="question"><p class="heading">12. Talks excessively.</p></td>
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<tr class="odd">
<td class="question"><p class="heading">13. Loses things necessary for tasks or activities.</p></td>
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<tr class="even">
<td class="question"><p class="heading">14. Blurts out answers before questions have been completed.</p></td>
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<td class="question"><p class="heading">15. Is easily distracted.</p></td>
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<tr class="even">
<td class="question"><p class="heading">16. Has difficulty awaiting turn.</p></td>
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<br>
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<tr class="odd">
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<td class="question"><p class="heading">Age 5-7 yr</p></td>
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<td class="question"><p class="heading">Age 8-10 yr</p></td>
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<td class="question"><p class="heading">Male</p></td>
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<br>
<div class="DoNotPrint">
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<tr>
<td><input type="button" onclick="TotalScoreOdd()" value="Calculate Total Score for Inattention"></td>
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</tr>
<tr>
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<tr>
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<td></td>
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</table>
</div>
<br>
<div name="Interpretation" class="DoNotPrint">
<table width=20%>
<tr>
<td class="heading1" colspan="2">Percentile for Inattention</td>
</tr>
<tr id="<90%">
<td> <90%</td>
</tr>
<tr id="90%-93%">
<td>90%-93%</td>
</tr>
<tr id="93%-98%">
<td>93%-98%</td>
</tr>
<tr id=">98%">
<td> >98%</td>
</tr>
<tr>
<td class="heading1" colspan="2">Percentile for Hyperactivity</td>
</tr>
<tr id="hyper<90%">
<td> <90%</td>
</tr>
<tr id="hyper90%-93%">
<td>90%-93%</td>
</tr>
<tr id="hyper93%-98%">
<td>93%-98%</td>
</tr>
<tr id="hyper>98%">
<td> >98%</td>
</tr>
</table>
</div>
<div name="DSM" class="DoNotPrint">
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<td class="heading1" colspan="2">Diagnostic criteria for ADHD</td>
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<td> A. Six or more of each Inattention Symptoms (odd numbers) and/or Hyperactivity-Impulsivity symptoms (even numbers) present for 6 months (rated "often" or "very often")</td>
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<td>B. Some hyperactive-impulsive or inattentive symptoms that caused impairment were present before age 7 yrs.</td>
</tr>
<tr >
<td>C. Some impairment from the symptoms is present in two or more settings(eg school and home) </td>
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<tr >
<td>D. There must be clear evidence of clinically significant impairment in social, academic, or occupational functioning. </td>
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<td>E.The symptoms are not part of another mental disorder (eg depression or personality disorder). </td>
</tr>
<tr >
<td>Codes: </td>
</tr>
<tr >
<td><b>314.01 Attention-Deficit/Hyperactivity Disorder, Combined Type </b> </td>
</tr>
<tr >
<td><b>314.00 Attention-Deficit/Hyperactivity Disorder, Predominantly Inattentive Type</b> </td>
</tr>
<tr >
<td><b>314.01 Attention-Deficit/Hyperactivity Disorder, Predominantly Hyperactive-Impulsive Type</b> </td>
</tr>
</table>
</div>
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