Form - Child ADHD Symptoms- SENCO/ teacher

Child's name

First

Name, position, school - person completing the form*

Please let us know of any concerns you have about this child's difficulties. How long have these difficulties been apparent?*

Does the child often fail to give close attention to detail or make careless errors at school ?*

Yes
No

Please give details

Does the child often fail to sustain attention in tasks or play activities at school ?*

Yes
No

Please give details

Does the child often appear not to listen to what is being said to them at school?

Yes
No

Please give details

Does the child often fail to follow through on instructions or complete tasks at school?*

Yes
No

Please give details

Does the child often appear to have difficulties organising tasks or activities school?*

Yes
No

Please give details

Does the child often avoid or strongly dislike tasks requiring sustained mental effort?*

Yes
No

Please give details

Does the child often lose things they need at school?*

Yes
No

Please give details*

Does the child often appear distracted by external stimuli?*

Yes
No

Please give details

Does the child often appear forgetful during daily activities at school*

Yes
No

Please give details

Does the child often fidget with hands or feet or squirm in seat at school?*

Yes
No

Please give details

Does the child often struggle to stay in their seat at school?*

Yes
No

Please give details

Does the child often run or climb excessively in inappropriate situations?*

Yes
No

Please give details

Does the child often appear unduly noisy in play or have difficulties engaging quietly with leisure activities?*

Yes
No

Please give details

Does the child often show excessive motor activity and have trouble switching off or calming down?*

Yes
No

Please give details

Does the child often blurt out answers before questions have been completed?*

Yes
No

Please give details

Does the child often fail to wait in lines or wait their turn in games or group situations?*

Yes
No

Please give details

Does the child often interrupt or intrude on others?*

Yes
No

Please give details

Does the child often talk excessively without appropriate response to social constraints?*

Yes
No

Are there any other issues you may have noticed, such as difficulties with friendship, mood, anxiety or emotional difficulties?*

Child ADHD Symptoms- SENCO/teacher form

Child ADHD Symptoms - SENCO / teacher form

Form – Child ADHD Symptoms- SENCO/ teacher

Child ADHD Symptoms- SENCO/teacher form

Child ADHD Symptoms - SENCO / teacher form