Concentration Assessment

To what extent does the following statement apply to you?

I find myself doodling when taking class notes.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I blurt out answers to questions in class before I think them through.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

It is hard for me to resume working on a task after I am interrupted.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I look at other things in the classroom when my teacher <br>writes something on the chalkboard.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I misplace personal objects.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I need to borrow a pencil or paper from other students.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I overlook details when working on an assignment.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

My performance in school is inconsistent from one day to the next.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I avoid activities that require sitting still.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I get bored easily.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I pick up and drop hobbies and interests.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

It is hard for me to listen for long periods of time in class.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I go from one assignment to another without completing them.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I have difficulty planning ahead.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I stop working on an assignment because I start thinking about other things.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I avoid activities that require a lot of effort.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

My study place is disorganized.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I am fidgety when I don't have something specific to do.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I lose things that I need for school.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I give up quickly when I have difficulty with an assignment.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I make careless mistakes when I take a test.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I leave my homework or assignments at home.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I find myself doing the same thing over and over <br>because I have lost track of what of I have done.(Required)

A lot like me

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To what extent does the following statement apply to you?

I have difficulty focusing on what the teacher is <br>saying when other students are talking.(Required)

A lot like me

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To what extent does the following statement apply to you?

I forget things I must do.(Required)

A lot like me

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To what extent does the following statement apply to you?

I interrupt others when they are speaking.(Required)

A lot like me

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To what extent does the following statement apply to you?

I am easily distracted by irrelevant sights and sounds in the classroom.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I have difficulty tuning out my environment when I have to really focus.(Required)

A lot like me

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To what extent does the following statement apply to you?

I find myself surfing the Internet when doing an assignment online.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

My accuracy decreases as I work on a task.(Required)

A lot like me

Somewhat like me

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To what extent does the following statement apply to you?

I don't follow the directions for an assignment.(Required)

A lot like me

Somewhat like me

Not like me

To what extent does the following statement apply to you?

I jump from topic to topic in a conversation.(Required)

A lot like me

Somewhat like me

Not like me

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