What is your child’s / teenager’s name? How old are they?
Screening questionnaire · 31 questions
ADHD screening questionnaire for a child or teenager
Answer at your own pace. Your responses will then be personally analyzed by Luc MARTRENCHAR.
Personal analysisby Luc MARTRENCHAR
Written feedbackwithin 24 hours
Price€49
Did you arrive directly on the questionnaire? The complete screening includes personal analysis of your answers about your child and written feedback within 24 hours.
How to answer
- Answer the questions in order.
- Your total response should not exceed the equivalent of about four Word pages.
- Answer briefly when the question is simple and give concrete examples when they are useful.
- After payment, send your answers to martrencharluc@gmail.com in the body of an e-mail or as an attachment.
This questionnaire does not match your situation? Use the adult version.
Background and impact
Does your child generally have difficulties with attention and concentration?
In what way?
How old were they when these difficulties began?
Do these attention difficulties have a negative impact on their schoolwork or education?
Do they have a negative impact outside school, for example on relationships with other people?
Attention and organization
Do they often fail to pay attention to details?
Do they often make careless mistakes, at school or in other activities?
Do they often have difficulty sustaining attention, at school or elsewhere?
Do they often seem not to listen when other people speak to them, as if their mind is elsewhere?
Do they often fail to follow instructions or do what is asked of them?
Do they often fail to finish tasks they start?
Do they often have difficulty doing things in an organized way, for example managing time, keeping belongings in order or being on time?
Do tasks requiring sustained mental effort often feel especially difficult for them?
Do they often lose things?
Are they easily distracted by noises or other stimuli?
Do they often forget to do things?
Restlessness and impulsivity
Do they generally have difficulty staying still, seem constantly 'on the go', and/or tend to act impulsively?
In what way?
How long has this been the case?
Does this difficulty staying still and/or tendency to act impulsively have a negative impact on their schoolwork or education?
Does it have a negative impact outside school, for example on relationships with other people?
Do they often fidget in their seat or move their hands or feet?
Do they often get up in situations where they are expected to remain seated?
Do they often feel restless, run around or climb on furniture, sofas, etc.?
Do they often have difficulty being quiet during leisure activities or games?
Is it often difficult for them to remain still, for example at the cinema, in a shop or at a restaurant?
Do they often talk so much that other people have difficulty getting a chance to speak?
Do they often finish other people’s sentences or answer questions before the question has been fully asked?
Do they often have difficulty waiting their turn, for example in a queue?
Do they often interrupt other people or intrude on what others are doing?
Are your answers ready?
After purchasing the screening, send all of your answers to martrencharluc@gmail.com. You will receive written feedback within 24 hours at the latest.
Screening and diagnosis
The screening provides an estimate of how likely ADHD is and whether a full assessment is recommended. It does not, by itself, constitute an official diagnosis.
Would you rather proceed directly with a full ADHD assessment?
You can request an appointment directly without completing the screening first.
