survey monkey

"College administrators, staff and faculty are not aware of the struggles of college students with ADHD"

1. When interacting with a student(s), which of one of the following characteristic(s) have you noticed on a student(s) when he/she is required to follow through on instructions to ensure he/she finish a task(s) or meets obligations? Tick accordingly

Does things that are muddled up together without

completing them

Difficulty completing tasks once the novelty has worn off

Difficulty completing administrative tasks

Difficultly following instructions from a manual

Needing a time limit to complete tasks

Other (please specify)

2. Among your students, tick/mark one or more of the following characteristics that you have observed when a student(s) is required to complete classwork assignments or other task(s) in the classroom?

Makes careless mistakes

Works too quickly and therefore making mistakes

Works slowly to avoid mistakes

Difficulty working in a detailed way

Does not read instructions carefully

Too much time needed to complete detailed tasks

Gets easily bogged down by details

Other (please specify)

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3. Among the behaviors stated below, tick/mark one or more behavior you have observed on a student(s) when he/she is required to sustain attention when completing task(s)?

Not able to keep attention on tasks for long

Finds it difficult to watch a film or read a book through to the

end.

Quickly becomes bored with things

Quickly distracted by own thoughts or associations

Asks questions about subjects that have already been

discussed

Other (please specify)

4. In your work, which one of the following characteristic(s) have you ever noted on a student(s) when he/she is spoken to directly? Tick/mark accordingly

Dreamy or preoccupied

Often changing the subject of the conversation

Afterwards, not knowing what a conversation was

about

Difficulty concentrating on a conversation

Others saying that his/her thoughts are somewhere else

Other (please specify)

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5. Which of the following characteristic(s) does a student(s) portray when he/she is required to organize classwork activities or other tasks in the school?Tick/mark accordingly

Difficulty with planning activities of daily life

Not able to use an agenda or diary consistently

Planning too many tasks or non-efficient planning

Having a disorganized working place

Inflexible because of the need to keep to schedules

Needing other people to structure things

Having a poor sense of time

Regularly booking things to take place at the same

time (double-booking)

Creating schedules but not using them

Other (please specify)

6. Which of the following behavior(s) have you noted on a student(s) when he/she is required to complete a task(s) or classwork that requires sustained mental effort? Tick/mark accordingly

Do the easiest or of most interesting things first of all Often postpone boring or difficult tasks

Avoid monotonous work, such as administration Other (please specify)

Postpone tasks so that deadlines are missed

Do not like reading due to mental effort

Avoidance of tasks that require a lot of concentration

7. Which of the following behavior does a student(s) portray when there is external stimuli nearby? Tick/mark accordingly

Difficulty shutting off from external stimuli

Easily distracted by noises or events

After being distracted, difficult to pick up the thread again

Difficulty in filtering and/or selecting information

Easily distracted by the conversations of others

Other (please specify)

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8. How does your student(s) keep or take care of things/tools which are necessary for completing various classwork/school activities? Tick/mark accordingly

Mislays agenda, apparatus, books and manuals

Often leaves things behind

Loses papers for work

Gets in a panic if other people move things around

Loses notes, lists or contact details

Stores things away in the wrong place

Loses a lot of time searching for things

Other (please specify)

9. How does the student(s) cope with the daily activities? Tick/mark one or more of the following manner.

Forgets appointments or other obligations	Rigid use of lists to make sure things aren’t forgotten
Forgets notebook, pencils, manual, agenda etc	Needs frequent reminders for appointment
Returning home to fetch forgotten things	Forgets to keep or look at daily agenda
Other (please specify)

10. How does the student(s) behave during lectures, meetings or gatherings? Tick/mark accordingly from the list below.

Difficulty sitting still	Fiddling with hair or biting nails
Tapping with a pen or playing with something	Able to control restlessness, but feels stressed as a
		result
Fidgets with the legs
Other (please specify)

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11. How does the student(s) reacts to a situation(s) that requires a few hours of remaining seated?

Tick/mark accordingly.

Avoids gatherings such as symposiums, lectures, religious services etc which requires some moment of remaining seated

Prefers to walk around rather than sit

Never sits still for long, always moving around

Other (please specify)

Makes excuses in order to be able to walk around

Stressed owing to the difficulty of sitting stil

12. Does the student often feel restless

Yes

No

13. Does the student(s) often find it difficult to engage in leisure activities quietly?

Yes

No

14. Does the student(s) often talk excessively?

Yes

No

Other (please specify)

15. Does the student(s) often give the answer before questions have been completed?

Yes

No

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