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146 A p p e n d i x d Russell A. Barkley, Ph.D. ©2006 Name_______________________________________________________________ Date___________________________ Instructions Please circle the number next to each item that best describes your behavior DURING THE PAST 6 MONTHS. Barkleyâs ADHD Quick Screen Questionnaire Items: Never or Rarely Sometimes Often Very Often 1. Easily distracted 0 1 2 3 2. Have difficulty organizing tasks and activities 0 1 2 3 3. Lose things necessary for tasks or activities 0 1 2 3 4. Have difficulty awaiting my turn 0 1 2 3 5. Feel restless 0 1 2 3 6. Have difficulty engaging in leisure activities or doing fun things quietly 0 1 2 3 For Office Use: Add up the scores for each item. Enter Total Score Here _____________________