Copeland Symptom List - The MPC

Behavioral - Copeland ADD/ADHD

Attention Deficit Hyperactivity Disorder (ADHD) & Undifferentiated Attention Deficit Disorder (ADD)

This checklist was developed from the experience of many specialists in the field of Attention Disorders and Hyperactivity. It is designed to help determine whether you or someone you are rating, has ADD/ADHD, to what agree, and if so, in which area(s) difficulties are experienced. Please mark all statements. Please be honest. The purpose of this questionnaire is to help you (or someone else), not to put him/her in a bad light.






I. INATTENTION/DISTRACTIBILITY


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much


Not at allJust a littlePretty muchVery much

II. IMPULSIVITY


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

III. ACTIVITY LEVEL PROBLEMS


A. Over activity/Hyperactivity



Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

B. Underactivity



Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

IV. NON-COMPLIANCE


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

V. UNDERACHIEVEMENT


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

VI. EMOTIONAL DIFFICULTIES


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

VII. POOR PEER RELATIONS


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

VIII. IMPAIRED FAMILY RELATIONSHIPS


Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much

Not at allJust a littlePretty muchVery much