ADD-ADHD Worksheet

ME, MYSELF AND I!

ADHD IS JUST ONE PART OF YOU! THERE ARE MANY THINGS ABOUT YOU THAT MAKES YOU SPECIAL! THIS IS A CHANCE FOR YOU TO TELL ABOUT YOURSELF. COMPLETE THE SENTENCES BELOW SO THEY DESCRIBE YOU!

I AM VERY GOOD AT:_____________________________________________________

THIS YEAR I HAVE GOTTEN BETTER AT:_______________________________________

MY FAVORITE SUBJECT AT SCHOOL IS:________________________________________

IF I COULD TRAVEL ANYWHERE IN THE WORLD, I WOULD LIKE TO GO TO:_____________

I LIKE TO _______________________________________________WITH MY FAMILY.

ONE OF THE BEST BOOKS I HAVE EVER READ IS:_________________________________

MY FAVORITE MEAL IS:____________________________________________________

WHEN I PLAY WITH A FRIEND, I LIKE TO:______________________________________

IF I COULD PLAN MY PERFECT DAY, I WOULD LIKE TO: MORNING____________________

AFTERNOON_________________________NIGHTTIME___________________________

I WOULD LIKE TO CHANGE SOMETHING ABOUT ME--WHAT?________________________

______________________________________________________________________

THE BEST THINGS ABOUT ME, MYSELF, AND I ARE: (1)____________________________

(2)______________________________(3)___________________________________

Top of Page

DO I REALLY DO THIS?

CHECKLIST FOR ADHD BOYS AND GIRLS ALIKE!

IF YOU KNOW HOW YOUR ADHD IS GOING TO AFFECT YOU IS THE FIRST STEP TO CONTROLLING YOUR BEHAVIOR. PUT A CHECK NEXT TO ANYTHING YOU THINK MAY DESCRIBE YOUR BEHAVIOR AND YOU CAN BEGIN TO PLAN HOW TO OVERCOME THESE PROBLEM AREAS!

_____ IT IS HARD FOR ME TO PAY ATTENTION TO MY TEACHER WHEN SHE/HE IS TALKING.

_____WHEN I SHOULD BE WORKING, I AM OFTEN THINKING "DAYDREAMING" ABOUT OTHER THINGS.

_____I HAVE TROUBLE GETTING STARTED ON MY WORK.

_____I HAVE DIFFICULTY FINISHING MY WORK WITHOUT HELP.

_____I DO THINGS WITHOUT THINKING.

_____I AM ALWAYS LOSING THINGS.

_____I AM DISORGANIZED.

_____I HAVE TROUBLE SITTING STILL.

_____MY MIND NEVER STAYS ON ONE THING AT A TIME.

_____I CANNOT DECIDE WHAT IS MORE IMPORANT AT TIMES.

_____I FORGET WHAT I AM ASKED TO DO.

_____I HAVE TROUBLE MAKING NEW FRIENDS.

_____I HAVE TROUBLE KEEPING FRIENDS.

_____I AM ALWAYS CALLED THE TROUBLEMAKER IN SCHOOL.

_____MY TEACHER SAYS I HAVE TROUBLE STAYING ON TASK.

_____IT IS HARD FOR ME TO GET READY FOR SCHOOL ON TIME IN THE MORNING.

_____BUGS, CHAIRLEGS, OTHER NOISES DISTRACT ME IN THE CLASS.

_____I LIKE TO PLAY VIDEO GAMES.

_____I HAVE TROUBLE GETTING TO SLEEP.

_____I LIKE BEING OUTDOORS.

_____I HAVE TROUBLE TELLING THE TRUTH.

_____I GET VERY ANGRY, VERY EASY.

Top of Page

Draw a picture of what you would like to do.....

Career Possibilities for you!

(Examples: fireman, police officer, accountant, lawyer, doctor,

YOU CAN BE ANYTHING YOU WANT TO BE USING YOUR A.D.H.D.!)

Top of Page

WHY DO I TAKE MEDICATION??

WHEN YOUR DOCTOR TELLS YOU THAT YOU NEED MEDICATION, HE MAY TELL YOU SOME OF THESE REASONS. YOU CHOOSE WHICH ONES WOULD BE GOOD REASONS FOR TAKING YOUR MEDICATION FOR A.D.D./A.D.H.D.

_____FINISHES MORE WORK AT SCHOOL

_____MAKES YOU SMART

_____HELPS YOU RIDE YOUR BIKE

_____BETTER PENCIL CONTROL

_____MORE RIGHT ANSWERS AT SCHOOL

_____LESS IMPULSIVE

_____SWIM A MILE

_____HELPS YOU MAKE FRIENDS

_____GIVES YOU MORE BRAIN CELLS

_____CONCENTRATE BETTER

_____MAKES YOU LIKE BROCCOLI

_____LESS ANGER FROM MOM OR DAD

_____CHASE CHICKENS

_____SHOWS KNOWLEDGE IN CLASS

WHAT YOUR MEDICATION WON’T DO!

CURE A.D.D/A.D.H.D.

IMPROVE SCORES ON APTITUDE TESTS

GET YOU BETTER SCORES ON GROUP ACHIEVEMENT TESTS

IS IT TRUE?

(1) THAT MY MEDICATION IS ADDICTIVE? NO!

(2) LEAD TO MY USING DRUGS LATER? NO!

(3) STUNT MY GROWTH, MAKE ME SHORT? NO!

(4) HELP ME CONCENTRATE? YES!

SOME POSSIBLE SIDE EFFECTS!

*DECREASED APPETITE

*TROUBLE SLEEPING

*IRRITABLE/WHINY

*SLOW WEIGHT GAIN~SKINNY!

*DIFFICULTY GETTING TO BED

*STOMACH ACHES/HEADACHES

ALTHOUGH USUALLY TEMPORARY, IF YOU SUFFER FROM ANY OF THESE SIDE EFFECTS WHILE YOUR ON MEDICATION, BE SURE TO TELL MOM OR DAD RIGHT AWAY!!

**INFORMATION PROVIDED BY THE VIRTUAL HOSPITAL AND THE IOWA HEALTH BOOK ON PSYCHIATRY**

Top of Page

Top of Page

HOME WORK ASSIGNMENT

TAKE THIS SHEET HOME TO MOM OR DAD, GRANDMA OR GRANDPA. IT IS A CONTRACT BETWEEN YOU AND YOUR PARENTS/GRANDPARENTS TO HELP IMPROVE YOUR OWN BEHAVIOR AT HOME AND MAKE THINGS NICER FOR YOU AND THEM.

BY SIGNING THIS WITH YOUR PARENTS/GRANDPARENTS, YOU AND YOUR PARENTS AGREE TO WORK TOGETHER TO IMPROVE YOUR BEHAVIOR. AFTER THIS WORKSHOP, POST THIS CONTRACT SOMEWHERE IN SIGHT SO YOU CAN BE REMINDED ABOUT THE CONTRACT.

I, ________________________, agree to work with my parents/grandparents (print student’s name)

at controlling my impulsivity. In doing so, I promise to STOP, LOOK, AND THINK, before I react.

My parents agree to help remind me to STOP, LOOK, AND THINK, so I can improve our lives. They agree to this contract by signing it too! I realize by doing this I will not be in as much trouble at home and at school, so by signing this contract and placing it in sight to constantly remind me to CONTROL MY IMPULSIVITY, I will learn to be even more special than I already am and much happier!

Working together, we can make a difference in the battle of A.D.D./A.D.H.D., and I can be a success at home, in school, in church, and even having friends.

_______________________ ________________________

Students’ signature

Date

_______________________ ________________________

Mom’s signature

Date

_______________________ ________________________

Dad’s signature

Date

Top of Page

COMPILING LISTS

LISTS CAN BE HELPFUL FOR REMEMBERING THINGS. TRY THIS ACTIVITY AND USE IT THROUGHOUT THE SUMMER EACH TIME YOU GO SOME PLACE SPECIAL, GET IN THE HABIT NOW FOR SCHOOL!

MAKE A LIST OF TEN THINGS YOU WOULD WANT TO REMEMBER TO TAKE WITH YOU THE NEXT TIME YOU GO ON A VACATION.

1.____________________________ 6.____________________________

2.____________________________ 7.____________________________

3.____________________________ 8.____________________________

4.____________________________ 9.____________________________

5.____________________________ 10.____________________________

PRETEND YOU ARE LEAVING ON THAT VACATION TOMORROW AND YOUR BEST FRIEND AGREES TO CARE FOR YOUR FAVORITE PET. WRITE DOWN 5 THINGS THAT HE/SHE NEEDS TO DO EVERY DAY FOR YOUR PET.

1._________________________________________________________________

2._________________________________________________________________

3._________________________________________________________________

4._________________________________________________________________

5._________________________________________________________________

Top of Page

DRAW YOURSELF A REMINDER!

Many children with attention problems find it helpful to draw reminders when someone gives them an oral direction or multiple tasks to complete. That way there is something to look back at later if they have forgotten what it is to be done. Here is some practive in recording directions.

YOUR PARENT TELLS YOU TO REMEMBER TO DO THREE THINGS AFTER SCHOOL: (1) FEED THE DOG, (2) PUT OUT THE TRASH, AND (3) HANG UP YOUR COAT.

DRAW YOURSELF THREE EASY PICTURES THAT WOULD REMIND YOU OF WHAT YOU NEED TO DO WHEN YOU GET HOME:

TODAY AFTER SCHOOL, INSTEAD OF GOING STRAIGHT HOME, YOU HAVE A DOCTOR’S APPOINTMENT AND BASEBALL PRACTICE. THEN YOU ARE GOING TO YOUR GRANDMOTHER’S HOUSE FOR DINNER.

DRAW YOURSELF THREE PICTURES TO REMIND YOURSELF WHERE TO GO:

Top of Page