Conners’ Parent Rating Scale ~ Revised (S) By C. Keith Conners, Ph.D, Child’s Name: Gender: MF (Circle One) Birthdate: tot Age: School Grade: ‘Month Day Year Parents Name, Today's Dat yt Month Day Year structions: Below are a number of common problems that children have, Please rate each item according to your child's behavior inthe last month, For each item, ask yourself, “How much of a problem has this been in the last month?” and circle the best answer for each one. If none, not at al, seldom, or very infrequently, you would circle 0. If very much true, ot it occurs very often or frequently, you would circle 3. You would circle 1 or2 for ratings in between. Please respond to each item. f NOTTRUE-] ETA] PREY] VERY MUCH ataLL | ume | muck | "TRUE rows | TRUE | TRUE | (very, Sion | osesonaiy | conen Que | Vary Fagus ai Ty Tnatontve, easily disracted a 1 2 A [BAngry and resentful a 1 2 5 3. Difficulty doing or completing homework a i 2 3 Ts always “onthe go” o acts as if driven bya molar a 1 2 3 5. Short altention span ° H 2 3 6.~Aegues with adults, of 2 3 [77 Fidgets with hands or Yet or SguiensTnseat 3 T a 3 3. Fails to complete assignments o 1 2 3 9-iard to contro in malls or while proeery Sapping @ [3 3 TO. Messy or disorganized at home or school am ee ee 5 Ti. Loses temper 0 1 z 3 12. Needs close supervision to get rough asignmens 3 1 z 5 TS. Only attends if is something she is very interested o 1 a i Ta. Runs about or elmbs excessively in stations where it ° 1 7 3 inappropriate 15, Distacbiliy oF afetion span a probly a 7 z i T6._iable 0 1 z 3 77. Avoids, expresses reluctance abut, ores duties 9 1 z 3 engoging in tasks that require sustained mental effort (sich a8 schootwor or hornewor) TS. Restless inthe “squiomy” see 7 [7 z A 19.Ges distracted when given insrutions todo somelhing oft 2 3 20.-Actively defies o refuses to comply with aduls" request 3 i 2 3 21, Has trouble concentrating in class of] 1 2 T 3 32s difculty waiting in ines or awatng tani gxmes OF 3 i 2 3 group stations 33, Leaves seat in lasavoom or in ohersuaions a which 7 i F 3 remaining seated i expected 24, Deliberately does things that annoy offer people a i zo 35. Does nt fllow trough on instructions and fils Rash a 1 3 f Schooler, chores or dies the workplace (not de Gopostional behavior of falar to understand insstions)_——_ L 536, Has difficulty playing o engaging in lesure activites quietly [0 i z z 27. Easily frustrated in. effors oO 1 2 3 Copyright ©1997, Muli-tleath Systems Ine. Allvights reserved. tthe USA, 908 Niagara Falls Bivd, Nowh Tonawanda, NY 12120- 2060, (808) 436-3003, In Canal, 3770 Victoria Park Avenue, Toronto, ON MH 3M, (800) 268-601 "International, + 1416488 2627. Fas + 1-416-492-3343 or 888-540-4184,