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Child ADHD Daily Symptom Tracker
Date:
Inattentiveness:
Difficulty sustaining focus – for example, the child may seem lost in thought or easily distracted from tasks.
Present
Select Severity (1-5; 5 is most severe)
1
2
3
4
5
Hyperactivity:
Excessive movement or fidgeting – for example, the child may have difficulty sitting still or may constantly be in motion.
Present
Select Severity (1-5; 5 is most severe)
1
2
3
4
5
Emotional Regulation Issues:
Difficulty managing emotions – for example, the child may have sudden outbursts or rapid mood swings with little provocation.
Present
Select Severity (1-5; 5 is most severe)
1
2
3
4
5
Disruptive Behaviors at Home:
Behaviors that disturb the household routine – for example, the child may refuse to follow instructions or engage in frequent arguments.
Present
Select Severity (1-5; 5 is most severe)
1
2
3
4
5
Disruptive Behaviors at School:
Behaviors that interrupt classroom activities – for example, the child may talk out of turn or otherwise disrupt the teacher’s instruction.
Present
Select Severity (1-5; 5 is most severe)
1
2
3
4
5
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