About

WEISS Parent Report

WEISS Symptom Report - Parent Report

(The code name is the first three letters of the client's first and last name. For example, John Doe, would have the following code name: JOHDOE).
Retrospective assessment of childhood symptoms:

Attentive Symptoms:

Check the appropriate box:
(0) Not at all
(1) Somewhat
(2) Pretty much
(3) Very Much
1. Fails to give close attention to details, careless mistakes
2. Difficulty sustaining attention in tasks or fun activities
3. Does not seem to listen when spoken to directly
4. Does not follow through on instructions and fails to finish work
5. Difficulty to organize tasks and activities
6. Avoids tasks that require sustained mental effort (boring)
7. Losing things
8. Easily distracted
9. Forgetful in daily activities

Hyperactive/Impulsive Symptoms:

Check the appropriate box:
(0) Not at all
(1) Somewhat
(2) Pretty much
(3) Very much
1. Fidgety or Squirms in seat
2. Leaves seat when sitting is expected
3. Feels restless
4. Difficulty in doing fun things quietly
5. Always on the go or acts as if "driven by a motor"
6. Talks excessively
7. Blurts answers before questions have been completed
8. Difficulty awaiting turn
9. Interrupting or intruding others
Check the appropriate box:
(0) Not at all
(1) Somewhat
(2) Pretty much
(3) Very much
1. Loses temper
2. Argues with adults
3. Actively defies or refuses to comply with requests or rules
4. Deliberately annoys people
5. Blames others for his or her mistakes or misbehavior
6. Touchy or easily annoyed by others
7. Angry or resentful
8. Spiteful or vindictive