A.D.H.D SURVEY FORM

Personal details

NAME: __________________________ AGE: ____________ GENDER: MALE/ FEMALE

Please spare a few minutes of your time to answer some questions about A.D.H.D disease.

The information you provide, including your name and age, for this survey will remain

confidential and will be used solely for research purposes only.

1. Is the full abbreviation of A.D.H.D, Attention Deficit Hyperactive Disorder?

Yes

No

2. Are there any differences between A.D.H.D and Attention Deficit Disorder?

Yes

No

3. What disorder is A.D.H.D?

Psychiatric/Mental disorder

Physical disorder

4. Is A.D.H.D genetic?

Yes

No

5. Is A.D.H.D infectious?

Yes

No

6. How many types of A.D.H.D diseases are there?

1

2

3

7. Who can be diagnosed A.D.H.D.?

Children

Adults

Elementary School Kids

All of the above

8. Is A.D.H.D different in girls from guys?

Yes

No

9. What are the symptoms of A.D.H.D?

Inattention

Impulsiveness

Hyperactive

All of the above

10. Do children and adults have the similar A.D.H.D. symptoms?

Yes

No

11. When do the symptoms for A.D.H.D normally occur?

Childhood

Old age

Adulthood

All of the above

12. What are the causes of A.D.H.D?

Brain injury

Environment exposure

Premature deliver

All of the above

13. How does A.D.H.D affect the sufferer of this disorder?

Low-self-esteem

Development of addictive disorders (e.g.drugs)

Social Anxiety

All of the above

14. Is there any cure for A.D.H.D?

Yes

No

15. Is A.D.H.D caused by bad parenting?

Yes

No