Child's Name/lD: Age:

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Date:
Birth / /
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Gender: M F Grade: Parent's Name/lD Admin Date: / /
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Conduct Disorder Oppositional Defiant Disorder

Required Score Requ¡red Score
DSM-IV.TR Item Item ÜSM.IV.TR Item Item
C riterion Numbér Score May be lndicated (/) Criter¡on Number May be lndicated (/)
Score
lndicated lndicated
A1 l6 1 23
30 1 23 A1 14 23
A3 27 12 3 A2 102 23
A4 39 123
41 12 3 AJ 94 23 a
A6 96 12 3 ,1

A7 11 12 3 A4 tro 23
AB 78 12 3 . ,'l
AO 65 12 3 A5 21 23 o
l
A10 B9 'l 2 3 N
All 56 23 A6 73 23 t

412 58 12 3 z
413 91 1 23 A7 4B 1 23 -d
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414 /o 12 3 E§
415 6 1 23 AB 57 1 23 '-§
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Total Symptom Count Total Symptom Count zY
{sum all checkmarks) (8um .ll checkmarts)
or
u criteria met if Total m Count > 3 tr ptom cr¡teria met if Total Count > 4
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Impairment
lnstructions: ü-i
For each item listed ¡n the lmpairment table below, refer to the Scoring Grid and circle the score.
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lmpairment
Not true at all/ Just a little truei Pretty much true/ Very much true/
Item (English Translation) BX
never occasionally often very often
106. Your child's problems seriously affect schoolwork or grades. 0 I 2 3 ác
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107. Your child's problems seriously affect friendships and relationships. 0 1 2 3 <*
108. Your child's problems seriously affect home life. 0 1 2 a
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Conners 3 ADHD lndex =(

lnstruct¡ons:
l. For each it€m listed below, transfer the circled score from the Scoring Grid ¡nto the ltem Score row. aó
2. Transpose each score by following the Transposing Rule and enter the score into each Transposed Score box. ;5
3 Sum the transposed scores to obta¡n the Total Transposed Score, then c¡rcle this score in the probability Score table.
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4. Determine the probability of a classification of ADHD by circling the conesponding Probability score. @a
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Item Item Itém ¡tém
47 84 88 lol 104 *o
Item Score

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2
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2,3
ü ü ü ü
2 3 2
.,
2 ¿,3 0,
.,
1 2,3 2 2
a
l+l
Transposing Rule ü ü ü ü ü ü ü ü ü ¡¡r
1 2 0 2 0 1 1 1 2 2 1 I 2 t-
TranSpo3gd Scors ¿
Total ffiil
Transposed
Score

Conners 3 ADHD lndex Probability Score

Total Tranapo$d Score 012 I 10 11 12 13 14 i i:, "iii 17 I '19 1 :¿,.
Probabll¡ty (%) 11 29 41 94 97 9B 99 r:t ,,ir frg SS 99 9:l