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Research Survey

ADHD-SSVS Research Participation Survey for Educators

How exciting! We've developed the ADHD-SSVS, the very first assessment designed to understand ADHD symptoms in students who learn online. Right now, it's in the early stages of field research, and we would be thrilled if you could be a part of it. Your contribution to this process is incredibly valuable!

To help us gather important data about the students that teachers complete the ADHD-SSVS for, we kindly request you to complete the following survey. Please note that the survey is exclusively for educators.

Once our research is complete, we'll be working hard to get the ADHD-SSVS officially approved for clinical use. With your input, we can turn it into a professional tool for educators that can be used for free and widely recognized in assessing ADHD and related symptoms.

Your participation in this survey and your support in improving education for students with ADHD are highly appreciated!

1. 
Student's Age

2. 
Student's Grade

3. 
Student's Gender

4. 
Student's Score in Attention Difficulties on the ADHD-SSVS (the screening scale you just completed above)

5. 
Student's Score in Hyperactive/Impulsive Behavior on the ADHD-SSVS

6. 
Student's Score in Executive Functioning Challenges on the ADHD-SSVS

7. 
Student's Total Score on the ADHD-SSVS

8. 
Which is accurate about this student?

9. 
Does this student have another diagnosis that could cause symptoms of ADHD? If yes, please list the diagnosis.

10. 
Does this student take medication for their symptoms of ADHD.

11. 
Have rating scales to assess for ADHD been completed for this student within the last three years such as current editions of the Conners or the Vanderbilt? If so, which scales were completed and by whom?

12. 
If formal scales were administered within the last three years to assess ADHD for this student, what kind of results were found? For instance did they have elevated scores in inattention or hyperactivity? Please explain.

13. 
What is your relationship to this student?

14. 
What is your geographic location? City, State, Country, etc.

15. 
What grade level do you teach if applicable?

16. 
What subject do you teach if applicable?

17. 
What is your role as an educator? Please provide your title and one to two sentences about what you do.

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