AIM-C: ADHD Impact Module - Child™

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Content from the HealthActCHQ Manuals (including norms, proprietary scoring algorithms, weights etc. and related syntax) or items from the surveys themselves may not be included in any appendices, reports, manuscripts or reproduced without expressed written permission from HealthActCHQ.

The ADHD Impact Module - Child™ (AIM-C) is comprised of two "core" multi-item scales, the Child Scale and the Home Scale, specifically constructed to capture the impact of ADHD on the child and the quality of life at home. It includes nine descriptor items to assess treatment status, history and other demographic information.

The Child Scale consists of eight items that measure the well-being of the child, for example:

  • Child does well following through with homework
  • Feedback from teachers has been positive
  • My child seems comfortable with how things are going

The Home Scale consists of ten items that assess the impact of their child's condition on the family/parent, including:

  • My child's ADHD limits what we can do as a family
  • My child's ADHD has added stress to our home life
  • I feel tired and worn out

Thinking about your child's ADHD during the past 2 weeks, how much does each statement describe your child?

  • My child did well following through with chores and homework on his/her own
  • My child seemed to get along with kids his/her age
  • Feedback from teachers and parents about my child with ADHD has been generally positive
  • My child was able to deal well with everyday hassles and frustrations with friends and siblings
  • My child behaved well in public places like stores/restaurants
  • My child seemed comfortable with how things are going with friends and siblings
  • My child worked to his/her potential
  • My child adapted well to disruptions or unexpected changes in his/her routine

In general, how closely do each of the following statements describe life for you and your family?

  • My child's ADHD has added stress to our home life
  • My child's ADHD limits me from entertaining at home
  • I avoid going certain places or doing certain things with my child because of problems with his/her ADHD
  • I feel as if I am "on guard" in public settings because I never know if my child with ADHD will act up
  • My child's ADHD limits what we can do as a family
  • I am anxious about my child's future because of the ADHD problems he/she is having
  • I feel tired and worn out because caring for a child with ADHD requires a lot of my time and energy
  • I feel my child's ADHD controls my life
  • I am frustrated that my child's ADHD is unmanageable
  • I am concerned about the long-term effect my child's ADHD behavior may have on his/her siblings

Please tell us how long your child has been on the following treatments for his/her ADHD.

Which of the following statements best describes your child's current ADHD medication status?

Are the following statements TRUE or FALSE for your child?

  • My child's behavior stays about the same throughout the day
  • My child's behavior seems to be up and down at different times throughout the day
  • My child's behavior becomes more problematic at night

Is it difficult to handle changes in your child's behavior when the medication wears off?

In general, how often are you successful in getting him/her to focus or regain self-control?

How would you rate the school's cooperation in each of the following areas:

  • Diagnostic/testing process for ADHD
  • Obtaining additional academic services
  • Developing a classroom behavior management plan
  • Designing a homework "plan of action"
  • Giving your child his/her ADHD medicine
  • Ongoing support in managing your child's ADHD

Please answer each of the following questions:

  • How much tension is there between you and your child about taking his/her ADHD medication?
  • How much do you worry about your child missing a dose of ADHD medication at school or when you are not around?
  • How bothered are you by having to monitor your child's ADHD medication every day?
  • How embarrassed do you think your child is about taking ADHD medication at school?
  • How much does your child resist taking medication at school?
  • How often does your child's dose at school get missed or forgotten?
  • How often has your child had problems because of a missed dose at school?

During the last 7 days, how many scheduled doses of your child's ADHD medication have been missed?

How strongly do you agree or disagree with the following statements?

  • ADHD can be helped by drugs alone
  • ADHD can be helped by behavioral interventions and therapy/counseling WITHOUT medication
  • ADHD can be helped by behavioral interventions and therapy/counseling with medication
  • ADHD can't really be helped. It's something my child will "outgrow"

During the past 6 months, has your child missed days from school due to problems with his/her ADHD?

During the past 6 months, have you, your spouse or partner missed days from work due to problems with your child's ADHD?

During the past 6 months, has your child required any hours of extra tutoring, nursing, home healthcare, or other services as a result of his/her ADHD?

During the past 6 months, has your child visited an emergency room due to an accident or incident that you believe was related to his/her ADHD?