Child & Youth Mental Health Algorithm - GPSC

Patient Name:Date of Birth:Physician Name:MRN/File No:Date:Weiss Symptom Record (WSR)Instructions to Informant: Check the box that best# itemsdescribes typical behavior scored 2 or 3Instructions to Physician: Symptoms rated 2 or 3 Not at all Somewhat Pretty much Very much N/A (DSMare positive and total count completed below (0) (1) (2) (3) Criteria)ADHD COMBINED TYPE 314.01≥6/9 IA & HIATTENTION 314.00Fails to give close attention to details, careless mistakesDifficulty sustaining attention in tasks or fun activitiesDoes not seem to listen when spoken to directlyDoes not follow through on instructions and failsto finish workDifficulting organizing tasks and activitiesAvoids tasks that require sustained mental effort (boring)Losing thingsEasily distractedForgetful in daily activitiesHYPERACTIVE/IMPULSIVE 314.01Fidgety or squirms in seat/9 (≥6/9)Leaves seat when sitting is expectedFeels restlessDifficulty in doing fun things quietlyAlways on the go or acts as if "driven by a motor"Talks excessivelyBlurts answers before questions have been completedDifficulty awaiting turnInterrupting or intruding on othersOPPOSITIONAL DEFIANT DISORDER 313.81Loses temper/9 (≥6/9)Argues with adultsActively defies or refuses to comply with requests or rulesDeliberately annoys peopleBlames others for his or her mistakes or misbehaviourTouchy or easily annoyed by othersAngry or resentfulSpiteful or vindictive100 Version: January 2011. Refer to www.caddra.ca for latest updates./8 (≥4/8)WSR 1/5