ADHD Teacher Observation and Parent Collaboration Form
- What does this child’s day look like at school and at home?
- What should we talk about together?
By Dr. Douglas Cowan, Psy.D., MFT
This form helps teachers and parents give each other a clearer, more specific picture of what a child needs to succeed. Teachers: please complete Section One and share it with the parents. Parents: please complete Section Two and bring it to your next meeting with the teacher or school team.
This form is a conversation starter. It does not diagnose ADHD. Only a qualified clinician can do that, using information from home and school and a check for other causes (1).
Section One: Teacher observations
Student: ____________ Grade: ______ Teacher: ____________ Subject/Class: ____________ Date: ________
Please mark how often each behavior happens in your classroom.
| Behavior | Sometimes | Often | Very often |
|---|---|---|---|
| Struggles to complete assigned tasks | ☐ | ☐ | ☐ |
| Does not seem to listen or pay attention | ☐ | ☐ | ☐ |
| Has difficulty concentrating on tasks | ☐ | ☐ | ☐ |
| Is easily distracted by sights, sounds, or movement | ☐ | ☐ | ☐ |
| Acts impulsively without thinking first | ☐ | ☐ | ☐ |
| Has trouble organizing schoolwork or materials | ☐ | ☐ | ☐ |
| Interrupts or blurts out answers | ☐ | ☐ | ☐ |
| Is very restless or cannot stay seated | ☐ | ☐ | ☐ |
| Seems constantly “on the go” | ☐ | ☐ | ☐ |
| Gets frustrated or angry easily | ☐ | ☐ | ☐ |
| Resists or argues with instructions | ☐ | ☐ | ☐ |
| Has difficulty with reading or spelling | ☐ | ☐ | ☐ |
| Has trouble following verbal directions | ☐ | ☐ | ☐ |
| Has difficulty with handwriting | ☐ | ☐ | ☐ |
| Seems anxious, worried, or fearful | ☐ | ☐ | ☐ |
| Gets stuck and has trouble shifting to a new task | ☐ | ☐ | ☐ |
| Has difficulty waiting for a turn | ☐ | ☐ | ☐ |
| Loses or forgets materials often | ☐ | ☐ | ☐ |
| Mood changes quickly without an obvious cause | ☐ | ☐ | ☐ |
| Seems withdrawn, sad, or low in energy | ☐ | ☐ | ☐ |
Teacher’s additional observations:
What strategies have worked best so far?
What situations or times of day are hardest?
Section Two: Parent home checklist
Please read each question and think about what might be worth talking about with the school team and your child’s doctor.
| Question | Yes | No | Not sure |
|---|---|---|---|
| Is my child getting enough sleep for their age? (About 9 to 12 hours for ages 6 to 12, and 8 to 10 for teens) (2) | ☐ | ☐ | ☐ |
| Does my child fall asleep easily and wake rested? | ☐ | ☐ | ☐ |
| Does my child eat breakfast with some protein before school? | ☐ | ☐ | ☐ |
| Is my child drinking enough water during the day? | ☐ | ☐ | ☐ |
| Is my child active for about an hour a day? | ☐ | ☐ | ☐ |
| Does my child seem physically well, with no unaddressed illness or pain? | ☐ | ☐ | ☐ |
| Has my child had a vision and hearing check in the past two years? | ☐ | ☐ | ☐ |
| Is my child taking any medicine that may affect focus or behavior? | ☐ | ☐ | ☐ |
| Can I give steady supervision and support for schoolwork at home? | ☐ | ☐ | ☐ |
| Does my child seem anxious, sad, or worried more than usual? | ☐ | ☐ | ☐ |
| Has anything big changed at home lately, such as a move, divorce, loss, or new sibling? | ☐ | ☐ | ☐ |
| Has my child been evaluated for ADHD by a qualified professional? | ☐ | ☐ | ☐ |
Parent’s notes from home:
What does your child say about school, the teacher, and friends?
Section Three: Next steps together
Most of what you see on this form can be helped, and it helps most when teachers and parents work from the same information.
If several items in Section One are marked “Often” or “Very often,” talk with your child’s pediatrician and the school team about a full evaluation. A good evaluation looks across settings, uses standard rating scales, and rules out other causes (1, 3). Our free SWAN rating scale and ADHD inventory are practical first steps.
Plan a time to talk through these observations. The best results come from regular, specific, solution-focused conversations, throughout the year and not only at report card time.
For ideas that help in class, see our teacher checklist and guide for teachers.
Together, you can help this child find his footing.
This form is for education and is not a substitute for professional diagnosis or treatment.
References
- Wolraich, M. L., Hagan, J. F., Allan, C., Chan, E., Davison, D., Earls, M., et al. (2019). Clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics, 144(4), e20192528. https://doi.org/10.1542/peds.2019-2528
- Paruthi, S., Brooks, L. J., D’Ambrosio, C., Hall, W. A., Kotagal, S., Lloyd, R. M., et al. (2016). Recommended amount of sleep for pediatric populations: A consensus statement of the American Academy of Sleep Medicine. Journal of Clinical Sleep Medicine, 12(6), 785-786. https://doi.org/10.5664/jcsm.5866
- Wolraich, M. L., Lambert, W., Doffing, M. A., Bickman, L., Simmons, T., Worley, K., & Bickman, L. (2003). Psychometric properties of the Vanderbilt ADHD diagnostic parent rating scale in a referred population. Journal of Pediatric Psychology, 28(8), 559-568. https://doi.org/10.1093/jpepsy/jsg046
Frequently Asked Questions
Can this form diagnose ADHD?
No. It is a conversation starter. Only a qualified clinician can diagnose ADHD, using information from home and school, a developmental history, and a check for other causes. Validated rating scales such as the Vanderbilt are used in evaluations.
Who fills out which part?
The teacher completes Section One and shares it with the parents. Parents complete Section Two and bring it to the next meeting.
What if many items are marked Often or Very Often?
Talk with the school team and your child's pediatrician about a full evaluation. The American Academy of Pediatrics recommends gathering information from parents and teachers across settings when evaluating possible ADHD.
Why does the form ask about sleep, vision, and hearing?
Poor sleep, vision or hearing problems, anxiety, and other issues can look like ADHD or make it worse. Checking them first gives a clearer picture.