It provides ratings in 8 desired effects categories such as emotional control, focus, and diligence using grades of A through F. It also rates 8 potential undesired side effects from 0 to 3 in terms of severity. Finally, it requests descriptions of any other positive or negative changes observed since starting the medication. The summary evaluates the effectiveness and side effects of Taylor's current ADHD medication treatment plan.
It provides ratings in 8 desired effects categories such as emotional control, focus, and diligence using grades of A through F. It also rates 8 potential undesired side effects from 0 to 3 in terms of severity. Finally, it requests descriptions of any other positive or negative changes observed since starting the medication. The summary evaluates the effectiveness and side effects of Taylor's current ADHD medication treatment plan.
It provides ratings in 8 desired effects categories such as emotional control, focus, and diligence using grades of A through F. It also rates 8 potential undesired side effects from 0 to 3 in terms of severity. Finally, it requests descriptions of any other positive or negative changes observed since starting the medication. The summary evaluates the effectiveness and side effects of Taylor's current ADHD medication treatment plan.
It provides ratings in 8 desired effects categories such as emotional control, focus, and diligence using grades of A through F. It also rates 8 potential undesired side effects from 0 to 3 in terms of severity. Finally, it requests descriptions of any other positive or negative changes observed since starting the medication. The summary evaluates the effectiveness and side effects of Taylor's current ADHD medication treatment plan.
Download as DOCX, PDF, TXT or read online from Scribd
Download as docx, pdf, or txt
You are on page 1/ 3
The Taylor Medication Effectiveness Report
Child’s Name ________________________________________________________________________________
Your Name _________________________________________________ Phone ____________________________
Time period being rated: From (date) ____________________________ To (date) __________________________
Current regimen:______________ mg. of _________________________ taken at _________________a.m./ p.m.
_________________ mg. of ____________________________________ taken at _________________a.m./ p.m.
1. DESIRED EFFECTS: Simply fill out as a teacher would a grade report, with these grades:
Grade Rating: The percentage of times the child shows this trait, from among all opportunities to do so.
AExcellent- very pleasant 80% to 100% of the time
B Good – O.K livable with 60% to 80% of the time C Fair – barely tolerable 40% to 60% of the time D Poor – very unpleasant 20% to 40% of the time F Failure – not tolerable less than 20% of the time
ACTIVITY CONTROL: Mouth, hands, and EMOTIONAL CONTROL: Patient, can be
feet well teased, not easily controlled; sits for normal length of time; upset, can take frustrations in stride, not fidgety or squirmy; ABCDEF doesn’t have tantrums. ABCDEF doesn’t poke, touch, and grab; stays seated appropriately.
BRAIN IN GEAR: Not impulsive, asks FOCUSING: Normal attention span,
thoughtful questions, pursues a goal without understands and remembers clearly, not getting sidetracked, completes activities, ABCDEF absentminded, seems “tuned ABCDEF not overly distractible, in”, stops and thinks before taking action. doesn’t flit from activity to activity.
CONSCIENCE: Considers moral aspects GENTLENESS: Doesn’t argue or power
of decisions; doesn’t struggle, obedient, lie, cheat or steal; respects boundaries; cooperative, respects authority. ABCDEF asks permission before doing ABCDEF things; repentant and apologetic if caught in a misdeed.
DILIGENCE: Does things without being HELPFULLNESS: Polite, generous,
reminded or nagged, courteous, kind-hearted, faces tasks and responsibilities head-on, doesn’t demand own way with other ABCDEF wants to do a good and ABCDEF children. thorough job, earnest and serious minded rather than flippant, careful rather than careless, concerned about neatness. A’s and B’s in all eight desired effects signifiescorrect dosage for ADHD symptom control. Please describe any other positive changes in behavior orperformance since starting this particular medication arrangement:
2. UNDESIRED EFFECTS: Please indicate the levels that are happening: 0= This effect is not occurring or is so small that adapting to it requires no effort. 1= This effect is mild and manageable with just a small effort that is not inconvenient. 2= This effect is moderate, causing some inconvenience but still livable with. 3= This effect is severe, causing great inconvenience and cannot be allowed to continue.
3. OTHER CHANGES: Please describe any other negative changes in behavior orperformance since starting this particular medication arrangement,whether or not you think they might be directly related to this child’smedication treatment:
____________________________________________________________________________________________ The Pennsylvania Child Welfare Training Program 303: Attention & Activity Disorders in Children & Adolescents
Bernardi, N. F., Schories, A., Jabusch, H. C., Colombo, B., & Altenmüller, E. (2013). Mental Practice in Music Memorization. An Ecological-Empirical Study. Music Perception. An Interdisciplinary Journal, 30(3), 275-290
