True Children

Strengths and Difficulties Questionnaire (SDQ) Teacher version, for ages 4-10

Initial SDQ

For each item, please mark the box for Not True, Somewhat True or Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain. Please give your answers on the basis of the child's behavior over the last six months or this school year.

Student's name Ajanae Banks Gender: Date of birth 07/09/2011

The following choices are: Not True, Somewhat True, or Certainly True

Not True Somewhat True Certainly True

1. Considerate of other people's feelings

2. Restless, overactive, cannot stay still for long

3. Often complains of headaches, stomach-aches or sickness

4. Shares readily with other children, for example toys, treats, pencils

5. Often loses temper

6. Rather solitary, prefers to play alone

7. Generally well behaved, usually does what adults request

8. Many worries or often seems worried

9. Helpful if someone is hurt, upset or feeling ill

10. Constantly fidgeting or squirming

11. Has at least one good friend

12. Often fights with other children or bullies them

13. Often unhappy, depressed or tearful

14. Generally liked by other children

15. Easily distracted, concentration wanders

16. Nervous in new situations, easily loses confidence

17. Kind to younger children

18. Often lies or cheats

19. Picked on or bullied by other children

20. Often offers to help others (parents, teachers, children)

21. Thinks things out before acting

22. Steals from home, school or elsewhere

23. Gets along better with adults than with other children

24. Many fears, easily scared

25. Good attention span, sees work through to the end

Do you have any other comments or concerns?

Overall, do you think that this child has difficulties in any of the following areas: emotions, concentration, behavior or being able to get on with other people?

No Yes- minor difficulties Yes – definite difficulties Yes – severe difficulties

If you have answered "Yes", please answer the following questions about these difficulties:

· How long have these difficulties been present?

Less than a Month 1 – 5 Months 6 – 12 Months Over a Year

· Do the difficulties upset or distress the child?

Not at all Only a little A medium amount A great deal

· Do the difficulties interfere with the child's everyday life in the following areas?

Peer Relationships: Not at all Only a little A medium amount A great deal

Classroom Learning: Not at all Only a little A medium amount A great deal

· Do the difficulties put a burden on you or the class as a whole?

Not at all Only a little A medium amount A great deal

Your Name Date

Thank you very much for your help by completing this SDQ!

© Robert Goodman, 2005

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