Start















If yes,
qc_A4_a == 1


For each statement below please answer all items as well as you can even if you are not absolutely certain. Please give your answers on the basis of the child's behaviour over the last school year.
- | |
---|---|
1 - Not true 2 - Somewhat true 3 - Certainly true |
|
Makes careless mistakes | |
Fails to pay attention | |
Quickly loses interest in what he/she is doing | |
Doesn't seem to listen | |
Fails to finish things he/she starts | |
Is disorganised | |
Tries to avoid tasks that require thought | |
Loses things | |
Is easily distracted | |
Is forgetful | |
Fidgets | |
Can't stay sitting when required to do so | |
Runs or climbs about when he/she shouldn't | |
Has difficulty playing quietly | |
Finds it hard to calm down when asked to do so | |
Interrupts, blurts out answers to questions | |
Finds it hard to wait his/her turn | |
Interrupts or butts in on others | |
Goes on talking if asked to stop |
If you have ticked 'Certainly true' to any of B2(a) - (s) please answer (a) - (d) below. Otherwise go to section C.
qc_B2_a-s == 3


If you have ticked 'Certainly true' to any of C1(a) - (u) please answer (a) - (d) below. Otherwise go to section D. [qc_C1_
a-u] == 3




If yes, please answer the following questions about these difficulties:
qc_D23 == 2 || qc_D23 == 3 || qc_D23 == 4


End
alspac_99_cba
CHILD'S BEHAVIOUR AND ABILITIES
Please complete 1 questionnaire for each study child
This questionnaire is in 4 sections: A asks you to rate his/her abilities, parental involvement and special needs; sections B and C are parts of the teacher version of the Development and Well-being Assessment and are aimed to identify the degree of hyperactivity and conduct disorder; section D comprises many of the general behaviour questions known as the Strengths and Difficulties scale.
Please tick the appropriate box in answer to each question.
THANK YOU SO MUCH FOR YOUR HELP
This child is:
1
Boy
2
Girl
Date of birth:
Date of birth
All answers are confidential
and will be retained without identifying information
When completed please return the questionnaire to:
Professor Jean Golding
Children of the Nineties - ALSPAC
Institute of Child Health
SECTION A: ABILITIES AND SPECIAL NEEDS
For each item, please tick one of the boxes. It would help us if you answered all items as well as you can even if you are not absolutely certain.
In comparison with the national average, how would you rate the child for his/her age in regard to the following? General ability
1
Very good
2
Good
3
Average
4
Not very good
5
Poor
In comparison with the national average, how would you rate the child for his/her age in regard to the following? Art
1
Very good
2
Good
3
Average
4
Not very good
5
Poor
6
Is unable to do this
In comparison with the national average, how would you rate the child for his/her age in regard to the following? Singing/music
1
Very good
2
Good
3
Average
4
Not very good
5
Poor
6
Is unable to do this
In comparison with the national average, how would you rate the child for his/her age in regard to the following? General knowledge
1
Very good
2
Good
3
Average
4
Not very good
5
Poor
6
Is unable to do this
In comparison with the national average, how would you rate the child for his/her age in regard to the following? Games/gymnastics
1
Very good
2
Good
3
Average
4
Not very good
5
Poor
6
Is unable to do this
How much support do you think the child gets from his/her parents in regard to his/her learning?
1
very supportive
2
somewhat supportive
3
not at all supportive
4
can't say
Have the child's parents been involved in any of the following ways?
- | |
---|---|
1 - Yes 2 - No |
|
Help in class | |
Help with out-of-class activities | |
Attend parent-teacher sessions | |
Other school activity |
Space for comments
Generic text
Has this child ever been recognised as having special educational needs?
1
Yes
2
No
If no, go to A5 on page 5
Please tick the specific problem(s) below: Learning difficulties
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Specific learning difficulties* (e.g. Dyslexia)
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Emotional and behavioural difficulties
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Speech and language difficulties
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Sensory impairment (Hearing)
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Sensory impairment (Visual)
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Physical disabilities*
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Medical conditions*
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Developmental delay*
1
Yes now
2
In past not now
3
No
If yes,
Please tick the specific problem(s) below: Other*
1
Yes now
2
In past not now
3
No
If yes,
*Please describe
Generic text
If yes,
PLEASE MAKE SURE YOU HAVE A TICK ON EACH LINE
If yes,
Is this child statemented?
1
child has a statement
2
currently undergoing statutory assessment
3
not statemented nor being considered
4
has been refused a statement
If yes,
What is happening at the moment? (please tick all that apply)
- | |
---|---|
1 - Yes |
|
Taught within school provision | |
Child is at special school | |
Child goes to special classes | |
Child has a special teacher | |
Hospital school | |
Educated at home | |
Child excluded from school |
If yes,
What is happening at the moment? (please tick all that apply) Something else (please tick and describe )
1
Yes
Other
If yes,
Please indicate which stream (or ability group) if any, the child is in for: Maths
1
Do not stream
2
STREAM (ABILITY GROUP): Most able
3
STREAM (ABILITY GROUP): Middle
4
STREAM (ABILITY GROUP): Least able
Please indicate which stream (or ability group) if any, the child is in for: Literacy/English
1
Do not stream
2
STREAM (ABILITY GROUP): Most able
3
STREAM (ABILITY GROUP): Middle
4
STREAM (ABILITY GROUP): Least able
How does the child cope with homework?
1
none given
2
given, but rarely does it
3
given, sometimes does it
4
given, usually does it
5
given, always does it
SECTION B: ATTENTION, ACTIVITY AND IMPULSIVENESS
When doing something in class that he/she enjoys and/or is good at, whether reading, drawing, making something or whatever, how long does he/she typically stick to that task?
1
Less than 2 minutes
2
2-4 minutes
3
5-9 minutes
4
10-19 minutes
5
20 minutes or more
For each statement below please answer all items as well as you can even if you are not absolutely certain. Please give your answers on the basis of the child's behaviour over the last school year.
- | |
---|---|
1 - Not true 2 - Somewhat true 3 - Certainly true |
|
Makes careless mistakes | |
Fails to pay attention | |
Quickly loses interest in what he/she is doing | |
Doesn't seem to listen | |
Fails to finish things he/she starts | |
Is disorganised | |
Tries to avoid tasks that require thought | |
Loses things | |
Is easily distracted | |
Is forgetful | |
Fidgets | |
Can't stay sitting when required to do so | |
Runs or climbs about when he/she shouldn't | |
Has difficulty playing quietly | |
Finds it hard to calm down when asked to do so | |
Interrupts, blurts out answers to questions | |
Finds it hard to wait his/her turn | |
Interrupts or butts in on others | |
Goes on talking if asked to stop |
Do these behaviour patterns: Upset or distress him/her?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of B2(a) - (s) please answer (a) - (d) below. Otherwise go to section C.
Do these behaviour patterns: Interfere with his/her peer relationships?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of B2(a) - (s) please answer (a) - (d) below. Otherwise go to section C.
Do these behaviour patterns: Interfere with his/her classroom learning?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of B2(a) - (s) please answer (a) - (d) below. Otherwise go to section C.
Do these behaviour patterns: Put a burden on you or the class as a whole?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of B2(a) - (s) please answer (a) - (d) below. Otherwise go to section C.
SECTION C: AWKWARD AND TROUBLESOME BEHAVIOUR
Over the past school year how much to your knowledge has his /her behaviour been like the following:
As far as I know he/she: Has temper tantrums or hot tempers
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Argues a lot with adults
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Is disobedient at school
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Deliberately does things to annoy others
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Blames others for his/her own mistakes
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Is easily annoyed by others
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Is angry and resentful
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Is spiteful
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Tries to get his/her own back
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Lies or cheats
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Starts fights
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Bullies others
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Plays truant
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Uses weapons when fighting
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Has been physically cruel, has really hurt someone
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Has been deliberately cruel to animals
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Sets fire deliberately
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Steals things
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Vandalises property or destroys things belonging to others
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Shows unwanted sexual behaviour towards others
1
Not true
2
Somewhat true
3
Certainly true
As far as I know he/she: Has been in trouble with the law
1
Not true
2
Somewhat true
3
Certainly true
Do these behaviour patterns: Upset or distress him/her?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of C1(a) - (u) please answer (a) - (d) below. Otherwise go to section D. [qc_C1_
Do these behaviour patterns: Interfere with his/her peer relationships?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of C1(a) - (u) please answer (a) - (d) below. Otherwise go to section D. [qc_C1_
Do these behaviour patterns: Intefere with his/her classroom learning?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of C1(a) - (u) please answer (a) - (d) below. Otherwise go to section D. [qc_C1_
Do these behaviour patterns: Put a burden on you or the class as a whole?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If you have ticked 'Certainly true' to any of C1(a) - (u) please answer (a) - (d) below. Otherwise go to section D. [qc_C1_
SECTION D: STRENGTHS AND DIFFICULTIES
(N.B. The right-hand column sometimes represents strengths and sometimes difficulties)
Please think about this child's behaviour over the last 6 months if you can:
This child: Is considerate of other people's feelings
1
Not true
2
Somewhat true
3
Certainly true
This child: Is restless, overactive, cannot stay still for long
1
Not true
2
Somewhat true
3
Certainly true
This child: Often complains of headaches, stomach-aches or sickness
1
Not true
2
Somewhat true
3
Certainly true
This child: Shares readily with other children (treats, toys, pencils etc.)
1
Not true
2
Somewhat true
3
Certainly true
This child: Is rather solitary, tends to play alone
1
Not true
2
Somewhat true
3
Certainly true
This child: Is generally obedient, usually does what adults request
1
Not true
2
Somewhat true
3
Certainly true
This child: Has many worries, often seems worried
1
Not true
2
Somewhat true
3
Certainly true
This child: Is helpful if someone is hurt, upset or feeling ill
1
Not true
2
Somewhat true
3
Certainly true
This child: Constantly fidgets or squirms
1
Not true
2
Somewhat true
3
Certainly true
This child: Has at least one good friend
1
Not true
2
Somewhat true
3
Certainly true
This child: Often fights with other children or bullies them
1
Not true
2
Somewhat true
3
Certainly true
This child: Is often unhappy, down-hearted or tearful
1
Not true
2
Somewhat true
3
Certainly true
This child: Is generally liked by other children
1
Not true
2
Somewhat true
3
Certainly true
This child: Is nervous or clingy in new situations, easily loses confidence
1
Not true
2
Somewhat true
3
Certainly true
This child: Is kind to younger children
1
Not true
2
Somewhat true
3
Certainly true
This child: Is picked on or bullied by other children
1
Not true
2
Somewhat true
3
Certainly true
This child: Often volunteers to help others (parents, teachers, other children)
1
Not true
2
Somewhat true
3
Certainly true
This child: Thinks things out before acting
1
Not true
2
Somewhat true
3
Certainly true
This child: Gets on better with adults than with other children
1
Not true
2
Somewhat true
3
Certainly true
This child: Has many fears, is easily scared
1
Not true
2
Somewhat true
3
Certainly true
This child: Sees tasks through to the end, good attention span
1
Not true
2
Somewhat true
3
Certainly true
Do you have any other comments or concerns? Please describe
1
Yes
2
No
Other
Overall, to summarise, do you think that this child has difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?
1
No
2
Yes minor difficulties
3
Yes definite difficulties
4
Yes severe difficulties
If no, go to Section E on page 12.
How long have these difficulties been present?
1
Less than 1 month
2
1-5 months
3
6-12 months
4
more than a year
5
don't know
If yes, please answer the following questions about these difficulties:
Do the difficulties upset or distress the child?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If yes, please answer the following questions about these difficulties:
Do the difficulties interfere with the child's everyday life in the following areas? Peer relationships
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If yes, please answer the following questions about these difficulties:
Do the difficulties interfere with the child's everyday life in the following areas? Classroom learning
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If yes, please answer the following questions about these difficulties:
Do the difficulties put a burden on you or the class as a whole?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
If yes, please answer the following questions about these difficulties:
SECTION E:
How long have you been the teacher of this child?
1
<1 month
2
1-2 months
3
3-5 months
4
6-11 months
5
1 year or more
9
don't know
Date of completion of this questionnaire
Generic date
THANK YOU VERY MUCH FOR YOUR HELP
Name
Child's Behaviour and Abilities
External Instrument Location