Start
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
intro i

This child is:

1
Boy
2
Girl
intro ii

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.
A1 a

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
A1 b

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
A1 c

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
A1 d

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
A1 e

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
A2

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
A3 a-d
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
A3 i

Space for comments

Generic text
A4 a

Has this child ever been recognised as having special educational needs?

1
Yes
2
No
If no, go to A5 on page 5
If yes,
qc_A4_a == 1
A4 b(i)

Please tick the specific problem(s) below: Learning difficulties

1
Yes now
2
In past not now
3
No
A4 b(ii)

Please tick the specific problem(s) below: Specific learning difficulties* (e.g. Dyslexia)

1
Yes now
2
In past not now
3
No
A4 b(iii)

Please tick the specific problem(s) below: Emotional and behavioural difficulties

1
Yes now
2
In past not now
3
No
A4 b(iv)

Please tick the specific problem(s) below: Speech and language difficulties

1
Yes now
2
In past not now
3
No
A4 b(v)

Please tick the specific problem(s) below: Sensory impairment (Hearing)

1
Yes now
2
In past not now
3
No
A4 b(vi)

Please tick the specific problem(s) below: Sensory impairment (Visual)

1
Yes now
2
In past not now
3
No
A4 b(vii)

Please tick the specific problem(s) below: Physical disabilities*

1
Yes now
2
In past not now
3
No
A4 b(viii)

Please tick the specific problem(s) below: Medical conditions*

1
Yes now
2
In past not now
3
No
A4 b(ix)

Please tick the specific problem(s) below: Developmental delay*

1
Yes now
2
In past not now
3
No
A4 b(x)

Please tick the specific problem(s) below: Other*

1
Yes now
2
In past not now
3
No
A4 b(xi)

*Please describe

Generic text
PLEASE MAKE SURE YOU HAVE A TICK ON EACH LINE
A4 c

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
A4 d(i-vii)
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
A4 d(viii)

What is happening at the moment? (please tick all that apply) Something else (please tick and describe )

1
Yes
Other
A5 i

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
A5 ii

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
A6

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
B1

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
B2 a-s
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
B3 a

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
B3 b

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
B3 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
B3 d

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
SECTION C: AWKWARD AND TROUBLESOME BEHAVIOUR
Over the past school year how much to your knowledge has his /her behaviour been like the following:
C1 a

As far as I know he/she: Has temper tantrums or hot tempers

1
Not true
2
Somewhat true
3
Certainly true
C1 b

As far as I know he/she: Argues a lot with adults

1
Not true
2
Somewhat true
3
Certainly true
C1 c

As far as I know he/she: Is disobedient at school

1
Not true
2
Somewhat true
3
Certainly true
C1 d

As far as I know he/she: Deliberately does things to annoy others

1
Not true
2
Somewhat true
3
Certainly true
C1 e

As far as I know he/she: Blames others for his/her own mistakes

1
Not true
2
Somewhat true
3
Certainly true
C1 f

As far as I know he/she: Is easily annoyed by others

1
Not true
2
Somewhat true
3
Certainly true
C1 g

As far as I know he/she: Is angry and resentful

1
Not true
2
Somewhat true
3
Certainly true
C1 h

As far as I know he/she: Is spiteful

1
Not true
2
Somewhat true
3
Certainly true
C1 i

As far as I know he/she: Tries to get his/her own back

1
Not true
2
Somewhat true
3
Certainly true
C1 j

As far as I know he/she: Lies or cheats

1
Not true
2
Somewhat true
3
Certainly true
C1 k

As far as I know he/she: Starts fights

1
Not true
2
Somewhat true
3
Certainly true
C1 l

As far as I know he/she: Bullies others

1
Not true
2
Somewhat true
3
Certainly true
C1 m

As far as I know he/she: Plays truant

1
Not true
2
Somewhat true
3
Certainly true
C1 n

As far as I know he/she: Uses weapons when fighting

1
Not true
2
Somewhat true
3
Certainly true
C1 o

As far as I know he/she: Has been physically cruel, has really hurt someone

1
Not true
2
Somewhat true
3
Certainly true
C1 p

As far as I know he/she: Has been deliberately cruel to animals

1
Not true
2
Somewhat true
3
Certainly true
C1 q

As far as I know he/she: Sets fire deliberately

1
Not true
2
Somewhat true
3
Certainly true
C1 r

As far as I know he/she: Steals things

1
Not true
2
Somewhat true
3
Certainly true
C1 s

As far as I know he/she: Vandalises property or destroys things belonging to others

1
Not true
2
Somewhat true
3
Certainly true
C1 t

As far as I know he/she: Shows unwanted sexual behaviour towards others

1
Not true
2
Somewhat true
3
Certainly true
C1 u

As far as I know he/she: Has been in trouble with the law

1
Not true
2
Somewhat true
3
Certainly true
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
C2 a

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
C2 b

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
C2 c

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
C2 d

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
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:
D1

This child: Is considerate of other people's feelings

1
Not true
2
Somewhat true
3
Certainly true
D2

This child: Is restless, overactive, cannot stay still for long

1
Not true
2
Somewhat true
3
Certainly true
D3

This child: Often complains of headaches, stomach-aches or sickness

1
Not true
2
Somewhat true
3
Certainly true
D4

This child: Shares readily with other children (treats, toys, pencils etc.)

1
Not true
2
Somewhat true
3
Certainly true
D5

This child: Is rather solitary, tends to play alone

1
Not true
2
Somewhat true
3
Certainly true
D6

This child: Is generally obedient, usually does what adults request

1
Not true
2
Somewhat true
3
Certainly true
D7

This child: Has many worries, often seems worried

1
Not true
2
Somewhat true
3
Certainly true
D8

This child: Is helpful if someone is hurt, upset or feeling ill

1
Not true
2
Somewhat true
3
Certainly true
D9

This child: Constantly fidgets or squirms

1
Not true
2
Somewhat true
3
Certainly true
D10

This child: Has at least one good friend

1
Not true
2
Somewhat true
3
Certainly true
D11

This child: Often fights with other children or bullies them

1
Not true
2
Somewhat true
3
Certainly true
D12

This child: Is often unhappy, down-hearted or tearful

1
Not true
2
Somewhat true
3
Certainly true
D13

This child: Is generally liked by other children

1
Not true
2
Somewhat true
3
Certainly true
D14

This child: Is nervous or clingy in new situations, easily loses confidence

1
Not true
2
Somewhat true
3
Certainly true
D15

This child: Is kind to younger children

1
Not true
2
Somewhat true
3
Certainly true
D16

This child: Is picked on or bullied by other children

1
Not true
2
Somewhat true
3
Certainly true
D17

This child: Often volunteers to help others (parents, teachers, other children)

1
Not true
2
Somewhat true
3
Certainly true
D18

This child: Thinks things out before acting

1
Not true
2
Somewhat true
3
Certainly true
D19

This child: Gets on better with adults than with other children

1
Not true
2
Somewhat true
3
Certainly true
D20

This child: Has many fears, is easily scared

1
Not true
2
Somewhat true
3
Certainly true
D21

This child: Sees tasks through to the end, good attention span

1
Not true
2
Somewhat true
3
Certainly true
D22

Do you have any other comments or concerns? Please describe

1
Yes
2
No
Other
D23

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.
If yes, please answer the following questions about these difficulties:
qc_D23 == 2 || qc_D23 == 3 || qc_D23 == 4
D23 a

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
D23 b

Do the difficulties upset or distress the child?

1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
D23 c(i)

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
D23 c(ii)

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
D23 d

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
SECTION E:
E1

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
E2

Date of completion of this questionnaire

Generic date
THANK YOU VERY MUCH FOR YOUR HELP
End

alspac_99_cba

s_intro_i
CHILD'S BEHAVIOUR AND ABILITIES
s_intro_ii
Please complete 1 questionnaire for each study child
s_intro_iii
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.
s_intro_iv
Please tick the appropriate box in answer to each question.
s_intro_v
THANK YOU SO MUCH FOR YOUR HELP
intro i
This child is:
1
Boy
2
Girl
intro ii
Date of birth:
Date of birth
s_intro_vi
All answers are confidential
s_intro_vii
and will be retained without identifying information
s_intro_viii
When completed please return the questionnaire to:
s_intro_ix
Professor Jean Golding
s_intro_x
Children of the Nineties - ALSPAC
s_intro_xi
Institute of Child Health

SECTION A: ABILITIES AND SPECIAL NEEDS

s_qA1
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.
A1 a
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
A1 b
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
A1 c
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
A1 d
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
A1 e
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
A2
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
A3 a-d

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
A3 i
Space for comments
Generic text
A4 a
Has this child ever been recognised as having special educational needs?
1
Yes
2
No
s_qA4_a
If no, go to A5 on page 5
A4 b(i)
Please tick the specific problem(s) below: Learning difficulties
1
Yes now
2
In past not now
3
No
If yes,
A4 b(ii)
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,
A4 b(iii)
Please tick the specific problem(s) below: Emotional and behavioural difficulties
1
Yes now
2
In past not now
3
No
If yes,
A4 b(iv)
Please tick the specific problem(s) below: Speech and language difficulties
1
Yes now
2
In past not now
3
No
If yes,
A4 b(v)
Please tick the specific problem(s) below: Sensory impairment (Hearing)
1
Yes now
2
In past not now
3
No
If yes,
A4 b(vi)
Please tick the specific problem(s) below: Sensory impairment (Visual)
1
Yes now
2
In past not now
3
No
If yes,
A4 b(vii)
Please tick the specific problem(s) below: Physical disabilities*
1
Yes now
2
In past not now
3
No
If yes,
A4 b(viii)
Please tick the specific problem(s) below: Medical conditions*
1
Yes now
2
In past not now
3
No
If yes,
A4 b(ix)
Please tick the specific problem(s) below: Developmental delay*
1
Yes now
2
In past not now
3
No
If yes,
A4 b(x)
Please tick the specific problem(s) below: Other*
1
Yes now
2
In past not now
3
No
If yes,
A4 b(xi)
*Please describe
Generic text
If yes,
s_qA4
PLEASE MAKE SURE YOU HAVE A TICK ON EACH LINE
If yes,
A4 c
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,
A4 d(i-vii)

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,
A4 d(viii)
What is happening at the moment? (please tick all that apply) Something else (please tick and describe )
1
Yes
Other
If yes,
A5 i
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
A5 ii
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
A6
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

B1
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
B2 a-s

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
B3 a
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.
B3 b
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.
B3 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.
B3 d
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

s_qC1
Over the past school year how much to your knowledge has his /her behaviour been like the following:
C1 a
As far as I know he/she: Has temper tantrums or hot tempers
1
Not true
2
Somewhat true
3
Certainly true
C1 b
As far as I know he/she: Argues a lot with adults
1
Not true
2
Somewhat true
3
Certainly true
C1 c
As far as I know he/she: Is disobedient at school
1
Not true
2
Somewhat true
3
Certainly true
C1 d
As far as I know he/she: Deliberately does things to annoy others
1
Not true
2
Somewhat true
3
Certainly true
C1 e
As far as I know he/she: Blames others for his/her own mistakes
1
Not true
2
Somewhat true
3
Certainly true
C1 f
As far as I know he/she: Is easily annoyed by others
1
Not true
2
Somewhat true
3
Certainly true
C1 g
As far as I know he/she: Is angry and resentful
1
Not true
2
Somewhat true
3
Certainly true
C1 h
As far as I know he/she: Is spiteful
1
Not true
2
Somewhat true
3
Certainly true
C1 i
As far as I know he/she: Tries to get his/her own back
1
Not true
2
Somewhat true
3
Certainly true
C1 j
As far as I know he/she: Lies or cheats
1
Not true
2
Somewhat true
3
Certainly true
C1 k
As far as I know he/she: Starts fights
1
Not true
2
Somewhat true
3
Certainly true
C1 l
As far as I know he/she: Bullies others
1
Not true
2
Somewhat true
3
Certainly true
C1 m
As far as I know he/she: Plays truant
1
Not true
2
Somewhat true
3
Certainly true
C1 n
As far as I know he/she: Uses weapons when fighting
1
Not true
2
Somewhat true
3
Certainly true
C1 o
As far as I know he/she: Has been physically cruel, has really hurt someone
1
Not true
2
Somewhat true
3
Certainly true
C1 p
As far as I know he/she: Has been deliberately cruel to animals
1
Not true
2
Somewhat true
3
Certainly true
C1 q
As far as I know he/she: Sets fire deliberately
1
Not true
2
Somewhat true
3
Certainly true
C1 r
As far as I know he/she: Steals things
1
Not true
2
Somewhat true
3
Certainly true
C1 s
As far as I know he/she: Vandalises property or destroys things belonging to others
1
Not true
2
Somewhat true
3
Certainly true
C1 t
As far as I know he/she: Shows unwanted sexual behaviour towards others
1
Not true
2
Somewhat true
3
Certainly true
C1 u
As far as I know he/she: Has been in trouble with the law
1
Not true
2
Somewhat true
3
Certainly true
C2 a
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_
C2 b
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_
C2 c
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_
C2 d
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

s_section_D_i
(N.B. The right-hand column sometimes represents strengths and sometimes difficulties)
s_section_D_ii
Please think about this child's behaviour over the last 6 months if you can:
D1
This child: Is considerate of other people's feelings
1
Not true
2
Somewhat true
3
Certainly true
D2
This child: Is restless, overactive, cannot stay still for long
1
Not true
2
Somewhat true
3
Certainly true
D3
This child: Often complains of headaches, stomach-aches or sickness
1
Not true
2
Somewhat true
3
Certainly true
D4
This child: Shares readily with other children (treats, toys, pencils etc.)
1
Not true
2
Somewhat true
3
Certainly true
D5
This child: Is rather solitary, tends to play alone
1
Not true
2
Somewhat true
3
Certainly true
D6
This child: Is generally obedient, usually does what adults request
1
Not true
2
Somewhat true
3
Certainly true
D7
This child: Has many worries, often seems worried
1
Not true
2
Somewhat true
3
Certainly true
D8
This child: Is helpful if someone is hurt, upset or feeling ill
1
Not true
2
Somewhat true
3
Certainly true
D9
This child: Constantly fidgets or squirms
1
Not true
2
Somewhat true
3
Certainly true
D10
This child: Has at least one good friend
1
Not true
2
Somewhat true
3
Certainly true
D11
This child: Often fights with other children or bullies them
1
Not true
2
Somewhat true
3
Certainly true
D12
This child: Is often unhappy, down-hearted or tearful
1
Not true
2
Somewhat true
3
Certainly true
D13
This child: Is generally liked by other children
1
Not true
2
Somewhat true
3
Certainly true
D14
This child: Is nervous or clingy in new situations, easily loses confidence
1
Not true
2
Somewhat true
3
Certainly true
D15
This child: Is kind to younger children
1
Not true
2
Somewhat true
3
Certainly true
D16
This child: Is picked on or bullied by other children
1
Not true
2
Somewhat true
3
Certainly true
D17
This child: Often volunteers to help others (parents, teachers, other children)
1
Not true
2
Somewhat true
3
Certainly true
D18
This child: Thinks things out before acting
1
Not true
2
Somewhat true
3
Certainly true
D19
This child: Gets on better with adults than with other children
1
Not true
2
Somewhat true
3
Certainly true
D20
This child: Has many fears, is easily scared
1
Not true
2
Somewhat true
3
Certainly true
D21
This child: Sees tasks through to the end, good attention span
1
Not true
2
Somewhat true
3
Certainly true
D22
Do you have any other comments or concerns? Please describe
1
Yes
2
No
Other
D23
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
s_qD23
If no, go to Section E on page 12.
D23 a
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:
D23 b
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:
D23 c(i)
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:
D23 c(ii)
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:
D23 d
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:

E1
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
E2
Date of completion of this questionnaire
Generic date
s_outro_i
THANK YOU VERY MUCH FOR YOUR HELP
Name

Child's Behaviour and Abilities