Strength and Difficulties Questionnaire Child

Strength and Difficulties Questionnaire

For each item, please mark the box for Not True, Somewhat True and Certainly True. It would help us if you answered all items as best you can even if you are not absolutely certain or the item seems daft! Please give your answers on the basis of how things have been for you over the last 6 months.

Your name:

* required

Maximum 255 characters

0/255

Date of birth:

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Maximum 255 characters

0/255

Male/Female (choose as applicable)

* required

Male

Female

I try to be nice to other people. I care about their feelings

* required

Not true

True

Certainly true

I am restless, I cannot stay still for long

* required

Not true

True

Certainly true

I get a lot of headaches, stomach-aches or sickness

* required

Not true

True

Certainly true

I usually share with others (food, games, pens, etc.)

* required

Not true

True

Certainly true

I get very angry and often lose my temper

* required

Not true

True

Certainly true

Other (please specify)

I am usually on my own, I generally play alone or keep to myself

* required

Not true

True

Certainly true

10.

I usually do as I am told

* required

Not true

True

Certainly true

11.

I worry a lot

* required

Not true

True

Certainly true

12.

I am helpful if someone is hurt, upset or feeling ill

* required

Not true

True

Certainly true

13.

I am constantly fidgeting or squirming

* required

Not true

True

Certainly true

14.

I fight a lot. I can make other people do what I want

* required

Not true

True

Certainly true

15.

I am often unhappy, down-hearted or tearful

* required

Not true

True

Certainly true

Other (please specify)

16.

Other people my age generally like me

* required

Not true

True

Certainly true

17.

I have one good friend or more

* required

Not true

True

Certainly true

18.

I am easily distracted, I find it difficult to concentrate

* required

Not true

True

Certainly true

19.

I am nervous in new situations, I easily lose confidence

* required

Not true

True

Certainly true

20.

I am kind to younger children

* required

Not true

True

Certainly true

21.

I am often accused or lying or cheating

* required

Not true

True

Certainly true

22.

Other children or young people pick on me or bully me

* required

Not true

True

Certainly true

23.

I often volunteer to help others (parent, teachers, children, etc.)

* required

Not true

True

Certainly true

24.

I think before I do things

* required

Not true

True

Certainly true

25.

I take things that are not mine from home, school or elsewhere

* required

Not true

True

Certainly true

26.

I have many fears, I am easily scared

* required

Not true

True

Certainly true

Other (please specify)

27.

I finish the work I’m doing. My attention is good

* required

Not true

True

Certainly true

28.

I get on better with adults than with people my own age

* required

Not true

True

Certainly true

29.

How long have these difficulties been present?

* required

Less than a month

1-5 months

6-12 months

Over a year

30.

Do the difficulties upset or distress you?

* required

Not at all

Only a little

Quite a lot

A great deal

31.

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

* required

HOME LIFE

Not at all

Only a little

Quite a lot

A great deal

FRIENDSHIPS

Not at all

Only a little

Quite a lot

A great deal

CLASSROOM LEARNING

Not at all

Only a little

Quite a lot

A great deal

CLASSROOM LEARNING

Not at all

Only a little

Quite a lot

A great deal

32.

Do the difficulties make it harder for those around you (family, friends, teachers, etc)?

* required

Not at all

Only a little

Quite a lot

A great deal

33.

Do you have any other comments or concerns?

34.

Overall, do you think that you have difficulties in one or more of the following areas:

Emotions, concentration, behaviour or being able to get on with other people

* required

Yes – minor difficulties

Yes – definite difficulties

Yes – Severe difficulties

If you have answered “Yes”, please answer the following questions about these difficulties