Strengths and Difficulties Questionnaire After

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 or the item seems irrelevant. Please give your answers on the basis of the child’s/young person’s behaviour over the last six months.

Parents Name

Date (DD/MM/YYYY)

Child/Young Persons Name

Child/Young Persons Male/Female
MaleFemale

Age of Child/Young Persons

Are you the Childs/Young Persons?
MotherFatherOther

Considerate of other people’s feelings
Not TrueSomewhat TrueCertainly True

Restless, overactive, cannot stay still for long
Not TrueSomewhat TrueCertainly True

Often complains of headaches, stomach-aches or sickness
Not TrueSomewhat TrueCertainly True

Shares readily with other children (treats, toys, pencils etc)
Not TrueSomewhat TrueCertainly True

Often has temper tantrums or hot tempers
Not TrueSomewhat TrueCertainly True

Rather solitary, tends to play alone
Not TrueSomewhat TrueCertainly True

Generally obedient, usually does what adults request
Not TrueSomewhat TrueCertainly True

Many worries often seems worried
Not TrueSomewhat TrueCertainly True

Helpful if someone is hurt, upset or feeling ill
Not TrueSomewhat TrueCertainly True

Constantly fidgeting or squirming
Not TrueSomewhat TrueCertainly True

Has at least one good friend
Not TrueSomewhat TrueCertainly True

Often fights with other children or bullies them
Not TrueSomewhat TrueCertainly True

Often unhappy, down-hearted or tearful
Not TrueSomewhat TrueCertainly True

Generally liked by other children
Not TrueSomewhat TrueCertainly True

Easily distracted, concentration wanders
Not TrueSomewhat TrueCertainly True

Nervous or clingy in new situations, easily loses confidence
Not TrueSomewhat TrueCertainly True

Kind to younger children
Not TrueSomewhat TrueCertainly True

Often lies or cheats
Not TrueSomewhat TrueCertainly True

Picked on or bullied by other children
Not TrueSomewhat TrueCertainly True

Often volunteers to help others (parents, teachers, other children)
Not TrueSomewhat TrueCertainly True

Thinks things out before acting
Not TrueSomewhat TrueCertainly True

Steals from home, school or elsewhere
Not TrueSomewhat TrueCertainly True

Gets on better with adults than with other children
Not TrueSomewhat TrueCertainly True

Many fears, easily scared
Not TrueSomewhat TrueCertainly True

Sees tasks through to the end, good attention span
Not TrueSomewhat TrueCertainly True

Do you have any other comments or concerns?

Since attending the group, are your child’s/young person’s problem
Much worseA bit worseAbout the sameA bit betterMuch better

Has coming the group been helpful in other ways e.g. providing information or making the problems more bearable
Not at allOnly a littleQuite a lotA great deal

Over the last month, has your child/young person had difficulties in one or more of the following areas:

Emotions, concentration, behaviour or being able to get on with other people?
NoYes, minor difficultiesYes, definite difficultiesYes, severe difficulties

[group if-yes]
Do the difficulties upset or distress your child/young person?
Less that a month1-5 months6-12 monthsOver a year

Do the difficulties interfere with your child’s/young person’s everyday life in the following areas?

Home Life
Not at allOnly a littleQuite a lotA great deal

Friendships
Not at allOnly a littleQuite a lotA great deal

Classroom Learning
Not at allOnly a littleQuite a lotA great deal

Leisure Activities
Not at allOnly a littleQuite a lotA great deal

Do the difficulties put a burden on you or the family as a whole?
Not at allOnly a littleQuite a lotA great deal
[/group]

Group leaders email address*
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Your email address
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