SDQ Form 11-17 (Parent)

SDQ Form

11-17 Parent
For each item, please mark the box for Not True, Somewhat True, or Certainly True. It would help us if you ansered all items as best you can even if you are not absolutely certain. Please give your answers on the basis of this oung person's behavior over the last six months or this school year.
Young Person's Name*

First NameLast Name
Gender

MaleFemaleOther
Date of Birth*

MonthDayYear
Date
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 youth, for example, books, games, food

Not TrueSomewhat TrueCertainly True
Often loses temper

Not TrueSomewhat TrueCertainly True
Would rater be alone than with other youth

Not TrueSomewhat TrueCertainly True
Generally well behaved, usually does what adults request

Not TrueSomewhat TrueCertainly True
Many worries or 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 youth or bullies them

Not TrueSomewhat TrueCertainly True
Often unhappy, depressed or tearful

Not TrueSomewhat TrueCertainly True
Generally liked by other youth

Not TrueSomewhat TrueCertainly True
Easily distracted, concentration wanders

Not TrueSomewhat TrueCertainly True
Nervous 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 our bullied by other youth

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

Not TrueSomewhat TrueCertainly True
Thinks things out before acting

Not TrueSomewhat TrueCertainly True
Steal from home, school, or elsewhere

Not TrueSomewhat TrueCertainly True
Gets along better with adults than with other youth

Not TrueSomewhat TrueCertainly True
Many fears, easily scared

Not TrueSomewhat TrueCertainly True
Good attention span, sees work through to the end

Not TrueSomewhat TrueCertainly True
Signature

Clear
Date

MonthDayYear
Date
Relation to child
Therapist you’re scheduled with*

First NameLast Name
Should be Empty: