The pages that follow contain statements that describe how children may act. Please read each phrase and select the option that best describes how often your child shows these behaviors. Please mark one option for every statement.
Use these guidelines to mark your responses:
When presented with the opportunity, my child...
5- Almost Always= responds in this manner Almost Always (90% or more of the time).
4- Frequently= responds in this manner Frequently (75% of the time).
3- Half the Time= responds in this manner Half the Time (50% of the time).
2- Occasionally= responds in this manner Occasionally. (25% of the time).
1- Almost Never= responds in this manner Almost Never. (10% or less of the time).
0- Does Not Apply= If you are unable to answer because you have not observed the behavior or believe that it does not apply to your child, please check Does Not Apply.
**This item is not part of the Visual Raw Score**
**This item is not part of the Touch Raw Score.**
**This is not part of the Movement Raw Score.**