• Strengths and Difficulties Questionnaire

  • 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. Please give your answers on the basis of your child's behavior over the last six months.

  • Format: (000) 000-0000.
  • Date of birth
     / /
    2 digit month, 2 digit day, 4 digit year
  • Considerate of other people's feelings
  • Restless, overactive, cannot stay still for long
  • Often complains of headaches, stomach-aches or sickness
  • Shares readily with other children, for example toys, treats, pencils
  • Often loses temper
  • Rather solitary, prefers to play alone
  • Generally well behaved, usually does what adults request
  • Many worries or often seems worried
  • Helpful if someone is hurt, upset or feeling ill
  • Constantly fidgeting or squirming
  • Has at least one good friend
  • Often fights with other children or bullies them
  • Often unhappy, depressed or tearful
  • Generally liked by other children
  • Easily distracted, concentration wanders
  • Nervous or clingy in new situations, easily loses confidence
  • Kind to younger children
  • Often argumentative with adults
  • Picked on or bullied by other children
  • Often offers to help others (parents, teachers, other children)
  • Can stop and think things out before acting
  • Can be spiteful to others
  • Gets along better with adults than with other children
  • Many fears, easily scared
  • Good attention span, sees work through to the end

  • Please turn over - there are a few more questions on the other side

  • Overall, do you think that your child has difficulties in one or more of the following areas: emotions, concentration, behavior or being able to get on with other people?
  • If you have answered "Yes", please answer the following questions about these difficulties: How long have these difficulties been present?
  • Do the difficulties upset or distress your child?
  • Rows
  • Do the difficulties put a burden on you or the family as a whole?
  • Date
     / /
    2 digit month, 2 digit day, 4 digit year

  • Thank you very much for your help

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  • Should be Empty: