SDQ Parent/Carer, 4-10 years (Followup Version)
Time to complete: 5 mins
Child's Name
*
First Name
Last Name
Date
*
/
Day
/
Month
Year
1) Is considerate of other people's feelings
*
Not True
Somewhat True
Certainly True
2) Is restless, overactive, cannot stay still for long
*
Not True
Somewhat True
Certainly True
3) Often complains of headaches, stomach-aches or sickness
*
Not True
Somewhat True
Certainly True
4) Shares readily with other children, for example toys, treats, pencils
*
Not True
Somewhat True
Certainly True
5) Often Loses Temper
*
Not True
Somewhat True
Certainly True
6) Rather Solitary, prefers to play alone
*
Not True
Somewhat True
Certainly True
7) Generally well behaved, usually does what adults request
*
Not True
Somewhat True
Certainly True
8) Many worries or often seems worried
*
Not True
Somewhat True
Certainly True
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9) Helpful if someone is hurt, upset or feeling ill
*
Not True
Somewhat True
Certainly True
10) Constantly fidgeting or squirming
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Not True
Somewhat True
Certainly True
11) Has at least one good friend
*
Not True
Somewhat True
Certainly True
12) Often fights with other children or bullies them
*
Not True
Somewhat True
Certainly True
13) Often unhappy, depressed or tearful
*
Not True
Somewhat True
Certainly True
14) Generally liked by other children
*
Not True
Somewhat True
Certainly True
15) Easily distracted, concentration wanders
*
Not True
Somewhat True
Certainly True
16) Nervous or clingy in new situations, easily loses confidence
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Not True
Somewhat True
Certainly True
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17) Kind to younger children
*
Not True
Somewhat True
Certainly True
18) Often lies or cheats
*
Not True
Somewhat True
Certainly True
19) Picked on or bullied by other children
*
Not True
Somewhat True
Certainly True
20) Often volunteers to help others (parents, teachers, other children)
*
Not True
Somewhat True
Certainly True
21) Thinks things out before acting
*
Not True
Somewhat True
Certainly True
22) Steals from home, school or elsewhere
*
Not True
Somewhat True
Certainly True
23) Gets along better with adults than with other children
*
Not True
Somewhat True
Certainly True
24) Many fears, easily scared
*
Not True
Somewhat True
Certainly True
25) Good attention span, sees chores or homework through to the end
*
Not True
Somewhat True
Certainly True
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Since coming to the service, are your child's problems:
*
Much better
A bit better
About the same
A bit worse
Much worse
Has coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable?
*
Not at all
Only a little
Quite a lot
A great deal
Over the last month, has your child had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?
*
No
Yes - minor difficulties
Yes - definite difficulties
Yes- severe difficulties
Do the difficulties upset or distress your child?
*
Not at all
Only a little
Quite a lot
A great deal
Do the difficulties interfere with your child's everyday life in the following areas?
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
Leisure Activites
*
Not at all
Only a little
Quite a lot
A great deal
Do the difficulties put a burden on you or the family as a whole?
*
Not at all
Only a little
Quite a lot
A great deal
Conduct Score
Emotional Score
Hyperactivity Score
Peer Problems Score
Prosocial Score
Total Difficulties Score
Impact Score
Submit
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