Strengths and Difficulties Questionnaire
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Teacher referring student: *
Child's name: *
Date of birth *
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Male or Female *
Required
Considerate of other people's feelings *
Required
Restless, overactive, cannot stay still for long *
Required
Often complains of headaches, stomach-aches or sickness *
Required
Shares readily with other children, for example, toys, treats, pencils *
Required
Often loses temper *
Required
Rather solitary, prefers to play alone *
Required
Generally well behaved, usually does what adults request *
Required
Many worries or often seems worried *
Required
Helpful if someone is hurt, upset or feeling ill *
Required
Constantly fidgeting or squirming *
Required
Has at least one good friend *
Required
Often fights with other children or bullies them *
Required
Often unhappy, depressed or tearful *
Required
Generally liked by other children *
Required
Easily distracted, concentration wanders *
Required
Nervous or clingy in new situations, easily loses confidence *
Required
Kind to younger children *
Required
Often lies or cheats *
Required
Picked on or bullied by other children *
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Often offers help to others (parents, teachers, other children) *
Required
Thinks things out before acting *
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Steals from home, school or elsewhere *
Required
Gets along better with adults than with other children *
Required
Many fears, easily scared *
Required
Good attention span, sees work through to the end *
Required
Good attention span, sees work through to the end *
Required
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