GT Home Rating Scale

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Directions:
Read each statement and decide how often your child exhibits each behavior.
As you respond, ask yourself, "To what degree does my child exhibit the behavior listed when compared with his or her age peers?"

Please respond to all statements, filling one number for each.

0 = NEVER Exhibits the behavior in comparison to his or her age peers.
1 = RARELY Exhibits the behavior in comparison to his or her age peers.
2 = Exhibits the behavior about the same as his or her age peers.
3 = Exhibits the behavior SOMEWHAT MORE in comparison to his or her age peers.
4 = Exhibits the behavior MUCH MORE in comparison to his or her age peers.

IF YOUR CHILD IS RATED WITH SIX OR MORE 4'S, PLEASE PROVIDE EXAMPLES THAT DEMONSTRATE HIS OR HER STRENGTH IN THAT AREA AT THE END OF THIS FORM.

Email *

Raters Name (Parent or Guardian filling this form out.) *

Relationship to Child *

Mother

Father

Guardian

Child's Name *

What is your child's current teachers name and room number? (New students to MES, please write what grade your child will be entering in the school year of 2024-2025. *

Date of Child's birth. *

YYYY

Age in years *

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