Directions: Each rating should be considered in the context of what is appropriate for the age of your child. When completing this form, please think about your child’s behaviors in the past 6 months.
(0 - Never, 1 - Occasionally, 2 - Often, 3 - Very Often)
(1 - Excellent, 2 - Above Average, 3 - Average, 4 - Somewhat of a Problem, 5 - Problematic)
The information contained in this publication should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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