Strengths and Difficulties Questionnaire (Parent 11-17)
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.
Your child's name Male Female
Date of Birth
Do you have any other comments or concerns?
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?
No Yes - minor difficulties Yes - definite difficulties Yes - severe difficulties
If you have answered "Yes", please answer the following questions about these difficulties:
Less than a month 1-5 months 6-12 months Over a year
Not at all Only a little A medium amount A great deal
Mother/Father/Other (please specify:)
Thank you very much for your help
Leave this empty:
Your legal name
Your email address
If you have questions about the contents of this document, you can email the document owner.
Document Name: Strengths and Difficulties Questionnaire (Parent 11-17)
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