Child's Behavior Assesment form - Teacher Informant

Child's Behavior Assesment form - Teacher Informant

Let the teachers fill this well detailed checklist that will enable you evaluate the child behavior. Form Preview
Vanderbilt Assessment-Teacher Informant
  • Vanderbilt Assessment-Teacher Informant

  •   Never Occasionally Often Very Often
    1. Does not pay attention to details or makes careless mistakes, such as in home-work
    2. Has difficulty sustaining attention to tasks or activities
    3. Does not seem to listen when spoken to directly
    4. Does not follow through on instruction and fails to finish schoolwork (not due to oppositional behavior or failure to understand)
    5. Has difficulty organizing tasks and activities
    6. Avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort
    7. Loses things necessary for tasks or activities (school assignments, pencils, or books)
    8. Is easily distracted by extraneous stimuli
    9. Is forgetful in daily activities
    10. Fidgets with hands or feet or squirms in seat
    11. Leaves seat when remaining in seated is expected
    12. Runs about or climbs excessively when remaining seated is expected
    13. Has difficulty playing or engaging in leisure activities quietly
    14. Is “on the go” or often acts as if “driven by a motor”
    15. Talks too much
    16. Blurts out answers before questions have been completed
    17. Has difficulty waiting his or her turn
    18. Interrupts or intrudes in on others (butts into conversations or games)
    19. Loses temper
    20. Actively defies or refuses to comply with adults’ requests or rules
    21. Is angry or resentful
    22. Is spiteful and vindictive
    23. Bullies, threatens, or intimidates others
    24. Initiates physical fights
    25. Lies to obtain goods for favors or to avoid obligations (“cons” other
    26. Is physically cruel to people
    27. Has stolen items of nontrivial value
    28. Deliberately destroys others’ property
    29. Is fearful, anxious, or worried
    30. Is self-conscious or easily embarrassed
    31. Is afraid to try new things for fear of making mistakes
    32. Feels worthless or inferior
    33. Blames self for problems, feels guilty
    34. Feels lonely, unwanted, or unloved; complains that “no one loves him/her”
    35. Is sad, unhappy, or depressed
  •   Problematic Average Above Average
    Performance
    Reading
    Mathematics
    Written Expression
  •   Problematic Average Above Average
    Relationship with Peers
    Following Directions/Rules
    Disrupting Class
    Assignment Completion
    Organizational Skills
  • Should be Empty: