Strengths and Difficulties Questionnaire Youth Report Measure for Youth aged 11-17 Baseline version (SDQ-YR1a)
Name
*
Date of Birth
*
Address
Street address
Street address line 2
City
State
Please select
ACT
NSW
NT
QLD
SA
TAS
VIC
WA
Postcode
Country
Please select
Afghanistan
Albania
Algeria
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo (Brazzaville)
Congo
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor (Timor Timur)
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Fiji
Finland
France
Gabon
Gambia, The
Georgia
Germany
Ghana
Greece
Grenada
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
Korea, North
Korea, South
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Norway
Oman
Pakistan
Palau
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia and Montenegro
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Yemen
Zambia
Zimbabwe
This service is only available within South Australia. Check our services page for specific locations. Or contact Head to Health directly on 1800 595 212 or visit website www.headtohealth.gov.au for alternative services in their area.
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 our answers on the basis of your child’s behaviour over the last six months.
Kessler 10 Plus
Not True
Somewhat True
Certainly True
I try to be nice to other people. I care about their feelings
Not True
Somewhat True
Certainly True
I am restless, I cannot stay still for long
Not True
Somewhat True
Certainly True
I get a lot of headaches, stomach-aches or sickness
Not True
Somewhat True
Certainly True
I usually share with others, for example CD’s, games, food
Not True
Somewhat True
Certainly True
I get very angry and often loses my temper
Not True
Somewhat True
Certainly True
I would rather be alone than with people of my age
Not True
Somewhat True
Certainly True
I usually do as I am told
Not True
Somewhat True
Certainly True
I worry a lot
Not True
Somewhat True
Certainly True
I am helpful if someone is hurt, upset or feeling ill
Not True
Somewhat True
Certainly True
I am constantly fidgeting or squirming
Not True
Somewhat True
Certainly True
I have one good friend or more
Not True
Somewhat True
Certainly True
I fight a lot. I can make other people do what I want
Not True
Somewhat True
Certainly True
I am often unhappy, depressed or tearful
Not True
Somewhat True
Certainly True
Other people my age generally like me
Not True
Somewhat True
Certainly True
I am easily distracted, I find it difficult to concentrate
Not True
Somewhat True
Certainly True
I am nervous in new situations, I easily loses confidence
Not True
Somewhat True
Certainly True
I am kind to younger children
Not True
Somewhat True
Certainly True
I am often accused of lying or cheating
Not True
Somewhat True
Certainly True
Other children or young people pick on me or bully me
Not True
Somewhat True
Certainly True
I often volunteer to help others (parents, teachers, children)
Not True
Somewhat True
Certainly True
I thinks before I do things
Not True
Somewhat True
Certainly True
I take things that are not mine from home, school or elsewhere
Not True
Somewhat True
Certainly True
I get along better with adults than with people my own age
Not True
Somewhat True
Certainly True
I have many fears, I am easily scared
Not True
Somewhat True
Certainly True
I finish the work I’m doing. My attention is good
Not True
Somewhat True
Certainly True
No
Yes, minor difficulties
Yes, definite difficulties
Yes, severe difficulties
Overall do you think that you have difficulties in any of the following areas: emotions, concentration, behaviour or being able to get along 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
How long have these difficulties been present?
Less than a month
1-5 months
6-12 months
Over a year
Not at all
Only a little
Quite a lot
A great deal
Do the difficulties upset or distress you?
Not at all
Only a little
Quite a lot
A great deal
Do the difficulties interfere with your child's everyday life in the following areas?
Not at all
Only a little
Quite a lot
A great deal
Home Life
Not at all
Only a little
Quite a lot
A great deal
Friendships
Not at all
Only a little
Quite a lot
A great deal
Classroom Learning
Not at all
Only a little
Quite a lot
A great deal
Leisure Activities
Not at all
Only a little
Quite a lot
A great deal
Do the difficulties make it harder for those around you (family, friends, teachers etc)?
Not at all
Only a little
Quite a lot
A great deal
Does your family complain about you having problems with over activity or poor concentration?
Not at all
Only a little
Quite a lot
A great deal
Do your teachers complain about you having problems with over activity or poor concentration?
Not at all
Only a little
Quite a lot
A great deal
Does your family complain about you being awkward or troublesome?
Not at all
Only a little
Quite a lot
A great deal
Do your teachers complain about you being awkward or troublesome?
Not at all
Only a little
Quite a lot
A great deal
Date
Captcha
*
Please wait, files are uploading..
Submit