Childhood behaviour scale – self report form

Please choose the best rating to describe your behaviour when you were a child between the ages of seven and 12 years of age.

Failed to give close attention to details or made careless mistakes in my work Required

Fidgeted with hands or feet or squirmed in seat Required

Had difficulty sustaining my attention in tasks or fun activities Required

Left my seat in classroom or other situations in which sitting was expected Required

Didn’t listen when spoken to directly Required

Restless in the 'squirmy' sense Required

Didn’t follow through on instructions and failed to finish work Required

Had difficulty engaging in leisure activities or doing fun things quietly Required

Had difficulty organising tasks and activities Required

Felt 'on the go' or acted as if 'driven by a motor' Required

Avoided, disliked, or was reluctant to engage in work that required sustained mental effort Required

Talked excessively Required

Lost things necessary for tasks or activities Required

Blurted out answers before questions had been completed Required

Easily distracted Required

Had difficulty awaiting turn Required

Forgetful in daily activities Required

Interrupted or intruded on others Required

In your home life with your immediate family Required

In your social interactions with other children Required

In your activities or dealings in the community Required

In school Required

In sports, clubs, or other organisations Required

In learning to take care of yourself Required

In your play, leisure or recreational activities Required

In your handling of your daily chores or other responsibilities Required

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