Read each item carefully. Score each item for the previous month only
Problem Behaviors - Directed to others (Include behavior that is directed to other persons). *
Do not include behavior directed towards self or behavior primarily directed at property or other behaviors. Rate risk as it is currently perceived.
Behavioral problems – directed at self (self-injury) *
Include all forms of self-injurious behavior. Do not include behavior directed towards others
Other behavioral problems. This is a global rating to include behavioral problems not described above *
Do not include behavior directed towards others, or self-injurious behavior. Include: a) Behavior destructive to property b) Problems with personal behaviors (e.g. spitting, eating trash, self-induced vomiting, continuous eating or drinking, hoarding trash, inappropriate sexual behavior) c) Rocking, stereotyped and ritualistic behavior d) Anxiety, phobias, obsessive, compulsive behavior.
Attention and concentration *
Include problems that may arise from underactivity, overactive behavior, restlessness, fidgeting or inattention etc.
Communication *
Include all types of responses to verbal, gestural and signed communication, supported if necessary with environmental cues.
Communication (problems with expression) *
Include all attempts to make needs known and communicate with others (words, gestures, signs). Rate behavior under Scales 1, 2 and 3.
Problems associated with mood changes *
Include problems associated with low mood, elated mood, mixed moods and mood swings (alternating between unhappiness, weeping and withdrawal on one hand and excitability and irritability on the other).
Activities of daily living at home *
Include skills such as household chores and/or involvement in activities household tasks.
Problems with relationships *
Include effects of problems with relationships with family, friends, staff and therapy providers etc. Measure what is occurring regardless of cause, for example, somebody who is known to have good relationships may still display problems.
Level of self-care *
Rate the overall level of functioning in activities of self-care such as eating, washing, dressing and toileting. Rate the current level achieved with the existing support. Rate appearance not motivation.
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