Referral For Initial Multidisciplinary Team Evaluation (50 Day Timeline) Page 5
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8Dramatic or attention seeking
Obeys school rules and authority
Uses inappropriate language or gestures
Displays sudden outbursts or temper flares
Threatens others or is aggressive
Displays negative verbal or physical
actions towards others
Perfectionistic
Cries
Anxious or nervous
Withdrawn or a “loner”
Empathetic
Displays hostile/violent themes in work
Compulsive or obsessive
Flexible with changes in routine
Seldom expresses feelings
Communicates needs clearly/ Advocates
for self
Included by peers
Takes responsibility for actions
Talks about sex or displays sexual themes
in work
Talks about death or suicide
Engages in self-harm
Has good personal hygiene
Wets or soils clothes
Frequent visits to nurse or Social Worker
Referral for Multidisciplinary Team Evaluation
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