Adolescent Psychosocial Asessment Page 8
ADVERTISEMENT
1
2
3
4
5
6
7
8
9
10
11
12
13
14MOOD (what is my child’s mood most of the time)?
ANXIOUS‐usually
CALM‐usually relaxed
frustrated and worried ____: ____: ____: ____: ____: ____: ____
1 2 3 4 5 6 7
HAPPY‐usually enjoys
SAD‐usually unhappy;
what he/she is doing ____: ____: ____: ____: ____: ____: ____ hard time having fun
1 2 3 4 5 6 7
CURIOUS‐usually eager
TIMID‐usually not
to know something ____: ____: ____: ____: ____: ____: ____ interested
1 2 3 4 5 6 7
ANGRY‐easily frustrated
CALM‐usually
and annoyed with others ____: ____: ____: ____: ____: ____: ____ composed and
1 2 3 4 5 6 7 peaceful with others
INTENSITY (how strongly does my child express feelings, wants and opinions?)
MILD REACTION‐calm
STRONG REACTION‐
and cooperative; Easily ____: ____: ____: ____: ____: ____: ____ may cry or yell over
pushed around by others 1 2 3 4 5 6 7 small things
PERSISTENCE (Can my child stick with and complete tasks?)
Will stick with something
Gives up on tasks;
until it is done
____: ____: ____: ____: ____: ____: ____ has trouble finishing
1 2 3 4 5 6 7 things
SENSITIVITY TO SENSES (How sensitive is my child to light, smells, sounds, and touching?)
Learns by seeing
Has strong reaction to
touching and using all ____: ____: ____: ____: ____: ____: ____ noise, lights, hugging
his/her senses
1 2 3 4 5 6 7 or touching
PERCEPTIVENESS (How aware is my child of feelings and emotions?)
Sympathetic to others;
Unaware of the
can use words to tell ____: ____: ____: ____: ____: ____: ____ feelings of others
how he/she feels
1 2 3 4 5 6 7
8
ADVERTISEMENT
0 votes
Related Articles
Related forms
Related Categories
Parent category: Medical