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Please enable JavaScript in your browser to complete this form.Strengths and Difficulties Questionnaire Youth Report Measure for Youth aged 11-17 Baseline version (SDQ-YR1a)Name *Date of Birth *DD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920AddressAddress Line 1CityState / Province / RegionPostal CodeThis 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 TrueSomewhat TrueCertainly True I try to be nice to other people. I care about their feelingsNot TrueI try to be nice to other people. I care about their feelings Not TrueSomewhat TrueI try to be nice to other people. I care about their feelings Somewhat TrueCertainly TrueI try to be nice to other people. I care about their feelings Certainly TrueI am restless, I cannot stay still for longNot TrueI am restless, I cannot stay still for long Not TrueSomewhat TrueI am restless, I cannot stay still for long Somewhat TrueCertainly TrueI am restless, I cannot stay still for long Certainly TrueI get a lot of headaches, stomach-aches or sicknessNot TrueI get a lot of headaches, stomach-aches or sickness Not TrueSomewhat TrueI get a lot of headaches, stomach-aches or sickness Somewhat TrueCertainly TrueI get a lot of headaches, stomach-aches or sickness Certainly TrueI usually share with others, for example CD’s, games, foodNot TrueI usually share with others, for example CD’s, games, food Not TrueSomewhat TrueI usually share with others, for example CD’s, games, food Somewhat TrueCertainly TrueI usually share with others, for example CD’s, games, food Certainly TrueI get very angry and often loses my temperNot TrueI get very angry and often loses my temper Not TrueSomewhat TrueI get very angry and often loses my temper Somewhat TrueCertainly TrueI get very angry and often loses my temper Certainly TrueI would rather be alone than with people of my ageNot TrueI would rather be alone than with people of my age Not TrueSomewhat TrueI would rather be alone than with people of my age Somewhat TrueCertainly TrueI would rather be alone than with people of my age Certainly TrueI usually do as I am toldNot TrueI usually do as I am told Not TrueSomewhat TrueI usually do as I am told Somewhat TrueCertainly TrueI usually do as I am told Certainly TrueI worry a lotNot TrueI worry a lot Not TrueSomewhat TrueI worry a lot Somewhat TrueCertainly TrueI worry a lot Certainly TrueI am helpful if someone is hurt, upset or feeling illNot TrueI am helpful if someone is hurt, upset or feeling ill Not TrueSomewhat TrueI am helpful if someone is hurt, upset or feeling ill Somewhat TrueCertainly TrueI am helpful if someone is hurt, upset or feeling ill Certainly TrueI am constantly fidgeting or squirmingNot TrueI am constantly fidgeting or squirming Not TrueSomewhat TrueI am constantly fidgeting or squirming Somewhat TrueCertainly TrueI am constantly fidgeting or squirming Certainly TrueI have one good friend or moreNot TrueI have one good friend or more Not TrueSomewhat TrueI have one good friend or more Somewhat TrueCertainly TrueI have one good friend or more Certainly TrueI fight a lot. I can make other people do what I wantNot TrueI fight a lot. I can make other people do what I want Not TrueSomewhat TrueI fight a lot. I can make other people do what I want Somewhat TrueCertainly TrueI fight a lot. I can make other people do what I want Certainly TrueI am often unhappy, depressed or tearfulNot TrueI am often unhappy, depressed or tearful Not TrueSomewhat TrueI am often unhappy, depressed or tearful Somewhat TrueCertainly TrueI am often unhappy, depressed or tearful Certainly TrueOther people my age generally like meNot TrueOther people my age generally like me Not TrueSomewhat TrueOther people my age generally like me Somewhat TrueCertainly TrueOther people my age generally like me Certainly TrueI am easily distracted, I find it difficult to concentrateNot TrueI am easily distracted, I find it difficult to concentrate Not TrueSomewhat TrueI am easily distracted, I find it difficult to concentrate Somewhat TrueCertainly TrueI am easily distracted, I find it difficult to concentrate Certainly TrueI am nervous in new situations, I easily loses confidenceNot TrueI am nervous in new situations, I easily loses confidence Not TrueSomewhat TrueI am nervous in new situations, I easily loses confidence Somewhat TrueCertainly TrueI am nervous in new situations, I easily loses confidence Certainly TrueI am kind to younger childrenNot TrueI am kind to younger children Not TrueSomewhat TrueI am kind to younger children Somewhat TrueCertainly TrueI am kind to younger children Certainly TrueI am often accused of lying or cheatingNot TrueI am often accused of lying or cheating Not TrueSomewhat TrueI am often accused of lying or cheating Somewhat TrueCertainly TrueI am often accused of lying or cheating Certainly TrueOther children or young people pick on me or bully meNot TrueOther children or young people pick on me or bully me Not TrueSomewhat TrueOther children or young people pick on me or bully me Somewhat TrueCertainly TrueOther children or young people pick on me or bully me Certainly TrueI often volunteer to help others (parents, teachers, children)Not TrueI often volunteer to help others (parents, teachers, children) Not TrueSomewhat TrueI often volunteer to help others (parents, teachers, children) Somewhat TrueCertainly TrueI often volunteer to help others (parents, teachers, children) Certainly TrueI thinks before I do thingsNot TrueI thinks before I do things Not TrueSomewhat TrueI thinks before I do things Somewhat TrueCertainly TrueI thinks before I do things Certainly TrueI take things that are not mine from home, school or elsewhereNot TrueI take things that are not mine from home, school or elsewhere Not TrueSomewhat TrueI take things that are not mine from home, school or elsewhere Somewhat TrueCertainly TrueI take things that are not mine from home, school or elsewhere Certainly TrueI get along better with adults than with people my own ageNot TrueI get along better with adults than with people my own age Not TrueSomewhat TrueI get along better with adults than with people my own age Somewhat TrueCertainly TrueI get along better with adults than with people my own age Certainly TrueI have many fears, I am easily scaredNot TrueI have many fears, I am easily scared Not TrueSomewhat TrueI have many fears, I am easily scared Somewhat TrueCertainly TrueI have many fears, I am easily scared Certainly TrueI finish the work I’m doing. My attention is goodNot TrueI finish the work I’m doing. My attention is good Not TrueSomewhat TrueI finish the work I’m doing. My attention is good Somewhat TrueCertainly TrueI finish the work I’m doing. My attention is good Certainly True NoYes, minor difficultiesYes, definite difficultiesYes, 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?NoOverall 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? NoYes, minor difficultiesOverall 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? Yes, minor difficultiesYes, definite difficultiesOverall 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? Yes, definite difficultiesYes, severe difficultiesOverall 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? Yes, severe difficulties If you have answered "Yes", please answer the following questions about these difficulties: Less than a month1-5 months6-12 monthsOver a year How long have these difficulties been present?Less than a monthHow long have these difficulties been present? Less than a month1-5 monthsHow long have these difficulties been present? 1-5 months6-12 monthsHow long have these difficulties been present? 6-12 monthsOver a yearHow long have these difficulties been present? Over a year Not at allOnly a littleQuite a lotA great deal Do the difficulties upset or distress you?Not at allDo the difficulties upset or distress you? Not at allOnly a littleDo the difficulties upset or distress you? Only a littleQuite a lotDo the difficulties upset or distress you? Quite a lotA great dealDo the difficulties upset or distress you? A great deal Do the difficulties interfere with your child's everyday life in the following areas? Not at allOnly a littleQuite a lotA great deal Home LifeNot at allHome Life Not at allOnly a littleHome Life Only a littleQuite a lotHome Life Quite a lotA great dealHome Life A great dealFriendshipsNot at allFriendships Not at allOnly a littleFriendships Only a littleQuite a lotFriendships Quite a lotA great dealFriendships A great dealClassroom LearningNot at allClassroom Learning Not at allOnly a littleClassroom Learning Only a littleQuite a lotClassroom Learning Quite a lotA great dealClassroom Learning A great dealLeisure ActivitiesNot at allLeisure Activities Not at allOnly a littleLeisure Activities Only a littleQuite a lotLeisure Activities Quite a lotA great dealLeisure Activities A great dealDo the difficulties make it harder for those around you (family, friends, teachers etc)?Not at allDo the difficulties make it harder for those around you (family, friends, teachers etc)? Not at allOnly a littleDo the difficulties make it harder for those around you (family, friends, teachers etc)? Only a littleQuite a lotDo the difficulties make it harder for those around you (family, friends, teachers etc)? Quite a lotA great dealDo the difficulties make it harder for those around you (family, friends, teachers etc)? A great dealDoes your family complain about you having problems with over activity or poor concentration?Not at allDoes your family complain about you having problems with over activity or poor concentration? Not at allOnly a littleDoes your family complain about you having problems with over activity or poor concentration? Only a littleQuite a lotDoes your family complain about you having problems with over activity or poor concentration? Quite a lotA great dealDoes your family complain about you having problems with over activity or poor concentration? A great dealDo your teachers complain about you having problems with over activity or poor concentration?Not at allDo your teachers complain about you having problems with over activity or poor concentration? Not at allOnly a littleDo your teachers complain about you having problems with over activity or poor concentration? Only a littleQuite a lotDo your teachers complain about you having problems with over activity or poor concentration? Quite a lotA great dealDo your teachers complain about you having problems with over activity or poor concentration? A great dealDoes your family complain about you being awkward or troublesome?Not at allDoes your family complain about you being awkward or troublesome? Not at allOnly a littleDoes your family complain about you being awkward or troublesome? Only a littleQuite a lotDoes your family complain about you being awkward or troublesome? Quite a lotA great dealDoes your family complain about you being awkward or troublesome? A great dealDo your teachers complain about you being awkward or troublesome?Not at allDo your teachers complain about you being awkward or troublesome? Not at allOnly a littleDo your teachers complain about you being awkward or troublesome? Only a littleQuite a lotDo your teachers complain about you being awkward or troublesome? Quite a lotA great dealDo your teachers complain about you being awkward or troublesome? A great deal DateDD12345678910111213141516171819202122232425262728293031MM123456789101112YYYY20262025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920EmailSubmit
