Strengths and Difficulties Questionnaire Youth Report Measure for Youth aged 11-17 Follow Up version (SDQ-YR2 11-17 FU)

Strengths and Difficulties Questionnaire
Youth Report Measure for Youth aged 11-17
Follow Up version (SDQ-YR2 11-17 FU)

Please complete all information required in the form fields below

Strengths and Difficulties Questionnaire Youth Report Measure for Youth aged 11-17 Follow Up version (SDQ-YR2 11-17 FU)

Name *

Date of Birth *

Address
Address Line 1
City
State / Province / Region
Postal Code
This 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 your answers on the basis of your child’s behaviour over the last month.

Kessler 10 Plus

Not True Somewhat True Certainly True

I try to be nice to other people. I care about their feelings
Not TrueI try to be nice to other people. I care about their feelings Not True
Somewhat TrueI try to be nice to other people. I care about their feelings Somewhat True
Certainly TrueI try to be nice to other people. I care about their feelings Certainly True
I am restless, I cannot stay still for long
Not TrueI am restless, I cannot stay still for long Not True
Somewhat TrueI am restless, I cannot stay still for long Somewhat True
Certainly TrueI am restless, I cannot stay still for long Certainly True
I get a lot of headaches, stomach-aches or sickness
Not TrueI get a lot of headaches, stomach-aches or sickness Not True
Somewhat TrueI get a lot of headaches, stomach-aches or sickness Somewhat True
Certainly TrueI get a lot of headaches, stomach-aches or sickness Certainly True
I usually share with others, for example CD’s, games, food
Not TrueI usually share with others, for example CD’s, games, food Not True
Somewhat TrueI usually share with others, for example CD’s, games, food Somewhat True
Certainly TrueI usually share with others, for example CD’s, games, food Certainly True
I get very angry and often loses my temper
Not TrueI get very angry and often loses my temper Not True
Somewhat TrueI get very angry and often loses my temper Somewhat True
Certainly TrueI get very angry and often loses my temper Certainly True
I would rather be alone than with people of my age
Not TrueI would rather be alone than with people of my age Not True
Somewhat TrueI would rather be alone than with people of my age Somewhat True
Certainly TrueI would rather be alone than with people of my age Certainly True
I usually do as I am told
Not TrueI usually do as I am told Not True
Somewhat TrueI usually do as I am told Somewhat True
Certainly TrueI usually do as I am told Certainly True
I worry a lot
Not TrueI worry a lot Not True
Somewhat TrueI worry a lot Somewhat True
Certainly TrueI worry a lot Certainly True
I am helpful if someone is hurt, upset or feeling ill
Not TrueI am helpful if someone is hurt, upset or feeling ill Not True
Somewhat TrueI am helpful if someone is hurt, upset or feeling ill Somewhat True
Certainly TrueI am helpful if someone is hurt, upset or feeling ill Certainly True
I am constantly fidgeting or squirming
Not TrueI am constantly fidgeting or squirming Not True
Somewhat TrueI am constantly fidgeting or squirming Somewhat True
Certainly TrueI am constantly fidgeting or squirming Certainly True
I have one good friend or more
Not TrueI have one good friend or more Not True
Somewhat TrueI have one good friend or more Somewhat True
Certainly TrueI have one good friend or more Certainly True
I fight a lot. I can make other people do what I want
Not TrueI fight a lot. I can make other people do what I want Not True
Somewhat TrueI fight a lot. I can make other people do what I want Somewhat True
Certainly TrueI fight a lot. I can make other people do what I want Certainly True
I am often unhappy, depressed or tearful
Not TrueI am often unhappy, depressed or tearful Not True
Somewhat TrueI am often unhappy, depressed or tearful Somewhat True
Certainly TrueI am often unhappy, depressed or tearful Certainly True
Other people my age generally like me
Not TrueOther people my age generally like me Not True
Somewhat TrueOther people my age generally like me Somewhat True
Certainly TrueOther people my age generally like me Certainly True
I am easily distracted, I find it difficult to concentrate
Not TrueI am easily distracted, I find it difficult to concentrate Not True
Somewhat TrueI am easily distracted, I find it difficult to concentrate Somewhat True
Certainly TrueI am easily distracted, I find it difficult to concentrate Certainly True
I am nervous in new situations, I easily loses confidence
Not TrueI am nervous in new situations, I easily loses confidence Not True
Somewhat TrueI am nervous in new situations, I easily loses confidence Somewhat True
Certainly TrueI am nervous in new situations, I easily loses confidence Certainly True
I am kind to younger children
Not TrueI am kind to younger children Not True
Somewhat TrueI am kind to younger children Somewhat True
Certainly TrueI am kind to younger children Certainly True
I am often accused of lying or cheating
Not TrueI am often accused of lying or cheating Not True
Somewhat TrueI am often accused of lying or cheating Somewhat True
Certainly TrueI am often accused of lying or cheating Certainly True
Other children or young people pick on me or bully me
Not TrueOther children or young people pick on me or bully me Not True
Somewhat TrueOther children or young people pick on me or bully me Somewhat True
Certainly TrueOther children or young people pick on me or bully me Certainly True
I often volunteer to help others (parents, teachers, children)
Not TrueI often volunteer to help others (parents, teachers, children) Not True
Somewhat TrueI often volunteer to help others (parents, teachers, children) Somewhat True
Certainly TrueI often volunteer to help others (parents, teachers, children) Certainly True
I thinks before I do things
Not TrueI thinks before I do things Not True
Somewhat TrueI thinks before I do things Somewhat True
Certainly TrueI thinks before I do things Certainly True
I take things that are not mine from home, school or elsewhere
Not TrueI take things that are not mine from home, school or elsewhere Not True
Somewhat TrueI take things that are not mine from home, school or elsewhere Somewhat True
Certainly TrueI take things that are not mine from home, school or elsewhere Certainly True
I get along better with adults than with people my own age
Not TrueI get along better with adults than with people my own age Not True
Somewhat TrueI get along better with adults than with people my own age Somewhat True
Certainly TrueI get along better with adults than with people my own age Certainly True
I have many fears, I am easily scared
Not TrueI have many fears, I am easily scared Not True
Somewhat TrueI have many fears, I am easily scared Somewhat True
Certainly TrueI have many fears, I am easily scared Certainly True
I finish the work I’m doing. My attention is good
Not TrueI finish the work I’m doing. My attention is good Not True
Somewhat TrueI finish the work I’m doing. My attention is good Somewhat True
Certainly TrueI finish the work I’m doing. My attention is good Certainly True

Much worse A bit worse About the same A bit better Much better

Since coming to the service, are your problems:
Much worseSince coming to the service, are your problems: Much worse
A bit worseSince coming to the service, are your problems: A bit worse
About the sameSince coming to the service, are your problems: About the same
A bit betterSince coming to the service, are your problems: A bit better
Much betterSince coming to the service, are your problems: Much better

	Much worse	A bit worse	About the same	A bit better	Much better
Since coming to the service, are your problems:	Much worseSince coming to the service, are your problems: Much worse	A bit worseSince coming to the service, are your problems: A bit worse	About the sameSince coming to the service, are your problems: About the same	A bit betterSince coming to the service, are your problems: A bit better	Much betterSince coming to the service, are your problems: Much better

Not at all Only a little Quite a lot A great deal

Has coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable?
Not at allHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? Not at all
Only a littleHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? Only a little
Quite a lotHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? Quite a lot
A great dealHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? A great deal

	Not at all	Only a little	Quite a lot	A great deal
Has coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable?	Not at allHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? Not at all	Only a littleHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? Only a little	Quite a lotHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? Quite a lot	A great dealHas coming to the service been helpful in other ways, e.g. providing information or making the problems more bearable? A great deal

No Yes, minor difficulties Yes, definite difficulties Yes, severe difficulties

Over the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?
NoOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? No
Yes, minor difficultiesOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? Yes, minor difficulties
Yes, definite difficultiesOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? Yes, definite difficulties
Yes, severe difficultiesOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? Yes, severe difficulties

	No	Yes, minor difficulties	Yes, definite difficulties	Yes, severe difficulties
Over the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?	NoOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? No	Yes, minor difficultiesOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? Yes, minor difficulties	Yes, definite difficultiesOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? Yes, definite difficulties	Yes, severe difficultiesOver the last month, o you think you have had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people? Yes, severe difficulties

If you have answered “Yes”, please answer the following questions about these difficulties:

Not at all Only a little Quite a lot A great deal

Do the difficulties upset or distress you?
Not at allDo the difficulties upset or distress you? Not at all
Only a littleDo the difficulties upset or distress you? Only a little
Quite a lotDo the difficulties upset or distress you? Quite a lot
A great dealDo the difficulties upset or distress you? A great deal

	Not at all	Only a little	Quite a lot	A great deal
Do the difficulties upset or distress you?	Not at allDo the difficulties upset or distress you? Not at all	Only a littleDo the difficulties upset or distress you? Only a little	Quite a lotDo the difficulties upset or distress you? Quite a lot	A great dealDo the difficulties upset or distress you? A great deal

Do the difficulties interfere with your everyday life in the following areas?

Not at all Only a little Quite a lot A great deal

Home Life
Not at allHome Life Not at all
Only a littleHome Life Only a little
Quite a lotHome Life Quite a lot
A great dealHome Life A great deal
Friendships
Not at allFriendships Not at all
Only a littleFriendships Only a little
Quite a lotFriendships Quite a lot
A great dealFriendships A great deal
Classroom Learning
Not at allClassroom Learning Not at all
Only a littleClassroom Learning Only a little
Quite a lotClassroom Learning Quite a lot
A great dealClassroom Learning A great deal
Leisure Activities
Not at allLeisure Activities Not at all
Only a littleLeisure Activities Only a little
Quite a lotLeisure Activities Quite a lot
A great dealLeisure Activities A great deal
Do 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 all
Only a littleDo the difficulties make it harder for those around you (family, friends, teachers, etc.)? Only a little
Quite a lotDo the difficulties make it harder for those around you (family, friends, teachers, etc.)? Quite a lot
A great dealDo the difficulties make it harder for those around you (family, friends, teachers, etc.)? A great deal

	Not at all	Only a little	Quite a lot	A great deal
Home Life	Not at allHome Life Not at all	Only a littleHome Life Only a little	Quite a lotHome Life Quite a lot	A great dealHome Life A great deal
Friendships	Not at allFriendships Not at all	Only a littleFriendships Only a little	Quite a lotFriendships Quite a lot	A great dealFriendships A great deal
Classroom Learning	Not at allClassroom Learning Not at all	Only a littleClassroom Learning Only a little	Quite a lotClassroom Learning Quite a lot	A great dealClassroom Learning A great deal
Leisure Activities	Not at allLeisure Activities Not at all	Only a littleLeisure Activities Only a little	Quite a lotLeisure Activities Quite a lot	A great dealLeisure Activities A great deal
Do 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 all	Only a littleDo the difficulties make it harder for those around you (family, friends, teachers, etc.)? Only a little	Quite a lotDo the difficulties make it harder for those around you (family, friends, teachers, etc.)? Quite a lot	A great dealDo the difficulties make it harder for those around you (family, friends, teachers, etc.)? A great deal

Date

Website

	Not True	Somewhat True	Certainly True
I try to be nice to other people. I care about their feelings	Not TrueI try to be nice to other people. I care about their feelings Not True	Somewhat TrueI try to be nice to other people. I care about their feelings Somewhat True	Certainly TrueI try to be nice to other people. I care about their feelings Certainly True
I am restless, I cannot stay still for long	Not TrueI am restless, I cannot stay still for long Not True	Somewhat TrueI am restless, I cannot stay still for long Somewhat True	Certainly TrueI am restless, I cannot stay still for long Certainly True
I get a lot of headaches, stomach-aches or sickness	Not TrueI get a lot of headaches, stomach-aches or sickness Not True	Somewhat TrueI get a lot of headaches, stomach-aches or sickness Somewhat True	Certainly TrueI get a lot of headaches, stomach-aches or sickness Certainly True
I usually share with others, for example CD’s, games, food	Not TrueI usually share with others, for example CD’s, games, food Not True	Somewhat TrueI usually share with others, for example CD’s, games, food Somewhat True	Certainly TrueI usually share with others, for example CD’s, games, food Certainly True
I get very angry and often loses my temper	Not TrueI get very angry and often loses my temper Not True	Somewhat TrueI get very angry and often loses my temper Somewhat True	Certainly TrueI get very angry and often loses my temper Certainly True
I would rather be alone than with people of my age	Not TrueI would rather be alone than with people of my age Not True	Somewhat TrueI would rather be alone than with people of my age Somewhat True	Certainly TrueI would rather be alone than with people of my age Certainly True
I usually do as I am told	Not TrueI usually do as I am told Not True	Somewhat TrueI usually do as I am told Somewhat True	Certainly TrueI usually do as I am told Certainly True
I worry a lot	Not TrueI worry a lot Not True	Somewhat TrueI worry a lot Somewhat True	Certainly TrueI worry a lot Certainly True
I am helpful if someone is hurt, upset or feeling ill	Not TrueI am helpful if someone is hurt, upset or feeling ill Not True	Somewhat TrueI am helpful if someone is hurt, upset or feeling ill Somewhat True	Certainly TrueI am helpful if someone is hurt, upset or feeling ill Certainly True
I am constantly fidgeting or squirming	Not TrueI am constantly fidgeting or squirming Not True	Somewhat TrueI am constantly fidgeting or squirming Somewhat True	Certainly TrueI am constantly fidgeting or squirming Certainly True
I have one good friend or more	Not TrueI have one good friend or more Not True	Somewhat TrueI have one good friend or more Somewhat True	Certainly TrueI have one good friend or more Certainly True
I fight a lot. I can make other people do what I want	Not TrueI fight a lot. I can make other people do what I want Not True	Somewhat TrueI fight a lot. I can make other people do what I want Somewhat True	Certainly TrueI fight a lot. I can make other people do what I want Certainly True
I am often unhappy, depressed or tearful	Not TrueI am often unhappy, depressed or tearful Not True	Somewhat TrueI am often unhappy, depressed or tearful Somewhat True	Certainly TrueI am often unhappy, depressed or tearful Certainly True
Other people my age generally like me	Not TrueOther people my age generally like me Not True	Somewhat TrueOther people my age generally like me Somewhat True	Certainly TrueOther people my age generally like me Certainly True
I am easily distracted, I find it difficult to concentrate	Not TrueI am easily distracted, I find it difficult to concentrate Not True	Somewhat TrueI am easily distracted, I find it difficult to concentrate Somewhat True	Certainly TrueI am easily distracted, I find it difficult to concentrate Certainly True
I am nervous in new situations, I easily loses confidence	Not TrueI am nervous in new situations, I easily loses confidence Not True	Somewhat TrueI am nervous in new situations, I easily loses confidence Somewhat True	Certainly TrueI am nervous in new situations, I easily loses confidence Certainly True
I am kind to younger children	Not TrueI am kind to younger children Not True	Somewhat TrueI am kind to younger children Somewhat True	Certainly TrueI am kind to younger children Certainly True
I am often accused of lying or cheating	Not TrueI am often accused of lying or cheating Not True	Somewhat TrueI am often accused of lying or cheating Somewhat True	Certainly TrueI am often accused of lying or cheating Certainly True
Other children or young people pick on me or bully me	Not TrueOther children or young people pick on me or bully me Not True	Somewhat TrueOther children or young people pick on me or bully me Somewhat True	Certainly TrueOther children or young people pick on me or bully me Certainly True
I often volunteer to help others (parents, teachers, children)	Not TrueI often volunteer to help others (parents, teachers, children) Not True	Somewhat TrueI often volunteer to help others (parents, teachers, children) Somewhat True	Certainly TrueI often volunteer to help others (parents, teachers, children) Certainly True
I thinks before I do things	Not TrueI thinks before I do things Not True	Somewhat TrueI thinks before I do things Somewhat True	Certainly TrueI thinks before I do things Certainly True
I take things that are not mine from home, school or elsewhere	Not TrueI take things that are not mine from home, school or elsewhere Not True	Somewhat TrueI take things that are not mine from home, school or elsewhere Somewhat True	Certainly TrueI take things that are not mine from home, school or elsewhere Certainly True
I get along better with adults than with people my own age	Not TrueI get along better with adults than with people my own age Not True	Somewhat TrueI get along better with adults than with people my own age Somewhat True	Certainly TrueI get along better with adults than with people my own age Certainly True
I have many fears, I am easily scared	Not TrueI have many fears, I am easily scared Not True	Somewhat TrueI have many fears, I am easily scared Somewhat True	Certainly TrueI have many fears, I am easily scared Certainly True
I finish the work I’m doing. My attention is good	Not TrueI finish the work I’m doing. My attention is good Not True	Somewhat TrueI finish the work I’m doing. My attention is good Somewhat True	Certainly TrueI finish the work I’m doing. My attention is good Certainly True