Observation of adolescent behavior


Dr. V.K.Maheshwari, M.A(Socio, Phil) B.Sc. M. Ed, Ph.D

Former Principal, K.L.D.A.V.(P.G) College, Roorkee, India

Adolescence Stage is the period of rapid and revolutionary changes in the individual’s physical, mental, moral, emotional, spiritual, sexual and social outlook. A.T. Jersield defines, “Adolescence is that span of years during which boys and girls move from childhood to adulthood, mentally, emotionally, socially and physically”. The period of adolescence is considered as crucial and significant period of an individual’s life. Psychologically, adolescence is the age when the individual becomes integrated into the society of the adults. It is the stage when the child no longer feels that he is below the level of his elders but rather an equal with them, at least in rights. It also includes profound intellectual changes. These intellectual transformations, typical of an adolescent’s thinking, enable him to achieve his integration into the social relationships of the adults.

Characteristics of Adolescence Stage

It is a significant period because it is a period of:

  • Fast physical development
  • Fast mental development  Fast social development
  • Fast emotional development
  • Fast sexual development

Adolescent Inpatient Behavioral Rating Scale of  David Colton,  can be used for the observation  of adolescent behavior in an objective and scientific manner.

The purpose of this instrument is to provide a consistent and stable approach for measuring

variation in observed behaviors. This behavioral rating scale can be used as a measure to identify changes including trends and patterns in specified behaviors.

The instrument consists of 64 defined behaviors. There is also space to add behaviors that might not be reflected in these scales. The items have been grouped thematically, however behaviors to be observed and rated should be selected from across the instrument; item selection should not be limited by how the items are categorized. For example, the item “Difficulty settling at night” has been placed with behaviors that are often associated with anxiety.

All of the items are rated using a scale of severity: 0 = not present, 1 = mild, 2 = moderate, and 3 = severe. In turn, severity may be said to be a measurement of three dimensions: intensity, frequency and duration. These attributes may be assessed individually or in combination. Each item includes specific descriptors to assist in determining how the behavior should be rated.


This instrument may be used as either a pretreatment/post-treatment measure or as the basis for repeated (weekly, daily, shift-to-shift, or hourly) observations.

The entire form (all items) should be completed. If the behaviors are not observed, use “Not Present” to rate the item.


Anxiety Not Present        Mild         Moderate        Severe

‰ 1. Hyper vigilant                                       0                            1               2                        3

‰ 2. Difficulty settling at night                   0                            1                2                        3

‰ 3. Repetitive behaviors                            0                           1                2                        3

‰ 4. Nightmares/flashbacks                        0                           1                 2                       3

‰ 5. Low startle threshold                           0                           1                 2                        3

‰ 6. Panic attacks                                          0                           1                  2                        3

‰ 7. Grandiose                                               0                           1                 2                        3


Not Present    Mild       Moderate           Severe

‰ 8. Withdrawn                                                    0                1               2                         3

‰ 9. Sad affect                                                       0                1                2                          3

‰ 10. Flat affect                                                     0                1                2                         3

‰ 11. Crying spells                                                 0                1                2                         3

‰ 12. Tired/loss of energy                                     0               1                2                          3

‰ 13. Negative self-statements                             0              1                2                          3

‰ 14. Physical complaints                                       0              1               2                            3

‰ 15. Irritable                                                             0              1              2                           3

‰ 16. Self-harmful statements                                0             1               2                            3

‰ 17. Self-injurious behavior                                   0              1             2                           3

Communication Problems Not Present      Mild       Moderate     Severe

‰ 18. Loud/shouting                                                    0                     1             2                        3

‰ 19. Under-productive speech                                  0                     1            2                        3

‰ 20. Incoherent speech                                               0                     1            2                       3

‰ 21. Pressured speech                                                 0                     1            2                        3

‰ 22. Disorganized speech                                            0                     1             2                       3

‰ 23. Echolalia                                                                 0                     1             2                       3

Psycho-Motor Activity Not Present    Mild            Moderate     Severe

‰ 24. Dizziness and/or difficulty standing                   0                1                    2                    3

‰ 25. Exaggerated mannerisms                                     0                1                     2                   3

‰ 26. Stereotypical movements                                    0                 1                     2                   3

‰ 27. Perseveration                                                          0                1                     2                   3

‰ 28. Tremors and tics                                                     0                1                     2                   3

‰ 29. Psychomotor retardation                                       0               1                     2                   3

‰ 30. Clumsiness                                                                0                1                     2                   3

Attention Problems/Hyperactive Not Present     Mild      Moderate       Severe

‰ 31. Difficulty staying on task                                    0                      1              2                      3

‰ 32. Difficulty following directions                            0                      1              2                     3

‰ 33. Distracted by external stimuli                            0                       1              2                     3

‰ 34. Distracted by internal stimuli                              0                      1              2                     3

‰ 35. Fidgets/Restless                                                     0                     1                2                    3

‰ 36. Hyper-kinetic                                                         0                       1               2                     3

Conduct Problems/Disruptive Behaviors Not Present   Mild     Moderate     Severe

‰ 37. Cursing                                                                        0                     1            2                      3

‰ 38. Argumentative                                                          0                     1            2                      3

‰ 39. Frustration/Tantrums 0 1 2 3

‰ 40. Disobedient 0 1 2 3

‰ 41. Does not accept responsibility                             0                     1              2                       3

‰ 42. Rude                                                                          0                     1             2                        3

‰ 43. Manipulates others                                                0                     1              2                        3

‰ 44. Lies                                                                            0                     1              2                        3

‰ 45. Verbally threatens                                                  0                     1               2                       3

‰ 46. Physically intimating                                               0                     1               2                       3

‰ 47. Aggressive toward objects                                     0                      1              2                       3

‰ 48. Aggressive toward people                                      0                     1              2                        3

‰ 49. Demands must be met immediately                     0                     1              2                        3

‰ 50. Passively defiant                                                        0                     1             2                        3

Social Skills Not Present     Mild     Moderate         Severe

‰ 51. Touches others when/where they don’t want           0                  1             2                       3

‰ 52. Teases others                                                                    0                  1             2                       3

‰ 53. Does not maintain appropriate social distance          0                   1             2                       3

‰ 54. Engages in attention seeking behaviors                       0                   1             2                       3

‰ 55. Interrupts or intrudes                                                       0                  1             2                        3

‰ 56. Difficulty waiting one’s turn                                            0                  1              2                       3

‰ 57. Difficulty picking up social cues                                       0                 1               2                       3

‰ 58. Sexually inappropriate – directed toward self               0                1               2                       3

‰ 59. Sexually inappropriate – directed toward others          0                 1              2                       3

‰ 60. Difficulty maintaining personal hygiene                          0                1               2                       3

‰ 61. Incontinence (including bedwetting)                               0                 1              2                        3

‰ 62. Bowel management problems 0 1 2 3




Eating Habits

‰ 63.                          Ate most          Skipped most      Picky about what    Overeats or

of this meal     of this meal             he/she ate             gorges

Breakfast                           1                      2                                3                           4

Lunch                                  1                      2                                3                           4

Dinner                                 1                     2                                 3                           4

Snack                                   1                     2                                 3                           4

Sleeping Habits

‰ 64

Sleeps thru the night               Difficulty falling        Awakens early          Restless sleep

1                                               2                                  3                                 4

Other Behaviors (specify)

Not Present        Mild           Moderate    Severe

‰ 65. ___________________________________ 0                         1                    2                       3

‰ 66. ___________________________________ 0                         1                     2                      3

Adolescent Inpatient Behavioral Rating Scale David Colton,


1. Hyper Vigilant

0 1 2 3
Not Present: Behavior was not observed. Mild: Has expressed distrust and need to watch others; tends to scan the environment. Moderate: Intermittent periods of watching others or the environment to the extent that the individual is not attending to immediate tasks. May express belief that others are plotting against him/her Severe: Watching is pervasive and becomes the primary task to the extent that attention to other tasks is compromised. May associate everyday activities with plots of harm. May not want to interact with others due to these fears.




  1. Difficulty Settling at Night
0 1 2 3
Not Present: Behavior was not observed. Mild: Procrastinates in completing nighttime routines. Doesn’t look forward to going to bed Moderate: Resists completing nighttime routines. May request that bedroom or hallway lights be kept on. Still awake an hour or more after lights out. Severe: Power struggles over going to bed or being in bedroom. Frequent excuses for leaving bedroom at night. Still awake two or more hours after lights out.
  1. Repetitive Behaviors
0 1 2 3
Not Present: Behavior was not observed. Mild: May display some repetitive or ritualistic behaviors, such as hand washing or lining toiletries in a set pattern. Moderate: Repetitive/ ritualistic behaviors are noticeable and interfere with daily functioning. For example, may become upset if he/she is not allowed to complete the behavior. Severe: Has physical reaction to nightmares and/or flashbacks, which occur on a daily basis, such as crying, shaking, screaming, fast breathing, and/or increased heart rate.



  1. Low Startle Threshold 0


0 1 2 3
Not Present: Behavior was not observed. Mild: Individual appears “jumpy” and easily startled by others or events in the environment. Moderate: Individual is very “jumpy” in response to specific situations. Severe: “Jumpy” and “nervous” almost all the time. May isolate self from others and situations to reduce fears.


6. Panic Attacks

0 1 2 3
Not Present: Behavior was not observed. Mild: Appears to be in physical discomfort, such as sweating, shaking, feeling short of breath, which is not incapacitating. Moderate: Sudden periods of intense sweating, shaking, feeling short of breathe, or other physical discomfort. Needs reassurance to calm down. Severe: Sudden periods of intense sweating, shaking, or feeling short of breathe, which is physically incapacitating. Routines are restricted in response to potential panic attacks (for example, refuses to leave room or unit).



  1. Grandiose
0 1 2 3
Not Present: Behavior was not observed. Mild: Occasionally exaggerates selfimportance or exploits. Likes to brag about self to others. Moderate: Often exaggerates or concocts elaborate stories of selfimportance and denies grandiosity when confronted. Severe: Boastful on a daily basis, with elaborate stories of self-importance. Expresses little or no remorse when confronted with exaggeration and will defend in the face of overwhelming evidence to the contrary.















18. Loud/Shouting      
  1 2 3
Not Present: Behavior

was not observed.

Mild: Occasionally raises

voice or becomes excited

when speaking.

Moderate: Often speaks

loudly or shouts when


Severe: Primary method

of communicating is by

speaking loudly or

shouting. Voice may be

hoarse from shouting


19. Under-Productive



  1 2 3
Not Present: Behavior

was not observed.

Mild: Often needs

coaxing to speak. This is

different than speaking

softly or in a monotone.)

Moderate: Constantly

needs coaxing to speak.

Rarely initiates verbal


Severe: Virtually or

entirely mute. Will not

respond when spoken to.



20. Incoherent Speech      
  1 2 3
Not Present: Behavior

was not observed.



Mild: Speech may be

slurred, mumbled, and at

times difficult to



Moderate: Mumbles and

mutters often. Speech

very difficult to


Severe: Speech does not

make sense or speech is

so garbled that it not




21. Pressured Speech      
  1 2 3
Not Present: Behavior

was not observed.


Mild: Not applicable as

pressured speech is

typically a moderate to

severe condition.


Moderate: Speaks

rapidly and has difficulty

slowing down speech,

even when prompted.


Severe: Speaks so

rapidly may be difficult to understand; has extreme difficulty trying to stop is unable to stop talking



22. Disorganized Speech      
  1 2 3
Not Present: Behavior

was not observed.


Mild: May mix words or

topics during verbal

interactions, so that

sentences don’t always

make sense.


Moderate: Content of

speech shifts from subject

to subject, in an apparent

random fashion. May

make up words as he/she



Severe: Very difficult to

converse with the

individual as the content

of their speech is

constantly shifting.

Individual may respond in totally irrelevant ways or reach illogical




23. Echolalia      
  1 2 3
Not Present: Behavior

was not observed.


Mild: Occasionally will

repeat a word or phrase

spoken by another.

Happens once or twice a



Moderate: Frequently

(several times a shift)

repeats words or phrases.

Speaks in a mechanical,

robot like speech pattern.


Severe: Repeats words

or phrases of others

several times an hour.

Has difficulty being

redirected from this





24. Dizziness and/or

Difficulty Standing

  1 2 3
Not Present: Behavior

was not observed.


Mild: Patient verbally

complains of dizziness or nausea, but able to



Moderate: Patient

verbally complains of

dizziness or nausea, needs assistance to stand.


Severe: Difficulty

getting out of bed or may need to remain in bed. Needs physical assistance to ambulate.



25. Exaggerated


  1 2 3
Not Present: Behavior

was not observed.



Mild: May display broad and embellished gestures,



Moderate: Often uses

overstated gestures and

facial expressions when


Severe: All body

movements, at virtually

all times appear




26. Stereotypical


  1 2 3
Not Present: Behavior

was not observed.



Mild: Occasional

repetitive motor activity,


Moderate: Persistent motor activity often

appears repetitive and nonproductive


Severe: Repetitive motor activity occurs throughout

the day and may interfere with social communication with others.



27. Perseveration      
  1 2 3
Not Present: Behavior

was not observed.



Mild: May occasionally

appear to be stuck on a

thought or behavior

Moderate: Frequently

“is stuck” on the same

movement or thought,


Severe: Perseverative

behaviors interfere with

ability to engage in other

tasks, including activities

of daily living and social




28. Tremors and Tics      
  1 2 3
Not Present: Behavior

was not observed.



Mild: Sudden motor jerk

or spasm in face or hands noted once or twice in an



Moderate: Sudden facial and hand muscle spasms, or uncontrolled

utterances noted more

than twice an hour.


Severe: Almost

continuous, multiple

facial and hand spasms

and/or uncontrolled

utterances observed.

Muscles or limbs may be

severely contorted.



29. Psychomotor



  1 2 3
Not Present: Behavior

was not observed.


Mild: Some

psychomotor stiffness or



Moderate: Notable

psychomotor difficulties

including stiff or jerky

movements, pill-rolling,


facial expression.


Severe: Most or all

physical movement is

exaggerated or difficult

30. Difficulty Staying

on Task

  1 2 3
Not Present: Behavior

was not observed.


Mild: May need

prompting to stay on task

several times a day.


Moderate: Needs

frequently prompting and coaxing to attend to a task, but does not stay on task for more than 10 –15 minutes before needing

additional redirection.


Severe: Cannot stay

focused on tasks for more than 5 – 10 minutes or cannot engage in the task

when directed. When not

on task the behaviors are

disruptive to others.

Attention Problems/Hyperactive


31. Clumsiness


  1 2 3
Not Present: Behavior

was not observed.



Mild: Somewhat more

clumsy for age, such as a

teenager who frequently

falls while running

Moderate: Frequently

clumsy, such as falling

over objects or knocking

over objects several times

a day/shift.


Severe: Extremely

awkward, frequently

bumping into things and

people throughout the




32. Difficulty Following


  1 2 3
Not Present: Behavior

was not observed.



Mild: Difficulty

immediately focusing on

verbal prompts and

directions, but does return

to task or response within

a minute or two.


Moderate: Responds to

multiple prompts with

great difficulty and may

or may not respond to the

redirection. May require

physical touch to

establish contact

Severe: Is so

preoccupied and/or off

task that is unable to

respond to prompts and

redirection. Physical

touch used as primary

means of redirection.

May not be able to

complete a task.


33. Distracted by

external stimuli

  1 2 3
Not Present: Behavior

was not observed.


Mild: Responds to minor

interruptions or external




Moderate: Responds to

objects and activities in

immediate surroundings

without thinking.

Severe: Response to

external stimuli is

persistent and prevents

individual from

completing immediate





34. Distracted by

internal stimuli

  1 2 3
Not Present: Behavior

was not observed.



Mild: Appears deep in


with little awareness of

surroundings. May appear

surprised or startled when



Moderate: Does not

appear aware of

surroundings or others in

the environment. May

engage in behaviors in

response to thoughts

without awareness of



Severe: Individual is so

preoccupied by thoughts

that he/she has difficulty

responding to others or

his/her environment.

May not respond even

when prompted. May

converse with self (in

response to voices).



35. Fidgets/Restless      
  1 2 3
Not Present: Behavior

was not observed.



Mild: Difficulty sitting

still for much more than

15 minutes. Body in

frequent motion

Moderate: Squirms and

has difficulty sitting still

for more than 5 minutes.

Body in frequent random



Severe: Squirms and

wriggles constantly.

Difficulty sitting still for

more than a few minutes. Body in constant, random




36. Hyper-kinetic      
  1 2 3
Not Present: Behavior

was not observed.


Mild: Has high levels of

energy, which interferes

with staying on task.

Needs verbal prompts to



Moderate: Physical

motion greatly interferes

with staying on task.

Needs constant verbal

prompts to help focus.

May at times need

physical prompts to



Severe: Cannot stay on

task due to high levels of

physical activity, such as

running, jumping, and

climbing. Ignores verbal

prompts and may need

physical touch such as

holding to help refocus



Conduct Problems/Disruptive Behaviors

37. Cursing      
  1 2 3
Not Present: Behavior

was not observed.



Mild: Curses at both

appropriate and

inappropriate times, i.e.,

language is ‘peppered’

with sporadic cursing.


Moderate: Cursing is a

routine part of verbal

communication and may

interject curse words in

most statements.

Severe: Has difficulty

not using curse words,

even when prompted.

Defends use of curse

words even when told by

others that it is offensive



38. Argumentative      
  1 2 3
Not Present: Behavior

was not observed.


Mild: Initiates arguments

over minor offenses or

when given simple

directions. Easily

becomes defensive.


Moderate: Frequently

contests directions and

feedback. May raise

voice, curse, or appear to

be excited.


Severe: Interactions are

frequently based on

conflict. Verbal

communication is

characterized by cursing,

shouting, “getting in your face,” and being highly defensive.



39. Frustration/


  1 2 3
Not Present: Behavior

was not observed.



Mild: Gives up easily on

tasks when the task

appears to be demanding.

May express frustration

by cursing, stomping feet,

or leaving activity.


Moderate: May initially

refuse and therefore

require encouragement to engage in a demanding activity. May externalize frustration through attempts to escape the

situation or through


toward objects.

Severe: Is very avoidant

of demanding activities.

May externalize

frustration through

attempts to escape the

situation or through


toward objects and/or




40. Disobedient      
  1 2 3
Not Present: Behavior

was not observed.




Mild: Occasionally

refuses to do as asked,

which may be evidenced

by being argumentative,

cursing, and shouting

Moderate: Often refuses

to do as asked or as

suggested and may do

exactly the opposite of

what was requested.

Appears to be reinforced

by this behavior.

Severe: Often breaks

rules and does not follow through with

expectations. Interactions

over disobedient

behaviors typically result

in conflict and may lead

to aggressive behaviors



41. Does Not Accept


  1 2 3
Not Present: Behavior

was not observed.


Mild: When making a

poor or inadequate

decision, tends to refuse

to accept responsibility

and the consequences that  result from those choices.


Moderate: Demonstrates

poor decision making

skills and then minimizes

impact on self and others.


Severe: In addition to

minimizing the effects of

poor choices, when

confronted about his/her

choices, is likely to blame

others for own behaviors



42. Rude      
  1 2 3
Not Present: Behavior

was not observed.



Mild: Occasionally says

or does things to be

hurtful of others. For

example, may ridicule

another person.

Moderate: Often

engages others by saying

and doing things that are

hurtful. Demonstrates a

lack of sensitivity to the

feelings of others.


Severe: Persistently will

say or do things to illicit

negative behaviors from

others. Appears to be

reinforced when others

become irritated by these




43. Manipulates Others      
  1 2 3
Not Present: Behavior

was not observed.


Mild: May occasionally

do or say things to

influence others to engage

in negative behaviors.


Moderate: Appears to

be reinforced by ability to

manipulate others. Often

uses manipulation to

obtain personal gain.


Severe: Manipulation

gets in the way of

developing healthy

relationships with others.

May take advantage of

‘weaker’ peers who are

easily victimized. Seems

to enjoy ability to get

others into trouble.



44. Lies      
  1 2 3
Not Present: Behavior

was not observed.


Mild: May use a lie to

defend a poor decision or

exaggerate a situation.


Moderate: Feels

comfortable in telling

falsehoods and denies that

he/she is lying when



Severe: Expresses little

or no remorse when

confronted with a

falsehood and will defend the lie in the face of overwhelming evidence

to the contrary.



45. Verbally Threatens      
  1 2 3
Not Present: Behavior

was not observed.



Mild: In response to

frustration or anger, will

threaten aggression.

However, will usually

apologize later and can

acknowledge that the

threat was a response to

the situation

Moderate: Uses verbal

threats to intimate others.

Demonstrates little or no

contrition after the threat

is made. Threats are

often verbalized through

shouting and cursing


Severe: Significant level

of harm is implied or

evident in the threat,


may be verbalized in a

steady, “steely” tone of




46. Physically



  1 2 3
Not Present: Behavior

was not observed.



Mild: Has on occasion

used physical presence to

frighten or manipulate

another. May be used in

response to frustration or



Moderate: Seeks out

individuals and tends to

repeatedly physically

intimate another person;

i.e., behavior is clearly

volitional. Tends to use

intimation with

individuals who are easily


Severe: Uses physical

intimidation as the

primary means of

connecting with and/or

obtaining gain from

another. Uses intimation

with whoever he/she

wants to take advantage

of regardless of age, size,




47. Aggressive toward


  1 2 3
Not Present: Behavior

was not observed.


Mild: May throw, punch,

or hit objects out of

frustration or anger.


Moderate: Sustained

and intense aggression

toward objects, usually

accompanied by other

behaviors, such as

shouting, cursing, or



Severe: Aggression

toward objects is

accompanied by loss of

self-control and may

result in self-injury, such

as from banging hands on the wall



48. Aggressive toward


  1 2 3
Not Present: Behavior

was not observed.


Mild: When angered or

frustrated may lash out at others, such as pushing or shoving.


Moderate: Physical

aggression such as

punching, kicking, and

biting, which is often

targeted toward another.


Severe: Aggression does

bodily harm to another.



49. Demands must be

met immediately

  1 2 3
Not Present: Behavior

was not observed.



Mild: May fidget, stomp

feet, shake, and/or pout

when he/she doesn’t get

demand met immediately.


Moderate: In additional

to physical expression,

repeats demands over and

over in a loud or shrill

tone of voice.

Severe: May become

verbally threatening,

physically aggressive, or

may lose self-control in

response to not getting

demands met




50. Passively Defiant      
  1 2 3
Not Present: Behavior

was not observed.



Mild: Occasionally will

refuse to follow directions

by ignoring the person

providing the guidance

Moderate: Ignores

directions and continues

with alternative activities

even when asked to stop.

Appears to enjoy the

frustration this engenders.


Severe: Does not follow

directions, engage in

scheduled activities or

participate as requested.

Ignores attempts at

redirection. These

behaviors often escalate

into power struggles and

heated arguments




Social Skills

51. Touches others

when/ where they don’t


  1 2 2
Not Present: Behavior

was not observed.


Mild: May use physical

contact at inappropriate

times and does not appear

to recognize social cues

that the behavior is

unwanted. For example,

may use a hug as a



Moderate: Touches

another’s body in socially

unacceptable ways, such

as rubbing against a

person or grabbing a

woman’s breasts. Needs

verbal redirection to stop

the behaviors.


Severe: Continues

inappropriate touching

even when reminded and

may require physical

interaction to stop the

behavior, such as

extending a hand to keep

the individual at arm’s





52. Teases others      
  1 2 3
Not Present: Behavior

was not observed.


Mild: Occasionally

teases others in a manner

that is not always age

appropriate. Is fairly



Moderate: Often teases

others in ways that are

clearly not age

appropriate. Needs

frequent redirection.

Teasing is usually not

tolerated by peers.


Severe: Continues

inappropriate teasing

even with frequent

prompts. May require

physical interaction to

stop the behavior, such as

use of time out. Peers

may respond in an

aggressive manner if

teasing does not desist.




53. Does not maintain

social distance

  1 2 3
Not Present: Behavior

was not observed.


Mild: Stands or sits very

close to another person

during interactions. The

other person may need to

step back or move from

the seat in response to the

close proximity.


Moderate: Requires

frequent prompts

regarding being to close.

Does not appear to be

aware of another’s



Severe: Continues to

intrude into another’s

personal space, even

when reminded and may

require physical

interaction to stop the

behavior, such as

extending a hand to keep

the individual at arm’s




54. Engages in attention

seeking behaviors

  1 2 3
Not Present: Behavior

was not observed.



Mild: Occasional

attention seeking requires

staff redirection, which

the individual accepts

without becoming



Moderate: Attention

seeking behavior

continues after several

prompts and may require

physical redirection, such

as time out. Behaviors

may be tolerated by peers

Severe: Behaviors

interfere with staying on

task and require

assistance from staff to

manage. Peers have

difficulty tolerating the




55. Interrupts or


  1 2 3
Not Present: Behavior

was not observed.



Mild: Interrupts without

using appropriate social

skills, e.g., without

saying, “excuse me.”

Behaviors are generally

tolerated by others.

Moderate: Requires

frequent verbal prompts

regarding interrupting or

intruding on others. Does  not appear to be aware of another’s discomfort.


Severe: Continues to

intrude or interrupt even

when reminded and may

require physical removal

from the area/situation to

stop the behavior, such as using time out. Peers

have difficulty tolerating

the behaviors.



56. Difficulty waiting

one’s turn

  1 2 3
Not Present: Behavior

was not observed.



Mild: Occasionally

disrupts others when

speaking or breaks into an

activity. At times

requires redirection for

this behavior.


Moderate: Frequently

disrupts others when

speaking or breaks into an

activity. Requires

redirection for this


Severe: Constantly

initiates without regard

for the feelings or needs

of others. Appears to

lack self-control over this behavior, even when




57. Difficulty picking

up social cues

  1 2 3
Not Present: Behavior

was not observed.


Mild: Needs occasional

prompting regarding

social behaviors and

responding to social cues

from others.


Moderate: Often

misreads social cues,

resulting in need for

verbal and or physical

redirection, such as

separating from peers.


Severe: Maladroit social

behaviors and inability to

respond to social cues

results in negative social





58. Sexually

Inappropriate: Directed

toward others

  1 2 3
Not Present: Behavior

was not observed.


Mild: Occasionally

makes sexually

inappropriate comments

or initiates sexually

inappropriate touching of others, such as rubbing

against another person.


Moderate: Requires

verbal redirection for

using sexually

inappropriate comments

during social interactions.

May require verbal and/or

physical redirection due

to attempting to touch

another’s private parts.


Severe: Attempts to

grope another person

requiring physical

separation from others.

May be hypersexual, with

these behaviors occurring

frequently throughout the




59. Difficulty with

personal hygiene

  1 2 3
Not Present: Behavior

was not observed.



Mild: Occasionally needs

prompting to complete

daily hygiene. For

example, may need to

send back to the

bathroom to take a

shower or brush teeth

Moderate: Needs

frequent prompting, on a

daily basis, to complete

personal hygiene, such as

bathing and brushing

teeth. Does not pick up

social cues that poor

hygiene is undesirable.


Severe: Requires

physical assistance and

direction in completing

personal hygiene. Cannot

complete daily hygiene

activities without this





Eating and Sleeping Behaviors

60. Eating Habits      
1 2 3 4
Ate Most of Meal: Eats

all or most of the portions

served with the meal.


Skipped Most of Meal:

Ate only one or two items

and/or did not eat all of

each portion served, so

that most of the food was

left on the plate.


Picky About What

he/she Eats: Has very

limited range of foods

that he or she will eat.

May eat snacks in lieu of

meals served or request

extra portions of a

particular item.


Overeats or Gorges:

Eats quickly and often

asks for extra servings.

May ask for or take extra

portions from peers. May

ask for additional food

and snacks throughout the




61.Sleeping Habits      
1 2 3 4
Sleeps thru the night

w/o incident: When 15

minute bed checks are

made, child usually

appears to be deeply

asleep. If awakens to use

the bathroom, typically

falls back to sleep



Difficulty falling asleep:

Has difficulty falling

asleep. May be up an

hour or two after lights

out. May result in being

sleepy and/or irritable

later in the day.


Awakens early:

Awakens early and

cannot fall back to sleep.

May result in being

sleepy and/or irritable

later in the day.


Restless sleeper:

Difficulty falling and

staying asleep. Is often

up and out of room during

the night and is awake

when bed checks are

made. May result in being

sleepy and/or irritable

later in the day.


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