School:______
Age:______Female Male (Please tick) Date:______
Read each statement and then put a tick in the box that best describes how you feel today. Please do each statement.
Strongly Agree / Agree / Not Sure / Disagree / Strongly Disagree
1. / I try to help people when they are unhappy.
2. / I often forget what I should be doing.
3. / I know what things I’m good at.
4. / I often lose my temper.
5. / I get annoyed when other people make mistakes.
6. / I can describe how I am feeling most of the time.
7. / I get upset if I don’t do something well.
8. / I would like to have more friends at school
9. / I know when people are starting to get upset.
10. / If I find something difficult I still try to do it.
11. / I’m easily hurt by what others say about me.
12. / I calm down quickly after I have got angry or upset.
13. / I find it easy to make new friends.
14. / I laugh at other people when they get something wrong.
15. / I am usually calm.
16. / I have lots of friends at school.
17. / I find it easy to pay attention in class.
Strongly Agree / Agree / Not Sure / Disagree / Strongly Disagree
18. / I worry about the things I can’t do.
19. / I get on with most people in my classes.
20. / Most of the time I can ignore other people’s disruptive behaviour and get on with my work.
21. / I want to do well in my work.
22. / I get on well with members of staff.
23. / I sulk or argue when I am told off.
24. / I listen well in class.
25. / I am happy being me.
26. / I am good at some things.
27. / Most of the time I can work independently.
28. / I look forward to catching up with my friends at breaks.
29. / Members of staff are fair in the way they treat us.
30. / It is easy to work in class.
31. / I can talk to a member of staff about anything.
32. / I am sometimes picked on or bullied by other people.
33. / I can tell a member of staff if anyone is unkind to me.
34. / I sometimes bully or pick on other people
35. / I like coming to school.
Thank you for your help.
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