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Conners’ Teacher Rating Scale - Revised (S) by C. Keith Conners, Ph.D. Child’s Name: Gender: MF Birthdate:___/ Age: School Grade: ‘Teacher's Name: ‘Today's Date:___/__/ Instructions: Below are a number of common problems that children have in schol, Please rate each item according to how much of a problem ithas been inthe last month, For each item, ask yourself, “How much ofa problem has this ‘been in the last manth?”, and circle the best answer for each one. If none, nat at all, seldom. or very intrequestly, you would circle 0. Hf very much true, or it occurs very often or frequently, you would circle 3. You would circle 1 or? for ratings in between, Please respond to each item. NOTTRUE aust pREFTY._ VERY MUCH imac TRE mn Qs Inattentive, easily distracted ... Defiant Restless in the “squirmy” sense ~ Forgets things he/she has already learned Disturbs other children ssn Actively defies or refuses to comply with adults” requests {s always “on the go” or acts as if driven by a motor Poor in spelling Cannot remain still Spiteful or vindictive se Leaves seat in classroom or in other situations in which remaining seated is expected Fidgets with hands or feet or squirms in seat Not reading up to par Shot attention span Argues with adults. Only pays attention to things he/she is really interested in Has difficulty waiting Lacks interest in schoolwork Distractibility or atention span a problem ‘Temper outbursts; explosive, unpredictable behavior Runs about or climbs excessively in situations where itis inappropriate Poor in arithmetic Interrupts or intrudes on others. butt into others’ conversations orgamses) Has difficulty playing or engaging in leisure activities quietly Fails to finish things he/she starts Does not follow through on instructions and fails to finish schoolwork (Wot due to oppositional behavior or failure to understand instructions) Excitable, impulsive Restless, always up and on the go