CDE Detailed Report
Subdomain Name: Psychiatric and Psychological Status
CRF: system
Displaying 151 - 174 of 174
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C52266 | Child Behavior Checklist (CBCL) - Demands a lot of attention scale | CBCLDemandALotOfAttentionScl | Scale for whether the child demands a lot of attention, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child demands a lot of attention, as part of the Child Behavior Checklist (CBCL) | Demands a lot of attention | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-23 11:12:42.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C19500 | Assessment performed date | AssessmentPerformedDate | The date of assessment of the examination being performed | The date of assessment of the examination being performed | Today's Date | Date or Date & Time | Pediatric | Supplemental | 1.00 | 2014-06-18 08:10:12.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Free-Form Entry |
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| C52310 | Child Behavior Checklist (CBCL) - Use drug nonmedical purpose scale | CBCLUsDrgNonMdPrpScl | Scale for whether the child uses drugs for nonmedical purposes, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child uses drugs for nonmedical purposes, as part of the Child Behavior Checklist (CBCL) | Uses alcohol or drugs for nonmedical purposes (don't include tobacco) | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-27 12:40:00.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52229 | Child Behavior Checklist (CBCL) - Bragging boasting scale | CBCLBragBoastScl | Scale for whether the child brags, boasts, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child brags, boasts, as part of the Child Behavior Checklist (CBCL) | Bragging, boasting | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-22 14:35:01.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C55049 | Child Behavior Checklist (CBCL) - Problems with eyes describe text | CBCLProblemWithEyesDescribeTxt | The free-text field related to 'Child Behavior Checklist (CBCL) - Problems with eyes scale' for describing the child's eye problems that are not corrected by glasses, as part of the Child Behavior Checklist (CBCL) | The free-text field related to 'Child Behavior Checklist (CBCL) - Problems with eyes scale' for describing the child's eye problems that are not corrected by glasses, as part of the Child Behavior Checklist (CBCL) | Eye problems (not if corrected by glasses) (describe) | Alphanumeric | Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2017-04-18 12:27:18.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points | 255 |
Free-Form Entry |
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| C52286 | Child Behavior Checklist (CBCL) - Stares blankly scale | CBCLStrBlnkScl | Scale for whether the child stares blankly, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child stares blankly, as part of the Child Behavior Checklist (CBCL) | Stares blankly | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-27 10:35:32.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52059 | Child Behavior Checklist (CBCL) - Daydreams or gets lost in their thoughts scale | CBCLDaydreamLostInThoughtScl | Scale for whether the child daydreams or gets lost in their thoughts, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child daydreams or gets lost in their thoughts, as part of the Child Behavior Checklist (CBCL) | Daydreams or gets lost in his/her thoughts | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-21 11:44:21.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C55017 | Child Behavior Checklist (CBLC) - Child time in class service week duration | CBLCChildTimeInClassSvcWkDur | Duration in hours per week that the child spends in the respondent's class or service, as part of the Child Behavior Checklist (CBLC) | Duration in hours per week that the child spends in the respondent's class or service, as part of the Child Behavior Checklist (CBLC) | How much time does he/she spend in your class or service per week? | Numeric Values |
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Adult;Pediatric | Supplemental | 1.00 | 2017-04-18 11:11:33.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Free-Form Entry |
0.1 | 30 | Hours per week | |||||||
| C55028 | Child Behavior Checklist (CBCL) - Achievement test most recent name | CBCLAchvmntTestMstRcntName | Name of the most recent achievement test in a subject, as part of the Child Behavior Checklist (CBCL) | Name of the most recent achievement test in a subject, as part of the Child Behavior Checklist (CBCL) | Name of test | Alphanumeric |
Most recent achievement test scores (optional) |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2017-04-18 11:49:33.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points | 255 |
Free-Form Entry |
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| C52250 | Child Behavior Checklist (CBCL) - Feels or complains that no one loves them scale | CBCLComplainNoOneLoveThemScl | Scale for whether the child feels or complains that no one loves them, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child feels or complains that no one loves them, as part of the Child Behavior Checklist (CBCL) | Feels or complains that no one loves him/her | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-22 16:57:52.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C55060 | Child Behavior Checklist (CBCL) - Behave irresponsible scale | CBCLBehavIrresponsibleScl | Scale for the child's tendency to behave irresponsibly, as part of the Child Behavior Checklist (CBCL) | Scale for the child's tendency to behave irresponsibly, as part of the Child Behavior Checklist (CBCL) | Behaves irresponsibly | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-22 12:57:12.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C55069 | Child Behavior Checklist (CBCL) - Underachievement scale | CBCLUnderachievementScl | Scale for the child's tendency to underachieve or not work up to his or her potential, as part of the Child Behavior Checklist (CBCL) | Scale for the child's tendency to underachieve or not work up to his or her potential, as part of the Child Behavior Checklist (CBCL) | Underachieving, not workinig up to potential | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-22 12:57:12.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52299 | Child Behavior Checklist (CBCL) - Talks too much scale | CBCLTlkTooMchScl | Scale for whether the child talks too much, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child talks too much, as part of the Child Behavior Checklist (CBCL) | Talks too much | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-27 11:51:50.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52092 | Child Behavior Checklist (CBCL) - Confused or seems to be in a fog scale | CBCLConfusedInAFogScl | Scale for whether the child is confused or seems to be in a fog, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child is confused or seems to be in a fog, as part of the Child Behavior Checklist (CBCL) | Confused or seems to be in a fog | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil.s |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-21 16:06:05.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52184 | Child Behavior Checklist (CBCL) - Illness or disability indicator | CBCLIllnessDisabilityInd | Indicator that the child has an illness or disability (either physical or mental), as part of the Child Behavior Checklist (CBCL) | Indicator that the child has an illness or disability (either physical or mental), as part of the Child Behavior Checklist (CBCL) | Does this pupil have any illness or disability (either mental or physical)? | No;Yes | No;Yes | Alphanumeric | Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-22 13:26:35.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C55039 | Child Behavior Checklist (CBCL) - Cry often scale | CBCLCryOftenScl | Scale of the child's tendency to cry often, as part of the Child Behavior Checklist (CBCL) | Scale of the child's tendency to cry often, as part of the Child Behavior Checklist (CBCL) | Cries a lot | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2017-04-18 12:04:30.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52270 | Child Behavior Checklist (CBCL) - Biggest concerns description text | CBCLBiggestConcernDescTxt | Description text of what concerns the respondent has most about the child, as part of the Child Behavior Checklist (CBCL) | Description text of what concerns the respondent has most about the child, as part of the Child Behavior Checklist (CBCL) | What concerns you most about this pupil? | Alphanumeric |
Your answers will be used to compare the pupil with other pupils whose teachers have completed similar forms. The information on this form will also be used for comparison with other information about this pupil. Please answer as well as you can, even if you lack full information. Scores on individual items will be combined to identify general patterns of behavior. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-23 11:31:06.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points | 4000 |
Free-Form Entry |
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| C21117 | Subject name | SubjectName | Name of subject/participant | Name of subject/participan | Pupil's full name, First Middle Last | Alphanumeric | Pediatric | Supplemental | 1.00 | 2015-06-12 15:16:39.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points | 255 |
Free-Form Entry |
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| C52314 | Child Behavior Checklist (CBCL) - Whining scale | CBCLWhngScl | Scale for whether the child whines, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child whines, as part of the Child Behavior Checklist (CBCL) | Whining | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-27 13:02:17.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C55018 | Child Behavior Checklist (CBLC) - School class service type | CBLCSchoolClassServiceTyp | Type of class or service provided by the respondent at the child's school, as part of the Child Behavior Checklist (CBLC) | Type of class or service provided by the respondent at the child's school, as part of the Child Behavior Checklist (CBLC) | What kind of class or service is it? | Alphanumeric |
Please be specific, e.g., regular 5th grade, 7th grade math, learning disability, counseling, etc. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2017-04-18 11:14:09.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points | 255 |
Free-Form Entry |
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| C52232 | Child Behavior Checklist (CBCL) - Other problems description text | CBCLOthrProbTxt | description text of the child's other problems not already listed, as part of the Child Behavior Checklist (CBCL) | description text of the child's other problems not already listed, as part of the Child Behavior Checklist (CBCL) | Please write in any problems the pupil has that were not listed above. | Alphanumeric | Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-22 14:37:32.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points | 255 |
Free-Form Entry |
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| C55050 | Child Behavior Checklist (CBCL) - Talk out of turn scale | CBCLTalkOutOfTurnScl | Scale for the child's tendency to talk out of turn, as part of the Child Behavior Checklist (CBCL) | Scale for the child's tendency to talk out of turn, as part of the Child Behavior Checklist (CBCL) | Talks out of turn | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2017-04-18 12:04:30.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52288 | Child Behavior Checklist (CBCL) - Steals outside home scale | CBCLStlOutHmeScl | Scale for whether the child steals outside the home, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child steals outside the home, as part of the Child Behavior Checklist (CBCL) | Steals | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-27 10:40:44.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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| C52062 | Child Behavior Checklist (CBCL) - Doesn?t get along with other kids scale | CBCLNoGetAlongOthrKidsScl | Scale for whether the child doesnt get along with other kids, as part of the Child Behavior Checklist (CBCL) | Scale for whether the child doesnt get along with other kids, as part of the Child Behavior Checklist (CBCL) | Doesn't get along with other pupils | 0;1;2 | Not True (as far as you know);Somewhat or Sometimes True;Very True or Often True | Numeric Values |
For each item that describes the pupil *now or within the past 2 months*, please circle the 2 if the item is *very true or often true* of the pupil. Circle the 1 if the item is *somewhat or sometimes true* of the pupil. If the item is *not true* of the pupil, circle the 0. Please andser all the items as well as you can, even if some do not seem to apply to this pupil. |
Copyright 2001 T. Achenbach, ASEBA, University of Vermont, 1 South Prospect St., Burlington, VT 05401-3456 www.ASEBA.org | Pediatric | Supplemental | 1.00 | 2016-12-21 11:47:51.0 | Child Behaviors Checklist (CBCL) Teacher Report Form for Ages 6-18 | Psychiatric and Psychological Status | Outcomes and End Points |
Single Pre-Defined Value Selected |
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