Definition 1 of 21
this item rates the presence of problems with weight gain or growth.
0 - no current need
1 - may have experienced problems in the past but is currently not experiencing problems.
2 - experiencing problems in maintaining weight
3 - currently at serious medical risk
N/A - the child is 6 years of age or older
Interpersonal Problems
Eating Disturbance
Failure to Thrive (0-6)
Adjsutment to Trauma
Definition 2 of 21
0 - no evidence
1 - substance use causes problems that might occasionally interfere with daily life (intoxication,
loss of money, reduced work/school, parental concern). history of su problems without
evidence of current problems.
2 - su problem that interferes with ability to function but does not completely prevent
functioning in an unstructured setting
3 - immediate and/or intensive interventions are indicated.
Oppositional (3-18)
Psychosis
Substance Use
Somatization (21+)
,Definition 3 of 21
0 - no evidence
1 - repetitive behaviors that may have mild or occasional interference with the child's
functioning
2 - noticed by unfamiliar people and cause interference in functioning
3 - occur with high frequency and are disabling/dangerous
N/A - 6 years of age or older
Eating Disturbance
Anger Control/Frustration Tolerance
Adjsutment to Trauma
Atypical/Repetitive Behaviors (0-6)
Definition 4 of 21
0 - no evidence
1 - limited impulse control - yelling out answers in class or difficulty waiting their turn. some
motor difficulties such as pushing or shoving others due to impulsive behaviors.
2 - interfering with at least one life domain. individual often intrudes on others and exhibits
aggressive impulses.
3 - dangerous/disabling placing individual at risk of harm - running into the street, dangerous
driving/bike riding. impulsive on continuous basis. endanger self or others without thinking.
Somatization (21+)
Impulsivity/Hyperactivity
Oppositional (3-18)
Adjsutment to Trauma
, Definition 5 of 21
0 - no evidence
1 - history or suspicion (preoccupation with weight, calorie intake, body image)
2 - restrictive eating habits, excessive activity, binge/purge episodes
3 - significantly low weight resulting in hospitalization or excessive binging/purging episodes.
Eating Disturbance
Adjsutment to Trauma
Somatization (21+)
Oppositional (3-18)
Definition 6 of 21
0 - no evidence
1 - history of mild level of defiance towards authority figures that has not yet begun to cause
functional impairment
2 - clear evidence of oppositional and/or defiant behavior interfering with functioning in at
least one life domain
3 - oppositional behaviors involving the threat of physical harm to others
N/A - younger than 3 or older than 18
Substance Use
Oppositional (3-18)
Adjsutment to Trauma
Somatization (21+)
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