SCT Module of the Child and Adolescent Behavior Inventory (CABI), Parent Version 1.

Very
Almost Often Almost
Please circle the answer that indicates how often the Sometimes often
Never Seldom (about Always
(several (several
behavior has occurred in the last month at home and (Never or (about once
times per
once (many
per week) per times
in the community (Do not consider behavior at school). about once times
week) per
per month) day) per day)
day)

1 Behavior is slow (sluggish) 0 1 2 3 4 5

2 Lost in a fog 0 1 2 3 4 5

3 Stares blankly into space 0 1 2 3 4 5

4 Drowsy or sleepy (yawns) during the day 0 1 2 3 4 5

5 Daydreams 0 1 2 3 4 5

6 Loses train of thought 0 1 2 3 4 5

7 Low level of activity (underactive) 0 1 2 3 4 5

8 Gets lost in own thoughts 0 1 2 3 4 5

9 Easily tired or fatigued 0 1 2 3 4 5

10 Forgets what was going to say 0 1 2 3 4 5

11 Easily confused 0 1 2 3 4 5

12 Spaces or zones out 0 1 2 3 4 5

13 Gets mixed up 0 1 2 3 4 5

14 Thinking is slow 0 1 2 3 4 5

Difficulty expressing thoughts (e.g., gets “tongue-

15 0 1 2 3 4 5
tied”)

Does the presence of these 15 behaviors CURRENTLY cause academic difficulties for your son or daughter?

No Difficulty Slight Difficulty Moderate Difficulty Severe Difficulty

Does the presence of these 15 behaviors CURRENTLY cause social difficulties (e.g., difficulties in interactions with parents,
siblings, peers, other adults at community activities) for your son or daughter?

No Difficulty Slight Difficulty Moderate Difficulty Severe Difficulty

© 2018 G. Leonard Burns, SoYean Lee, Mateu Servera, Keith McBurnett, and Stephen P. Becker.

Daniela Salazar pires batista - daniela.salazar.dsp@gmail.com - CPF: 011.856.971-60