EFFECTS OF CLASSROOM INTERVENTIONS ON PROBLEMATIC BEHAVIORS OF

GRADE 2 PUPILS IN DR. JOSE P. RIZAL ELEMENTARY SCHOOL

BEHAVIORAL PROBLEMS QUESTIONNAIRE FOR TEACHERS

Research by Maria Victoria V. Gualin

Students Name: _____________________________________________________________

Grade: ____________

Section: __________ Name of Teacher: ___________________

Instructions: Read the statements below and put a check () on either ALWAYS, OFTEN,
SOMETIMES, RARELY or NEVER depending on which one is true to your observation of your own
students occurrence of problematic behaviors. There are no right or wrong answers.
Patnugot: Basahin ang mga sumusunod na pangungusap sa ibaba. Lagyan ng TSEK () ang
PALAGI, MALIMIT, PAMINSAN, MADALANG o HINDI KAILANMAN depende sa kung ano ang
totoo sa iyong nakita patungkol sa problema ng iyong mag-aaral. Walang tama o maling sagot.
Behavioral Problems
Encountered

1. My pupil lacks attention

during class.
Ang aking mag-aaral ay hindi
nagbibigay ng atensyon sa
aming klase.
2. My pupil ignores my
instructions, orders and my
comments.
Ang aking mag-aaral ay hindi
nagbibigay pansin sa aking
mga turo, utos at opinyon. .
3. My pupil provokes his or
her classmates.
Ang aking mag-aaral ay
hinahamon ang kanyang mga
kaklase.
4. My pupil does not
participate in group
discussions.
Ang aking mag-aaral ay hindi
sumasali sa mga grupong
pag-aaral.

Always
(Palagi)

Often
(Malimit)

Sometimes
(Paminsan)

Rarely
(Madalang)

Never
(Hindi
Kailanman)

Behavioral Problems
Encountered

5. My pupil plays during

class.
Ang aking mag-aaral ay
naglalaro tuwing ako ay
nagka-klase.
6. My pupil attempted
cheating during
examinations.
Ang aking mag-aaral ay
sinubukang mandaya sa
kanyang mga pagsusulit.
7. My pupil lacks concern in
performing his homework.
Ang aking mag-aaral ay
walang interes sa pag-gawa
ng kanyang mga takdang
aralin.
8. My pupil lacks interest in
my lessons.
Ang aking mag-aaral ay
walang interes sa kanyang
pag-aaral.
9. My pupil smokes before
going to school.
Ang aking mag-aaral ay
naninigarilyo bago pumasok
sa paaralan.
10. My pupil threatens his
or her classmates.
Ang aking mag-aaral ay
tinatakot ang kanyang mga
kaklase.
11. My pupil makes
unnecessary noises while I
am explaining lessons.
Ang aking mag-aaral ay
gumagawa ng ingay tuwing
ako ay nagtuturo.
12. My pupil throws things
to his or her classmates.
Ang aking mag-aaral ay
nambabato ng kanyang
kaklase.

Always
(Palagi)

Often
(Malimit)

Sometimes
(Paminsan)

Rarely
(Madalang)

Never
(Hindi
Kailanman)

Behavioral Problems
Encountered

13. My pupil utters vulgar and

indecent words.
Ang aking mag-aaral ay
nagsasalita ng mga bulgar at
bastos na salita.
14. My pupil cuts class.
Ang aking mag-aaral ay hindi
pumapasok sa tamang oras.
15. My pupil disobeys school
rules.
Ang aking mag-aaral ay hindi
sumusunod sa mga patakaran
ng paaralan.
16. My pupil steals things
from his or her classmates.
Ang aking mag-aaral ay ay
nagnanakaw ng gamit ng
kanyang mga kaklase.
17. My pupil gambles in the
classroom whenever I am not
around.
Ang aking mag-aaral ay ay
nagsusugal tuwing wala sa
ako sa silid aralan.
18. My pupil is angry at me.
Ang aking mag-aaral ay galit
sa akin.
19. My pupil walks around
the room while I am
discussing lessons.
Ang aking mag-aaral ay
naglalakad sa loob ng silid
aralan sa tuwing ako ay
nagtuturo.
20. My pupil eats inside the
classroom while we are
having class.
Ang aking mag-aaral ay
kumakain sa loob ng silid
aralan habang kami ay may
nagkaklase.

Always
(Palagi)

Often
(Malimit)

Sometimes
(Paminsan)

Rarely
(Madalang)

Never
(Hindi
Kailanman)

EFFECTS OF CLASSROOM INTERVENTIONS ON PROBLEMATIC BEHAVIORS OF

GRADE 2 PUPILS IN DR. JOSE P. RIZAL ELEMENTARY SCHOOL

BEHAVIORAL PROBLEMS QUESTIONNAIRE FOR PUPILS

Research by Maria Victoria V. Gualin

Students Name: _____________________________________________________________

Grade: ____________

Section: __________ Name of Teacher: ___________________

Instructions: Read the statements below and put a check () on either ALWAYS, OFTEN,
SOMETIMES, RARELY or NEVER depending on which one is true to your own experience. There
are no right or wrong answers.
Patnugot: Basahin ang mga sumusunod na pangungusap sa ibaba. Lagyan ng TSEK () ang
PALAGI, MALIMIT, PAMINSAN, MADALANG o HINDI KAILANMAN depende sa kung ano ang
totoo sa iyong karanasan. Walang tama o maling sagot.
Behavioral Problems
Encountered

1. I lack attention during

class.
Ako ay hindi nagbibigay ng
atensyon sa aming klase.
2. I ignore the teachers
instructions, orders and
their comment.
Hindi ko binibigyan ng
pansin ang mga turo, utos
at opinion ng aking guro.
3. I provoke my classmates.
Hinahamon ko ang aking
mga kaklase.
4. I do not participate in
group discussions.
Hindi ako sumasali sa mga
grupong pag-aaral.
5. I play during class.
Naglalaro ako tuwing klase.

Always
(Palagi)

Often
(Malimit)

Sometimes
(Paminsan)

Rarely
(Madalang)

Never
(Hindi
Kailanman)

Behavioral Problems
Encountered

6. I attempted cheating
during examinations.
Sinubukan kong mandaya
sa aking mga pagsusulit.
7. I lack concern in the
performance of homework.
Wala akong interes sa paggawa ng aking takdang
aralin.
8. I lack interest in my
lessons.
Ako ay walang interes sa
aking pag-aaral.
9. I smoke before going to
school.
Ako ay naninigarilyo bago
pumasok sa paaralan.
10. I threaten my
classmates.
Tinatakot ko ang aking mga
kaklase.
11. I make unnecessary
noise while the teacher is
explaining the lesson.
Gumagawa ako ng ingay
tuwing nagtuturo ang aking
guro.
12. I throwing things to my
classmates.
Nambabato ako ng kaklase.
13. I utter vulgar and
indecent word.
Nagsasalita ako ng mga
bulgar at bastos na salita.
14. I cut class.
Hindi ako pumapasok sa
tamang oras.

Always
(Palagi)

Often
(Malimit)

Sometimes
(Paminsan)

Rarely
(Madalang)

Never
(Hindi
Kailanman)

Behavioral Problems
Encountered

15. I disobey school rules.

Hindi ako sumusunod sa
mga patakaran ng
paaralan.
16. I steal things from my
classmates.
Ako ay nagnanakaw ng
gamit ng aking kaklase.
17. I gamble in the
classroom when the teacher
is not around.
Ako ay nagsusugal tuwing
wala sa silid aralan ang
aking guro.
18. I am angry at my
teacher.
Galit ako sa aking guro.
19. I walk around the room
while the teacher discusses
her lessons.
Naglalakad ako sa loob ng
silid aralan tuwing
nagtuturo ang aking guro.
20. I eat inside the
classroom while we are
having class.
Ako ay kumakain sa loob ng
silid aralan habang kami ay
nagkaklase.

Always
(Palagi)

Often
(Malimit)

Sometimes
(Paminsan)

Rarely
(Madalang)

Never
(Hindi
Kailanman)

EFFECTS OF CLASSROOM INTERVENTIONS ON PROBLEMATIC BEHAVIORS OF

GRADE 2 PUPILS IN DR. JOSE P. RIZAL ELEMENTARY SCHOOL

GRADE 2 PUPIL PROFILE QUESTIONNAIRE

(to be filled up by parents)
Research by Maria Victoria V. Gualin

Students Name: _____________________________________________________________

Grade: ____________

Section: __________ Name of Teacher: ___________________

Pupil Socio-Demographic Profile

Kindly put a check () in the option that best describes the pupil respondents personal profile.
Personal na Impormasyon ng Estudyante
Lagyan ng tsek () ang talatang higit na naglalarawan sa iyong anak na aming mag-aaral.
1. Age (Edad):
_____ 6 _____ 7
_____ 8 _____ 9
_____ 10 _____ 11
_____ 12 _____ 12
_____ 13 15
_____ 16 18
_____ 19 21

2. Highest Educational Attainment of Parents

(Pinakamataas na pinag-aralan ng mga magulang)
____
____
____
____
____
____
____
____
____

elementary graduate and below

high school level
high school graduate
Vocational or some college units
College/tertiary graduate
Graduate School Units
Graduate School (Masters) Graduate
Some Doctoral units
Doctoral Graduate and above

_____ 22 and above

3. Gender (Kasarian):

____male

____ female

4. Combined Family Monthly Income

(Pinagsamang kabuuhang kita sa Isang Buwan):
_____ 2,000 pesos and below _____ 26,001 to 29,000 pesos
_____ 2,001 to 5,000 pesos
_____ 29,001 to 32,000 pesos
_____ 5,001 to 8,000 pesos
_____ 32,001 to 35,000 pesos
_____ 8,001 to 11,000 pesos
_____ 35,001 to 38,000 pesos
_____ 11,001 to 14,000 pesos _____ 38,001 to 150,000 pesos
_____ 14,001 to 17,000 pesos _____ 151,000 pesos and above
_____ 17,001 to 20,000 pesos
_____ 20,001 to 23,000 pesos
_____ 23,001 to 26,000 pesos

5. How many children do you have? (Ilan ang iyong anak?)

_____________ 1
_____________ 2
_____________ 3
_____________ 4
_____________ 5
_____________ 6
_____________ More than 6 children

Thank you!

CONFIDENTIAL GUIDANCE PERSONNEL REFERRAL FORM

Date Received _______________
Students Name _______________________________________ Advisory Teacher________________
First
Last
Parent/Guardian Name _________________________________________ Contact number _________
Referred by:

___ Teacher

___ Parent

___ Self

___ Other (please specify):__________

DOB ________________ Student lives with: ________________________________________________

Reason(s) for Referral- Problems/Concerns related to: (Please check all that apply.)
[ ] Dramatic change in behavior
[ ] Worries
[ ] Daydream/fantasizes
[ ] Grief
[ ] Fears
[ ] Sadness
[ ] Always tired
[ ] Motivation
[ ] Inattentive
[ ] Withdrawn
[ ] Cries easily for age
[ ] Self-image/confidence
[ ] Non-touchable/pulls away
[ ] Nervous/anxious
[ ] Perfectionist
[ ] Aggression/Anger

[ ] Swearing
[ ] Fighting
[ ] Lying
[ ] Bullying
[ ] Disrespectful
[ ] Defiant
[ ] Hurts self
[ ] Impulsive
[ ] Over Active
[ ] Easily distracted
[ ] Chews (paper/clothes/hair)
[ ] Makes Odd Sounds
[ ] Stealing
[ ] Destruction of Property
[ ] Sexual Acting Out
[ ] Peer Relationships
[ ] Social Skills

[ ] Personal Hygiene
[ ]Family Concerns
[ ] Academics
[ ] Absences
[ ] Tardy
[ ] Wk habits/organization
[ ] Completion of
Assignments/Homework
[ ] Drop out risk
[ ] Other_________

Clarify Referral Problem / History:

_____________________________________________________________________________________
_____________________________________________________________________________________
ACTIONS taken by the person referring this student, if applicable: (Please attach copies of any
interventions attempted)
_____________________________________________________________________________________
_____________________________________________________________________________________
Have you contacted parent/guardian about your concern? Y/N Date: _______________
Explain below the outcome of parent contact:
_____________________________________________________________________________________
_____________________________________________________________________________________
What other services is student receiving (Out of school counseling, etc.)?
_____________________________________________________________________________________
_____________________________
Signature of Person Making Referral

___________________
Date of Referral