IdentifyYourSchoolTriggersPage1of4

Name: ___________________________________

Date: _______________________________

Directions:Readeachitemandanswerhonestly.Takeyourtimeasyoucompletethis.Askforhelpifyoudont
understandanitem.
Rateeachitemfrom15.
1=Doesnotbothermeatall
2=Makesmefeelalittleuncomfortable
3=Makesmefeelstressed
4=Thisupsetsme
5=Imgoingtoexplode!

Ateachergivesmefeedback/constructivecriticism.
SomeoneorsomethinginterruptsmewhileIamworking.
Ateachertellsmetocorrectamistake.
WhenIdontunderstandwhatsomeoneissayingtome.
WhenIdisagreewithclassmate.
Whenaclassmateasksforhelp.
Homework.
Whenateachertellsmetodosomething.
Groupworkwithpeers/classmates.
Whenothersmakesuggestionsonhowtodosomething.
Whenoneofmyideasisnotincludedinaproject/activity.
Whensomeonestartssmalltalkwithme.
WhenIamexcludedfromanactivityorconversation.
Meetingnewpeople.

IdentifyYourSchoolTriggersPage2of4
Gettingalowergradeonatest,quiz,orpaper.
WhensomeonepointsoutamistakeImade.
Greetingpeople.
Takingtests.
WhenImakeamistake.
Reportingtoschoolontime.
Writingpapers.
Wearingspecificclothing(i.e.longpants,coat)
Schoolbellsorloudspeakerannouncements.
Firedrills.
Whenaclassmatedisagreeswithme.
Surprisequizzes(popquizzes).
Tornadodrills.
WhenIamlatetowork/school.
WhenIhavetodosomethingnewordifferent.
Hearingotherpeoplesmusic/radio.
Whenotherstouchme(i.e.handshake,patonback).
Largecrowds.
WhenIhavetowaitforsomething.
Teasingbyothers.
Crowdedhallways.
Peerpressure.
Whenmydailyroutineischanged.
Loudplaces.
Specificnoises(i.e.beeping,humming).
Certainsmells(examples:perfumes,foods).
Mathassignments.
Bigprojects.
Whenateacher/authorityfiguretellsmeno.
Changingclasses.

IdentifyYourSchoolTriggersPage3of4
Brightlighting(i.e.fluorescent).
WhenIhavetodosomethinginadifferentwayfromusual.
Bigclassrooms.
WhenIdontunderstandacertainideaorconcept.
WhenIdontfinishsomethingontime.
Gettingwet(i.e.hands,shoes).
Fieldtrips.
WhensomeonetalkstomeaboutsomethingthatIamnotinterested
Certaintextures(examples:inclothing,paint,glue,chalk).
Changesinnoiselevel.
Deadlines,timepressures.
Sittingatadeskforlongperiodsoftime.
Readingassignments.
Whenotherpeoplearetalkingnearme.
Smallspaces(i.e.cubicles).
Askingforhelp.
WhenIamconfusedaboutatask/activity.
WhenIhavetofollowspecificinstructions.
Physicalactivity(i.e.inhealthclassorP.E.).
Largespaces(i.e.auditoriums,gyms,conferencerooms).
WhenIhavetoorganizemythings.

IdentifyYourSchoolTriggersPage4of4
Now that you have finished rating these items, identify your BIG TRIGGERS. These are items that you scored
as a 5 (or perhaps even a 4). Write those down below, and be as specific as you can. For example, if
certain noises make you want to explode, describe the specific noise that makes you feel this way.

My TOP FIVE 5s ARE:

1.______________________________________________________________________
2.______________________________________________________________________
3.______________________________________________________________________
4.______________________________________________________________________
5.______________________________________________________________________
________________________________________________________________________
________________________________________________________________________
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