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  • Calcutta International School Student Screening Questionnaire by Class Teachers Middle and Senior School

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    Spriha Patronobis
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    This document is a student screening questionnaire from Calcutta International School that is completed by class teachers to evaluate students' social, work, and emotional behaviors. It includes a scale of 0-3 to rate how frequently students display certain behaviors in the current academic session, such as arguing, cooperating with peers, preparedness for class, distraction, sadness, anxiety, and more. Teachers are to indicate only one number for each behavior, and there is space at the end for any additional comments from the teacher about the student.

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    for student screening

    Original Title

    Screening

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    This document is a student screening questionnaire from Calcutta International School that is completed by class teachers to evaluate students' social, work, and emotional behaviors. It includes a scale of 0-3 to rate how frequently students display certain behaviors in the current academic session, such as arguing, cooperating with peers, preparedness for class, distraction, sadness, anxiety, and more. Teachers are to indicate only one number for each behavior, and there is space at the end for any additional comments from the teacher about the student.

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    11 views2 pages

    Calcutta International School Student Screening Questionnaire by Class Teachers Middle and Senior School

    Uploaded by

    Spriha Patronobis
    This document is a student screening questionnaire from Calcutta International School that is completed by class teachers to evaluate students' social, work, and emotional behaviors. It includes a scale of 0-3 to rate how frequently students display certain behaviors in the current academic session, such as arguing, cooperating with peers, preparedness for class, distraction, sadness, anxiety, and more. Teachers are to indicate only one number for each behavior, and there is space at the end for any additional comments from the teacher about the student.

    Copyright:

    © All Rights Reserved
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    CALCUTTA INTERNATIONAL SCHOOL

    STUDENT SCREENING QUESTIONNAIRE BY CLASS TEACHERS


    MIDDLE AND SENIOR SCHOOL

    Name of the student:________________________________ Age:_________________

    Class + Section: ____________; Students age :____________; Year of joining CIS: ________________

    Using the following scale, identify how frequently the student has displayed each of the following
    behaviours in this academic session. Indicate only one number for each behaviour

    0 = Never, 1 = Sometimes, 2 = Often, 3 = Almost Always

    SOCIAL BEHAVIOUR

    0 1 2 3
    Arguing with peers
    Complains frequently about peers
    Rebel behaviour towards authority figures
    Co-operating with peers
    Polite and socially appropriate response towards others
    Impulsiveness
    Aggression towards others ( Verbal/Physical )
    Teases others frequently
    Bullies other
    Is being/Has been bullied
    Is able to make and keep friendships
    Is able to make eye contact
    Remains aloof
    Isolated by some or many peers
    Can easily interact with new students
    WORK HABITS AND CLASSROOM BEHAVIOUR

    0 1 2 3
    Interested in class lessons
    Preparedness for instructions/ Follows instructions
    Needs repeated instructions
    Slow to finish work
    Difficulty in copying from board
    Does not bring required books to school frequently
    Production of acceptable work
    Difficulty working independently
    Distracted easily
    Restless (frequently out of place or fidgeting)
    Class engagement
    Completes work
    Not able to submit work within deadlines
    Age appropriate written work
    Has been involved in disciplinary issues/ warning given for
    not following school rules

    EMOTIONAL BEHAVIOUR
    0 1 2 3
    Sadness
    Fearfulness
    Anxious
    Temper outbursts
    Adaptable to change
    Easily demotivated
    Lack of Confidence
    Takes feedback well
    Withdrawal
    Difficulty rebounding from setbacks
    Hypersensitive to feedback from others (misconstrues
    feedback from others)
    Takes onus for own behaviour (even if he/she has done
    something wrong)
    Blames others

    Any other comments :

    Signature of Class Teacher :_______________________________

    Date :_____________________________

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