SAEBRS Social, Academic, & Emotional Behavior Risk Screener Teacher Rating Scale Your Name: Student Date of Birth: Student Name: _ Student Grade: Today's Date: Using the following scale, identify how frequently the student has displayed each of the following behaviors during the previous month. Circle only one number for each behavior. 0 = Never, 1 = Sometimes, 2 = Often, 3 = Almost Always Social Behavior a ca ] Arguing o 41 2 3 Cooperation with peers o 4 2 3 Temper outbursts o 1 2 3 Disruptive behavior o 4 2 3 Polite and socially appropriate responses toward others 0 = 1023 Impulsiveness o 1 2 3 ‘Academic Behavior Interest in academic topics On 4 “2h gs) Preparedness for instruction o 4 2 3 Production of acceptable work o 41 2 3 Difficulty working independently o 4 2 3 Distractedness o i 2 3 Academic engagement o 1 2 3 he SALDICS fom was ers by Stns FR, Samra NM Chats T Chri RieyVillnan, and Nathan P. vx de Embae fee anevaftic Gears ante lleepyegh aes induaedvallcopics ne Pvmel amd cvealodhats alone(Emotional Behavior Sadness Oa eee) Fearfuiness o 41 2 3 Adaptable to change o 41 2 8 Positive attitude o 1 2 3 Worry 0) hos) Difficulty rebounding from setbacks oO 1 2 3 Withdrawal o f 2 8 “The SAEDRS fonm was erected by Staphen P. Kilo, Sundes M. Chetoleas, Chris Riley-Tllman, abd Natanil P, von der Embse CCopytight 2013 by Stephen Kilzs. Al sights reserved. Permission Grated w photoeopy for peteonal and educational use a ong. ss thomas ofthe erates ee all opti opis ise ae insluded