Professional Documents
Culture Documents
For each item, check the column which best describes this child/adolescent:
Not at Just a Quite a Very
all little bit much
16. Often blurts out answers before questions have been completed
17. Often has difficulty awaiting turn
Often interrupts or intrudes on others (e.g., butts into
18. conversations/ games
c) What is going well for your child? For example, what are their achievements,
what are they proud about?
d) What strategies have you tried and have they been helpful?
e) Have you received any other help from school, local authority or any other
professional. If so what was the help you received and from whom?
f) Any other information you feel would be helpful to assist with this referral?
Should your child’s referral meet criteria, do you consent to your contact details
being passed onto the Mindsight Surrey CAMHS partner agency run by Barnardos
for a referral to their skills building Nurturing Programme? (Please see course
outline on the back of this page)
Date: …………………………………………………………