FBA Profiler Teacher Entry

FREE FBA Profiler On-Line Behavior/Mental Health Screeing

Please provide the following information (for the student being rated).

When finished, click the "Submit Rating" button at the bottom of the page to view the report.

First Name:

 
Last Name:
 
Grade (if in school):

Age of student:

Sex of student:

malefemale

Does this student have any of these diagnosed conditions?

noneadhdanxietydepressionOCDODDConductThought Disorder

Does this student have any of these suspected (but not diagnosed) conditions?

noneadhdanxietydepressionOCDODDConductThought Disorder

Do you believe that this student currently has serious emotional or behavioral difficulties which interfere in his/her life?

yesno

Ethnic Origin:

WhiteBlackAsianIndianHispanicMixed

State in which you live:

For the following items please select the rating that best describes the student being rated based on the scale to the right.

Note, there are 120 items, please complete them all for an accurate rating.

When finished click the "Submit Rating" button at the bottom of the page.

1
2
3
Not True
Somewhat True
Very True
1

Fails to give close attention to details

123
2

Fidgety or squirmy

123
3

Seems easily embarrassed

123
4

Seems to have delusions - believes things to be true which are not

123
5

Seems sad or depressed

123
6

Spreads rumors about others

123
7

Is physically cruel to animals

123
8

Can't get mind off of certain thoughts or mental images

123
9

Has difficulty organizing tasks or activities

123
10

Is constantly moving or "on the go"

123
11

Easily annoyed by others

123
12

Sleeps too much during the day

123
13

Seems to perform certain actions over and over to relieve stress

123
14

Becomes angry or upset when ignored

123
15

Avoids talking or interacting with peers

123
16

Attempts to get others in trouble

123
17

Complains of headaches

123
18

Is reluctant to engage in tasks which require sustained attention or effort

123
19

Talks too much

123
20

Seems angry and/or resentful

123
21

Follows negative peer influence

123
22

Has a strong preference for being alone or isolated rather than with others

123
23

Perceives criticism or teasing when it was not intended

123
24

Seeks attention from others

123
25

Loses things which are necessary to complete tasks (such as pencils, paper, books, etc.)

123
26

Blurts out answers even before a question has been competed

123
27

Vindictive - wants to "get back at" someone

123
28

Slow or delayed body movements

123
29

Does not participate in sports, clubs, or other group activities

123
30

Easily distracted by noises or activities

123
31

Has difficulty waiting for his/her turn

123
32

Seems tired or lacking energy

123
33

Seems generally anxious or nervous

123
34

Does not follow or obey rules

123
35

Seems forgetful

123
36

Interrupts others

123
37

Appears to feel guilty or worthless

123
38

Gets angry when teased

123
39

Has difficulty concentrating or making decisions

123
40

Vandalizes property

123
41

Expresses thoughts of suicide or death

123
42

Appears shy

123
43

Bullies, threatens, or intimidates others

123
44

Starts fires with intent to cause damage

123
45

Has broken into someone's house, building, locker, car, etc.

123
46

Stays out at night beyond curfew

123
47

Makes careless mistakes

123
48

Leaves seat in classroom or other situations when expected to be seated

123
49

Verbal arguments with adults

123
50

Hallucinations - reports hearing or seeing things which others do not

123
51

Seems to lack interest in or pleasure for most daily activities

123
52

Tends to overreact to criticism or embarrassment

123
53

Complains of stomachaches

123
54

Bites or picks at fingernails, hair, or skin

123
55

Frequent excused absences from school

123
56

Withdraws or "shuts down" when embarrassed

123
57

Gets angry when embarrassed

123
58

Appears nervous when speaking or performing in front of others

123
59

Starts fights with others

123
60

Deliberately destroys the property of others

123
61

Lies to or otherwise manipulates others to gain favors or avoid obligations

123
62

Runs away from home

123
63

Has difficulty staying focused on tasks or activities

123
64

Loses temper

123
65

Skips class or school

123
66

Uses tobacco, alcohol, or other "street drugs"

123
67

Runs about or climbs on things inappropriately

123
68

Disorganized speech - difficult for others to follow or understand

123
69

Significant weight change (gain or loss)

123
70

Perfectionistic

123
71

Complains of body aches or pains

123
72

Teases others

123
73

Does not complete schoolwork

123
74

Is a negative leader among peers

123
75

Gets angry when criticized

123
76

Swears or uses obscene language

123
77

Has used a weapon which could cause serious harm to others (like a knife, gun, bat, etc.)

123
78

Has stolen from home, school or elsewhere (like shoplifting)

123
79

Frequent unexcused absences from school

123
80

Does not seem to listen when spoken to

123
81

Seems restless

123
82

Deliberately annoys others

123
83

Grossly disorganized or unpredictable behavior without an apparent purpose

123
84

Frequently visits the doctor or school nurse

123
85

Seems irritable

123
86

Verbal arguments with peers

123
87

Complains of eye problems (not related to a need for glasses)

123
88

Makes disruptive noises

123
89

Does not complete chores

123
90

Appears to resent authority

123
91

Uses behavior to conceal frustration

123
92

Has a high need for social acceptance

123
93

Physical cruelty to other people

123
94

Does not follow instructions or finish assigned tasks

123
95

Has difficulty quietly engaging in leisure activities

123
96

Writes threatening letters or notes

123
97

Displays very little emotion or "affect"

123
98

Complains of difficulty sleeping at night

123
99

Seems tense

123
100

Seems to have a compulsive need to repeat certain behaviors (i.e. hand washing, counting steps, saying a series of words silently or aloud, et.)

123
101

Appears to have skin problems (rashes, etc.)

123
102

Likes to be the "center of attention"

123
103

Is often difficult to find - hides or disappears

123
104

Doesn't like being told what to do

123
105

Gets more upset if punished or criticized in front of others

123
106

Likes to be "in charge"

123
107

Tendency to engage is a certain impulsive reaction over and over

123
108

Holds a grudge

123
109

Inflexible - needing to always do things in a certain way

123
110

Blames others for his/her mistakes or misbehavior

123
111

Seems unable to make or keep friends

123
112

Has considerable difficulty relating to other people

123
113

Misinterprets social cues or the behavior of others

123
114

Has difficulty using or understanding nonverbal communication (such as gestures, facial expressions, tone of voice, etc.)

123
115

Demonstrates very unusual speech patterns (such as tone, rhythm, or rate)

123
116

Has considerable difficulty initiating or maintaining a conversation

123
117

Insists on following certain rules, routines, or rituals

123
118

Seems very resistant to changes in activity

123
119

Seems overly preoccupied with a specific area of interest

123
120

Is highly sensitive to certain sensory stimuli (such as light, sound, texture, smell, etc.)

123
 
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