ASRS DSM-5 Teacher Ratings QuikScore Form (6–18 Years)

Instructions

Please answer each item based on the child's behavior over the past 4 weeks.
Circle the response that best describes how often you have observed the behavior.
Use the following rating scale:

Rating/Description

0 Never – Never observed the behavior.

1 Rarely – Behavior is observed once or twice in 4 weeks.

2 Occasionally – Behavior is observed a few times in 4 weeks.

3 Frequently – Behavior is observed regularly, at least once a week.

4 Very Frequently – Behavior is observed almost daily or more often.

Young Person's Name Full Name

Teacher/SENCO Name

Teacher/SENCO Last Name

Teacher/SENCO Phone *

Teacher/SENCO Email *

Section 1 – Social/Communication

1 Avoids eye contact with others.

2 Struggles to initiate or maintain conversations.

3 Has difficulty understanding social cues (e.g., facial expressions, tone).

4 Responds inappropriately in social situations.

5 Rarely shows interest in interacting with peers.

6 Displays limited facial expressions during social interactions.

7 Has difficulty making or maintaining friendships.

Section 2 – Unusual Behaviors

8 Engages in repetitive behaviors (e.g., hand flapping, rocking).

9 Becomes upset by changes in routine or environment.

10 Shows unusual attachment to objects.

11 Appears overly sensitive to sounds, lights, or textures.

12 Reacts strongly to minor changes in the environment.

13 Fixates on specific interests or activities for extended periods.

14 Engages in self-stimulating behaviors (e.g., pacing, spinning).

Section 3 – Emotional Regulation

15 Has difficulty managing frustration or disappointment.

16 Becomes anxious or withdrawn in social situations.

17 Struggles to regulate emotional responses.

18 Becomes upset when others do not follow specific rules.

19 Has trouble calming down after becoming upset.

20 Overreacts to small changes or minor setbacks.

Section 4 – Cognitive/Executive Functioning

21 Has trouble following multi-step instructions.

22 Requires frequent reminders to stay on task.

23 Demonstrates difficulty with transitions between activities.

24 Shows inflexible thinking patterns.

25 Struggles to organize tasks and activities.

26 Tends to focus on small details rather than the overall picture.

27 Becomes easily distracted by unimportant stimuli.

Section 5 – Sensory Processing

28 Is sensitive to clothing textures or tags.

29 Reacts negatively to loud or unexpected noises.

30 Avoids certain textures, smells, or tastes.

31 Seeks out specific sensory experiences (e.g., spinning, touching).

32 Shows discomfort with bright lights or crowded spaces.

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