Conner氏儿童行为问卷

(父母用)

 

姓名_________  性别____  年龄____  出生日期________  年级______

 

 

 

以下是一些有关您的孩子平时或一贯表现情况的描述，请您仔细阅读，并圈选○最适合您小孩情况的答案。

 

 

                                                                1.无 2.稍有 3.较多 4.很多

 

1. 某种小动作（咬指甲、吸手指拉头发、拉衣服上的布毛）                       1   2   3   4                                            

2. 对大人粗鲁无礼                                                           1   2   3   4

3. 在交朋友或保持友谊上存在问题                                             1   2   3   4

4. 易兴奋、易冲动                                                           1   2   3   4

5. 爱指手划脚                                                               1   2   3   4

6. 吸吮或咬嚼（拇指、衣服、毯子）                                           1   2   3   4

7. 容易或经常哭叫                                                           1   2   3   4

8. 脾气很大                                                                 1   2   3   4

9. 白日梦                                                                   1   2   3   4

10. 学习困难                                                                1   2   3   4

11. 扭动不安                                                                1   2   3   4

12. 惧怕（新环境、陌生人、陌生地方、上学）                                  1   2   3   4

13. 坐立不安、经常“忙碌”                                                  1   2   3   4

14. 破坏性                                                                  1   2   3   4

15. 撒谎或捏造情节                                                          1   2   3   4

16. 怕羞                                                                    1   2   3   4

17. 造成的麻烦比同龄孩子多                                                  1   2   3   4

18. 说话与同龄儿童不同（像婴儿、口吃、别人不易听懂）                        1   2   3   4

19. 抵赖错误或归罪他人                                                      1   2   3   4

20. 好争吵                                                                  1   2   3   4

21. 撅嘴和生气                                                              1   2   3   4

22. 偷窃                                                                    1   2   3   4

23. 不服从或勉强服从                                                        1   2   3   4

                                                                1.无 2.稍有 3.较多 4.很多

 

24. 忧虑比别人多（忧虑孤独、疾病、死亡）                                    1   2   3   4

25. 做事有始无终                                                            1   2   3   4

26. 感情易受损害                                                            1   2   3   4

27. 欺凌别人                                                                1   2   3   4

28. 不能停止重复性活动                                                      1   2   3   4

29. 残忍                                                                    1   2   3   4

30. 稚气或不成熟（自己会的事要人帮忙、依缠别人、常需别人鼓励、支持）        1   2   3   4

31. 容易分心或注意力不集中                                                  1   2   3   4

32. 头痛                                                                    1   2   3   4

33. 情绪变化迅速剧烈                                                        1   2   3   4

34. 不喜欢或不遵从纪律或约束                                                1   2   3   4

35. 经常打架                                                                1   2   3   4

36. 与兄弟姊妹不能很好相处                                                  1   2   3   4

37. 在努力中容易泄气                                                        1   2   3   4

38. 妨害其他儿童                                                            1   2   3   4

39. 基本上是一个不愉快的小孩                                                1   2   3   4

40. 有饮食问题（食欲不佳、进食中常跑开）                                    1   2   3   4

41. 胃痛                                                                    1   2   3   4

42. 有睡眠问题（不能入睡、早醒或夜间起床）                                  1   2   3   4

43. 其他疼痛                                                                1   2   3   4

44. 呕吐或恶心                                                              1   2   3   4

45. 感到在家庭圈子中被欺骗                                                  1   2   3   4

46. 自夸或吹牛                                                              1   2   3   4

47. 让自己受别人欺骗                                                        1   2   3   4

48. 有大便问题（腹泻、排便不规则、便秘）                                    1   2   3   4

    Conner^,s量表应用至今约有20年历史，是筛查儿童行为问题（特别是多动症）用得最广泛的量表。主要有三种问卷，即父母问卷，教师问卷及父母教师问卷。