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EARLY CHILDHOOD CHECKLIST
The
following list highlights key topics to consider in promoting mental health in
early childhood. These topics may be discussed selectively during office
visits, depending on the needs of the child and family.
Self
*
Sleep patterns and bedtime routines
*
Eating, including
*
Healthy eating
*
Self-feeding
*
Picky eating
*
Family meals
*
Toilet learning, including
*
Signs of readiness
*
Parents’ concerns
*
Children’s fears
*
Self-care, including
*
Encouragement of independence in feeding, dressing, and bathing
*
Emotions, including
*
Increasing self-control
*
Tantrums
*
Aggression
*
Fears
Family
*
Parent-child relationship, including
*
Self-esteem
*
“Goodness-of-fit” between parents’ expectations and child’s temperament
*
Praise
*
Limit setting
*
Discipline
*
Sibling relationships, including
*
Preparation for new siblings
*
Cooperation
*
Conflict resolution
Friends
Community
*
School readiness
*
Child care
Bridges
*
Opportunities for early identification and
intervention, including
*
Anxiety disorders
*
Attention deficit hyperactivity disorder
(ADHD)
*
Child maltreatment
*
Domestic violence
*
Learning disorders
*
Mental retardation
*
Mood disorders (depression and bipolar disorder)
*
Obesity
*
Oppositional and aggressive behaviors
*
Parental depression
*
Pervasive developmental disorders
Notes
MIDDLE
CHILDHOOD CHECKLIST
The
following list highlights key topics to consider in promoting mental health in
middle childhood. These topics may be discussed selectively during office
visits, depending on the needs of the child and family.
Self
*
Self-esteem, including
*
Fostering success
* Taking reasonable risks
*
Resilience and handling failure
*
Parental verbal abuse
*
Importance of supportive family and peer
relationships to self-esteem
*
Self-image, including
*
Body image
* Prepubertal changes
*
Initiating discussions about sexuality and
reproductive health
Family
*
What matters at home, including
*
Expectations and limit setting
*
Family time together
*
Communication
*
Family responsibilities
*
Family transitions—divorce, blended families
*
Sibling relationships
Friends
*
Friendships, including:
*
Making friends
*
Aggression and bullying
*
Victims of bullying
*
Family support of friendships
Community
*
School, including
*
Expectations for school performance
*
Homework
*
Child-teacher conflicts
*
High-risk behaviors and environments,
including
*
Absenteeism
*
Substance use (e.g., alcohol, tobacco, and other drugs)
*
Unsafe friendships
*
Unsafe community environments
Bridges
*
Opportunities for early identification,
including
*
Anxiety disorders
*
Attention deficit hyperactivity disorder
*
Child maltreatment
*
Domestic violence
*
Eating disorders
*
Learning problems and disorders
*
Mental retardation
*
Mood disorders: depressive disorders and bipolar disorder
*
Obesity
*
Oppositional and aggressive behaviors
*
Parental depression
*
Pervasive developmental disorders
*
Substance use disorders
PEDIATRIC
SYMPTOM CHECKLIST (PSC)
Emotional
and physical health go together in children. Because
parents are often the first to notice a problem with their child’s behaviour,
emotions, or learning, you may help your child get the best care possible by
answering these questions.
Please
indicate which statement best describes your child.
Please mark
under the heading that best describes your child:
Never Sometimes Often
1. Complains of aches and pains 1_______
_______ _______
2. Spends more time alone 2_______ _______ _______
3. Tires easily, has little energy 3_______ _______ _______
4. Fidgety, unable to sit still 4_______ _______ _______
5. Has trouble with teacher 5_______ _______ _______
6. Less interested in school 6 ______ _______ _______
7. Acts as if driven by a motor 7_______ _______ _______
8. Daydreams too much 8_______ _______ _______
9. Distracted easily 9_______ _______ _______
10. Is
afraid of new situations 10_______ _______ _______
11. Feels sad, unhappy 11_______ _______ _______
12. Is
irritable, angry 12_______ _______ _______
13. Feels hopeless 13_______ _______ _______
14. Has trouble concentrating 14_______ _______ _______
15. Less interested in friends 15_______ _______ _______
16. Fights with other children 16_______ _______ _______
17. Absent from school 17_______ _______ _______
19. Is
down on him or herself 19_______ _______ _______
20. Visits the doctor with doctor
finding nothing wrong 20_______ _______ _______
21. Has trouble sleeping 21_______ _______ _______
22. Worries a lot 22_______ _______ _______
23. Wants to be with you more than
before 23_______ _______ _______
24. Feels he or she is bad 24_______ _______ _______
25. Takes unnecessary risks 25_______
_______ _______
26. Gets hurt frequently 26_______ _______ _______
27. Seems to be having less fun 27_______ _______ _______
28. Acts younger than children his
or her age 28_______ _______ _______
29. Does not listen to rules 29_______ _______ _______
30. Does not show feelings 30_______ _______ _______
31. Does not understand other
people’s feelings 31_______ _______ _______
32. Teases others 32_______ _______ _______
33. Blames others for his or her
troubles 33_______ _______ _______
34. Takes things that do not
belong to him or her 34_______ _______ _______
35. Refuses to share 35_______ _______ _______
DEPRESSION SCALE FOR CHILDREN
INSTRUCTIONS
Below
is a list of the ways you might have felt or acted. Please check how much you
have felt this way during the past week.
DURING
THE PAST WEEK Not At All, A Little ,Some,
A
1. I
was bothered by things that usually don’t bother me._____ _____ _____ _____
2. I
did not feel like eating, I wasn’t very hungry ._____
_____ _____ _____
3. I
wasn’t able to feel happy, even when my family or _____ _____ _____ _____
friends tried to help me feel
better.
4. I
felt like I was just as good as other kids. _____
_____ _____ _____
5. I
felt like I couldn’t pay attention to what I was doing._____ _____ _____ _____
DURING
THE PAST WEEK Not At All, A Little, Some, A
6. I
felt down and unhappy.
_____ _____ _____ _____
7. I
felt like I was too tired to do things.
_____ _____ _____ _____
8. I
felt like something good was going to happen. _____
_____ _____ _____
9. I
felt like things I did before didn’t work out right. _____ _____ _____ _____
10. I
felt scared.
_____ _____ _____ _____
DURING
THE PAST WEEK
Not At All, A Little, Some A
11. I
didn’t sleep as well as I usually sleep. _____
_____ _____ _____
12. I
was happy.
_____ _____ _____ _____
13. I
was more quiet than usual. _____
_____ _____ _____
14. I
felt lonely, like I didn’t have any friends. _____
_____ _____ _____
15. I
felt like kids I know were not friendly or that
_____ _____ _____ _____
they didn’t want to be
with me.
DURING
THE PAST WEEK Not At All, A Little, Some, A
16. I
had a good time. _____
_____ _____ _____
17. I
felt like crying.
_____ _____ _____ _____
18. I
felt sad. _____
_____ _____ _____
19. I
felt people didn’t like me. _____
_____ _____ _____
20.
It was hard to get started doing things. _____
_____ _____ _____