BEHAVIOR DIMENSIONS SCALE-2 Name of student: Andrea Thomas School: Midvale High School Class: Science City: Midvale SCHOOL VERSION RATING FORM PROFILE SHEET Gender: Female Grade: State: NY Subscales SUMMARY OF SCORES Raw Standard Standard Score Score Score SEM (Appendix A) (Appendix C) Date of rating: Date of birth: 200 10 3 30 2 Age at rating: 1 7 1 (years) (months) (days) Rated by (observer's name): J. Jackson Dates during which observation of student occurred: From 0/21/200 To 03/30/200 Amount of time spent with student: Per day 0 min. Per week 4 hrs. min. Standard Scores Inattentive Hyperactive-Impulsive Oppositional Defiant Conduct Disorder Avoidant Personality Total Score Sum of Subscale SS Generalized Anxiety Major Depressive Episode (Appendix B) SCHOOL VERION PROFILE SAMPLE %ile SEM (Appendix B) (Appendix C) SUBSCALES Attention-Deficit/ Hyperactivity Disorder Major Hyperactive- Oppositional Conduct Avoidant Generalized Depressive Inattentive Impulsive Defiant Disorder Personality Anxiety Episode s Percentile 2 0 13 22 4.0 1 7 0.71 0.4 0. 0.7 0.7 1.0 0.4 Confidence Interval % Percentile Rank 20 10 > 1 14 1 140 0 17 13 1 130 0 1 12 7 14 120 13 12 1 0 0 0 4 0 40 7 3 0 30 7 2 4 20 3 1 2 0 1 0 <1 BDS-2 SV Copyright (c) 200 Hawthorne Educational Servces, Inc.
The Inattentive subscale is a measure of a pattern of inattention that may be manifest in academic, occupational, or social situations evidenced by (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities, (b) often has difficulty sustaining attention in tasks or play activities, (c) often does not seem to listen when spoken to directly, (d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace, (e) often has difficulty organizing tasks and activities, (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort, (g) often loses things necessary for tasks or activities, (h) is often easily distracted by extraneous stimuli, (i) is often forgetful in daily activities. (DSM-IV, American Psychiatric Association, 14). Andrea scored within one standard deviation above the mean on the Inattentive subscale. The Hyperactive-Impulsive subscale is a measure of a pattern of hyperactivity-impulsivity that interferes with developmentally appropriate social, academic, or occupational functioning: hyperactivity evidenced by (a) often fidgets with hands or feet or squirms in seat, (b) often leaves seat in classroom or in other situations in which remaining seated is expected, (c) often runs about or climbs excessively in situations in which it is inappropriate, (d) often has difficulty playing or engaging in leisure activities quietly, (e) is often "on the go" or often acts as if "driven by a motor," (f) often talks excessively, and; impulsivity by (g) often blurts out answers before questions have been completed, (h) often has difficulty awaiting turn, (i) often interrupts or intrudes on others. (DSM-IV, American Psychiatric Association, 14) Andrea scored at the mean on the Hyperactive-Implusive subscale. The Oppositional Defiant subscale is a measure of a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures evidenced by (a) often loses temper, (b) often argues with adults, (c) often actively defies or refuses to comply with adults' requests or rules, (d) often deliberately annoys people, (e) often blames others for his or her mistakes or misbehavior, (f) is often touchy or easily annoyed by others, (g) is often angry and resentful, (h) is often spiteful or vindictive. (DSM-IV, American Psychiatric Association, 14). Andrea scored at the mean on the Oppositional Defiant subscale. The Conduct Disorder subscale is a measure of a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated evidenced by aggression to people and animals: (a) often bullies, threatens, or intimidates others, (b) often initiates physical fights, (c) has used a weapon that can cause serious physical harm to others, (d) has been physically cruel to people, (e) has been physically cruel to animals, (f) has stolen while confronting a victim, (g) has forced someone into sexual activity; destruction of property: (a) has deliberately engaged in fire setting with the intention of causing serious damage, (b) has deliberately destroyed others' property (other than by fire setting); deceitfulness or theft: (a) has broken into someone SCHOOL VERSION SAMPLE else's house, building, or car, (b) often lies to obtain goods or favors or to avoid obligations, (c) has stolen items of nontrivial value without confronting a victim; serious violations of rules: (a) often stays out at night despite parental prohibitions, beginning before age 13 years, (b) has run away from home overnight at least twice while living in parental or parental surrogate home, (c) is often truant from school, beginning before age 13 years. (DSM-IV, American Psychiatric Association, 14). Andrea scored within one standard deviation above the mean on the Conduct Disorder subscale. The Avoidant Personality subscale is a measure of a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation evidenced by (a) avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection, (b) is unwilling to get involved with people unless certain of being liked, (c) shows restraint within intimate relationships because of the fear of being shamed or ridiculed, (d) is preoccupied with being criticized or rejected in social situations, (e) is inhibited in new interpersonal situations because of feelings of inadequacy and low self-esteem, (f) views self as socially inept, personally unappealing, or inferior to others, (g) is unusually reluctant to take personal risks or to engage in any new activities because these may prove embarrassing. (DSM-IV, American Psychiatric Association, 14). Andrea scored at one standard deviation below the mean on the Avoidant Personality subscale. The Generalized Anxiety subscale is a measure of excessive anxiety and worry evidenced by (a) restlessness or feeling keyed up or on edge, (b) being easily fatigued, (c) difficulty concentrating or mind going blank, (d) irritability, (e) muscle tension, (f) sleep disturbance. (DSM-IV, American Psychiatric Association, 14). Andrea scored within one standard deviation below the mean on the Generalized Anxiety subscale.
The Major Depressive Episode subscale is a measure of either a depressed mood or the loss of interest or pleasure in nearly all activities evidenced by (a) depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others, (b) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day, (c) significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day, (d) insomnia or hypersomnia nearly every day, (e) psychomotor agitation or retardation nearly every day, (f) fatigue or loss of energy nearly every day, (g) feelings of worthlessness or excessive or inappropriate guilt nearly every day, (h) diminished ability to think or concentrate, or indecisiveness, nearly every day, (i) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. (DSM-IV, American Psychiatric Association, 14). Andrea scored within one standard deviation above the mean on the Major Depressive Episode subscale. SCHOOL VERSION SAMPLE
HOME VERSION RATING FORM PROFILE SHEET SUMMARY OF SCORES Name of student: Thomas Andrews Gender: Male Raw Standard Standard School: Midvale Elementary Subscales Score Score Score SEM Class: Midvale Grade: 2 (Appendix A) (Appendix C) City: Midvale State: PA Inattentive 21 7 1.3 Date of rating: Date of birth: Age at rating: 200 17 Rated by (observer's name): Relationship to the child: Standard Scores BEHAVIOR DIMENSIONS SCALE-2 12 13 1 3 (years) (months) (days) Mother M. Jackson Hyperactive-Impulsive Oppositional Defiant Conduct Disorder Avoidant Personality Total Score Sum of Subscale SS Generalized Anxiety Major Depressive Episode (Appendix B) %ile SEM (Appendix B) (Appendix C) SUBSCALES Attention-Deficit/ Hyperactivity Disorder Major Hyperactive- Oppositional Conduct Avoidant Generalized Depressive Inattentive Impulsive Defiant Disorder Personality Anxiety Episode s Percentile 20 10 > 1 14 1 140 0 17 13 1 130 0 1 12 7 14 120 13 12 1 0 0 0 4 0 40 7 3 0 30 7 2 4 20 3 1 2 0 1 0 <1 BDS-2 HV Copyright (c) 200 Hawthorne Educational Servces, Inc. HOME VERSION PROFILE SAMPLE 4 2 3 3 1 0 24. 1.3 2.32 3. 3.07 3. 2.43 Confidence Interval % Percentile Rank
The Inattentive subscale is a measure of a pattern of inattention that may be manifest in academic, occupational, or social situations evidenced by (a) often fails to give close attention to details or makes careless mistakes in schoolwork, work, or other activities, (b) often has difficulty sustaining attention in tasks or play activities, (c) often does not seem to listen when spoken to directly, (d) often does not follow through on instructions and fails to finish schoolwork, chores, or duties in the workplace, (e) often has difficulty organizing tasks and activities, (f) often avoids, dislikes, or is reluctant to engage in tasks that require sustained mental effort, (g) often loses things necessary for tasks or activities, (h) is often easily distracted by extraneous stimuli, (i) is often forgetful in daily activities. (DSM-IV, American Psychiatric Association, 14). Thomas scored at one standard deviation below the mean on the Inattentive subscale. 7. Is easily distracted by other things happening in the home 17. Needs oral questions and directions frequently repeated 30. Is disorganized with possessions The Hyperactive-Impulsive subscale is a measure of a pattern of hyperactivity-impulsivity that interferes with developmentally appropriate social, academic, or occupational functioning: hyperactivity evidenced by (a) often fidgets with hands or feet or squirms in seat, (b) often leaves seat in classroom or in other situations in which remaining seated is expected, (c) often runs about or climbs excessively in situations in which it is inappropriate, (d) often has difficulty playing or engaging in leisure activities quietly, (e) is often "on the go" or often acts as if "driven by a motor," (f) often talks excessively, and; impulsivity by (g) often blurts out answers before questions have been completed, (h) often has difficulty awaiting turn, (i) often interrupts or intrudes on others. (DSM-IV, American Psychiatric Association, 14) Thomas scored more than one standard deviation below the mean on the Hyperactive-Implusive subscale. 1. Moves about while seated, fidgets, squirms, etc. 3. Handles objects 4. Does not remain seated. Engages in inappropriate behaviors while seated. Does not wait for questions to be completed before blurting out responses. Reacts immediately to situations without thinking, is impatient, fails to wait for a turn or for assistance, etc. 24. Interrupts others 33. Climbs on things The Oppositional Defiant subscale is a measure of a recurrent pattern of negativistic, defiant, disobedient, and hostile behavior toward authority figures evidenced by (a) often loses temper, (b) often argues with adults, (c) often actively defies or refuses to comply with adults' requests or rules, (d) often deliberately annoys people, (e) often blames others for his or her mistakes or misbehavior, (f) is often touchy or easily annoyed by others, (g) is often angry and resentful, (h) is often spiteful or vindictive. (DSM-IV, American Psychiatric Association, 14). Thomas scored within one standard deviation below the mean on the Oppositional Defiant subscale. The Conduct Disorder subscale is a measure of a repetitive and persistent pattern of behavior in which the basic rights of others or major age-appropriate societal norms or rules are violated evidenced by aggression to people and animals: (a) often bullies, threatens, or intimidates others, (b) often initiates physical fights, (c) has used a weapon that can cause serious physical harm to others, (d) has been physically cruel to people, (e) has been physically cruel to animals, (f) has stolen while confronting a victim, (g) has forced someone into sexual activity; destruction of property: (a) has deliberately engaged in fire setting with the intention of causing serious damage, (b) has deliberately destroyed others' property (other than by fire setting); deceitfulness or theft: (a) has broken into someone else's house, building, or car, (b) often lies to obtain goods or favors or to avoid obligations, (c) has stolen items of nontrivial value without confronting a victim; serious violations of rules: (a) often stays out at night despite parental prohibitions, beginning before age 13 years, (b) has run away from home overnight at least twice while living in parental or parental surrogate home, (c) is often truant from school, beginning before age 13 years. (DSM-IV, American Psychiatric Association, 14). Thomas scored at the mean on the Conduct Disorder subscale. HOME VERSION SAMPLE
The Avoidant Personality subscale is a measure of a pervasive pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation evidenced by (a) avoids occupational activities that involve significant interpersonal contact because of fears of criticism, disapproval, or rejection, (b) is unwilling to get involved with people unless certain of being liked, (c) shows restraint within intimate relationships because of the fear of being shamed or ridiculed, (d) is preoccupied with being criticized or rejected in social situations, (e) is inhibited in new interpersonal situations because of feelings of inadequacy and low self-esteem, (f) views self as socially inept, personally unappealing, or inferior to others, (g) is unusually reluctant to take personal risks or to engage in any new activities because these may prove embarrassing. (DSM-IV, American Psychiatric Association, 14). Thomas scored within one standard deviation below the mean on the Avoidant Personality subscale. The Generalized Anxiety subscale is a measure of excessive anxiety and worry evidenced by (a) restlessness or feeling keyed up or on edge, (b) being easily fatigued, (c) difficulty concentrating or mind going blank, (d) irritability, (e) muscle tension, (f) sleep disturbance. (DSM-IV, American Psychiatric Association, 14). Thomas scored within one standard deviation below the mean on the Generalized Anxiety subscale. The Major Depressive Episode subscale is a measure of either a depressed mood or the loss of interest or pleasure in nearly all activities evidenced by (a) depressed mood most of the day, nearly every day, as indicated by either subjective report or observation made by others, (b) markedly diminished interest or pleasure in all, or almost all, activities most of the day, nearly every day, (c) significant weight loss when not dieting or weight gain, or decrease or increase in appetite nearly every day, (d) insomnia or hypersomnia nearly every day, (e) psychomotor agitation or retardation nearly every day, (f) fatigue or loss of energy nearly every day, (g) feelings of worthlessness or excessive or inappropriate guilt nearly every day, (h) diminished ability to think or concentrate, or indecisiveness, nearly every day, (i) recurrent thoughts of death, recurrent suicidal ideation without a specific plan, or a suicide attempt or a specific plan for committing suicide. (DSM-IV, American Psychiatric Association, 14). Thomas scored within one standard deviation above the mean on the Major Depressive Episode subscale. HOME VERSION SAMPLE