School Refusal Assessment Scale-Revised (P)
First Name
*
Last Name
*
Email
*
Phone
*
1. How often does your child have bad feelings about going to school because he/she is afraid of something related to school (for example, tests, school bus, teacher, fire alarm)?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
2. How often does your child stay away from school because it is hard for him/her to speak with the other kids at school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
3. How often does your child feel he/she would rather be with you or your spouse than go to school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
4. When your child is not in school during the week (Monday to Friday), how often does he/she leave the house and do something fun?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
5. How often does your child stay away from school because he/she will feel sad or depressed if he/she goes?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
6. How often does your child stay away from school because he/she feels embarrassed in front of other people at school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
7. How often does your child think about you or your spouse or family when in school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
8. When your child is not in school during the week (Monday to Friday), how often does he/she talk to or see other people (other than his/her family)?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
9. How often does your child feel worse at school (for example, scared, nervous, or sad) compared to how he/she feels at home with friends?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
10. How often does your child stay away from school because he/she does not have many friends there?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
11. How much would your child rather be with his/her family than go to school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
12. When your child is not in school during the week (Monday to Friday), how much does he/she enjoy doing different things (for example, being with friends, going places)?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
13. How often does your child have bad feelings about school (for example, scared, nervous, or sad) when he/she thinks about school on Saturday and Sunday?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
14. How often does your child stay away from certain places in school (e.g., hallways, places where certain groups of people are) where he/she would have to talk to someone?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
15. How much would your child rather be taught by you or your spouse at home than by his/her teacher at school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
16. How often does your child refuse to go to school because he/she wants to have fun outside of school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
17. If your child had less bad feelings (for example, scared, nervous, sad) about school, would it be easier for him/her to go to school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
18. If it were easier for your child to make new friends, would it be easier for him/her to go to school?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
19. Would it be easier for your child to go to school if he/she could do more things he/she likes to do after school hours (for example, being with friends)?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
20. How much more does your child have bad feelings about school (for example, scared, nervous, or sad) compared to other kids his/her age?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
21. How much more does your child have bad feelings about school (for example, scared, nervous, or sad) compared to other kids his/her age?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
22. How often does your child stay away from people at school compared to other kids his/her age?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
23. Would your child like to be home with you or your spouse more than other kids his/her age would?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always
24. Would your child rather be doing fun things outside of school more than most kids his/her age?
Never
Seldom
Sometimes
Half the Time
Usually
Almost Always
Always