School Refusal Assessment Scale-Revised (C)

First Name *

Last Name *

Email *

Age *

Please select the answer that best fits the following questions:

1. How often do you have bad feelings about going to school because you are 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 do you stay away from school because it is hard to speak with the other kids at school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

3. How often do you feel you would rather be with your parents than go to school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

4. When you are not in school during the week (Monday to Friday), how often do you leave the house and do something fun?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

5. How often do you stay away from school because you will feel sad or depressed if you go?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

6. How often do you stay away from school because you feel embarrassed in front of other people at school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

7. How often do you think about your parents or family when in school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

8. When you are not in school during the week (Monday to Friday), how often do you talk to or see other people (other than your family)?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

9. How often do you feel worse at school (for example, scared, nervous, or sad) compared to how you feel at home with friends?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

10. How often do you stay away from school because you do not have many friends there?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

11. How much would you rather be with your family than go to school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

12. When you are not in school during the week (Monday to Friday), how much do you enjoy doing different things (for example, being with friends, going places)?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

13. How often do you have bad feelings about school (for example, scared, nervous, or sad) when you think about school on Saturday and Sunday?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

14. How often do you stay away from certain places in school (e.g., hallways, places where certain groups of people are) where you would have to talk to someone?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

15. How much would you rather be taught by your parents at home than by your teacher at school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

16. How often do you refuse to go to school because you want to have fun outside of school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

17. If you had less bad feelings (for example, scared, nervous, sad) about school, would it be easier for you to go to school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

18. If it were easier for you to make new friends, would it be easier for you to go to school?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

19. Would it be easier for you to go to school if your parents went with you?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

20. Would it be easier for you to go to school if you could do more things you like to do after school hours (for example, being with friends)?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

21. How much more do you have bad feelings about school (for example, scared, nervous, or sad) compared to other kids your age?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

22. How often do you stay away from people at school compared to other kids your age?

Sometimes

Half the Time

Usually

Never

Seldom

Almost Always

Always

23. Would you like to be home with your parents more than other kids your age would?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always

24. Would you rather be doing fun things outside of school more than most kids your age?

Never

Seldom

Sometimes

Half the Time

Usually

Almost Always

Always