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How to use or fill out the brief problem checklist
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Click ‘Get Form’ to open the brief problem checklist in our editor.
Begin by entering your child’s name and the primary caregiver’s name in the designated fields at the top of the form.
Fill in your preferred phone number and select three preferred call times. This ensures effective communication for follow-up calls.
In the 'Phone Log' section, record dates and notes from previous calls to maintain a clear history of interactions.
Rate each of the top three problems listed by assigning a score from 0 to 10, indicating how much of a problem each still is.
For each item describing general behaviors, indicate how true you think it is for your child over the past week by selecting 'very true,' 'somewhat true,' or 'not true.'
Finally, if there are additional comments or concerns, note them on the back of the form as instructed.
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Problem behavior is often repetitive and may serve a specific function, such as attention-seeking or escape from a task. Examples of problem behavior include aggression, self-injury, and disruptive behavior.
What is a problem checklist?
a type of self-report scale listing various personal, social, educational, or occupational problems. The participant indicates the items that apply to their situation.
What is the revised behavior problem checklist?
The Revised Behavior Problem Checklist (Quay, 1983) is an 89 item questionnaire used to assess parents report of child problem behaviors under six constructs: conduct disorder, socialized aggression, attention problems/immaturity, anxiety/withdrawal, psychotic behavior, and motor excess using a 3 point Likert scale (0
What is a problem behaviour checklist?
The Behavior Problem Checklist (BPC) is a self-report measure that structures caregivers reports of specific behavior problems, activities of daily living (ADLs) and instrumental activities of daily living (IADLs) in care recipients and inquires about the caregivers understanding of the cause of those problems.
What is a behavioral checklist?
Behavior Checklists commonly use a Likert scale to rate responses. Behavior checklists are often initially introduced to monitor behaviors by caregivers and therapists. After, they are used as a self-management system as an individual becomes ready to independently self-monitor their own behaviors.
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child and caregiver interviews to measure clinical progress
by BF Chorpita 2010 Cited by 178 Method: We first developed child and caregiver forms of a 12-item Brief Problem Checklist (BPC) interview by applying item response theory and factor analysis
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