Behaviour Questionnaire

Rationale: This is a behavioural tool to inform the risk assessment and management process of group setting, this helps us prepare for assessment and the course.

Your Information

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Please score your answers using the following criteria:

  • None = 1
  • Slight = 2
  • Moderate = 3
  • High = 4
  • Very High = 5

Physical Aggression

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Angry Language

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Attempts To Run Away

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Damage To Property

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Self Injurious Behaviour

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Cooperation

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Takes Other Peoples Belongings

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Socially Inappropriate Behaviours

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Stereotypy

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Epilepsy (if applicable)

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Fears/Obsessions

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Groups

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In submitting this form I agree to my details being used for the purposes of Autism Support UK/Reach North West Data Collection. The information will only be accessed by necessary staff. I understand my data will be held securely and will not be distributed under any circumstances to third parties.

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We thank you in advance for filling the form and sending back in a timely manner to assist us in understanding and meeting your child’s needs.

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