School Refusal Assessment Scale - Revised (P) Survey

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 9. How often does your child feel worse at school (for example, scared, nervous, sad) compared to how he/she feels at home with friends?

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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 place)?

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

You're doing well, only 13 more questions to go!

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 17. If you child has 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 19. Would it be easier for your child to go to school if you or your spouse went with him/her?

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 20. 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Only 5 more questions to go!

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 23. Would your child like to be home with you or your spouse more than other kids his/her age?

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 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

Never

Seldom

Sometimes

Half the Time

Usually

Almost always

Always

Question Title

* 25. Name (confidential)

Your Name *

Your Surname

Child's name

Child's surname

Child's age

Your Personal Email Address *

Your Mobile or Home Number

Question Title

* 26. I would like the School Refusal Clinic to call me back to discuss an appointment

don't forget to submit your results.

School Refusal Assessment Scale - Revised, Developed by Christopher Kearney and Wendy Silverman.

Kearney, C. A.; Silverman, W. K. (1993), "Measuring the function of school refusal behavior: The School Refusal Assessment Scale", Journal of Clinical Child Psychology, 22 (1): 85–86
Kearney, C. A. (2002), "Identifying the function of school refusal behavior: A revision of the School Refusal Assessment Scale", Journal of Psychopathology and Behavioral Assessment, 24 (4): 235–245
Kearney, C.A. (2006), "Confirmatory factor analysis of the School Refusal Assessment Scale-Revised: Child and parent versions", Journal of Psychopathology and Behavioral Assessment, 28 (3): 139–144