Page 99 - Meeting with Children Manual

P a g e | 5 Child and Youth Meeting

File Number ________________________

CHILD AND YOUTH

TEMPERAMENT SCALE

INSTRUCTIONS:

Circle the number that generally describes this child most of the time.
Note: No child responds exactly the same way to every circumstance.

1) ACTIVITY / ENERGY:
Physical motion during sleep, eating, play, dressing, bathing –
What amount of energy would you say your child has? Does he/she jump, run, use whole body to feel good?

1 2 3 4 5
Low energy, quiet, Always moving even
sleeps in one place, when sitting, high
likes time alone, energy, very active
plays quietly

2) RYTHMICITY / REGULARITY:
How regular is this child re: physiologic functions such as eating times, sleeping times, amount of sleep
required, elimination etc.

1 2 3 4 5
Needs routine, Very irregular, can’t
highly predictable predict the eating,
schedule / eats, falling asleep,
sleeps on a schedule elimination schedule

3) APPROACH / WITHDRAWAL OR FIRST REACTION:
What is the child’s initial reaction to new people, activities, ideas, going somewhere new, etc.?

1 2 3 4 5
Immediately Withdraws at first,
approaches, jumps watches before
right in learns by joining in, learns by
doing, no trouble watching, distressed
with new requests by new activities or
open to new things, says no
activities, people initially
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