Behavioral/emotional dysregulation: I am concerned about my child’s acting out behaviors (for example: not following rules for safety, destroying things, hitting or threatening) or signs of severe emotional distress (for example: self harm, severe anxiety or depression, angry outbursts, refusing to do things they used to do).

MILD -My child does not have prior treatment history and/or their symptoms have limited impact on daily life

MODERATE -My child has symptoms that negatively impact their daily functioning at home and/or school

SEVERE -My child's emotional/behavioral difficulties are highly disruptive at home, in school and/or in the community; my child has a significant psychiatric diagnosis and/or is at risk of out-of-home placement/hospitalization or is being discharged from a hospital or out-of-home placement and we will need a high level of therapeutic support

0-5

9-18

Problem Sexual Behavior - taking advantage of or assaulting others sexually.

Psychosis - e.g. seeing or hearing things that are not real, "bizarre" beliefs or behaviors and/or multiple psychiatric hospitalizations

Neither of the above.

0-5

4-8

9-18