merrell ssbs2 sample.pdf

SSBS-2

RATING FORM

School Social Behavior Scales SECOND EDITION

To Be Completed by Teacher or Other School Personnel for Students in Grades K–12

Identifying Information

Name of student: ____________________________________________________________________________________
School: _____________________________________________________________________________________________
Grade: __________________ Age: years: _______ months: _______ Sex: Male ❑ Female ❑

Name of person completing form: _____________________________________________________________________
Date form completed: ________________________________________________________________________________
Relationship of rater to student: ______________________________________________________________________
List the settings in which you observe or interact with this student: ________________________________________________________________

Directions

After you have completed the Identifying Information section, please rate this student’s behavior using all of the items on pages 2 and 3 of this rating form. Ratings should be based on your observations of this student’s behavior during the past three months. The rating points after each item are based on the following format: Never If the student does not exhibit a particular behavior, or if you have not had an opportunity to SAMPLE observe a particular behavior, circle 1, which indicates Never. Frequently If the student often exhibits a particular behavior, circle 5, which indicates Frequently. Sometimes Circle the numbers 2, 3, or 4, (which indicate Sometimes) if the student exhibits the behavior somewhere in between the two extreme rating points, based on your judgment of how frequently it occurs. The rating points after each item appear in the following format:

NEVER SOMETIMES FREQUENTLY

1 2 3 4 5 Please complete all items, and do not circle between numbers. If you have any additional comments about this student, write them in the space provided at the top of page 4.

Scale A Never Sometimes Frequently Scoring Key
1. Cooperates with other students 1 2 3 4 5
2. Makes appropriate transitions between different activities 1 2 3 4 5
3. Completes schoolwork without being reminded 1 2 3 4 5
4. Offers help to other students when needed 1 2 3 4 5
5. Participates effectively in group discussions and activities 1 2 3 4 5
6. Understands problems and needs of other students 1 2 3 4 5
7. Remains calm when problems arise 1 2 3 4 5
8. Listens to and carries out directions from teachers 1 2 3 4 5
9. Invites other students to participate in activities 1 2 3 4 5
10. Asks appropriately for clarification of instructions 1 2 3 4 5
11. Has skills or abilities that are admired by peers 1 2 3 4 5
12. Is accepting of other students 1 2 3 4 5
13. Completes school assignments or other tasks independently 1 2 3 4 5
14. Completes school assignments on time 1 2 3 4 5
15. Will give in or compromise with peers when appropriate 1 2 3 4 5
16. Follows school and classroom rules 1 2 3 4 5
17. Behaves appropriately at school 1 2 3 4 5
18. Asks for help in an appropriate manner 1 2 3 4 5
19. Interacts with a wide variety of peers 1 2 3 4 5
20. Produces work of acceptable quality for his/her ability level 1 2 3 4 5
21. Is good at initiating or joining conversations with peers 1 2 3 4 5
22. Is sensitive to feelings of other students 1 2 3 4 5
23. Responds appropriately when corrected by teachers 1 2 3 4 5
24. Controls temper when angry 1 2 3 4 5
25. Enters appropriately into ongoing activities with peers 1 2 3 4 5
26. Has good leadership skills 1 2 3 4 5
27. Adjusts to different behavioral expectations across settings 1 2 3 4 5
28. Notices and compliments accomplishments of others 1 2 3 4 5
29. Is assertive in an appropriate way when he or she needs to be 1 2 3 4 5
30. Is invited by peers to join in activities 1 2 3 4 5
31. Shows self-control 1 2 3 4 5
32. Is “looked up to” or respected by peers 1 2 3 4 5
Totals
Scale B Never Sometimes Frequently Scoring Key
1. Blames others for his or her problems 1 2 3 4 5
2. Takes things that are not his or hers 1 2 3 4 5
3. Is defiant to teachers or other school personnel 1 2 3 4 5
4. Cheats on schoolwork or in games 1 2 3 4 5
5. Gets into fights 1 2 3 4 5
6. Is dishonest; tells lies 1 2 3 4 5
7. Teases and makes fun of other students 1 2 3 4 5
8. Is disrespectful or "sassy" 1 2 3 4 5
9. Is easily provoked; has a "short fuse" 1 2 3 4 5
10. Ignores teachers or other school personnel 1 2 3 4 5
11. Acts as if he or she is better than others 1 2 3 4 5
12. Destroys or damages school property 1 2 3 4 5
13. Will not share with other students 1 2 3 4 5
14. Has temper outbursts or tantrums 1 2 3 4 5
15. Disregards feelings or needs of other students 1 2 3 4 5
16. Is overly demanding of attention from teachers 1 2 3 4 5
17. Threatens other students; is verbally aggressive 1 2 3 4 5
18. Swears or uses offensive language 1 2 3 4 5
19. Is physically aggressive 1 2 3 4 5
20. Insults peers 1 2 3 4 5
21. Whines and complains 1 2 3 4 5
22. Argues or quarrels with peers 1 2 3 4 5
23. Is difficult to control 1 2 3 4 5
24. Bothers and annoys other students 1 2 3 4 5
25. Gets into trouble at school 1 2 3 4 5
26. Disrupts ongoing activities 1 2 3 4 5
27. Boasts and brags 1 2 3 4 5
28. Is not dependable 1 2 3 4 5
29. Is cruel to other students 1 2 3 4 5
30. Acts impulsively without thinking 1 2 3 4 5
31. Is easily irritated 1 2 3 4 5
32. Demands help from other students 1 2 3 4 5
Totals

SSBS-2 Additional Information

Please use the following space to provide any additional information about this student that you believe would be useful for understanding his or her social behavior:

SSBS-2 Score Summary (for scorer use only—refer to Appendix A or B in User’s Guide)

Raw Percentile Social

SSBS-2 Scales Score T-Score Rank Functioning Level

Scale A: Social Competence Peer Relations (PR) Self-Management/Compliance (SM) Academic Behavior (AB) Social Competence Total Scale B: Antisocial Behavior Hostile/Irritable (HI)

SAMPLE

Antisocial/Aggressive (AA) Defiant/Disruptive (DD) Antisocial Behavior Total Higher Social Competence scores indicate greater levels of social adjustment. Higher Antisocial Behavior scores indicate greater levels of social behavior problems.

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