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Worksheets

Adaptive Behavior

Total questions: 11

Worksheet time: 6mins

Name
Class
Date
1.

Receptive age 6-9: Pays attention to to a story for at least 15 minutes

a)

Usually

b)

Sometimes

c)

Never

d)

Taco

2.

Expressive 10+: Tells about experiences in detail (5 W's)

a)

It's Friday Eve!

b)

Sometimes

c)

Never

d)

Usually

3.

Written Ages 0-7: Holds a book correctly for reading and turns the pages from front to back.

a)

Usually

b)

books are cool

c)

Sometimes

d)

Never

4.

Numeric Daily Living (13+): Tells time using a digital clock or watch.

a)

Usually

b)

Sometimes

c)

It's time for dinner

d)

Never

5.

Personal Daily Living (8+): Covers mouth and nose when coughing and sneezing.

a)

Usually

b)

Please do not wipe snot on your sleeve

c)

Never

d)

Sometimes

6.

School Daily Living: Stays on task for at least 15 minutes without needing the teacher's attention.

a)

Never

b)

Gen. Ed. kids do not do this.

c)

Usually

d)

Sometimes

7.

Interpersonal Relationships (12+): Shows reciprocity in conversations (listens and responds, asks for others' views, etc.)

a)

Sometimes

b)

Never

c)

Usually

d)

Most adults struggle with this

8.

Play and Leisure: Takes turns when asked while playing games or sports

a)

Usually

b)

Sometimes

c)

Never

d)

My kids do not share during COVID

9.

Coping skills (0+): Respects others' time (does not keep others waiting or interrupt others who are busy)

a)

Never

b)

Sometimes

c)

My Dr.

d)

Usually

10.

Gross Motor (0-5): Throws a ball of any size in a specific direction

a)

Usually

b)

Sometimes

c)

Never

d)

Not the San Francisco Giants

11.

Fine Motor (6-9): Draws a straight line using a ruler or a straightedge

a)

Usually

b)

Sometimes

c)

Never