Burk's Behavior Rating Scale

One of the forms used to obtain teacher input, usually used prior to treatments, and also for following calculations after treatment has been started.

Burk's Behavior Rating Scale

Name _____________________   Age _____     Grade _____
Completed by _______________   Teacher ______________
School __________________________   Date ___________

Please rate each and every statement by putting an X in the appropriate square after the statement.  The sections are lettered from A to E and represent the degress to which you have noticed the described behavior. The bases for making a judgement are given below:

A
B
C
D
E		 You have not noticed this behavior at all.
You have noticed the behavior to a slight degree.
You have noticed the behavior to a large degree.
You have noticed the behavior to a large degree.
You have noticed the behavior to a very large degree.

VEGETATIVE-AUTONOMIC

A

B

C

D

E
 
  1.Hyperactive and restless
  2.Erratic, flighty, or scattered behavior
  3.Easily distracted, lacks continuity of effort and persevrance
  4.Behavior goes in cycles
  5.Quality of work may vary from day to day
  6.Daydreaming, alternating with hyperactivity
  7.Explosive and unpredictable behavior
  8.Cannot seem to control self (will speak out or jump out of seat)
  9.Poor coordination in large muscle activities (games, etc.)

PERCEPTUAL-DISCRIMINATIVE

10.Confusion in spelling and writing
11.Inclined to become confused in number processes; gives illogical responses
12.Reading is poor
13.Lacks a variety of responses; repeats himself in many situations
14.Upset by changes in routine
15.Confused in following directions
16.Confused and apprehensive about rightness of response; indecisive
17.Classroom comments are often "off the track" or peculiar
18.Difficulty reasoning things out logically with others

SOCIAL-EMOTIONAL

19.Demands much attention
20.Tends to be destructive especially of the work of others
21.Many evidences of stubborn uncooperative behavior
22.Often withdraws quickly from group activities, prefers to work by self
23.Constant difficulty with other children and/or adults (apparently purposeless)
24.Shallow feeling for others
25.Cries often and easily
26.Often more confused by punishment
27.Seems generally unhappy
28.Often tells bizarre stories
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This page last updated 09/26/02