6 Q-abc

Attach. 13 Quick Assessment of Behavior in Children OMB #: 0925-0661

Executive Function Expiration Date: 06/30/2015

Name of test: Quick Assessment of Behavior in Children (Q-ABC)

Estimated time burden: 3 minutes

Estimated number of items: 16 items

Description:

This is a quick, 16-item measure of a child’s behavior in the last 24 hours, to be filled out by the parent. The measure is presented below.

Q-ABC: Parent Daily Check-in

For the following common behaviors in children, please rate how true each behavior was for your child over the past 24 hours.

Over the past 24 hours…	Not at all True	A little True	Somewhat True	Very True	Extremely True
1. Played well with other children
2. Forgot what he or she was told to do
3. Listened well
4. Defiant – Disrespectful
5. Well-organized
6. Acted without thinking – Impulsive
7. Waited turn – Took turns
8. Stopped to think before acting
9. Easily distracted
10. Minded well – Obeyed commands
11. Couldn’t sit still – Fidgety
12. Paid attention to directions
13. Hit other people
14. Finished things he or she started
15. Threw temper tantrums
16. Cheerful

Public reporting burden for this collection of information is estimated to average 3 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-0661). Do not return the completed form to this address. 1