Admissions Assessment

Please contact
Oxbow Academy at
(435) 436-9460
or email us

Gregg Lott, LCSW
Admissions Director

Educational Consultants
please call Steve
at 801-380-8820

Oxbow Academy provides this behaviorial assessment service to you free of charge. The instrument measures a wide range of troublesome behaviors, situations, and moods which commonly apply to troubled teenagers including intrapersonal distress, psycho somatic, interpersonal relations, critical items, social problems and behavioral dysfunction. This is the same standardized instrument the University of Idaho used in their research regarding the outcome success of adolescent treatment programs. Through this assessment, we can help you determine what level of intervention may or may not be necessary according to national standards. Please complete the assessment according to the instructions and submit them to us. We are happy to give you the assessment results via e-mail, however, we have found that telephone interaction and discussion are far more insightful and helpful. If you prefer telephone interaction please make sure you leave a phone number and the best time to call you. It usually takes 1-2 business days to process the assessment. A representative will contact you at that time. Please make sure you mark every question so we can accurately process the assessment.

You may discover that some of the items do not apply to your child’s current situation. If so, please do not leave these items blank. Rather, select the “Never or almost never” category. When you begin to complete this evaluation, you will see that you can easily make your child look as healthy or unhealthy as you wish. Please do not do that. If you are as accurate as possible, it is more likely that you will be able to receive the help that you are seeking for your child.

We have learned through sad experience that some parents are trying to use this assesment tool in divorce and custody cases. The purpose of this assesment tool is informational in nature and is not to be used or represented as a diagnostic instrument.

DIRECTIONS:
  • The assessment is only to be completed for children that are 13-18 years old.
  • Fill out the evaluation test for ONE child only.
  • Read each statement carefully.
  • Select the number that most accurately describes your child.
Child Information




Parent/Guardian Information


 


(optional)



Assessment - Part I
  1. Wants to be alone more than other children of the same age.
  2. Complains of dizziness or headaches.
  3. Doesn't participate in activities that were previously enjoyable.
  4. Argues or is verbally disrespectful.
  5. Is more fearful than other children of the same age.
  6. Cuts school or is truant.
  7. Cooperates with rules and expectations.
  8. Has difficulty completing assignments or completes them carelessly.
  9. Complains or whines that things are unfair.
10. Experiences trouble with her/his bowels, such as constipation or diarrhea.
11. Gets into physical fights with peers or family members.
12. Worries and/or can't get certain ideas out of his/her mind.
13. Steals or lies.
14. Is fidgety, restless, or hyperactive.
15. Seems anxious or nervous.
16. Communicates in a pleasant and appropriate manner.
17. Seems tense, is easily startled.
18. Soils or wets self.
19. Is aggressive toward adults.
20. Sees, hears, or believes things that are not real.
21. Has participated in self-harm (e.g. cutting or scratching self, attempted suicide)
22. Uses alcohol or drugs.
23. Seems unable to get organized.
24. Enjoys relationships with family and friends.
25. Appears sad or unhappy.
26. Experiences pain or weakness in muscles or joints.
27. Has a negative or distrustful attitude toward friends, family members, or adults.
28. Believes that others are trying to hurt him/her even when they are not.
29. Threatens to or has run away from home.
30. Experiences rapidly changing and strong emotions.
31. Deliberately breaks rules, laws, or expectations.
32. Appears happy with her/himself.
33. Sulks, pouts, or cries more than other children of the same age.
34. Pulls away from family or friends.
35. Complains of stomach pains or feeling sick more than other children of same age.
36. Doesn't have or keep friends.
37. Has friends of whom I don't approve.
38. Believes that others can hear his/her thoughts or that s/he can hear the thoughts of others.
39. Engages in inappropriate sexual behavior (e.g. sexually active, exhibits self, sexual abuse toward family members or others).
40. Has difficulty waiting his/her turn in activities or conversations.
41. Thinks about suicide, says s/he would be better if s/he were dead.
42. Complains of nightmares, difficulty getting to sleep, oversleeping, or waking up from sleep too early.
43. Complains about or challenges rules, expectations, or responsibilities.
44. Has times of unusual happiness or excessive energy.
45. Handles frustration or boredom appropriately.
46. Has fears of going crazy.
47. Feels appropriate guilt for wrongdoing.
48. Is unusually demanding.
49. Is irritable.
50. Vomits or is nauseous more than other children of the same age.
51. Becomes angry enough to be threatening to others.
52. Seems to stir up trouble when bored.
53. Is appropriately hopeful and optimistic.
54. Experiences twitching muscles or jerking movements in face, arms, or body.
55. Has deliberately destroyed property.
56. Has difficulty concentrating, thinking clearly, or attending to tasks.