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Free Resources The ANSER System

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Revised in 1996, The ANSER System is a series of questionnaires for parents, clinicians, and schools to assess the development, behavior, and health of children from ages 3 through adolescence. The program was developed at and is used in the Division of Ambulatory Pediatrics in the Department of Medicine at Children’s Hospital in Boston, Massachusetts. This is a unique assessment tool that does not yield a specific label or category to apply to a child and does not collect norms. The goal of The ANSER System is to gather information pertinent to the assessment of behavior disorders, school adjustment problems, and learning differences.

The ANSER System is designed to be used in health-care settings, guidance and counseling centers, or schools to evaluate children who are thought to have specific learning disabilities or behavior disorders. The various forms in the system are completed by parents, school personnel, and older students. The system is comprised of 6 forms, broken down by student age as follows:

Form 1 (ages 3–5): 1 questionnaire for parents, 1 questionnaire for schools
Form 2 (ages 6–11): 1 questionnaire for parents, 1 questionnaire for schools
Form 3 (ages 12+): 1 questionnaire for parents, 1 questionnaire for schools
Form 4 (ages 9+): a self-administered student profile for older children who are being evaluated
Form 5 (all ages): follow-up questionnaires for parents and schools to monitor progress
Form 6 (ages 9+): follow-up questionnaire for older children to monitor progress

Forms 1–4 are sold in packages of 1 dozen; Forms 5 and 6 are sold in packages of 2 dozen.

An Interpreter’s Guide, which offers a general introduction to the exam and sample pages from all forms, is also available.

For information about each component of The ANSER System, click on individual titles below.

Pricing

All Items |

			Pricing
#	Item	Grade Range	1-5	6+	Quantity	Sub-total
1771-WX	Interpreter’s Guide 1–5 pricing: 21.40 6+ pricing: 15.00 The Interpreter’s Guide offers a general introduction to The ANSER System as well as specific guidelines for evaluating data that is collected including multiple levels of interpretation. The guide suggests common ways of grouping traits that may elucidate a problem. It also suggests ways to discuss possible problem areas with children and gives precautions on the administration of the exam. Also included are questions for follow-up interviews and a list of suggested readings. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	PK–12	21.40	15.00
1764-WX	Form 1–Parent Questionnaire (Ages 3-5) 1–5 pricing: 41.35 6+ pricing: 28.95 Form 1P is the Parent Questionnaire for development, behavior, and health assessment of the preschool and kindergarten child. Parents are asked to respond to questions about: • Identifying information • Initial background information • Possible pregnancy problems • Newborn infant problems • Health problems or conditions • Early life problems • Early development • Family history • Skills and interests • Attention problems (mental energy control, processing control, production control) • Affect • Somatic control • Aggression level • Social adaptation • Personality • Social interaction • Coping skills Forms are sold in packages of 1 dozen. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	PK–1	41.35	28.95
1765-WX	Form 1–School Questionnaire (Ages 3-5) 1–5 pricing: 34.90 6+ pricing: 24.45 Form 1S is the School Questionnaire for development, behavior, and health assessment of the preschool and kindergarten child. This questionnaire surveys the child’s educational setting and program, special facilities available, and the results of previous testing. The questions cover: • General classroom setting • Gross motor function • Fine motor function • Spatial/spatial motor function • Expressive language • Language and memory • Time and sequence • Academic motivation • Mental energy control • Processing control • Production control • Affect • Social adaptation • Somatic control • Aggression level • Dependency Forms are sold in packages of 1 dozen. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	PK–1	34.90	24.45
1766-WX	Form 2–Parent Questionnaire (Ages 6-11) 1–5 pricing: 41.35 6+ pricing: 28.95 Form 2P is the Parent Questionnaire for development, behavior, and health assessment of the elementary school child. Parents are asked to respond to questions about: • Identifying information • Previous evaluations • Current and previous medications and treatments • Possible pregnancy problems • Newborn infant problems • Health problems or conditions • Early life problems • Early development • Family history • Skills and abilities (academic and nonacademic) • Attention problems (mental energy control, processing control, production control) • Affect • Somatic control • Aggression level • Social adaptation • Personality • Social interaction • Coping skills Forms are sold in packages of 1 dozen. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	PK–6	41.35	28.95
1767-WX	Form 2–School Questionnaire (Ages 6-11) 1–5 pricing: 34.90 6+ pricing: 24.45 Form 2S is the School Questionnaire for development, behavior, and health assessment of the elementary school child. This questionnaire surveys the child’s educational setting and program, special facilities available, and the results of previous testing. The questions cover: • School services • Reading • Writing • Arithmetic • Language • Memory • Visual and motor abilities • Higher thinking • Organization • Other academic skills • Mental energy control • Processing control • Production control • Affect • Social adaptation • Somatic control • Coping skills • Aggression level Forms are sold in packages of 1 dozen. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	PK–1	34.90	24.45
1768-WX	Form 3–Parent Questionnaire (Ages 12+) 1–5 pricing: 41.35 6+ pricing: 28.95 Form 3P is the Parent Questionnaire for development, behavior, and health assessment of the secondary school student. Parents are asked to respond to questions about: • Identifying information • Previous evaluations • Current and previous medications and treatments • Possible pregnancy problems • Newborn infant problems • Health problems or conditions • Early life problems • Early development • Family history • Early educational performance • Skills and abilities (academic and nonacademic) • Specific interests • Affect • Somatic control • Aggression level • Social adaptation • Attention problems (mental energy control, processing control, production control) Forms are sold in packages of 1 dozen. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	6–12	41.35	28.95
1769-WX	Form 3–School Questionnaire (Ages 12+) 1–5 pricing: 34.90 6+ pricing: 24.45 Form 3S is the School Questionnaire for development, behavior, and health assessment of the secondary school student. This questionnaire surveys the child’s educational setting and program, special facilities available, and the results of previous testing. The questions cover: • School services • Reading • Writing • Mathematics • Content areas • Language • Memory • Higher thinking • Organization • Other academic skills • Mental energy control • Processing control • Production control • Affect • Social adaptation • Somatic control • Coping skills • Aggression level Forms are sold in packages of 1 dozen. Skills Addressed Assessment of: • Skills and interests • Attention control • Behavioral strengths • Language function • Spatial motor function • Graphomotor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function	6–12	34.90	24.45
1770-WX	Form 4–Self-Administered Student Profile (Ages 9+) 1–5 pricing: 33.60 6+ pricing: 23.55 The Self-Administered Student Profile asks students aged 9 and up to rate how they think they are doing in the following developmental areas: • Attention • Language function • Spatial-motor function • Graphomotor function • Gross motor function • Memory function • Temporal-sequential ordering • Efficiency • Affect • Outlook • Academic skills • Social function • Outside activities There is also space provided for open-ended response about how students feel about their life and school situation. Forms are sold in packages of 1 dozen.	3–12	33.60	23.55
1763-WX	Form 5–Parent Follow-Up Questionnaire 1–5 pricing: 34.05 6+ pricing: 23.85 The Parent Follow-up Questionnaire provides an update on information obtained from school and parent questionnaires. These are completed just before each follow-up visit. The questionnaire surveys parents’ concerns, recent testing, the child’s medication, academic performance, and physical symptoms. It also inventories the child’s behavior. Forms are sold in packages of 2 dozen.	PK–12	34.05	23.85
1762-WX	Form 5–School Follow-Up Questionnaire 1–5 pricing: 34.05 6+ pricing: 23.85 The School Follow-up Questionnaire provides an update on information obtained from school and parent questionnaires. These are completed just before each follow-up visit. The questionnaire asks specific questions about a child’s academic program, requests results of recent tests, and inventories the child’s degree of change in the following 5 areas: • Performance • Subskills • Attention/activity • Socialization/affect • Other Forms are sold in packages of 2 dozen.	PK–12	34.05	23.85
1754-WX	Form 6–Self-Administered Follow-Up Profile 1–5 pricing: 34.05 6+ pricing: 23.85 The Self-Administered Follow-up Profile asks students aged 9 and up to rate how they feel about their performance in 46 tasks in the following 8 areas: • Reading • Writing and spelling • Math • Other subjects • Work habits • Paying attention • Getting along • Feeling There is also space for open-ended response about how things are going in general for the student. Forms are sold in packages of 2 dozen.	3–12	34.05	23.85