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Informal Child & Adolescent Self-Esteem Checklist (print to use)

The following checklist does not have a scoring key.  These are all important dimensions of self-esteem that should be discussed with a counselor or psychologist.

 Put an “X” in the appropriate box:

Symptom

None

Just a little

Pretty much

Very much

 

 

 

 

 

Child says he or she is “dumb” or “stupid”

 

 

 

 

Child gives up easily

 

 

 

 

Child is failing or doing poorly in school

 

 

 

 

Child gets picked on or teased frequently by peers

 

 

 

 

Child doesn’t like his or her physical appearance

 

 

 

 

Child cries easily over minor provocation

 

 

 

 

Child “hates” school or certain subjects

 

 

 

 

Child does not respond normally to adult encouragement

 

 

 

 

 

Chronic low self-esteem is toxic to successful development and should be treated.  Any marks of Pretty Much or Very Much may be serious problems and should be evaluated professionally. 

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