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Child’s Score No Need

child’s score no need average need social functioning range of scores range of scores range of scores se
29 Nov, 2022
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Child’s Score
No Need
Average
Need
Social Functioning
Range of Scores
Range of Scores
Range of Scores
SelfAwareness
6 12
13 23
24 30
Empathy
3 6
7 11
12 18
Managing Emotions
7 14
15 27
28 35
NonVerbal Relationship Skills
7 14
15 27
28 35
Social Interactions
7 14
15 27
28 35
Interpersonal
9 18
19 35
36 45
Play Skills
3 6
7 11
12 18
Total Social Functioning
42 84
91 161
168 216
Behavioral Functioning
Safety
6 12
13 23
24 30
Behaviors
5 10
11 19
20 25
Verbal Aggression
5 1 0
11 19
20 25
Physical Aggression
5 10
11 19
20 25
Total Behavioral Functioning
21 42
46 – 80
84 105
FLS – Activities of Daily Living
Communication
4 8
9 15
16 20
Physical Ability
4 8
9 15
16 20
Feeding Skills
3 6
7 11
12 15
Personal Hygiene
8 16
17 31
32 40
Dressing
7 14
15 27
28 35
Time Awareness
6 12
13 23
24 30
Total FLS – Daily Living
32 64
70 122
128 160
FLS – Independent Living for Youth 14 and over
Medications Skills
3 3
4 5
6 6
Home Living Skills
9 18
19 35
36 45
Food Preparation Skills
9 18
19 35
36 45
Community Skills
9 18
19 35
36 5
Money Skills
9 18
19 35
36 5
Total FLS – Youth 14 & over
39 75
80 145
150106
Assessment Total
134 265
287508
>530
Child/Youth:

Date: //
DOB: // Age: MaineCare:

Agency:

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