| Primary School Version | YES | NO | DON’T KNOW |
| Do you think that you parents usually like to hear about your ideas? | |||
| Do you often feel lonely at school? | |||
| Do other children often break friends or or fall out with you? | |||
| Do you like team games? | |||
| Do you think that other children often Say nasty things about you? | |||
| When you have to say things in front of teachers, do you usually feel shy? | |||
| Do you like writing stories or doing creative writing? | |||
| Do you often feel sad because you have nobody to play with at school? | |||
| Are you good at mathematics? | |||
| Are there lots of things about yourself you would like to change? | |||
| When you have to say things in front of other children, do you usually feel foolish? | |||
| Do you find it difficult to do things like woodwork or other crafts? | |||
| When you want to tell a teacher something, do you usually feel foolish? | |||
| Do you often have to find new friends because your old friends are playing with someone else? | |||
| Do you usually feel foolish when you talk to your parents? | |||
| Do other people often think that you tell lies? |

| Secondary School Version | YES | NO | DON’T KNOW |
| Do you think that your parents usually like to hear about your ideas? | |||
| Do you often feel lonely at school? | |||
| Do other children often get fed up with you and stop being friends with you? | |||
| Do you like outdoor games? | |||
| Do you think that other students often dislike you? | |||
| When you have to say things in front of teachers, do you usually feel shy? | |||
| Do you like writing stories or doing creative writing? | |||
| Do you often feel sad because you have nobody to play with at school? | |||
| Are you good at mathematics? | |||
| Are there lots of things about yourself you would like to change? | |||
| When you have to say things in front of other students, do you usually feel foolish? | |||
| Do you find it difficult to do things like woodwork or other crafts? | |||
| When you want to tell a teacher something, do you usually feel foolish? | |||
| Do you often have to find new friends because your old friends are playing with someone else? | |||
| Do you usually feel foolish when you talk to your parents? | |||
| Do other people often think that you tell lies? |
The higher the score, the higher the child’s self-esteem:
No answers score 2 pts (except for questions 4, 7, 9 & 12, which do not count).
Don’t know answers score 1 pt.
Average/Mean score for “primary version” is 19 pts.
Average/Mean score for “secondary version” is 18 pts.
The standard deviation (S.D.) on both scales is 4 pts. This means that if a child scores less than 4pts (1 S.D.) above or below the mean, they have neither significantly above or below average self-esteem. The greater the number of standard deviations in the score the greater the overall problem (in the case of negative self-esteem).

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