Child Complaint Questionnaire, BFB-K Test - the question form
Questions: 86 · 16 minutes
1. Vision problems
Yes
No
2. Other eye conditions
Yes
No
3. Hearing loss
Yes
No
4. Ear problems
Yes
No
5. Frequent runny nose and mouth breathing
Yes
No
6. Hay fever (seasonal allergic rhinitis)
Yes
No
7. Frequent nosebleeds
Yes
No
8. Swollen lymph nodes in the neck
Yes
No
9. Sore throat, throat redness, pain when swallowing
Yes
No
10. Frequent toothaches
Yes
No
11. Teeth grinding
Yes
No
12. Shortness of breath with exertion
Yes
No
13. Prone to bronchitis
Yes
No
14. Bronchial asthma
Yes
No
15. Heart palpitations or heart pain
Yes
No
16. Dizziness, weakness
Yes
No
17. Numbness in the arms or legs
Yes
No
18. Prone to redness
Yes
No
19. Fever
Yes
No
20. Decreased appetite
Yes
No
21. Nausea, vomiting
Yes
No
22. Digestive problems
Yes
No
23. Increased appetite or ravenous hunger
Yes
No
24. Overeating sweets
Yes
No
25. Increased thirst
Yes
No
26. Thumb sucking
Yes
No
27. Nail biting and picking at hangnails
Yes
No
28. Weight gain or weight loss
Yes
No
29. Stomach pain or a feeling of heaviness in the stomach
Yes
No
30. Stomach pain, sharp pain in the side
Yes
No
31. Pain in the right lower abdomen
Yes
No
32. Jaundice
Yes
No
33. Constipation
Yes
No
34. Loose or frequent stools
Yes
No
35. Fecal incontinence
Yes
No
36. Constipation
Yes
No
37. Worm infestation
Yes
No
38. Difficulty urinating; urination in drops
Yes
No
39. Nighttime or daytime urinary incontinence
Yes
No
40. Pain when urinating
Yes
No
41. Sexual problems
Yes
No
42. Blinking, tics, shoulder shrugging
Yes
No
43. Hand tremor, writer's cramp
Yes
No
44. Unsteady gait or stumbling
Yes
No
45. Pain in the arms or legs
Yes
No
46. Jerking movements of the head and upper body
Yes
No
47. Seizures
Yes
No
48. Postural problems
Yes
No
49. Left-handedness
Yes
No
50. Hair pulling
Yes
No
51. Increased skin sensitivity
Yes
No
52. Rashes, eczema, or skin that is easily irritated
Yes
No
53. Itching
Yes
No
54. Boils, pimples
Yes
No
55. Easily fatigued or tires quickly
Yes
No
56. Headache
Yes
No
57. Sleep problems
Yes
No
58. Crying out during sleep
Yes
No
59. Prone to frequent illnesses
Yes
No
60. Irritability, quick temper
Yes
No
61. Stuttering or other speech disorders
Yes
No
62. Speech blocks, fear of speaking, mutism
Yes
No
63. Sleepwalking
Yes
No
64. Restlessness, fidgetiness, lack of self-control
Yes
No
65. Feelings of worthlessness; lack of self-confidence
Yes
No
66. Difficulty interacting with other children or adults
Yes
No
67. Depressed mood, tearfulness
Yes
No
68. Suicidal thoughts or tendencies
Yes
No
69. Easily frightened
Yes
No
70. Fear of the dark
Yes
No
71. Fear of water, animals, etc.
Yes
No
72. Fear of school or being called on to answer in front of the class
Yes
No
73. Refuses to go to school
Yes
No
74. Forgetfulness, difficulty concentrating
Yes
No
75. Tendency to engage in unproductive daydreaming
Yes
No
76. Impaired play
Yes
No
77. Rumination
Yes
No
78. Pedantic behavior
Yes
No
79. Fanatical preoccupation with cleanliness
Yes
No
80. Eccentric behavior; preference for being alone
Yes
No
81. Stubbornness, disobedience
Yes
No
82. Clowning around or making faces
Yes
No
83. Difficulty following rules
Yes
No
84. Dishonesty, lying
Yes
No
85. Stealing, lying
Yes
No
86. Truancy from school
Yes
No