Universal Screening

Rating Scale
0 = Never (0 times)
1 = Rarely (Occurred 1-2 times or to a minimal extent)
2 = Sometimes (Occurred 3-4 times or to a moderate extent)
3 = Often (Occurred 5-6 times or to a significant extent)
4 = Very Often (Occurred 7 or more times or to an extreme extent)

Rating - Teacher Rated:

During the past week, this student....

1. shared what they were thinking. 
2. appeared angry. 
3. had trouble paying attention. 
4. followed directions. 
5. appeared sleepy or tired.
6. was impulsive, acted before thinking. 
7. played well with others. 
8. appeared sad or depressed. 
9. talked back to adults. 
10. had problems staying focused on task. 
11. maintained friendships
12. avoided others.
13. fought with others (yelled/screamed or pushed others). 
14. struggled to sit and listen when asked. 
15. appeared comfortable when relating to others. 
16. was easily embarrassed or felt ashamed.
17. lied or cheated. 
18. had trouble remembering previously learned materials. 
19. was generally friendly with others. 
20. appeared anxious (worried or nervous). 
21. had a temper tantrum. 
22. was easily frustrated.
23. worked out problems with others.
24. lost interest in fun activities. 
25. was aggressive (hit, bit or spat at others). 
26. received positive reports from caregivers or school staff.
27. was emotional or upset. 
28. fidgeted. 
29. was able to complete assigned tasks.
30. learned new things easily.
31. was removed or disciplined due to their behavior. 
32. damaged or broke something on purpose. 
33. appeared interested in learning. 
34. complained of being physically ill. 
35. communicated clearly with others
36. developed early academic skills (knows colors, letters, numbers, etc.)

To view a PDF version of the questions on the teacher rating form for 4K students who are 4 years old, click HERE.

Rating Scale
0 = Never (0 times)
1 = Rarely (Occurred 1-2 times or to a minimal extent)
2 = Sometimes (Occurred 3-4 times or to a moderate extent)
3 = Often (Occurred 5-6 times or to a significant extent)
4 = Very Often (Occurred 7 or more times or to an extreme extent)

Rating - Teacher Rated:

During the past week, this student....

1. shared what they were thinking. 
2. appeared angry. 
3. had trouble paying attention. 
4. followed directions. 
5. appeared sleepy or tired.
6. was impulsive. 
7. spoke clearly with others.
8. appeared depressed. 
9. engaged in risk-taking behavior. 
10. had problems staying focused on task. 
11. maintained friendships.
12. acted sad or withdrawn.
13. fought with others (yelled/physically, or both). 
14. acted without thinking.
15. appeared comfortable when relating to others. 
16. was easily embarrassed or felt ashamed.
17. lied or cheated. 
18. had trouble remembering.
19. was generally friendly with others. 
20. appeared anxious (worried or nervous). 
21. lost his/her temper when upset. 
22. had trouble with organizing and planning.
23. worked out problems with others.
24. expressed thoughts of hurting himself/herself
25. was aggressive (threatened or bullied others).
26. received failing grades at school.
27. felt emotional or upset. 
28. fidgeted. 
29. was suspected of using alcohol and/or drugs
30. worked up to his/her academic potential.
31. was sent to an authority for discipline.
32. was suspected of smoking or chewing tobacco.
33. went prepared to class.
34. was absent from school.

To view the PDF questions on the teacher rating form for 4K students who are 5 years old and students in grades K-5, click HERE.

Rating Scale
0 = Never (0 times)
1 = Rarely (Occurred 1-2 times or to a minimal extent)
2 = Sometimes (Occurred 3-4 times or to a moderate extent)
3 = Often (Occurred 5-6 times or to a significant extent)
4 = Very Often (Occurred 7 or more times or to an extreme extent)

Rating - Student Rated:

During the past week, I....

1. shared my thoughts with others.
2. felt angry.
3. had trouble paying attention.
4. followed directions.
5. felt sleepy or tired.
6. was impulsive.
7. communicated clearly with others.
8. was depressed.
9. did something risky. 
10. had problems staying on task.
11. maintained friendships.
12. was sad or withdrawn.
13. fought with others (verbally, physically, or both).
14. acted without thinking.
15. felt relaxed interacting with others.
16. was easily embarrassed or felt ashamed.
17. lied or cheated.
18. had trouble remembering things.
19. was friendly with others.
20. was anxious (worried or nervous).
21. lost my temper when I was upset.
22. had trouble with organizing and planning.
23. worked out problems with others.
24. had thoughts of hurting myself.
25. threatened or bullied others.
26. received failing grades at school.
27. felt emotional or upset.
28. fidgeted.
29. used alcohol and/or drugs.
30. tried my hardest when it came to schoolwork.
31. was sent to an authority for discipline.
32. smoked or chewed tobacco.
33. went prepared to class.
34. was absent from school

To view the PDF questions on the student rating form for students in grades 6-12, click HERE.

The mental well-being screening will be administered twice during each school year. The screening was designed to be completed by the student's classroom teacher for students in 4K-5th grade, and by students themselves in 6th-12th grade. Currently, not all grade levels are being screened, and we are working to expand the screening process to more over time. This universal screening is part of our ongoing process to monitor and support our students' mental well-being.

Prior to each screening, teachers and students who will be completing the screening will receive information about the BIMAS-2 to understand its contents and process. Students in grades 6-12 will receive instructions from their homeroom/Flex teachers on how to complete the screening. The BIMAS-2 is estimated to take 5-10 minutes to complete.

On the day of the screening, if it is reported that a student has had thoughts of harming themselves, a staff member will contact the student individually and confidentially to ensure their safety. Students' parents/guardians would then be notified via phone call by a student services staff member who will connect with you to discuss possible next steps and resources for you to consider. 

If a student in grades 6-12 is absent on the day of the screening, they will have an opportunity to complete the screening on a designated makeup day, given that both student and their parent/guardian consent. 

Students' results are stored in the BIMAS-2 system, where administration, student services, and SROs can access the data. Teachers of grades 4K-5 can see their class' results if they complete the screening for them. Teachers of grades 6-12 cannot see individual responses but may see a summary of their students' results. If parents would like to receive information regarding their student's screening results, they can request results by sending an email to kasdstudentservices@kaukaunasd.org.

All students are automatically included in the screening unless they are opted out by a parent/guardian or opt out themselves (for students in grades 6-12). Although we aim to address the needs of as many students as possible through this screening, participation is completely voluntary.

You will receive information via email and text when a screening is to occur. If you prefer not to have your student(s) participate, please fill out the Opt-Out form linked on the electronic letter you receive by the deadline stated on the letter. Once you opt your student(s) out, they will remain opted out unless you choose to opt them back in. To re-enroll your student(s) in the screening, please email kasdstudentservices@kaukaunasd.org with the name(s) of your student(s).

To re-enroll your student(s) in the screening, please email kasdstudentservices@kaukaunasd.org with the name(s) of your student(s).

Reach out to a member of the student services team from your student's school at Student Services, or email the District Office at kasdstudentservices@kaukaunasd.org.