1
.
A person in the household often or very often acted in a way that made the child/teen afraid that they would be hurt (e.g., sworn at, insulted, put down, humiliated)
Yes
No
2
.
A person in the household often or very often hit, pushed, grabbed, or slapped the child/teen so hard that they had marks or were injured
Yes
No
3
.
A person touched the child/teen’s private parts or asked them to touch their private parts
Yes
No
4
.
Child/teen often or very often felt that people they lived with did not love them, look out for each other, feel close to each other, or were a source of strength and support
Yes
No
5
.
Child/teen often or very often did not have enough to eat or clean clothes to wear, and did not have someone to take care of and protect them
Yes
No
6
.
Child/teen’s parents or guardians were separated or divorced
Yes
No
7
.
Child/teen witnessed a person in the household being pushed, grabbed, hit, or physically threatened
Yes
No
8
.
Someone the child/teen lived with had a problem with drinking or used street drugs
Yes
No
9
.
Someone the child/teen lived with was depressed, mentally ill, or attempted suicide
Yes
No
10
.
Someone the child/teen lived with served time in prison
Yes
No
Score