NAME: _________________________________ AGE:_________

GRADE AND SECTION:_____________________ SEX:_________

ATTENDANCE 4 3 2 1

1.1 I lose sleep due to overthinking.

1.2 I feel tired going to school because of exhaustion.

1.3 I skip classes because I want to be alone.

1.4 I am often absent in school because I don’t like to interact with people.

1.5 I slack in class due to lack of sleep.

ACADEMIC PERFORMANCE

2.1 I feel like contemplating on the corners rather than doing my projects.

2.2 I spend more on my alone time rather than participating in a group activity/presentation.

2.3 I am not in the mood to do my studies for my oral examination.

2.4 I prefer to just sit than doing my assigned group presentation.

2.5 My grades in performance tasks are low due to inadequate time doing it because I spend all of
my time to be alone.

CLASS INTERACTION

3.1 I am not in the mood to listen to my classes.

3.2 I don’t like to talk with my classmates or my friends.

3.3 I don’t like to interact with my classmates or friends.

3.4 I get cold to everyone whenever they try to talk to me and ask me something about myself.

3.5 I don’t like to socialize inside and outside the classroom.

4 - STRONGLY AGREE

3- AGREE

2- DISAGREE

1- STRONGLY DISAGREE

______________________________________________________________________________________________________

NAME: _________________________________ AGE:_________

GRADE AND SECTION:_____________________ SEX:_________

ATTENDANCE 4 3 2 1

1.1 I lose sleep due to overthinking.

1.2 I feel tired going to school because of exhaustion.

1.3 I skip classes because I want to be alone.

1.4 I am often absent in school because I don’t like to interact with people.

1.5 I slack in class due to lack of sleep.

ACADEMIC PERFORMANCE

2.1 I feel like contemplating on the corners rather than doing my projects.

2.2 I spend more on my alone time rather than participating in a group activity/presentation.

2.3 I am not in the mood to do my studies for my oral examination.

2.4 I prefer to just sit than doing my assigned group presentation.

2.5 My grades in performance tasks are low due to inadequate time doing it because I spend all of
my time to be alone.

CLASS INTERACTION

3.1 I am not in the mood to listen to my classes.

3.2 I don’t like to talk with my classmates or my friends.

3.3 I don’t like to interact with my classmates or friends.

3.4 I get cold to everyone whenever they try to talk to me and ask me something about myself.

3.5 I don’t like to socialize inside and outside the classroom.

4 - STRONGLY AGREE

3- AGREE

2- DISAGREE

1- STRONGLY DISAGREE