My Feelings Check-In

Name: ________________________
Date: ________________________

1. How do you usually feel?

• Really happy! 😄 (3 points)
  
  
• Just okay. 😐 (2 points)
  
  
• A little bit sad or worried. 😞 (1 point)
  
  

2. When you are with your friends, how do you usually feel?

• Super happy and included! 😄 (3 points)
  
  
• Happy, but sometimes a little shy. 😐 (2 points)
  
  
• Mostly shy or not included. 😞 (1 point)
  
  

3. How do you usually feel about coming to school?

• So excited and happy! 😄 (3 points)
  
  
• It's okay, maybe a little sleepy. 😐 (2 points)
  
  
• A little worried. 😞 (1 point)
  
  

4. When you have a problem, how do you usually feel?

• Like I can make it better! 😄 (3 points)
  
  
• A little frustrated, but I try. 😐 (2 points)
  
  
• Mostly like I need help. 😞 (1 point)
  
  

5. When you feel sad or mad, how easy is it for you to feel better?

• Pretty easy! I know what to do. 😄 (3 points)
  
  
• Sometimes I need a little help. 😐 (2 points)
  
  
• It's hard to feel better. 😞 (1 point)
  
  

6. How do you feel about learning new things at school?

• Excited and ready to learn! 😄 (3 points)
  
  
• Happy to try, but sometimes confused. 😐 (2 points)
  
  
• A little bit confused or not ready. 😞 (1 point)
  
  

7. How do you feel about doing your schoolwork?

• Ready to try and it's fun! 😄 (3 points)
  
  
• Ready to try, but it can be a little bit difficult. 😐 (2 points)
  
  
• Mostly difficult and I need help. 😞 (1 point)
  
  

8. How do you feel about playing with friends at school?

• So excited and ready to share! 😄 (3 points)
  
  
• Happy to play, but sometimes a little shy. 😐 (2 points)
  
  
• Mostly shy or prefer to play alone. 😞 (1 point)
  
  

9. How often do you feel proud of yourself?

• Very often! 😄 (3 points)
  
  
• Sometimes. 😐 (2 points)
  
  
• Not very often. 😞 (1 point)
  
  

10. If you need help with your feelings, how easy is it to ask a grown-up?

• Super easy! I know who to ask. 😄 (3 points)
  
  
• Sometimes I can ask, but it's hard. 😐 (2 points)
  
  
• It's very hard for me to ask for help. 😞 (1 point)
  
  

11. When you have a challenge, what coping skill helps you feel better or solve the problem?

Teacher Total Score:

Circle the total score for your student. (Maximum: 30 points)

24-30 points: Minimal Support Needed.

16-23 points: Moderate Support Needed.

10-15 points: Significant Support Needed.

Teacher Notes:

Teacher Script: My Feelings Check-In

Introduction and Warm-Up (5 minutes)

"Hi [Student's Name]! Thanks for coming to chat with me today. How are you doing?"
(Pause for response.)

"Today, we're going to do something special. We're going to talk about our feelings! Do you know what feelings are? They are like special messages inside our bodies that tell us how we are doing. Sometimes we feel happy, sometimes a little sad, or maybe excited! All feelings are okay to have."

"I have some pictures here [Refer to Slide Deck or visual aids]. This face looks happy! What makes you feel happy?"
(Allow for discussion.)

"This face looks a little sad. What makes someone feel sad sometimes?"
(Allow for discussion.)

"Today, you get to show me how you are feeling inside. It's a special paper for you to tell me about your feelings!"

Introducing the Self-Assessment Tool (5 minutes)

"Look at this paper [Present the My Feelings Check-In Worksheet]. This is your 'My Feelings Check-In' paper! We're going to look at some questions and you'll circle the face that best shows how you feel. See the little numbers next to the faces? Those points help us understand your feelings even better. Remember, there are no right or wrong answers. It's just about what's true for you."

"See these different faces? [Point to the emojis and points on the worksheet]. We'll go through them together. If you usually feel really happy, you can circle the happy face with a smile!"

Completing the Self-Assessment (10 minutes)

"Okay, let's start with number one. It says, 'How do you usually feel?' Look at the faces. Do you feel really happy (😄), just okay (😐), or a little bit sad or worried (😞)? Circle the one that feels most like you."
(Pause for student to circle.)

"Great! Now let's look at number two: 'When you are with your friends, how do you usually feel?' Do you feel super happy and included (😄), happy, but sometimes a little shy (😐), or mostly shy or not included (😞)? Circle the best one for you."
(Pause for student to circle.)

"Moving on to number three: 'How do you usually feel about coming to school?' Are you so excited and happy (😄), just okay or a little sleepy (😐), or a little worried (😞)? What fits best?"
(Pause for student to circle.)

"Almost done! Number four says, 'When you have a problem, how do you usually feel?' Do you feel like I can make it better (😄), a little frustrated, but I try (😐), or mostly like I need help (😞)?"
(Pause for student to circle.)

"Next, number five: 'When you feel sad or mad, how easy is it for you to feel better?' Is it pretty easy! I know what to do (😄), sometimes I need a little help (😐), or it's hard to feel better (😞)?"
(Pause for student to circle.)

"Now for number six: 'How do you feel about learning new things at school?' Do you feel excited and ready to learn (😄), happy to try, but sometimes confused (😐), or a little bit confused or not ready (😞)? Circle the one that is most like how you feel."
(Pause for student to circle.)

"Let's go to number seven: 'How do you feel about doing your schoolwork?' Do you feel ready to try and it's fun (😄), ready to try, but it can be a little bit difficult (😐), or mostly difficult and I need help (😞)?"
(Pause for student to circle.)

"Fantastic! Number eight: 'How do you feel about playing with friends at school?' Are you so excited and ready to share (😄), happy to play, but sometimes a little shy (😐), or mostly shy or prefer to play alone (😞)?"
(Pause for student to circle.)

"Number nine: 'How often do you feel proud of yourself?' Do you feel proud very often (😄), sometimes (😐), or not very often (😞)?"
(Pause for student to circle.)

"Number ten: 'If you need help with your feelings, how easy is it to ask a grown-up?' Is it super easy! I know who to ask (😄), sometimes I can ask, but it's hard (😐), or it's very hard for me to ask for help (😞)?"
(Pause for student to circle.)

"And finally, number eleven: 'When you have a challenge, what coping skill helps you feel better or solve the problem?' You can tell me in your own words or draw a picture!"
(Pause for student to respond/draw.)

Discussion and Reflection (8 minutes)

"Wow, thank you for sharing all your feelings with me, [Student's Name]! That was very brave."

"I noticed you chose [mention a specific feeling and point value, e.g., 'the happy face (😄) which is 3 points'] for how you usually feel. Can you tell me a little more about why you picked that one? What makes you feel that way?"
(Engage in a gentle, curious conversation. Refer to the My Feelings Check-In Scoring Guide & Teacher Summary for prompts for all questions, noting patterns in their responses.)

"And for question eleven, you [mention their response/drawing, e.g., 'told me that taking deep breaths is a coping skill that helps you feel better']. That's a wonderful coping skill to help yourself! Can you tell me more about that coping skill? What else helps you when you have a challenge?"
(Continue asking open-ended questions about their responses, focusing on understanding rather than judgment. Be sure to touch on their responses to several questions, especially those with 1-point (😞) and 2-point (😐) responses, keeping the My Feelings Check-In Scoring Guide & Teacher Summary in mind.)

"Remember, all your feelings are important, and it's good to talk about them. If you ever feel [mention a specific challenging feeling they indicated, e.g., 'a little worried (😞) about school'], you can always come talk to me or another grown-up you trust."

Wrap-Up & Summary (2 minutes)

"Thank you again for doing this feelings check-in with me. You did a wonderful job showing me how you feel. It helps me know how to best help and support you."

"You are [mention one positive thing, e.g., 'so good at thinking about your feelings']! We'll do this again sometime soon to see how your feelings change."
Teacher Note: After the student leaves, go back to the My Feelings Check-In Worksheet to total the points the student circled for each question. Then, use the scoring guide in the My Feelings Check-In Scoring Guide & Teacher Summary to understand the total score and complete the summary section.

My Feelings Check-In: Scoring Guide & Teacher Summary

This document is designed to help you calculate and interpret the student's score on the first 10 questions of the My Feelings Check-In Worksheet and guide your follow-up discussion. The goal is to gain a deeper understanding of the student's social and emotional functioning and identify areas for support.

Scoring Instructions:

1. For each of the first 10 questions on the My Feelings Check-In Worksheet, the student circled one of three options.
2. Each option has a point value (3, 2, or 1) indicated next to it.
3. Sum the points from these 10 circled answers to get a Total Score.
4. The minimum possible score is 10 (1 point for each question), and the maximum possible score is 30 (3 points for each question).
5. Question 11 is an open-ended question for qualitative insight and does not contribute to the numerical score.

Interpreting the Total Score (for Questions 1-10):

• Total Score 24-30 points: Minimal Support Needed.
  This indicates the student is generally demonstrating strong social-emotional functioning, positive coping strategies, and a sense of well-being. They likely feel connected, capable, and are able to manage their emotions effectively.
  Continue to provide positive reinforcement and opportunities for growth.
  
  

• Total Score 16-23 points: Moderate Support Needed.
  This suggests the student might be experiencing some social-emotional challenges or could benefit from developing stronger coping skills. They may feel shy, occasionally worried, or sometimes struggle with problem-solving. This range often indicates areas of concern that warrant further attention.
  Consider targeted observation, check-ins, or introducing simple social-emotional learning strategies.
  
  

• Total Score 10-15 points: Significant Support Needed.
  This score indicates significant areas of concern in the student’s social-emotional functioning. They may be experiencing frequent negative emotions (like feeling sad or mad often), difficulty with school or friends, or a lack of coping strategies. Deeper exploration and intervention are likely needed to address these concerns.
  Implement intensive individualized support, consult with school support staff (e.g., counselor, psychologist), and communicate with parents/guardians (following school protocol).
  
  

General Guidance for Discussion (informed by score):

• Emphasize Validation: Always start by validating the student's feelings. "It sounds like you felt [feeling] when [situation]. That makes sense."
• Open-Ended Questions: Encourage elaboration with questions like "Can you tell me more about that?" or "What made you choose that face?" Pay particular attention to questions where the student selected a 1-point response (😞), as these often highlight areas of concern.
• Observe Non-Verbal Cues: Pay attention to body language, tone of voice, and eye contact during the discussion.
• Normalize Feelings: Remind the student that all feelings are okay and that everyone experiences a range of emotions, like happy, sad, mad, or excited.
• Focus on Solutions/Support: If a student indicates a challenging feeling (like being worried or mad), gently pivot to what helps them feel better or who they can ask for help.

Question-Specific Discussion Prompts:

(Use these prompts to deepen your understanding, especially for answers that scored 1 or 2 points.)

1. How do you usually feel?

• Prompt for 1-point response (😞): "You circled that you usually feel a little bit sad or worried. Can you tell me more about what makes you feel sad or worried? Is there anything on your mind often?"
• Prompt for 2-point response (😐): "You circled you usually feel just okay. What would help you feel even happier or more excited most of the time?"

2. When you are with your friends, how do you usually feel?

• Prompt for 1-point response (😞): "It looks like you feel mostly shy or not included with friends. Can you tell me about a time that happened? What makes it feel hard? Are you worried about playing with friends?"
• Prompt for 2-point response (😐): "You feel happy, but sometimes a little shy. What helps you feel a little braver when you're with friends?"

3. How do you usually feel about coming to school?

• Prompt for 1-point response (😞): "You circled you usually feel a little worried about school. Can you tell me what makes you feel worried? Is there something specific on your mind or a concern about coming to school?"
• Prompt for 2-point response (😐): "You circled that coming to school is usually okay, maybe a little sleepy. Are you getting enough rest at night? What would make you feel more excited about school?"

4. When you have a problem, how do you usually feel?

• Prompt for 1-point response (😞): "You circled that you mostly feel like I need help when you have a problem. Who do you usually ask for help, and what kind of help do you need? Do you ever feel sad or mad when you have a problem?"
• Prompt for 2-point response (😐): "You feel a little frustrated, but you try. What makes it feel frustrating? What do you usually do when you feel frustrated or a little mad?"

5. When you feel sad or mad, how easy is it for you to feel better?

• Prompt for 1-point response (😞): "You said it's hard to feel better when you're sad or mad. What do you wish could help you? Maybe we can think of some ideas together. What are your biggest concerns when you feel this way?"
• Prompt for 2-point response (😐): "Sometimes you need a little help to feel better when you're sad or mad. Who do you usually go to for help?"

6. How do you feel about learning new things at school?

• Prompt for 1-point response (😞): "You feel a little bit confused or not ready to learn new things. What makes it confusing or hard for you? Are you worried about learning something new?"
• Prompt for 2-point response (😐): "You're happy to try, but sometimes confused. What helps you when you feel confused about something new? Who do you ask for help?"

7. How do you feel about doing your schoolwork?

• Prompt for 1-point response (😞): "You said your schoolwork is mostly difficult and you need help. What part feels most difficult? How can I help you? Does it make you feel sad or mad when schoolwork is hard?"
• Prompt for 2-point response (😐): "You're ready to try, but your schoolwork can be a little bit difficult. What kind of schoolwork feels a little bit difficult?"

8. How do you feel about playing with friends at school?

• Prompt for 1-point response (😞): "You feel mostly shy or prefer to play alone when it's time to play with friends. What makes you feel shy? Do you wish you could play with friends more? Are you worried about playing with others?"
• Prompt for 2-point response (😐): "You're happy to play, but sometimes a little shy. What helps you feel ready to play with your friends?"

9. How often do you feel proud of yourself?

• Prompt for 1-point response (😞): "You said you don't feel proud very often. Can you remember anything lately that you did well, or that made you feel happy about yourself? What are your concerns about feeling proud?"
• Prompt for 2-point response (😐): "You sometimes feel proud. What kind of things make you feel proud?"

10. If you need help with your feelings, how easy is it to ask a grown-up?

• Prompt for 1-point response (😞): "You said it's very hard for me to ask for help with my feelings. What makes it hard? Is there anything I can do to make it easier for you to talk to me when you feel sad or worried?"
• Prompt for 2-point response (😐): "Sometimes you can ask for help with your feelings, but it's hard. Who do you usually try to ask? What makes it hard to ask?"

11. When you have a challenge, what coping skill helps you feel better or solve the problem?

• Open-ended prompt: "You [mentioned/drew] that [their coping skill] helps you when you have a challenge. Can you tell me more about that? What other coping skills might help you feel calm and ready to learn? Who do you ask for help when a challenge feels very big?"

Teacher Summary for [Student's Name]:

(To be completed by teacher after the discussion)

Total Score (for Questions 1-10): ____________ / 30 points

Overall Interpretation (based on score range for Questions 1-10):

Key Observations & Areas for Support (based on 1-point (😞) and 2-point (😐) responses from Q1-10, and insights from Q11, noting any concerns):

• (Note specific questions where student scored low, any insights from discussion about coping skills, particularly areas of worry, sadness, or anger)
  
  
  
  
  
  

Strengths & Positive Indicators (based on 3-point (😄) responses from Q1-10, and positive coping skills from Q11, noting happy, excited, or proud feelings):

• (Note specific questions where student scored high, any positive behaviors/feelings observed, and effective coping skills identified)
  
  
  

Recommended Follow-Up Actions:

• (Outline specific next steps, e.g., )"