THE ADULT CHECKLIST FOR PSYCHOLOCIGAL INJURY

The accident has resulted in disfigurement
The person expresses statements such as, "want my life back" or, "I'm not the same person"
Family members relate that the injured person is not the same person anymore
The injured person is experiencing panic attacks
The injured person has withdrawn from others and acts hopeless
The injured person believes she will never be normal again
The injury has resulted in a life-time disability
The injured person considers himself handicapped after the accident
The injury has resulted in loss of a limb
The injury has resulted in traumatic brain injury
The injured person thought she was going to die during the accident
The injured person is forced to earn a living in a field different from the career he had prior to the accident
The injured person's parenting has been impaired

Permission to copy grantedby Kenneth N. Condrell, Ph.D

Kenneth N. Condrell, PhD

Psychologist, (716) 634-7220

THE CHILD CHECKLIST FOR PSYCHOLOGICAL INJURY

Since the accident, the child has become a behavior problem in school
The child is defiant or belligerent at home since the accident
Since the accident the child is withdrawn and stays close to home
Since the accident the child's grades have dropped
Since the accident the teacher reports the child is not the same
The child is having difficulty sleeping, cries more easily, and is moody, since the accident
Since the accident the child shows excessive fears
Since the accident the child says he hates himself
Since the accident the child says she wishes he were dead
The child fears what other children will say when they see his injury
The child has lost a limb or been disfigured as a result of the accident
Since the accident the child has had to give up some cherished activity that she no longer can do

Permission to copy granted by Kenneth N. Condrell Ph.D

Kenneth N.Condrell, PhD

Psychologist, (716) 634-7200