婴儿-初中生社会生活能力量表

1、SM量表简单记录表儿童姓名： 性别： 被询问者： 检查日期： 出生日期： 实足年龄： 序号结果序号结果序号结果序号结果（领域）01（领域）01（领域）01（领域）01I34.(S)67.(SH)100.(SD)1.(C)35.(0)68.(SH)101.(C)2.(0)36.(SH)69.(S)102.(S)3.(C)37.(C)70.(SD)103.(0)4.(S)38.(SH)71.(SD)104.(S)5.(SH)39.(C)72.(C)105.(SD)6.(S)40.(SH)73.(0)106.(L)7.(0)41.(SH)74.(C)107.(C)8.(L)m75.(SD)108.(

2、0)9.(S)42.(SD)76.(L)109.(SD)10.(L)43.(S)77.(0)110.(L)11.(C)44.(SD)78.(S)111.(0)12.(SH)45.(L)79.(S)112.(S)13.(S)46.(SH)80.(L)113.(L)14.(SH)47.(SH)Vvn15.(C)48.(S)81.(SD)114.(SH)16.(0)49.(SH)82.(SH)115.(SD)17.(L)50.(SH)83.(SH)116.(0)18.(SH)51.(0)84.(C)117.(SH)19.(L)52.(SH)85.(SD)118.(SD)n53.(SH)86.(SH)

3、119.(0)20.(SH)54.(S)87.(SD)120.(SH)21.(SH)55.(L)88.(0)121.(0)22.(SD)56.(0)89.(S)122.(L)23.(S)57.(C)90.(L)123.(C)24.(S)58.(C)91.(C)124.(C)25.(C)59.(SH)92.(S)125.(S)26.(SD)60.(SH)93.(0)126.(L)27.(SD)61.(C)94.(C)127.(SD)28.(C)62.(0)95.(C)128.(C)29.(L)63.(S)96.(S)129.(S)30.(SH)WVI130.(L)31.(SH)64.(SH)97

4、.(SH)131.(L)32.(L)65.(0)98.(SD)132.(0)33.(0)66.(C)99.(SH)总计：SHL 分，OC 分，S 分，SD粗分：分；标准分：分；最终评定：#11粗分与标准分换其费if * 11林喀r，r W.fllJj E' 'W- JJ JPt-pf-fi- 孰 22.5-3-标准分品h居、III-12-H分5 d<q<30<701965-169-2210-42刑72 634 小航2dli1-157l7-；aW3-V743-54 53-6675-«6SJ-9!N(3<K】±rR1JU-2BK 券制。3

5、K=5I 势力丁 67-KON7=犷 92-1024<437fr-17 2H2V24T 2 K7y 41-31兔W，6K- H(J Ht-91 9M-HI9 0?- ： I.1叩4-10 lft-25 IftE 30-48 UT3 4IF5(Q6MJ5 8k-lM * 124 11k122 14126H I*14 A&s 3*-47 枷-料 5jyJ 667bn 75-ss96-()9 MP-li9 >124>133>12fi1215LS W-W 4B-57 2 0田笛中I12 的700ll(FL23 120*131>18. >5?>&7>735S，J- + . - j3>100>J23>|J| 一1同标准分及评定结果6分（重度）7分（中度）8分（轻度）9分（边缘）10分（正常）11分（高常）12分（优秀）表3智力水平的分级IQ范围等纲频率姆Stanford-Binrf Fgn【lMWisc-RM13 口非常超常4.42.312U-129理常8.27.4110-119高再弭】16590-110正常45.549.480-8S假常14.5J 6.270-79边缘5.6fl.Ow方7智力低下2,6-> 1M<