| 1 | I felt calm and able to manage my emotions this week. | 1–5 Likert | Emotional Regulation | Low scores may indicate heightened stress, anxiety, or emotional dysregulation. |
| 2 | I felt connected to friends, classmates, or teachers. | 1–5 Likert | Social Connectedness | Low scores suggest risk of isolation, loneliness, or peer conflict. |
| 3 | I was able to focus and get my schoolwork done. | 1–5 Likert | Academic Engagement | Low scores may signal disengagement, cognitive overload, or emotional distraction. |
| 4 | I felt supported by at least one adult at school. | 1–5 Likert | Adult Support / Protective Factors | Low scores indicate lack of trusted adult relationships, a key protective factor. |
| 5 | I had enough energy to get through the school day. | 1–5 Likert | Physical Well-being / Fatigue | Low scores may reflect sleep issues, burnout, or underlying health concerns. |
| 6 | I felt stressed or worried this week. | 1–5 Likert | Stress Load | High scores indicate elevated stress; persistent highs may require intervention. |
| 7 | I had trouble sleeping or relaxing. | 1–5 Likert | Sleep & Recovery | High scores suggest chronic fatigue, anxiety, or environmental stressors. |
| 8 | I felt left out or isolated. | 1–5 Likert | Social Isolation | High scores flag potential bullying, exclusion, or withdrawal from peers. |
| 9 | Open reflection: Anything you’d like your counselor or teachers to know? | Free text | Contextual Insight | Qualitative data to explain anomalies in scores; can reveal unreported issues. |
| 10 | Would you like someone from school to check in with you soon? | Yes/No/Not sure | Help-Seeking Behavior | “Yes” indicates readiness for support; “Not sure” may warrant gentle outreach. |
Early Signal Project 