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Observe your child when he/she comes home after being out alone or with friends. |
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1. |
Does your child have a runny nose? |
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2. |
Does your child have watery eyes? |
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3. |
Is he/she drowsy or loses consciousness? |
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4. |
Does the child have poor muscle control or appears drunk? |
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5. |
Is your child's speech slurred? |
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6. |
Does your child complain of nausea or loss of appetite? |
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7. |
Does your child have trouble paying attention, is irritable, or depressed? |
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8. |
Are there spots or sores around the child's mouth? |
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9. |
Have you noticed an unusual substance odor (gas, glue, paint thinner, etc.) on your child's breath and/or clothes? |
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10. |
Have you seen paint or other stains on your child's face, hands, or clothes? |
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11. |
Have you found bags or rags with dry plastic cement or other solvent at home, at their work, in their car, or in his/her school locker? |
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12. |
Have you found whipped cream cans, spray paint cans, or other items with a similar discharger, hidden or in the garbage (used by nitrous oxide abusers)? |
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13. |
Have you found small bottles labeled "incense" (used by butyl nitrite abusers)? |
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| Total 'Yes' |
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(out of 13 possible) |
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| Interpretation |
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