In DSM-III the highest level of social adaptation attained is diagnosed on a special diagnostic axis. Thus, separate statements about general impairment in children and adolescents with psychological disturbances can be made independently of specific diagnoses and severity ratings. The present study reports theoretical considerations and the results of the construction of an operationalized scale that measures social adaptation in the areas of family, school and peer group using information about leisure time activities independent of an individual's psychiatric symptoms. In general, the correlations between the social adaptation level and psychiatric disturbances were rather low, the closest association being in the school domain (grade-point average). The reasons for this are discussed.