Caregiver Experience Survey: Challenging or Disruptive Behaviors in Children

This survey has 21 questions including some multiple-choice, yes-or-no, and fill in-the-blank. The purpose of this survey is to collect information from parents/caregivers of children who exhibit challenging or disruptive behaviors. The data collected will be used to better understand these behaviors and the impact they have on the occupations of the child and family members. Burnout is a reality that many people face in their daily lives. The mental health of parents/caregivers can often be overlooked. Your responses will be used to collect valuable information that will assist in the creation and collection of resources for parents/caregivers with children who exhibit these types of behaviors. 

Question Title

* 1. Are you a parent/caretaker for a child who exhibits challenging or disruptive behaviors ?

Question Title

* 2. Age of child

Question Title

* 3. Gender of child

Question Title

* 4. Does the child have a formal diagnosis?

Question Title

* 5. Diagnosis (if relevant):

Question Title

* 6. Current therapies:

Question Title

* 7. Previous therapies:

Question Title

* 8. What is the level of routine within the household?

Question Title

* 9. What is the level of structure within the household?

Question Title

* 10. Are behaviors disruptive to child and/or family members lives?

Question Title

* 11. Frequency of challenging or disruptive behaviors?

Question Title

* 12. Please check all challenging or disruptive behaviors exhibited:

Question Title

* 13. Please list any strategies that you have found effective to help the child return to a regulated state or helpful in decreasing the length or frequency of the behaviors. (Examples: deep breathing, sensory activities, talking)

Question Title

* 14. What strategy have you tried that you feel was ineffective to help the child return to a regulated state or helpful in decreasing the length or frequency of the behaviors.

Question Title

* 15. Please list any resources you have found helpful that you would recommend to other caregivers of children who exhibit similar behaviors. (Examples: books, websites, groups, social media pages, etc.)

Question Title

* 16. What type of resources/information would you find personally helpful regarding the child’s behaviors? (Examples: List of sensory activities for the home, pamphlets/handouts with coping strategies, classes available for parents, specific diagnosis resources, research articles discussing behavior management strategies, etc.)

Question Title

* 17. How would you rate your level of mental load/burnout? (This survey is anonymous and information will be used to build resources for caregivers experiencing similar situations.)

Question Title

* 18. How frequently do you take time to address your own mental health/well being?

Question Title

* 19. Have you experienced feelings of being isolated or alone as a result of challenging or disruptive behaviors?

Question Title

* 20. Are you in communication with other caregivers/families who share similar experiences in regards to children exhibiting challenging or disruptive behaviors?

Question Title

* 21. Would you join a Facebook Group/Page for parents/caregivers with children who exhibit challenging or disruptive behaviors. The purpose of the page would be for members to share resources, experiences, strategies and stories. The page would be a closed group that Facebook users can request to join and be admitted by a page administrator.

T