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Data

1 question

Q1Single Select*Required

How long have you known this student

0-1 month2-4 months5 months or more

Max: 2 pts

Context and Moderator

7 questions

Q1Rating Scale*Required

The child has had disrupted or insufficient sleep in the last two weeks

0: No1: Yes

Max: 1 pts

Q2Rating Scale*Required

The child has shown signs of discomfort, illness, or medication change in the last 2 weeks

0: False1: True

Max: 1 pts

Q3Rating Scale*Required

Behavior increases during changes in schedule, activity, or environment.

0: False1: True

Max: 1 pts

Q4Rating Scale*Required

Tasks often appear too hard or too easy for the child’s ability level.

0: False1: True

Max: 1 pts

Q5Rating Scale*Required

The child struggles to express wants, needs, or refusals effectively

0: False1: True

Max: 1 pts

Q6Rating Scale*Required

The child reacts strongly to unexpected events or unclear routines

0: False1: True

Max: 1 pts

Q7Rating Scale*Required

Expectations and responses from adults vary across settings

0: False1: True

Max: 1 pts

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Showing 12 of 63 questionnaires

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