Child Survey: Ages 6-12 Years - OhioGuidestone Research Portal

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Questionnaire for Children 6-12 Years Old

Please read each statement carefully and answer for your child that is participating in the Joyful Play study. If you have more than one child participating, please complete one for each child. There are no right or wrong answers!

Select the answer that best fits: Never, Rarely, Occasionally, Frequently or Very Frequently

During the past 4 weeks, how often did your child:

Accept responsibility for what he/she did? *

Do something nice for somebody? *

Speak about positive things? *

Pay attention? *

Contribute to group efforts? *

Perform the steps of a task in order? *

Show care when doing a project or school work? *

Follow the advice of a trusted adult? *

Follow the example of a positive role model? *

Keep trying when unsuccessful? *

Take an active role in learning? *

Attract positive attention from peers? *

Respect another person's opinion? *

Attract positive attention from adults? *

Work hard on projects? *

Offer to help somebody? *

Show good judgement? *

Take steps to achieve goals? *

Try to do her/his best? *

Focus on a task despite problem or distraction? *

Prepare for school activities or upcoming events? *

Do routine tasks or chores without being reminded? *

Learn from experience? *

Express high expectations of herself/himself? *

Look forward to classes or activities at school? *

Show appreciation of others? *

Encourage positive behavior in others? *

Teach another person to do something? *

Show an awareness of her/his personal strengths? *

Make a suggestion request in a polite way? *

Use available resources (people or objects) to solve a problem? *

Seek out additional knowledge or information? *

How was this form completed? *

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