Parent Stress Survey - OhioGuidestone Research Portal

Electronic Agreement *

By checking this box, I agree to use electronic records and electronic signatures.

Access Code *

Date *

Person Completing Form *

Mom
Dad
Other

If other, please explain *

Form Number *

If other, please explain *

Questionnaire for Parents/Caregivers

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: Strongly Agree, Agree, Not Sure, Disagree, Strongly Disagree

Questions About You

I often have the feeling that I cannot handle things very well *

I find myself giving up more of my life to meet my children's needs than I ever expected *

I feel trapped by my responsibilities as a parent *

I am unhappy with the last purchase of clothing I made for myself *

There are quite a few things that bother me about my life *

Having a child caused more problems than I expected in my relationship with my spouse/parenting partner *

I feel alone and without friends *

When I go to a party, I usually expect to not enjoy myself *

I am not as interested in people as I used to be *

I do not enjoy things as I used to *

I feel that I am... *

How many children are participating in this study? *

Child 1

Child 1's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 2

Child 2's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 3

Child 3's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 4

Child 4's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 5

Child 5's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 6

Child 6's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 7

Child 7's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

Child 8

Child 8's Date of Birth *

Since having this child, I have been unable to do new different things *

Since having this child, I feel that I am almost never able to do things that I like to do *

My child rarely does things for me that make me feel good *

When I do things for my child, I get the feeling that my efforts are not appreciated very much *

My child smiles at me much less than I expected *

Sometimes I feel my child doesn't like me and doesn't want to be close to me *

My child is very emotional and gets upset easily *

My child doesn't seem to learn as quickly as most children *

My child doesn't seem to smile as much as most children *

My child is not able to do as much as I expected *

I expected to have closer and warmer feelings for my child than I do, and this bothers me *

It takes a long time and is very hard for my child to get used to new things *

Sometimes my child does things that bother me just to be mean *

My child seems to cry or fuss more often than most children *

My child generally wakes up in a bad mood *

I feel that my child is very moody and easily upset (copy) (copy) (copy) (copy) (copy) (copy) (copy) *

Compared to the average child, my child has a great deal of difficulty in getting used to changes in schedules or changes around the house (copy) (copy) (copy) (copy) (copy) (copy) (copy) *

My child reacts very strongly when something happens that my child doesn't like *

When playing, my child doesn't often giggle or laugh *

My child's sleeping or eating schedule was much harder to establish than I expected *

I have found that getting my child to do something or stop doing something is *

Think carefully and count the number of things which your child does that bothers you. For example, dawdles, refuses to listen, overactive, cries, interrupts, fights, whines, etc. *

There are some things my child does that really bother me a lot *

My child's behavior is more of a problem than I expected *

My child makes more demands on me than most children *

How was this form completed? *

In-Person
By Phone
Online
Mail-In