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Parent to Parent Pre-Evaluation

Parent to Parent Pre-Evaluation

Question Title

* 1. Please complete the following:

First Name

Last Name

Email Address

How did you hear about this P2P class?

Question Title

* 2. Rate impairment based on behavior, learning, and social skills compared to children of similar age who do not have ADHD. Please rate the degree of impairment of your child(ren) with ADHD.

	No Impairment	Minimal Impairment	Some Impairment	Severe Impairment
Child 1	Child 1 No Impairment	Child 1 Minimal Impairment	Child 1 Some Impairment	Child 1 Severe Impairment
Child 2	Child 2 No Impairment	Child 2 Minimal Impairment	Child 2 Some Impairment	Child 2 Severe Impairment
Child 3	Child 3 No Impairment	Child 3 Minimal Impairment	Child 3 Some Impairment	Child 3 Severe Impairment
Child 4	Child 4 No Impairment	Child 4 Minimal Impairment	Child 4 Some Impairment	Child 4 Severe Impairment

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* 3. How confident are you in your ability to:

	Not at all Confident	Somewhat Confident	Confident	Very Confident	I don't know
Understand the characteristics of ADHD?	Understand the characteristics of ADHD? Not at all Confident	Understand the characteristics of ADHD? Somewhat Confident	Understand the characteristics of ADHD? Confident	Understand the characteristics of ADHD? Very Confident	Understand the characteristics of ADHD? I don't know
Understand evidence-based treatments for ADHD.	Understand evidence-based treatments for ADHD. Not at all Confident	Understand evidence-based treatments for ADHD. Somewhat Confident	Understand evidence-based treatments for ADHD. Confident	Understand evidence-based treatments for ADHD. Very Confident	Understand evidence-based treatments for ADHD. I don't know
Understand current knowledge about medications for ADHD.	Understand current knowledge about medications for ADHD. Not at all Confident	Understand current knowledge about medications for ADHD. Somewhat Confident	Understand current knowledge about medications for ADHD. Confident	Understand current knowledge about medications for ADHD. Very Confident	Understand current knowledge about medications for ADHD. I don't know
Understand current knowledge about behavioral strategies for ADHD.	Understand current knowledge about behavioral strategies for ADHD. Not at all Confident	Understand current knowledge about behavioral strategies for ADHD. Somewhat Confident	Understand current knowledge about behavioral strategies for ADHD. Confident	Understand current knowledge about behavioral strategies for ADHD. Very Confident	Understand current knowledge about behavioral strategies for ADHD. I don't know
Cope with having a child with ADHD.	Cope with having a child with ADHD. Not at all Confident	Cope with having a child with ADHD. Somewhat Confident	Cope with having a child with ADHD. Confident	Cope with having a child with ADHD. Very Confident	Cope with having a child with ADHD. I don't know
Organize your child's schoolwork.	Organize your child's schoolwork. Not at all Confident	Organize your child's schoolwork. Somewhat Confident	Organize your child's schoolwork. Confident	Organize your child's schoolwork. Very Confident	Organize your child's schoolwork. I don't know
Obtain educational services foryour child.	Obtain educational services foryour child. Not at all Confident	Obtain educational services foryour child. Somewhat Confident	Obtain educational services foryour child. Confident	Obtain educational services foryour child. Very Confident	Obtain educational services foryour child. I don't know
Set up a system to communicate with your child's school	Set up a system to communicate with your child's school Not at all Confident	Set up a system to communicate with your child's school Somewhat Confident	Set up a system to communicate with your child's school Confident	Set up a system to communicate with your child's school Very Confident	Set up a system to communicate with your child's school I don't know
Set up a system to communicate with your child's teacher specifically.	Set up a system to communicate with your child's teacher specifically. Not at all Confident	Set up a system to communicate with your child's teacher specifically. Somewhat Confident	Set up a system to communicate with your child's teacher specifically. Confident	Set up a system to communicate with your child's teacher specifically. Very Confident	Set up a system to communicate with your child's teacher specifically. I don't know
Respond to others who ask you questions about ADHD.	Respond to others who ask you questions about ADHD. Not at all Confident	Respond to others who ask you questions about ADHD. Somewhat Confident	Respond to others who ask you questions about ADHD. Confident	Respond to others who ask you questions about ADHD. Very Confident	Respond to others who ask you questions about ADHD. I don't know
Advocate for your child in a variety of settings.	Advocate for your child in a variety of settings. Not at all Confident	Advocate for your child in a variety of settings. Somewhat Confident	Advocate for your child in a variety of settings. Confident	Advocate for your child in a variety of settings. Very Confident	Advocate for your child in a variety of settings. I don't know

Question Title

* 4. How confident are you in using the following strategies with your child:

	Not at all Confident	Somewhat Confident	Confident	Very Confident	I don't know
Effective praise	Effective praise Not at all Confident	Effective praise Somewhat Confident	Effective praise Confident	Effective praise Very Confident	Effective praise I don't know
Effective commands	Effective commands Not at all Confident	Effective commands Somewhat Confident	Effective commands Confident	Effective commands Very Confident	Effective commands I don't know
Time out	Time out Not at all Confident	Time out Somewhat Confident	Time out Confident	Time out Very Confident	Time out I don't know
A token reward/consequences system	A token reward/consequences system Not at all Confident	A token reward/consequences system Somewhat Confident	A token reward/consequences system Confident	A token reward/consequences system Very Confident	A token reward/consequences system I don't know
Home/school daily report card	Home/school daily report card Not at all Confident	Home/school daily report card Somewhat Confident	Home/school daily report card Confident	Home/school daily report card Very Confident	Home/school daily report card I don't know