Part C Indicator - Parent Survey

The survey is for parents whose child or children are under 3. It is for parents of children who are getting early intervention services thru CDS. This survey is important to you and your child in Maine because your answers will help to improve services for children and families.

2. Over the past year; early intervention has helped me and/or my family:

  Never Rarely Often Always
participate in typical activities for children and families in my community

3. Over the past year; early intervention has helped me and/or my family:

  Never Rarely Often Always
know about services in the community

4. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
improve my family's quality of life

5. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
know where to go for support to meet my child's needs

6. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
know where to go for support to meet my family's needs

7. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
get the services my child and family need

8. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
feel more confident in my skills as a parent

9. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
keep up friendships for my child and family

10. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
make changes in our routines that benefit my child with special needs

11. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
be more effective in managing my child's behavior

12. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Ofrten Always
do activities that are good for my child even in times of stress

13. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
understand how the early intervention system works

14. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
feel I can get the services and support my child and family need

15. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
be able to evaluate how much progress my child is making

16. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
feel that my child will be accepted and welcomed in the community

17. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
feel that my family will be accepted and welcomed in the community

18. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
communicate better with the people who work with my child and family

19. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
understand the roles of the people who work with my child and family

20. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
do things with and for my child that are good for their development

21. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
understand my child's special needs

22. Over the past year, early intervention has helped me and/or my family:

  Never Rarely Often Always
feel that my efforts are helping my child

23. What is your current involvement with CDS

24. How old was your infant/toddler at the time you completed this survey?

25. old was your child when he or she was first referred to CDS?

26. Is your child a male or a female?

27. What is your child’s race / ethnicity?

28. What is your relationship to the child?

29. Which statement best describes how well you understand your child’s development?

30. How well do you know your rights and what to do if you are not satisfied?

31. How much has early intervention helped you know and understand your rights?

32. How would you describe your ability to help your child develop and learn?

33. How much has early intervention helped your family be able to help your child develop and learn?

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