24-25 Family Accommodation Scale - Anxiety (FASA) T2 - CANCELLED (Using Teacher Response T3 instead) Survey

Question Title

* 1.
Type the 4 digit code for your school given to you by the school (this number is the same for all parents at your school)

Question Title

* 2. Your email address will be used as your unique identifier. Please type in you email address.

Email:

Type in your email address a second time for confirmation:

Question Title

* 3. This question refers to the children you have which are attending this school. Please choose your most anxious child and respond with them in mind. Please mark the age that child turns this year.

Question Title

* 4. Relationship to child

Father or Step-father

Mother or Step-mother

Grandfather or Step-Grandfather

Grandmother or Step-Grandmother

Other carer

Other (please specify)

	Never	1-3 times a month	1-2 times a week	3-6 times a week	Daily
1. How often did you re-assure your child?	1. How often did you re-assure your child? Never	1. How often did you re-assure your child? 1-3 times a month	1. How often did you re-assure your child? 1-2 times a week	1. How often did you re-assure your child? 3-6 times a week	1. How often did you re-assure your child? Daily
2. How often did you provide items needed because of anxiety?	2. How often did you provide items needed because of anxiety? Never	2. How often did you provide items needed because of anxiety? 1-3 times a month	2. How often did you provide items needed because of anxiety? 1-2 times a week	2. How often did you provide items needed because of anxiety? 3-6 times a week	2. How often did you provide items needed because of anxiety? Daily
3. How often did you participate in behaviours related to your child's anxiety?	3. How often did you participate in behaviours related to your child's anxiety? Never	3. How often did you participate in behaviours related to your child's anxiety? 1-3 times a month	3. How often did you participate in behaviours related to your child's anxiety? 1-2 times a week	3. How often did you participate in behaviours related to your child's anxiety? 3-6 times a week	3. How often did you participate in behaviours related to your child's anxiety? Daily
4. How often did you assist your child in avoiding things that might make him or her more anxious?	4. How often did you assist your child in avoiding things that might make him or her more anxious? Never	4. How often did you assist your child in avoiding things that might make him or her more anxious? 1-3 times a month	4. How often did you assist your child in avoiding things that might make him or her more anxious? 1-2 times a week	4. How often did you assist your child in avoiding things that might make him or her more anxious? 3-6 times a week	4. How often did you assist your child in avoiding things that might make him or her more anxious? Daily
5. Have you avoided doing things, going places, or being with people because of your child's anxiety?	5. Have you avoided doing things, going places, or being with people because of your child's anxiety? Never	5. Have you avoided doing things, going places, or being with people because of your child's anxiety? 1-3 times a month	5. Have you avoided doing things, going places, or being with people because of your child's anxiety? 1-2 times a week	5. Have you avoided doing things, going places, or being with people because of your child's anxiety? 3-6 times a week	5. Have you avoided doing things, going places, or being with people because of your child's anxiety? Daily

Never

1-3 times a month

1-2 times a week

3-6 times a week

Daily

1. How often did you re-assure your child?

1. How often did you re-assure your child? Never

1. How often did you re-assure your child? 1-3 times a month

1. How often did you re-assure your child? 1-2 times a week

1. How often did you re-assure your child? 3-6 times a week

1. How often did you re-assure your child? Daily

2. How often did you provide items needed because of anxiety?

2. How often did you provide items needed because of anxiety? Never

2. How often did you provide items needed because of anxiety? 1-3 times a month

2. How often did you provide items needed because of anxiety? 1-2 times a week

2. How often did you provide items needed because of anxiety? 3-6 times a week

2. How often did you provide items needed because of anxiety? Daily

3. How often did you participate in behaviours related to your child's anxiety?

3. How often did you participate in behaviours related to your child's anxiety? Never

3. How often did you participate in behaviours related to your child's anxiety? 1-3 times a month

3. How often did you participate in behaviours related to your child's anxiety? 1-2 times a week

3. How often did you participate in behaviours related to your child's anxiety? 3-6 times a week

3. How often did you participate in behaviours related to your child's anxiety? Daily

4. How often did you assist your child in avoiding things that might make him or her more anxious?

4. How often did you assist your child in avoiding things that might make him or her more anxious? Never

4. How often did you assist your child in avoiding things that might make him or her more anxious? 1-3 times a month

4. How often did you assist your child in avoiding things that might make him or her more anxious? 1-2 times a week

4. How often did you assist your child in avoiding things that might make him or her more anxious? 3-6 times a week

4. How often did you assist your child in avoiding things that might make him or her more anxious? Daily

5. Have you avoided doing things, going places, or being with people because of your child's anxiety?

5. Have you avoided doing things, going places, or being with people because of your child's anxiety? Never

5. Have you avoided doing things, going places, or being with people because of your child's anxiety? 1-3 times a month

5. Have you avoided doing things, going places, or being with people because of your child's anxiety? 1-2 times a week

5. Have you avoided doing things, going places, or being with people because of your child's anxiety? 3-6 times a week

5. Have you avoided doing things, going places, or being with people because of your child's anxiety? Daily

	Never	1-3 times a month	1-2 times a week	3-6 times a week	Daily
1. Have you modified your family routine because of your child's symptoms?	1. Have you modified your family routine because of your child's symptoms? Never	1. Have you modified your family routine because of your child's symptoms? 1-3 times a month	1. Have you modified your family routine because of your child's symptoms? 1-2 times a week	1. Have you modified your family routine because of your child's symptoms? 3-6 times a week	1. Have you modified your family routine because of your child's symptoms? Daily
2. Have you had to do things that would usually be your child's responsibility?	2. Have you had to do things that would usually be your child's responsibility? Never	2. Have you had to do things that would usually be your child's responsibility? 1-3 times a month	2. Have you had to do things that would usually be your child's responsibility? 1-2 times a week	2. Have you had to do things that would usually be your child's responsibility? 3-6 times a week	2. Have you had to do things that would usually be your child's responsibility? Daily
3. Have you modified your work schedule because of your child's anxiety?	3. Have you modified your work schedule because of your child's anxiety? Never	3. Have you modified your work schedule because of your child's anxiety? 1-3 times a month	3. Have you modified your work schedule because of your child's anxiety? 1-2 times a week	3. Have you modified your work schedule because of your child's anxiety? 3-6 times a week	3. Have you modified your work schedule because of your child's anxiety? Daily
4. Have you modified your leisure activities because of your child's anxiety?	4. Have you modified your leisure activities because of your child's anxiety? Never	4. Have you modified your leisure activities because of your child's anxiety? 1-3 times a month	4. Have you modified your leisure activities because of your child's anxiety? 1-2 times a week	4. Have you modified your leisure activities because of your child's anxiety? 3-6 times a week	4. Have you modified your leisure activities because of your child's anxiety? Daily

Never

1-3 times a month

1-2 times a week

3-6 times a week

Daily

1. Have you modified your family routine because of your child's symptoms?

1. Have you modified your family routine because of your child's symptoms? Never

1. Have you modified your family routine because of your child's symptoms? 1-3 times a month

1. Have you modified your family routine because of your child's symptoms? 1-2 times a week

1. Have you modified your family routine because of your child's symptoms? 3-6 times a week

1. Have you modified your family routine because of your child's symptoms? Daily

2. Have you had to do things that would usually be your child's responsibility?

2. Have you had to do things that would usually be your child's responsibility? Never

2. Have you had to do things that would usually be your child's responsibility? 1-3 times a month

2. Have you had to do things that would usually be your child's responsibility? 1-2 times a week

2. Have you had to do things that would usually be your child's responsibility? 3-6 times a week

2. Have you had to do things that would usually be your child's responsibility? Daily

3. Have you modified your work schedule because of your child's anxiety?

3. Have you modified your work schedule because of your child's anxiety? Never

3. Have you modified your work schedule because of your child's anxiety? 1-3 times a month

3. Have you modified your work schedule because of your child's anxiety? 1-2 times a week

3. Have you modified your work schedule because of your child's anxiety? 3-6 times a week

3. Have you modified your work schedule because of your child's anxiety? Daily

4. Have you modified your leisure activities because of your child's anxiety?

4. Have you modified your leisure activities because of your child's anxiety? Never

4. Have you modified your leisure activities because of your child's anxiety? 1-3 times a month

4. Have you modified your leisure activities because of your child's anxiety? 1-2 times a week

4. Have you modified your leisure activities because of your child's anxiety? 3-6 times a week

4. Have you modified your leisure activities because of your child's anxiety? Daily

	No	Mild	Moderate	Severe	Extreme
1. Does helping your child in these ways cause you distress?	1. Does helping your child in these ways cause you distress? No	1. Does helping your child in these ways cause you distress? Mild	1. Does helping your child in these ways cause you distress? Moderate	1. Does helping your child in these ways cause you distress? Severe	1. Does helping your child in these ways cause you distress? Extreme
2. Has your child become distressed when you have not provided assistance? To what degree?	2. Has your child become distressed when you have not provided assistance? To what degree? No	2. Has your child become distressed when you have not provided assistance? To what degree? Mild	2. Has your child become distressed when you have not provided assistance? To what degree? Moderate	2. Has your child become distressed when you have not provided assistance? To what degree? Severe	2. Has your child become distressed when you have not provided assistance? To what degree? Extreme
3. Has your child become angry/abusive when you have not provided assistance? To what degree?	3. Has your child become angry/abusive when you have not provided assistance? To what degree? No	3. Has your child become angry/abusive when you have not provided assistance? To what degree? Mild	3. Has your child become angry/abusive when you have not provided assistance? To what degree? Moderate	3. Has your child become angry/abusive when you have not provided assistance? To what degree? Severe	3. Has your child become angry/abusive when you have not provided assistance? To what degree? Extreme
4. Has your child's anxiety been worse when you have not provided assistance? How much worse?	4. Has your child's anxiety been worse when you have not provided assistance? How much worse? No	4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Mild	4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Moderate	4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Severe	4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Extreme

Mild

Moderate

Severe

Extreme

1. Does helping your child in these ways cause you distress?

1. Does helping your child in these ways cause you distress? No

1. Does helping your child in these ways cause you distress? Mild

1. Does helping your child in these ways cause you distress? Moderate

1. Does helping your child in these ways cause you distress? Severe

1. Does helping your child in these ways cause you distress? Extreme

2. Has your child become distressed when you have not provided assistance? To what degree?

2. Has your child become distressed when you have not provided assistance? To what degree? No

2. Has your child become distressed when you have not provided assistance? To what degree? Mild

2. Has your child become distressed when you have not provided assistance? To what degree? Moderate

2. Has your child become distressed when you have not provided assistance? To what degree? Severe

2. Has your child become distressed when you have not provided assistance? To what degree? Extreme

3. Has your child become angry/abusive when you have not provided assistance? To what degree?

3. Has your child become angry/abusive when you have not provided assistance? To what degree? No

3. Has your child become angry/abusive when you have not provided assistance? To what degree? Mild

3. Has your child become angry/abusive when you have not provided assistance? To what degree? Moderate

3. Has your child become angry/abusive when you have not provided assistance? To what degree? Severe

3. Has your child become angry/abusive when you have not provided assistance? To what degree? Extreme

4. Has your child's anxiety been worse when you have not provided assistance? How much worse?

4. Has your child's anxiety been worse when you have not provided assistance? How much worse? No

4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Mild

4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Moderate

4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Severe

4. Has your child's anxiety been worse when you have not provided assistance? How much worse? Extreme

24-25 Family Accommodation Scale - Anxiety (FASA) T2 - CANCELLED (Using Teacher Response T3 instead)

Question Title

* 1.
Type the 4 digit code for your school given to you by the school (this number is the same for all parents at your school)

Question Title

* 2. Your email address will be used as your unique identifier. Please type in you email address.

Question Title

* 3. This question refers to the children you have which are attending this school. Please choose your most anxious child and respond with them in mind. Please mark the age that child turns this year.

Question Title

* 4. Relationship to child

Question Title

* 5. Participation in symptom-related behaviours in the past month:

Question Title

* 6. Modification of functioning during the past month:

Question Title

* 7. Distress and consequences

24-25 Family Accommodation Scale - Anxiety (FASA) T2 - CANCELLED (Using Teacher Response T3 instead)

Question Title

* 1. Type the 4 digit code for your school given to you by the school (this number is the same for all parents at your school)

Question Title

* 2. Your email address will be used as your unique identifier. Please type in you email address.

Question Title

* 3. This question refers to the children you have which are attending this school. Please choose your most anxious child and respond with them in mind. Please mark the age that child turns this year.

Question Title

* 4. Relationship to child

Question Title

* 5. Participation in symptom-related behaviours in the past month:

Question Title

* 6. Modification of functioning during the past month:

Question Title

* 7. Distress and consequences

* 1.
Type the 4 digit code for your school given to you by the school (this number is the same for all parents at your school)