Fresh Air Self Care FOR ALL: Your Hiker's Profile Survey

The goal of this training is to help you to plan and then implement walks in nature with a person with an Intellectual / Developmental Disability (I/DD) and/or Autism Spectrum Disorder (ASD).

To help you to build a plan and to help us to suggest specific options for you, we need to gather some information about your hiker's interests, abilities, and experiences. We will never share information in any way that would allow anyone to identify you or your hiker.

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* 1. I understand and consent to the use of the information gathered through these surveys as described here.

Yes

Other (please specify)

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* 2. What is your first and last name?

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* 3. At what email address would you like to be contacted?

We refer to the person you would like to help take walks in nature as your hiker. and use the pronouns they or them. If you are a professional planning activities for several potential hikers, we want to think of your most challenging hiker when you answer any of the questions in this survey.

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* 4. Tell us a bit about your hiker. How old is your hiker?

Younger than 10 years old

10 to 14 years old

15 to 18 years old

19 to 22 years old

23 to 30 years old

More than 30 years old

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* 5. Margot's ability to walk, to understand what we expect of her, and to communicate what she feels and wants is complicated by a range of diagnoses. Diagnoses can sometimes help us to anticipate a hiker's strengths and challenges. What are some of the challenges that your hiker faces (check all that apply)

Intellectual / Developmental Disability (I/DD)

Autism Spectrum Disorder (ASD)

Cerebral Palsy

Visual impairment

Hearing impairment

Communication impairment

Seizure Disorder

Obesity

Anxiety

Other information (please specify)

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* 6. When we began walking with Margot, she could not walking 100 yards without showing signs that she was not comfortable (pulling at us, grinding her teeth, and so on). When walking somewhere in the community to a place they want to go to (like a store, mall, or park), what is the furthest that your hiker can comfortably walk (e.g., without sitting down or taking a break or becoming upset)?

They sometimes have trouble walking even just 200 yards.

They are usually comfortable walking up to 200 yards

They are usually comfortable walking up to a quarter mile (400 yards or around a football field)

They are usually comfortable walking up to a mile.

They can comfortably walk more a mile.

Other information (please specify)

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* 7. For those whose hiker often does not continue after walking less than 200 yards, why do you think they want to stop (check all that apply)?

They want to walk but just tire easily

Walking is physically difficult for them

They have trouble understanding why we want them to walk or where we want to walk to

They do not like trying new things or going to new places

Other (please specify)

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* 8. Margot's ability to walk comfortably on anything other than a smooth path is affected by the limited balance, strength and coordination associated with her Cerebral Palsy. What are some of the challenges that your hiker might face walking on a natural path that move have some rock or roots? (check all that apply)

Unsure of their footing on uneven ground

Does not watch where they are stepping

Sometimes stumbles or falls even on a smooth path

Often stumbles or falls even on a smooth path

Might stumble or trip when stepping over larger rocks or roots more than 2" high

Might stumble or trip even when stepping over smaller rocks or roots less than 2" high

Often insists on holding on to someone walking beside them

Sometimes insists on holding on to someone walking beside them

Other information (please specify)

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* 9. We only discovered how much Margot liked being outdoors in nature once we started towing her in her special bike trailer. We do not know if it was the sensory experiences (sights, sounds, and/or smells) or because we were making fewer demands of her. Starting a walking program may be easier for those who already enjoy being outside in nature, whether at the beach, in a park, or just a backyard. How much does your hiker enjoy being outside in nature?

Does not like being outside in nature

Sometimes likes being outside in nature

Usually likes being outside in nature

Always likes being outside in nature

Other information? (please specify)

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* 10. The US Department of Health makes specific recommendations about the amount of aerobic activity we should aim to complete. Any activity that gets your hiker's heart beating faster counts here. For 5 to 17 year olds, they recommend at least 60 minutes of aerobic activity every day. For 18 to 65 year olds, they recommend at least 150 minutes of aerobic activity every week. How often does your hiker get the recommended amount of aerobic activity for their age?

They rarely get the recommended amount of aerobic activity for their age.

They sometimes get the recommended amount of aerobic activity for their age.

They usually get the recommended amount of aerobic activity for their age.

They always get the recommended amount of aerobic activity for their age.

Other (please specify)

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* 11. Other national guidelines include recommendations about the amount of sleep children and adults should get each night: 9 to 11 hours of uninterrupted sleep for children aged 5-13 years; 8 to 10 hours of uninterrupted sleep for adolescents aged 14-17 years, and; 7-9 hours of good quality sleep for those aged 18 to 64 years. A program of walking may become more important for those who do not get enough sleep. How often does your hiker get the recommended amount of sleep for their age?

They rarely get the recommended amount of sleep for their age.

They sometimes get the recommended amount of sleep for their age.

They usually get the recommended amount of sleep for their age.

They always get the recommended amount of sleep for their age.

Other (please specify)

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* 12. Other national guidelines also include recommendations about the maximum amount of time children and adults should spend in recreational screen time each day: no more than 2 hours for those aged 5-17 years, and no more than 3 hours for those aged 18-64 years. How often does your hiker exceed the recommended amount of recreational screen time for their age?

They rarely exceed the amount of recreational screen time recommended for their age.

They sometimes exceed the amount of recreational screen time recommended for their age.

They usually exceed the amount of recreational screen time recommended for their age.

They always exceed the amount of recreational screen time recommended for their age.

Other (please specify)

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* 13. Margot is happier, focused, and capable of more work after she has had a walk or exercised or done some other kind of physical work outdoors. Have you ever noticed that a physical activity seems to improve your hiker's mood or ability to work?

Yes, it always seems to improve their mood and ability to work

Yes, it usually seems to improve their mood and ability to work

Yes, it occasionally seems to improve their mood and ability to work

It rarely seems to improve their mood and ability to work

It does not improve their mood and ability to work

I do not know - we rarely or never do outdoor physical activity.

Other information (please specify)

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* 14. Are there any triggers that you might encounter during a walk in a park or preserve - for example, something that your hiker is afraid or and that might lead to behaviors that you find difficult to manage? Check all that apply.

No triggers come to mind

They are afraid of insects

They are worried about getting dirty

They are afraid of dogs

Other fears or triggers (please specify)

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* 15. Are there any other any behaviors that might occur and that would be difficult for you to manage during a walk in a park or preserve? Check all that apply

No other behaviors come to mind

They sometimes react very aggressively towards themselves or towards others when asked to do something they do not want to do.

They sometimes just sit down and refuse to move

They sometimes scream loudly and will not stop when we are out in public

They sometimes run away from us when we are out in public

Other behaviors (please specify)

Fresh Air Self Care FOR ALL: Your Hiker's Profile

1. Background

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* 1. I understand and consent to the use of the information gathered through these surveys as described here.

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* 2. What is your first and last name?

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* 3. At what email address would you like to be contacted?

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* 4. Tell us a bit about your hiker. How old is your hiker?

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* 7. For those whose hiker often does not continue after walking less than 200 yards, why do you think they want to stop (check all that apply)?

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* 13. Margot is happier, focused, and capable of more work after she has had a walk or exercised or done some other kind of physical work outdoors. Have you ever noticed that a physical activity seems to improve your hiker's mood or ability to work?

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* 14. Are there any triggers that you might encounter during a walk in a park or preserve - for example, something that your hiker is afraid or and that might lead to behaviors that you find difficult to manage? Check all that apply.

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* 15. Are there any other any behaviors that might occur and that would be difficult for you to manage during a walk in a park or preserve? Check all that apply