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* 1. Where are you located?

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* 2. What age group(s) of children/youth are you in direct contact with? Check all that apply.

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* 3. On a scale of 1 to 5, rate the behaviors below, and how challenging they are for you to address.

  Not at all challenging Somewhat challenging Challenging  Very challenging Extremely challenging 
Difficulty focusing on activities 
Not participating in activities/interacting with others 
Unable to sit for an activity for its full duration 
Overactive - can’t stay still, running, jumping frequently 
Uncooperative with transitions 
Refusing to nap / other routine activities 
Refusing to share or take turns with other children
Refusing to do as asked/arguing (“defiant” behavior) 
Tantrums 
Running away 
Destruction of toys / materials/ property 
Biting 
Hitting, kicking, throwing things at other children 
Hitting, kicking, throwing things at adults

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* 4. On a scale of 1 to 5, rate the strategies that you find are the most effective in response to children exhibiting challenging behaviors.

  Not at all effective Somewhat effective Effective Very effective Extremely effective
Take away privileges (e.g. restrict use of toy / material for a period of time or participating in certain activities)
Redirect child’s behavior 
Ignore negative behavior and focus on positive behavior
Use a louder voice to correct a child
Talk calmly with the child
Help the child find words or feelings
Time out/cool off corner
Behavior management system with visual cues (e.g. smiley /frowny faces; red, yellow, green cards)
Contact parent
Logical consequences
Quiet areas, cozy corners
Guide the child to self-calming / soothing strategies
Individualized behavior plans / behavior observation logs
Assign staff to shadow the child
Address basic needs (e.g. sleep, hunger)
Get support from a mental health
Consultant or other source
Implement program disciplinary policy (e.g. - remove child from classroom, send child home, etc.)
Other (Please specify)

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* 5. On a scale of 1 to 5, rate the stress you experience when responding to a child whom you experience as having the most challenging behaviors.

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