This survey is for families with children receiving Early Intervention services.
 
Your responses will help guide efforts at the statewide and local levels to improve services and results for children and families. 
  • Please read each question carefully and base your responses on your thoughts on that specific question.
  • We understand that families may have experiences with a variety of different people in Early Intervention.  We are asking that you consider your experiences with these individuals as a whole.  
  • Your responses are confidential.
  • Programs will not be able to identify your responses within their summary reports. 
 
Please skip the items that are not applicable. 

The first few questions are about your child.  This information will help us know what Early Intervention Program your child participates in.  

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* 2. My child is

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* 3. My child's zip code is

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* 6. My child's race is

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* 7. My child's ethnicity is 

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* 8. In the past year, Early Intervention staff . . . . . 

  Very Strongly Agree Strongly Agree Agree Disagree Strongly Disagree Very Strongly Disagree
Worked with my family to develop ideas and strategies to help my child learn.
Supported my family as the first teacher for my child.
Helped my child to build relationships with other children and adults.
Helped me to communicate more effectively with the people who work with my child and family.
Helped me know about my child’s and family’s rights concerning EI services (such as filing a complaint, requesting mediation, due process).

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* 9. In the past year, Early Intervention staff . . . . .

  Very Strongly Agree Strongly Agree Agree Disagree Strongly Disagree Very Strongly Disagree
Explained what options parents have if they disagree with a decision made by EI staff.
Used my home language and preferred communication methods.
Helped me to incorporate my cultural values and practices to help my child learn.
Made me feel part of the IFSP/IEP decision-making process.
Built on my child’s strengths and interests.

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* 10. In the past year, Early Intervention staff . . . . .

  Very Strongly Agree Strongly Agree Agree Disagree Strongly Disagree Very Strongly Disagree
 Had ongoing and open communication with my family.
Were honest with me, even if they had difficult things to discuss.
Helped me to support my child in typical places with children of the same age (for example, at home, in childcare, the playground, or preschool).
Provided me with resources to further my knowledge of my child’s unique needs.
Helped me to connect with other programs and/or non-EI services that met our family’s needs, interests, and goals.

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* 11. In the past year, Early Intervention staff . . . . .

  Very Strongly Agree Strongly Agree Agree Disagree Strongly Disagree Very Strongly Disagree
Encouraged me to connect with other families (for example, by connecting me to: Parent to Parent of PA, Parent Training and Information Centers, Family Centers).
Shared information with me about family leadership opportunities.
Told me about opportunities to be involved in improving the local Early Intervention program.
Developed a transition plan based on my child and our family’s strengths, needs, and concerns.
Helped me to address concerns and problem solve during the transition process.
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