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.  

Question Title

* 1. My child's birthday is

Question Title

* 2. My child is

Question Title

* 3. My child's zip code is

Question Title

* 6. My child's race is

Question Title

* 7. My child's ethnicity is 

Question Title

* 8. In the past year, the Early Intervention services that my family received....

  Very Strongly Disagree Strongly Disagree  Disagree  Agree  Strongly Agree  Very Strongly Agree 
Helped me to effectively communicate my child's needs.
Helped our child and family participate in typical activities for children and families in my community. 
Helped me to understand my child's special needs. 
Helped me to access other programs and/or services for my family (for example: parent support, food stamps, WIC, get a library card, etc).

Question Title

* 9. In the past year, the Early Intervention services that my family received....

  Very Strongly Disagree Strongly Disagree  Disagree  Agree  Strongly Agree  Very Strongly Agree 
Helped me to be able to see how much progress my child is making.
Helped me to understand and support my child's behavior. (For example, helping my child to handle their feelings, helping my child to get along with others, helping my child to feel secure with my chosen caregiver(s), helping my child transition from activity to activity).
Helped families get to know and support each other.
Helped me know about my child's and family's rights concerning EI services (such as: filing a complaint, requesting mediation, due process).

Question Title

* 10. In the past year, Early Intervention (EI) staff....

  Very Strongly Disagree Strongly Disagree Disagree Agree  Strongly Agree Very Strongly Agree 
Made it easy for me to talk to them about my child and our family.
Explained what options parents have if they disagree with a decision made by EI staff.
Gave my family information about modifications of routines, activities and the physical setting that would help my child.
Gave me ideas of how to support my child's development at home.

Question Title

* 11. In the past year, Early Intervention (EI) staff....

  Very Strongly Disagree Strongly Disagree Disagree Agree  Strongly Agree Very Strongly Agree 
Gave me information about their mission, goals, policies, and procedures.
Talked to me about how information about my child's performance is used to help teach my child new things.
Gave me choices regarding my family's services and supports.
Built on my child's strengths and interests.

Question Title

* 12. In the past year, Early Intervention (EI) staff....

  Very Strongly Disagree Strongly Disagree Disagree Agree  Strongly Agree Very Strongly Agree 
Helped me to understand how the information collected about my child and family is used for program improvement.
Talked to me about how information about my child's performance is used to help teach my child new things.
Explained the relationship between assessment/evaluation findings and my child's outcomes/goals.
Made me feel part of the IFSP/IEP decision-making process.

Question Title

* 13. In the past year, Early Intervention (EI) staff....

  Very Strongly Disagree Strongly Disagree Disagree Agree  Strongly Agree Very Strongly Agree 
Gave me information about organizations that offer support to parents (for example: Parent to Parent of Pa, Support Groups, Parent Training Information Centers, Family Resource Centers)
Provided me information about community organizations, agencies and events that are of interest to young families.
Gave me information about opportunities for my child to play with other children.
Were available to talk with me at times that fit into my schedule.

Question Title

* 14. In the past year, Early Intervention (EI) staff....

  Very Strongly Disagree Strongly Disagree Disagree Agree  Strongly Agree Very Strongly Agree 
Understood my family's culture, beliefs and traditions.
Were dependable.
Provided opportunities for parent training or information sessions.
Provided all of the services listed on his/her IFSP/IEP.

Question Title

* 15. In the past year, Early Intervention (EI) staff....

  Very Strongly Disagree Strongly Disagree Disagree Agree  Strongly Agree Very Strongly Agree 
Provided the services on our IFSP/IEP in a timely way.
Asked me about how well the program is meeting my child's needs.
Were honest with me, even if they had difficult things to discuss.
Provided information and/or resources to help my family understand how my child can be supported to learn and develop, as they grow, in places that are typical for children of the same age. (for example: at home, in child care, the playground,
0 of 17 answered
 

T