*1.1. **Diagnosis**
Were you or your child diagnosed with a speech disorder?
- Yes
- No
- If yes, please specify the diagnosis: ____________(Required.)

*2.2. **Communication Devices**
Do you have access to communication devices or assistive technology in school?
- Yes
- No
- If yes, please specify the devices used: ____________(Required.)

*3.3. **Communication Methods**
What methods do you primarily use to communicate? (Select all that apply)
- Picture Exchange Communication System (PECS)
- Makaton signing
- Augmentative and Alternative Communication (AAC) devices
- Spelling
- Music
- Art
- Other (please specify): ____________(Required.)

4.4. **Communication Effectiveness**
How effective do you feel your current communication methods are?
- Very effective
- Somewhat effective
- Not effective
- Please explain your answer: ____________

*5.5. **Support from Family/Friends**
Do you feel that family and friends understand your communication methods?
- Yes
- No
- Sometimes
- Please elaborate: ____________(Required.)

*6.6. **Speech Therapy**
Have you participated in speech therapy?
- Yes
- No
- If yes, for how long? ____________(Required.)

*7.7. **Impact of Speech Therapy**
Do you feel that speech therapy has helped improve your communication skills?
- Yes
- No
- Somewhat
- Please explain your answer: ____________(Required.)

*8.8. **School Support**
Do you feel that your school provides adequate support for your communication needs?
- Yes
- No
- Somewhat
- Please explain your answer: ____________(Required.)

*9.9. **Future Needs**
What additional support or resources do you feel would help improve your communication?
- ____________(Required.)

*10.10. **Additional Comments**
Please share any other thoughts or experiences related to communication that you would like to add:
- ____________(Required.)