Questionaire for Parenting Book

Thank for taking the time to answer a few questions! These questions are purely for the sake of my gaining an understanding of other parents’ daily experiences with their kids. Please answer truthfully to the best of your knowledge. We all are always trying to grow as parents and my goal is to offer solutions rather than judgements. Your own personal experiences will help tremendously.

1. What name would you like to go by in the book (if used)?Required

2. How many kids do you have and what are their names (you may make up a name or use middle names), ages, and genders?Required

3. Do your kids have ADHD, ASD, dyslexia, or another type of development or learning disorder? If so, which ones?

4. Are you a stay-at-home mom or working mom? If working, how many hours per week? At home or away from home?

5. Are you single or married?

6. What is your children’s daily schedule like on a weekday?

7. How many extracurricular activities does each child take right now for each child? How many hours for each child does this include? How long is the commute to these activities? Are all the kids with you when the other child takes the activities? If so, what do they do while there?

8. How much screen time do they get each day at this current point in time? Is there a set time per day, unlimited, zero screen time, or is it random?

9. Do you let your kids have screen time in the car, at doctor’s appointments, at sporting events, while shopping, etc?

10. Do you worry about how much screen time your kids get? If so, what makes it hard to reduce it?

11. What happens in the daily schedule that causes screen time? Example could be my child throws a temper tantum, I need to work/run errands, or I’m just too tired.

12. Does your child spend a lot of time begging for screen time?

13. How much time would you estimate your child plays with toys at home daily? Weekly?

14. How much time would you estimate your child plays alone or with siblings outside daily? Weekly?

15. Do you encourage your kids to play together? If so, how?

16. How much time would you estimate your child plays with other kids (freeplay, not sports) daily? Weekly?

17. How often do you play with your kids? Daily? Weekly? Inside or outside? What do you play?

18. Do you bake with your kids? Do crafts? Art? Etc. If so, how often?

19. If your family has an entire day off, what do you spend the time doing? Examples Include: Museums, chores, playdates, parks, etc.

20. Do your kids help with chores? Voluntarily or do you have a system for that?

21. How often, if ever, do you take your kids to a park or playground?

22. What do you do on a day off if the weather is cold or wet?

23. How much time would you estimate your kid spends outside in a day?

24. How many minutes of exercise would you estimate your child gets, inside or outside?

25. On a 10 point scale, would you rate your child as extremely happy (10), moderately happy (8) unsure or in the middle (5), mildly depressed (3) or extremely depressed (1).

26. What talents do your child have?

27. How creative would you say your child is? Please include examples.

28. Does your child ever have quiet time without a screen?

29. Do your children have any phobias? If so, what and how severe?

30. Does your child have nightmares?

31. Do you or your partner have any phobias?

32. Do you let your children play in grass, woods, or dirt? Do you worry about poison ivy or other hazards? Explain your reasoning and other details.

33. Do you let your children climb trees, balance on logs, play in creeks, etc. Why or why not?

34. Do your children ride a bicycle? A scooter? Something else?

35. How are your children performing academically this year?

36. What do their teachers say about your kids?

37. Are your kids nice to each other?

38. Do your kids play together much? If so, what do they do?

39. Are your kids nice to other kids at school or at extracurricular activities or neighbors?

40. Do they have close friends?

41. What is your top challenge with your children overall?

42. What is your top scheduling challenge with your family?

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Questionaire for Parenting Book

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