Parent Questionnaire

Score on a scale of 1-5
(1 = Never, 2 = Seldom, 3 = Occasionally/Monthly, 4 = Weekly, 5 = Daily)

1.	I nag to get the results I want.
	1	2	3	4	5

2.	I give in when my children don't comply.
	1	2	3	4	5


3.	When I get angry, I can't help blowing up, yelling, calling my children names, or swearing at them.
	1	2	3	4	5


4.	I hit my children.
	1	2	3	4	5


5.	I feel guilty when I realize how I have treated my children.
	1	2	3	4	5


6.	My children refuse to take "No," for an answer, keep bugging me for a positive response, or do what they want to do anyway.
	1	2	3	4	5


7.	My children throw tantrums, kick and yell, or scream.
	1	2	3	4	5


8.	My children disagree, squabble, and fight at least verbally with each other.
	1	2	3	4	5


9.	My children lack confidence in themselves, in completing tasks and homework, in handling social situations.
	1	2	3	4	5


10.	My children do not accept or comply with consequences given to them.
	1	2	3	4	5

Scores:

Scores:

0-10 Good parenting skills.

11-20 Parenting skills need improvement; need new information

21-30 Parenting skills could be improved with new information and practice by parenting classes/workshop/group or individual or family counseling

31-40 Parenting skills could be improved MORE by parenting classes/workshop/group or individual or family counseling

41-50 Parenting skills could be improved MOST by parenting classes/workshop/group or individual or family counseling

SCORE:

QUESTIONS:

COMMENTS:

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