You and Your Child: 10-12

Alternate languages:

Chinese Simplified	Chinese Traditional	Farsi	Punjabi	Vietnamese	Spanish

Section description

• The following questions relate to your child’s motor skills. The skills are in sequential order; for example, the item that describes “running” is listed earlier on in the list than “hopping on one foot”.
• In this section, there is specific information about your child’s motor skills, that is, your child’s ability to use his/her hands, move around and be as independent as his/her age permits.

Section instructions

• Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

A1. Motor: Fine: Ten to Twelve Years of Age

I am (very much/somewhat/slightly, not) concerned that my (10-12 year-old) child does not

A2. Motor: Gross: Ten to Twelve Years of Age

I am (very much/somewhat/slightly, not) concerned that my (10-12 year-old) child does not

Section description

• The following statements relate to your child’s social and emotional skills.

Section Instructions

• Please indicate how much you agree to each of these statements by checking one of the boxes for each item

B1: Social Development: Ten to Twelve Years of Age

Social Skills - description

• In this section, there is specific information about your child’s social skills, that is, the way your child relates to others and interacts with them in socially acceptable ways.
• Please note that items in this section contain statements that apply to children with ages ranging between 10 AND 12 years old.

I am (very much/somewhat/slightly, not) concerned that my (10-12 year-old) child does not

Section description

• The following questions relate to your child’s intellectual/cognitive skills.
• This section contains information about how your child deals with the world around him/her, how well he/she is able to solve problems and how well he/she is able to recognize and express basic information.

Section instructions

• Please indicate how much you agree to each of these statements by checking one of the boxes for each question:

I am (very much/somewhat/slightly, not) concerned that my (10-12 year-old) child does not

D1: Literacy: Reading: Ten to Twelve Years of Age

I am (very much/somewhat/slightly, not) concerned that my (10-12 year-old) child does not

D2. Literacy: Writing: Ten to Twelve Years of Age

I am (very much/somewhat/slightly, not) concerned that my (10-12 year-old) child does not

Please write your email address in the box bellow and your responses will be sent to you.