This free survey is powered by
 
 
This section assesses BEHAVIORAL issues and has a total of 6 questions.

Please choose the response that BEST fits your child's situation.

Please start with the survey now by clicking on the Continue button below.

 
 
 
* Does your child stop using technology when requested?
 
Yes
 
No
 
Sometimes
 
 
 
* Does your child spend increasing amounts of time using technology?
 
Yes
 
No
 
Sometimes
 
 
 
* Have you made unsuccessful attempts to limit your child’s technology use?
 
Yes
 
No
 
Have not placed limits
 
 
 
* Has your child's school performance become problematic? (e.g., incomplete homework, failing on tests, or sleeping through classes).
 
Yes
 
No
 
Sometimes
 
 
 
* Has your child given up previously enjoyed hobbies? (e.g., sports, dramatics, music, outdoor recreation, etc.)
 
Yes
 
No
 
Some
 
 
 
* Does your child’s use of technology cause arguments in your family?
 
Yes
 
No
 
Sometimes
 
 
 
Please click on continue to view the results.
 
 
 
Your responses indicate your child as NO risk of behavioral issues related to technology use. Congratulations your family appears to have a good balance between technology use and physical factors.

Please click on the Continue button below.
 
 
 
Your responses indicate your child has a SLIGHT risk of behavioral issues related to technology use. There may be one or two changes you could make to further decrease your child's risk in this area.
 
 
 
Your responses indicate your child has a MODERATE risk of behavioral issues related to technology. However, the decisions you make today can help your child lower their risk in this area.
 
 
 
Your responses indicate your child has a SEVERE risk of behavioral issues related to technology use. However, the decisions you make today can help your child lower their risk in this area.
 
 
 
Please select Continue to move to the next section.
 
Continue
 
© Technology Wellness Center. This questionnaire is protected by copyright laws. You are expressly prohibited from copying or using this questionnaire without the express approval from the Technology Wellness Center.