This free survey is powered by
 
 
This section assesses EMOTIONAL 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 demonstrate periods of unusual sadness or anger?
 
Yes
 
No
 
Sometimes
 
 
 
* Does your child seem to be emotionally withdrawn?
 
Yes
 
No
 
Sometimes
 
 
 
* Does your child demonstrate periods of unusual anxiety (i.e., nervousness or worry)?
 
Yes
 
No
 
Sometimes
 
 
 
Does your child's mood improve when engaged in technology?
 
Yes
 
No
 
Sometimes
 
 
 
* Does your child demonstrate rage or extreme anger when technology is taken away?
 
Yes
 
No
 
Sometimes
 
 
 
* Does your child demonstrate dramatic mood swings?
 
Yes
 
No
 
Sometimes
 
 
 
Please click on continue to view the results.
 
 
 
Your responses indicate your child as NO risk of emotional issues related to technology use. Congratulations your family appears to have a good balance between technology use and emotional factors.

Please continue to the last section assessing interpersonal issues.
 
 
 
Your responses indicate your child has a SLIGHT risk of emotional 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 emotional 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 emotional issues related to technology use. However, the decisions you make today can help your child lower their risk in this area.
 
 
 
Please click on continue to move to final section of the assessment.
 
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.