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Questionnaire For Parents

Questionnaire for parents

Are you trying to figure out what's going on with your child/teen?? Take our online self-assessment right away. Keep in mind that this is a self-assessment tool and not a formal clinical diagnosis.

Read each one of the statements listed below and note the ones that are true for your child/teen during the last month.

1. 

My child complains of suddenly feeling as if (s)he can't breathe when there is no reason for this

2. 

My child suddenly starts to tremble or shake when there is no reason for this

3. 

My child feels scared if (s)he has to travel in the car, or on a bus or train

4. 

My child is afraid of being in crowded places (like shopping centres, the movies, buses, busy playgrounds)

5. 

My child would feel afraid of being on his/her own at home

6. 

My child worries about being away from us / me

7. 

My child worries that something awful will happen to someone in our family

8. 

My child is scared if (s)he has to sleep on his/her own

9. 

My child is scared when s(he) has to take a test

10. 

My child is afraid when (s)he has to use public toilets or bathrooms

11. 

My child feels afraid that (s)he will make a fool of him/herself in front of people

12. 

My child worries that (s)he will do badly at school

13. 

My child has to keep checking that (s)he has done things right (like the switch is off, or the door is locked)

14. 

My child can't seem to get bad or silly thoughts out of his / her head

15. 

My child has to think special thoughts (like numbers or words) to stop bad things from happening

16. 

My child has to do some things over and over again (like washing his / her hands, cleaning or putting things in a certain order)

17. 

My child worries about things

18. 

When my child has a problem, s(he) complains of having a funny feeling in his / her stomach

19. 

My child complains of feeling afraid

20. 

When my child has a problem, s(he) complains of his/her heart beating really fast


Press "What's going on with my child/teen?" Button To Submit your Quiz . After clicking you will see your results.

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