PARENT/CARER FEEDBACK PARENT/CARER FEEDBACK Thank you for participating in our programme. Your feedback is essential in helping us understand the impact of physical activity on your child’s well-being. We will ask you to complete this questionnaire periodically to assess any changes over time. Please answer the following questions based on your most recent observations. 1. GENERAL INFORMATION 1.1. Parent/Carer Name First Name Last Name 1.2. Child's Name First Name Last Name 1.3. Child's Date of Birth MM DD YYYY 1.4. Today's Date MM DD YYYY 2. CHILD'S BEHAVIOURS and WELLBEING 2.1. Mood and Emotional Regulation Have you noticed any improvements in your child’s general mood or ability to self-regulate their emotions and behaviour? No Improvement Moderate Improvement Significate Improvement 2.2. Impulsivity and Behaviour Have you noticed any improvements in your child's impulsivity or challenging behaviours? No Improvement Moderate Improvement Significate Improvement 2.3. Social Engagement and Communication Have you noticed any improvements in your child’s social engagement, communication skills, or interactions with peers? No Improvement Moderate Improvement Significate Improvement 2.4. Motor Skills and Coordination Have you noticed any improvements in your child’s motor control and coordination? No Improvement Moderate Improvement Significate Improvement 2.5. Physical Health and Confidence Have you noticed any improvements in your child’s physical health (e.g., weight, overall health) or confidence in their abilities? No Improvement Moderate Improvement Significate Improvement 2.6. Interest in Physical Activities Since starting the programme, has your child shown increased interest in or asked to participate in physical activities outside of the programme? No Somewhat Significantly 2.7. Sleep Quality Have you noticed any improvements in your child’s sleep quality since starting the programme? No Improvement Moderate Improvement Significant Improvement 3. ADDITIONAL AREAS OF IMPROVEMENT 3.1. Attention and Focus Have you noticed any improvements in your child’s attention span or ability to focus on tasks? No Improvement Moderate Improvement Significant Improvement 3.2. Adaptability and Flexibility Have you observed any improvements in your child's adaptability to changes in routine or new situations, or their flexibility in behaviour or thinking? No Improvement Moderate Improvement Significant Improvement 3.3. Sensory Sensitivities Have you observed any changes in your child’s sensitivity to sensory input (e.g., noise, textures)? No Change Somewhat Reduced Significantly Reduced 3.4. Daily Living Skills Have there been any improvements in your child’s daily living skills (e.g., personal hygiene, organisation)? No Improvement Moderate Improvement Significant Improvement 3.5. Family Dynamics Have you noticed any positive changes in family dynamics or relationships? No Change Somewhat Improved Significantly Improved 4. ACADEMIC IMPROVEMENTS 4.1. Attendance Has your child’s attendance at school or place of study improved? No Improvement Moderate Improvement Significant Improvement 4.2. Engagement Have you noticed any improvements in their engagement with schoolwork? No Improvement Moderate Improvement Significant Improvement 4.3. Performance Have you observed any improvements in your child’s academic performance or grades? No Improvement Moderate Improvement Significant Improvement 5. OVERALL EXPERIENCE 5.1. Child Enjoyment How much does your child enjoy attending the programme? Does Not Enjoy Generally Enjoys Greatly Enjoys 5.2. Parent/Carer Satisfaction Overall, how satisfied are you with the programme? Not Satisfied Neutral Satisfied Greatly Satisfied 5.3. Suggestions and Comments Please leave any further feedback here. Thank you!
