PROGRAMME DESIGN QUESTIONNAIRE PROGRAMME DESIGN QUESTIONNAIRE Your input is essential for creating a programme that meets the child's unique needs. This questionnaire is based on the four domains of physical literacy: Physical, Psychological, Social, and Cognitive. Please select the skills and attributes most important for the child right now. Your responses will help us tailor the programme to support their overall growth and development. Options marked with a * are often included as starting points, but feel free to choose what you feel best suits the child's needs GENERAL INFORMATION Your Name First Name Last Name Your Email Your Relationship to Child Child's Name First Name Last Name Child's Date of Birth MM DD YYYY 1. PHYSICAL DOMAIN The physical domain focuses on movement skills, body control and general fitness. Fundamental Movement Skills * Moving With Equipment Object Manipulation * Coordination * Stability/Balance * Flexibility Agility Strength * Muscular Endurance Cardiovascular Endurance * Reaction Time Speed 2. PSYCHOLOGICAL DOMAIN The Psychological domain focuses on the feelings, attitudes and emotions towards movement and physical activity. Engagement and Enjoyment * Confidence * Motivation * Connection to Place * Self-Perception * Self-Regulation (Emotional) * Self-Regulation (Physical) * 3. SOCIAL DOMAIN The Social domain focuses on the ability to interact with others in relation to movement. Relationships * Collaboration * Ethics Society and Culture 4. COGNITIVE DOMAIN The Cognitive domain focuses on the development of knowledge and understanding required for movement and physical activity. Content Knowledge Safety and Risk * Rules * Reasoning * Strategy and Planning Tactics Perceptual Awareness * Thank you!
