Parent Resource Guide - Learning Questionnaire

2-minute check-in so I can personalise your guide

8 questions | No essay writing | Just share brief insights.

Your summary will be emailed to you by the next business day.

Your Name

Your child's name

Grade

Email address

Main Concern

Example prompts: -

"She melts down every time I mention homework"

"He can't stay focused for more than 5 minutes"

"Smart kid but refuses to write anything down" (200 characters max)

Academic Struggle Areas

Reading (decoding, comprehension, fluency)

Writing (getting started, organizing ideas, handwriting)

Maths (understanding concepts, remembering steps, word problems)

Focus and attention (starting tasks, staying on task)

Organisation (keeping track of materials, planning ahead)

Memory (remembering instructions, learning new information)

Emotional regulation (frustration, meltdowns, anxiety about school)

Other (please specify below)

Please detail "other" response

Homework Behaviour - How does homework typically go?

Constant battles - tears, refusal, takes hours

Struggles but tries - needs lots of support and encouragement

Avoids and procrastinates - huge fight to get started

Starts okay but can't sustain - gives up partway through

Anxious and perfectionist - won't start unless it's "perfect"

Rushes through carelessly - just wants it done

Current Support - What support does your child currently have? (Select all that apply)

None - we're trying to figure it out ourselves

Tutoring (literacy, maths, general)

Therapy (OT, speech, psychologist, counsellor)

School support (aide, modifications, IEP/NEP/ One Plan)

Medication (ADHD, anxiety, etc.)

Previous assessment or diagnosis (please specify below)

Previous Assessments/Diagnosis (if applicable)

ADHD, dyslexia, ASD Level 1

School vs Home Discrepancy - What do teachers say about your child?

"No concerns at school" - but we see major struggles at home

"Some concerns" - school sees similar issues to home

"Significant concerns" - school has raised red flags

"We're not sure" - haven't had recent feedback from school

Your Goal - What would make this guide worth it for you? What do you most want to understand or change?

Example prompts:

"Know if this is ADHD or something else"

"Get through homework without everyone crying"

"Understand why she's so smart but struggles so much"

Please keep to 1-2 sentences (about 200 characters)

Urgency Indicator - How urgent does this feel for you right now?

Crisis mode - we need help immediately

Serious concern - want to address this soon

Moderate concern - researching options

Just curious - exploring whether this could help

Parent Resource Guide - Learning Questionnaire

2-minute check-in so I can personalise your guide

Questions? Email info@ascendlimits.com.au