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  • Appendix E: Child Survey: Required

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    Thomas Geffen
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    This document appears to be a child survey that collects information about: 1) The child's gender, age, and language proficiency 2) How challenging the child rates issues like poverty, HIV/AIDS, and risky behavior in their community 3) Who the child's caregivers are and what problems, if any, the child faces with those caregivers such as physical harm, disrespect, or difficulty communicating.

    Original Description:

    Orange Farm intervention survey

    Original Title

    Child Survey

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    This document appears to be a child survey that collects information about: 1) The child's gender, age, and language proficiency 2) How challenging the child rates issues like poverty, HIV/AIDS, and risky behavior in their community 3) Who the child's caregivers are and what problems, if any, the child faces with those caregivers such as physical harm, disrespect, or difficulty communicating.

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    © All Rights Reserved
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    6 views2 pages

    Appendix E: Child Survey: Required

    Uploaded by

    Thomas Geffen
    This document appears to be a child survey that collects information about: 1) The child's gender, age, and language proficiency 2) How challenging the child rates issues like poverty, HIV/AIDS, and risky behavior in their community 3) Who the child's caregivers are and what problems, if any, the child faces with those caregivers such as physical harm, disrespect, or difficulty communicating.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
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    of 2

    AppendixE:ChildSurvey

    *Required

    1.Gender*
    Markonlyoneoval.
    Male
    Female
    Prefernottosay
    Other
    2.Age

    3.Howproficientlycanyouspeakthefollowinglanguages?
    Markonlyoneovalperrow.
    Justafewwords/phrases

    Areasonableamount

    Fluent

    Afrikaans
    English
    isiNdebele
    isiZulu
    isiXhosa
    Sesotho
    SesothosaLaboa
    Setswana
    siSwathi
    Tshivenda
    Xitsonga
    4.Howchallengingwouldyouratethefollowingissuesinyourcommunity?
    Markonlyoneovalperrow.
    Not
    challenging
    Poverty
    HIV/AIDS
    Riskysexualbehaviourofyoung
    people
    Childabuse
    Caregiverchildrelationships

    Somewhat
    challenging

    Very
    challenging

    5.Whowouldyouconsidertobethepeoplewhocareforyou,disciplineyou,raiseyouor
    parentyou(caregivers)?(chooseasmanyasyoulike)
    Checkallthatapply.
    Mother
    Father
    Sister
    Brother
    Aunt
    Uncle
    Grandmother
    Grandfather
    6.Whataresomeoftheproblemsyoufacewiththecaregiversabove?
    Checkallthatapply.
    Rulesaretoostrict
    Theyhitmeorhurtmephysically
    Theydonotrespectme
    Theyshoutatme
    Theysayhurtfulthings,insultorthreatenme
    IdonotfeelIcantrustthem
    Itcanbedifficulttotalktothemaboutdifficultthings
    TheyonlycareformewhenIamgood,orobeythem
    Other:
    7.Wouldyoufindithelpfultodiscussbetterwaysofinteractingwiththesecaregiversat
    home,insessionswithaprofessionaland:
    Checkallthatapply.
    Yourmaincaregiver
    Otherchildren
    Otherfamilymembers
    Iwouldnotfindanydiscussionhelpful

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