Fatigue Survey
Teacher – Social Emotional
Please enable JavaScript in your browser to complete this form.
Please enable JavaScript in your browser to complete this form.
–
Step
1
of 9
T1S) After an average school day, how often does the student seem emotionally exhausted?
0
% of the time.
Next
T2S) Which of these statements do you feel apply to the student when they are emotionally exhausted? Choose all that apply.
Gives up more easily
Acts out (Example: behaves badly, gets into arguments, yells or shouts)
Less motivated or has no desire to participate in class or do their schoolwork
Too tired to spend time with others
Wants to be alone
Avoids noisy areas
Withdraws from conversations
Other
I don’t know
If you selected other, type your response here.
Previous
Next
T3S) How do you know when the student is emotionally exhausted? Choose all that apply.
Becomes frustrated or irritable
Becomes impatient or angry
Becomes nervous or anxious
Becomes sad or depressed
Becomes sleepy or tired
Is less confident or their self-esteem is affected
Other
I don’t know
If you selected other, type your response here.
Previous
Next
T4S) What situations make the student feel emotionally exhausted? Choose all that apply.
When there are too many people talking around them (Example: big crowds)
Mishearing information or miscommunications
People not including them in conversations
People having side conversations
When they are in unfamiliar settings or social situations
When they have lots of things to do (Example: busy schedule)
Repeating themselves or asking others to repeat information
Other
I don’t know
If you selected other, type your response here.
Previous
Next
T5S) What does the student do when they are emotionally exhausted? Choose all that apply.
Stays away from the things that make them feel emotionally exhausted (Example: staying home from school)
Takes a break (Example: closing eyes, turning off hearing aids or implants, eating or drinking something)
Finds distractions with things they enjoy (Example: listening to music, pulling out their phone)
Distracts others
Expresses their feelings
Doesn’t do anything
Tries to push through
Other
If you selected other, type your response here.
Previous
Next
T6S) When does the student seem emotionally exhausted? Choose all that apply.
At the beginning of the school day
During classes throughout the school day
During breaks throughout the school day
At the end of the school day
During after-school activities (Example: sports)
Other
They don’t ever seem to feel emotionally exhausted
If you selected other, type your response here.
Previous
Next
T7S) What strategies do you use to support the student when they are emotionally exhausted? Choose all that apply.
Encourage them to discuss/show their emotions
Acknowledge their emotions
Allow them to take breaks when needed
Engage them in a calming activity (Example: colouring, meditating)
Other
I do not use any strategies
If you selected other, type your response here.
Previous
Next
T8S) How often does feeling emotionally exhausted affect the student's relationships with others?
0
% of the time
Previous
Next
Submit