Testing Survey Page – Fatigue Survey

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– Step 1 of 21

S1C) During a typical school day, how often do you feel mentally exhausted?

0 % of the time.

S2C) How do you know when you are mentally exhausted? Choose all that apply.

I’m less focused and get distracted more easily
I have trouble following instructions or I need to ask for things to be repeated.
I zone out, give up, or let someone else do things for me
I have more difficulty making choices or decisions
I make more mistakes
Other:

If you selected other, type your response here.

S3C) What situations make you feel mentally exhausted? Choose all that apply.

Classes where I need to learn a lot of new words or do a lot of reading.
Being in a noisy or visually busy environment.
Not being able to take a break when I need it.
Listening or watching for a long time.
Other

If you selected other, type your response here.

S4C) What do you do when you are mentally exhausted? Choose all that apply.

I take a movement break (Example: stretch, walk around)
I take a brain break (Example: breathing exercises, meditation)
I ask for what I need (Example: asking for breaks, letting someone know if I need help)
I try to reduce background noise (Example: take off hearing aids or cochlear implants)
I stop paying attention (Example: close my eyes, lay my head down on my desk)
Other

If you selected other, type your response here.

S5C) What time of day do you feel mentally exhausted?

In the morning before the school day begins.
At school during classes
At school during breaks (Example: lunch time)
In the afternoon after school ends.
During after-school activities (Example: sports)
In the evening before bed
Other

If you selected other, type your response here.

S6C) At the end of the day, how often do you feel too mentally exhausted to do after-school activities (Example: playing sports, participating in clubs)?

0 % of the time

S7C) Do you have to use more mental effort than your classmates to watch, listen and understand?

S8C) Do your teachers think that you have to use more mental effort than your classmates to watch, listen and understand?

Yes
No
I don’t know

S9C. Do your parents/guardians think that you have to use more mental effort than your classmates to watch, listen and understand?

Yes
No
I don’t know

S10C. Do you need breaks from listening and watching during class?

S11C) How often do you take breaks from listening and watching during class?

All the time
Often
Not Often
Never

S12C) Are you the only one getting a break?

Yes, I’m the only one getting a break.
No, other kids get breaks too.
No, the whole class takes breaks together.

S13C) Do you have to ask your teacher for a break?

Yes, I have to ask for a break.
No, my teacher gives me scheduled breaks.
No, my teacher lets me take breaks whenever I need to.

S14C) In which of the following classes do you feel mentally exhausted? Choose all that apply.

Math
Language Arts
Social Studies
Science
Other (Example: Physical Education, Art, Drama, Culinary Arts, Second Language Course)
None of these classes make me feel mentally exhausted

S15C) Are there any strategies you use now to help with mental exhaustion? Choose all that apply.

Ask for breaks during the day
Ask for a quiet space
Ask for better seating location (Example: close to the front of the class, close to speaker)
Use tools to help with stress and anxiety (Example: fidget toys)
Reduce background noise
Use visuals (Example: visual schedule, closed captions on videos, images to support text)
Ask for audio/video recorded lessons
Ask for note takers or get class notes in advance
Let my teacher, classmates, EAs know about my needs
Ask for information to be repeated
Other
I don’t use any strategies to help with mental exhaustion.

If you selected other, type your response here.

S16C) What kind of background noise in the classroom makes it difficult to listen, watch and understand? Choose all that apply.

Heating or air conditioning system
Outdoor sounds
People fidgeting with papers
People moving around
Chairs moving
People talking
Equipment or applicances (Examples; projectors, kettle, smartboard, TVs, gym equipment)
Other

If you selected other, type your response here.

S17C) What kind of communication problems make it difficult to listen, watch and understand? Choose all that apply.

Talking over each other (Example: group discussions)
Speaking fast, quietly, or mumbling
People with an accent that is difficult to understand
People covering their mouths or turning away while speaking
Other

If you selected other, type your response here.

S18C) What kind of lighting problems in the classroom make it difficult to listen, watch and understand? Choose all that apply.

Glare from window or computer screen
Computer screen brightness
Room is too dark or bright
Flickering light
Reflection on projector or smartboard
Other

If you selected other, type your response here.

S19C) What kind of seating arrangement problems in the classroom make it difficult to listen, watch and understand? Choose all that apply.

I can’t see the teacher
I can’t see the board
I can’t see the board
I can’t see my classmates
Classroom design (Example: large classrooms, open ceilings)
Other

If you selected other, type your response here.

S20C) What kind of class material problems make it difficult to listen, watch and understand? Choose all that apply.

Videos with the wrong auto-generated captions
Videos without captions
Videos without captions
Not having the notes beforehand
FM/DM connection issues
Other

If you selected other, type your response here.

S21C) What other problems in the classroom make it difficult to listen, watch and understand? Choose all that apply.

Classes with new information or vocabulary I don’t know
Fast-paced class (Example: missing information and having to catch up)
Having to watch and focus without breaks
Having to do a lot of things at the same time (Example: watching interpreter, lip/speech-reading, note-taking)
Too much information given in class
No other problems apply to me
Other

If you selected other, type your response here.

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