KIDSCREEN-52

Health Questionnaire for Children and Young People

Parent Version
English (UK)

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 1 of 8
 Date: ________ _______
Month Year

Dear Parents,

How is your child? How does she/he feel? This is what we would like
to know from you.

Please answer the following questions to the best of your knowledge,

ensuring that the answers you give reflect the perspective of your
child. Please try to remember your child’s experiences over the last
week...

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 2 of 8
1. Physical Activities and Health
In general,
1. how would your child rate her/his health?

excellent
very good
good
fair
poor

Thinking about the last week ...

not at all slightly moderately very extremely

not at all slightly moderately very extremely

2. Has your child felt fit and well?

Has your child been physically active not at all slightly moderately very extremely
3.
(e.g. running, climbing, biking)?
not at all slightly moderately very extremely
4. Has your child been able to run well?

Thinking about the last week ...

never seldom quite often very often always

never seldom quite often very often always

5. Has your child felt full of energy?

2. Feelings

Thinking about the last week ...

not at all slightly moderately very extremely

Has your child felt that life was not at all slightly moderately very extremely
1.
enjoyable?

Has your child felt pleased that he/she not at all slightly moderately very extremely
2.
is alive?

Has your child felt satisfied with not at all slightly moderately very extremely
3.
his/her life?

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 3 of 8
 Thinking about the last week ...

never seldom quite often very often always

never seldom quite often very often always

4. Has your child been in a good mood?
never seldom quite often very often always
5. Has your child felt cheerful?
never seldom quite often very often always
6. Has your child had fun?

3. General Mood

Thinking about the last week ...

never seldom quite often very often always

Has your child felt that he/she does never seldom quite often very often always
1.
everything badly?
never seldom quite often very often always
2. Has your child felt sad?

Has your child felt so bad that he/she never seldom quite often very often always
3.
didn’t want to do anything?

Has your child felt that everything in never seldom quite often very often always
4.
his/her life goes wrong?
never seldom quite often very often always
5. Has your child felt fed up?
never seldom quite often very often always
6. Has your child felt lonely?
never seldom quite often very often always
7. Has your child felt under pressure?

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 4 of 8
4. About Your Child

Thinking about the last week ...

never seldom quite often very often always

Has your child been happy with the never seldom quite often very often always
1.
way he/she is?

Has your child been happy with never seldom quite often very often always
2.
his/her clothes?

Has your child been worried about the never seldom quite often very often always
3.
way he/she looks?

Has your child felt jealous of the way never seldom quite often very often always
4.
other girls and boys look?

Has your child wanted to change never seldom quite often very often always
5.
something about his/her body?

5. Free Time

Thinking about the last week ...

never seldom quite often very often always

Has your child had enough time for never seldom quite often very often always
1.
him/herself?

Has your child been able to do the never seldom quite often very often always
2. things that he/she wants to do in
his/her free time?

Has your child had enough opportunity never seldom quite often very often always
3.
to be outside?

Has your child had enough time to never seldom quite often very often always
4.
meet friends?

Has your child been able to choose never seldom quite often very often always
5.
what to do in his/her free time?

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 5 of 8
6. Family and Home Life

Thinking about the last week ...

not at all slightly moderately very extremely

Has your child felt understood by not at all slightly moderately very extremely
1.
his/her parent(s)?

Has your child felt loved by his/her not at all slightly moderately very extremely
2.
parent(s)?

Thinking about the last week ...

never seldom quite often very often always

never seldom quite often very often always

3. Has your child been happy at home?

Has your child felt that his/her never seldom quite often very often always
4. parent(s) had enough time for
him/her?

Has your child felt that his/her never seldom quite often very often always
5.
parent(s) treated him/her fairly?

Has your child been able to talk to never seldom quite often very often always
6. his/her parent(s) when he/she wanted
to?

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 6 of 8
7. Money matters

Thinking about the last week ...

never seldom quite often very often always

1. Has your child had enough money to never seldom quite often very often always

do the same things as his/her friends?

Has your child felt that he/she had never seldom quite often very often always
2.
enough money for his/her expenses?

Thinking about the last week ...

not at all slightly moderately very extremely

Does your child feel that he/she has not at all slightly moderately very extremely
3. enough money to do things with
his/her friends?

8. Friends

Thinking about the last week ...

never seldom quite often very often always

Has your child spent time with his/her never seldom quite often very often always
1.
friends?

Has your child done things with other never seldom quite often very often always
2.
girls and boys?

Has your child had fun with his/her never seldom quite often very often always
3.
friends?

Have your child and his/her friends never seldom quite often very often always
4.
helped each other?

Has your child been able to talk about never seldom quite often very often always
5.
everything with his/her friends?

Has your child been able to rely on never seldom quite often very often always
6.
his/her friends?

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
Page 7 of 8
9. School and Learning

Thinking about the last week ...

not at all slightly moderately very extremely

not at all slightly moderately very extremely

1. Has your child been happy at school?

not at all slightly moderately very extremely

2. Has your child got on well at school?

Has your child been satisfied with not at all slightly moderately very extremely
3.
his/her teachers?

Thinking about the last week ...

never seldom quite often very often always

Has your child been able to pay never seldom quite often very often always
4.
attention?

Has your child enjoyed going to never seldom quite often very often always
5.
school?

Has your child got along well with never seldom quite often very often always
6.
his/her teachers?

10. Bullying

Thinking about the last week ...

never seldom quite often very often always

Has your child been afraid of other never seldom quite often very often always
1.
girls and boys?

Have other girls and boys made fun of never seldom quite often very often always
2.
your child?

Have other girls and boys bullied your never seldom quite often very often always
3.
child?

© The KIDSCREEN Group, 2004; EC Grant Number: QLG-CT-2000- 00751

KIDSCREEN-52, Parent Version
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