Grounded Learning for Life Parent Survey

First Name

Last Name

Email address

SECTION ONE: ATTACHMENT. Attachment describes the emotional relationship a child experiences with their parent(s)/caregiver(s)/ family of origin. It is the thing that helps a person feel grounded and safe. Persons with healthy relationships we would say have secure attachment. Conversely, in situations where relationships are a challenge, characteristics of insecure attachment might be prevalent.

I read the description for this section.

I am intentional about making my child feel loved and worthy.

I have people in my life that make me feel loved and worthy.

When I was a child, my parent(s) made me feel loved and worthy.

My children know that they can always depend on me.

I have a support systems and friends that I know I can depend on.

When I was a child, I was confident I could depend on my parent(s)/caregiver(s).

My children know that they can expect consistent (same over time) behavior and responses from me.

I have a support system and friends that I know are going to show up the same way consistently (same over time).

When I was a child, I knew I could expect consistent (same over time) behavior and responses from my parent(s) / caregiver(s).

My children know that I am predictable (behave a way that is expected).

I have a support system and friends that I know are predictable (behave a way that is expected).

When I was a child, I knew I my parents were predictable (behave a way that is expected).

I think my child feels like they live in an environment that is stable and secure.

I feel that I live in an environment that is stable and secure.

When I was a child, I felt that I lived in an environment that was stable and secure.

I create an environment for my children where they feel that they belong.

I live in an environment where I feel like I belong.

When I was a child, I felt that I lived in an environment where I belonged.

SECTION TWO: REGULATION. A state of cognitive development that allows you the ability to maintain control over your emotions and behaviors reflective of an internal alignment and attunement of psychological, physiological, and biological processes and functions.

I read the description for this section.

I help my children establish responsibility through the process of setting goals.

I establish responsibility for myself through the process of setting goals.

When I was a child, my parents helped me to be responsible through the process of setting goals.

I partner with my children in achieving their goals by helping to hold them accountable with encouraging and supportive reminders and incentives.

I have people in my support system that help hold me accountable by encouraging and supporting me with reminders and positive thoughts.

When I was a child, my parent(s)/caregiver(s), helped hold me accountable by encouraging and supporting me with reminders and positive thoughts.

I encourage my child to learn different strategies and techniques for monitoring their progress.

I possess different strategies and techniques for monitoring my progress.

When I was a child, my parent(s)/caregiver(s), helped me to learn different strategies and techniques for monitoring my progress.

My child and I have open and reflective communication that helps them with objective, non-judgmental self-assessment.

I have people in my support system with whom I can engage in open and reflective communication that helps me with objective, non-judgmental self-assessment.

When I was a child, my parent(s)/caregiver(s) and I engaged in open and reflective communication that helped me with objective, non-judgmental self-assessment.

When my child experiences things in the world and in school, I help them process by creating context and application in their own lives.

When I experience things in life and work, I process by pausing to understanding the context so that I can better apply it to my life.

When I was a child and I would experience things, my parent(s)/caregiver(s) helped me process by creating context and application into my own life.

In an effort to make connections necessary for grounded living, when I communicate with my child(ren) we are intentional about using patterns and associations to process experiences and extend understanding.

In an effort to make connections necessary for grounded living, when I communicate with friends, we are intentional about using patterns and associations to process experiences and extend our understanding.

In an effort to create a grounded living environment, when I was a child my parent(s)/caregiver(s) were intentional about using patterns and associations to process experiences and extend my understanding.

SECTION THREE: PERSONAL AGENCY. Personal agency is about exercising control over your life by acting upon your environment in a goal directed manner. Personal or human agency is something that is purposeful, constructive, and planned. Personal agency helps you to anticipate the effects of your actions, estimate your capabilities or ability to do a task in a given situation; it contributes to you positively being able to regulate your emotions and initiate effort, some may call it drive. When agency increases, so does achievement.

I read the description for this section.

I encourage my child or children to try new things.

I am intentional about trying new things.

As a child, I was encouraged to try new things.

My children are good about asking for my help.

I am good about asking others when I need help.

I felt comfortable asking my parent(s) for help when I was a child.

I encourage my children to work hard on their projects and interests and refuse to give up.

I work hard on my projects and interests and refuse to give up.

As a child, I was encouraged to work hard on my projects and interests and refuse to give up.

When my children are not successful at a task, I encourage them to keep going.

When I run into a difficult spot, I get up and keep moving.

When I was a child, my parent(s) encouraged me to never give up when I was having difficulty.

I know my child’s strengths and passions.

I know what I am passionate about and the things that I do well.

When I was a child, my parents celebrated my strengths and passions.

Cart

Grounded Learning for Life Parent Survey