Ending Date for the activity/all the classes further explaination

______________

Please complete the behavioral scales again after the activity ends:

Daily Child Strength Scale to be done by your child — you may help them.

Past Week’s Quality of Family Life to be completed by parent

Pediatric Symptom Checklist to be completed by parent

Please rate the following areas using a scale of 0-10 with 10 being the highest rating and 0 being no change. These ratings will help you think about the experiences.

Since doing this activity, what has improved for the child and family?

Self satisfaction in child _________

Self-satisfaction in parent________

Family satisfaction______________

General sense of pleasure and feeling good in child_____

General sense of pleasure and feeling good in parent _____

General Sense of pleasure and feeling good in family _______

Improvements in child’s behavior, sadness, depression? _______

Any school improvements for the child? ____________

Child’s friendships?

Camera and Story_____________ further explaination

Storybook is for your child as part of a memory book, scrapbook or portfolio. We would need a Xerox copy of the book for the benefactors.

Thank you note ______________ further explaination

Plans to continue the activity or another activity? further explaination