Questionnaire

To help us assess the particular needs of your school, we have developed this short questionnaire.  Check off the answer that best represents your situation.  After completing the quiz we will get back to you with the analysis.

Name:

School:

Phone:

Grade Level:

Email:

1. We have an all-school discipline cycle that is printed in our handbook. This cycle outlines the steps that will be taken as we work with children whose behavior is dangerous, abusive or out-of-control.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

2. In practice, the all school discipline cycle works the way we have it in print.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

3. The all-school rules remain the same each year.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

4. I have a clear understanding regarding the appropriate use of office referrals.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

5. The classroom rules are the same from one room to the next.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

6. I teach students about the rules and give them a chance to help develop procedures for following the rules.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

7. I have a classroom discipline cycle that outlines how I plan to work with the children when rules are not followed.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

8. My classroom discipline cycle is written and posted in the room as well as given to parents.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

9. The Administrator has a copy of my discipline cycle on file in the office.

   1.) Not at all 2.) Somewhat 3.) Definitely

    

10. I teach children the difference between discipline and self-discipline.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

11. I teach children how to be self-disciplined.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

12. Our common areas are safe, respectful and orderly.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

13. Our parents are aware of our discipline policies and procedures.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

14. There is good parental support for our discipline policies and practices.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

15. Teachers in the primary, intermediate and upper grades would agree on the disciplinary needs of the students in school.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

16. I teach my students the four skills of discipline. Listening, Following Instructions, Understanding the Rules and Resolving Problems.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

17. I know fifteen self-discipline skills a person who is self-directed can do.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

18. I teach self-discipline just like I teach every other subject.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

19. I pre-teach students expected behavioral outcomes before I do activities.

    1.) Not at all 2.) Somewhat 3.) Definitely

     

20. I have visual posters of what it means to be self-disciplined displayed throughout my classroom.

    1.) Not at all 2.) Somewhat 3.) Definitely

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