Speech and Language Outpatient Clinic - Parent Questionnaire

Click Here to Start Questionnaire

It is helpful for the therapist who will see your child to have some background information before your appointment. The link above will take you to a secure website where you can provide different types of information about your child before his or her appointment. You will be asked to provide background information about your child and provide ratings of his or her learning and behavior. We appreciate your willingness to take time out of your busy schedule to provide us with this information. Getting this type of information in advance will help us prepare to get the most out of your child’s speech and language appointment.

The questionnaire takes most people over an hour to complete. You may want to plan time to complete it during a quiet period of the day. It is okay if you do not finish it all at one time. You do not have to finish the whole questionnaire at one time. You can continue the questionnaire at any time as long as you are on the same computer and internet browser (e.g., Internet Explorer, Firefox, Google Chrome, etc.) on which you started the survey.

We use Qualtrics.com, a secure website, to collect information about our patients. By clicking the link below, you will be taken to our parent questionnaire on the Qualtrics website. If you have questions about this process, please see the Frequently Asked Questions below and/or feel free to contact Ms. Roberta Mason at 443-923-3223 or Mason@KennedyKrieger.org.

Frequently Asked Questions:

Why can’t I go back to previous screens as I’m taking the questionnaire?

For data security purposes, you are not allowed to return to previously completed screens of this online questionnaire. This prevents anyone from "backing up" and looking at your responses if you step away from the computer while completing the questions.

What other steps have been taken to ensure the safety and security of my responses?

Computerized security measures are used to protect privacy and reduce the risk of a breach of confidentiality. Many of these measures are described at the Qualtrics website: www.qualtrics.com/security-statement. To prevent someone from viewing your responses when they are transferred to us over the Internet, they are instantly encrypted with technology equivalent to the industry standard for securely transmitting credit card information. While it is HIGHLY unlikely that encrypted responses would be intercepted by someone on the Internet, responses would still be in a form that could not be read without a unique encryption key that is held only by the database provider, i.e., Qualtrics.

About Our Program:

Through Kennedy Krieger's Speech-Language Department, speech and language pathologists (SLPs) offer assessments and treatment to children in the toddler through adolescent age range. Children seen at the clinic receive complete, in-depth speech language evaluations from a SLP, accompanied by a hearing screening offered by an audiologist. Depending on the outcome of the evaluation, SLPs may request that the children receive referrals to health professionals in such areas as medicine, mental health, cognition, education, behavior management, motor or sensory areas. Alternatively, SLPs may function as part of an interdisciplinary team, coordinating findings and recommendations with other professionals. The clinic also offers treatment focused on helping children and their parents learn strategies for improving functional communication and oral motor or feeding/swallowing skills. Treatment sessions may be offered jointly with other departments, as appropriate.

Primary Program Goals:

• To provide thorough speech and language evaluations to children ranging in age from toddlers to adolescents
• To make referrals for children to utilize services of other health professional services as needed
• To provide treatment to help children and their parents learn strategies for improving functional communication and oral motor or feeding/swallowing skills