Appendix 2
Pre- and Post-training Personnel Survey
Name: _______________________________ Date:
______________________________
Position: _____________________________ Department:
_____________________
Years in position: _____________
Directions: Please use the 5-point rating scales to indicate your responses to the following questions.
1 2 3 4 5
Not at all true Extremely true
1. Understanding the unique challenges of children with ASD and their families can help me do my job effectively.
2. I feel that my department is “Autism Friendly.”
3. It is important that Boston Children’s Hospital be an Autism Friendly Hospital.
4. I have a general understanding about the symptoms of Autism Spectrum Disorder:
5. I am knowledgeable about resources at Boston Children’s Hospital to prepare patients with ASD for visits
6. I am knowledgeable about strategies to help prevent behavioral incidents in patients with ASD during visits
7. I am knowledgeable about Boston Children’s Hospital resources for responding to behavioral incidents
8. Overall, I feel confident working with children with ASD and their families in my role at Boston Children’s Hospital
9. Overall, I feel confident managing challenging behaviors of children with ASD during visits (e.g., aggression, bolting, noncompliance)?
Rate your level of agreement with the following statements:
1 2 3 4 5
Not at all true
Extremely true In the past four weeks, I have:
10.Interacted with a patient with ASD as part of my job.
11.Helped a patient with ASD adjust to the hospital setting
12.Collaborated with the caregivers of a patient with ASD to make the child more comfortable
13.Shared my knowledge around how to care for patients with ASD with colleagues.
12. You are about to take vitals on patient with ASD when the patient becomes agitated and anxious. Possible strategies you may initially use include (select all that apply):
A. Get more people in the room to help you
B. Explain what you plan to do in advance and as you do it C. Ignore the behavior by walking away
D. Let the patient see and touch the instruments and materials that will be used
E. Ask the child’s parents to leave
13. Strategies for communicating with a child with ASD are (select all that apply):
A. Use multistep questions to avoid too many conversational turns B. Point to pictures or visuals to convey a message
C. Use an animated, enthusiastic voice
D. Stick to questions that require only a “yes” or “no” answer
E. Encourage response by trying to catch the child’s gaze and look directly in their eyes
14. Families of a child with ASD may experience stress in medical settings. Which of the following is LEAST likely to cause stress for families?
A. They may have previous negative experiences with receiving medical care B. Children with ASD often have difficulty with changes in routine
C. Children with ASD are often unfamiliar with the hospital environment because they have few medical needs
D. Parents may feel stigmatized by their child's behaviors E. The hospital is a highly stimulating environment