Language Development Therapy Program Evaluation Survey Form
Share your experience to help us evaluate and improve the program.
What is your role?
*
Participant
Parent/caregiver
Other
How long have you participated in the program?
*
Less than 1 month
1–3 months
4–6 months
7–12 months
More than 1 year
How would you rate the program overall?
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1
2
3
4
5
How much progress have you noticed toward language development goals?
*
No progress
A little progress
Some progress
A lot of progress
A great deal of progress
How effective is communication from program staff?
*
Very ineffective
Somewhat ineffective
Neither effective nor ineffective
Somewhat effective
Very effective
How suitable is the frequency of sessions?
*
Much too infrequent
Somewhat too infrequent
About right
Somewhat too frequent
Much too frequent
How helpful is the support provided by the therapist?
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Not at all helpful
Slightly helpful
Moderately helpful
Very helpful
Extremely helpful
How useful are the program activities and materials?
*
Not at all useful
Slightly useful
Moderately useful
Very useful
Extremely useful
What aspect of the program has been most helpful?
What changes or improvements would you suggest?
Submit evaluation
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