| Question | Answers | Source | Source Link | Dates Used | |
|---|---|---|---|---|---|
| 1 | There are often people coming and going in my house that my child(ren) did not expect to be there. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 2 | My family moves frequently. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 3 | My child(ren) changed pre-schools or child care centers/programs they attend frequently, or changed mid-year. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 4 | I and my child(ren) live in a clean house. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 5 | I and my child(ren) live in a cluttered house (e.g., piles of stuff everywhere). | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 6 | There was a period of time when I and my child(ren) did not feel safe in my home. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 7 | I or my partner were often late to pick my child(ren) up (e.g., from school, day care). | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 8 | My child(ren) usually knew when I and/or my partner were going to be home. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 9 | I or my partner have punishments towards my child(ren) that were unpredictable. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 | |
| 10 | I or my partner would plan something for the family, but then not follow through with the plan. | • Yes • No • N/A | NA | 06/02/2022-06/09/2022 |