Digital Behavior Assessment in Children
SUNY Plattsburgh's Shine On program is studying the relationship between phone/social media usage and the mental health of North Country children. Answers are completely confidential and will only be used in aggregate for research purposes. 

You are welcome to submit responses through this form multiple times for multiple children who reside in your household. Thank you for your participation!


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What is your household income?
First guardian/parent highest education completed
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Second guardian/parent highest education completed
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Child's grade
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Child's gender
Does your child own a phone? 
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If yes, at what age did they receive their first phone? 
If different from the above, at what age did they receive their first internet-connected phone?
If no, when do you plan on allowing your child to have their own phone? 
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Does your child currently have access to social media? 
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If your uses social media, which applications do they use at least once per week? 
Do you monitor your child's phone activity? 
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Has your child ever received a mental health diagnosis from a physician or psychiatrist? 
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Does your child take any medications for their mental health? 
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Use the below scale to indicate your perceptions about the safety of social media.
1 = Very Safe
10 = Very Dangerous
Very Safe
Very Dangerous
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Does your child bring their phone to school?
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If yes, why?
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On average, how many hours do you think your child spends on social media per day? 
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Would you be in support of a phone-free environment in K-12 schools? 
Absolutely NOT in favor of banning phone in schools
Absolutely IN FAVOR of banning phone in schools
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Why do you feel this way?
We appreciate your candor. If you have any follow up questions, concerns, or would like to know more about our research, visit www.shineongirl.org. You can also use this link for information about our upcoming SHINE ON Unplugged & Engaged evening for families.
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