RESILIENCE Questionnaire
This questionnaire was developed by the early childhood service providers, pediatricians, psychologists, and health advocates of Southern Kennebec Healthy Start, Augusta, Maine, in 2006, and updated in February 2013. For more information, visit: https://acestoohigh.com

Please select the most accurate answer for each statement:
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Email *
I believe that my mother loved me when I was little. *
1 point
I believe that my father loved me when I was little. *
1 point
When I was little, other people helped my mother and father take care of me and they seemed to love me. *
1 point
I’ve heard that when I was an infant someone in my family enjoyed playing with me, and I enjoyed it, too. *
1 point
When I was a child, there were relatives in my family who made me feel better if I was sad or worried. *
1 point
When I was a child, neighbors or my friends’ parents seemed to like me. *
1 point
When I was a child, teachers, coaches, youth leaders or ministers were there to help me. *
1 point
Someone in my family cared about how I was doing in school. *
1 point
My family, neighbors and friends talked often about making our lives better. *
1 point
We had rules in our house and were expected to keep them. *
1 point
When I felt really bad, I could almost always find someone I trusted to talk to. *
1 point
As a youth, people noticed that I was capable and could get things done. *
1 point
I was independent and a go-getter. *
1 point
I believed that life is what you make it. *
1 point
A copy of your responses will be emailed to the address you provided.
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