AIA Student Resilience Survey 2019
Gender *
Year Level *
Self Confidence *
Never
Rarely
Sometimes
Often
Always
1. I have goals and plans for the future.
2. I plan to go to a university.
3. There are many things that I do well.
4. There is a purpose to my life.
Problem Solving Skills *
Never
Rarely
Sometimes
Often
Always
1. I know where to go for help with a problem.
2. I try to work out problems by talking or writing about them.
3. I can work out my problems.
4. I can do most things if I try.
5. I can work with someone who has different opinions than mine.
6. When I need help, I find someone to talk with.
Empathy *
Never
Rarely
Sometimes
Often
Always
1. I feel bad when someone gets their feelings hurt.
2. I try to understand what other people go through.
3. I enjoy working together with other students my age.
4. I stand up for myself without putting others down.
5. I try to understand how other people feel and think.
6. I understand my moods and feelings.
7. I understand why I do what I do.
I have a friend about my own age: *
Never
Rarely
Sometimes
Often
Always
1. who really cares about me.
2. who talks with me about my problems.
3. who helps me when I'm having a hard time.
My friends... *
Never
Rarely
Sometimes
Often
Always
1. get into a lot of trouble.
2. try to do what is right.
3. do well in school.
4. are people I can trust
How true are these statements about your HOME or the ADULTS WITH WHOM YOU LIVE? *
In my home, there is a parent or some other adult...
Never
Rarely
Sometimes
Often
Always
1.      who expects me to follow the rules.
2.      who is interested in my schoolwork.
3.      who believes that I will be a success.
4.      who talks with me about my problems.
5.      who always wants me to do my best.
6.      who listens to me when I have something to say.
At home... *
Never
Rarely
Sometimes
Often
Always
1. I do fun things or go fun places with my parents or other adults.
2. I do things that make a difference.
3. I help make decisions with my family.
Outside of my home and school, there is an adult... *
Never
Rarely
Sometimes
Often
Always
1. who really cares about me.
2. who tells me when I do a good job
3. who notices when I am upset about something.
4. who believes that I will be a success.
5. who always wants me to do my best.
6. whom I trust.
Outside of my home and school... *
Never
Rarely
Sometimes
Often
Always
1. I am part of clubs, sports teams, Mosque or other group activities.
2. I am involved in music, art, literature, sports or a hobby.
3. I help other people.
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