Tourette Syndrome Association Education Program Evaluation
“
Form Approved
OMB No. 0920-XXXX
Exp. Date XX/XX/20XX
Speaker
Date
Location
Learning Objectives. Participants will be able:
List the criteria for the diagnosis of Tourette Syndrome
Identify the most common disorders associated with TS
Assess the impact of these disorders on classroom performance
Identify specific classroom strategies and techniques for working with children who have TS.
1. Please indicate your PROFESSION: Teacher____ TA/Aide____ SPED Teacher ____ School Nurse____
School Psychologist____ Guidance Counselor____ Social Worker____ O.T.____ SLP____
SPED Director/Administrator_____ Principal/Superintendent____ Other________________(Please Specify)
2. Do you have experience working with clients/students who have TS or tic disorders? Yes___ No___
3. Please rate your knowledge before and after participating in this program
Knowledge BEFORE program None Some A lot |
Self-rating of your knowledge related to: |
Knowledge AFTER program None Some A lot |
||||
1 |
2 |
3 |
Recognition of TS symptoms |
1 |
2 |
3 |
1 |
2 |
3 |
Recognition of symptoms of co-occurring conditions |
1 |
2 |
3 |
1 |
2 |
3 |
Impact of symptoms on classroom performance |
1 |
2 |
3 |
1 |
2 |
3 |
Strategies for working with students with TS |
1 |
2 |
3 |
1 |
2 |
3 |
Communicating with students and families |
1 |
2 |
3 |
4. How much of this content was new to you? Almost all____ 75%____ 50%____ 25%____ Almost None____
Please rate the following statements using a 1-4 scale, where 1 indicates strongly disagree and 4 indicates strongly agree
|
Strongly disagree |
Disagree |
Agree |
Strongly agree |
N/A |
5. My skills in working with students who have TS will be improved as a result of this program |
1 |
2 |
3 |
4 |
|
6. I can assess the impact of these disorders on classroom performance |
1 |
2 |
3 |
4 |
|
7. I can identify specific classroom strategies and techniques for working with students who have TS |
1 |
2 |
3 |
4 |
|
8. If given an opportunity, I can apply the knowledge gained as a result of this program |
1 |
2 |
3 |
4 |
|
9. I intend to use my knowledge to identify students with TS in my school |
1 |
2 |
3 |
4 |
|
10. I intend to implement educational supports and adaptations for children with TS, where appropriate |
1 |
2 |
3 |
4 |
|
11. The presenter communicated the content effectively |
1 |
2 |
3 |
4 |
|
Please describe any changes to your skills, strategy and/or practice:
Suggestions to improve this program: ________________________________________________________________________________
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File Type | application/msword |
File Title | Tourette Syndrome Association Education Program Evaluation |
Author | Patricia Finnerty |
Last Modified By | bhv6 |
File Modified | 2011-04-13 |
File Created | 2011-04-12 |