Does my child have a sleeping disorder?

The following questionnaire is based on 21 questions which will be analysed by a qualified Child Psychotherapist. The evaluation will include the severity of any difficulty, if any, and advice on how to proceed with regard to your child's sleeping routine.


1. Age of child









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2. How long has sleep been an issue for this child?






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3. How frequently is getting your child to sleep a problem?




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4. Have there been any family changes, bereavements, traumas in the past year?



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5. Where does your child most regularly sleep?






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6. Would you describe your main sleep difficulty as:





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7. What time do you start the bedtime routine?






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8. What time does your child usually fall asleep?







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9. How long does the normal bedtime routine take (The average time between first getting the child in to bed and when the child finally falls asleep)







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10. How many hours of crying, tantrums or general distress does bedtime regularly include?







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11. How would you rate the frustration levels of the parents during bedtimes on a scale of 1-10?



12. How long does your child sleep during the first period of sleep (from first falling asleep until the first time they wake up in the night?







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13. How many hours does your child regularly get in total during the night?





9-11 hours

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14. Does your child regularly (once a week or more) have any kind of nightmares?



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15. Does your child have any other sleep disturbance such as:





16. Does your child have a nap during the day and if so for how long?








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17. How would you describe your child during the day?






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18. How badly is the parent's sleep being disturbed?





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19. How do you feel about your child's sleeping pattern (please tick all that apply)








20. What do you think underlies your child's difficulty (please tick all that apply)?








21. Please give a brief statement (up to 100 words) of any other information you feel is relevant to your child's sleep difficulties



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After submitting your Assessment you will be asked to make your payment of £50 to Ask A Child Therapist through Paypal.


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