Screen Time Guidance Survey

Please register with fulEDU here before you fill out this form.
For open-ended questions, please begin your response with “A:” or “Answer:” for clarity.

fulEDU Username

Section 1: Daily Screen Habits

On a typical school day, how many hours does your child spend on:

TV/YouTube videos: ___ hrs
Instagram short/TikTok/YouTube short videos: ___ hrs
Gaming (console/PC/mobile): open response, e.g., taming.io on computer for 1 hour, other games on iPad for 0.5 hour.
Social media (Instagram, Snapchat, Discord): ___ hrs

Copy the weekend screen time items and fill out hours below.

On a weekend day, how many hours does your child spend on:

TV/YouTube videos: ___ hrs
Instagram short/TikTok/YouTube short videos: ___ hrs
Gaming (console/PC/mobile): e.g., taming.io on computer for 1 hour, other games on iPad for 0.5 hour.
Social media (Instagram, Snapchat, Discord): ___ hrs

Copy the weekend screen time items and fill out hours below.

What are your child’s top 3 favorite games? (e.g., taming.io on laptop; minecraft on X-box console/TV screen, brawl stars on smartphone or iPad)

What are your child’s top 5 (or more) favorite YouTube or TikTok channels/accounts/topics?

Besides screen activities, what are your child’s top 5 activities to do?

Section 2: Problem Behaviors

How often does your child do the following?
(For example: 1–2 times a week, once a week, once a month, or once every 3 months or longer.)

Play or watch for 1+ hours without breaks
Play or watch for 2+ hours without breaks
Hide screen use or sneak a device at night
Become irritable, angry, or withdrawn when asked to stop
Use screens past midnight on school nights

Copy the screen time habits above and add the corresponding frequency after each one, e.g., Use screens past midnight on school nights – twice a month.

Select the problems you have observed in your child (check all that apply):

Sleep disruption

Declining school focus/grades

Eye strain/headaches

Social withdrawal (less interest in offline friends/activities)

Mood issues (increased anxiety, sadness, irritability)

Section 3: Family Rules & Supports

What strategies have you tried to reduce screen time? (Examples: parental control apps, screen-free family activities, rewards for reduced usage, peer/community challenges, or any other approaches)

Do you have limits for gaming hours per day?

Yes

Do you have limits for phone use at night?

Yes

Do you have limits for no-screen times (meals, bedtime, homework)?

Yes

What is your biggest worry or concern about your child’s screen use?

(Optional) Please provide your comments or suggestions so we can improve.

Screen Time Control & Balance

Screen Time Guidance Survey