Assess the extent and nature of teasing in your classroom or school by gathering information.  This assessment can be an oral survey or a written questionnaire. Most of my assessments in small groups and in classrooms in the elementary school are oral. I believe, however, that a written questionnaire is more appropriate for middle school, junior high, and high school students, who generally are uncomfortable or embarrassed to share teasing experiences with their peers.

This questionnaire will provide you with valuable information, and will increase the student awareness of teasing.  The choices in question #3 should be adapted or modified according to the age of your students. Explain that you will not share their specific information with anyone without their permission. However, you will share general results with the class. 

WHAT IS TEASING?

1. What is teasing? __________________________________________________________
__________________________________________________________
__________________________________________________________

2. Have you ever been teased, made fun of, or insulted?
Please circle your answer.
     Yes       No

3. What have you been teased about?
Please circle all that apply.
what you do
what you think
what you believe
what you have
what you don't have
what you wear
what you like
what you don't like
what you say
what you eat
how you eat
how you act
how you look
how you feel
how you perform in school
how you draw
how you sing
how you play
how you kick a ball
how you throw a ball
how you catch a ball
how you jump rope
how you talk
how you walk
how you run
how you learn
if you are overweight
if you are underweight
if you are tall
if you are short
if your teeth are not straight
if you wear braces
if you wear glasses
if you wear hearing aids
if you take medication
if you have allergies
if you have a scar
if you are the oldest in class
if you are the youngest in the class
if you are smart
if you are not smart
if you read a lot of books
if you don't know how to read
if your parents are divorced
if a family member has died
if you have a single parent
your hair
your toys
your clothes
your name
your habits
your mother
your father
your sisters
your brothers
your friends
your opinions
your culture
your race
your religion
your gender
a learning disability
a physical disability
any difference
other______________________________________________

4.  How often are you teased? Please circle your answer.
 ·      Every day
·      Several times a day
·      Several times a week
·      Maybe once a week
·      Rarely
 
 5. Where does the teasing take place?
Circle the place or places where you have been teased.
In the classroom
·      In gym class
·      The locker area
·      At lunch
·      On the playground
·      On the school bus
·      On the way to school
 On the way home from school
·      In the neighborhood
·      In the bathroom
·      On the telephone
·      E-mail
·      Other places____________________
            ___________________________


6. What age is the teaser? Circle your answer.
 ·     Your age
·      Older than you
·      Younger than you
 
7. Do you consider the teaser to be your friend?
Circle your answer.
 ·     Yes
·      No
·      Sometimes
·      I don’t know.
 
8.Does the person who teases you tease other kids?
Circle your answer. 
·      Yes
·      No
·      I don’t know.
 
 9.  How do you feel when you are teased, put-down, or insulted?
Circle all the feelings that you experience in teasing situations.
·      Upset  
·      Sad
·      Angry
·      Frustrated
·      Helpless
·      Embarrassed
·     Scared
·      Guilty
·      Hurt
·      Afraid
·      Stressed
·      Excluded
·      It does not bother me.

10. What do you say or do when you are teased?
Circle the way or ways you react to teasing.
      Yell or scream at the teaser
     Hit the teaser
     Tease the teaser
     Argue with the teaser
      Cry
      Ignore the teaser
    Tell an adult
      Other responses or reactions:_________________________
___________________________________________________
___________________________________________________

EASING THE TEASING® copyright 2001-04 by Judy Freedman. All rights reserved.