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Caregiver Buren Scale Special Needs
Name of Child –                                                          Date-

Parent/Guardian-

Questions
Please, place a tick in the appropriate box.
No 1. Do you feel tired and worn out?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 2. Do you feel lonely and isolated because of your child’s problem?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 3. Do you think you have to shoulder too much responsibility for your child’s welfare?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 4. Do you sometimes feel as if you would like to run away from the entire
situation you find yourself in?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 5. Do you find yourself facing purely practical problems in the care of your
Child that you think is difficult to solve?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 6. Do you ever feel offended and angry with your child?
�Not at all1
�Seldom2
�Sometimes3
�Often4
Caregiver Burden Scale
Questions
Please, place a tick in the appropriate box.

No 7. Do you think your own health has suffered because you have been taking care of your
Child?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 8. Has your social life, eg with family and friends, been lessened?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 9. Does the physical environment make it troublesome for you taking care of your
child?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 10. Do you feel tied down by your childs problem?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 11. Do you feel embarrassed by your child’s behavior?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 12. Has your child’s problem prevented you from doing what you had
Planned to do in this phase of your life?
�Not at all1
�Seldom2
�Sometimes3
�Often4
Caregiver Burden Scale
Questions
Please, place a tick in the appropriate box.
No 13. Do you find it physically tyring to take care of your child?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 14. Do you think you spend so much time with your child that the time for
yourself is insufficient?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 15. Do you worry about not taken care of your child in the proper way?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 16. Are you sometimes ashamed of your child’s behaviour?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 17. Is there anything in the neighborhood of your child’s home making it
troublesome for you to take care of your child?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 18. Have you experienced economic sacrifice because you have been taking care
of your child’s?
�Not at all1
�Seldom2
�Sometimes3
�Often4
Caregiver Burden Scale
Questions
Please, place a tick in the appropriate box.
No 19. Do you find it mentally tiring to take care of your child’s?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 20. Have you a feeling that life has treated you unfairly?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 21. Had you expected that life would be different than it is at your age?
�Not at all1
�Seldom2
�Sometimes3
�Often4

No 22. Do you avoid inviting friends and acquaintances home because of your
Child’s problem?
�Not at all1
�Seldom2
�Sometimes3
�Often4
Total Score-

Notes/Comments-
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________
______________________________________________________________________________




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Caregiver burden scale special needs

  • 1. Caregiver Buren Scale Special Needs Name of Child – Date- Parent/Guardian- Questions Please, place a tick in the appropriate box. No 1. Do you feel tired and worn out? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 2. Do you feel lonely and isolated because of your child’s problem? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 3. Do you think you have to shoulder too much responsibility for your child’s welfare? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 4. Do you sometimes feel as if you would like to run away from the entire situation you find yourself in? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 5. Do you find yourself facing purely practical problems in the care of your Child that you think is difficult to solve? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 6. Do you ever feel offended and angry with your child? �Not at all1 �Seldom2 �Sometimes3 �Often4
  • 2. Caregiver Burden Scale Questions Please, place a tick in the appropriate box. No 7. Do you think your own health has suffered because you have been taking care of your Child? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 8. Has your social life, eg with family and friends, been lessened? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 9. Does the physical environment make it troublesome for you taking care of your child? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 10. Do you feel tied down by your childs problem? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 11. Do you feel embarrassed by your child’s behavior? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 12. Has your child’s problem prevented you from doing what you had Planned to do in this phase of your life? �Not at all1 �Seldom2 �Sometimes3 �Often4
  • 3. Caregiver Burden Scale Questions Please, place a tick in the appropriate box. No 13. Do you find it physically tyring to take care of your child? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 14. Do you think you spend so much time with your child that the time for yourself is insufficient? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 15. Do you worry about not taken care of your child in the proper way? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 16. Are you sometimes ashamed of your child’s behaviour? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 17. Is there anything in the neighborhood of your child’s home making it troublesome for you to take care of your child? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 18. Have you experienced economic sacrifice because you have been taking care of your child’s? �Not at all1 �Seldom2 �Sometimes3 �Often4
  • 4. Caregiver Burden Scale Questions Please, place a tick in the appropriate box. No 19. Do you find it mentally tiring to take care of your child’s? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 20. Have you a feeling that life has treated you unfairly? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 21. Had you expected that life would be different than it is at your age? �Not at all1 �Seldom2 �Sometimes3 �Often4 No 22. Do you avoid inviting friends and acquaintances home because of your Child’s problem? �Not at all1 �Seldom2 �Sometimes3 �Often4 Total Score- Notes/Comments- ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ ______________________________________________________________________________ Signature of the person administrating