Assessment Form

Assessment Form

Full Name

Your Current Age

Sex, as identified by your family in childhood

Male

Female

Please consider “siblings” to include brothers, sisters, step-brothers, step-sisters or any others, even if now deceased, who shared your household during the majority of your childhood.

If you shared household with male sibling(s) / brother(s) – indicate their current age(s)

If you shared household with female sibling(s) / sister(s) – indicate their current age(s)

While taking this survey please think about your childhood experiences through your early teenage years.

If a question DOES NOT APPLY to you, please use Not Applicable.

1. During your childhood, you often took care of your less able siblings—either because you were asked to, or because you simply felt it was the right thing to do.

Yes

Not Applicable

2. You grew up with more than one sibling and had to interact daily with different personalities.

Yes

Not Applicable

3. For at least a few years during childhood, you felt physically less powerful than your sibling(s).

Yes

Not Applicable

4. You grew up without siblings and were the center of attention of your caregivers.

Yes

Not Applicable

5. During your childhood, there was a period of a few years when you often made decisions for your siblings in your parents’ absence.

Yes

Not Applicable

6. You grew up in a household with both older and younger siblings.

Yes

Not Applicable

7. You received consistent, unconditional love and attention.

Yes

Not Applicable

8. For several years in childhood (due to being an only child, a large age gap, your gender, or other family circumstances), you generally had your parents’ full attention and resources and rarely needed to share.

Yes

Not Applicable

9. You grew up with clear parental expectations to do well and excel—whether in academics, sports, or other areas.

Yes

Not Applicable

10. You almost never had things all to yourself — almost everything had to be shared or negotiated with other sibling(s).

Yes

Not Applicable

11. When you look back at your childhood, you feel the rules for you were generally less strict than for your siblings, giving you more freedom to push boundaries and test limits.

Yes

Not Applicable

12. You spent much of your childhood alone, relying on imagination and solving problems independently.

Yes

Not Applicable

13. You were expected to be a role model for your siblings and uphold high standards.

Yes

Not Applicable

14. While growing up, you often felt like just ‘one of the kids,’ without a distinct role or special place in the family. You sometimes felt ‘squeezed’ between your siblings and believed you didn’t receive your fair share of your caregivers’/parents’ attention.

Yes

Not Applicable

15. Compared to your siblings, your parents expected less from you. Whether they were more relaxed by the time you came along or just didn’t push as hard, the pressure to perform or excel was less.

Yes

Not Applicable

16. You often felt highly empowered—almost omnipotent—encouraged to believe you could do anything. Yet, at other times, you felt completely helpless and dependent on your caregivers as your sole source of guidance and answers.

Yes

Not Applicable

17. You were often expected by your parents or caregivers to enforce family rules and maintain order among your siblings.

Yes

Not Applicable

18. You grew up focusing on just getting things done – not seeking perfection or recognition – because of lower expectations from your caregivers.

Yes

Not Applicable

19. You learned by observing and interacting with siblings.

Yes

Not Applicable

20. You grew up holding high standards for yourself—reinforced by both your caregivers’ expectations and your own inner drive.

Yes

Not Applicable

21. You grew up with siblings that had differing opinions, needs, and personalities; you felt like you needed to navigate disagreements, smooth tensions, and help to restore balance.

Yes

Not Applicable

22. You never had siblings to share responsibility with—or to shift the blame to—so you were forced to take full responsibility for outcomes.

Yes

Not Applicable

23. Growing up, there were moments when older or more physically dominant siblings did not always respect your personal space or privacy, sometimes in playful ways and sometimes by crossing boundaries.

Yes

Not Applicable

24. Growing up, you were often praised for being cute, funny, or entertaining.

Yes

Not Applicable

Start Survey

Please consider “siblings” to include brothers, sisters, step-brothers, step-sisters or any others, even if now deceased, who shared your household during the majority of your childhood.

While taking this survey please think about your childhood experiences through your early teenage years.

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