The wording of a question and its answer choices must fit together. “How satisfied are you with our communication?” needs a satisfaction scale (Very satisfied to Very dissatisfied). A statement such as “Our communication keeps me informed” needs an agreement scale (Strongly agree to Strongly disagree). When they don’t match, families have to translate the question in their heads, and their answers become less reliable.

Use balanced scales: five choices with the same number of positive and negative options and a neutral midpoint. Add “Not applicable” when some families can’t answer, such as a question about before-care for families who don’t use it.