Teacher Background and Classroom Data

OMB Clearance Package for Study 2.1c

Teacher Background & Classroom Level Data

What is your most advanced degree?

 BA/BS  MA/MS  Education Specialist  PhD/EdD  Other ___________

What type of teaching certificate do you have in the state where you currently teach1? (select one)
	Regular or standard state certificate or advanced professional certificate
	Probationary certificate (the initial certificate issues after satisfying all requirements except the completion of a probationary period)
	Provisional or other type of certificate given to persons who are still participating in what the state calls an “alternative certification program”
	Temporary certificate (requires some additional college coursework and/or student teaching before regular certification can be obtained)
	Emergency certificate or waiver (issued to persons with insufficient teacher preparation who must complete a regular certification program in order to continue teaching
	No certificate

Did you have coursework specific to teaching English language learners (ELLs) or English as a Second Language (ESL) methodology in your teacher preparation program (pre-service)?

 Yes _____ hours  No

Do you have certification in ESL?

 Yes  No

What staff development (not including college/university teacher preparation classes) directly related to teaching ELLs have you had in the past five years? (for each staff development opportunity, please specify the name of the program, the number of hours you spent in the program, and the year in which you were enrolled in this staff development opportunity)

Program Name	Number of hours in program	Year of enrollment

During the current school year, how many times did you use each of the following resources to obtain information about improving the academic performance of English Language Learners or English as a Second Language students?²

	Never	1-2 times	3-4 times	5+ times
Online web sites or databases to find lesson plans, curricular materials, or instructional strategies
Online web sites or databases to find research reports or articles
Professional journals
In-service classes and workshops
Local resources including libraries or local cultural centers
Consultation with local experts
Consultation with other teachers in your school

How would you characterize your knowledge of Spanish (level/proficiency?)

 None  Minimal  Intermediate  Advanced/Fluent

What practices do you normally utilize in your classroom teaching? (check all that apply):
	Cooperative learning
	Thematic units integrating subject areas across curriculum
	Learning styles research applied to bilingual students
	Whole language approaches combined with balanced literacy instruction
	Activating background knowledge (multicultural literature, authentic assessment, community connections)
	Other (explain):
	Other (explain):
	Other (explain):

The U.S. Department of Education wants to protect the privacy of individuals who participate in surveys.  Your answers will be combined with other surveys, and no one will know how you answered the questions.  This survey is authorized by law (1) Sections 171(b) and 173 of the Education Sciences Reform Act of 2002, Pub. L. 107-279 (2002); and (2) Section 9601 of the Elementary and Secondary Education Act (ESEA), as amended by the No Child Left Behind (NCLB) Act of 2001 (Pub. L. 107-110). Responses to this data collection will be used only for statistical purposes.  The reports prepared for this study will summarize findings across the sample and will not associate responses with a specific district or individual.  We will not provide information that identifies you or your district to anyone outside the study team, except as required by law. 

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is xxxx-xxxx. The time required to complete this information collection is estimated to average 5 minutes per respondent, including the time to review instructions, gather the data needed, and complete and review the information collected. If you have any comments concerning the accuracy of the time estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, DC 20202. If you have comments or concerns regarding the status of your individual submission of this form, write directly to: U.S. Department of Education, Institute of Education Sciences, 555 New Jersey Avenue, NW, Washington, DC 20208.

1 Adapted from NCES, NAEP (2004)

2 Adopted from NCES, NAEP (2004)

A Study of the Differential Effects of ELL Training and Materials

Exhibit B: Data Collection Instruments