Appendix I - Links to Constructs

Appendix I Links to Constructs ECLSK-2011 Spring 5th Grade.xlsx

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011) Spring Fifth-Grade National Data Collection

Appendix I - Links to Constructs

OMB: 1850-0750

Document [xlsx]
Download: xlsx | pdf

Overview

Explanation
App A Spring 5th CQ.2
App B Spring 5th Hearing.2
App C Spring 5th PI.2
App D Spring 5th TQ.2
App E Spring 5th TQC-R.2
App E Spring 5th TQC-M.2
App E Spring 5th TQC-S.2
App F Spring 5th SpEd A.2
App F Spring 5th SpEd B.2
App G Spring 5th SAQ.2


Sheet 1: Explanation

This file contains a listing of every question asked of study children, parents, reading, math, and science teachers, special education teachers, and school administrators in the spring fifth-grade data collection round (with the exception of the direct assessment items). For each question, the question wording is provided, along with the item source, the construct the item measures, and the specific research question in Part C of this OMB package for which the item is intended to provide information.

Each worksheet in this file pertains to one instrument. The worksheet name notes the specific instrument, as well as the appendix within the OMB package in which the full instrument can be found. Below is a list of the worksheet name and a full description of the instrument to which the worksheet pertains.





Worksheet Name
Instrument
App A Spring 5th Child Quex
Spring Fifth-Grade Child Questionnaire, Appendix A
App B Spring 5th Hearing Eval
Spring Fifth-Grade Child Questions for Hearing Evaluations, Appendix B
App C Spring 5th Parent Interview
Spring Fifth-Grade Parent Interview, Appendix C
App D Spring 5th TQ
Spring Fiffth-Grade Teacher Questionnaire, Appendix D
App E Spring 5th Reading TQC
Spring Fifth-Grade Reading and Language Arts Teacher Questionanire, Appendix E
App E Spring 5th Math TQC
Spring Fifth-Grade Mathematics Teacher Questionnaire, Appendix E
App E Spring 5th Science TQC
Spring Fifth-Grade Science Teacher Questionnaire, Appendix E
App F Spring 5th SpEd A
Spring Fifth-Grade Special Education Teacher Questionnaire A, Appendix F
App F Spring 5th SpEd B
Spring Fifth-Grade Special Education Teacher Questionnaire B, Appendix F
App G Spring 5th School Adm
Spring Fifth-Grade School Administrator Questionnaire, Appendix G

Sheet 2: App A Spring 5th CQ.2

Spring Fifth-Grade Child Questionnaire, Appendix A
Section Item # Item Stem Source Construct Research Question
Introduction CLQ600 TURN LAPTOP AROUND AND ROTATE LAPTOP SCREEN TO FACE THE CHILD. PLUG HEADPHONES INTO THE COMPUTER. POSITION LAPTOP IN FRONT OF THE CHILD.
SAY: Now, you are going to use the computer to tell us about yourself. The computer will read some sentences while you listen on the headphones. [HOLD UP HEADPHONES.]
SAY: Then you will pick the answer that best describes you by touching your answer on the computer screen. [TOUCH THE MIDDLE OF THE COMPUTER SCREEN WITH ONE FINGER.]
SAY: If the volume is too loud or too soft, you can change it with these buttons. [POINT TO VOLUME BUTTONS ABOVE STICKER.]
SAY: Okay, go ahead and put these headphones on and adjust them so they fit. Then, you will get started.
ECLS-K:2011 4th Grade CQ (modified) Introduction NA
CLQ605 Hello.
In a minute, sentences will be read to you, along with a list of answers. For these questions, there are no right or wrong answers, and all your answers are private. No one will be told the answers that you pick.
To choose your answer, just touch it on the computer screen. You don't have to wait for the computer to finish reading all the answers before you choose your answer.
If you want to change your answer, touch the "ERASE" button and then touch the new answer you want to pick.
To go back and change an answer, touch the "BACK" button to move to earlier screens.
If there is a question you do not want to answer, touch the “NEXT” button to skip it.
ECLS-K:2011 4th Grade CQ (modified) Introduction NA
Feelings and attitudes about school CLQ620 Think about yourself and your experiences this school year. How often do the following things happen?

I try hard to do well in school.
Skinner, Ellen A., Kindermann, T. A., and Furrer, C. J. (In press). Behavior engagement C1
CLQ625 In class, I work as hard as I can.

Skinner, Ellen A., Kindermann, T. A., and Furrer, C. J. (In press). Behavior engagement C1

CLQ630 When I'm in class, I participate in class discussions.

Skinner, Ellen A., Kindermann, T. A., and Furrer, C. J. (In press). Behavior engagement C1
CLQ635 I pay attention in class.


Skinner, Ellen A., Kindermann, T. A., and Furrer, C. J. (In press). Behavior engagement C1
CLQ640 When I'm in class, I listen very carefully.

Skinner, Ellen A., Kindermann, T. A., and Furrer, C. J. (In press). Behavior engagement C1

CLQ645 This school year, how often did you…
Feel like you fit in at your school?

K:1998, grade 8 student questionnaire School Belonging C1

CLQ650 [This school year, how often do you…]
Feel close to classmates at your school?

K:1998, grade 8 student questionnaire School Belonging C1

CLQ655 [This school year, how often do you…]
Feel close to teachers in your school?

K:1998, grade 8 student questionnaire School Belonging C1

CLQ660 [This school year, how often do you…]
Enjoy being at your school?

K:1998, grade 8 student questionnaire School Belonging C1

CLQ665 [This school year, how often do you…]
Feel safe at your school?

K:1998, grade 8 student questionnaire School Belonging C1

CLQ670 How much does each of the following statements describe a person like you?
I finish whatever I begin.

Developed in collaboration with Angela Duckworth Grit C1

CLQ675 [How much does each of the following statements describe a person like you?]
I try very hard even after making mistakes.

Developed in collaboration with Angela Duckworth Grit C1

CLQ680 [How much does each of the following statements describe a person like you?]
I continue to work towards my goals, even when they take a long time to complete.
Developed in collaboration with Angela Duckworth Grit C1

CLQ685 [How much does each of the following statements describe a person like you?]
I keep working hard even when I feel like quitting.

Developed in collaboration with Angela Duckworth Grit C1

CLQ690 [How much does each of the following statements describe a person like you?]
I continue working on what I set out to do, even when it takes a long time to complete.

Developed in collaboration with Angela Duckworth Grit C1

CLQ695 [How much does each of the following statements describe a person like you?]
I keep trying to improve myself, even when it takes a long time to get there.

Developed in collaboration with Angela Duckworth Grit C1

CLQ700 How true is each of these things about you?
I worry about taking tests.


K:1998, grades 3, 5, 8 child questionnaire Worry/stress about school C1

CLQ705 [How true is each of these things about you?]
It's hard for me to finish my school work.

K:1998, grades 3, 5, 8 child questionnaire Worry/stress about school C1

CLQ710 [How true is each of these things about you?]
I feel ashamed when I make mistakes at school.

K:1998, grades 3, 5, 8 child questionnaire Worry/stress about school C1

CLQ715 [How true is each of these things about you?]
I worry about doing well in school.

K:1998, grades 3, 5, 8 child questionnaire Worry/stress about school C1

CLQ720 [How true is each of these things about you?]
I worry about finishing my work.
K:1998, grades 3, 5, 8 child questionnaire Worry/stress about school C1
Peer Relationships CLQ725 Think about yourself and your experiences this school year. How often do the following things
happen?
Kids in my class make me feel better if I'm having a bad day.

SECCYD (Vandell, using Ladd items) "Kids in My Class at School" Peer social support C2

CLQ730 I worry about what other kids think of me.

LaGreca and Stone (1993)
Social distress C2, C3
CLQ735 I feel lonely at school.

Parker, J. G. and Asher, S. R. (1993). Loneliness C2, C3
CLQ740 Kids in my class let me play with them.

SECCYD (Vandell, using Ladd items) "Kids in My Class at School" Peer social support C2

CLQ745 I worry that other kids don't like me.

LaGreca and Stone (1993)
Social distress C2, C3
CLQ750 I feel left out at school.

Parker, J. G. and Asher, S. R. (1993). Loneliness C2, C3
CLQ755 Kids in my class make me feel happy.

SECCYD (Vandell, using Ladd items) "Kids in My Class at School" Peer social support C2
CLQ760 Kids in my class would help me if I hurt myself at school.

SECCYD (Vandell, using Ladd items) "Kids in My Class at School" Peer social support C2

CLQ765 I'm afraid other kids will not like me.

LaGreca and Stone (1993)
Social distress C2, C3
CLQ770 Kids in my class tell me that I'm their friend.

SECCYD (Vandell, using Ladd items) "Kids in My Class at School" Peer social support C2
CLQ775 I feel alone at school.

Parker, J. G. and Asher, S. R. (1993). Loneliness C2, C3
CLQ780 Kids in my class would help me if other kids were being mean to me.

SECCYD (Vandell, using Ladd items) "Kids in My Class at School" Peer social support C2
CLQ785 Next, please think about experiences that you have had with other students.

During this school year, how often have other students teased you, made fun of you, or called you names?

Espelage and Holt (2001) (modified)

Also used in ECLS-K:2011 Spring 3rd grade CQ
Peer victimization C4
CLQ790 During this school year, how often have other students told lies or untrue stories about you?

Espelage and Holt (2001) (modified)

Also used in ECLS-K:2011 Spring 3rd grade CQ
Peer victimization C4
CLQ795 During this school year, how often have other students pushed, shoved, slapped, hit, or kicked you?

Espelage and Holt (2001) (modified)

Also used in ECLS-K:2011 Spring 3rd grade CQ
Peer victimization C4
CLQ800 During this school year, how often have other students left you out from playing with them on purpose?

Espelage and Holt (2001) (modified)

Also used in ECLS-K:2011 Spring 3rd grade CQ
Peer victimization C4
Media Usage CLQ805 How often do you send texts, messages, or emails using an app, cell phone, computer, iPad or tablet, or other electronic device?

Adapted from the PEW September Tracking Survey (2009) (modified) Media usage C5

CLQ810 How often do you play an online game against another online player using an app, cell phone, computer, iPad or tablet, or other electronic device?

Adapted from the PEW September Tracking Survey (2009) (modified) Media usage C5

CLQ815 How often do you use a social networking site like Facebook, Twitter, Instagram, or Vine using an app, cell phone, computer, iPad or tablet, or other electronic device?

Adapted from the PEW September Tracking Survey (2009) (modified) Media usage C5

CLQ820 Does your family have rules about who you can send texts, messages, or emails to?

ECLS Media usage C5

CLQ825 Does your family have rules about when you can send texts, messages, or emails?

ECLS Media usage C5
Parental monitoring CLQ830 How often do your parents/guardians…
Know what you do during your free time?
Self-Disclosure & Parental Monitoring/Knowledge Scale (Kerr and Statin, 2000) Parental monitoring C7

CLQ835 How often do your parents/guardians…
Know how much homework you have?

Self-Disclosure & Parental Monitoring/Knowledge Scale (Kerr and Statin, 2000) Parental monitoring C7

CLQ840 How often do your parents/guardians…
Know what your school grades are?

Self-Disclosure & Parental Monitoring/Knowledge Scale (Kerr and Statin, 2000) Parental monitoring C7
Life Satisfaction CLQ845 The next set of sentences are about how you feel about your life. Think about the sentence and decide how well it describes you. Does the sentence describe you "Not at all; A little bit; Somewhat; Quite a bit; or Very much"?

I am happy with the clothes, games, toys, and other things I have.
NIH Toolbox Supplemental Battery Domain-specific life satisfaction C6

CLQ850 I am happy with how much attention I get from my parents.
NIH Toolbox Supplemental Battery Domain-specific life satisfaction C6

CLQ855 I am happy with the neighborhood and community in which I live.
NIH Toolbox Supplemental Battery Domain-specific life satisfaction C6
CLQ860 Thank you for working with me. You are done answering questions on the computer. Please take off the headphones now. ECLS-K:2011 3rd Grade CQ (modified) Closing NA
CLQ865 TAKE THE HEADPHONES FROM THE CHILD. UNPLUG HEADPHONES FROM COMPUTER.
TAKE THE LAPTOP FROM THE CHILD AND PLACE THE LAPTOP DIRECTLY IN FRONT OF YOU.
SAY: Thank you. Now we are going to do something else.
TOUCH THE "NEXT" BUTTON TO CONTINUE.
ECLS-K:2011 3rd Grade CQ (modified) Closing NA

Sheet 3: App B Spring 5th Hearing.2

Spring Fifth-Grade Child Questions for Hearing Evaluations, Appendix B
Section Item # Item Stem Source Construct Research Question
Pre-Test Questionnaire PTQ001 Do you have a cold or a runny nose today? ECLS-K:2011 fall 2nd grade Child Health and Well-Being PQ1; PQ2

PTQ002 Did you have a cold or a runny nose yesterday? ECLS-K:2011 fall 2nd grade Child Health and Well-Being PQ1; PQ2

PTQ003 Have you had an earache today? ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

PTQ004 Did you have an earache yesterday? ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

PTQ005 Which ear(s) hurt? ECLS-K:2011 fall 2nd grade Child Health and Well-Being PQ1; PQ2

PTQ006 Have you listened to sounds today that were so loud you would have to shout so someone close by could hear you? ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

PTQ007 Did you listen to any sounds that were that loud yesterday? [Did you listen to any sounds yesterday that were so loud you would have to shout so someone close by could hear you?] ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

PTQ008 Do you have tubes in your ears now that a doctor put there [to keep you from getting earaches or ear infections]? ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

PTQ009 Do you have to wear earplugs when you swim or take a bath or shower? ECLS-K:2011 fall 2nd grade Child Health and Well-Being PQ1; PQ2

PTQ010 In which ear do you have the tube(s)? ECLS-K:2011 fall 2nd grade Child Health and Well-Being PQ1; PQ2

PTQ011 In which ear do you wear the earplug(s)? New Child Health and Well-Being PQ1; PQ2

PTQ012 Is it easier for you to hear out of one ear than the other? ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

PTQ013 Which ear is easier to hear with? ECLS-K:2011 fall 2nd grade - Revised Child Health and Well-Being PQ1; PQ2

Sheet 4: App C Spring 5th PI.2

Spring Fifth-Grade Parent Interview, Appendix C
Section Item # Item Stem Construct Research Question
Introduction INQ.005 {In the fall of 2010/In the spring of 2011/In the fall of 2011/In the spring of 2012/In the fall of 2012/In the spring of 2013/In the spring of 2014/In the spring of 2015}, we spoke with {NAME OF RESPONDENT} who took part in the Early Childhood Longitudinal Study, Kindergarten Class of 2010-2011 on {DATE OF LAST INTERVIEW}. Am I talking to the same person? Introduction NA

INQ.010 May I please speak with {NAME OF PREVIOUS ROUND RESPONDENT}? Introduction NA

INQ.015 Are you the parent or guardian in this household who knows the most about {CHILD}'s care, education, and health? Introduction NA

INQ.020 May I please speak with the parent or guardian in the household who knows the most about {CHILD}'s care, education, and health? Introduction NA

INQ.025 May I please speak with a household member who is 18 or older and knows about {CHILD}'s care, education, and health? Introduction NA

INQ.030 May I have your name please? Introduction NA

INQ.060 [May I have your name, please?] Introduction NA

INQ.070 [May I have your name, please?] Introduction NA

INQ.080/080b (As I mentioned earlier), you and {CHILD} were selected to take part in the Early Childhood Longitudinal Study Kindergarten Class of 2010-2011, which is sponsored by the U.S. Department of Education, National Center for Education Statistics. I have some questions for you that ask about {CHILD}’s school and home experiences. The information I collect in this interview will be extremely valuable in understanding the development of children and how their school experiences can be improved.

All responses that relate to or describe identifiable characteristics of individuals may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose, except as required by law.

This call will be recorded for quality control purposes.

Introduction NA

INQ.090/090b {In the fall of 2010/In the spring of 2011/In the fall of 2011/In the spring of 2012/In the fall of 2012/In the spring of 2013/In the spring of 2014/In the spring of 2015}, you took part in the Early Childhood Longitudinal Study Kindergarten Class of 2010-2011, which is sponsored by the U.S. Department of Education, National Center for Education Statistics. I have some questions for you that ask about {CHILD}’s school and home experiences since our last interview. The information I collect in this interview will be extremely valuable in understanding the development of young children and how their early school experiences can be improved.

All responses that relate to or describe identifiable characteristics of individuals may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose, except as required by law.

This call will be recorded for quality control purposes.


Introduction NA

INQ.130 Before we begin the interview, I would like to verify some information. I have recorded {CHILD's FIRST, MIDDLE, AND LAST NAME} as {CHILD}'s full name. Is this correct? Introduction NA

INQ180 I have recorded that {CHILD}'s home address is…Is this still correct? Introduction NA

INQ190 What is {CHILD}'s home address? Introduction NA

INQ.200 I have recorded that {PHONE NUMBER} is {CHILD}'s family's current home phone number. Is this correct? Introduction NA

INQ.205 {What is {CHILD}'s family's current home phone number?} Introduction NA

INQ.300 Next, I have a few questions about {CHILD}'s background. Was {CHILD} born in this country, that is, in any of the fifty states or the District of Columbia? Country of origin for sample child PQ1, PQ3

INQ.310/312OS In what country or territory was {CHILD} born? Country of origin for sample child PQ1, PQ3

INQ.320 In what year did {CHILD} come to the United States to stay? Length of residence in U.S. for sample child PQ1, PQ3

INQ.330 Is {CHILD} a U.S. citizen? Citizenship of child PQ1, PQ3
Parent Involvement with Child's School PIQ.060 Now, I'd like to ask you about {CHILD}'s school. Is {CHILD} attending {his/her} regularly assigned school or a school that you or someone else in your household chose? Parent's choice of school for child PQ5

PIQ.065 Does {CHILD} attend a school? School attendance by homeschooled child PQ5

PIQ.066 How many hours each week does {CHILD} usually go to a school for instruction? Please do not include time spent in extracurricular activities. School attendance by homeschooled child PQ5

PIQ.080 When {CHILD} was in kindergarten in the fall of 2010, was that {his/her} first, second, or third year of kindergarten? Whether child repeated kindergarten before fall 2010 C

PIQ.120 How far in school do you expect {CHILD} to go? Would you say you expect {him/her}…

To receive less than a high school diploma,
To graduate from high school,
To attend a vocational or technical school after high school,
To attend two or more years of college,
To finish a four- or five-year college degree,
To earn a master's degree or equivalent, or
To finish a Ph.D., MD, or other advanced degree?
Parent’s educational expectations for child PQ3, PQ5

PIQ.127 Since the beginning of this school year, how many times have any of {CHILD}’s teachers or {his/her} school contacted you or any adult in your household about any behavior problems {he/she} is having in school? School communication with parents PQ5

PIQ.128 [Since the beginning of this school year, how many times have any of {CHILD}’s teachers or {his/her} school contacted you or any adult in your household...] About any problems {he/she} is having with school work? School communication with parents PQ5

PIQ.129 [Since the beginning of this school year, how many times have any of {CHILD}’s teachers or {his/her} school contacted you or any adult in your household...] About anything {CHILD} is doing particularly well or better in school? School communication with parents PQ5

PIQ.130 Now I'd like to ask you about {CHILD}'s school.

Since the beginning of this school year, have you or the other adults in your household attended an open house or a back-to-school night?
Parent participation in school activities PQ5

PIQ.140 [Since the beginning of this school year, have you or the other adults in your household…] Attended a meeting of a PTA, PTO, or Parent-Teacher Organization? Parent participation in school activities PQ5

PIQ.150 [Since the beginning of this school year, have you or the other adults in your household…] Gone to a regularly-scheduled parent-teacher conference with {CHILD}'s teacher or meeting with {CHILD}'s teacher? Parent attendance at parent-teacher conferences and meetings PQ5

PIQ.160 [Since the beginning of this school year, have you or the other adults in your household…] Attended a school or class event, such as a play, sports event, or science fair? Parent participation in school activities PQ5

PIQ.170 [Since the beginning of this school year, have you or the other adults in your household…] Served as a volunteer in {CHILD}’s classroom or elsewhere in the school?
Parent participation in school activities PQ5

PIQ.185 During this school year, how many times have you or other adults in your household gone to meetings or participated in activities at {CHILD}'s school?
Parent participation in school activities PQ5

PIQ.190 For each of the following statements, please tell me how well {CHILD}'s school has done with each activity during this school year. The school lets you know between report cards how {CHILD} is doing in school. Would you say {CHILD}'s school…

Does this very well,
Just OK, or
Doesn't do this at all?
School communication with parents PQ5

PIQ.200 [For each of the following statements, please tell me how well {CHILD}'s school has done with each activity during this school year.] The school helps you understand what children at {CHILD}'s age are like. Would you say {CHILD}'s school…

Does this very well,
Just OK, or
Doesn't do this at all?
School communication with parents PQ5

PIQ.210 [For each of the following statements, please tell me how well {CHILD}'s school has done with each activity during this school year.] The school makes you aware of chances to volunteer at the school. Would you say {CHILD}'s school…

Does this very well,
Just OK, or
Doesn't do this at all?
School communication with parents PQ5

PIQ.220 [For each of the following statements, please tell me how well {CHILD}'s school has done with each activity during this school year.] The school provides workshops, materials, or advice about how to help {CHILD} learn at home. Would you say {CHILD}'s school…

Does this very well,
Just OK, or
Doesn't do this at all?
School communication with parents PQ5

PIQ.230 [For each of the following statements, please tell me how well {CHILD}'s school has done with each activity during this school year.] The school provides information on community services to help {CHILD} or your family. Would you say {CHILD}'s school…

Does this very well,
Just OK, or
Doesn't do this at all?
School communication with parents PQ5

PIQ.300 About how many parents of children in {CHILD}'s class do you talk with regularly, either in person, on the phone, or by texting, emailing, or using a social networking site? Parent networks PQ5

PIQ.410 This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school? Inconvenient meeting times?

Has that made it harder for you to participate in activities at {CHILD}'s school?
Barriers to parent participation in school activities PQ5

PIQ.420 [This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school?] No child care keeps your family from going to school meetings or events?

[Has that made it harder for you to participate in activities at {CHILD}'s school?]
Barriers to parent participation in school activities PQ5

PIQ.430 [This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school?] Family members can't get time off from work?

[Has that made it harder for you to participate in activities at {CHILD}'s school?]
Barriers to parent participation in school activities PQ5

PIQ.440 [This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school?] Problems with safety going to the school?

[Has that made it harder for you to participate in activities at {CHILD}'s school?]
Barriers to parent participation in school activities PQ5

PIQ.450 [This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school?] The school does not make your family feel welcome?

[Has that made it harder for you to participate in activities at {CHILD}'s school?]
Barriers to parent participation in school activities PQ5

PIQ.460 [This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school?] Problems with transportation to the school?

[Has that made it harder for you to participate in activities at {CHILD}'s school?]
Barriers to parent participation in school activities PQ5

PIQ.480 [This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s school?] You don't hear about things going on at school that you might want to be involved in?

[Has that made it harder for you to participate in activities at {CHILD}'s school?]
Barriers to parent participation in school activities PQ5

PIQ.490 Would you say that you are very satisfied, somewhat satisfied, somewhat dissatisfied, or very dissatisfied with the school {CHILD} attends this year? Parent's satisfaction with the teachers and school PQ5

PIQ.495 Do you {or your spouse/partner} use a computer or any other electronic device to communicate with or get information from {CHILD}'s school? Parent involvement online PQ5

PIQ.496a/b/c How often do you [or your spouse or partner] use a computer or any other electronic device in the following ways? Would you say never, less than once a year, once or twice a year, several times a year, at lease once a month, or weekly?

a. To communicate with {CHILD}'s teachers and administrative staff by email about {CHILD}, for example, about how {he/she} is performing, or about absences or tardiness?
b. To find out about homework and other school assignments and projects?
c. To find out about {CHILD}'s grades?
Parent involvement online PQ5

PIQ.510 How often does {CHILD} do homework at home? Would you say…
Never,
Less than once a week,
1 to 2 times a week,
3 to 4 times a week, or
5 or more times a week?
Frequency child does homework at home PQ4, PQ5

PIQ.520 During this school year, how often did you or someone else help {CHILD} with {CHILD}'s homework? Would you say…
Never,
Less than once a week,
1 to 2 times a week,
3 to 4 times a week, or
5 or more times a week?
Homework monitoring by parents PQ4, PQ5

PIQ.550 How often do you check that {CHILD} has completed all homework? Would you say never, rarely, sometimes, or always?
Homework monitoring by parents PQ4, PQ5

PIQ.560 Now I would like to ask you about {his/her} grades during this school year. Overall, across all subjects {he/she} takes at school, does {he/she} get...
Mostly A's,
Mostly B's,
Mostly C's,
Mostly D's and lower, or
Does {his/her} school not give those grades?
Grades received at school PQ1, PQ2

PIQ.570 Would you describe {CHILD}'s work at school as…
Excellent,
Above average,
Average,
Below average, or
Failing?
Grades received at school PQ1, PQ2

PIQ.585 How often would you say that {CHILD}...

a. Makes up reasons to stay home from school?
b. Seems to dread going to school?
c. Becomes upset when it's time to go to school in the morning?
d. Asks to stay home from school?
e. Complains about going to school?

Would you say almost never, rarely, sometimes, a lot, or almost always?
School avoidance PQ1, PQ2
Family Structure FSQ.010 Now I have a few questions about your household. We have listed that (READ NAMES FROM MATRIX) lived in this household at the time of our last interview.

As I read each person's name again, please tell me if he or she still lives in this household.

Does {NAME} still live in this household?
Household roster: current PQ1, PQ3

FSQ.015/015OS Why is {NAME} no longer living in this household? Household roster: former household member's status PQ1, PQ3

FSQ020 {Other than the people I just asked about, is there anyone else currently living in this household? For example, anyone who has moved in or any babies born since our last interview? Please tell me the names and ages of all the other people who normally live here. Please do not include anyone staying here temporarily who usually lives somewhere else.}

{Now I have a few questions about your household. We have noted that you and {CHILD} currently live in this household. First I’d like to ask you some questions about yourself, then I’d like you to please tell me the names and ages of all the other people who normally live here. Please do not include anyone staying here temporarily who usually lives somewhere else.}
Household roster: current PQ1, PQ3

FSQ.025 ENTER LAST NAME OF {NAME}. Household roster: current PQ1, PQ3

FSQ.030 How old {are you/is {NAME}}? Household roster: current PQ1, PQ3

FSQ.040 CODE IF OBVIOUS. OTHERWISE, ASK: {Are you/Is {NAME} male or female?} Household roster: current PQ1, PQ3

FSQ.045 CHECK HOUSEHOLD MATRIX. Household roster: current PQ1, PQ3

FSQ.060 Have we missed anyone who usually lives here who is temporarily away from home or living in a dorm at school, or any babies or small children? Household roster: current PQ1, PQ3

FSQ.110 Do you have a spouse or partner who lives in this household? Marital status of the primary caretakers PQ1, PQ3

FSQ.120 Who in the household is your spouse or partner? Marital status of the primary caretakers PQ1, PQ3

FSQ.121 During our last interview with this household (or family), it was reported that you were {the girlfriend or female partner of {CHILD}’s parent or guardian}/the boyfriend or male partner of {CHILD}’s parent or guardian/the female guardian of {CHILD}/the male guardian of {CHILD}/{CHILD}’s relative, but not a guardian/not related to {CHILD}/{CHILD}'s {RELATIONSHIP}}. Has there been a change in your relationship to {CHILD}? Change in family relationship of respondent to child PQ1, PQ3

FSQ.122 During our last interview with this household (or family), it was reported that {NAME OF SPOUSE/PARTNER} was {the girlfriend or female partner of {CHILD}’s parent or guardian/the boyfriend or male partner of {CHILD}’s parent or guardian/{CHILD}’s relative, but not a guardian/the female guardian of {CHILD}/the male guardian of {CHILD}/not related to {CHILD}/{CHILD}'s {RELATIONSHIP}}. Has there been a change in the relationship of {NAME OF SPOUSE/PARTNER} to {CHILD}? Change in family relationship of spouse/partner to child PQ1, PQ3

FSQ.130 What is {your/{NAME}'s} relationship to {CHILD}?
Relationship of household member to child PQ1, PQ3

FSQ.140 {Are you/Is {NAME}} {CHILD}'s…
Biological or birth mother,
Adoptive mother,
Step mother,
Foster mother or female guardian, or
Other female parent or guardian?
Relationship of household member to child PQ1, PQ3

FSQ.150 {Are you/Is {NAME}} {CHILD}'s…
Biological or birth father,
Adoptive father,
Step father,
Foster father or male guardian, or
Other male parent or guardian?
Relationship of household member to child PQ1, PQ3

FSQ.160 {Are you/Is {NAME}} {CHILD}'s…
Full sister,
Half sister,
Step sister,
Adoptive sister, or
Foster sister?
Relationship of household member to child PQ1, PQ3

FSQ.170 {Are you/Is {NAME}} {CHILD}'s…
Full brother,
Half brother,
Step brother,
Adoptive brother, or
Foster brother?
Relationship of household member to child PQ1, PQ3

FSQ.180/181 {Are you/Is {NAME}} {CHILD}'s…
CODE NON-RELATIVE RELATIONSHIP BELOW IF MORE DESCRIPTIVE.
Relationship of household member to child PQ1, PQ3

FSQ.190 {Are you/Is {NAME}} Hispanic or Latino? Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.195 What is {your/{NAME}'s} race? You may name one or more races to indicate what {you/NAME} {consider/considers} {yourself/himself/herself} to be. Race of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.196a Though we may have asked you about {CHILD}'s ethnicity and race in the past, I do have a few more questions I'd like to ask about that now. Is {CHILD} a member of a Spanish, Hispanic, or Latino group? Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.196b Which of the following Spanish, Hispanic, or Latino groups best describes {CHILD}'s origin? Is {he/she}…
Mexican, Mexican American or Chicano,
Puerto Rican,
Cuban, or
Other Spanish/Hispanic/Latino group?
Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.197a Is {CHILD} a member of an Asian group? Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.197b Which of the following Asian groups best describes {CHILD}'s origin? Is {he/she}…
Asian Indian,
Chinese,
Filipino,
Japanese,
Korean,
Vietnamese,
Hmong, or
Other Asian?
Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.198a Is {CHILD} a member of a Pacific Islander group? Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.198b Which of the following Pacific Islander groups best describes {CHILD}'s origin? Is {he/she}…
Native Hawaiian,
Guamanian or Chamarro,
Samoan, or
Other Pacific Islander?
Ethnicity of child, parent figures, respondent and respondent's spouse (if no mother or father figures) PQ1, PQ3

FSQ.200a {FILL 1} currently married, separated, divorced, widowed, in a domestic partnership, or {FILL 2} never been married {FILL 3}? Marital status of the primary caretakers PQ1, PQ3

FSQ.200b See matrix. Marital status of the primary caretakers NA
Primary Language(s) Spoken PLQ.020 Is any language other than English regularly spoken in your home? Languages spoken in the home PQ1, PQ3

PLQ.030 Is English also spoken in your home? Languages spoken in the home PQ1, PQ3

PLQ.040/040OS What languages other than English are spoken in your home? Languages spoken in the home PQ1, PQ3

PLQ.060/060OS What is the primary language spoken in your home? Languages spoken in the home PQ1, PQ3

PLQ.083 How often {do/does} {you/{NAME}} use {{NON-ENGLISH LANGUAGE}/a language other than English} in speaking to {CHILD}? Would you say never, sometimes, often, or very often? Non-English language use PQ1, PQ3

PLQ.090 How often does {CHILD} use {{NON-ENGLISH LANGUAGE}/a language other than English} in speaking to {you/{NAME}}? Would you say never, sometimes, often, or very often? Non-English language use PQ1, PQ3

PLQ.095 This year, has it been harder for you to participate in activities at {CHILD}'s school because you or members of your family speak a language other than English and meetings are conducted only in English? [Has that made it harder for you to participate in activities at {CHILD}'s school?]


Non-English language as a barrier to parent involvement with the school PQ3, PQ5
Home Environment, Activities, and Cognitive Stimulation HEQ.010 c/d/e/f Now I'd like to talk with you about {CHILD}'s activities with family members. In a typical week, how often do you or any other family members do the following things with {CHILD}?

c. Play games or do puzzles with {CHILD}?
d. Talk about nature or do science projects with {CHILD}?
e. Play a sport or exercise together?
f. Practice reading, writing or working with numbers?

Would you say not at all, once or twice a week, 3-6 times a week, or every day?
Frequency of home activities with child PQ4, PQ5

HEQ.040 About how many children's books does {CHILD} have in your home now, including library books? Please only include books that are for children. Literacy materials in the home PQ4

HEQ.105 In the past month, that is, since {MONTH} {DAY}, has anyone in your family done the following things with {CHILD}?

Visited a library or bookstore?
Literacy related outings PQ4

HEQ.130 [In the past month, that is, since {MONTH} {DAY}, has anyone in your family done the following things with {CHILD}?]

Gone to a play, concert, or other live show?
Outings PQ4

HEQ.140 [In the past month, that is, since {MONTH} {DAY}, has anyone in your family done the following things with {CHILD}?]

Visited an art gallery, museum, or historical site?
Outings PQ4

HEQ.150 [In the past month, that is, since {MONTH} {DAY}, has anyone in your family done the following things with {CHILD}?]

Visited a zoo, aquarium, or petting farm?
Outings PQ4

HEQ.180 [In the past month, that is, since {MONTH} {DAY}, has anyone in your family done the following things with {CHILD}?]

Attended an athletic or sporting event in which {CHILD} was not a player?
Outings PQ4

HEQ.210 In the past week, how often did {CHILD} read to {himself/herself} or to others outside of school? Would you say…
Never,
Once or twice a week,
3 to 6 times a week, or
Every day?
Frequency of reading activities with child PQ2, PQ4

HEQ.215 Generally, how many minutes did {CHILD} read at each of these times? Frequency of reading activities with child PQ2, PQ4

HEQ.225 In an average week, how often does {CHILD} use a home computer or other electronic device to play with programs that teach {him/her} something, like math or reading skills? Would you say…
Never,
Once or twice a week,
3 to 6 times a week, or
Every day?
Use of electronic/computer devices PQ4

HEQ.226 Do you monitor how many hours {CHILD} spends online? Parental monitoring child's use of electronic/computer devices PQ4

HEQ.227 Do you monitor what {CHILD} looks at online, or what websites and accounts {CHILD} can join online? Include everything the child may look at online, such as websites, email, videos, movies, television shows, online games, chat rooms, and picture or social media sites such as Instagram, Vine, Snapchat, YouTube, Twitter, and Facebook. Parental monitoring child's use of electronic/computer devices PQ4

HEQ.228 How many close friends does {CHILD} have? Child's friends PQ1, PQ2

HEQ.229 What kind of influence is {CHILD}'s {best} friend? Would you say always a good influence, usually a good influence, neither a good nor a bad influence, usually a bad influence, or always a bad influence? Child's friends PQ1, PQ2

HEQ.280 Is {CHILD} tutored on a regular basis, by someone other than you or a family member, in a specific subject, such as reading, math, science, or a foreign language? Tutoring PQ5

HEQ.290/290OS What is {CHILD} tutored in? Tutoring PQ5

HEQ300 Outside of school hours in the past year, has {CHILD} participated in: Academic activities, like science, computers, math lab, or taking a class to learn a language other than English? Child activities outside of school hours PQ4

HEQ.301 Did {he/she} specifically learn about math, science, or technology in any of those academic activities? Child activities outside of school hours: STEM related PQ4

HEQ305 As part of {CHILD}’s participation in that activity, did {he/she} ever take a field trip focused on science activities, for example to a science museum or center, a science lab, a planetarium, or a nature center? Child activities outside of school hours: science related field trips PQ4

HEQ310 Outside of school hours in the past year, has {CHILD} participated in organized athletic activities, like basketball, soccer, baseball, or gymnastics? Child activities outside of school hours PQ4

HEQ320 [Outside of school hours in the past year, has {CHILD} participated in:] Organized clubs or recreational programs, like scouts? Child activities outside of school hours PQ4

HEQ325 As part of {CHILD}’s participation in that program, did {he/she} ever take a field trip focused on science activities, for example to a science museum or center, a science lab, a planetarium, or a nature center? Child activities outside of school hours: science related field trips PQ4

HEQ330 Outside of school hours in the past year, has {CHILD} participated in music lessons, for example, piano, instrumental music, or singing lessons? Child activities outside of school hours PQ4

HEQ340 [Outside of school hours in the past year, has {CHILD} participated in:] Drama classes? Child activities outside of school hours PQ4

HEQ350 [Outside of school hours in the past year, has {CHILD} participated in:] Art classes or lessons, for example, painting, drawing, or sculpture? Child activities outside of school hours PQ4

HEQ370 [Outside of school hours in the past year, has {CHILD} participated in:] Organized performing arts programs, such as children's choirs, dance programs, or theater performances? Child activities outside of school hours PQ4

HEQ.391 [Outside of school hours in the past year, has {CHILD} participated in:] Religious activities or instruction? Child activities outside of school hours PQ4

HEQ.393 Did {CHILD}’s participation in {academic activities/organized athletic activities/ organized clubs or recreational programs/music lessons/drama classes /art classes or lessons/organized performing arts programs/ religious activities or instruction/any of these activities} help to cover the hours when you needed adult supervision for {him/her}?
Whether child activities serve as child care PQ6

HEQ.520 Now, I have a question about meals. In a typical week, please tell me the number of days your family eats the evening meal together. Frequency of family dinner together PQ4

HEQ.600a/b On an average school night, how many hours of sleep does {CHILD} get? Amount of sleep PQ4
Critical Family Processes CFQ.100 Now, I'd like to ask a question about your relationship with {NAME OF CURRENT PARTNER}. Would you say that your relationship is…

Very happy,
Fairly happy, or
Not too happy?
Marital/partner satisfaction PQ4
Child Care CCQ.005 Next, I'd like to talk with you about the child care arrangements you have for {CHILD} this year. First, I'd like to talk to you about all the child care {CHILD} now receives on a regular basis from someone other than {you/{his/her} parents} {or {his/her} guardians}. This does not include occasional baby-sitting or backup care providers.
Participation in child care PQ6

CCQ010 Is {CHILD} now receiving care from a relative on a regular basis (including care provided before or after school)? This may include grandparents, brothers and sisters, or any relatives other than {you/{CHILD}'s parents} {or {CHILD}’s guardians}. Participation in relative care PQ6

CCQ.060 How many different regular care arrangements do you currently have with relatives? Participation in relative care PQ6

CCQ.065 {Let's talk about the relative who provides the most care for {CHILD} now.} Who is the relative who cares for {CHILD}? Participation in relative care PQ6

CCQ.070 Is the care provided by {{CHILD}'s {RELATIVE}/that relative} in your home or another home? Participation in relative care PQ6

CCQ.075 Does {CHILD} receive that care before school, after school, or on weekends? Time child spends in care arrangements PQ6

CCQ.080 Is the care that {CHILD} receives from {{his/her} {RELATIVE}/that relative} regularly scheduled at least once each week? Time child spends in care arrangements PQ6

CCQ.085 How many days each week does {CHILD} receive care from {{his/her} {RELATIVE}/that relative}? Time child spends in care arrangements PQ6

CCQ.090 How many hours each week does {CHILD} receive care from {{his/her} {RELATIVE}/that relative}? Time child spends in care arrangements PQ6

CCQ.110 You said that {CHILD} was cared for by {NUMBER} other {relatives/relative} on a regular basis. How many hours each week does {CHILD} receive care from {these/this} other {relatives/relative}? Time child spends in care arrangements PQ6

CCQ.115 {Now I'd like to ask you about any care {CHILD} receives from nonrelatives in a private home, not including child care centers.} Is {CHILD} now receiving care in a private home on a regular basis from someone who is not related to {him/her} (including care provided before or after school)? This includes home child care providers, regular sitters or neighbors. {It does not include child care centers.} Participation in nonrelative care PQ6

CCQ.165 How many different regular care arrangements do you currently have with nonrelatives? Participation in nonrelative care PQ6

CCQ.170 {Let's talk about the nonrelative who provides the most care for {CHILD} now.} Is that care provided in your home or another home? Participation in nonrelative care PQ6

CCQ.175 Does {CHILD} receive that care before school, after school, or on weekends? Time child spends in care arrangements PQ6

CCQ.180 Is the care that {CHILD} receives from that person regularly scheduled at least once each week? Time child spends in care arrangements PQ6

CCQ.185 How many days each week does {CHILD} receive care from that person? Time child spends in care arrangements PQ6

CCQ.190 How many hours each week does {CHILD} receive care from that person? Time child spends in care arrangements PQ6

CCQ.205 You said that {CHILD} was cared for by {NUMBER} other {nonrelative/nonrelatives} on a regular basis. How many hours each week does {CHILD} receive care from {this nonrelative/these nonrelatives}? Time child spends in care arrangements PQ6

CCQ.260 {Now I'd like to ask you about any care {CHILD} receives from day care centers or before- or after-school programs.} Is {CHILD} now attending a day care center or a before- or after-school program at a school or in a center on a regular basis? Participation in center-based care PQ6

CCQ.325 How many different day care centers or before- or after-school care programs does {CHILD} currently go to on a regular basis? Participation in center-based care PQ6

CCQ.330 {Let's talk about the program where {CHILD} spends the most time now.} Is that program located in the school {CHILD} currently attends? Participation in center-based care PQ6

CCQ.335 Does {CHILD} go to that program before school, after school, or on weekends? Time child spends in care arrangements PQ6

CCQ.340 Does {CHILD} go to that program on a regularly scheduled basis at least once each week? Time child spends in care arrangements PQ6

CCQ.350 How many days each week does {CHILD} go to that program? Time child spends in care arrangements PQ6

CCQ.353 As part of {CHILD}'s participation in that program, did {he/she} ever take a field trip focused on science activities, for example to a science museum or center, a science lab, a planetarium, or a nature center? Science related field trips in center-based care PQ6

CCQ.355 Other than regular school hours, how many hours each week does {CHILD} go to that program? Time child spends in care arrangements PQ6

CCQ.375 You said that {CHILD} attended {NUMBER} other day care {center/centers} or before- or after-school {program/programs} on a regular basis. How many hours each week does {CHILD} attend {this program/these programs}? Time child spends in care arrangements PQ6

CCQ.376 Sometimes children spend time caring for themselves, either at home or somewhere else, without an adult or older child responsible for them. Does {CHILD} spend time caring for {himself/herself} on a regular basis before or after school? Time child spends in self-care PQ6

CCQ.377 How many hours per week does {CHILD} take care of {himself/herself}? Time child spends in self-care PQ6
Non-Resident Parents NRQ.040 The next questions are about {CHILD}'s contact with {his/her} {biological/adoptive} {father/mother}.

[We understand that some of these questions may be difficult {for adoptive parents} to answer; however, these are standard questions we ask when a child does not live with {his/her} biological parents. Any information you can provide will be helpful.]

How long has it been since {CHILD} last had a visit, a phone call, a video call, an e-mail, a text or other electronic message, or received a card or letter from {his/her} {biological/adoptive} {father/mother}? Would you say...

Less than one month,
More than a month but less than a year,
More than a year, or
No contact since birth?
Current contact and nature of relationship with biological/adoptive parents no longer living in household PQ1, PQ3, PQ4

NRQ.123 How many times have {CHILD} and {his/her} {biological/adoptive} {father/ mother} talked on the telephone or in a video call to each other, e-mailed, texted, or had some other type of contact that was not in person in the past 4 weeks? Current contact and nature of relationship with biological/adoptive parents no longer living in household PQ1, PQ3, PQ4
Country of Origin for Non-Resident Biological Parents COQ.005/OS Now we'd like to ask {another question} about {CHILD}'s biological mother. {I know you mentioned that {CHILD}'s biological mother is deceased, and I am sorry for this loss. We understand that it may be hard to talk about those who are no longer living, but I was hoping I could ask a couple quick background questions about where she was from.} In what country was {his/her} biological mother born? Country of origin for nonresident parents PQ1, PQ3

COQ.010 How old was {CHILD’}’s biological mother when she first moved to {any of the fifty states in the United States or the District of Columbia /the United States}? Country of origin for nonresident parents PQ1, PQ3

COQ.020/OS Now we'd like to ask {another question} about {CHILD}'s biological father. {I know you mentioned that {CHILD}'s biological father is deceased, and I am sorry for this loss. We understand that it may be hard to talk about those who are no longer living, but I was hoping I could ask a couple quick background questions about where he was from.} In what country was {his/her} biological father born? Country of origin for nonresident parents PQ1, PQ3

COQ025 How old was {CHILD’}’s biological father when he first moved to {any of the fifty states in the United States or the District of Columbia /the United States}? Country of origin for nonresident parents PQ1, PQ3
Discipline, Warmth, and Emotional
Supportiveness
DWQ.010 Now, I'm going to read some statements. Please tell me whether each statement is completely true, mostly true, somewhat true, or not at all true.
{CHILD} and I often have warm, close times together.
Parent-child relationship: warmth PQ4

DWQ.015 Most of the time I feel that {CHILD} likes me and wants to be near me. Parent-child relationship: warmth PQ4

DWQ.025 Even when I'm in a bad mood, I show {CHILD} a lot of love. Parent-child relationship: warmth PQ4

DWQ.035 I express affection by hugging, kissing, and holding {CHILD}. Parent-child relationship: warmth PQ4

DWQ.040 Being a parent is harder than I thought it would be. Parenting Stress PQ4

DWQ.045 {CHILD} does things that really bother me. Parenting Stress PQ4

DWQ.050 I find myself giving up more of my life to meet {CHILD}'s needs than I ever expected.
Parenting Stress PQ4

DWQ.060 I often feel angry with {CHILD}.
Parenting Stress PQ4

DWQ070a/b/c/d/e/f Now I am going to read some additional statements. Please tell me whether each statement is never true for you, sometimes true for you, often true for you, or very often true for you.

a. Even if I am really busy, I make time to listen to {CHILD}.
b. I discourage {CHILD} from talking about {his/her} worries because it upsets {him/her}.
c. I encourage {CHILD} to talk about {his/her} troubles.
d. I encourage {CHILD} to tell me about {his/her} friends and activities.
e. I encourage {CHILD} to express {his/her} opinions.
f. When I lose my patience with {CHILD}’s questions and demands, I just don’t listen to {CHILD} anymore.
Parent-child relationship: communication PQ4

DWQ.075 How often do you argue with {CHILD}? Please include major arguments as well as minor arguments, such as over homework or chores. Would you say never, almost never, sometimes, often, or always? Time spent arguing with child PQ4

DWQ077a/b/c The following are a number of statements about your family. Please tell me how often each typically occurs in your home.

a. You threaten to punish {CHILD} and then do not actually punish {him/her}. Would you say this occurs never, almost never, sometimes, often, or always?
b. {CHILD} talks you out of being punished after {he/she} has done something wrong.
c. You let {CHILD} out of punishment early, like lift restrictions earlier than you originally said?
Inconsistent Discipline PQ4

DWQ.081a/b Now I’d like to ask some questions about the amount of time {CHILD} plays video games. We want you to include games played on systems like Playstation, Wii, or Xbox, or on handheld devices such as a Nintendo DS, Sony PSP, iPod, iPad, or cellphone, or games played on the computer.
On any given weekday, how much time does {CHILD} spend playing video games? Please do not include time {CHILD} spends on the computer doing educational activities or homework.


Time child spent playing video games PQ4
Child's Health and Well-Being CHQ.010 Now we'd like to discuss {CHILD}'s health and well-being. How long has it been since {CHILD}'s last visit to a dentist or dental hygienist for dental care? Dental visits PQ1, PQ2

CHQ.020 How long has it been since {CHILD}'s last visit to a clinic, health center, hospital, doctor's office, or other place for routine health care? Doctor visits PQ1, PQ2

CHQ.021 Has {CHILD} had an ear infection since last spring? Ear infections since last spring PQ1, PQ2

CHQ.022 Has {CHILD} had an ear ache since last spring? Ear aches since last spring PQ1, PQ2

CHQ.023 Since last spring, how many times did a doctor, nurse, or other medical professional tell you that {CHILD} had an ear infection? Ear infections since last spring PQ1, PQ2

CHQ.024/024OS How have {CHILD}’s {ear infections/ear aches} been treated by your doctor, nurse, or other medical professional since last spring? Ear infections/aches treatment since last spring PQ1, PQ2

CHQ.025 Since last spring, have ear tubes been placed in the right ear, left ear, or both ears when your child had surgery to place tubes in {his/her} ears?

IF NEEDED: Please consider all surgeries since last spring if {CHILD} had more than one to place ear tubes.
Ear tubes since last spring PQ1, PQ2

CHQ.026 Has a doctor, nurse, or other medical professional ever told you that {CHILD} has asthma? Asthma PQ1, PQ2

CHQ.027 Does {he/she} receive treatment for this condition? Asthma PQ1, PQ2

CHQ.060 In a typical week, on how many days does {CHILD} get exercise that causes rapid breathing, perspiration, and a rapid heartbeat for 20 continuous minutes or more? Exercise/physical activities PQ1, PQ2

CHQ.095 For the next set of questions, please base your answer on how {CHILD} compares to other children of the same age. {CHILD} is independent and takes care of {himself/herself} …
Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Behavioral comparison to peers: Independence and ability to take care of him/herself PQ1, PQ2

CHQ.100 Does {CHILD} pay attention…
Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Behavioral comparison to peers: Attention PQ1, PQ2

CHQ.105 Does {CHILD} learn, think, and solve problems…
Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Behavioral comparison to peers: Learn, think, solve problems PQ1, PQ2

CHQ.106 Does {CHILD} show good coordination in moving {his/her} arms and legs? Would you say {he/she} does this…
Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Behavioral comparison to peers: Child's coordination PQ1, PQ2

CHQ.107 Would you say {CHILD} behaves and relates to other children…
Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Behavioral comparison to peers: Relating to children PQ1, PQ2

CHQ.108 Would you say {CHILD} behaves and relates to adults…
Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Behavioral comparison to peers: Relating to adults PQ1, PQ2

CHQ.109 Thinking about {CHILD}'s overall activity level, would you say {he/she} is…
Less active than other children {his/her} age,
About as active,
Slightly more active, or
A lot more active than other children {his/her} age?
Behavioral comparison to peers: Overall activity level PQ1, PQ2

CHQ.110 Does {CHILD} have any emotional or psychological difficulties? Emotional and psychological difficulties PQ1, PQ2

CHQ.111 Do you think this is a mild problem, a moderate problem, or a severe problem? Emotional and psychological difficulties PQ1, PQ2

CHQ.115 {Since last spring has {CHILD}/Has {CHILD} ever} been evaluated by a professional because of an issue with {independence and taking care of {himself/herself} {or}/paying attention {or}/learning, thinking, and solving problems {or}/ coordination in moving {his/her} arms and legs {or}/behaving and relating to other children {or}/ behaving and relating to adults {or}/{his/her} overall activity level {or}/{his/her} emotional or psychological difficulties}? Evaluation of disabilities and health conditions PQ1, PQ2

CHQ.120 {Since last spring, have you obtained/Did you obtain} a diagnosis or diagnoses of a problem from a professional? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.125/125OS What was the diagnosis or were the diagnoses? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ126/126OS What type of autism spectrum disorder does {CHILD} have? Is it autism, Asperger's Disorder, Pervasive Developmental Disorder, something else, or was it identified generally as Autism Spectrum Disorder? Diagnoses of disabilities and health conditions: Autism spectrum disorder PQ1, PQ2

CHQ.130/131 How old was {CHILD} when the first diagnosis of a problem related to {a learning disability/Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/a developmental delay/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder/dyslexia/dyscalculia/an intellectual disability, severe cognitive disability, or mental retardation/an orthopedic impairment/a serious emotional disturbance/a traumatic brain injury/a panic disorder/separation anxiety disorder/obsessive compulsive disorder/generalized anxiety disorder/an {other} anxiety disorder/bipolar disorder/depression/speech/a sensory deficit disorder/oppositional defiant disorder/{TEXT FROM OTHER SPECIFY}} was made? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.135a/b What was the month and year when the diagnosis was made? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.140 Is {CHILD} now taking any prescription medicine for the condition related to {his/her} {learning disability/Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/developmental delay/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder/dyslexia/dyscalculia/intellectual disability, severe cognitive disability, or mental retardation/orthopedic impairment/serious emotional disturbance/traumatic brain injury/panic disorder/separation anxiety disorder/obsessive compulsive disorder/generalized anxiety disorder/{other} anxiety disorder/bipolar disorder/depression/speech problems/sensory deficit disorder/oppositional defiant disorder{TEXT FROM OTHER SPECIFY}}? Prescription medications PQ1, PQ2

CHQ.155 Is {CHILD} medicated for ADD or ADHD at school, at home, or both? Prescription medications PQ1, PQ2

CHQ.173 How long has {CHILD} taken such prescription medicine for the condition related to {his/her} {a learning disability/Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/a developmental delay/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder/dyslexia/dyscalculia/an intellectual disability, severe cognitive disability, or mental retardation/orthopedic impairment/ a serious emotional disturbance/a traumatic brain injury/a panic disorder/separation anxiety disorder/obsessive compulsive disorder/generalized anxiety disorder/an {other} anxiety disorder/bipolar disorder/depression/speech problems/a sensory deficit disorder/oppositional defiant disorder/{TEXT FROM OTHER SPECIFY}}, in total?

Less than one month,
Less than a year,
1 to 2 years,
3 to 4 years, or
5 years or more?
Prescription medications PQ1, PQ2

CHQ.200 For the next question, please base your answer on how {CHILD} compares to other children of the same age. Does {CHILD} pronounce words, communicate with and understand others…

Better than other children {his/her} age,
As well as other children,
Slightly less well than other children, or
Much less well than other children?
Communication: comparison to peers PQ1, PQ2

CHQ.206e Since last spring, has {CHILD} had a problem with stuttering? Communication problems PQ1, PQ2

CHQ.210 {Since last spring has {CHILD}/Has {CHILD} ever} been evaluated by a professional because of {his/her} ability to communicate? Evaluation of communication problems PQ1, PQ2

CHQ.215 Did you obtain a diagnosis or diagnoses of a problem related to {his/her} ability to communicate from a professional? Diagnoses for communication problems PQ1, PQ2

CHQ.216 Which best describes {CHILD}’s hearing? If {CHILD} has a hearing aid or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device. Would you say {CHILD} has…
excellent hearing,
good hearing,
a little trouble hearing,
moderate trouble hearing,
a lot of trouble hearing, or
is {CHILD} deaf?
Hearing ability PQ1, PQ2

CHQ.217 Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device. {CHILD} can usually hear and understand what a person says without seeing his or her face if that person whispers to {him/her} from across a quiet room. Hearing ability PQ1, PQ2

CHQ.218 [Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device.] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person talks in a normal voice to {him/her} from across a quiet room. Hearing ability PQ1, PQ2

CHQ.219 [Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device.] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person shouts to {him/her} from across a quiet room. Hearing ability PQ1, PQ2

CHQ.220 [Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device.] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person speaks loudly into {his/her} ears or better ear. Hearing ability PQ1, PQ2

CHQ.221 Is {CHILD}’s hearing worse in one ear? Hearing ability PQ1, PQ2

CHQ.222 Which best describes {CHILD}'s hearing in {his/her} worse ear? If {CHILD} has a hearing aid or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device.
In {his/her} worse ear, would you say {CHILD} has…
Excellent hearing,
Good hearing,
A little trouble hearing,
Moderate trouble hearing,
A lot of trouble hearing, or
is {CHILD} Deaf?
Hearing ability PQ1, PQ2

CHQ.235 {Besides the ECLS-K:2011 hearing evaluation done for this study, {Since last spring, has/Since the spring of 2013, has/Since the fall of 2012, has/has}} / {Since last spring, has/Since the spring of 2013, has/Since the fall of 2012,
has/Has}} {CHILD}'s hearing {ever} been evaluated by a professional? .
Evaluated for hearing ability PQ1, PQ2

CHQ.245 Did you obtain a diagnosis of a problem from a professional? Diagnoses for hearing ability PQ1, PQ2

CHQ.246/246OS What was the diagnosis? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ250a/b/c How old was {CHILD} when the first diagnosis of a problem related to {his/her} {ability to communicate/hearing} was made? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.255a/b What was the month and year the problem with {CHILD}'s {ability to communicate/hearing} was diagnosed? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.256a Since last spring, has {CHILD} worn a hearing aid? Use of hearing aid PQ1, PQ2

CHQ.256b Has {CHILD} ever worn a hearing aid? Use of hearing aid PQ1, PQ2

CHQ.257a/b At what age was the recommendation that {CHILD} wear a hearing aid first made? Use of hearing aid PQ1, PQ2

CHQ.258 How often does {CHILD} use the hearing aid(s) in school? Would you say…
All of the time,
Most of the time,
Sometimes,
Rarely, or
Never?
Use of hearing aid PQ1, PQ2

CHQ.259 Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} hearing aid(s). {CHILD} can usually hear and understand what a person says without seeing his or her face if that person whispers to {him/her} from across a quiet room. Hearing ability: with hearing aid PQ1, PQ2

CHQ.260 [Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} hearing aid(s). ] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person talks in a normal voice to {him/her} from across a quiet room. Hearing ability: with hearing aid PQ1, PQ2

CHQ.261 [Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} hearing aid(s). ] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person shouts to {him/her} from across a quiet room. Hearing ability: with hearing aid PQ1, PQ2

CHQ.262 [Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} hearing aid(s).] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person speaks loudly into {his/her} {better} ear. Hearing ability: with hearing aid PQ1, PQ2

CHQ.263 {Since last spring has/Has} a doctor or other health care professional {ever} recommended that {CHILD} wear a hearing aid? Use of hearing aid PQ1, PQ2

CHQ.264a/b At what age was the recommendation that {CHILD} wear a hearing aid first made? Use of hearing aid PQ1, PQ2

CHQ.270 Does {CHILD} have a cochlear implant? Use of cochlear implant PQ1, PQ2

CHQ.271 In what year was it implanted? Use of cochlear implant PQ1, PQ2

CHQ.272a/b How old was {CHILD} when it was implanted? Use of cochlear implant PQ1, PQ2

CHQ.273 In what years were they implanted? Use of cochlear implant PQ1, PQ2

CHQ.274 [In what years were they implanted?] Use of cochlear implant PQ1, PQ2

CHQ.275a/b {How old was {CHILD} when it was implanted in the left ear?}{How old was {CHILD} when they were implanted?} Use of cochlear implant PQ1, PQ2

CHQ.276a/b {How old was {CHILD} when it was implanted in the right ear?}{How old was {CHILD} when they were implanted?} Use of cochlear implant PQ1, PQ2

CHQ.277 Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant(s). {CHILD} can usually hear and understand what a person says without seeing his or her face if that person whispers to {him/her} from across a quiet room. Hearing ability: with cochlear implant PQ1, PQ2

CHQ.278 [Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant(s).]{CHILD} can usually hear and understand what a person says without seeing his or her face if that person talks in a normal voice to {him/her} from across a quiet room. Hearing ability: with cochlear implant PQ1, PQ2

CHQ.279 [Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant(s).] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person shouts to {him/her} from across a quiet room. Hearing ability: with cochlear implant PQ1, PQ2

CHQ.280 [Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant(s).] {CHILD} can usually hear and understand what a person says without seeing his or her face if that person speaks loudly into {his/her} {better} ear. Hearing ability: with cochlear implant PQ1, PQ2

CHQ.285 Now I want to ask you about {CHILD}’s vision. Without the use of eyeglasses or contact lenses, does {CHILD} have difficulty seeing objects in the distance or letters on paper? Vision ability PQ1, PQ2

CHQ.286 Is {CHILD}’s difficulty with seeing objects in the distance, things up close (like letters on paper), or both? Vision ability PQ1, PQ2

CHQ.290 {Since last spring has/Has} {CHILD}'s vision {ever} been evaluated by an eye care professional? Evaluated for vision ability PQ1, PQ2

CHQ.300 Did you obtain a diagnosis of a vision-related problem from an eye care professional? Diagnoses for vision-related problems PQ1, PQ2

CHQ.301/301OS What was the diagnosis? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.305a/b How old was {CHILD} when the first diagnosis of a problem was made? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.310a/b What was the month and year the diagnosis was made? Diagnoses of disabilities and health conditions PQ1, PQ2

CHQ.311 Has {CHILD} been prescribed glasses or contact lenses to improve {his/her} vision? Use of glasses or contact lenses PQ1, PQ2

CHQ.312 How often does {CHILD} wear glasses or contact lenses?
All of the time,
Most of the time,
Sometimes,
Rarely, or
Never?
Use of glasses or contact lenses PQ1, PQ2

CHQ.313 Does {CHILD} have glasses or contact lenses? Use of glasses or contact lenses PQ1, PQ2

CHQ.314 Do {CHILD}’s glasses or contacts help {him/her} see things up close, see things in the distance, or both? Use of glasses or contact lenses PQ1, PQ2

CHQ.330 Would you say {CHILD}'s health is …
Excellent,
Very good,
Good,
Fair, or
Poor?
Child's general health PQ1, PQ2

CHQ.340 During this school year, has {CHILD} received therapy services or taken part in a program for children with disabilities? Services for disabilities PQ1, PQ2

CHQ.350 Did that therapy or program ever involve {CHILD} playing or working with an animal as a way to help {him/her} with {a learning disability {or}/Attention Deficit Disorder (ADD) {or}/Attention Deficit Hyperactivity Disorder (ADHD) {or}/a developmental delay {or}/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder {or}/dyslexia {or}/dyscalculia {or}/an intellectual disability,
severe cognitive disability, or mental retardation {or}/an orthopedic impairment {or}/a serious emotional disturbance {or}/a traumatic brain injury/a panic disorder {or}/separation anxiety disorder {or}/obsessive compulsive disorder {or}/generalized anxiety disorder {or}/an{other} anxiety disorder {or}/bipolar disorder {or}/depression {or}/speech {or}/a sensory deficit disorder {or}/oppositional defiant disorder {or}/{TEXT FROM OTHER SPECIFY} {or}/issues related to having a communication diagnosis {or}/issues related to having a hearing diagnosis {or}/issues related to having a vision diagnosis}? You may have heard this called Animal Assisted Therapy, or AAT.
Services for disabilities PQ1, PQ2

CHQ.355 Has a health professional ever recommended that {CHILD} play or work with an animal as a way to help {him/her} with {a learning disability {or}/Attention Deficit Disorder (ADD) {or}/Attention Deficit Hyperactivity Disorder (ADHD) {or}/a developmental delay {or}/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder {or}/dyslexia {or}/dyscalculia {or}/an intellectual disability,
severe cognitive disability, or mental retardation {or}/an orthopedic impairment {or}/a serious emotional disturbance {or}/a traumatic brain injury/a panic disorder {or}/separation anxiety disorder {or}/obsessive compulsive disorder {or}/generalized anxiety disorder {or}/an{other} anxiety disorder {or}/bipolar disorder {or}/depression {or}/speech {or}/a sensory deficit disorder {or}/oppositional defiant disorder {or}/{TEXT FROM OTHER SPECIFY} {or}/issues related to having a communication diagnosis {or}/issues related to having a hearing diagnosis {or}/issues related to having a vision diagnosis}? For example, a health professional may recommend that a child have his or her own dog that is trained to provide emotional support or participate in an occupational therapy program that involves riding horses.
Services for disabilities PQ1, PQ2

CHQ.360 As a result of that recommendation, has {CHILD} ever played or worked with an animal to help {him/her} with {a learning disability {or}/Attention Deficit Disorder (ADD) {or}/Attention Deficit Hyperactivity Disorder (ADHD) {or}/a developmental delay {or}/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder {or}/dyslexia {or}/dyscalculia {or}/an intellectual disability,
severe cognitive disability, or mental retardation {or}/an orthopedic impairment {or}/a serious emotional disturbance {or}/a traumatic brain injury/a panic disorder {or}/separation anxiety disorder {or}/obsessive compulsive disorder {or}/generalized anxiety disorder {or}/an{other} anxiety disorder {or}/bipolar disorder {or}/depression {or}/speech {or}/a sensory deficit disorder {or}/oppositional defiant disorder {or}/{TEXT FROM OTHER SPECIFY} {or}/issues related to having a communication diagnosis {or}/issues related to having a hearing diagnosis {or}/issues related to having a vision diagnosis}??
Services for disabilities PQ1, PQ2

CHQ.420 During this school year, did {CHILD} participate in a special education program? Participation in school services for disabilities PQ1, PQ2

CHQ.430 Overall, how satisfied are you with the progress {CHILD} has made in the special services or special education program this school year? Are you…
Completely satisfied,
Very satisfied,
Fairly satisfied,
Somewhat dissatisfied, or
Very dissatisfied?
Rating school services for disabilities PQ1, PQ2
Parent's Psychological Well-Being and Health PPQ.100 I'm going to read some statements that may relate to how you have felt about yourself and your life during the past week. For each statement I read, please indicate how often in the past week you felt or behaved this way. There are no right or wrong answers.

How often during the past week have you felt that you were bothered by things that don't usually bother you? Would you say never, some of the time, a moderate amount of the time, or most of the time?
Depression and subjective well-being PQ1, PQ3

PPQ.110 How often during the past week have you felt that you did not feel like eating, that your appetite was poor? Depression and subjective well-being PQ1, PQ3

PPQ.120 How often during the past week have you felt that you could not shake off the blues even with help from your family or friends? Depression and subjective well-being PQ1, PQ3

PPQ.130 How often during the past week have you felt that you had trouble keeping your mind on what you were doing? Depression and subjective well-being PQ1, PQ3

PPQ.140 How often during the past week have you felt depressed? Depression and subjective well-being PQ1, PQ3

PPQ.150 How often during the past week have you felt that everything you did was an effort? Depression and subjective well-being PQ1, PQ3

PPQ.160 How often during the past week have you felt fearful? Depression and subjective well-being PQ1, PQ3

PPQ.170 How often during the past week have you felt your sleep was restless? Depression and subjective well-being PQ1, PQ3

PPQ.180 How often during the past week have you felt that you talked less than usual? Depression and subjective well-being PQ1, PQ3

PPQ.190 How often during the past week have you felt lonely? Depression and subjective well-being PQ1, PQ3

PPQ.200 How often during the past week have you felt sad? Depression and subjective well-being PQ1, PQ3

PPQ.210 How often during the past week have you felt that you could not get going? Depression and subjective well-being PQ1, PQ3

PPQ.220 Now, I would like to ask you about your health. In general, would you say that your health is…
Excellent,
Very good,
Good,
Fair, or
Poor?
Parent health PQ1, PQ3, PQ5

PPQ.225 During the past 12 months, would you say that you experienced a lot of stress, a moderate amount of stress, relatively little stress, or almost no stress at all? Parent health PQ1, PQ3, PQ5
Food Security FDQ.130a/b/c These next questions are about whether your family is able to afford the food that you need. I am going to read you several statements that people have made about their food situation. For these statements, please tell me whether the statement was often true, sometimes true, or never true for {you/your household} in the last 12 months, that is, since last {CURRENT MONTH}, 2015.

a. {I/We} worried whether {my/our} food would run out before {I/we} got money to buy more.
b. The food that {I/we} bought just didn't last, and {I/we} didn't have money to get more.
c. {I/We} couldn't afford to eat balanced meals.
Family food security PQ1, PQ3

FDQ.140 In the last 12 months, did {you/you or other adults in your household} ever cut the size of your meals or skip meals because there wasn't enough money for food? Family food security PQ1, PQ3

FDQ.150 How often did this happen? Would you say…

Almost every month
Some months, but not every month, or
In only 1 or 2 months?
Family food security PQ1, PQ3

FDQ.160 In the last 12 months, did you ever eat less than you felt you should because there wasn't enough money for food? Adult food security PQ1, PQ3

FDQ.170 In the last 12 months, were you ever hungry but didn't eat because there wasn't enough money for food? Adult food security PQ1, PQ3

FDQ.180 In the last 12 months, did you lose weight because there wasn't enough money for food? Adult food security PQ1, PQ3

FDQ.190 In the last 12 months, did {you/you or other adults in your household} ever not eat for a whole day because there wasn't enough money for food? Adult food security PQ1, PQ3

FDQ.191 How often did this happen? Would you say…
Almost every month,
Some months, but not every month, or
In only 1 or 2 months?
Adult food security PQ1, PQ3

FDQ.192 Now I am going to read you several statements that people have made about the food situation of their children. For these statements, please tell me whether the statement was often true, sometimes true, or never true in the last 12 months, that is, since last {CURRENT MONTH}, 2015 for {your child/children living in the household who are under 18 years old}.

a. {I/We} relied on only a few kinds of low-cost food to feed {{CHILD}/the children} because {I was/we were} running out of money to buy food. Was that often true, sometimes true, or never true for {you/your household} in the last 12 months?
b.{I/We} couldn't feed {{CHILD}/the children} a balanced meal because {I/we} couldn't afford that. Was that often true, sometimes true, or never true for
{you/your household} in the last 12 months?
c. {{CHILD} was/The children were} not eating enough because {I/we} just couldn't afford enough food.
Children's food security PQ1, PQ3

FDQ210 In the last 12 months, that is, since last {CURRENT MONTH}, 2015, did you ever cut the size of {CHILD}'s/any of the children's} meals because there wasn't enough money for food? Children's food security PQ1, PQ3

FDQ240 In the last 12 months {was {CHILD}/were any of the children} ever hungry but you just couldn't afford more food? Children's food security PQ1, PQ3

FDQ242 In the last 12 months, did {{CHILD}/any of the children} ever skip a meal because there wasn't enough money for food? Children's food security PQ1, PQ3

FDQ243 How often did this happen? Would you say…
Almost every month,
Some months, but not every month, or
In only 1 or 2 months?
Children's food security PQ1, PQ3

FDQ250 In the last 12 months}, did {CHILD}/any of the children} ever not eat for a whole day because there wasn't enough money for food? Children's food security PQ1, PQ3
Parent's Education PEQ.020 {Now I have a few questions about education.} What is the highest grade or year of school that {you/{NAME}} {have/has} completed? Parent education PQ1, PQ3

PEQ.021 {Do/Does} {you/{NAME}} have a high school diploma, or its equivalent, such as a GED, or neither? Parent education PQ1, PQ3

PEQ.030 {Are you/Is {NAME}} currently attending or enrolled in any courses from a school, college, or university? Parent education PQ1, PQ3

PEQ.040 {Are you/Is {NAME}} currently taking courses full-time or part time? Parent education PQ1, PQ3

PEQ.050 {Are you/Is {NAME}} currently participating in a job training or on the job training program? Please do not report participation in any vocational or technical programs taken at a college or university that you just told me about. Job training PQ1, PQ3

PEQ.060 About how many hours a week {do/does} {you/{NAME}} spend in that program? Please include hours spent on homework for the training program. Parent education PQ1, PQ3

PEQ.062 What type of school or job training {are you/Is {NAME}} currently in? Parent education PQ1, PQ3
Parent's Employment EMQ.020 During the past week, did {you/{NAME}} work at a job for pay? Parent employment PQ1, PQ3

EMQ.030 {Were you/Was {NAME}} on leave or vacation from a job? Parent employment PQ1, PQ3

EMQ.040 How many jobs {do you/does {NAME}} have now? Parent employment PQ1, PQ3

EMQ.050 About how many total hours per week {do you/does {NAME}} usually work for pay {counting {all/both} {# of jobs from EMQ.040 IF MORE THAN TWO} jobs}? Parent employment PQ1, PQ3

EMQ.060 {Have you/Has {NAME}} been actively looking for work in the past 4 weeks? By actively looking for work, we mean activities such as checking with a public employment agency, a private employment agency, or an employer directly; checking about jobs with friends or relatives; placing or answering ads; sending a resume; contacting a school or university employment center; or checking a union or professional register. Parent employment PQ1, PQ3

EMQ.070 What {have you/has {NAME}} been doing in the past 4 weeks to find work? Parent employment PQ1, PQ3

EMQ.080 What {were you/was {NAME}} doing most of last week? Would you say…
Keeping house, or caring for children or other family members,
Going to school,
Retired,
Unable to work, or
Something else? What was that? (SPECIFY)
Parent employment PQ1, PQ3

EMQ.100 Could {you/{NAME}} have taken a job last week if one had been offered? Parent employment PQ1, PQ3

EMQ.120 For whom {do/does/did} {you/{NAME}} work {when {you/{he/she}}last worked}? Parent employment PQ1, PQ3

EMQ.130 What kind of business or industry {is/was} this? Parent employment PQ1, PQ3

EMQ.140 What kind of work {are/is/were/was} {you {NAME}} doing? Parent employment PQ1, PQ3

EMQ.150 What {are/were} {your/{NAME}'s} most important activities or duties on this job? What {do/does/did} {you/{NAME}} actually do at this job? Parent employment PQ1, PQ3

EMQ.210 {Since last spring/Since {CHILD} was born}, {have you/has {NAME}} served on active duty in the U.S. Armed Forces, military Reserves, or National Guard? Active duty does not include training for the Reserves or National Guard, but does include activation, for example, for the war in Afghanistan. Active duty military service: since child was born PQ1, PQ3

EMQ.215 {Are you/Is {NAME}} currently on active duty in the U.S. Armed Forces, military Reserves, or National Guard? Active duty military service: current PQ1, PQ3
Welfare and Other Public Transfers WPQ.100 In the past 12 months, have you or anyone in your household received Temporary Assistance for Needy Families, sometimes called {TANF or} {STATE TANF PROGRAM NAME}? Public assistance PQ1, PQ3

WPQ.110 In the past 12 months, have you or anyone in your household received food stamps, also called SNAP (the Supplemental Nutrition Assistance Program), or food benefits on EBT (Electronic Benefit Transfer)? Public assistance PQ1, PQ3

WPQ.170 Does {CHILD} receive complete school lunches for free or reduced price at school? Free/reduced lunch PQ1, PQ3

WPQ.180 Are these lunches free or reduced price?

Parent Income and Assets PAQ.100 In studies like this, households are sometimes grouped according to income. What was the total income of all persons in your household over the past year, including salaries or other earnings, interest, retirement, and so on for all household members? Was it…
$25,000 or less, or
More than $25,000?
Annual family income PQ1, PQ3

PAQ.110 Was it…
$5,000 or less
$5,001 to $10,000
$10,001 to $15,000
$15,001 to $20,000
$20,001 to $25,000
$25,001 to $30,000
$30,001 to $35,000
$35,001 to $40,000
$40,001 to $45,000
$45,001 to $50,000
$50,001 to $55,000
$55,001 to $60,000
$60,001 to $65,000
$65,001 to $70,000
$70,001 to $75,000
$75,001 to $100,000
$100,001 to $200,000
$200,001 or more
Annual family income PQ1, PQ3

PAQ.120 What was your total household income last year, to the nearest thousand? Annual family income PQ1, PQ3

PAQ.140/140OS What is your current housing situation? Do you…
own your own house or condominium,
rent your house or apartment,
exchange services for housing,
not pay for housing,
live in temporary housing or a shelter,
live with a relative or in a dwelling owned by a relative (MAY OR MAY NOT CONTRIBUTE TO EXPENSES OR CONTRIBUTION UNKNOWN), or
have another type of arrangement (SPECIFY)?
Housing PQ1, PQ3
Mobility and Tracking Updates CMQ.010 Have you moved since {DATE OF LAST INTERVIEW}? Child Mobility NA

CMQ.020/020OS Why did you move? Child Mobility NA

CMQ.680 WAS THIS INTERVIEW CONDUCTED BY TELEPHONE OR IN-PERSON? Closing NA

CMQ.690/690OS WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, A CHINESE LANGUAGE, VIETNAMESE, OR ANOTHER LANGUAGE? Closing NA

CMQ.695 WHERE WAS THIS INTERVIEW CONDUCTED? Closing NA

CMQ.700 Thank you very much for your cooperation and for taking the time to participate in the Early Childhood Longitudinal Study.

We really appreciate the time you have taken over the past 6 years to talk to us. You and others who have participated in the study have given us a wealth of information for researchers and policymakers to use to learn more about children’s educational experiences. At this time we do not have plans to contact you next year, but someone may follow up with you in the future to see how {CHILD} is doing. If you want to know more about the study, please go to nces.ed.gov/ecls.
Closing NA

CMQ.701 We would like to call the parent or guardian for {CHILD} at the household where {he/she} lives. Could you please give me the name and telephone number for the home that I should call? Closing NA

CMQ.702 We would like to call back when {this person/{CHILD}’s parent or guardian is available. Please tell me when we should call back. Closing NA

CMQ.703 Thank you. Closing NA

CMQ.720 PRESS 1 AND ENTER TO SAVE AND EXIT THIS CASE. Closing NA

Sheet 5: App D Spring 5th TQ.2

Spring Fifth-Grade General Classroom Teacher Questionnaire, Appendix D
Section Item # Item Stem Source Construct Research Question
Student, School, and Staff Activities A1 a-d Which of the following subjects do you teach during this school year? ECLS-K:2011 Grade 3 Subjects taught TQ3

a. Reading/language arts



b. Mathematics



c. Science



d. Social studies



A2 a-j How often does the typical child in your class(es) usually work on lessons or projects in the following general subject areas, whether as a whole class, in small groups, or in individualized arrangements?
a. Reading and language arts
b. Mathematics
c. Social studies
d. Science
e. Music
f. Art
g. Physical education
h. Dance/creative movement
i. Theatre/creative dramatics
j. Foreign language (excluding English for ELL students)
ECLS-K Use of class time, by subject area TQ1

A3 a -j On days when children have work in these areas, how much time does the typical child in your class(es) usually work on lessons or projects in the following general subject areas?
a. Reading and language arts
b. Mathematics
c. Social studies
d. Science
e. Music
f. Art
g. Physical education
h. Dance/creative dramatics
i. Theatre/creative dramatics
j. Foreign language (excluding English for ELL students)
ECLS-K Use of class time, by subject area TQ1

A4 How many days a week do children have recess? Zero; One; Two; Three; Four; Five; Other/Varies by week ECLS-K Class activities (outside of class)/ recess TQ1

A5 On days when children have recess, between the school day starting time and the dismissal time, how many times a day do children have recess? ECLS-K Class activities (outside of class)/ recess TQ1

A6 a-d What percentage of children in your class(es) have parents who participate in the following activities?
a. Attend teacher-parent conferences
b. Volunteer regularly to help in your
classroom or another part of the school
c. Attend open houses or parties
d. Attend art/music events or demonstrations
ECLS-K Parent involvement in school TQ2

A7 a-i How important is each of the following in evaluating the children in your class(es) for reporting to parents?
a. Individual child's achievement relative
to the rest of the class
b. Individual child's achievement relative
to local, state, or professional standards
c. Individual improvement or progress
over past performance
d. Effort
e. Class participation
f. Daily attendance
g. Classroom behavior or conduct
h. Cooperativeness with other children
i. Ability to follow directions
ECLS-K Methods of assessing children's progress TQ1
Views on School Climate and School Environment B1 a-h Please indicate the extent to which you agree or disagree with each of the following statements about your school. ECLS-K School climate TQ4
a. The level of child misbehavior ) for example, noise, horseplay, or fighting in the halls or cafeteria) in this school interferers with my teaching.
b. Many of the children I teach are not capable of learning the material I am supposed to teach them.
c. Parents are supportive of school staff.
d. There is a great deal of cooperative effort among the staff members.
e. There is a consensus among administrators and teachers on goals and expectations.
f. The academic standards at this school are too low.
g. The school administrator sets priorities, makes plans, and sees that they are carried out.
h. The school administration's behavior toward the staff is supportive and encouraging.

B2 a-e To what extent do you agree or disagree with the following statements?
a. The attitudes and habits students bring
to my class﴾es﴿ greatly reduce their
chances for academic success.
b. My success or failure in teaching is due
primarily to factors beyond my control
rather than to my own effort or ability.
c. The amount a student can learn is
primarily related to family background.
d. I really enjoy my present teaching job.
e. If I could start over, I would choose
teaching again as my career.
ECLS-K Teacher’s sense of efficacy; Job satisfaction TQ4
Teacher Background C1 What is your gender? ECLS-K Teacher demographic information TQ4

C2 In what year were you born? ECLS-K Teacher demographic information TQ4

C3 Are you Hispanic or Latino? ECLS-K Teacher demographic information TQ4

C4 Which best describes your race? MARK ONE OR MORE RESPONSES TO INDICATE WHAT YOU CONSIDER YOURSELF TO BE.
ECLS-K Teacher demographic information TQ4

C5 a-j Counting this school year, how many years have you taught each of the following grades and programs, including years in which you taught part time?
a. Preschool or kindergarten
b. First grade
c. Second grade
d. Third grade
e. Fourth grade
f. Fifth grade
g. Sixth grade or higher
h. English as a Second Language (ESL), bilingual education, and/or dual language program
i. Special education program
j. Program for gifted children
ECLS-K Teaching experience, by grade and program TQ4

C6 Counting this school year, how many total years have you been a school teacher, including years in which you taught part-time? ECLS-K Teaching experience, total years TQ4

C7 Is this school year the first year you have taught in this school? New First year teaching in this school TQ4

C8 What is the highest level of education you have completed?
ECLS-K Teacher's education TQ4

C9 a-n If you have an associate's or bachelor's degree, indicate your undergraduate major field of study.
a. Early childhood education
b. Elementary education
c. English
d. Reading and/or language arts
e. Curriculum and instruction
f. Mathematics education
g. Mathematics
h. Science education
i. Life science
j. Physical science
k. Earth science
l. Special education
m. Other education-related major (for example, secondary education, educational psychology, administration, music education, etc.)
n. Non-education major (for example, history, etc.)
ECLS-K Teacher's education: major field of study TQ4

C10 a-n If you have a graduate degree, indicate the major field of study of your highest level graduate degree.
a. Early childhood education
b. Elementary education
c. English
d. Reading and/or language arts
e. Curriculum and instruction
f. Mathematics education
g. Mathematics
h. Science education
i. Life science
j. Physical science
k. Earth science
l. Special education
m. Other education-related major (for example, secondary education, educational psychology, administration, music education, etc.)
n. Non-education major (for example, history, etc.)
ECLS-K Teacher's education: major field of study TQ4

C11 a-d Have you ever taken a college course that addressed issues related to the following?
a. Using published research evidence to identify and select effective interventions and supports for students
b. Using formal assessment data to inform the choice of READING interventions and supports for students
c. Using formal assessment data to inform the choice of MATH interventions and supports for students
d. Using data to inform the choice of behavioral interventions and supports for students

Teacher's education: coursework ; Response to Intervention-related practices TQ4

C12 Which of the following describes the teaching certificate you currently hold in THIS state?
ECLS-K Type of teaching certification held TQ4

C13 Date questionnaire completed


N/A N/A

Sheet 6: App E Spring 5th TQC-R.2

Spring Fifth-Grade Reading and Language Arts Teacher Questionnaire, Appendix E
Section Item # Item Stem Source Construct Research Question
Part 1: Please answer the questions in Part 1 about the child identified on the cover of this questionnaire.
Social Skills A1 a-z Items focusing on general social skills in the classroom. Items not included due to copyright restrictions (26 items total) SSRS Elementary Scale A; ECLS-K Social skills and approaches to learning TQ5

A2 a-g Please indicate how often each of these items applies to the child identified on the cover of this questionnaire. Adapted from Ladd & Price, 1987; Ladd, 1990 School liking and avoidance TQ5
a. Likes to come to school
b. Dislikes school
c. Has fun at school
d. Likes being in school
e. Seems unhappy in school
f. Enjoys most classroom activities
g. Groans or complains about suggested activities
Classroom Behaviors B1 a-m Please read each statement and decide
whether it is a "true" or "untrue" description of this child's reaction to a number of situations within the past six months. If you cannot answer one of the items because you have never seen the child in that situation, then mark "not applicable."
a. Is easily distracted when listening to a story.
b. Can stop him/herself when s/he is told to stop.
c. Looks around the room when doing school work.
d. Can stop him/herself from doing things too quickly.
e. When working on an activity, has a hard time keeping her/his mind on it.
f. Has an easy time waiting.
g. Has a hard time paying attention.
h. Has a hard time waiting his/her turn to talk when excited.
i. Needs to be told to pay attention.
j. Gets distracted when trying to pay attention in class.
k. Likes to plan carefully before doing something.
l. Is good at following directions.
m. Has a hard time slowing down when rules say to walk.
Source: Adapted from the Temperament in Middle Childhood Questionnaire. Simonds, J. and Rothbart, M. (2004) Classroom behaviors TQ5
Peer Relationships C1 a-i For the items below, please think about the friends with whom the child identified on the cover of this questionnaire has associated the most during the past month or two. Please indicate how true you think each of these items is for this group of children. If you cannot answer these items because the child has not usually associated with a group of other children in the past month or two, then mark "Not applicable." Adapted from Vandell, 2001. Peer relationships TQ5
a. This is a good group of kids
b. I worry when this child is with this group
c. Some of these kids are a bad influence
d. These kids must be closely supervised by an adult
e. These kids get into trouble
f. These kids are excellent students
g. These kids are hard workers
h. This child has a fun time with this group
i. Most of these kids are kind to other children

C2 a-i Please indicate how often each of these items applies to the child identified on the cover of this
questionnaire, particularly in the context of his or her behavior with peers.
a. Seems concerned when other children are distressed.
b. Is not chosen as playmate by peers.
c. Peers avoid this child.
d. Is kind towards peers.
e. Is excluded from peers' activities.
f. Is cooperative with peers.
g. Shows concern for moral issues (for example, fairness, welfare of others).
h. Is ignored by peers.
i. Offers help or comfort when other children are upset.
Adapted from the Child Behavior Scale. Gary W. Ladd, 2010 Peer acceptance/exclusion TQ5

C3 a-d During this school year, how often have other students… Source: Adapted from Espelage and Holt, 2011 Target of victimization by other students TQ5
a. Teased, made fun of, or called this student names?
b. Told lies or untrue stories about this student?
c. Pushed, shoved, slapped, hit, or kicked this student?
d. Intentionally excluded or left this student out from playing with them?

C4 a-d During this school year, how often has this student…
a. Teased, made fun of, or called
other students names?
b. Told lies or untrue stories about
other students?
c. Pushed, shoved, slapped, hit, or
kicked other students?
d. Intentionally excluded or left other
students out from playing with him
or her?
Source: Adapted from Espelage and Holt, 2001 Victimization of other students by this student TQ5

C5 a-d Thinking about the child identified on the cover of this questionnaire compared to a typical child in his/her grade, please evaluate this child in the following areas. Source: Pierce, Hamm, and Vandell, 1999. Peer relationships; emotional intelligence TQ5
a. Understands others' feelings
b. Accurately interprets what a peer is trying to do
c. Generates good quality solutions to interpersonal problems
d. Is aware of the effects of his/her behavior on others
Student Information D1 a-d Are you this child's primary teacher in the following subject areas?
a. Reading/language arts
b. Mathematics
c. Science
d. Social studies
ECLS-K Grade/class configuration TQ1

D2 How long has this child been in your reading/language arts class this school year until now?
ECLS-K Family mobility TQ3

D3 Please indicate the total number of times this child has been absent from your reading/language arts class during the current school year.
ECLS-K Attendance TQ3; TQ5

D4 a-c Does this child receive (or has he/she received during this school year) instruction in any of the following types of programs in your school?
a. Individual tutoring or remedial program in reading/language arts
b. Gifted and talented program in reading/language arts
c. Gifted and talented program with no specific content focus
ECLS-K Receipt of remedial or gifted services TQ3; TQ7

D5 Is English this child's native language?
ECLS-K Native language other than English TQ2; TQ3

D6 Does this child participate in an instructional program designed to teach English language skills to children with limited English proficiency? ECLS-K Receipt of instruction for English language learners TQ1; TQ3

D7 Would you say the instruction this child receives is primarily …
Programs that focus on developing students' literacy in two languages; programs that focus on developing students' literacy solely in English; other program(s) (PLEASE SPECIFY); No specialized language program is provided to this child.
Adapted from the "Types of language instruction educational programs," provided by the National Clearinghouse for English Language Acquisition. Receipt of instruction for English language learners TQ1; TQ3

D8 a-c
ECLS-K Receipt of instruction for English language learners TQ1; TQ3

D9 a-c On the days when this child receives specialized language instruction, for how much time does he/she receive instruction of the following program types?
a. Program that focuses on developing students'
literacy in two languages
b. Program that focuses on developing students'
literacy solely in English
c. Other program
ECLS-K Receipt of instruction for English language learners TQ1; TQ3

D10 During this school year, how often is this child's reading instruction provided in his/her native language?
ECLS-K Receipt of instruction for English language learners TQ1; TQ3

D11 Does this child have an IEP on record with the school? ECLS-K IEP status TQ3; SEQ1

D12 a-b Does this child receive instruction in any of the following types of programs in your school?
a. Speech‐language therapy for children with speech or language disorders/impairments
b. Special education services, not including speech therapy, whether provided in the classroom or in a pull‐out setting
ECLS-K Receipt of special education services TQ1; TQ3; SEQ1

D13 Does this child receive special accommodations (for example, for a disability or limited English proficiency) to participate in the school's testing or assessment program? ECLS-K Use of accommodations in assessments TQ3; TQ7

D14 a-d Overall, how would you rate this child’s academic skills in each of the following areas, based on curriculum standards for his/her current grade level?
a. Reading
b. Writing
c. Oral language
d. Social studies
ECLS-K Comparison to peers: academic skills for current grade level in reading, language arts, and social studies TQ5

D15 How often does this child work to the best of her/his ability in READING AND LANGUAGE ARTS? ECLS-K Working to the best of one's ability TQ5

D16 How many instructional groups based on achievement or ability levels in READING do you currently have in this child's class? ECLS-K Use of achievement grouping: Reading TQ1; TQ3

D17 In which reading instructional group is this child currently placed? ECLS-K Placement in achievement grouping: Reading TQ5

D18 During this school year, have this child's parents/guardians participated in the following activities? ECLS-K Parent involvement in school activities TQ2
a. Attend regularly-scheduled conferences at your school
b. Attend parent/teacher informal meetings that you initiated to talk about the child's progress
c. Returned your telephone calls or e-mails
d. Initiated contact with you
e. Volunteered to help in your classroom or school

D19 How involved at the school would you say this child’s parents/guardians are? ECLS-K Parent involvement in school activities TQ2

D20 During this school year, besides regular teacher conferences, have you communicated with this child's parents/guardians? ECLS-K Communication with parents about child's performance TQ6

D21 Was the purpose of the communication with this child's parents/guardians to discuss ECLS-K Communication with parents about child's performance TQ6
a. Behavior problems the child is having in school
b. Any problems the child is having with school work
c. Anything the child is doing particularly well in or better in at school

D22 Date questionnaire completed

N/A






Part 2: To be completed only if there is a red dot next to the child's name on the cover of this questionnaire.
Reading and Language Arts Instruction E1 a-j From the first day of school until today, please indicate on how many days you have covered each of the following READING AND LANGUAGE ARTS skills and concepts in this child's class. Please include the time during which you provide direct instruction as well as the time you spend supervising students as they work.
a. Understanding key ideas and details, for
example, identifying the main idea or theme;
summarizing; comparing characters and settings; using details and quotations from the text to support understanding of the passage; etc.
b. Understanding craft and structure, for
example, understanding metaphors and similes; explaining the structure of a story, drama, or poem; describing the influence of the narrator's point of view; etc.
c. Integrating knowledge and ideas, for example, analyzing how visual or multi-media presentation of a text contributes to the meaning or tone of the text comparing treatment of similar them+D66es in stories and myths; etc.
d. Understanding key ideas and details, for example, quoting accurately from a text; summarizing main ideas from a text; etc.
ECLS-K, updated to reflect "Common Core State Standards," corestandards.org Time spent on specific activities and skills in reading/language arts TQ7
e. Understanding craft and structure, for example, comparing the structure of events, concepts, or information in two or more texts; analyzing different accounts of the same event; etc.
f. Integrating knowledge and ideas, for example, using information from multiple print or digital sources to locate an answer; explaining how the author uses evidence to support a point in the text; integrating information from several texts to write or speak knowledgeably about the topic; etc.
g. Writing narratives, opinion pieces, and informational text with facts and details
h. Developing and strengthening writing by planning, drafting, revising, and editing
i. Building vocabulary, for example, studying words and their meanings in text; learning about roots, prefixes, and suffixes; etc.
j. Understanding conventions of standard English, for example, explaining the functions of conjunctions and prepositions; using verb tense to convey various times; using punctuation to separate items in a series; etc.

E2 a-k How often do the children in this class engage in the following reading and language arts activities?
a. Read silently
b. Read books they have chosen themselves
c. Make oral presentations about what they have read
d. Do a group activity or project about what they have read
e. Discuss different interpretations of what they have read
f. Look up vocabulary words and write
definitions
g. Demonstrate understanding of words by relating them to their opposites ﴾antonyms﴿ and to words
with similar meanings ﴾synonyms﴿
h. When given specific questions, write responses
that are at least 3 to 4 sentences long
i. Cite evidence from literary or informational texts ﴾in books and/or digital sources﴿ in their writing
j. Spend extended time writing and revising text that they have written
k. Edit their classmates' writing
ECLS-K, updated to reflect "Common Core State Standards," corestandards.org Time spent on specific activities and skills in reading/language arts TQ7
Classroom and Student Characteristics F1 As of today’s date, how many children…
a. Are currently enrolled in this class?
b. Are boys?
c. Are girls?
ECLS-K Classroom characteristics: enrollment, gender distribution TQ7

F2 What grade levels are included in this class?
a. 3rd grade or lower
b. 4th grade
c. 5th grade
d. 6th grade
e. 7th grade or higher
ECLS-K Classroom characteristics: grade levels within class TQ7

F3 How many of the children in this class are repeating their grade this year? ECLS-K Classroom characteristics: number of repeaters TQ2; TQ3

F4 How many children in this class…
a. Are classified as Gifted and Talented?
b. Are participating in a Gifted and Talented program?
ECLS-K Student absenteeism TQ2

F5 How many children in this class are absent on an average day? ECLS-K Student absenteeism TQ2

F6 a-b How many children in this class are below grade level, about on grade level, or above grade level in their English reading skills and in social studies?
a. English reading skills?
b. Social studies?
ECLS-K Students above or below grade level in reading/social studies TQ3

F7 At this point in the school year, how would you rate the behavior of the children in this class?

ECLS-K Overall behavior of the class TQ2; TQ5

F8 a-d Approximately what percentage of the students in this class demonstrate the following problems?
a. Have difficulty paying attention in class
b. Lack self‐control ﴾disruptive behavior﴿
c. Are rejected by peers
d. Do not accept authority
New. From Abry, Swanson, & Fabes (2012) Classroom climate (student difficulties) TQ2; TQ5

F9 How many children in this class have a diagnosed disability? ECLS-K Number of students with disabilities TQ3

F10 Do you have any children who are English language learners in this class? (English language learners are children whose native language is one other than English and whose skills in listening, speaking, reading, or writing English are such that they have difficulty understanding school instruction in English.) ECLS-K Number of English language learners TQ3

F11 How many English language learners (ELLs) do you have in this class? ECLS-K Number of English language learners TQ3
Classroom Instruction and Evaluation G1 a-e In a typical day, how much time do children in this reading and language arts class spend in the following activities?
a. Working independently
b. Working on individual tasks under teacher direction
c. Working with peers under teacher direction
d. Working in small groups with teacher
e. Teacher lecture with large group and/or large group discussion led by teacher
ECLS-K:2011 Grade 1 Proportion of time students spend working independently, small group, large group TQ1

G2 How often do children in this reading and language arts class go to the school library or media center? ECLS-K Availability, use, and adequacy of resources TQ1

G3 In this class, how frequently do you or your students use computers or the following electronic devices for instructional purposes in reading and language arts? Please include any desktop, laptop, or other computer-type devices.
a. Desktop or laptop computer or other computer-type device (for example, iPad/other tablet, eReader such as Kindle or Nook)
b. Cell phone/smartphone (for example, iPhone)
c. Interactive whiteboard ﴾for example, SMART Board, Activboard﴿
d. Document camera or document projector (for example, ELMO, HoverCam)
e. LCD or DLP projector
f. Digital camera (still or video)
g. CD player, MP3 player/iPod, cassette/tape player
h. DVD player, VCR, or video streaming device (for example, Roku)
i. TV j. Student response system (for example, clickers, responders, ActiVote, ActivExpression)
k. Microphone or classroom audio sound system (for example, TopCat, Redcat)
ECLS-K Availability, use, and adequacy of resources TQ1

G4 In an average week, how many days a week is reading and language arts homework assigned in this class? Please count homework assigned over the weekend as one day.
ECLS-K Use of homework TQ1

G5 On days when homework is assigned, how much time do you expect children in this class to spend on homework in reading and language arts?
ECLS-K Use of homework TQ1

G6 a-e In this class, how often do you use a formal assessment in READING for the following purposes?
a. To evaluate how well each student is responding to the core curriculum provided in
the general education classroom
b. To monitor each student's progress on specific skills over the school year
c. To identify the deficits in specific skills of struggling students
d. To monitor the progress of students who fall below benchmark levels
e. To determine whether students need placement in a more or less intensive level of
instruction
ECLS-K:2011 Grade 1 Response to Intervention-related policies and practices TQ6
Staff Activities H1 Did you participate in any professional development within the last 12 months?
ECLS-K:2011 Grade 1 Professional development activities TQ4

H2 a-c How often did you participate in professional development activities covering the following topics in the last 12 months?
a. How to use assessment data to identify students who are struggling or at risk of failure in READING
b. How to use and apply assessment data to guide READING instruction
c. How to implement the READING curriculum
Adapted from Reading First Impact Study--Teacher Survey Professional development activities; Response to Intervention-related policies and practices TQ6

Sheet 7: App E Spring 5th TQC-M.2

Spring Fifth-Grade Math Teacher Questionnaire, Appendix E
Section Item # Item Stem Source Construct Research Question
Part 1: Please answer the questions in Part 1 about the child identified on the cover of this questionnaire.
Student Information A1 a-d Are you this child's primary teacher in the following subject areas?
a. Reading/language arts
b. Mathematics
c. Science
d. Social studies
ECLS-K Grade/class configuration TQ1

A2 How long has this child been in your math class this school year until now? ECLS-K Family mobility TQ3

A3 Please indicate the total number of times this child has been absent from your math class during the current school year.
ECLS-K Attendance TQ3; TQ5

A4 a-b Does this child receive (or has he/she received during this school year) instruction in any of the following types of programs in your school?
a. Individual tutoring or remedial program in mathematics
b. Gifted and talented program in mathematics
ECLS-K Receipt of remedial or gifted services TQ3; TQ7

A5 Is English this child's native language? ECLS-K Native language other than English TQ2; TQ3

A6 During this school year, how often is this child's math instruction provided in his/her native language?
ECLS-K Receipt of instruction for English language learners TQ2; TQ3

A7 Overall, how would you rate this child’s academic skills in math, based on curriculum standards for his/her current grade level? ECLS-K Comparison to peers: academic skills for current grade level in math TQ5

A8 How often does this child work to the best of her/his ability in MATH? ECLS-K Working to the best of one's ability TQ5

A9 How many instructional groups based on achievement or ability levels in MATHEMATICS do you currently have in this child's class?
ECLS-K Use of achievement grouping: mathematics TQ1; TQ3

A10 In which mathematics instructional group is this child currently placed? ECLS-K Placement in achievement grouping: mathematics TQ5

A11 During this school year, have this child's parents/guardians participated in the following activities?
a. Attend regularly-scheduled conferences at your school
b. Attend parent/teacher informal meetings that you initiated to talk about the child's progress
c. Returned your telephone calls or e-mails
d. Initiated contact with you
e. Volunteered to help in your classroom or school
ECLS-K Parent involvement in school activities TQ2

A12 During this school year, besides regular teacher conferences, have you communicated with this child's parents/guardians? ECLS-K Communication with parents about child's performance TQ6

A13 Was the purpose of the communication with this child's parents/guardians to discuss
a. Behavior problems the child is having in school
b. Any problems the child is having with school work
c. Anything the child is doing particularly well in or better in at school
ECLS-K Communication with parents about child's performance TQ6

A14 Date questionnaire completed

N/A
Part 2: To be completed only if there is a red dot next to the child's name on the cover of this questionnaire
Mathematics Instruction B1 a-g From the first day of school until today, please indicate on how many days you have covered each of the following MATHEMATICS skills and concepts in this child's class. Please include the time during which you provide direct instruction as well as the time you spend supervising students as they work. Please focus on the skill areas that are shown in bold text. ﴾The unbolded examples are only a sample of things you may do or cover under this skill area.﴿

a. Using algebraic thinking, for example, using parentheses in numerical expressions; writing and interpreting simple numerical expressions; generating and graphing numerical patterns; etc.
b. Understanding place value, for example, understanding the value of a digit in one place as compared to an adjacent place; using whole number exponents to denote powers of 10; reading, writing, and comparing decimals to thousandths; rounding decimals; etc.
c. Adding, subtracting, multiplying, and dividing multiple‐digit whole numbers and decimals to hundredths

ECLS-K, updated to reflect "Common Core State Standards," corestandards.org Time spent on specific activities and skills in mathematics TQ7

d. Understanding fractions, for example, adding and subtracting fractions with unlike denominators; understanding the relationship between decimals and fractions; solving real world problems involving multiplying and dividing fractions by whole numbers; etc.

e. Using concepts of geometric measurement, for example, converting among different measurement units; making plots or graphs to display fractions of a unit; understanding and using units of volume; solving volume problems using multiplication and addition; etc.

f. Representing and interpreting data, for example, making line plots or other visuals to display fractions of a unit; using operations on fractions to answer questions about a line plot; etc.

g. Understanding geometric concepts, for example, using axes (perpendicular lines) to define a coordinate system; classifying two-dimensional figures such as squares and rectangles; etc.

B2 a-m How often do the children in this class engage in the following mathematics activities? ECLS-K, updated to reflect "Common Core State Standards," corestandards.org Time spent on specific activities and skills in mathematics TQ7
a. Solve mathematics problems from textbooks or workbooks
b. Solve mathematics problems from the blackboard, whiteboard/SMART Board@, or projector
c. Solve mathematics problems in small groups or with a partner
d. Work with measuring instruments (for example, rulers, compasses, protractors)
e. Work with manipulatives (for example, geometric shapes, fraction bars)
f. Use a calculator
g. Take mathematics tests/quizzes
h. Write a few sentences about how to solve a mathematics problem
i. Discuss solutions to mathematics problems with other students
j. Work on and discuss mathematics problems that reflect real-life situations
k. Use a computer or tablet (e.g., iPad, Surface) for math (beyond using the device's calculator)
l. Interpret visual representations (for example, diagrams, graphs, tables, models)
m. Create visual representations (for example, diagrams, graphs, tables, models)
Classroom and Student Characteristics C1 a-c As of today’s date, how many children…
a. Are currently enrolled in this class?
b. Are boys?
c. Are girls?
ECLS-K Classroom characteristics: enrollment, gender distribution TQ1; TQ2

C2 a-e What grade levels are included in this class?
a. 3rd grade or lower
b. 4th grade
c. 5th grade
d. 6th grade
e. 7th grade or higher
ECLS-K Classroom characteristics: grade levels within class TQ2

C3 How many of the children in this class are repeating their grade this year? ECLS-K Classroom characteristics: number of repeaters TQ2; TQ3

C4 a-b How many children in this class…
a. Are classified as Gifted and Talented?
b. Are participating in a Gifted and Talented program?
ECLS-K Classroom characteristics: number of gifted and talented TQ3

C5 How many children in this class are absent on an average day? ECLS-K Students above or below grade level TQ3

C6 How many children in this class are below grade level, about on grade level, or above grade level in mathematics skills?

ECLS-K Student absenteeism TQ2

C7 At this point in the school year, how would you rate the behavior of the children in this class? ECLS-K Overall behavior of the class TQ2; TQ5

C8 a-d Items asking the percentage of the students in the classroom who demonstrate behaviors or characteristics that either disrupt or create a challenging learning environment. Items not included due to copyright restrictions (4 items total). New. From Abry, Swanson, & Fabes (2012) Classroom climate (student difficulties) TQ2; TQ5

C9 How many children in this class have a diagnosed disability? ECLS-K Number of students with disabilities TQ3

C10 Do you have any children who are English language learners in this class? (English language learners are children whose native language is one other than English and whose skills in listening, speaking, reading, or writing English are such that they have difficulty understanding school instruction in English.) ECLS-K Number of English language learners TQ3

C11 How many English language learners (ELLs) do you have in this class? ECLS-K Number of English language learners TQ3
Classroom Instruction and Evaluation D1 a-e In a typical day, how much time do children in this math class spend in the following activities?
a. Working independently
b. Working on individual tasks under teacher direction
c. Working with peers under teacher direction
d. Working in small groups with teacher
e. Teacher lecture with large group and/or large group discussion led by teacher
ECLS-K:2011 Grade 1 Proportion of time students spend working independently, small group, large group TQ1

D2 a-h In this class, how frequently do you or your students use computers or the following electronic devices for instructional purposes in reading and language arts? Please include any desktop, laptop, or other computer-type devices.
a. Desktop or laptop computer or other computer-type device (for example, iPad/other tablet, eReader such as Kindle or Nook)
b. Cell phone/smartphone (for example, iPhone)
c. Interactive whiteboard ﴾for example, SMART Board, Activboard﴿
d. Document camera or document projector (for example, ELMO, HoverCam)
e. LCD or DLP projector
f. Digital camera (still or video)
g. CD player, MP3 player/iPod, cassett/tape player
h. DVD player, VCR, or video streaming device (for example, Roku)
i. TV
j. Student resonse system (for example, clickers, responders, ActiVote, ActivExpression)
k. Microphone or classroom audio sound system (for example, TopCat, Redcat)
ECLS-K Availability, use, and adequacy of resources TQ1

D3 In an average week, how many days a week is math homework assigned in this math class? Please count homework assigned over the weekend as one day. ECLS-K Use of homework TQ1

D4 On days when homework is assigned, how much time do you expect children in this class to spend on homework in math? ECLS-K Use of homework TQ1

D5 a-e In this class, how often do you use a formal assessment in MATH for the following purposes?
a. To evaluate how well each student is responding to the core curriculum provided in
the general education classroom
b. To monitor each student's progress on specific skills over the school year
c. To identify the deficits in specific skills of struggling students
d. To monitor the progress of students who fall below benchmark levels
e. To determine whether students need placement in a more or less intensive level of
instruction
ECLS-K:2011 Grade 1 Response to Intervention-related policies and practices TQ6
Staff Activities E1 Did you participate in any professional development* within the last 12 months? ECLS-K:2011 Grade 1 Professional development activities TQ4

E2 a-c How often did you participate in professional development activities covering the following topics in the last 12 months?
a. How to use assessment data to identify students who are struggling or at risk of failure in MATH
b. How to use and apply assessment data
to guide MATH instruction
c. How to implement the MATH
curriculum
Adapted from Reading First Impact Study--Teacher Survey Response to Intervention-related policies and practices TQ6

Sheet 8: App E Spring 5th TQC-S.2

Spring Fifth-Grade Science Teacher Questionnaire, Appendix E
Section Item # Item Stem Source Construct Research Question
Part 1: Please answer the questions in Part 1 about the child identified on the cover of this questionnaire.
Student Information A1 a-d Are you this child's primary teacher in the following subject areas?
a. Reading/language arts
b. Mathematics
c. Science
d. Social studies
ECLS-K Grade/class configuration TQ1

A2 How long has this child been in your science class this school year until now? ECLS-K Family mobility TQ3

A3 Please indicate the total number of times this child has been absent from your science class during the current school year. ECLS-K Attendance TQ3; TQ5

A4 Is English this child's native language? ECLS-K Native language other than English TQ2; TQ3

A5 During this school year, how often is this child's science instruction provided in his/her native language? ECLS-K Receipt of instruction for English language learners TQ2; TQ3

A6 Overall, how would you rate this child’s academic skills in SCIENCE, based on curriculum standards for his/her current grade level?
ECLS-K Comparison to peers: academic skills for current grade level in science TQ5

A7 How often does this child work to the best of his/her ability in SCIENCE? ECLS-K Working to the best of one's ability TQ5

A8 During this school year, have this child's parents/guardians participated in the following activities?
a. Attend regularly-scheduled conferences at your school
b. Attend parent/teacher informal meetings that you initiated to talk about the child's progress
c. Returned your telephone calls or e-mails
d. Initiated contact with you
e. Volunteered to help in your classroom or school
ECLS-K Parent involvement in school activities TQ2

A9 During this school year, besides regular teacher conferences, have you communicated with this child's parents/guardians? ECLS-K Communication with parents about child's performance TQ6

A10 Was the purpose of the communication with this child's parents/guardians to discuss
a. Behavior problems the child is having in school
b. Any problems the child is having with school work
c. Anything the child is doing particularly well in or better in at school
ECLS-K Communication with parents about child's performance TQ6

A11 Date questionnaire completed

N/A
Part 2: To be completed only if there is a red dot next to the child's name on the cover of this questionnaire.


Science Instruction B1 a-h From the first day of school until today, please indicate on how many days you have covered each of the following SCIENCE skills and concepts in this child's class. Please include the time during which you provide direct instruction as well as the time you spend supervising students as they work. Please focus on the skill areas that are shown in bold text. The unbolded examples are only a sample of things you may do or cover under this skill area.﴿
a. Physical science, for example, understanding matter, chemical reactions, gravity, energy, etc.
b. Life science, for example, learning about
organisms, life cycles, food chains,
ecosystems, etc.
c. Earth science, for example, learning about the solar system; interactions of the geosphere, hydrosphere, atmosphere, and biosphere; effects of human activity on Earth's resources and environments, etc.
d. Conceptual modeling, for example, developing and using models to describe events, phenomena, etc.
ECLS-K, updated to reflect "Common Core State Standards," corestandards.org Time spent on specific activities and skills in science TQ7
e. Scientific testing, for example, planning and conducting investigations, observing and measuring using appropriate tools and fair tests to generate data, etc.
f. Analysis and conclusions, for example, analyzing the results of a scientific investigation and determining whether the results support the initial prediction, etc.
g. Interdependence of science, technology and engineering, for example, exploring how scientific discoveries lead to the development of new technologies, new technologies lead to new scientific discoveries, etc.
h. Engineering concepts, for example, identifying a simple design problem that can be solved through the development of an object, tool, process, or system; etc.

B2 a-l How often do the children in this class engage in the following science activities?
a. Read a science textbook or e-book
b. Discuss science in the news
c. Generate and test hypotheses
d. Work with other children on a science activity or
project
e. Use hands-on science equipment (e.g., magnifying glass, scales, thermometers, microscopes, dissecting tools, etc.)
f. Use "virtual" science equipment, that is, use computer-based interactive renderings of science equipment
g. Engage in hands‐on activities or investigations
in science
ECLS-K, updated to reflect "Common Core State Standards," corestandards.org Time spent on specific activities and skills in science TQ7

h. Engage in "virtual" activities or investigations in science, that is, using computer-based tools for the activities or investigations

i. Talk about measurements and results from
children’s hands‐on activities
j. Talk about measurements and results from "virtual" activities
k.Prepare a written science report
l. Take a science test or quiz
m. Use library or media center resources for science
Classroom and Student Characteristics C1 a-c As of today's date, how many children: are currently in this class, are boys, are girls ECLS-K Classroom characteristics: enrollment, gender distribution TQ1; TQ2

C2 a-e What grade levels are included in this class? ECLS-K Classroom characteristics: grade levels within class TQ2

a. 3rd grade or lower

b. 4th grade

c. 5th grade

d. 6th grade

e. 7th grade or higher

C3 How many of the children in this class are repeating their grade this year? ECLS-K Classroom characteristics: number of repeaters TQ2; TQ3

C4 a-b How many children in this class… ECLS-K Classroom characteristics: number of gifted and talented TQ3


a. Are classified as Gifted and Talented?




b. Are participating in a Gifted and Talented program?



C5 How many children in this class are absent on an average day? ECLS-K Student absenteeism TQ3

C6 How many children in this class are below grade level, about on grade level, or above grade level in science? ECLS-K Students above or below grade level in science TQ2

C7 At this point in the year, how would you rate the behavior of the children in this class? ECLS-K Overall behavior of the class TQ2; TQ5

C8 Items asking the percentage of the students in the classroom who demonstrate behaviors or characteristics that either disrupt or create a challenging learning environment. Items not included due to copyright restrictions (4 items total). New. From Abry, Swanson, & Fabes (2012) Classroom climate (student difficulties) TQ2; TQ5

C9 How many children in this class have a diagnosed disability? ECLS-K Number of students with disabilities TQ3

C10 Do you have any children who are English language learners in this class? (English language learners are children whose native language is one other than English and whose skills in listening, speaking, reading, or writing English are such that they have difficulty understanding school instruction in English.) ECLS-K Number of English language learners TQ3

C11 How many English language learners (ELLs) do you have in this class? ECLS-K Number of English language learners TQ3
Classroom Instruction and Evaluation D1 a-e In a typical day, how much time do children in this science class spend in the following activities?
a. Working independently
b. Working on individual tasks under teacher direction
c. Working with peers under teacher direction
d. Working in small groups with teacher
e. Teacher lecture with large group and/or large group discussion led by teacher
ECLS-K:2011 Grade 1 Proportion of time students spend working independently, small group, large group TQ1

D2 a-h In this class, how frequently do you or your students use computers or the following electronic devices for instructional purposes in reading and language arts? Please include any desktop, laptop, or other computer-type devices.
a. Desktop or laptop computer or other computer-type device (for example, iPad/other tablet, eReader such as Kindle or Nook)
b. Cell phone/smartphone (for example, iPhone)
c. Interactive whiteboard ﴾for example, SMART Board, Activboard﴿
d. Document camera or document projector (for example, ELMO, HoverCam)
e. LCD or DLP projector
f. Digital camera (still or video)
g. CD player, MP3 player/iPod, cassett/tape player
h. DVD player, VCR, or video streaming device (for example, Roku)
i. TV j. Student resonse system (for example, clickers, responders, ActiVote, ActivExpression)
k. Microphone or classroom audio sound system (for example, TopCat, Redcat)
ECLS-K Availability, use, and adequacy of resources TQ1

D3 In an average week, how many days a week is science homework assigned in this class? Please count homework assigned over the weekend as one day. ECLS-K Use of homework TQ1

D4 On days when homework is assigned, how much time do you expect children in this class to spend on homework in science? ECLS-K Use of homework TQ1

D5 a-e In this class, how often do you use a formal assessment in SCIENCE for the following purposes?
a. To evaluate how well each student is responding to the core curriculum provided in the general education classroom
b. To monitor each student's progress on specific skills over the school year
c. To identify the deficits in specific skills of struggling students
d. To monitor the progress of students who fall below benchmark levels
e. To determine whether students need placement in a more or less intensive level of
instruction
ECLS-K:2011 Grade 1 Response to Intervention-related policies and practices TQ7
Staff Activities E1 Did you participate in any professional development* within the last 12 months? ECLS-K:2011 Grade 1 Professional development activities TQ4

E2 a-c How often did you participate in professional development activities covering the following topics in the last 12 months?
a. How to use assessment data to identify students who are struggling or at risk of failure in SCIENCE
b. How to use and apply assessment data
to guide SCIENCE instruction
c. How to implement the SCIENCE
curriculum
Adapted from Reading First Impact Study--Teacher Survey Professional development activities; Response to Intervention-related policies and practices TQ6

Sheet 9: App F Spring 5th SpEd A.2

Spring Fifth-Grade Special Education Teacher Teacher-Level Questionnaire, Appendix F
Item # Item Stem Source Construct Research Question
1 What is your gender? ECLS-K Teacher demographic information SEQ4
2 In what year were you born? ECLS-K Teacher demographic information SEQ4
3 Are you Hispanic or Latino? ECLS-K Teacher demographic information SEQ4
4 Which best describes your race? MARK ONE OR MORE RESPONSES TO INDICATE WHAT YOU CONSIDER YOURSELF TO BE.
ECLS-K Teacher demographic information SEQ4
5 What is the highest level of education you have completed?
ECLS-K Teacher’s education SEQ4
6 Is this school year the first year you have worked with children in this school? ECLS-K:2011 First year teaching in current school SEQ4
7 Counting this school year, how many total years have you been working with children receiving special education or related services in any school, including years in which you worked part time? ECLS-K Teaching experience in special education SEQ4
8 Counting this school year, how many total years have you been working with children in any school, including years in which you worked part time? This would include other
assignments such as teaching in a regular classroom or otherwise providing services to children.
ECLS-K Total years teaching experience SEQ4
9 a-m Which of the following credentials, licenses, or certificates do you have for working with children with disabilities? DO NOT INCLUDE ACADEMIC DEGREES, SUCH AS A BACHELOR'S DEGREE, MASTER'S DEGREE OR PH.D.
a. Emergency credential
b. Provisional or temporary credential
c. Disability‐specific credential or endorsement
d. Special education credential or endorsement ﴾for more than one disability category﴿
e. General education credential
f. Speech/language therapy state license or certification
g. Physical therapy state license or certification
h. Occupational therapy state license or certification
i. Social work license or certification
j. School psychology license or certification
k. Clinical psychology license or certification
l. Certificate of Clinical Competence
m. Other professional license, credential, or endorsement
﴾PLEASE SPECIFY﴿
ECLS-K Teaching certification, credentials, and licenses SEQ4
10 Have you taken the exam for National Board for Professional Teaching Standards certification?
Not taken; Taken and passed; Taken and have not yet passed;
Taken and awaiting test results; Not applicable
ECLS-K Teaching certification, credentials, and licenses SEQ4
11 a-r Have you ever taken a college course in the following areas?
a. Early childhood education
b. Early childhood special education
c. Elementary education
d. Child development
e. English as a Second Language ﴾ESL﴿ or teaching English
language learners
f. General special education
g. Learning disabilities
h. Intellectual disability *
i. Orthopedic impairments
j. Serious emotional disturbance
k. Deafness and hearing
l. Blindness and vision
m. Communication disorders
n. Infants and toddlers with disabilities
o. Physical therapy
p. Occupational therapy
q. School psychology
r. Classroom management
ECLS-K Teacher’s education SEQ4
12 a-d Have you ever taken a college course that addressed issues related to the following?
a. Using published research evidence to identify and select effective interventions and supports for students
b. Using formal assessment data to inform the choice of READING interventions and supports for students
c. Using formal assessment data to inform the choice of MATH interventions and supports for students
d. Using data to inform the choice of behavioral interventions and supports for students
ECLS-K:2011 Grade 1 Teacher’s education; Response to Intervention-related practices SEQ4
13 Which of the following best describes your current position in this school?
ECLS-K Teaching position and assignment SEQ4
14 How do you classify your main assignment at this school, that is, the activity at which you spend most of your time during this school year?
ECLS-K Teaching position and assignment SEQ4
15 a-e During this school year, where have you worked with children with IEPs? INCLUDE ONLY CHILDREN WHO ATTEND THIS SCHOOL.
a. In a general education classroom
b. In a special education classroom
c. In a non‐classroom space ﴾for example, office, therapy
room, small work space, mobile van, etc.﴿
d. In a location outside of the school setting ﴾for example, a child's home, a private clinic, etc.﴿
e. Other ﴾PLEASE SPECIFY﴿
ECLS-K Locations in which teacher delivers services SEQ1, SEQ3, SEQ5
16 a-d Please indicate the extent to which you agree or disagree with each of the following statements.
a. I really enjoy my present job.
b. I am certain I am making a difference in the lives of the
children I work with.
c. If I could start over, I would choose this career again.
d. I am satisfied with my class size/caseload.
ECLS-K Teacher’s sense of efficacy; Job satisfaction SEQ4
17 During the school year, how many children with IEPs have you worked with or provided services for, on average, each week? (Include children you work with directly, as well as children for whom you consult with the general education teacher and/or another special education teacher/service provider?
1‐10; 11‐20; 21‐40; More than 40; Don't know
ECLS-K Teaching student caseload SEQ4, SEQ5
18 Date questionnaire completed:

N/A

Sheet 10: App F Spring 5th SpEd B.2

Spring Fifth-Grade Special Education Teacher Child-Level Questionnaire, Appendix F
Item # Item Stem Source Construct Research Question
1 Is this child currently receiving gifted/talented services through an IEP, or has the child received such services during this school year? ECLS-K Child's receipt of services: gifted/talented SEQ1
2 Is this child currently receiving special education services through an IEP due to a disability or has the child received such services during this school year? ECLS-K Child's receipt of services: special education SEQ1
3 a-f In what capacity or capacities do you teach or provide services to this child?
a. Provide instruction directly to the child
b. Provide related services directly to the child
c. Provide consultation services directly to the child
d.Provide indirect consultation services ﴾for example, consultation to the child's teacher﴿
e. Provide case management
f. Other ﴾PLEASE SPECIFY﴿
ECLS-K Type of special education services SEQ1
4 When was this child first determined eligible for special education or related services?
ECLS-K Length of diagnosis and services SEQ7
5 Is this the first school year that the child has been receiving special education services? ECLS-K Age/Grade of first IEP and services for child SEQ7
6 When did this child first start receiving special education or related services?
ECLS-K Age/Grade of first IEP and services for child SEQ7
7 To what extent were you involved in planning the transition from last year's special education program to this year's special education program for this child?
ECLS-K Transition activities SEQ1
8 To what extent did you communicate with the person(s) who provided special education for this child last year?
ECLS-K Transition activities SEQ1
9 Have you reviewed this child’s records related to special education services provided before this school year?
ECLS-K Transition activities SEQ1
10 What is this child’s primary disability as identified on the child’s IEP? PLEASE SELECT THE CATEGORY BELOW INTO WHICH THE CHILD'S PRIMARY DISABILITY FITS BEST.
ECLS-K Child’s disability SEQ2
THE REST OF THE ITEMS IN THIS QUESTIONNAIRE REFER TO THIS CHILD'S SPECIAL EDUCATION EXPERIENCE DURING THE CURRENT SCHOOL YEAR.
11 a-n During this school year, for which of the following disabilities has this child received special education or related services, whether for the child’s primary disability or another of his/her disabilities?
a. Speech or language impairments
b. Specific learning disabilities
c. Emotional disturbance
d. Intellectual disability *
e. Developmental delay
f. Visual impairments ﴾including blindness﴿
g. Hearing impairments ﴾including deafness﴿
h. Orthopedic impairments
i. Other health impairments
j. Autism
k. Traumatic brain injury
l. Deaf‐blindness
m. Multiple disabilities (children included in this category should be those who have more than one primary disability which do not include deaf-blindness or developmental delay)
n. No classification given.
ECLS-K Child’s disability SEQ2
12 During this school year, has this child received any special education or related services because of a diagnosed Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD)? ECLS-K Child's disability SEQ2
13 a-p During this school year, which of the following describe(s) the IEP goals for this child?
Academics
a. Reading
b. Mathematics
c. Language Arts
d. Science
Speech and language
e. Auditory processing
f. Listening comprehension
g. Oral expression
h. Voice/speech articulation
i. Language pragmatics
Social
j. Social skills
k. General appropriateness of behavior
Life skills
l. Adaptive behavior or self-help skills
Physical/Mobility
m. Fine motor skills
n. Gross motor skills
o. Orientation and mobility
Other
p. Other (PLEASE SPECIFY)
ECLS-K IEP goals SEQ5
14 a-m During this school year, which of the following related services have been provided through the school to this child?
a. Audiology
b. Counseling services
c. Occupational therapy
d. Physical therapy
e. Psychological services
f. Health services
g. Social work services
h. Special transportation
i. Speech or language therapy
j. Orientation services
k. Mobility services
l. Rehabilitation services
m. Other ﴾PLEASE SPECIFY﴿
ECLS-K Type of special education services SEQ1, SEQ2
15 a-n During this school year, has this child received any of the following?
a. Adaptive physical education
b. Assistance from classroom aides ﴾for example, teacher aide,
behavioral assistant, special education aide﴿
c. Interpreter for the deaf or hard of hearing ﴾oral or sign﴿
d. Teacher used Braille to provide instruction
e. Child was taught how to use Braille
f. Teacher used American Sign Language to provide instruction
g. Child was taught how to use American Sign Language
h. Teacher used Manual English to provide instruction
i. Child was taught how to use Manual English
j. Teacher used Cued Speech to provide instruction
k. Child was taught how to use Cued Speech
l. Mental health services, personal/group counseling, therapy, or
psychiatric care provided to the child
m. Tutoring/remediation from special education teacher
n. Training, counseling, and other supports/services provided to
this child's family
ECLS-K Type of special education services SEQ1, SEQ2
16 During this school year, has this child’s primary placement been a general education classroom? ECLS-K Child’s classroom placement SEQ1;SEQ3, SEQ5
17 During this school year, approximately how many hours per week of direct special education and related services (that is, service provided directly to the child, from a teacher or another adult) has this child received? ECLS-K Frequency of special education services SEQ1
18 Of the hours of direct special education and related services reported above, approximately how many of those hours per week were the instruction/services provided outside of a general education classroom but within the school setting? ECLS-K Frequency of special education services: outside general education classroom SEQ1, SEQ3
19 a-l During this school year, what teaching practices and methods have you and/or other special education service providers used with this child?
a. One‐on‐one instruction
b. Small‐group instruction
c. Large‐group instruction
d. Co‐teaching ﴾see definition above﴿
e. Cooperative learning
f. Peer tutoring
g. Computer‐based instruction
h. Direct instruction
i. Cognitive strategies
j. Self‐management
k. Behavior management
l. Instruction received through a sign interpreter
ECLS-K Teaching methods and materials SEQ1, SEQ2
20 During this school year, which of the following best describes the curriculum materials used with this child in the general education classroom?
ECLS-K Teaching methods and materials SEQ1, SEQ2
21 During this school year, which of the following best describes the curriculum materials used with this child in the special education classroom/program?
ECLS-K Teaching methods and materials SEQ1, SEQ2
22 During this school year, has this child had the assistance of a service animal while at school? A SERVICE ANIMAL IS ANY GUIDE DOG, SIGNAL DOG, OR OTHER DOG INDIVIDUALLY TRAINED TO PROVIDE ASSISTANCE TO AN INDIVIDUAL WITH A DISABILITY. SERVICE ANIMALS CAN BE USED FULL TIME OR IN-SCHOOL ONLY AS PART OF A PROGRAM SUCH AS ANIMAL ASSISTED THERAPY (AAT).
ECLS-K:2011 Teaching methods and materials: assistive technology SEQ1, SEQ2
23 a-z During this school year, which of the following assistive technologies and devices has this child used?
Mobility aids
a. Vans, vehicles
b. Wheelchair
c. Walker
d. White cane
Communication aids
e. Electronic with voice output ﴾for example, Touch Talker﴿
f. Electronic without voice output ﴾for example, device with visual display or printed speech output﴿
g. Non‐electronic ﴾for example, manual printing board﴿
Hearing assistance
h. Hearing aids
i. FM loops
j. TTYs/TDDs
k. Cochlear implants
l. Real‐time captioning
Visual aids
m. Braille texts
n. Electronic Braille devices
o. Digital texts
p. Magnifying devices
q. Close‐captioned television ﴾CCTV﴿
ECLS-K Teaching methods and materials: assistive technology SEQ2, SEQ5
Learning aids (non-computer)
r. Tape recorder
s. Calculator
t. Electronic spelling devices
Computer hardware designed or adapted for children with disabilities (for example, alternate keyboards, switch interface)
u. Used solely by individual child
v. Shared with other children
Computer software designed for children with disabilities
w. Reading
x. Writing
y. Mathematics
Other assistive technologies or devices
z. Other (PLEASE SPECIFY)
24 Does this child have a computer, laptop, or word processing device assigned to him/her for use full time this school year? ECLS-K Teaching methods and materials: assistive technology SEQ5, SEQ7
25 During this school year, on average, how often have you met with general education teacher﴾s﴿ to discuss this child's program or progress?
ECLS-K Staff communication SEQ5, SEQ7
26 On average, how long were the meetings with the general education teacher﴾s﴿ to discuss this child's program or progress?
ECLS-K Staff communication SEQ5, SEQ7
27 During this school year, approximately how often have you communicated with this child's parents about this child's program or progress ﴾by phone, in person, or in writing, including e‐mail﴿?
ECLS-K Parent communication SEQ6
28 a-h During this school year, has this child received formal individual evaluations in any of the following areas for purposes of developing IEP goals?
a. Psychological
b. Speech/language
c. Vision
d. Hearing
e. Learning style
f. Motor skills
g. Academics
h. Other ﴾PLEASE SPECIFY﴿
ECLS-K Participation in assessment TQ3, SEQ5, SEQ7
29 To what extent is this child expected to achieve the same general education goals as other children at his/her grade level this school year?
ECLS-K Expectation for achievement of general education goals TQ3, SEQ5
30 What percentage of this child's current IEP goals have been met or nearly met at this point in the school year?
ECLS-K IEP goal achievement SEQ1; SEQ7
31 Which of the following best expresses the likelihood that this child will continue to receive some level of special education services ﴾through an IEP﴿ in the next school year?
ECLS-K IEP goal achievement TQ3, SEQ7
32 During this school year, to what extent has this child participated in any grade‐level assessment administered as part of the school's testing program?
ECLS-K Participation in assessment TQ3, SEQ3, SEQ5
33 Did this child receive special accommodations to participate in the school's regular testing or assessment program this school year? ECLS-K Participation in assessment: special accommodations TQ3, SEQ3, SEQ5
34 In which grade is this child enrolled?
ECLS-K Current grade level N/A
35 Date Questionnaire Completed:
N/A N/A

Sheet 11: App G Spring 5th SAQ.2

Spring Fifth-Grade School Administrator Questionnaire For All Schools, Appendix G
Section Item # Item Stem Source Construct Research Question
School Characteristics A1 How many instructional days will this school provide during this academic year? ECLS-K Length of school year SAQ1

A2 a-d School enrollment. WRITE IN THE APPROXIMATE NUMBER OF CHILDREN FOR EACH OF THE FOLLOWING. ECLS-K Enrollment and attendance SAQ2
a. Total enrollment in fifth grade in your school around October 1, 2015, or the date nearest to that for which data are available
b. Total enrollment for your school (across all grades) around October 1, 2015, or the date nearest to that for which data are available
c. Number of children who have enrolled in your school Since October 1, 2015
d. Number of children who have left your school since October 1, 2015, and have not returned

A3 Approximately, what is the Average Daily Attendance for your school this year? ECLS-K Enrollment and attendance SAQ7

A4 How many children is this school site designed to accommodate? ECLS-K Adequacy of school facility SAQ2

A5 Mark all grade levels included in your school. ECLS-K School type (grade levels) SAQ2

A6 Which of the following characterizes your school? MARK ALL THAT APPLY. ECLS-K School type (public/private/affiliation; grades; magnet; etc.) SAQ2
Regular public school (not including magnet school)
Public magnet school
Charter school
Catholic school: Diocesan; Parish; Private order
Other private school, religious affiliation
Private school affiliated with NAIS, no religious affiliation
Other private school, no religious or NAIS affiliation
Early childhood center (school/center includes preschool and/or early grades)
Special education school -- primarily serves children with disabilities
Year-round school
Bureau of Indian Education (BIE) or tribal school

A7 In what year did this school start providing instruction as a public CHARTER school? ECLS-K School type (public/private/affiliation; grades; magnet; etc.) SAQ2

A8 Which of the following characterizes your public CHARTER school? For profit; Not for profit ECLS-K School type (public/private/affiliation; grades; magnet; etc.) SAQ2

A9 a-h Approximately how many or what percentage of the children in your school belongs to each of the following racial/ethnic groups? ECLS-K Student demographic information: race/ethnicity distribution SAQ2
a. Hispanic/Latino of any race
b. American Indian or Alaska Native, not Hispanic or Latino
c. Asian, not Hispanic or Latino
d. Black or African American, not Hispanic or Latino
e. Native Hawaiian or Other Pacific Islander, not Hispanic or Latino
f. White, not Hispanic or Latino
g. Two or more races, not Hispanic or Latino
h. Total school enrollment (sum of a through g)

A10 If your school is a private, magnet, or charter school, please check here and SKIP TO Q A13. ECLS-K:2011 Grade 1 School type (public/private/affiliation; grades; magnet; etc.) SAQ2

A11 a-c About what percentage of the children enrolled in this school attend from outside of this school’s assigned attendance area because…. ECLS-K Student demographic information: transfers from outside attendance area SAQ2
a. They have special needs (gifted and talented, children with disabilities, etc.) and attend to receive a specialized program or service?
b. They transferred into the school because their previous school did not make adequate yearly progress (AYP)? (Adequate yearly progress is your state's measure of yearly progress toward achieving state academic standards.)
c. They attend this school under public school choice for reasons other than their assigned school did not make AYP (that is, excluding those who are reported in b)?

A12 About what percentage of the children enrolled in this school are from the surrounding neighborhood? ECLS-K School characteristics SAQ2

A13 About what percentage of the children enrolled in this school are eligible for free or reduced-price lunch? ECLS-K Student demographic information: indicator of poverty SAQ2
School-Family-Community Connections B1 Are any of the following programs for fifth-grade children and their families at your school site? Please include programs run by the school and those run by outside groups. ECLS-K Programs or services for children SAQ4
a. Before-school child care


b. After-school child care


c. Hearing screening


d. Vision screening


B2 Are any of the following programs or services for parents and families available at your school site? Please include programs run by the school and those run by outside groups. ECLS-K Programs or services for parents and families SAQ4
a. Parenting education programs (for example, classes on child development, education in being a parent, understanding children with special needs)
b. Adult literacy programs (including Adult Basic Education)
c. Family literacy program
d. Health or social services offered collaboratively by service agencies like hospitals
e. Orientation to school setting for new families
f. Child care so that parents can attend school parent meetings or events
g. Programs to learn English for parents or families whose native language is not English
B3 a-f Please indicate how often each of the following activities is provided by your school. ECLS-K School-based programs or services for parents and families SAQ3, SAQ4

a. PTA, PTO, or Parent-Teacher-Student organization meetings

b. Reports (report cards) of children's performance provided to parents

c. Information on the child's standardized assessment scores provided to parents

d. Teacher-parent conferences

e. School performances to which parents are invited

f. Classroom programs like class plays, book nights, or family math nights

B4 a-b During this school year, how often has your school used the following ways to communicate with all parents? ECLS-K:2011 Parent outreach and communication SAQ3, SAQ4
a. Electronic communication to all parents, such as group emails, electronic newsletters, website postings, "robocalls" (mass automated phone calls), text alerts, or other electronic notices for all parents
b. Non-electronic communications to all parents, such as letters, newsletters, phone calls, or other non-electronic messages for all parents

B5 During this school year, has your school used an online tool or website that is available to the general public and that parents can access without a login or password? ECLS-K:2011 Parent outreach and communication SAQ3, SAQ4

B6 During this school year, has your school (or any teacher)) used an online tool or website that parents can only access with a login or password to get information about their child, the child's class, or the school? ECLS-K:2011 Parent outreach and communication SAQ3, SAQ4

B7 a-b Have the following types of information been provided in the online tool or website that parents can only access with a login and password? ECLS-K:2011 Parent outreach and communication SAQ3, SAQ4
a. Classroom-specific assignments, including homework
b. Child- or parent-specific information, such as progress reports between grading periods

B8 a-f How much of a problem are the following in the neighborhood where this school is located? ECLS-K Neighborhood problems SAQ6
a. Tensions based on racial, ethnic, or religious differences
b. Selling or using drugs or excessive drinking in public
c. Gangs
d. Vacant houses and buildings
e. Crime in the neighborhood
f. Violence in the neighborhood

B9 a-i To the best of your knowledge how often do the following types of problems occur at your school? ECLS-K School safety SAQ7
a. Children bringing weapons to school
b. Theft
c. Physical conflicts among students
d. Children bringing in or using alcohol at school
e. Children bringing in or using illegal drugs at school
f. Vandalism of school property
g. Student bullying
h. Widespread disorder in classrooms
i. Class cutting

B10 a-g Does your school take any of the following measures to ensure the safety of children? ECLS-K Measures taken to ensure school safety SAQ7
a. Security guards, unarmed
b. Security guards, armed
c. Metal detectors
d. Locked doors during the school day
e. A requirement that visitors sign in
f. Intercoms or telephones in classrooms
g. Other (PLEASE SPECIFY)

B11 a-f To what extent is each of the following matters a problem in this school? Indicate whether each is a SERIOUS problem, a MODERATE problem, a MINOR problem, or NOT a problem in this school. ECLS-K Enrollment and attendance; School climate; Teacher mobility SAQ7
a. Student tardiness
b. Student absenteeism
c. Student aggressive or disruptive behavior
d. Teacher absenteeism
e. Teacher turnover
f. Overcrowding

B12 a-k During the past year, to what extent did any of the following changes occur at your school? ECLS-K Recent changes at the school SAQ2
a. Funding levels decreased
b. Enrollment increased
c. Enrollment decreased
d. The number of students receiving free or reduced-price lunch increased
e. Student mobility increased (that is, the number of students transferring in and out of the school increased)
f. There has been a reduction in staffing
g. Class sizes increased
h. Class sizes decreased
i. Salaries increased
j. Salaries decreased
k. Number of English language learners increased

B13 During the past year, were salaries frozen at your school? ECLS-K:2011 Grade 1 Recent changes at the school SAQ2


IF YOUR SCHOOL IS A PRIVATE, MAGNET, OR CHARTER SCHOOL, SKIP TO C1. IF YOUR SCHOOL IS NOT A PRIVATE, MAGNET OR CHARTER SCHOOL, GO TO Q C14.



B14 During the past year, were changes made to your school's assigned attendance area? ECLS-K:2011 Grade 1 Recent changes at the school SAQ2
School Policies and Practices C1 Which of the following statements describe your school's grade promotion and retention practices or policies?
a. This school has a formal retention policy.
b. Children can be retained more than once in each grade.

C2 How many fourth-grade children were retained at their current grade level last school year? ECLS-K Retention policies and practices SAQ2

C3 How many fifth-grade children were retained at their current grade level last school year? ECLS-K Retention policies and practices SAQ2

C4 Is a school-wide positive behavioral intervention and support program (for example, Positive Behavioral Support, Positive Behavioral Intervention System) implemented at your school? Adapted from FRSS 99: Dropout Prevention Services and Programs survey Response to Intervention-related policies and practices SAQ9

C5 a-d For each of the following statements about READING and MATH, indicate how strongly you agree or disagree. Adapted from WA (RTI) and HB 2136: Spring 2010 Response to Intervention-related policies and practices SAQ9
a. This school has a set of clear, predetermined, grade-level benchmarks (that is, cut scores, goals/targets, or percentiles) that are used to determine which students are struggling or at risk of failure in READING.
b. At this school, we use data from screening tests to determine if core instruction in READING is meeting the needs of most of our students.
c. This school has a set of clear, predetermined, grade-level benchmarks (that is, cut scores, goals/targets, or percentiles) that are used to determine which students are struggling or at risk of failure in MATH.
d. At this school, we use data from screening tests to determine if core instruction in MATH is meeting the needs of most of our students.

C6 Is Response to Intervention (RtI) currently used at your school in fifth grade, either partially or fully implemented? Adapted from IDEA national Assessment Implementation Study (LEA) Response to Intervention-related policies and practices SAQ9

C7 a-d Is RtI currently implemented at your school in fifth grade in the following areas? Adapted from IDEA national Assessment Implementation Study (LEA) Response to Intervention-related policies and practices SAQ9
a. Math
b. Reading
c. Writing
d. Behavior/Social skills

C8 Has your school implemented the Common Core State Standards at any grade(s)? ECLS-K:2011 Implementation of Common Core State Standards SAQ10

C9 a-b Are the Common Core State Standards currently implemented at your school in fifth grade in the following areas? ECLS-K:2011 Implementation of Common Core State Standards SAQ10
a. Reading and Language Arts
b. Mathematics

C10 Approximately how many years ago did your school begin implementing the Common Core State Standards in any grade or subject? ECLS-K:2011 Implementation of Common Core State Standards SAQ10
School Programs for Particular Populations D1 Do any of the children in this school come from a home where a language other than English is spoken? ECLS-K Student demographic information: language other than English SAQ2

D2 What percentage of children in this school are English language learners (ELL)? ECLS-K Delivery of instruction to English Language Learners (ELL) and services for language minority (LM) families SAQ2

D3 What percentage of children in fifth grade are English language learners (ELL)? ECLS-K Delivery of instruction to English Language Learners (ELL) and services for language minority (LM) families SAQ2

D4 a-c Are any of the following services provided to families of children from households where a language other than English is spoken? ECLS-K Delivery of instruction to English Language Learners (ELL) and services for language minority (LM) families SAQ5
a. Translators are made available to parents for parent/teacher and parent/school staff meetings and/or meetings are conducted in the parents' non-English language.
b. Translations of written communications are provided to these parents.
c. Home visits are made to families of these children.

D5 Since the beginning of this school year (2015-2016), how many students have been NEWLY evaluated at your school to determine if they are eligible for an IEP? Adapted from IDEA national Assessment Implementation Study (LEA) Evaluation for IEP SAQ9

D6 Of those students who have been NEWLY evaluated at your school this school year (2015-2016), how many were found eligible for an IEP, including those who may have an IEP for speech only? Adapted from IDEA national Assessment Implementation Study (LEA) Special education eligibility SAQ9

D7 a-b What method(s) are used in your school to determine special education ELIGIBILITY for students with learning disabilities? Adapted from IDEA national Assessment Implementation Study (LEA) Special education eligibility SAQ9
a. IQ-achievement discrepancy model which shows whether there is a discrepancy between expected performance and actual performance
b. Response to Intervention (RtI) model

D8 a-e Approximately what percentage of your fifth-graders are in each of the following instructional programs? ECLS-K Delivery of special education and related services to children with disabilities SAQ4
a. Special education with an Individualized Education Program (IEP)
b. Receive accommodations through a 504 plan
c. Reading instruction for students performing below grade level in reading
d. Math instruction for students performing below grade level in math
e. A gifted and talented program

D9 Where are children with Individualized Education Programs (IEPs) typically served in this school? ECLS-K Delivery of special education and related services to children with disabilities SAQ4
Federal Programs: Title I, Adequate Yearly Progress, and Title III E1 Did your school receive Federal Title I funds for this school year? ECLS-K:2011 Services and programs: Title I SAQ2

E2 Is your school operating a Title I targeted assistance or schoolwide program? Targeted assistance program; Schoolwide program ECLS-K:2011 Services and programs: Title I SAQ2

E3 Did your school receive Federal Title III funds for this school year? (Title III is “Language Instruction for Limited English Proficient and Immigrant Students.”) ECLS-K:2011 Services and programs: Title III SAQ2

E4 At the end of the LAST school year (2014-2015), did this school made Adequate Yearly Progress (AYP)? (Adequate Yearly Progress is your state's measure of yearly progress toward achieving state academic standards.) ECLS-K:2011, based on NCLB Title I regulations School status relative to Adequate Yearly Progress (AYP) SAQ2

E5 At the end of the LAST school year (2014-2015), was this school identified for improvement due to Adequate Yearly Progress (AYP) requirements? (A school is identified for improvement if it does not make Adequate Yearly Progress for two consecutive years or more in the same
content area.)
ECLS-K:2011, based on NCLB Title I regulations School status relative to Adequate Yearly Progress (AYP) and school improvement SAQ2
Staffing and Teacher Characteristics F1 a-f Approximately how many staff members does your school currently have in the following categories? ECLS-K Numbers of full- and part-time teachers, specialists, nurses, and paraprofessionals SAQ2
a. Regular classroom teachers
b. ESL/bilingual education/language immersion/ELL instruction teachers
c. Drama, music, or art teachers
d. Gym/PE or health teachers
e. Special education teachers and related service providers (for example, speech therapist, physical therapist, adaptive physical education, etc.)
f. Paraprofessionals (for example, classroom aides)

F2 a-h Does your school currently have any staff members (full- or part-time) in the following categories? ECLS-K:2011, Grade 1 Number of staff members and specialists SAQ2
a. Teachers of gifted/talented students
b. Reading specialists and interventionists
c. Math specialists and interventionists
d. School nurses or health professionals
e. School psychologists or social workers
f. Guidance counselors
g. Library media specialists/librarians
h. Computer/technology teachers or support staff

F3 a-e Does your school currently have any staff members who do the following as their primary role or one of their primary roles? ECLS-K Response to Intervention-related policies and practices SAQ9
a. A school staff member who provides ongoing training or support to classroom teachers in the delivery of effective READING instruction


b. A school staff member who provides ongoing training or support to classroom teachers in the delivery of effective MATH instruction


c. A school staff member who provides ongoing training or support to classroom teachers in the delivery of effective behavioral supports


d. A school staff member who supports teachers in collecting, organizing, and managing assessment data


e. A school staff member who supports teachers in the interpretation and use of assessment data to guide instruction



F4a-b Please indicate the number of regular classroom teachers who have joined or left your school since October 1, 2015. ECLS-K Teacher mobility SAQ2; SAQ7
a. Number of regular classroom teachers who have begun teaching in your school since October 1, 2015
b. Number of regular classroom teachers who have left your school since October 1, 2015

F5a-h What percentage of your part-time and full-time teachers, including regular classroom, ESL/bilingual, remedial, special education, art, music, and physical education teachers, belongs to each of the following racial/ethnic groups? ECLS-K Racial and ethnic composition of teaching staff SAQ2


a. Hispanic/Latino of any race




b. American Indian or Alaska Native, not Hispanic or Latino




c. Asian, not Hispanic or Latino




d. Black or African American, not Hispanic or Latino




e. Native Hawaiian or Other Pacific Islander, not Hispanic or Latino




f. White, not Hispanic or Latino




g. Two or more races, not Hispanic or Latino




h. Total number of teachers (sum of a through g)



F6 a-b Are monetary incentives such as cash bonuses, salary increases, or different steps on the salary schedule used in your school to reward teachers for... ECLS-K:2011, Grade 1 Teacher Incentives SAQ2
a. Improved student performance on state tests?
b. Reaching target goals on state tests?

F7 a-f Did this school's principal (or head administrator) complete the majority of the previous sections or was the majority completed by someone else? ECLS-K N/A N/A

F8 If a person other than the school's principal (or head administrator) has completed the previous sections, please write in the name and title of the person who completed the majority of the sections. ECLS-K N/A N/A

F9 How long has the individual listed above been employed at this school? ECLS-K School administrator demographic information SAQ8
School Administrator Characteristics G1 What is your gender? ECLS-K School administrator demographic information SAQ8

G2 In what year were you born? ECLS-K School administrator demographic information SAQ8

G3 Are you Hispanic or Latino? ECLS-K School administrator demographic information SAQ8

G4 Which best describes your race? ECLS-K School administrator's experience SAQ8

G5 a-c How many years of experience do you have in each of the following positions, including years in which you worked part time? ECLS-K:2011, Grade K School administrator's formal education and training SAQ8
a. Years as a teacher before becoming a school administrator
b. Total numbers of years as a school administrator
c. Number of years as school administrator at this school

G6 a-f Through which, if any, of the types of training programs below did you receive preparation for fulfilling your role as a school administrator? ECLS-K School administrator's formal education and training SAQ8
a. Traditional university-based training and certification program
b. District-based training program (for example, the Boston Principal Fellowship, New York City Leadership Academy's Aspiring Principals Program, Chicago's LAUNCH program)
c. City-based training program (for example, Cleveland's First Ring Leadership Academy )
d. State-based training program (for example, New Jersey EXCEL)
e. Training and/or certification program run by a national non- profit organization (for example, KIPP School Leadership Program, New Leaders for New Schools)
f. Another school administration preparation program

G7 What is the highest level of education you have completed? ECLS-K School administrator's formal education and training SAQ8

G8 a-f What was your major field(s) of study in the highest degree you completed? ECLS-K School administrator’s familiarity with students SAQ8
a. Early childhood education
b. Elementary education
c. Education administration/management
d. Special education
e. Other education-related major (such as secondary education, educational psychology, science education, music education, etc.)
f. Non-education major (such as history, English, etc.)

G9 What is your best estimate of the percentage of children in your school you know by name? ECLS-K School administrator’s use of a non-English language SAQ8

G10 During school hours, do you speak a language other than English with students at your school whose native language is not English? ECLS-K School administrator’s use of a non-English language SAQ8

G11 Do you speak a language other than English with students’ families whose native language is not English? ECLS-K School administrator’s use of a non-English language SAQ8

G12 If you do not speak a language other than English with EITHER students OR students’ families whose native language is not English, mark here and SKIP TO Q G14. ECLS-K School administrator’s use of a non-English language SAQ8

G13 What language(s) other than English do you speak with students at your school or with their families? ECLS-K School administrator’s familiarity with students SAQ8

G14 Date questionnaire completed/Questionnaire completed by: ECLS-K

File Typeapplication/vnd.openxmlformats-officedocument.spreadsheetml.sheet
File Modified0000-00-00
File Created0000-00-00

© 2024 OMB.report | Privacy Policy