Attachment C.6: Teacher reports to questions about children in classroom (administered as part of the follow-up teacher survey)

Variations in Implementation of Quality Interventions (VIQI)

C.6_VIQI OMB 30 Teacher Report on Children_revised clean

Attachment C.6: Teacher reports to questions about children in classroom (administered as part of the follow-up teacher survey)

OMB: 0970-0508

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Attachment C.6: VIQI Teacher Report on Children in the Impact Evaluation

April 2018

Attachment C.6


TEACHER REPORT ON CHILDREN


The purpose of the Teacher Report on Children is to capture children’s social and behavioral outcomes based on teacher observation and interaction during routine classroom activities at the end (follow-up) of the pilot study and impact evaluation and process study. Lead teachers will be asked to complete a report on selected children in their classroom. This will be handed out as the same time as the follow-up teacher survey.













An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-XXXX and the expiration date is XX/XX/XXXX.

  1. Introduction

Thank you for participating in the Variations in Implementation of Quality Interventions (VIQI) Project! As part of this study, we would like you to answer some questions about some children in your classroom. This information is crucial to helping us understand the impacts of early care and education centers on children.


Your participation is completely voluntary, and you may skip any questions you do not wish to answer. Your decision to participate will not have any effect on your job. The study team will follow strict procedures to protect your responses, and your responses will only be used for research and program improvement purposes. Your responses will be stored in password protected computer files and in locked research facilities. The data will be used only by the research team and other researchers bound by the same security requirements described here. We also may share de-identified responses with researchers looking at other education research topics who agree that they will protect your information.


Please complete this questionnaire within the next [X] days. Once complete, please send it back to [ADDRESS]. It will take approximately 40 minutes in total to complete. If you have any questions, please contact your project liaison at [PHONE] or [email].


Thank you!

  1. Please fill out the following inventory of classroom behaviors for [child name]. For each behavior, please select how often the behavior occurs for [child name] – never, seldom, often, or almost always.


Never

Seldom

Often

Almost Always

  1. Follows your directions.

1

2

3

4

  1. Completes tasks without bothering others

1

2

3

4

  1. Makes friends easily.

1

2

3

4

  1. Participates appropriately in class.

1

2

3

4

  1. Pays attention to your instructions.

1

2

3

4

  1. Interacts well with other children.

1

2

3

4

  1. Stays calm when teased.

1

2

3

4

  1. Joins activities that have already started.

1

2

3

4

  1. Ignores classmates when they are distracting.

1

2

3

4

  1. Invites others to join in activities.

1

2

3

4

  1. Takes criticism without getting upset.

1

2

3

4

  1. Participates in games or group activities.

1

2

3

4

  1. Uses appropriate language when upset.

1

2

3

4

  1. Resolves disagreements with you calmly.

1

2

3

4

  1. Follows classroom rules.

1

2

3

4

  1. Starts conversations with peers.

1

2

3

4

  1. Responds appropriately when pushed or hit.

1

2

3

4

  1. Introduces herself/himself to others.

1

2

3

4

  1. Makes compromise during a conflict.

1

2

3

4

  1. Stays calm when disagreeing with others.

1

2

3

4








































  1. Please fill out the following inventory of classroom behaviors for [child name]. For each behavior, please select how often the behavior occurs for [child name] – never, seldom, often, or almost always.



Never

Seldom

Often

Almost Always

  1. Acts without thinking.

1

2

3

4

  1. Bullies others.

1

2

3

4

  1. Has difficulty waiting for a turn.

1

2

3

4

  1. Fidgets or moves around too much.

1

2

3

4

  1. Forces others to act against their will.

1

2

3

4

  1. Withdraws from others.

1

2

3

4

  1. Has temper tantrums.

1

2

3

4

  1. Breaks into or stops group activities.

1

2

3

4

  1. Is aggressive toward people or objects.

1

2

3

4

  1. Gets embarrassed easily.

1

2

3

4

  1. Cheats in games or activities.

1

2

3

4

  1. Acts lonely.

1

2

3

4

  1. Is inattentive.

1

2

3

4

  1. Fights with others.

1

2

3

4

  1. Says bad things about self.

1

2

3

4

  1. Disobeys rules or requests.

1

2

3

4

  1. Has low energy or is lethargic.

1

2

3

4

  1. Gets distracted easily.

1

2

3

4

  1. Talks back to adults.

1

2

3

4

  1. Acts sad or depressed.

1

2

3

4

  1. Lies or does not tell the truth.

1

2

3

4

  1. Acts anxious with others.

1

2

3

4





































  1. Please report on whether each behavior describes [child name] not at all, a little, moderately well, well, or very well. Please select the most appropriate response to each question.

Not at all

A little

Moderately well

Well


Very well

  1. Completes work.

1

2

3

4

5

  1. Well organized.

1

2

3

4

5

  1. Functions well even with distractions.

1

2

3

4

5

  1. Works well without adult support.

1

2

3

4

5

  1. A self-starter.

1

2

3

4

5



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