OMB_CARES_2nd_Package_Appendix_A_1_Baseline_Lead_Teacher_Self-Report_Survey_rev050709[1]

Appendix A.1:  Head Start CARES Baseline Lead Teacher Self-Report Survey

Updated: May 5, 2009

TEACHER SELF-REPORT SURVEY

FOR

HEAD START CARES STUDY

To be completed by the Lead Teacher Only

Thank you for your participation in the Head Start CARES (Classroom-based Approaches and Resources for Emotion and Social skill promotion) research study. As part of this study, we would like you to answer some questions about yourself and your experiences as a Head Start teacher. This information is crucial in helping us understand the future impacts of Head Start CARES on children. Your participation is completely voluntary and you may, without penalty, skip any questions you do not wish to answer. However, please know that the answers to these questions will be kept completely private and will be used for research purposes only. Your performance as a teacher is not being evaluated, and your responses will not be shared with your supervisor, other staff at your school, or parents. The overall results of this study may be published in reports, but you will never be identified individually. To make sure we keep your information as private as possible, all paper data will be stored in locked research facilities, and electronic files will be password-protected.

You will receive $15 after filling out this survey to reimburse you for your time and effort.

General Instructions:

1. Complete the survey:

   • Please use pencil so that you can fix mistakes easily.

   • Bubbles do not have to be shaded in.

   • Xs or √s are fine.

   • You may skip any questions you do not wish to answer.

2. After you finish, please put it inside the provided envelope and seal it before you give it to the observer.

Section A

In this section, we would like to learn more about you and your professional background.

Date: __ __ /__ __ / 2009

Head Start Center Name:

Teacher Name:

First Last

A1. What is your age? |___|___| YEARS

A2. What is your gender? Female ¦₁ Male ¦₂

A3. What is your birth date? |___|___| / |___|___| /|___|___|

Month Day Year

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A4. Are you of Spanish, Hispanic, or Latino origin?

Yes ¦₁

N o ¦₀ GO TO A6

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A5. Which one of these best describes you? You may name more than one if you like.

Mexican, Mexican American,

Chicano ¦₁

Puerto Rican ¦₂

Cuban ¦₃

Another Spanish/

Hispanic/Latino group ¦₄

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A6. What is your race? You may name more than one if you like.

White ¦₁

Black or African American ¦₂

American Indian or Alaska Native ¦₃

Asian ¦₄

Native Hawaiian or Pacific Islander ¦₅

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A7. In what country were you born?

U SA ¦₁ GO TO A9

A nother country ¦₂ Specify:

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A8. How many years have you lived in the United States? |___|___| Number of years

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A9. What language(s) do you speak (include English)?

A10. In total, how many years have you been teaching (including all grades and preschool)?

| | | Number of years

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A11. How many of those years have you been teaching Head Start (as either lead or assistant teacher)?

| | | Number of years

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A12. How many years have you been teaching in this particular Head Start center?

| | | Number of years

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A13. What is the highest grade or year of school that you completed?

Up to 8th Grade ¦₁

9th to 11th Grade ¦₂

12th Grade but no Diploma ¦₃

High School Diploma/Equivalent ¦₄

Voc/Tech Program after High School

But No Voc/Tech Diploma ¦₅

Voc/Tech Diploma after High School ¦₆

GO TO A15

Some College but no Degree ¦₇

Associate’s Degree ¦₈

Bachelor’s Degree ¦₉

Graduate or Professional School

but no Degree ¦₁₀

Master’s Degree (MA, MS, MEd) ¦₁₁

Doctorate Degree (Ph.D., Ed.D) ¦₁₂

Professional Degree After Bachelor’s

Degree (Medicine/MD; Dentistry/DDS;

Law/JD/LLB etc.) ¦₁₃

D

GO TO A19

on’t know ¦₁₆

Refuse to answer ¦₁₇

A14. In what field/s did you obtain your highest degree? You may name two.

Child Development or

Developmental Psychology ¦₁

Early Childhood Education ¦₂

Elementary Education ¦₃

Special Education ¦₄

Other Field ¦₅ Specify:

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A15. Did your schooling include 6 or more college courses in early childhood education or child development?

Y es ¦₁ IF YES GO TO A17

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A16. Have you completed 6 or more college courses in early childhood education or child development since you finished your degree?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A17. What is the name of the college or university you attended or where you completed your highest degree?

Name of college or university

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A18. In what city and state is the (college/university) located?

City:

State:

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A19. Do you have a Child Development Associate (CDA) credential?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A20. Do you have a state-awarded preschool certificate?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A21. Do you have a teaching certificate or license?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A22. Including post-secondary school degrees, graduate degrees etc., are you currently enrolled in any additional teacher-related training or education?

Yes ¦₁

N o ¦₀ GO TO A24

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A23. What kind of training or education program are you enrolled in? Please pick one.

Child Development Associate (CDA)

Degree Program ¦₁

Teaching Certificate ¦₂

Special Education Teaching Degree ¦₃

Graduate Degree

(Master’s or Ph.D./ Ed.D.) ¦₄

Other ¦₅ Specify:

Don’t know ¦₁₆

Refuse to answer ¦₁₇

The following questions help us to understand your financial and family situation. All of your answers will be kept private.

A24. What is your total annual salary (before taxes) as a teacher for the current school year?

$ | | | |,| | | | per year

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A25. How many hours per week does this salary cover (not including overtime)?

| | | hours per week

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A26. Are you the primary income earner of your household?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A27. What is your marital status? (Choose only one)

Single ¦₁

Married ¦₂

Remarried ¦₃

Living with partner ¦₄

(not married)

Divorced ¦₅

Separated ¦₆

Widowed ¦₇

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A28. Do you have any children?

Yes ¦₁

No ¦₀ IF NO GO TO A30

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A29. If so, what are the ages of your children? (check all that apply)

Ages Do they currently live with you?

₁ 0-2 years ¦₁ Yes ¦₀ No

₂ 3-5 years ¦₁ Yes ¦₀ No

₃ 6-10 years ¦₁ Yes ¦₀ No

₄ 11-18 years ¦₁ Yes ¦₀ No

 ₅ 19+ ¦₁ Yes ¦₀ No

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A30. Do you have any children living in your household who attend Head Start now?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

A31. Did any child who lived in your household in the past attend Head Start?

Yes ¦₁

No ¦₀

Don’t know ¦₁₆

Refuse to answer ¦₁₇

Section B

In this section, we would like some information about your classroom. Please answer the following questions based on your classroom on a typical day. If you teach part day sessions, please answer for your morning session.

B1. Classroom Name or Number:

B2. Is this classroom full day or part day? Full day ¦₁ Part day ¦₂

B3. Number of boys enrolled in classroom: |___|___|

B4. Number of girls enrolled in classroom: |___|___|

B5. Number of teachers/teaching assistants assigned to classroom (please include yourself): |___|___|

B6. Average number of children absent on any given day: |___|___|

B7. Average number of children late on any given day: |___|___|

B8. Number of students present today: |___|___|

B9. Names of other teachers/teaching assistants in the classroom on any given day (and circle one):

1. ________________________________________ Teacher / Teaching Assistant / Other

2. ________________________________________ Teacher / Teaching Assistant / Other

3. ________________________________________ Teacher / Teaching Assistant / Other

4. ________________________________________ Teacher / Teaching Assistant / Other

Section C

In this section, you will be asked some questions about your experiences with children in your classroom.

	Never True	Rarely True	Sometimes True	Very Often True	Always True
C1. When a child in my classroom is acting sad, he/she turns into a real brat.	¦1	¦2	¦3	¦4	¦5
C2. Children in my classroom often act sad to get their way.	¦1	¦2	¦3	¦4	¦5
C3. I don’t mind dealing with a child’s sadness, so long as it doesn’t last too long.	¦1	¦2	¦3	¦4	¦5
C4. When a child in my classroom is sad, I try to help him/her explore what is making him/her sad.	¦1	¦2	¦3	¦4	¦5
C5. When a child in my classroom is sad, we sit down to talk over the sadness.	¦1	¦2	¦3	¦4	¦5
C6. When a child in my classroom is sad, I try to help him/her figure out why the feeling is there.	¦1	¦2	¦3	¦4	¦5
C7. When a child in my classroom gets sad, I warn him/her about not developing a bad character.	¦1	¦2	¦3	¦4	¦5
C8. When a child in my classroom is angry, it’s time to solve a problem.	¦1	¦2	¦3	¦4	¦5
C9. When a child in my classroom gets angry, my goal is to get him/her to stop.	¦1	¦2	¦3	¦4	¦5
C10. When a child in my classroom gets angry, it is important to help the child find out what caused his/her anger.	¦1	¦2	¦3	¦4	¦5

Section D

The purpose of this section is to discover how educators view their job and the people with whom they work closely.

	Never	A few times a year or less	Once a month or less	A few times a month	Once a week	A few times a week	Every day
D1. I feel emotionally drained from my work.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D2. I feel used up at the end of the workday.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D3. I feel fatigued when I get up in the morning and have to face another day on the job.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D4. I can easily understand how my students feel about things.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D5. I feel I treat some students as if they were impersonal objects.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D6. Working with people all day is really a strain for me.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D7. I deal very effectively with the problems of my students.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D8. I feel burned out from my work.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D9. I feel I’m positively influencing other people’s lives through my work.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D10. I’ve become more callous (hardened/less sympathetic) toward people since I took this job.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D11. I worry that this job is hardening me emotionally.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D12. I feel energetic.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D13. I feel frustrated by my job.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D14. I feel I’m working too hard on my job.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D15. I don’t really care what happens to some students.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D16. Working with people directly puts too much stress on me.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D17. I can easily create a relaxed atmosphere with my students.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D18. I feel exhilarated after working closely with my students.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D19. I have accomplished many worthwhile things in this job.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D.20 I feel like I’m at the end of my rope.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D.21 In my work, I deal with emotional problems very calmly.	¦0	¦1	¦2	¦3	¦4	¦5	¦6
D.22 I feel students blame me for some of their problems.	¦0	¦1	¦2	¦3	¦4	¦5	¦6

Section E

The following questions ask about how you have been feeling during the past 30 days. For each question, please mark the number that best describes how often you had this feeling. Please remember that your answers will be kept completely private.

During the last 30 days, about how often did you feel…	None of the time	A little of the time	Some of the time	Most of the time	All of the time
E1. … nervous?	¦1	¦2	¦3	¦4	¦5
E2. … hopeless?	¦1	¦2	¦3	¦4	¦5
E3. … restless or fidgety?	¦1	¦2	¦3	¦4	¦5
E4. … so depressed that nothing could cheer you up?	¦1	¦2	¦3	¦4	¦5
E5. … that everything was an effort?	¦1	¦2	¦3	¦4	¦5
E6. … worthless?	¦1	¦2	¦3	¦4	¦5

Section F

The next several questions ask about how you see yourself and people you work with. Your answers will be private and will not be shared with your supervisor or other staff.

How strongly do you agree or disagree with each of the following statements?

	Disagree Strongly	Disagree	Uncertain	Agree	Agree Strongly
F1. The staff here all get along very well.	¦1	¦2	¦3	¦4	¦5
F2. Too many staff decisions have to be reviewed by someone else.	¦1	¦2	¦3	¦4	¦5
F3. Management here fully trusts your professional judgment.	¦1	¦2	¦3	¦4	¦5
F4. There is too much friction among staff members.	¦1	¦2	¦3	¦4	¦5
F5. The staff here work together effectively as a team.	¦1	¦2	¦3	¦4	¦5
F6. Staff members are given broad authority in carrying out their duties.	¦1	¦2	¦3	¦4	¦5
F7. Staff here are always quick to help one another when needed.	¦1	¦2	¦3	¦4	¦5
F8. Novel ideas by staff are discouraged here.	¦1	¦2	¦3	¦4	¦5
F9. Mutual trust and cooperation among staff here are strong.	¦1	¦2	¦3	¦4	¦5
	Disagree Strongly	Disagree	Uncertain	Agree	Agree Strongly
F10. You are willing to try new ideas even if some people are reluctant.	¦1	¦2	¦3	¦4	¦5
F11. Learning and using new procedures are easy for you.	¦1	¦2	¦3	¦4	¦5
F12. It is easy to change routine procedures to meet new conditions.	¦1	¦2	¦3	¦4	¦5
F13. Staff here are free to try out different ideas or techniques.	¦1	¦2	¦3	¦4	¦5
F14. You are sometimes too cautious or slow to make changes.	¦1	¦2	¦3	¦4	¦5
F15. There are too many rules and limitations here.	¦1	¦2	¦3	¦4	¦5
F16. You frequently hear good staff ideas for improving operations.	¦1	¦2	¦3	¦4	¦5
F17. Some staff members do not do their fair share of work.	¦1	¦2	¦3	¦4	¦5
F18. The general attitude here is to change things that aren’t working.	¦1	¦2	¦3	¦4	¦5
F19. You are encouraged here to try new and different ideas.	¦1	¦2	¦3	¦4	¦5
F20. You are able to adapt quickly when you have to shift focus.	¦1	¦2	¦3	¦4	¦5

Section G

Before entering kindergarten, there are academic and social-emotional milestones that children should be able to master.

• Examples of academic skills include: can recite ABCs, knows all the letters in his/her first name, can recognize basic shapes and colors, and can count to 10.

• Examples of social-emotional skills include: plays nicely with other same-aged children, follows simple directions given by an adult, stays in seat when appropriate, and can wait his/her turn and share.  

Please indicate which of the following options best represents your opinion by marking the appropriate circle.

G1. Would you say (choose one):

¦₁ I value children’s academic readiness for school a lot more than I value children’s social-emotional readiness for school.

¦₂ I value children’s academic readiness for school a little more than I value children’s social-emotional readiness for school.

¦₃ I value children’s academic readiness for school as much as I value children’s social-emotional readiness for school.

¦₄ I value children’s academic readiness for school a little less than I value children’s social-emotional readiness for school.

¦₅ I value children’s academic readiness for school a lot less than I value children’s social-emotional readiness for school.

Section H

In this section, we are interested in your past training and professional development as a teacher.

H1. Within the last year, how many professional development days did you use? |___|___|

H2. Within the last year, have you had training in:

	No		Yes  When?	Number of hours?
a. how to foster social behavior and emotional skills in preschoolers?	¦0		¦1 
b. classroom management?	¦0		¦1 
c. children’s attention or self- regulation skills?	¦0		¦1 

H3. In the last year, have you had training in the following curricula:

	No		Yes  When?	Number of hours?
Al’s Pals	¦0		¦1 
As I am Program	¦0		¦1 
Behavior Modeling Curriculum	¦0		¦1 
Chicago School Readiness Project	¦0		¦1 
COMPASS	¦0		¦1 
Conscious Discipline	¦0		¦1 
CSEFEL (The Center on the Social and Emotional Foundations for Early Learning)	¦0		¦1 
Denham’s Teacher Training Intervention	¦0		¦1 
Emotions Course	¦0		¦1 
FACET	¦0		¦1 
Foundations of Learning	¦0		¦1 
Functional Assessment	¦0		¦1 
Gillespie Modeling Program	¦0		¦1 
Guralnick’s Intervention	¦0		¦1 
Head Start REDI	¦0		¦1 
Incredible Years Dinosaur School	¦0		¦1 
Incredible Years Parenting Program	¦0		¦1 
Incredible Years Teacher Training Program	¦0		¦1 
Positive Behavior Support	¦0		¦1 
Preschool PATHS	¦0		¦1 
Project STAR	¦0		¦1 
Resilient Peer Treatment	¦0		¦1 
Second Step	¦0		¦1 
Tools of the Mind	¦0		¦1 
Other (please specify below): When? à

Section I

For each question, please mark the circle that best represents your experience with the teaching assistant with whom you have been working. Please remember that your answers to these and all other questions will be kept private.

		Never	Seldom	Sometimes	Often	Always
I1.	The teaching assistant and I trust one another.	¦1	¦2	¦3	¦4	¦5
I2.	The teaching assistant and I work together collaboratively in the classroom.	¦1	¦2	¦3	¦4	¦5

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