TIMSS & PIRLS School Questionnaire

Identification Label

DRAFT

School ID:
School Name:
OMB # to go here

TIMSS & PIRLS 2011
Field Test Version

School
Questionnaire
Grade 4
National Center for Education Statistics
U.S. Department of Education
1990 K St., NW
Washington, DC 20006

School Questionnaire
Your school has agreed to participate in TIMSS 2011

NCES is authorized to collect information from

(Trends in International Mathematics and Science

this questionnaire under the Education Sciences

Study), an educational research project sponsored

Reform Act of 2002 (Public Law 107-279, Section

by the International Association for the Evaluation

153). You do not have to provide the information

of Educational Achievement (IEA). TIMSS measures

requested. However, the information you provide

trends in student achievement in mathematics and

will help the U.S. Department of Education’s ongoing

systems in more than 60 countries in order to help

system in the United States compares to that in other

improve teaching and learning worldwide.

countries. There are no penalties should you choose

This questionnaire is addressed to school
principals and department heads who are asked to

not to participate in this study. Your answers may be
used only for statistical purposes and may not be

supply information about their schools. Since your
school has been selected as part of a nationwide

purpose (Public Law 107-279, Section 183 and Title V,

sample, your responses are very important in helping

subtitle A of the E-Government Act of 2002 (P.L.

to describe primary education in the United States.

107-347)). Your responses will be combined with

It is important that you answer each question
carefully so that the information provided reflects
the situation in your school as accurately as possible.

those from other participants to produce summary
statistics and reports.
This survey is estimated to take an average of 30

Some of the questions will require that you look up

minutes, including time for reviewing instructions,

school records, so you may wish to arrange for the

and completing and reviewing the collection of
information. An agency may not conduct or sponsor,

this information.
Since TIMSS is an international study and all

and a person is not required to respond to, a collection of information unless it displays a currently valid

countries are using the same questionnaire, you may

OMB control number. Send comments regarding this

find that some of the questions seem unusual or are

burden estimate or any other aspect of this collection

not entirely relevant to you or schools in the United

of information, including suggestions for reducing

States. Nevertheless, it is important that you do your

this burden, to: Stephen Provasnik, National Center

best to answer all of the questions so comparisons can

for Education Statistics, U.S. Department of Educa-

be made across countries in the study.

tion, 1990 K Street NW, Room 9034, Washington, DC

It is estimated that you will need approximately
30 minutes to complete this questionnaire. We

20006-5650. Do not return the completed form to
this address.
Thank you.

thank you for your cooperation and contribution.
When you have completed the questionnaire,
please place it in the accompanying envelope and
return it to the school coordinator.

TIMSS & PIRLS 2011

School Enrollment
and Characteristics

4

1

Approximately what percentage of students in
your school have the following backgrounds?

What is the total enrollment of students in your
school as of March 1, 2010?

Check one circle only.
0 to 10%

_____________ students

11 to 25%

Write in a number.

26 to 50%
More than
50%

2

a) Come from economically
disadvantaged homes ---------O ---- O ----O ----O

What is the total enrollment of fourth-grade
students in your school as of March 1, 2010?

b) Come from economically
affluent homes ------------------O ---- O ----O ----O
_____________ students
Write in a number.

5
Approximately what percentage of students in
your school have English as their native
language?

3
A. Which best describes the immediate area in which
your school is located?

Check one circle only.

Check one circle only.

More than 90% ---O

Urban–Densely populated ---O

76 to 90% ---O

Suburban–On fringe or
outskirts of urban area ---O

50 to 75% ---O
Less than 50% ---O

Medium size city or large town ---O
Small town or village ---O
Remote rural ---O
B. Which best characterizes the average income level of
the school’s immediate area?

6
Compared with reading, how much emphasis
does your school place on teaching the following
subjects to students in the fourth grade?

Check one circle only.
Check one circle for each line.

High ---- O

More emphasis

Medium ---- O
Low ---- O

DRAFT

Same emphasis
Less emphasis

O----O----O
b) Science --------------------------- O ---- O ----O
a) Mathematics --------------------

Grade 4 School Questionnaire

3

Instructional Time

7

Resources and Technology

8
For the fourth-grade students in your school:

What is the total number of computers that can be
used for instructional purposes by fourth-grade
students?

A. How many days per year is your school open for
instruction?

___________computers

__________days

Write in the number.

Write in the number.

9

Does your school have a science laboratory that
can be used by fourth-grade students?
B. What is the total instructional time, excluding
breaks, in a typical day?

Check one circle only.

O
No ---- O

Yes ---_________hours and __________minutes
Write in the number of hours and minutes.

10

Does your school have a school library?
C. In one calendar week, how many days is the school
open for instruction?

Check one circle only.

O
No ---- O
(If No, go to #11)

Yes ----

Check one circle only.

O
5 1/2 days ---- O
5 days ---- O
4 1/2 days ---- O
4 days ---- O
Other ---- O
6 days ----

Please specify ____________

If Yes,
A. Approximately how many books with different titles
does your school library have (exclude magazines
and periodicals)?
Check one circle only.

O
251-500 ---- O
501-2,000 ---- O
2,001-5,000 ---- O
5,001-10,000 ---- O
More than 10,000 ---- O
250 or fewer ----

B. Approximately how many titles of magazines and
other periodicals does your school library have?
Check one circle only.

O
1-5 ---- O
6-10 ---- O
11-30 ---- O
31 or more ---- O
0 ----

4

Grade 4 School Questionnaire

DRAFT

11
How much is your school’s capacity to provide instruction affected by a shortage or inadequacy
of the following?
Check one circle for each line.

Check one circle for each line.

Not at all

Not at all

A little

A little
Some

Some
A lot

A.

General School Resources

A lot

C.

a) Teachers with a specialization
in mathematics -----------------O ---- O ----O ----O

a) Second language teachers ----O ---- O ----O ---- O
b) Instructional materials (e.g.,
textbooks) -----------------------O ---- O ----O ---- O

b) Computer software for
mathematics instruction-------O ---- O ----O ----O

c) Supplies (e.g., papers,
pencils) ---------------------------O ---- O ----O ---- O

c) Library materials relevant
to mathematics instruction ---O ---- O ----O ----O

d) School buildings and
grounds --------------------------O ---- O ----O ---- O

d) Audio-visual resources for
mathematics instruction-------O ---- O ----O ----O

e) Heating/cooling and lighting
systems---------------------------O ---- O ----O ---- O
f) Instructional space (e.g.,
classrooms) ----------------------O ---- O ----O ---- O
g) Technologically competent
staff -------------------------------O ---- O ----O ---- O
h) Special equipment for
physically disabled students --O ---- O ----O ---- O
i) Computers for instruction ----O ---- O ----O ---- O
B.

Resources for Reading
Instruction

Resources for Mathematics
Instruction

e) Calculators for mathematics
instruction -----------------------O ---- O ----O ----O
D.

Resources for Science
Instruction
a) Teachers with a
specialization in science------- O ---- O ----O ----O
b) Computer software for
science instruction-------------- O ---- O ----O ----O
c) Library materials relevant
to science instruction ---------- O ---- O ----O ----O
d) Audio-visual resources for
science instruction-------------- O ---- O ----O ----O

a) Teachers with a
specialization in reading ------O ---- O ----O ---- O

e) Calculators for science
instruction ----------------------- O ---- O ----O ----O

b) Computer software for
reading instruction -------------O ---- O ----O ---- O

f) Science equipment and
materials------------------------- O ---- O ----O ----O

c) Library books -------------------O ---- O ----O ---- O
d) Audio-visual resources for
reading instruction -------------O ---- O ----O ---- O

DRAFT

Grade 4 School Questionnaire

5

Parental Involvement

12
A. How often does your school do the following for
parents concerning individual students?

B. How often does your school do the following for
parents in general?

Ch ec k one circle for each line.

Che ck one circle for each line.

Never

Never
Once a year

Once a year

2-3 times a year

2-3 times a year

More than
3 times a
year

a) Inform parents about their
child’s learning progress -----

O---O---O---O

b) Inform parents about the
behavior and well-being of
their child at school ---------

O---O---O---O

c) Discuss parents’ concerns or
wishes about their child’s
learning --------------------

O---O---O---O

d) Support individual parents
in helping their child with
schoolwork -----------------

O---O---O---O

More than
3 times a
year

a) Inform parents about the
overall academic achievement
of the school ( e.g., results of
national tests, results of
inspections of learning)--O---O---O---O
b) Inform parents about school
accomplishments ( e.g.,
tournament results, facility
improvements) --------------

O---O---O---O

c) Inform parents about the
educational goals and
pedagogic principles of
the school ------------------

O---O---O---O

d) Inform parents about the
rules of the school ----------

O---O---O---O

e) Discuss parents’ concerns or
wishes about the school’s
organization ( e.g., rules and
regulations, time tables
safety measures) ------------ O---O---O---O

6

Grade 4 School Questionnaire

f) Provide parents with
additional learning materials
(e.g., books,computer
soft ware) for their child to
use at home ---------------

O---O---O---O

g) Organize workshops or
seminars for parents on
learning or pedagogical
issues ----------------------

O---O---O---O

h) Ask parents to raise funds
for the school ---------------

O---O---O---O

i) Ask parents to volunteer for
school projects, programs
and trips -------------------

O---O---O---O

DRAFT

School Climate

13

14
How would you characterize each of the following
within your school?

A. To what degree is each of the following a problem
among fourth-grade students in your school?
Check one circle for each line.

Check one circle for each line.

Not a problem

Very high

Minor problem

High

Moderate problem

Medium

Serious
problem

Low
Very
low

a) Teachers’ job
satisfaction ---------------------- O---O---O---O---O
b) Teachers’ understanding
of the school’s curricular
goals------------------------------ O---O---O---O---O
c) Teachers’ degree of
success in implementing
the school’s curriculum -------- O---O---O---O---O
d) Teachers’ expectations
for student
achievement--------------------- O---O---O---O---O
e) Parental support for
student achievement----------- O---O---O---O---O
f) Parental involvement
in school activities -------------- O---O---O---O---O
g) Students’ regard for
school property ----------------- O---O---O---O---O
h) Students’ desire to do
well in school ------------------- O---O---O---O---O

a) Arriving late at school --------- O---O---O---O
b) Absenteeism (i.e.,
unjustified absences) ---------- O---O---O---O
c) Classroom disturbance -------- O---O---O---O
d) Cheating ------------------------- O---O---O---O
e) Profanity ------------------------- O---O---O---O
f) Vandalism ----------------------- O---O---O---O
g) Theft ------------------------------ O---O---O---O
h) Intimidation or verbal abuse
among students (including
texting, emailing, etc.) -------- O---O---O---O
i) Physical fights among
students-------------------------- O---O---O---O
j) Intimidation or verbal abuse
of teachers or staff (including
texting, emailing, etc.)--------- O---O---O---O
B. To what degree is each of the following a problem
among teachers in your school?
Check one circle for each line.
Not a problem
Minor problem
Moderate problem
Serious
problem

a) Arriving late or leaving early-- O---O---O---O
b) Absenteeism -------------------- O---O---O---O

DRAFT

Grade 4 School Questionnaire

7

Teachers in Your School

Your Role as Principal

15

18
In your school, are any of the following used to
evaluate the practice of fourth-grade teachers?
Check one circle for each line.
Yes
No

a) Observations by the
principal or senior staff -------------------------- O ----O
b) Observations by inspectors
or other persons external
to the school -------------------------------------- O ----O
c) Student achievement ---------------------------- O ----O

During the past year, approximately how much time
have you spent on the following activities in your role
as a school principal?
Check one circle for each line.
No time
Some time
A lot of time

a) Promoting the school’s
educational vision or
goals within and outside
the school ----------------------- O ---- O ----O

d) Teacher peer review ------------------------------ O ----O

b) Monitoring teachers’
implementation of the
school’s educational goals
in their teaching ---------------- O ---- O ----O

Does your school have a mentoring program for
new teachers?

c) Monitoring students’
learning progress to ensure
that the school’s educational
goals are reached -------------- O ---- O ----O

16
Check one circle only.

d) Keeping an orderly
atmosphere in the school ----- O ---- O ----O

Yes ---- O
No ---- O

e) Ensuring that there are clear
rules for student behavior----- O ---- O ----O

17

f) Addressing disruptive
student behavior --------------- O ---- O ----O

Do the students in your school have specific
teachers for any of the core subjects?
Check one circle for each line.
Yes
No

a) Reading -------------------------------------------- O ----O
b) Mathematics -------------------------------------- O ----O
c) Science -------------------------------------------- O ----O

g) Creating a climate of trust
among teachers ---------------- O ---- O ----O
h) Initiating a discussion with
teachers who have problems
in the classroom ---------------- O ---- O ----O
i) Advising teachers who have
questions or problems --------- O ---- O ----O
j) Visiting other schools or
attending educational
conferences for new ideas ---- O ---- O ----O
k) Initiating educational
projects or improvements ---- O ---- O ----O
l) Participating in professional
development activities for
school principals ---------------- O ---- O ----O

8

Grade 4 School Questionnaire

DRAFT

School Readiness

Reading in Your School

19

20
About how many of the students in your school
can do the following when they begin first grade?

At which grade do the following reading skills
and strategies first receive a major emphasis in
instruction in your school?

Check one circle for each line.

Check one circle for each line.

Less than 25%

3_grds_blw+earlier

25-50%

2_grds_blw
51-75%

1_grd_blw
More than
75%

fourth
grade

a) Recognize most of the
letters of the alphabet --------- O ----O ----O ----O
b) Read some words -------------- O ----O ----O ----O
c) Read sentences ----------------- O ----O ----O ----O

Not in
these
grades

a) Knowing letters of the
alphabet ------------------------- O ---- O ----O ----O ---- O

d) Write letters of the alphabet - O ----O ----O ----O

b) Knowing letter-sound
relationships -------------------- O ---- O ----O ----O ---- O

e) Write some words -------------- O ----O ----O ----O

c) Reading words ------------------ O ---- O ----O ----O ---- O

f) Count up to 100 or higher ---- O ----O ----O ----O

d) Reading isolated sentences --- O ---- O ----O ----O ---- O

g) Recognize all 10 written
numerals from 1-10 ------------ O ----O ----O ----O

e) Reading connected text ------- O ---- O ----O ----O ---- O

h) Write all 10 numerals
from 1-10 ------------------------ O ----O ----O ----O

f) Locate information within
the text --------------------------- O ---- O ----O ----O ---- O
g) Identify the main ideas
of what they have read -------- O ---- O ----O ----O ---- O
h) Explain or support their
understanding of what they
have read ------------------------ O ---- O ----O ----O ---- O
i) Compare what they have
read with experiences they
have had ------------------------- O ---- O ----O ----O ---- O
j) Compare what they have
read with other things they
have read ------------------------ O ---- O ----O ----O ---- O
k) Make predictions about
what will happen next in the
text they are reading ----------- O ---- O ----O ----O ---- O
l) Make generalizations and
draw inferences based on
what they have read ----------- O ---- O ----O ----O ---- O
m) Describe the style or
structure of the text they
have read ------------------------ O ---- O ----O ----O ---- O
n) Determine the author’s
perspective or intention ------- O ---- O ----O ----O ---- O

DRAFT

Grade 4 School Questionnaire

9

21
Compared with other areas of the curriculum (e.g.,
mathematics and science), how much emphasis
does your school place on teaching the following
language and literacy skills to students in grades
1 to 4?
Check one circle for each line.
More emphasis
Same emphasis
Less emphasis

a) Reading -------------------------- O ----O ----O
b) Writing (not handwriting) ----- O ----O ----O
c) Speaking/listening
(oral language) ----------------- O ----O ----O

22
For students in fourth grade and below, does
your school make provisions for reading instruction
in mother tongue for students whose mother
tongue is not English?
Check one circle only.

Yes ---- O
No ---- O

10

Grade 4 School Questionnaire

DRAFT

[The following questions are national options that will
be added to the questionnaire. They will be formatted
and appropriately placed among the existing items.]

1. Measure of school poverty
Around the first of October 2010, what percentage of
students at this school were eligible to receive free or
reduced-price lunches through the National School
Lunch Program?
_________ ,percentage of students

2. Percentage of students who are LEP or ELLs
Of the students currently enrolled in your school,
what percentage has been identified as limitedEnglish proficient/English language learners?
0% ------------------------------------------------------------------ O
1-5% --------------------------------------------------------------- O
6-10%-------------------------------------------------------------- O
11-25% ------------------------------------------------------------ O
26-50% ------------------------------------------------------------ O
51-75% ------------------------------------------------------------ O
76-90% ------------------------------------------------------------ O
Over 90% --------------------------------------------------------- O

3. Type of school (school control)
What type of school is this?
Regular public elementary, middle school -------------- O
A regular public school with a magnet program ------ O
A magnet school or school with a special program
emphasis e.g ., science/math school, performing
arts school, talented/gifted school, foreign language
immersion school, etc. ---------------------------------------- O
Special education: a school that primarily serves
students with disabilities------------------------------------- O
Alternative: a school that offers a curriculum designed
to provide alternative or nontraditional education, not
clearly categorized as regular or special education --- O
Vocational -------------------------------------------------------- O
Charter school -------------------------------------------------- O
Private (independent)----------------------------------------- O
Private (religiously affiliated) -------------------------------- O
Other -------------------------------------------------------------- O

Thank You
Thank you for the thought, time, and effort you have
put into completing this questionnaire.

TIMSS & PIRLS International Study Center
Lynch School of Education, Boston College
timssandpirls.bc.edu

DRAFT

TIMSS & PIRLS 2011
Field Test Version

School
Questionnaire
Grade 4

©2010
International Association
for the Evaluation of
Educational Achievement