OMB #: 0970-0364
COVER PAGE
TEACHER REPORT
FOR HEAD START CARES
KINDERGARTEN FOLLOW-UP
S PRING 2012
MM DD YY
As part of the Head Start CARES research study, we would like you to answer some questions about selected children in your classroom. Please fill out the following form about yourself only once. Next, please fill out a teacher report for each child for which we have sent you a form. The research project is being carried out by MDRC and sponsored by the Office of Head Start and the Office of Planning, Research and Evaluation in the Administration for Children and Families, to learn about ways that teachers and children succeed in early educational classrooms. This information is crucial in helping us understand the impacts of social emotional programming on children as they transition into elementary school.
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 private to the extent permitted by law and will be used for research purposes only. 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 $7 for each report that you fill out as a token of our appreciation. This report will take approximately 20 minutes to complete. Thank you!
First, we would like you to answer the following few questions about yourself.
You only need to complete one cover sheet, then please fill out a teacher report for each child for which we have sent you a form.
Survey Instructions:
Please use pencil so that you can fix mistakes easily.
Bubbles should be filled in completely.
You may skip any questions you do not wish to answer.
You will receive $7 for each report that you fill out as a token of our appreciation. Thank you!
(over)
Section 1
In this section, we would like to learn more about you and your professional background.
Name of school ___________________________________________________
A11. How many years have you been teaching in early elementary school- Kindergarten through 3rd grade- as either lead or assistant teacher?
| | | years | | | months
Don’t know 16
Refuse to answer 17
A32. What is the highest grade or year of school that you completed?
GO
TO H2
High School Diploma/Equivalent 2
Some college, but did not obtain a degree 3
Associate’s Degree 4
Bachelor’s Degree 5
At least some graduate training 6
D
GO
TO H2
Refuse to answer 17
A33. Is your degree in a field of early childhood, including child development, developmental psychology, early childhood education, elementary education, or special education?
Yes 1
No 2
Don’t know 16
Refuse to answer 17
We are interested in your past training and professional development as a teacher.
H2. In this school year or last school year, have you had training in:
|
No |
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Yes |
Total number of hours in this school year or last school year? |
a. how to foster social behavior and emotional skills in preschoolers? |
0 |
1 |
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b. classroom management? |
0 |
1 |
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c. children’s attention or self- regulation skills? |
0 |
1 |
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d. children’s early literacy? |
0 |
1 |
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Section 2
In this section, we would like some information about your classroom.
B13. Do you teach more than one session (e.g. AM and PM session)? Yes 1 No 2
B14. Do you have CARES children in more than one session (e.g. AM and PM)? Yes 1 No 2
Please answer the following questions based on your classroom on a typical day. If you have more than one session with CARES children in it, please respond to the following questions about the AM session.
B1. Is this classroom full day or part day? Full day 1 Part day 2
B15. Number of children enrolled in classroom: |___|___|
B4. Number of teachers/teaching assistants assigned to classroom (please include yourself): |___|___|
B5. Average number of children absent on any given day: |___|___|
B8. Number of children enrolled in the school: |___|___|___|
B9. What grade is the classroom you currently teach?
Preschool 1
Kindergarten 2
Transition grade 3
First grade 4
Don’t know 16
Refuse to answer 17
B10. What type of school is the classroom you currently teach in?
Public 1
Private 2
Parochial 3
Don’t know 16
Refuse to answer 17
B11. At this point in the kindergarten year, how would you rate the behavior of children in this class? Would you say…
The group misbehaves very frequently and is almost always difficult to handle 1
The group misbehaves frequently and is often difficult to handle 2
The group misbehaves occasionally 3
The group behaves well 4
The group behaves exceptionally well 5
Don’t know 16
Refuse to answer 17
B12. How many children with limited English proficiency (LEP) are there in this classroom? |___|___|
Section 3
In this section, we would like some information about your school. Think about how well the statements below describe your school environment
Strongly disagree |
Disagree |
Neither agree nor disagree |
Agree |
Strongly agree |
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N1. Most students are pleasant and friendly to teachers. |
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N2. Most students are helpful and cooperative to teachers. |
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N3. There are many disruptive, difficult students in this school. |
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N4. There are many noisy, badly-behaved students. |
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N5. Students get along well with teachers. |
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N6. Most students are well-mannered and respectful to the school staff. |
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N7. Strict discipline is needed to control many of the students. |
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N8. The supply of equipment and resources is inadequate. |
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N9. Facilities are inadequate for catering for a variety of classroom activities and learning groups of different sizes. |
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N10. There is constant pressure to keep working. |
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N11. Teachers have to work long hours to complete all their work. |
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N12. There is no time for teachers to relax. |
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N13. It is hard to keep up with your workload. |
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We have a few more questions about you. Please remember that your answers will be kept completely private. 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.
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? |
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5 |
E2… hopeless? |
1 |
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E3… restless or fidgety? |
1 |
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E4… so depressed that nothing could cheer you up? |
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E5… that everything was an effort? |
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E6… worthless? |
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5 |
A1. What is your age? |___|___| YEARS
A2. What is your gender? Female 1 Male 2
A4. Are you of Spanish, Hispanic, or Latino origin?
Yes 1
No 0
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
TEACHER REPORT ON INDIVIDUAL CHILDREN
FOR HEAD START CARES
KINDERGARTEN FOLLOW-UP
S PRING 2012
MM DD YY
As part of the Head Start CARES research study, we would like you to answer some questions about selected children in your classroom. The research project is being carried out by MDRC and sponsored by the Office of Head Start and the Office of Planning, Research and Evaluation in the Administration for Children and Families, to learn about ways that teachers and children succeed in early educational classrooms. This information is crucial in helping us understand the impacts of social emotional programming on children as they transition into elementary school.
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 private to the extent permitted by law and will be used for research purposes only. 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 $7 for each report that you fill out as a token of our appreciation. This report will take approximately 20 minutes to complete. Thank you!
Survey Instructions:
Please use pencil so that you can fix mistakes easily.
Bubbles should be filled in completely.
You may skip any questions you do not wish to answer.
You will receive $7 for each report that you fill out as a token of our appreciation. Thank you!
In this section, we will be asking you some questions that are designed to measure how often this child exhibits certain social skills. Please fill in only one circle for each item.
The student…. |
Never |
Sometimes |
Very Often |
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In this section, please reflect on the degree to which each of the following statements currently applies to your relationship with this child. Please fill in only one response for each item.
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Definitely does not apply |
Not really |
Neutral, not sure |
Applies somewhat
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Definitely applies
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The following are statements that describe the behavior of many children. Please mark whether each statement has been OFTEN true, SOMETIMES true, or NOT true of this child since the beginning of school. Please fill in only one response for each item.
Since the beginning of school… |
Often True |
Sometimes True |
Not True |
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In this section, please mark the number of each question that best describes the behavior and skills of this child. You may use the even-numbered points if the child falls between the behavioral descriptors. Please fill in only one.
D2. Performance on Daily Non-Academic Tasks
1 2 3 4 5 6 7
Cheerfully does own Independently Will do chores, Often refuses to
chores, then takes on attends to routines but only with prodding do daily chores
extra duties
D4. Relevant Participation in Group Discussions
1 2 3 4 5 6 7
Often contributes Makes an occasional Inattentive to others; Makes irrelevant
original ideas; relevant relevant comment; quiet but uninvolved remarks; interrupts
and responsive to attentive the flow
others’ comments
and interests
D6. Behavior During Designated Work Time
1 2 3 4 5 6 7
Finishes all assigned Takes occasional Requires periodic Needs constant super-
tasks breaks from work, reminders or directives vision to redirect atten-
and returns promptly in order to stay on task tion from play to work
D14. Participation in Outdoor Games
1 2 3 4 5 6 7
Superior player; takes Plays most games Is a sluggish and Disrupts others’ play;
leadership role adequately unwilling participant hoards equipment;
cheats at games
D18. Expression of Feelings and Ideas During Discussion
1 2 3 4 5 6 7
Very open and Expresses self Makes minimal Closed; defies efforts
expressive; reveals adequately; shares statements when to elicit self-expression
personal insights feelings and ideas encouraged
D19. Response to Others’ Mistakes or Misfortune
1 2 3 4 5 6 7
Actively expresses Takes interest in others’ Appears to ignore Openly ridicules others;
sympathetic desire to problems; can be others’ problems; does adds insult to injury
help others persuaded to help not help or show
sympathy
D23. Activity Level in Group Activities
1 2 3 4 5 6 7
Fidgety; extremely Can sit for 5-10 minutes Sits 10-20 minutes for Sits quietly for 30
active; sits for 5 minutes but only for certain most types of lessons minutes or more
or less interesting activities or activities
(films, etc.)
D24. Work and Play with Peers
1 2 3 4 5 6 7
Is comfortable playing Plays or works well Shows a preference for Works or plays alone;
and working with most with a consistent group one other child; prefers rejects others’ efforts
children, both familiar of children to be with that child or to do things together
and unfamiliar alone
D25. Listening to Teacher Giving Instructions to Group
1 2 3 4 5 6 7
Seems to ignore the Can maintain attending Occasionally inattentive; Attends to the teacher
teacher; is very behavior with frequent attention is easily without reminders
distracted and reminders from the regained by a cue from
distracting teacher teacher
D27. Compliance with Teacher’s Instructions Relating to Work
1 2 3 4 5 6 7
Independently follows Performs tasks as Demands that instructions Seems to disregard
instructions instructed with minimal be repeated, or does instructions; does the
supervision the right task in the wrong task or nothing wrong way at all
D28. Social Interaction
1 2 3 4 5 6 7
Appears withdrawn, Can be coaxed to interact Socializes adequately Initiates friendly social
totally closed to the at a minimal level with with a variety of interactions
social environment certain children; slow children
to warm up
D29. Completion of Games and Activities
1 2 3 4 5 6 7
Finishes any activity that Generally persistent; Loses interest in group Abruptly disengages
is begun rarely quits games and activities from cooperative
before a logical activity to begin
conclusion is reached something else
D32. Independent Work
1 2 3 4 5 6 7
Works independently Works alone with Disorganized; tries to Lacking self-motivation;
without supervision minimal supervision work but requires much teacher prompting has assistance or prompting only slight impact on
work habits
D33. Memory for Instructions
1 2 3 4 5 6 7
Seems to quickly forget Retains instructions for Can recall detailed Remembers all
instructions relating to up to an hour, then series of instructions instructions, regardless work; needs frequent needs them repeated for several hours of time interval reminders
D36. Organization of Work Products
1 2 3 4 5 6 7
Totally disorganized; Slightly disorganized; Usually organized; work Meticulous; produces
work is sloppy; often occasionally produces is generally neat neat work consistently, misplaced messy work rarely loses material
D37. Functioning within Designated Time Periods
1 2 3 4 5 6 7
Never concludes Often slightly out of Concludes most activities Is synchronous with
activities at designated synch with group as on time; usually ready to beginnings and endings
time; late starting next they end and begin start next activity of all activities
activity activity periods
In this section, you will be asked to assess the academic skills of this child in several domains. Please read each question and its associated example and provide only one rating for each skill.
This child… |
Not yet |
Beginning |
In progress |
Inter- mediate |
Proficient |
Not applicable |
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Please read each question and its associated example and provide only one rating for each skill.
This child… |
Not yet |
Beginning |
In progress |
Inter- mediate |
Proficient |
Not applicable |
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Please read each question and its associated example and provide only one rating for each skill.
This child… |
Not yet |
Beginning |
In progress |
Inter- mediate |
Proficient |
N ot applicable |
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In this section, you will be asked to answer questions about your perceptions of the parents/caregivers of this child. Please remember that your answers to these and all questions will be kept completely confidential. Please select only one answer.
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Not at all |
A little |
Somewhat |
A lot
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A great deal
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In this section, you will be asked to answer a few more questions about the child.
I1. During this academic year, has this child been absent…
1 |
2 |
3 |
4 |
5 |
Hardly any days |
Fewer days than most children |
About an average number of days |
More days than most children |
A lot more days than most children |
I2. Do you expect this child to be promoted or retained?
Promoted 1
Retained 2
Don’t know 16
Refused 17
Overall, how would you rate this child’s academic skills in each of the following areas, compared to other children of the same grade level? |
Far below average |
Below average |
Average |
Above average
|
Far above average
|
I3. Language and literacy skills |
1 |
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5 |
I4. Science and social studies |
1 |
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5 |
I5. Mathematical skills |
1 |
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5 |
In this section, you will be asked to answer a few more questions about any special services received by the child.
Does this child receive… |
No |
Yes |
If yes, how many hours per week? |
I6. Speech or language therapy? |
1 |
2 |
______ hours |
I7. Occupational therapy? |
1 |
2 |
______ hours |
I8. Mental health consultation? |
1 |
2 |
______ hours |
I9. Physical therapy? |
1 |
2 |
______ hours |
File Type | application/msword |
Author | Matthew Kim |
Last Modified By | Molly Buck |
File Modified | 2012-04-05 |
File Created | 2012-04-04 |