Download:
pdf |
pdfMathematica Reference No.: 06876.341
National Longitudinal
Transition Study
Parent Baseline Questionnaire
October 10, 2011
Sections of the instrument:
Section
A
Title
Introduction and Consent
Begins at Page
1
B
Student’s Experience in School
6
C
Parent Involvement in School
19
D
Abilities, Disabilities, and Services
20
E
Experience with the IEP,504 Plan, and School Supports
41
F
Expectations for the Future
43
G
Demographics for Student
47
H
Demographics for Parent & Household
53
I
Contact information for follow-up
58
ADMINISTRATIVE NOTES:
EACH ITEM DRAWN FROM A PRE-EXISTING INSTRUMENT WILL HAVE, AT THE END OF THE QUESTION
TEXT, THE SOURCE INSTRUMENT AND ITEM REFERENCE NUMBER. IF THE ORIGINAL SOURCE HAS BEEN
MODIFIED, THE TEXT “REV” WILL FOLLOW.
THIS INSTRUMENT IS DESIGNED TO BE INTERVIEWER-ADMINISTERED OVER THE TELEPHONE WITH AN
ESTIMATED DURATION OF 40 MINUTES.
GUIDELINES FOR ADMINISTRATION ARE NOTED THROUGHOUT – ITEMS IN ALL CAPS ARE NOT READ
ALOUD, UNDERLINED VERBIAGE IS EMPHASIZED. STANDARDIZED PROBES AND DEFINITIONS ARE
PROVIDED.
PARENT INTERVIEW WILL BE CONDUCTED PRIOR TO STUDENT INTERVIEW. PARENT CONSENT = YES
( = 1) THEN CATI WILL RELEASE THE CASE FOR DATA COLLECTION WITH THE STUDENT, HIS / HER
SELECTED TEACHERS, AND THE SCHOOL PRINCIPAL.
PARENTAL CONSENT WILL BE DIGITALLY RECORDED AND STORED AT MATHEMATICA ON A SECURE
SERVER. ONCE CONSENT IS RECEIVED, THE SAMPLE MANAGEMENT (SMS) DATABASE WILL GENERATE A
MAILING TO THE PARENT DOCUMENTING THE CONSENT GRANTED.
CATI PROGRAMMING NOTES:
AGE OR IEP/ 504 STATUS-SPECIFIC SKIPS ARE DENOTED IN THE UNIVERSE, DIRECTLY PRECEDING
APPLICABLE ITEMS OR DELINEATED IN PRECEDING LOGIC BOXES. WHEN AN ITEM IS ASKED OF ALL
RESPONDENTS, NO UNIVERSE WILL BE EXPLICITLY SPECIFIED BEFORE THE ITEM.
ANY SKIP LOGIC BASED ON RESPONSE CATEGORIES IS LOCATED NEXT TO THE APPLICABLE RESPONSE.
STATE-SPECIFIC NAME FOR SNAP PROGRAM WILL BE PROVIDED UNDER SEPARATE COVER.
FILLS FOR YOUTH’S NAME ARE GENERATED BY SAMPLE FILE. AGE-SPECIFIC QUESTIONS ARE GUIDED BY
CALCULATION OF AGE FROM DATE OF BIRTH VARIABLE PROVIDED IN SAMPLE FILE OR FROM ITEM A2A
(IF SAMPLE INFO DEEMED INCORRECT). GENDER-RELATED FILLS DRAWN FROM ITEM A1.
NLTS 2012 Baseline Parent Interview
A. INTRODUCTION AND CONSENT
A1.
Hi, my name is _____. I’m calling on behalf of the U.S. Department of Education, who
is sponsoring the National Longitudinal Transition Study. Through this important
project, we hope to learn more about issues youth face today as they transition from
school to adult life and how schools can better support students in reaching their
goals. As {YOUTH}’s parent (or guardian), we are inviting you to be part of this study.
CONTINUE.................................................................... 1
HUNG UP DURING INTRODUCTION .......................... 2
DECLINES STUDY PARTICIPATION .......................... 0
A2.
TERMINATE
{YOUTH} is one of 15,000 students across the country being asked to take part in the
study. I will briefly explain what being in the study will mean for you and {YOUTH}. If
you have any questions, please stop me, I am happy to answer them. If you agree to
take part, this interview will take 40 minutes. I’ll ask about {YOUTH}’s experiences at
school, hopes for the future, and some basic information about your household. You
will be contacted for another interview in 2014, to see what may have changed since
we last spoke. You will be paid $20 for each interview completed.
We would also like to interview {YOUTH} over the telephone for about 30 minutes.
That interview has questions about experiences in and out of school and plans for the
future. You can help your child answer questions or answer for {him/her}, if needed.
Students will be contacted for another interview in 2014. {YOUTH} will get a $10 gift
card for each interview completed.
All the information the researchers collect about {YOUTH} will be kept confidential
and not shared with others. All reports will be in summary form only. Your child’s
name will never be used. There are no special risks to you or {YOUTH} from taking
part in this study. There is nothing experimental about this study. If you or your child
feels uncomfortable answering any of the questions, you can stop without penalty.
Do you give your permission for these interviews?
AGREED - CONTINUE ................................................. 1
DISAGREE / DECLINES THIS PORTION .................... 2
DECLINES STUDY PARTICIPATION .......................... 0
NLTS 2012 Baseline Parent Interview
1
TERMINATE
Draft dated 10.10.11
A3.
As part of the study, each student’s math or language arts teacher would be asked to
do a survey to learn more about [his / her] classroom experiences. Do we have your
permission to contact this teacher?
AGREED - CONTINUE ................................................. 1
DISAGREE / DECLINES THIS PORTION .................... 2
DECLINES STUDY PARTICIPATION .......................... 0
TERMINATE
IF SCHOOL HAS NOT PROVIDED TEACHER’S NAME (FIELD BLANK ON SAMPLE FILE)
A3a.
Our records show that {YOUTH}’s school did not provide (his / her) [MATH OR
LANGUAGE ARTS] teacher’s name. Can you provide the name of this teacher?
YES – SPECIFY: _______________________ ............ 1
DON’T KNOW ............................................................... d
REFUSED TO PROVIDE NAME ................................... r
SKIP TO A4
IF SCHOOL HAS NOT PROVIDED TEACHER’S NAME (FIELD BLANK ON SAMPLE FILE)
A3b.
Our records show that {YOUTH}’s school did not provide (his / her) [MATH OR
LANGUAGE ARTS] teacher’s email address. Can you provide us with this email
address?
YES – SPECIFY: _______________________ ............ 1
DON’T KNOW ............................................................... d
REFUSED TO PROVIDE NAME ................................... r
TERMINATE
YOUTH HAS IEP FROM SAMPLE INFO
A4.
We would like to complete two surveys with a staff person from {YOUTH}’s school, to
learn about services the school provides to (him/her) in (his / her) IEP. The first would
be completed this year and the next one would be in 2014. Do we have your
permission to contact this staff member?
AGREED - CONTINUE ................................................. 1
DISAGREE / DECLINES THIS PORTION .................... 2
DECLINES STUDY PARTICIPATION .......................... 0
A5.
TERMINATE
As part of the study, in 2014, researchers will look at students’ school transcripts to
see what courses they have taken. Do you grant permission for us to collect this
information?
AGREED - CONTINUE ................................................. 1
DISAGREE / DECLINES THIS PORTION .................... 2
DECLINES STUDY PARTICIPATION .......................... 0
NLTS 2012 Baseline Parent Interview
2
TERMINATE
Draft dated 10.10.11
A6.
As part of the study, when {YOUTH} is around 16 to 18 years old, {he/she} will be
asked to complete an academic assessment. This test is only for this study and will
not count towards any of {his/her} classes in school. Do you grant permission for this
assessment?
IF NEEDED:
if {YOUTH} is in school, the test will take place during school. If not,
it can be completed at another public place. The test takes between
15-45 minutes.
AGREED - CONTINUE ................................................. 1
DISAGREE / DECLINES THIS PORTION .................... 2
DECLINES STUDY PARTICIPATION .......................... 0
A7.
TERMINATE
To learn more about how students are doing in the future, the researchers may want
to look at databases on college enrollment, financial aid for college, or the Social
Security Administration’s records about jobs or benefits. If the researchers decide to
use data from the Social Security Administration, we would need [NAME]’s social
security number.
If we need your child’s social security number, we will ask for it during the second
interview in 2014. You can decide to give it to us then, or not. If you give us the
number, we will keep it private and will permanently erase it as soon as we link it to
the information needed. We did want to let you know now, however, that we may ask
for it. Do you have any questions about this?
NO QUESTIONS, OK TO CONTINUE .......................... 1
QUESTIONS RAISED AND ANSWERED,
CONTINUE.................................................................... 2
WILL NEVER GIVE SSN, BUT OK TO
CONTINUE WITH INTERVIEW .................................... 3
DECLINES STUDY PARTICIPATION........................... 0
NLTS 2012 Baseline Parent Interview
3
TERMINATE
Draft dated 10.10.11
A8.
Even if you consent for {YOUTH} to take part in this study, {he/she} must agree also.
When {he/she} turns 18 or no longer has a legal guardian, {he/she} must consent for
{him/herself}. You or {YOUTH} can ask questions or drop out of the study at any time
without penalty by calling Mathematica Policy Research. If you have any questions
about your child’s rights as a research volunteer, you can call the Institutional Review
Board who reviewed this study to make sure students’ rights are protected.
IF NEEDED: Public/Private Ventures telephone number is (215) 557-4482. Ask for
Melissa Billarrial.
IF NEEDED: Mathematica’s toll-free number is 866-964-7962.
I will mail you a letter describing what we just discussed, so you will have it for your
records. If you would like to see the consent form in writing before continuing with
the interview, we can email (or fax) it to you. Do you have any questions for me before
we begin the interview? [ANSWER QUESTIONS, AS NEEDED].
AGREES TO TAKE PART - CONTINUE ......................... 1
A9.
NOT AT THIS TIME – CALL LATER ................................ 2
WANTS TIME TO CONSIDER
FURTHER (SCHEDULE CALLBACK
WITHIN 1 WEEK)
DECLINED TO TAKE PART IN STUDY .......................... 3
CONSENT NOT GRANTED,
TERMINATE
I will begin by asking for some basic information about where you live and how we
can best reach you for the next survey in 2014. Let’s start with the address where you
get your mail. We will send your $20 check to this address. The school listed it as
[ADDRESS ON SAMPLE FILE]. Is that address correct?
YES ............................................................................... 1
GO TO A10
NO ................................................................................. 2
A9a.
What is your mailing address?
PROBE FOR AND RECORD BOTH P.O. BOX AND STREET ADDRESS
PROBE:
Where do you stay most often?
(STRING (200)
ADDRESS 1
(STRING (200)
ADDRESS 2
(STRING (200)
CITY
(STRING (50)
STATE/TERRITORY
| | | | | |-| | |
ZIP CODE (+ 4 IF NEEDED)
NLTS 2012 Baseline Parent Interview
|
|
4
Draft dated 10.10.11
A10.
What is the best telephone number at which to reach you:
| | | |-| | | |-|
(RANGE)
(RANGE)
A10a.
| | |
(RANGE)
| / Phone (STRING 30)
DOES NOT HAVE A TELEPHONE NUMBER .............. 1
GO TO A13
DON’T KNOW ............................................................... d
GO TO A13
REFUSED ..................................................................... r
GO TO A13
Is that a landline or cell phone?
LANDLINE ..................................................................... 1
GO TO A13
CELL PHONE................................................................ 2
A10b.
DON’T KNOW ............................................................... d
GO TO A13
REFUSED ..................................................................... r
GO TO A13
When we contact you for the next survey, may we send you a text message on that
phone?
YES ............................................................................... 1
NO ................................................................................. 0
PHONE DOES NOT USE TEXT MESSAGE ................ 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
A11.
I need to begin by asking a few questions about {YOUTH} to make sure I ask
questions that apply only to certain groups. Is {YOUTH} male or female? (NLTS2 A1,
rev)
MALE............................................................................. 1
FEMALE ........................................................................ 2
A12.
I have {YOUTH}’s birth date as {DOB FROM SAMPLE}? Is that correct? (NLTS2 A2A)
YES ............................................................................... 1
GO TO A13
NO ................................................................................. 0
DON’T KNOW ............................................................... d
GO TO A13
REFUSED ..................................................................... r
GO TO A13
NLTS 2012 Baseline Parent Interview
5
Draft dated 10.10.11
A12a.
What is {YOUTH’S} birth date? (NLTS2 A2B)
PROGRAMMER: SELECT NUMBER OF FIELDS
|
|
|/|
MONTH
(1-12)
|
DAY
(1-31)
|/|
|
|
|
|
YEAR
(1990-2000)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
A13.
What is your relationship to {YOUTH}? (NEW)
MOTHER ....................................................................... 1
FATHER ........................................................................ 2
OTHER RELATIVE ....................................................... 3
FOSTER PARENT ........................................................ 4
OTHER LEGAL GUARDIAN ........................................ 5
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 100)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B. STUDENT’S EXPERIENCE AT SCHOOL
B1_INTRO
B1.
The next questions are about {YOUTH}’s school experiences this school year, that
is, the 2011-2012 school year.
Has {YOUTH} been enrolled in an elementary, middle, junior or senior high school
this school year? (NLTS D1A)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO B7
DON’T KNOW ............................................................... d
GO TO B7
REFUSED ..................................................................... r
GO TO B7
NLTS 2012 Baseline Parent Interview
6
Draft dated 10.10.11
B2.
What grade {is/was} {YOUTH} in this year? [PROBE FOR UNGRADED IF PARENT IS
UNSURE.] (NLTS D10)
CODE ONE ONLY
UNGRADED CLASS ..................................................... 0
SIXTH GRADE .............................................................. 6
SEVENTH GRADE........................................................ 7
EIGHTH GRADE ........................................................... 8
NINTH GRADE.............................................................. 9
TENTH GRADE............................................................. 10
ELEVENTH GRADE...................................................... 11
TWELFTH GRADE........................................................ 12
THIRTEENTH GRADE .................................................. 13
MULTI-GRADE.............................................................. 14
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 50)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
7
Draft dated 10.10.11
B3.
Which of the following best describes the school {he/she} attended this year?
[2+ SCHOOLS IN SAME YEAR, ASK ABOUT THE MOST RECENT SCHOOL. 2+
SCHOOLS AT SAME TIME, ASK ABOUT THE SCHOOL WHERE MOST TIME SPENT.]
(NLTS D1B)
CODE ONE ONLY
A regular school that serves a wide variety of
students, ...................................................................... 1
A school that serves only students with
disabilities, ................................................................... 2
A magnet school that specializes in a particular
subject area or theme, ................................................ 3
A vocational/technical school (voc-tech),................. 4
A charter school, ......................................................... 5
An alternative school, or ............................................ 6
Another kind of school?
MARK FROM BELOW OR SPECIFY
HOME INSTRUCTION BY A PROFESSIONAL ............ 7
HOME SCHOOLING BY A PARENT ............................ 8
MEDICAL FACILITY, CONVALESCENT
HOSPITAL, OR INSTITUTION FOR PEOPLE
WITH DISABILITIES ..................................................... 9
MENTAL HEALTH FACILITY ........................................ 10
CORRECTIONAL OR JUVENILE JUSTICE
FACILITY....................................................................... 11
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
8
Draft dated 10.10.11
BOX B4
THIS LOGIC SKIPS PARENTS OF YOUTH IN SETTINGS OTHER THAN REGULAR SCHOOLS TO QUESTION
B4c and FILLS B4-B4b WITH INFORMATION WE KNOW FROM RESPONSES TO B3.
IF B3 = 7 THROUGH 11, CODE B4 = 1 AND CODE APPROPRIATE SETTINGS IN B4b, THEN GO TO B4c.
B4.
Has {he/she} received any elementary, middle, junior or senior high school level
instruction in any {other} setting during this school year? For example, that could
include instruction in a hospital, correctional facility, or a home school. (NLTS D2A)
YES ............................................................................... 1
GO TO BOX B4A
NO ................................................................................. 0
GO TO BOX B5
DON’T KNOW ............................................................... d
GO TO BOX B5
REFUSED ..................................................................... r
GO TO BOX B5
BOX B4A
IF B1 NE 1 (NOT ENROLLED) AND B4 = 1 (ENROLLED, NOT REGULAR SCHOOL), GO TO B4a.
IF B1 = 1 (ENROLLED) AND B4 = 1 (ENROLLED, NOT REGULAR SCHOOL), GO TO B4B.
ELSE, GO TO BOX B5.
B4a.
What grade {is/was} {YOUTH} in this year? [PROBE FOR UNGRADED IF PARENT IS
UNSURE.] (NLTS D10)
CODE ONE ONLY
UNGRADED CLASS ..................................................... 0
FIRST GRADE .............................................................. 1
SECOND GRADE ......................................................... 2
THIRD GRADE.............................................................. 3
FOURTH GRADE.......................................................... 4
FIFTH GRADE .............................................................. 5
SIXTH GRADE .............................................................. 6
SEVENTH GRADE........................................................ 7
EIGHTH GRADE ........................................................... 8
NINTH GRADE.............................................................. 9
TENTH GRADE............................................................. 10
ELEVENTH GRADE...................................................... 11
TWELFTH GRADE........................................................ 12
THIRTEENTH GRADE .................................................. 13
MULTI-GRADE.............................................................. 14
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 50)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
9
Draft dated 10.10.11
B4b.
Which of the following best describes the setting where {YOUTH} received this
instruction? Was it… [IF MORE THAN ONE SETTING, CODE MOST RECENT SETTING]
(NLTS D2B)
CODE ONE ONLY
Home instruction by a professional, ......................... 1
Home schooling by a parent, ..................................... 2
A hospital or hospital school, .................................... 3
A medical facility convalescent hospital or
institution for people with disabilities, ...................... 4
A mental health facility, .............................................. 5
A correctional or juvenile justice facility, or ............. 6
Another kind of place? ............................................... 7
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B4c.
Is {he/she} receiving this instruction now? (NLTS D2C)
YES ............................................................................... 1
GO TO BOX B5
NO ................................................................................. 0
GO TO BOX B5
DON’T KNOW ............................................................... d
GO TO BOX B5
REFUSED ..................................................................... r
GO TO BOX B5
NLTS 2012 Baseline Parent Interview
10
Draft dated 10.10.11
BOX B5
THIS LOGIC SEPARATES PARENTS OF YOUTH WHO ARE IN SCHOOL THIS YEAR FROM THOSE WHO
ARE NOT. PARENTS OF IN-SCHOOL YOUTH WHO ARE 16 OR OLDER ARE ASKED IF THEY WILL
GRADUATE THIS YEAR (B6). PARENTS OF IN-SCHOOL YOUTH WHO ARE YOUNGER ARE ASKED IF THEY
WILL ATTEND SCHOOL NEXT YEAR (B11). PARENTS OF YOUTH WHO ARE NOT IN SCHOOL ARE ASKED
WHY NOT.
IF B1 = 1 AND (B2 ≥ 12 OR (B2 = 0|14|99|D|R AND AGE ≥16), GO TO B6. ELSE IF B1 = 1, GO TO B11.
IF B1 ≠1 AND B4c = 1, GO TO B6. ELSE IF B1 ≠ 1, GO TO B5.
B5.
Is {he/she} not in school now because {he/she}… (NLTS D2D)
CODE ONE ONLY
Is on school vacation, ................................................. 1
GO TO B6
Graduated, ................................................................... 2
GO TO B8
Took a test and received a diploma or a
certificate without taking all of {his/her} high
school classes, ............................................................ 3
GO TO B8
Dropped out or just stopped going, .......................... 4
Was suspended (temporary), ..................................... 5
GO TO B6
Was expelled (permanent), ......................................... 6
GO TO B6
Was older than the school age limit, or ................... 7
GO TO B6
Some other reason? (SPECIFY) ................................. 99 GO TO B6
________________________________(STRING 150)
DON’T KNOW ............................................................... d
GO TO B8
REFUSED ..................................................................... r
GO TO B
NLTS 2012 Baseline Parent Interview
11
Draft dated 10.10.11
B5a.
What were {his/her} reasons for leaving? (NLTS D2F)
CODE ALL THAT APPLY
SCHOOL: ACADEMIC DIFFICULTY; POOR GRADES/NOT DOING WELL ................ 1
SCHOOL: DISLIKE OF SCHOOL EXPERIENCE .......................................................... 2
SCHOOL: SCHOOL TOO DANGEROUS ...................................................................... 3
SCHOOL: FAILED REQUIRED TEST/FAILED GRADUATION EXAM .......................... 4
SCHOOL: LACK OF APPROPRIATE CURRICULUM ................................................... 5
SCHOOL: POOR RELATIONSHIPS WITH TEACHERS AND SCHOOL STAFF .......... 6
SCHOOL: POOR RELATIONSHIP WITH FELLOW STUDENTS .................................. 7
SCHOOL: LANGUAGE DIFFICULTY ............................................................................. 8
SCHOOL: PROBLEMS WITH BEHAVIOR .................................................................... 9
FINANCIAL: ECONOMIC REASONS ............................................................................. 10
FINANCIAL: LACK OF CHILD CARE ............................................................................ 11
FINANCIAL: LACK OF TRANSPORTATION ................................................................ 12
HEALTH: SUBSTANCE ABUSE.................................................................................... 13
HEALTH: ILLNESS/DISABILITY.................................................................................... 14
HEALTH: PREGNANCY ................................................................................................ 15
PERSONAL: ENTERED THE CRIMINAL JUSTICE SYSTEM ...................................... 16
PERSONAL: NEEDED AT HOME ................................................................................. 17
PERSONAL: RELIGION ................................................................................................ 18
PERSONAL: MOVED .................................................................................................... 19
RELATIONSHIPS: PARENT/GUARDIAN INFLUENCE ................................................ 20
RELATIONSHIPS: FRIENDS WERE DROPPING OUT ............................................... 21
RELATIONSHIPS: MARRIAGE ..................................................................................... 22
WORK: MILITARY, JOINED ARMED FORCES ............................................................ 23
WORK: EMPLOYMENT, SOUGHT OR ACCEPTED JOB ............................................ 24
OTHER (SPECIFY) ......................................................................................................... 99
_________________________________________________ (STRING 150)
DON’T KNOW ................................................................................................................. d
REFUSED ....................................................................................................................... r
(GO TO BOX B7)
B6.
Do you expect that {he/she} will graduate or finish school this year? (NLTS D2G1)
YES. .............................................................................. 1
GO TO BOX B7
NO. ................................................................................ 0
GO TO BOX B7
DON’T KNOW ............................................................... d
GO TO BOX B7
REFUSED ..................................................................... r
GO TO BOX B7
NLTS 2012 Baseline Parent Interview
12
Draft dated 10.10.11
BOX B7
THIS LOGIC SEPARATES PARENTS OF YOUTH WHO DROPPED OUT, WERE SUSPENDED OR EXPELLED
AND NOT RECEIVING ANY INSTRUCTION. THOSE WHO DO NOT MEET THOSE CRITERIA, SKIP TO A
QUESTION ABOUT TAKING COURSES AT A TWO-YEAR OR COMMUNITY COLLEGE.
IF B5 = 4, 5, OR 6, GO TO B7. IF B1 ≠1 AND B4 ≠1, GO TO B7.
B7.
In the past school year has {YOUTH} taken any courses or tests to earn a high school
diploma since {dropping out/being suspended/ being expelled}? (NLTS D3A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B8.
Has {YOUTH} earned a diploma, GED, or certificate of completion?
IF NEEDED: What was it? (NLTS D2E REV)
CODE ONE ONLY
REGULAR DIPLOMA .................................................... 1
GED............................................................................... 2
CERTIFICATE OF COMPLETION ................................ 3
MODIFIED DIPLOMA.................................................... 4
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
13
Draft dated 10.10.11
BOX B9
THIS LOGIC SEPARATES PARENTS OF CHILDREN WHO WERE NOT ENROLLED IN ANY SCHOOL FROM
THOSE WHO ARE ENROLLED IN SCHOOL.
IF B1 AND B4 ≠ 1, GO TO B9. ELSE GO TO B10.
B9.
When did {he/she} last attend school or receive instruction in school subjects?
[RESPONSE MAY BE THE MONTH AND YEAR {YOUTH} LEFT SCHOOL OR HOW LONG
AGO {HE/SHE} LEFT SCHOOL. NOTE: THIS CAN INCLUDE HOME OR HOSPITAL
SCHOOLING] (NLTS D5A)
| | |/| | | |
MONTH
YEAR
(1-12) (2000-2011)
|
OR | | | MONTHS or YEARS AGO
NEVER ........................................................................... 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B10.
Did {YOUTH} attend summer school in the summer of 2011? (NLTS D7A)
CODE ONE ONLY
YES ............................................................................... 1
NO ................................................................................. 0
IN YEAR ROUND SCHOOL .......................................... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B11.
Do you expect that {YOUTH} will be enrolled in elementary, middle, junior, or senior
high school in the fall? [IF NEEDED: That is the 2012-2013 school year] (NLTS D5E)
YES ............................................................................... 1
GO TO B16
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
14
Draft dated 10.10.11
B12.
What are {YOUTH’S} plans for the fall? [IF NEEDED: That is the 2012-2013 school
year] (NLTS D6A)
PROBE:
IF R SAYS “GO TO SCHOOL”: Does {YOUTH} plan to go to a 2-year, junior,
or community college; a 4-year college or university; a vocational or
business school; a GED program; or another kind of school or program?
CODE ALL THAT APPLY
HAS NO PLANS/JUST HANG OUT ............................. 1
LOOK FOR WORK/GET A JOB .................................... 2
CONTINUE WORKING ................................................. 3
GO TO A 2-YEAR, JUNIOR/COMMUNITY/
TECHNICAL COLLEGE ................................................ 4
GO TO A 4-YEAR COLLEGE/UNIVERSITY ................. 5
GO TO A VOCATIONAL OR BUSINESS
SCHOOL OR JOB TRAINING PROGRAM ................... 6
GED PROGRAM ........................................................... 7
GO TO ANOTHER SCHOOL (UNSPECIFIED) ............ 8
GO TO AN ADULT DAY PROGRAM ............................ 9
GO TO AN ADULT RESIDENTIAL PROGRAM ............ 10
TRAVEL ........................................................................ 11
DO VOLUNTEER WORK .............................................. 12
GET MARRIED ............................................................. 13
HAVE A BABY............................................................... 14
MOVE ............................................................................ 15
GET OWN APARTMENT/HOUSING
ARRANGEMENT .......................................................... 16
JOIN THE MILITARY .................................................... 17
INCARCERATED .......................................................... 18
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
15
Draft dated 10.10.11
B13.
Since {he/she} entered kindergarten, has {he/she} ever been held back a grade in
school? (NLTS D7D)
YES ............................................................................... 1
B13a.
NO ................................................................................. 0
GO TO B14
DON’T KNOW ............................................................... d
GO TO B14
REFUSED ..................................................................... r
GO TO B14
What grade or grades was {he/she} held back? (NLTS D7E)
CODE ALL THAT APPLY
KINDERGARTEN .......................................................... 0
FIRST GRADE .............................................................. 1
SECOND GRADE ......................................................... 2
THIRD GRADE.............................................................. 3
FOURTH GRADE.......................................................... 4
FIFTH GRADE .............................................................. 5
SIXTH GRADE .............................................................. 6
SEVENTH GRADE........................................................ 7
EIGHTH GRADE ........................................................... 8
NINTH GRADE.............................................................. 9
TENTH GRADE............................................................. 10
ELEVENTH GRADE...................................................... 11
TWELFTH GRADE........................................................ 12
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
(CONSISTENCY CHECK: A18a CANNOT BE > A4 OR A6a)
B14.
Has {he/she} ever been expelled from school? (NLTS D7H REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO B15
DON’T KNOW ............................................................... d
GO TO B15
REFUSED ..................................................................... r
GO TO B15
NLTS 2012 Baseline Parent Interview
16
Draft dated 10.10.11
B14a.
From what grade or grades was {he/she} expelled? (NLTS D7I REV)
CODE ALL THAT APPLY
PRE-KINDERGARTEN ................................................. 98
KINDERGARTEN .......................................................... 0
FIRST GRADE .............................................................. 1
SECOND GRADE ......................................................... 2
THIRD GRADE.............................................................. 3
FOURTH GRADE.......................................................... 4
FIFTH GRADE .............................................................. 5
SIXTH GRADE .............................................................. 6
SEVENTH GRADE........................................................ 7
EIGHTH GRADE ........................................................... 8
NINTH GRADE.............................................................. 9
TENTH GRADE............................................................. 10
ELEVENTH GRADE...................................................... 11
TWELFTH GRADE........................................................ 12
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B15.
Did {he/she} ever have an out-of-school suspension? (NLTS D7H REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO B16
DON’T KNOW ............................................................... d
GO TO B16
REFUSED ..................................................................... r
GO TO B16
NLTS 2012 Baseline Parent Interview
17
Draft dated 10.10.11
B15a.
From what grade or grades was {he/she} suspended out of school? (NLTS D7I REV)
CODE ALL THAT APPLY
PRE-KINDERGARTEN ................................................. 98
KINDERGARTEN .......................................................... 0
FIRST GRADE .............................................................. 1
SECOND GRADE ......................................................... 2
THIRD GRADE.............................................................. 3
FOURTH GRADE.......................................................... 4
FIFTH GRADE .............................................................. 5
SIXTH GRADE .............................................................. 6
SEVENTH GRADE........................................................ 7
EIGHTH GRADE ........................................................... 8
NINTH GRADE.............................................................. 9
TENTH GRADE............................................................. 10
ELEVENTH GRADE...................................................... 11
TWELFTH GRADE........................................................ 12
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
B16.
Has {YOUTH} been arrested in the past two years? (NLTS, U8a)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
18
Draft dated 10.10.11
C. PARENT INVOLVEMENT AT SCHOOL
C_INTRO
The next set of questions are about your involvement in {YOUTH}’s experience at
school. There are no right or wrong answers to these questions – only your
experiences.
C1.
Since the beginning of this school year, have you or another adult in the household
done any of the following at {YOUTH’S} school? (NLTS2, E1 - REV)
C2.
[IF C1=YES, ASK:] About how many times has that happened? Would you say 1-2
times, 3-4 times, 5-6 times, or more than that?
C1
C2
YES
NO
DK
REF
1-2
TIMES
3-4
TIMES
5-6
TIMES
MORE
THAN
5-6
TIMES
a. Attend a general school meeting, for
example, back to school night, or a
meeting of a parent-teacher
organization? ...........................................
1
0
d
r
1
2
3
4
d
r
b. Attend a school or class event, such as a
play, sports event, or science fair? This
can include visits to the school for other
children in the family who are at this
school. .....................................................
1
0
d
r
1
2
3
4
d
r
Volunteer at the school, for example,
chaperoning a class field trip, or serving
on a committee? ......................................
1
0
d
r
1
2
3
4
d
r
d. Gone to a parent/teacher conference
with {YOUTH}’s teacher? ........................
1
0
d
r
1
2
3
4
d
r
c.
C3.
DK
REF
Adults differ in how much they talk to children about school. During this school year,
{did} you or another adult in the household talk with {YOUTH} about {his/her}
experiences in school? Would you say… (NLTS2, E7)
Not at all, ...................................................................... 0
Rarely, .......................................................................... 1
Occasionally or............................................................ 2
Regularly? .................................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
19
Draft dated 10.10.11
C4.
During this school year, how often did you or another adult in the household help
{YOUTH} with {his/her} homework? Would you say… (NLTS2, E8)
Never, ........................................................................... 0
Less than once a week, .............................................. 1
1-2 times a week, ......................................................... 2
3-4 times a week, or ................................................... 3
5 or more times a week? ............................................ 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D. ABILITIES, DISABILITIES, AND SERVICES
D_INTRO The next set of questions are about {YOUTH’S} abilities and disabilities.
D1.
Has a professional ever identified {YOUTH} as having a physical, sensory, learning, or
other disability or problem? (NLTS B1A REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO D2_INTRO IF IEP IN
RECORDS. ELSE GO TO
D7_INTRO
DON’T KNOW ............................................................... d
GO TO D2_INTRO IF IEP IN
RECORDS. ELSE GO TO
D7_INTRO
REFUSED ..................................................................... r
GO TO D2_INTRO IF IEP IN
RECORDS. ELSE GO TO
D7_INTRO
NLTS 2012 Baseline Parent Interview
20
Draft dated 10.10.11
D1a.
With what physical, sensory, learning, or other disabilities or problems has {YOUTH}
ever been identified by a professional as having? (NLTS B1A REV)
PROBE:
Any other disabilities or learning problems? That could include a speech
problem. IF NO DISABILITY OR NOT GETTING SPECIAL SERVICES, CODE
AS “0”.
CODE ALL THAT APPLY
HAS NO PROBLEM/DISABILITY/NOT GETTING
SPECIAL SERVICES .................................................... 0
GO BACK AND CORRECT D1
ASTHMA ....................................................................... 1
ATTENTION DEFICIT DISORDER(ADD or ADHD) ...... 2
AUTISM OR ASPERSERS ........................................... 3
BLINDNESS (COMPLETE BLINDNESS) ..................... 4
CEREBRAL PALSY ...................................................... 5
DEAFNESS ................................................................... 6
DEAFNESS AND BLINDNESS ..................................... 7
DOWN SYNDROME ..................................................... 8
DYSLEXIA ..................................................................... 9
EMOTIONAL DISTURBANCE/BEHAVIOR
DISORDER (ED, BD, SED)........................................... 10
HARD OF HEARING/HEARING IMPAIRMENT ............ 11
HEALTH IMPAIRMENT (SPECIFY DISEASE) ............. 12
________________________________(STRING 150)
LEARNING DISABILITY (LD)........................................ 13
INTELLECTUAL DISABILITY........................................ 14
PHYSICAL OR ORTHOPEDIC IMPAIRMENT .............. 15
SPEECH IMPAIRMENT/COMMUNICATION
IMPAIRMENT ................................................................ 16
SPINA BIFIDA ............................................................... 17
TRAUMATIC BRAIN INJURY (TBI) .............................. 18
VISUAL IMPAIRMENT/PARTIAL SIGHT ...................... 19
DEVELOPMENTAL DELAY .......................................... 20
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
21
Draft dated 10.10.11
D1b.
Which physical, sensory, learning, or other disabilities does a professional identify
{YOUTH} as having now? List all that apply. (NEW)
CODE ALL THAT APPLY
1. {RESPONSE01 FROM D1a} 12. {RESPONSE12 FROM D1a }
2. {RESPONSE02 FROM D1a } 13. {RESPONSE13 FROM D1a }
3. {RESPONSE03 FROM D1a } 14. {RESPONSE14 FROM D1a}
4. {RESPONSE04 FROM D1a } 15. {RESPONSE15FROM D1a }
5. {RESPONSE05 FROM D1a } 16. {RESPONSE16 FROM D1a }
6. {RESPONSE06 FROM D1a } 17. {RESPONSE17 FROM D1a }
7. {RESPONSE07 FROM D1a } 18. {RESPONSE18 FROM D1a }
8. {RESPONSE08 FROM D1a } 19. {RESPONSE19 FROM D1a }
9. {RESPONSE09 FROM D1a } 20. {RESPONSE20 FROM D1a }
10. {RESPONSE10 FROM D1a } 21. {RESPONSE21 FROM D1a }
11. {RESPONSE11 FROM D1a } 22. NONE
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D1c.
Which of those disabilities or problems that you told me about is {YOUTH}’s main
problem or disability? (NLTS B1B) [DO NOT READ RESPONSES ALOUD UNLESS
RESPONDENT NEEDS PROMPT]
CODE ONE ONLY
1. {RESPONSE01 FROM D1a} 12. {RESPONSE12 FROM D1a }
2. {RESPONSE02 FROM D1a } 13. {RESPONSE13 FROM D1a }
3. {RESPONSE03 FROM D1a } 14. {RESPONSE14 FROM D1a}
4. {RESPONSE04 FROM D1a } 15. {RESPONSE15FROM D1a }
5. {RESPONSE05 FROM D1a } 16. {RESPONSE16 FROM D1a }
6. {RESPONSE06 FROM D1a } 17. {RESPONSE17 FROM D1a }
7. {RESPONSE07 FROM D1a } 18. {RESPONSE18 FROM D1a }
8. {RESPONSE08 FROM D1a } 19. {RESPONSE19 FROM D1a }
9. {RESPONSE09 FROM D1a } 20. {RESPONSE20 FROM D1a }
10. {RESPONSE10 FROM D1a } 21. {RESPONSE21 FROM D1a }
11. {RESPONSE11 FROM D1a } 22. NONE
EQUALLY SEVERE ...................................................... 16
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
22
Draft dated 10.10.11
BOX D2
THIS LOGIC SEPARATES PARENTS WHOSE YOUTH HAVE A DISABILITY BUT WHOSE YOUTH’S SCHOOL RECORDS
SHOW NO IEP FROM THOSE WITH AN IEP IN THE RECORDS. THOSE WHO DO NOT HAVE AN IEP IN THE RECORDS
ARE SKIPPED TO A QUESTION THAT ASKS IF THEY EVER RECEIVED SPECIAL EDUCATION. IF IEP IN RECORDS, GO
TO D2_INTRO. ELSE IF D1 = 1 AND NO IEP IN RECORDS (THIS WOULD INCLUDE THOSE WITH NO RECORDS
BECAUSE THEY ARE NOT ENROLLED), GO TO D3.
D2_INTRO
Records from the school or school district indicate that at the beginning of the school
year {YOUTH} had received special education services for: (NLTS BCINTRO)
{DISNAM (1)}
{DISNAM (2)}
{DISNAM (3)}
PARENTS OF YOUTH WHOSE DISTRICT RECORDS SHOW AN IEP
D2.
[Is {any of} that still correct?] Did {YOUTH} receive special education services for…
(NLTS B1C)
YES
NO
NEVER
DID
DK
REF
a. {DISNAM(1)} ...................................................................
1
0
n
d
r
b. {DISNAM(2)} ...................................................................
1
0
n
d
r
c.
1
0
n
d
r
{DISNAM(3)} ...................................................................
IF A|B|C = 1, GO TO D4.
IF A AND B AND C = n, GO TO D6
ELSE, GO TO D2a.
D2a.
Did {YOUTH} ever receive special education services or have an IEP? (NEW)
IF NEEDED: “IEP” stands for an Individualized Education Program. An IEP is a written
statement for each student with a disability that sets goals for the student in
school, says how progress will be measured, describes the special education
and related services the school will provide, how much the student will be in
the regular class with nondisabled students, and lists accommodations or
modifications needed to measure what the student knows through tests. After
a student turns 16, the IEP must also include goals for what the student will
do after high school and services needed to help the student reach those
goals.
YES ............................................................................... 1
GO TO D4
NO ................................................................................. 0
GO TO D7_INTRO
DON’T KNOW ............................................................... d
GO TO D7_INTRO
REFUSED ..................................................................... r
GO TO D7_INTRO
NLTS 2012 Baseline Parent Interview
23
Draft dated 10.10.11
D3.
Did {YOUTH} ever receive special education services or have an IEP? (NEW)
IF NEEDED:
“IEP” stands for an Individualized Education Program. An IEP is a written statement
for each student with a disability that sets goals for the student in school, says how
progress will be measured, describes the special education and related services the
school will provide, how much the student will be in the regular class with
nondisabled students, and lists accommodations or modifications needed to
measure what the student knows through tests. After a student turns 16, the IEP
must also include goals for what the student will do after high school and services
needed to help the student reach those goals.
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D4.
At what point in {YOUTH}’s life did it become apparent that {he/she} had a disability,
problem, or condition?
IF NEEDED: About how old was {YOUTH} when {he/she} started having this difficulty
or condition? (NLTS B2A, REV)
IF NEEDED: If it’s easier to remember {YOUTH’s} grade level at that time, please give
me that information. IF RESPONDENT SAYS, LESS THAN 1 YEAR OLD,
THEN SELECT AGE AND THEN ENTER “0”. SELECT GRADE LEVEL AND
USE 0 FOR KINDERGARTEN AND 98 FOR PRE-KINDERGARTEN]
|
|
| AGE (0-21)
|
|
| GRADE LEVEL (0-13, 98)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D4a.
About how old was {YOUTH} when {he/she} started receiving special education
services from a professional? (NEW)
[IF NEEDED: If it’s easier to remember {HIS/HER} grade level at that time, please give
me that information. IF RESPONDENT SAYS, LESS THAN 1 YEAR OLD,
THEN SELECT AGE AND THEN ENTER “0”. SELECT GRADE LEVEL AND
USE 0 FOR KINDERGARTEN AND 98 FOR PRE-KINDERGARTEN]
|
|
| AGE (0-21)
|
|
| GRADE LEVEL (0-13, 98)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
24
Draft dated 10.10.11
ASKED ONLY OF THOSE WITH IEPS
D5.
As of the beginning of the 2011-12 school year, did {YOUTH} still receive special
education services and have an IEP? (NEW)
YES ............................................................................... 1
GO TO D6
NO ................................................................................. 0
D5a.
DON’T KNOW ............................................................... d
GO TO D6
REFUSED ..................................................................... r
GO TO D6
About how old was {YOUTH} when the IEP and special education services ended?
(NEW)
[IF NEEDED: If it’s easier to remember the YOUTH’s grade level at that time, please
give me that information. IF RESPONDENT SAYS, LESS THAN 1 YEAR
OLD, THEN SELECT AGE AND THEN ENTER “0”. SELECT GRADE LEVEL
AND USE 0 FOR KINDERGARTEN AND 98 FOR PRE-KINDERGARTEN]
|
|
| AGE (0-21)
|
|
| GRADE LEVEL (0-13, 98)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D5b.
Why is {he/she} no longer receiving special education services? (NLTS D8B REV)
CODE ALL THAT APPLY
NO LONGER NEEDS SPECIAL SERVICES ................ 1
MET IEP GOALS........................................................... 2
YOUTH WAS DECLASSIFIED, SCHOOL SAYS
NO LONGER NEEDS SERVICES ................................ 3
NO LONGER ELIGIBLE, DOESN’T QUALIFY .............. 4
SCHOOL DOESN’T HAVE THE PROGRAMS
{YOUTH} NEEDS .......................................................... 5
PARENT DOESN’T WANT YOUTH IN SPECIAL
EDUCATION ................................................................. 6
YOUTH DID NOT WANT TO BE IN SPECIAL
EDUCATION ................................................................. 7
YOUTH NOW HAS A 504 PLAN ................................... 9
DOESN’T THINK YOUTH EVER WAS IN
SPECIAL EDUCATION ................................................. 10
YOUTH HOME SCHOOLED BY PARENT ................... 11
OTHER (SPECIFY) ....................................................... 99
________________________________ (STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
25
Draft dated 10.10.11
ASK ONLY OF PARENTS WHOSE STUDENTS ARE NOT ON AN IEP NOW
D6.
Has {he/she} ever had a Section 504 plan? (NEW)
PROBE:
A Section 504 plan, which falls under civil-rights law, removes barriers so
students with disabilities can participate in school as freely as possible. This may
include students who do not need an IEP but may need extra help or assistance
to participate fully in school. Such help may include more time on tests, or sitting
in the front of the classroom. An IEP is more concerned with providing
educational services.
YES ............................................................................... 1
D6a.
NO ................................................................................. 0
GO TO D7_INTRO
DON’T KNOW ............................................................... d
GO TO D7_INTRO
REFUSED ..................................................................... r
GO TO D7_INTRO
About how old was {YOUTH} when the Section 504 plan began? (NEW)
[IF NEEDED: If it’s easier to remember {YOUTH}’s grade level at that time, please give
me that information. IF RESPONDENT SAYS, LESS THAN 1 YEAR OLD,
THEN SELECT AGE AND THEN ENTER “0”. SELECT GRADE LEVEL AND
USE 0 FOR KINDERGARTEN AND 98 FOR PRE-KINDERGARTEN]
|
|
| AGE (0-21)
|
|
| GRADE LEVEL (0-98)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D6b.
As of the beginning of the 2011-12 school year, did {he/she} still have a Section 504
plan? (NEW)
YES ............................................................................... 1
GO TO D7_INTRO
NO ................................................................................. 0
D6c.
DON’T KNOW ............................................................... d
GO TO D7_INTRO
REFUSED ..................................................................... r
GO TO D7_INTRO
About how old was {YOUTH} when the Section 504 plan ended? (NEW)
[IF NEEDED: If it’s easier to remember {YOUTH}’s grade level at that time, please give
me that information. IF RESPONDENT SAYS, LESS THAN 1 YEAR OLD,
THEN SELECT AGE AND THEN ENTER “0”. SELECT GRADE LEVEL AND
USE 0 FOR KINDERGARTEN AND 98 FOR PRE-KINDERGARTEN]
|
|
| AGE (0-21)
|
|
| GRADE LEVEL (0-98)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
26
Draft dated 10.10.11
D6d.
Why does {he/she} no longer have a Section 504 plan? (NLTS D8B REV)
CODE ALL THAT APPLY
NO LONGER NEEDS ACCOMMODATIONS ............... 1
SCHOOL SAYS NO LONGER NEEDS
ACCOMMODATIONS ................................................... 2
NO LONGER ELIGIBLE, DOESN’T QUALIFY .............. 3
PARENT DOESN’T WANT YOUTH TO RECEIVE
ACCOMMODATIONS ................................................... 4
YOUTH DOES NOT WANT TO RECEIVE
ACCOMMODATIONS ................................................... 5
YOUTH CHANGED SCHOOLS (DID NOT
REQUEST SPECIAL SERVICES OR NEW
SCHOOL DID NOT IDENTIFY [YOUTH] AS
NEEDING SPECIAL SERVICES) ................................. 6
DOESN’T THINK YOUTH EVER HAD A 504
PLAN ............................................................................. 7
YOUTH HOME SCHOOLED BY PARENT ................... 8
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D7_INTRO.
D7.
Now I want to ask you about how well {YOUTH} does some things. It is important
to know how different youth function in different areas. If these questions are
difficult for you, please stick with me, and we’ll be past this section soon.
First, I’m going to ask about {YOUTH’s} vision. Wearing glasses or contacts if
{he/she} uses them, how well does {YOUTH } see? (NLTS B3C rev)
CODE ONE ONLY
Sees normally, ............................................................. 1 GO TO D9_INTRO
has a little trouble seeing, .......................................... 2 GO TO D9_INTRO
has a lot of trouble seeing, or .................................... 3
doesn’t see at all? ....................................................... 4
DON’T KNOW ............................................................... d
GO TO D9_INTRO
REFUSED ..................................................................... r
GO TO D9_INTRO
NLTS 2012 Baseline Parent Interview
27
Draft dated 10.10.11
D8.
Does {YOUTH} use… (NLTS B3D)
YES
NO
DK
REF
a. Braille? ..........................................................................................................
1
0
d
r
b. IF B2A = 1, ASK: A portable Braille note taker or writer? .............................
1
0
d
r
c.
Large print type? ...........................................................................................
1
0
d
r
d. Optical devices, such as near vision magnification, telescopic devices, or
bioptic lenses? ..............................................................................................
1
0
d
r
e. Mobility devices, such as a cane, or electronic travel aids? .........................
1
0
d
r
1
0
d
r
1
0
d
r
f.
Assistive technology, such as voice synthesizers or software to enlarge the
size of the print on the computer screen? .....................................................
g. Any other devices to help {him/her} see or read? SPECIFY ........................
_________________________(CATI: STRING 150 CHAR)
D9_INTRO
D9.
Now I’m going to ask you some questions about {YOUTH}’s hearing.
Would you say {YOUTH}…
[IF NEEDED:
This assessment should be made of {YOUTH’s} hearing without any
hearing devices like a hearing aid.] (NLTS B4A)
CODE ONE ONLY
Hears normally, or ....................................................... 1
GO TO D14
Has a hearing problem? ............................................. 2
D10.
DON’T KNOW ............................................................... d
GO TO D14
REFUSED ..................................................................... r
GO TO D14
Is {YOUTH}’s hearing loss… (NLTS B4B)
CODE ONE ONLY
Mild, .............................................................................. 1
Moderate, or ................................................................. 2
Severe to profound? ................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D11.
Has a hearing aid or other kind of hearing device been prescribed for {him/her}?
(NLTS B4C)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO D12
DON’T KNOW ............................................................... d
GO TO D12
REFUSED ..................................................................... r
GO TO D12
NLTS 2012 Baseline Parent Interview
28
Draft dated 10.10.11
D11a.
How well does {YOUTH} hear with the hearing device? Would you say {he/she}…
(NLTS B4D)
CODE ONE ONLY
Hears normally, ........................................................... 1
Has a little trouble hearing, ........................................ 2
Has a lot of trouble hearing, or .................................. 3
Doesn’t hear at all? ..................................................... 4
DOES NOT HAVE ONE ................................................ 5
WILL NOT WEAR IT ..................................................... 6
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D12.
Does {YOUTH} have a cochlear implant?
IF NEEDED: A cochlear implant is a surgically implanted electronic device that can
restore partial hearing to people with some hearing impairments. (NLTS B4E)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D13.
How well does {YOUTH} communicate by any means? Would you say {he/she}…
(NLTS B4F)
CODE ONE ONLY
Has no trouble communicating,................................. 1
Has a little trouble communicating,........................... 2
Has a lot of trouble communicating, or ..................... 3
Doesn’t communicate at all?...................................... 4
GO TO D16
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
29
Draft dated 10.10.11
D13a.
Now I’d like to ask about ways that {he/she} may communicate. Does {YOUTH} use…
(NLTS B4G)
YES
NO
DK
REF
a. Sign language or manual communication? ..........................................
1
0
d
r
b. Lip reading? .........................................................................................
1
0
d
r
c.
Cued speech? ......................................................................................
1
0
d
r
d. Oral speech [TALKING]? .....................................................................
1
0
d
r
e. A communication board or book? .......................................................
1
0
d
r
f.
1
0
d
r
Anything else to help {him/her} communicate? SPECIFY ...................
______________________________________________________
BOX D14
THIS LOGIC SEPARATES PARENTS OF YOUTH WHO COMMUNICATE THROUGH ORAL SPEECH.
THOSE WHO SPEAK ARE TAKEN TO QUESTIONS ABOUT THEIR SPEECH.
IF D13A PART D= 1, GO TO D14. ELSE GO TO D16.
D14.
How clearly does {YOUTH} speak? Would you say {he/she}… (NLTS B4H)
CODE ONE ONLY
Has no trouble speaking clearly, ............................... 1
Has a little trouble speaking,...................................... 2
Has a lot of trouble speaking, or................................ 3
Does not speak at all? ................................................ 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D15.
How well does {he/she} carry on an oral conversation? Would you say {he/she}…
(NLTS B4I, rev)
CODE ONE ONLY
Has no trouble carrying on an oral conversation, ................ 1
Has a little trouble carrying on an oral conversation, .......... 2
Has a lot of trouble carrying on an oral conversation,
or ................................................................................................ 3
Doesn’t carry on an oral conversation at all? ....................... 4
DON’T KNOW ............................................................................ d
REFUSED .................................................................................. r
NLTS 2012 Baseline Parent Interview
30
Draft dated 10.10.11
D16.
How well does {YOUTH} understand what people say to {him/her}? Would you say
{he/she}… (NLTS B4J)
CODE ONE ONLY
Has no trouble understanding what others say, ...... 1
Has a little trouble understanding, ............................ 2
Has a lot of trouble understanding, or ...................... 3
Doesn’t understand at all? ......................................... 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
BOX D17
THIS LOGIC SEPARATES THOSE WHO HAVE HEARING IMPAIRMENTS FROM THOSE WHO DO NOT.
THOSE WITH HEARING IMPAIRMENTS CONTINUE WITH B13INTRO, PHYSICAL ABILITIES.
IF D9 = 2, GO TO D19_INTRO. ELSE GO TO D17.
D17.
My next questions are about {YOUTH’s} ability to use language. How clearly does
{he/she} speak? Would you say {he/she}… (NLTS B5A)
CODE ONE ONLY
Has no trouble speaking clearly, ............................... 1
GO TO D18
Has a little trouble speaking,...................................... 2
GO TO D18
Has a lot of trouble speaking, or................................ 3
Does not speak at all? ................................................ 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D17a.
How well does {YOUTH} communicate by any means? Would you say {he/she}…
(NLTS B5B)
CODE ONE ONLY
Has no trouble communicating,................................. 1
Has a little trouble communicating,........................... 2
Has a lot of trouble communicating, or ..................... 3
Doesn’t communicate at all?...................................... 4
GO TO D18a
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
31
Draft dated 10.10.11
D17b.
Now I’d like to ask about ways that {he/she} may communicate with you. Does
{YOUTH} use… (NLTS B5C)
YES
NO
DK
REF
a. Words? .....................................................................................................
1
0
d
r
b. Sounds that are not words? .....................................................................
1
0
d
r
c.
Gestures, including pointing? ...................................................................
1
0
d
r
d. Sign language? ........................................................................................
1
0
d
r
e. A communication board or book? ............................................................
1
0
d
r
f.
A computer to communicate with you? ....................................................
1
0
d
r
g. Anything else to help {him/her} communicate? SPECIFY .......................
1
0
d
r
________________________(CATI: STRING 150 CHAR)
D18.
How well does {he/she} carry on a conversation? Would you say {he/she}… (NLTS
B4I)
CODE ONE ONLY
Has no trouble carrying on a conversation, ............. 1
GO TO D19_INTRO
Has a little trouble carrying on a conversation, ....... 2
GO TO D19_INTRO
Has a lot of trouble carrying on a conversation, or . 3
Doesn’t carry on a conversation at all? .................... 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D18a.
How well does {YOUTH} understand what people say to {him/her}? Would you say
{he/she}… (NLTS B4J)
CODE ONE ONLY
Has no trouble understanding what others say, ...... 1
Has a little trouble understanding, ............................ 2
Has a lot of trouble understanding, or ...................... 3
Doesn’t understand at all? ......................................... 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
32
Draft dated 10.10.11
D19_INTRO
D19.
Next I want to ask about {YOUTH}’s physical abilities.
How well does {YOUTH} use both of {his/her} arms and hands? Would you say {he/she}
uses both arms and hands normally?
IF NEEDED: If there is a difference for each arm or hand, refer to the side that the YOUTH
is experiencing the most difficulty. Do not include temporary difficulties, such as a broken
arm. (NLTS B6C, REV)
IF YOUTH IS MISSING A HAND OR ARM CODE AS 2
YES ............................................................................... 1
GO TO D20
NO ................................................................................. 0
D19a.
HAS NO USE OF ONE OR BOTH HANDS OR
ARMS ............................................................................ 2
GO TO D20
DON’T KNOW ............................................................... d
GO TO D20
REFUSED ..................................................................... r
GO TO D20
Can {YOUTH} use {his/her} arms and hands normally for things like using a spoon or
holding a pencil? (NLTS B6A, REV)
IF NEEDED: If there is a difference for each arm or hand, refer to the side with which
the [YOUTH] is experiencing the most difficulty. Do not include temporary difficulties,
such as a broken arm.
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D19b.
Can {he/she} use {his/her} arms and hands normally for things like throwing, lifting,
or carrying? IF NEEDED: If there is a difference for each arm or hand, refer to the side
that the YOUTH is experiencing the most difficulty. Do not include temporary
difficulties, such as a broken arm. (NLTS B6B, REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
33
Draft dated 10.10.11
D20.
How well does {YOUTH} use both of {his/her} legs and feet? Would you say {he/she} uses
both legs and feet normally? IF NEEDED: If there is a difference for each leg or foot, refer
to the side that the YOUTH is experiencing the most difficulty. Do not include temporary
difficulties, such as a broken leg. (NLTS B6C)
YES ............................................................................... 1
GO TO D21
NO ................................................................................. 0
D20a.
DON’T KNOW ............................................................... d
GO TO D21
REFUSED ..................................................................... r
GO TO D21
Does {he/she} use any equipment to help {him/her} get around, such as crutches, a
wheelchair, or prosthetics? (NLTS B6D, rev)
YES ............................................................................... 1
D20b.
NO ................................................................................. 0
GO TO D21
DON’T KNOW ............................................................... d
GO TO D21
REFUSED ..................................................................... r
GO TO D21
What is the equipment {he/she} uses to get around? (NLTS B6E)
CODE ALL THAT APPLY
CRUTCHES .................................................................. 1
WALKER ....................................................................... 2
LEG BRACES ............................................................... 3
WHEELCHAIR .............................................................. 4
CANE ............................................................................ 5
PROSTHETICS ............................................................. 6
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D21.
Now I have some questions about {YOUTH}’s health. Would you say {his/her} general
health is… (NLTS B7A)
CODE ONE ONLY
Excellent,...................................................................... 1
Very good, .................................................................... 2
Good, ............................................................................ 3
Fair, or .......................................................................... 4
Poor? ............................................................................ 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
34
Draft dated 10.10.11
D22.
Does {YOUTH} have a chronic physical or mental health condition that requires
regular treatment or medical care? (NEW)
YES ............................................................................... 1
D22a.
NO ................................................................................. 0
GO TO D23
DON’T KNOW ............................................................... d
GO TO D23
REFUSED ..................................................................... r
GO TO D23
Is most of {his/her} health care currently provided by a pediatrician or an adult care
physician or specialist? (CSHCN)
IF NEEDED: A pediatrician is a doctor who generally treats children under the age of
18.
PEDIATRICIAN ............................................................. 1
ADULT CARE PHYSICIAN OR SPECIALIST ............... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D22b.
Has [YOUTH]’s doctor(s) or other health care provider(s) talked with you or [YOUTH]
about how {his/her} health care needs might change when {he/she} becomes an
adult? (CSHCN)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
PARENTS WITH YOUTH WHO HAVE EVER BEEN DIAGNOSED WITH A DISABILITY OR RECEIVED SPECIAL
EDUCATION SERVICES.
D23.
Is {he/she} taking any prescription medicine that controls {his/her} attention,
behavior, or activity level, or changes {his/her} mood, such as Ritalin or an
antidepressant? (NLTS B7C)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
35
Draft dated 10.10.11
BOX D24
THOSE WHO DESCRIBE THEIR YOUTH’S HEALTH AS EXCELLENT GO TO QUESTION B21 ABOUT ACTIVITIES OF
DAILY LIVING. IF D21=1, GO TO D25. ELSE GO TO D24.
D24.
Does {YOUTH} use any kind of medical equipment or device, like an oxygen tank or a
catheter? This does not include mobility devices, like a wheelchair, walker, or cane.
(NLTS B7F)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
BOX D25
FOR PRETEST- IF YOUTH HAS AUTISM, BLINDNESS OR VISUAL IMPAIRMENT, CEREBRAL PALSY,
DEAFNESS AND BLINDNESS, DOWN SYNDROME, INTELLECTUAL DISABILITY, PHYSICAL OR
ORTHOPEDIC IMPAIRMENT, SPINA BIFIDA, TRAUMATIC BRAIN INJURY, DEVELOPMENTAL DELAY, OR
SOMETHING ELSE SERIOUS, GO TO D25.
IF YOUTH HAS ASTHMA, ADD, DEAFNESS OR HARD OF HEARING, DYSLEXIA, EMOTIONAL
DISTURBANCE, LEARNING DISABILITY, SPEECH IMPAIRMENT, OR SOMETHING ELSE LIKE THIS, GO TO
D26.
THIS LOGIC IS FOR PARENTS WITH YOUTH WITH AUTISM, BLINDNESS OR VISUAL IMPAIRMENT, CP, DOWNS,
HEALTH IMPAIRMENT, INTELLECTUAL DISABILITY, PHYSICAL OR ORTHOPEDIC IMPAIRMENT, SPINA BIFIDA, TBI,
DEVELOPMENTAL DELAY, OR MULTIPLE DISABILITIES. IF (D1=0 AND NO IEP RECORD) OR (D1 = 0 AND NONE OF
D2= 1) OR (DISTRICT RECORD OF LEARNING DISABILITY, HEARING IMPAIRMENT, SPEECH DISORDER,
EMOTIONAL/BEHAVIORAL DISORDER, OR ADD) AND (NO AUTISM, BLINDNESS OR VISUAL IMPAIRMENT, CP,
DEVELOPMENTAL DELAY, DOWNS, HEALTH IMPAIRMENT, INTELLECTUAL DISABILITY, PHYSICAL OR ORTHOPEDIC
IMPAIRMENT, SPINA BIFIDA, TBI, OR MULTIPLE)), GO TO D26. ELSE GO TO D25.
PARENTS WITH YOUTH WITH AUTISM, BLINDNESS OR VISUAL IMPAIRMENT, CP, DOWNS, HEALTH IMPAIRMENT,
INTELLECTUAL DISABILITY, PHYSICAL OR ORTHOPEDIC IMPAIRMENT, SPINA BIFIDA, TBI, DEVELOPMENTAL
DELAY, OR MULTIPLE DISABILITIES.
D25.
How well does {YOUTH}…READ EACH ITEM …on {his/her} own, without help? Would
you say {he/she} does it very well, pretty well, not very well, or not at all well? (NLTS
G3, REV)
VERY
WELL
PRETTY
WELL
NOT
VERY
WELL
NOT AT
ALL
WELL
NOT
ALLOWED
DK
REF
a. Dress {himself/herself} completely ................
1
2
3
4
5
d
r
b. Feed {himself/herself} completely .................
1
2
3
4
5
d
r
Read and understand common signs, like
Stop, Men, Women, or Danger .....................
1
2
3
4
5
d
r
d. Count change or ensure {he/she} is given
proper change when making a purchase ......
1
2
3
4
5
d
r
e. Look up telephone numbers and use the
telephone.......................................................
1
2
3
4
5
d
r
c.
NLTS 2012 Baseline Parent Interview
36
Draft dated 10.10.11
ASK ONLY IF YOUTH HAS IEP OR 504 PLAN
D26.
How well does{YOUTH} do each of the following items on {his/her} own, without
help? READ STATEMENTS. CODE ONE RESPONSE FOR EACH.
Would you say {he/she} does it very well, pretty well, not very well, or not at all well?
(NLTS G4, rev)
VERY
WELL
PRETTY
WELL
NOT
VERY
WELL
NOT AT
ALL
WELL
N/A
DK
REF
a. Use an ATM or cash machine ..................
1
2
3
4
5
d
r
b. Make appointments, such as with a
doctor, dentist, or potential employer .......
1
2
3
4
5
d
r
1
2
3
4
5
d
r
c.
Get to places outside the home, like to
school, to a nearby store or park, or to a
neighbor’s house ......................................
D27.
When the following chores need doing, about how often, on {his/her} own, does
{he/she}… READ STATEMENTS. CODE ONE RESPONSE FOR EACH.
Would you say always, usually, sometimes, or never? (NLTS G5)
ALWAYS
USUALLY
SOMETIMES
NEVER
DK
REF
a. Fix {his/her} own breakfast or lunch? ...
1
2
3
4
d
r
b. Do laundry? ..........................................
1
2
3
4
d
r
Straighten up {his/her} own room or
living area? ...........................................
1
2
3
4
d
r
d. Buy a few things at the store {he/she}
needs?..................................................
1
2
3
4
d
r
c.
BOX D28
THIS BOX SEPARATES PARENT OF YOUTH WHO NEVER HAD AN IEP, 504 PLAN OR DISABILITY. IF D2 A|B|C|D = 1 OR
(D4 = 1 AND NO IEP IN RECORDS) OR D2A = 1 OR D3 = 1 OR D4A= D|R, OR D6 = 1, GO TO D28. ELSE, GO TO D32.
PARENTS OF YOUTH WHO CURRENTLY HAVE AN IEP OR 504 PLAN
D28.
The next questions are about assistive technology. Assistive technology is any object,
piece of equipment, or product that is used to increase, maintain, or improve functional
capabilities of individuals with disabilities. Does {YOUTH} use any assistive technology
at school? (NEW)
PROBE:
Assistive technology is not only computers. The equipment can be shared
with others. Usually the need for assistive technology is written in an IEP.
YES ............................................................................... 1
NO ................................................................................. 0
GO TO D31
DON’T KNOW ............................................................... d
GO TO D31
REFUSED ..................................................................... r
GO TO D31
NLTS 2012 Baseline Parent Interview
37
Draft dated 10.10.11
D29.
What technology does {YOUTH} use? What is the device called? If {YOUTH} uses
more than one device, please tell us about the one specified in {his/her} IEP or that is
most important for {YOUTH}’s education. (NEW)
________________________________(STRING 150)
USE AS REFERENCE IN QUESTIONS THAT FOLLOW
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
D30.
Does {YOUTH} bring the [FILL DEVICE FROM A28] home?
YES ............................................................................... 1
D30a.
NO ................................................................................. 0
GO TO D31
DON’T KNOW ............................................................... d
GO TO D31
REFUSED ..................................................................... r
GO TO D31
Was someone in the household trained on using, or helping {YOUTH} use, the [FILL
DEVICE FROM D29]?
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
38
Draft dated 10.10.11
PARENTS OF YOUTH WHO HAVE EVER HAD AN IEP, 504 PLAN, OR BEEN DIAGNOSED WITH A DISABILITY
D31.
During the past 12 months, has {YOUTH} received any of the following
accommodations or services through school? (NLTS H1A REV and teacher B8 REV)
YES
NO
DK
REF
a. More time in taking tests ........................................................................................
1
0
d
r
b. Modified tests or alternate tests or assessments ...................................................
1
0
d
r
c.
Additional time to complete assignments...............................................................
1
0
d
r
d. Shorter or different assignments ............................................................................
1
0
d
r
e. Teacher’s aide, instructional assistant, or other personal aide or assistant ..........
1
0
d
r
f.
Books on tape, CD, in Braille, large print, or in another alternate format ..............
1
0
d
r
g. Use of a computer or calculator for activities not allowed other students ..............
1
0
d
r
h. Reader or interpreter, including sign language ......................................................
1
0
d
r
i.
Tutor .......................................................................................................................
1
0
d
r
j.
Psychological or mental health services or counseling .........................................
1
0
d
r
k.
Speech or language therapy, or communication services .....................................
1
0
d
r
l.
Audiology services for hearing problems ...............................................................
1
0
d
r
m. Vision services, such as Braille instruction ............................................................
1
0
d
r
n. Physical or occupational therapy ...........................................................................
1
0
d
r
o. Orientation and mobility services (to help individuals navigate their environment)
1
0
d
r
p. Nursing care ...........................................................................................................
1
0
d
r
q. Special transportation because of disability ...........................................................
1
0
d
r
r.
1
0
d
r
Other, SPECIFY ...............................................................................
________________________ (STRING 100)
NLTS 2012 Baseline Parent Interview
39
Draft dated 10.10.11
PARENTS OF YOUTH IN GRADE 9 OR HIGHER
D32.
I am going to read a list of programs and services schools may offer to help students
prepare for life after high school. For each, please tell me whether or not [YOUTH] has
taken part during this school year (2011-2012). Has {he/she} taken part in … (NEW)
YES
NO
DK
REF
a. Catch-up courses or double-dosing of classes during the regular school day?
1
0
d
r
b. Supplemental instruction or tutoring in academic subjects before or after school? .....
1
0
d
r
c.
Supplemental instruction or tutoring in academic subjects on weekends? ..................
1
0
d
r
d. ASK IF GRADE >10: Helping students sign up for standardized college entrance
tests—reminders, aid with test taking fees, prep courses? ..........................................
1
0
d
r
e. ASK IF GRADE >11: Help with financial aid forms, comparing financial aid
packages? .....................................................................................................................
1
0
d
r
ASK IF IEP ONLY: Connecting students to outside transition services, supports, and
activities (e.g., tutoring, mentoring, transportation, assistive technology, networking)?
1
0
d
r
g. ASK IF IEP ONLY AND EITHER GRADE >11 OR 17 YRS OLD: Helping students
connect to adult residential providers and day services? .............................................
1
0
d
r
h. ASK IF IEP ONLY: Help developing capability to dress, clean, care for self................
1
0
d
r
1
0
d
r
f.
i.
ASK IF IEP ONLY: Helping families understand youth’s rights and responsibilities
under disability-related laws
PARENTS OF YOUTH WITH IEP ONLY
D33.
As {YOUTH}’s parent or guardian, during this school year, have you received any
classes or counseling on [YOUTH]’s rights and responsibilities under disabilityrelated laws? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
40
Draft dated 10.10.11
E. EXPERIENCE WITH THE IEP, 504 PLAN, AND SCHOOL SUPPORTS
BOX E1
THIS LOGIC SEPARATES PARENTS OF YOUTH WHO RECEIVE SERVICES. PARENTS OF YOUTH WHO DO NOT
RECEIVE SERVICES ARE TAKEN TO THE NEXT SECTION.
IF D5 = 1 OR D2 (ANY PART) = 1, GO TO E1. ELSE, GO TO F_INTRO.
E1.
During this or last school year, did you or another adult in the household go to a
meeting about an Individualized Education Plan, or IEP, for {YOUTH’S} special
education program or services? (NLTS E2A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
E1a.
During this or last school year, did {YOUTH} go to {“that same” if E1 = 1}{“a” if E1≠1}
meeting about an Individualized Education Plan, or IEP, for {his/her} special
education program or services? (NLTS E2B REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
IF E1 ≠ 1 AND E1A ≠ 1, GO TO E1B. ELSE GO TO E2.
E1b.
Has there been an IEP meeting about {YOUTH’S} special education program or
services this or last year? (NLTS E4A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
PARENTS OF YOUTH AGE >16
E2.
Have you or another adult in the household met with teachers to set goals for what
{YOUTH} will do after high school and make a plan for how {he/she} will achieve
them? Sometimes this is called a transition plan or a transition focused IEP. (NLTS
E2C, REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO E5
DON’T KNOW ............................................................... d
GO TO E5
REFUSED ..................................................................... r
GO TO E5
NLTS 2012 Baseline Parent Interview
41
Draft dated 10.10.11
PARENTS OF YOUTH AGE >16
E3.
Did the school mostly come up with the goals on [his/her] IEP [IF E2=1 ADD: and
transition plan] or was it mostly you or {YOUTH} who came up with the goals? CAN
READ CATEGORIES. (NLTS E3A)
CODE ONE ONLY
MOSTLY SCHOOL ....................................................... 1
MOSTLY RESPONDENT OR OTHER ADULT ............. 2
MOSTLY YOUTH .......................................................... 3
SCHOOL AND YOUTH EQUALLY ............................... 4
SCHOOL AND RESPONDENT OR OTHER ADULT
EQUALLY ...................................................................... 5
YOUTH AND RESPONDENT OR OTHER ADULT
EQUALLY ...................................................................... 6
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
PARENTS OF YOUTH AGE >16
E4.
Which of the following best describes {YOUTH’S} role in {his/her} {“IEP and transition
planning” IF E2a = 1 AND E2= 1, ELSE “IEP planning”}? (NLTS E3B)
CODE ONE ONLY
{He/She} did not participate ....................................... 1
{He/She} was present in discussions but
participated very little or not at all ............................. 2
{He/She} provided some input ................................... 3
{He/She} took a leadership role (helping set the
direction of the discussions, goals and plans) ........ 4
DOESN’T KNOW ABOUT ANY GOALS ....................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
PARENTS OF YOUTH AGE >16
E5.
To the best of your knowledge, did [YOUTH]’s high school have a “transition
planning” meeting to help [YOUTH]’s plan what {he/she} might do after high school?
(NEW)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO F_INTRO
DON’T KNOW ............................................................... d
GO TO F_INTRO
REFUSED ..................................................................... r
GO TO F_INTRO
NLTS 2012 Baseline Parent Interview
42
Draft dated 10.10.11
PARENTS OF YOUTH AGE >16
E6.
The next set of questions are about the transition planning meeting:
YES
NO
DK
REF
a.
Were you invited to that meeting? ........................................................
1
0
d
r
b.
Was [YOUTH] invited to that meeting? .................................................
1
0
d
r
c.
Were [YOUTH]’s interests, strengths, and preferences discussed at
that meeting? ........................................................................................
1
0
d
r
d.
Did staff from any community service agency, such as vocational
rehabilitation services, take part in that meeting? ................................
1
0
d
r
e.
Was YOUTH] given information on education, careers, or community
living options for when {he/she} leaves high school? ...........................
1
0
d
r
F. PLANS FOR THE FUTURE
F_INTRO My next questions are about your expectations for the future.
F1.
Has/Did {YOUTH} taken any courses at {YOUTH}’s high school for which {he/she}
earned college credit at either a two or four year college?
PROBE:
By credit we mean it will count towards the requirements for a two or fouryear degree.
YES ............................................................................... 1
F1a.
NO ................................................................................. 0
GO TO F2
DON’T KNOW ............................................................... d
GO TO F2
REFUSED ..................................................................... r
GO TO F2
What course(s) is {YOUTH} taking at (his /her) high school to earn college credit?
AP COURSE (ANY SUBJECT) ..................................... 1
IB COURSE (INTERNATIONAL BACCALAUREATE) .. 2
OTHER COURSE(S): SPECIFY: _______________ ... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
43
Draft dated 10.10.11
F2.
This school year, is {YOUTH} taking courses in high school designed to expose or
prepare him for a career (or careers) of interest to (him/her)? This could be one or
more courses. For example, if the student is interested in going to medical school
they may take more science classes. (NEW)
YES ............................................................................... 1
F3.
NO ................................................................................. 0
GO TO F4
DON’T KNOW ............................................................... d
GO TO F4
REFUSED ..................................................................... r
GO TO F4
Will {YOUTH} receive college credit for this course (at either 2 or 4 year college)?
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ALL PARENTS OF YOUTH AGE >15
F4.
Have you talked with a school counselor or someone else at school about what
{YOUTH} might do after high school including education or career options? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
44
Draft dated 10.10.11
BOX F5
THIS LOGIC SEPARATES PARENTS WITH YOUTH WHO ARE NOT IN SCHOOL FOR REASONS OTHER THAN
GRADUATING OR TESTING OUT. THEY ARE DIRECTED TO THE LOGIC CHECK.
IF B8 =2 OR 3 (GRADUATED FROM HIGH SCHOOL OR TOOK A TEST FOR DIPLOMA OR CERTIFICATE) GO TO F6, ELSE
GO TO F5.
F5.
As things stand now, how far do you think {YOUTH} will get in school? IF NEEDED:
What is the highest level of schooling you think {he/she} will complete?
CODE ONE ONLY
LESS THAN HIGH SCHOOL (WILL NOT GRADUATE
OR GET GED)............................................................... 1
HIGH SCHOOL DIPLOMA OR GED ............................. 2
TECHNICAL OR TRADE SCHOOL .............................. 3
2 YEAR COLLEGE........................................................ 4
4-YEAR COLLEGE ....................................................... 5
MASTER’S, PHD, OR OTHER ADVANCED
DEGREE ....................................................................... 6
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ALL PARENTS OF YOUTH AGE >15
F6.
Next I’d like to ask about issues youth sometimes face in furthering their education
and training after high school. For each statement I read, please tell me whether you
agree or disagree that this will be an issue {YOUTH} is likely to face. (NEW)
AGREE
DISAGREE
DK
REF
a.
We do not have enough information about education or training
options for {YOUTH} after high school ..........................................
1
0
d
r
b.
{YOUTH} needs to work.................................................................
1
0
d
r
c.
We do not know how to get financial aid or help paying for school
1
0
d
r
d.
{YOUTH} Is not ready – either academically or socially ................
1
0
d
r
e.
{YOUTH} has health issues that would make it difficult.................
1
0
d
r
f.
We don’t think schools could accommodate {YOUTH}’s disability
1
0
d
r
i.
Are there any other difficulties or issues that would make it
difficult for {YOUTH} to further (his /her) education in the first two
years after high school? SPECIFY: ..............................................
1
0
d
r
___________________________________________________
NLTS 2012 Baseline Parent Interview
45
Draft dated 10.10.11
F7.
When {YOUTH} is 30 years old, do you think {he/she} will be living: (NEW)
CODE ONE ONLY
On (his/ her) own - without friends of family, ........... 1
At home with parents, ................................................. 2
With a relative, ............................................................. 3
With friends,................................................................. 4
With a spouse or partner, ........................................... 5
In military housing, ..................................................... 6
In a group home, ......................................................... 7
In an institution, or ...................................................... 8
Some other place? (SPECIFY) ................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
PARENTS WITH YOUTH WHO HAVE EVER HAD AN IEP OR BEEN DIAGNOSED WITH A DISABILITY
F8.
By the time {YOUTH} is 30 years old, how likely do you think it is that {YOUTH} will
earn enough to support {him/her} self without financial help from {his/her} family or
government benefit programs? Do you think {he/she}… (NLTS J10)
(READ RESPONSES IF NECESSARY)
CODE ONE ONLY
Definitely will, .............................................................. 1
Probably will, ............................................................... 2
Probably won’t, or ....................................................... 3
Definitely won’t?.......................................................... 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
46
Draft dated 10.10.11
ALL PARENTS OF YOUTH AGE >15
F9.
Next I’d like to ask about issues youth sometimes face in getting a job after high school.
For each statement I read, please tell me whether you agree or disagree that this will be an
issue {YOUTH} is likely to face. (NEW)
AGREE
DISAGREE
DK
REF
a. ASK IF: NO IEP or 504 PLAN AND HEALTH NOT EXCELLENT ITEM B15
≠ 1: Health issues could prevent [YOUTH] from working ...............................
1
0
d
r
b. ASK IF YOUTH HAS AN IEP: [YOUTH] might lose SSI or other benefits .....
1
0
d
r
c. Staff at the high school has not provided enough information about career
planning or job opportunities ..........................................................................
1
0
d
r
d. Are there any other challenges [YOUTH] might face in getting a job after
high school? SPECIFY: ..................................................................................
1
0
d
r
________ (500 char)
G. DEMOGRAPHICS FOR YOUTH
Now I would like to ask some questions about [YOUTH]’s characteristics and
living arrangements.
G1.
Is any language other than English regularly used in {your/his/her} home? (NLTS2
A4A)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO G3
DON’T KNOW ............................................................... d
GO TO G3
REFUSED ..................................................................... r
GO TO G3
NLTS 2012 Baseline Parent Interview
47
Draft dated 10.10.11
G1a.
What is the main language {you/YOUTH} usually use{s} at home? (NLTS2 A4B)
CODE ONE ONLY
ENGLISH............................................................................... 1
SPANISH............................................................................... 2
ALBANIAN............................................................................. 3
ARABIC ................................................................................. 4
BULGARIAN.......................................................................... 5
CAMBODIAN......................................................................... 6
CHINESE .............................................................................. 7
CREOLE................................................................................ 8
CROATIAN ............................................................................ 9
CZECHOSLOVAKIAN ........................................................... 10
DUTCH .................................................................................. 11
FARSI .................................................................................... 12
FINNISH ................................................................................ 13
FRENCH ............................................................................... 14
GERMAN............................................................................... 15
GREEK .................................................................................. 16
HEBREW............................................................................... 17
HMONG................................................................................. 18
HUNGARIAN ......................................................................... 19
ITALIAN ................................................................................. 20
JAPANESE............................................................................ 21
KOREAN ............................................................................... 22
LAOTIAN ............................................................................... 23
PERSIAN............................................................................... 24
POLISH ................................................................................. 25
PORTUGUESE ..................................................................... 26
PUNJABI ............................................................................... 27
ROMANIAN ........................................................................... 28
RUSSIAN .............................................................................. 29
SAMOAN ............................................................................... 30
SWAHILI................................................................................ 31
TAGALOG (FILIPINO LANGUAGE) ...................................... 32
THAI ...................................................................................... 33
TURKISH............................................................................... 34
URDU .................................................................................... 35
VIETNAMESE ....................................................................... 36
SIGN LANGUAGE/MANUAL COMMUNICATION/ASL ......... 37
YOUTH DOES NOT USE A LANGUAGE ............................. 38
OTHER (SPECIFY) ............................................................... 99
________________________________(STRING (30))
DON’T KNOW ....................................................................... d
REFUSED ............................................................................. r
NLTS 2012 Baseline Parent Interview
48
Draft dated 10.10.11
G2.
Is {YOUTH} Hispanic or Latino?
YES - HISPANIC OR LATINO....................................... 1
NO - NOT HISPANIC OR LATINO ................................ 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
G3.
Please choose one or more categories that best describe {YOUTH}’s race. Is
{he/she}… [IF RESPONDENT SAYS MIXED RACE OR BI- OR MULTIRACIAL, ASK AS
NEEDED: “I can record more than one. Which races should I enter?
CODE ALL THAT APPLY
American Indian or Alaska Native ............................. 1
Asian............................................................................. 2
Black or African American ......................................... 3
Native Hawaiian or Other Pacific Islander, or ........... 4
White? .......................................................................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
G4.
In the past school year (2011-2012), has {YOUTH} lived with you… ? [EXCLUDING
CAMPS AND VACATIONS] (NLTS2 A5A, REV)
CODE ONE ONLY
All of the time,.............................................................. 1 GO TO BOX G5
Some of the time, ........................................................ 2
None of the time? ........................................................ 3
ONLY DURING SCHOOL VACATIONS ....................... 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
49
Draft dated 10.10.11
G4a.
Where has {he/she} lived in the past school year (2011-2012)? (NLTS2 A5C)
CODE ALL THAT APPLY
WITH [HIS/HER] OTHER PARENT .............................. 1
WITH [HIS/HER] PARENTS ......................................... 2
WITH ANOTHER RELATIVE/ADULT FAMILY
MEMBER OTHER THAN SPOUSE OR PARENT ........ 3
IN FOSTER CARE ........................................................ 4
WITH NON-FAMILY LEGAL GUARDIAN ..................... 5
IN A RESIDENTIAL OR BOARDING SCHOOL
OTHER THAN A COLLEGE.......................................... 6
IN A GROUP HOME, OTHER ASSISTED LIVING
CENTER, SUPERVISED APARTMENT ....................... 7
IN A HOSPITAL, MEDICAL FACILITY,
CONVALESCENT HOSPITAL, OR INSTITUTION
FOR PERSONS WITH DISABILITIES .......................... 8
IN A MENTAL HEALTH FACILITY ................................ 9
IN A CORRECTIONAL FACILITY/YOUTH
DETENTION CENTER .................................................. 10
ON [HIS/HER] OWN...................................................... 11
WITH A SPOUSE OR ROOMMATE ............................. 12
IN A COLLEGE DORMITORY OR OTHER
COLLEGE HOUSING.................................................... 13
IN MILITARY HOUSING ............................................... 14
TRANSIENT, HOMELESS, ON THE STREET, IN
THEIR CAR ................................................................... 15
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
50
Draft dated 10.10.11
BOX G5
IF LIVES WITH SOMEONE OTHER THAN PARENT OR FOSTER PARENT AT LEAST SOME OF THE TIME,
GO TO G6. ELSE GO TO BOX G7.
THIS LOGIC SEPARATES YOUTH LIVING WITH FOSTER PARENTS OR LEGAL GUARDIANS.
IF YOUTH LIVES WITH ANOTHER RELATIVE OR NON FAMILY LEGAL GUARDIAN (A13 = 3 or 5 OR G4a =
3|5) AND RESPONDENT IS NOT FOSTER PARENT (A13 ≠ 4) GO TO G6. ELSE GO TO BOX G7.
G5.
Is {YOUTH} living in a foster care arrangement? (NLTS2 A5E)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
IF YOUTH AGE >16
G6.
Has {YOUTH} ever {had/fathered} any children? (NLTS K3A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
BOX G7
THIS LOGIC SEPARATES PARENTS OF YOUTH AGE 16 AND OVER WHO HAVE HAD CHILDREN AND TAKES THEM TO
G7. THOSE WHO HAVE NOT HAD CHILDREN OR WHO HAVE BUT ARE UNDER AGE 16 GO TO G8.
IF G6 = 1 (HAS CHILDREN) AND AGE ≥16 YEARS OF AGE, GO TO G7. ELSE, GO TO G8.
IF YOUTH AGE >16
G7.
Is {YOUTH} … (NLTS K3B)
CODE ONE ONLY
Engaged, ...................................................................... 1
Single, never married, ................................................. 2
Married, or .................................................................... 3
In a marriage-like relationship, .................................. 4
Divorced or separated, or ........................................... 5
Widowed? .................................................................... 6
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
51
Draft dated 10.10.11
G8.
My next questions are about {YOUTH}’s health insurance. Is {YOUTH} now covered by
private health insurance from an employer or union, or that your family buys directly?
(NLTS C1)
YES ............................................................................... 1
GO TO G11
NO ................................................................................. 0
G9.
DON’T KNOW ............................................................... d
GO TO G11
REFUSED ..................................................................... r
GO TO G11
Is {he/she} covered by any other health insurance program, including a governmentassisted or public health insurance plan such as Medicare, Medicaid, or [state
program name]? (NLTS C2 REV)
YES ............................................................................... 1
G10.
G11.
NO ................................................................................. 0
GO TO I1_INTRO
DON’T KNOW ............................................................... d
GO TO I1_INTRO
REFUSED ..................................................................... r
GO TO I1_INTRO
Does {his/her} insurance cover any of the cost of … (NLTS C5)
[IF ASKED, INCLUDES PARTIAL COVERAGE]
YES
NO
DK
REF
a. Dental care?...................................................
1
0
d
r
b. Vision care? ...................................................
1
0
d
r
c.
Medicines or prescriptions? ...........................
1
0
d
r
d. Mental health care? .......................................
1
0
d
r
Does {YOUTH} have access to a computer with a high-speed internet connection at
home? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
52
Draft dated 10.10.11
H. DEMOGRAPHICS FOR PARENT & HOUSEHOLD
H1.
Are you…
CODE ONE ONLY
Married ......................................................................... 1
In a marriage-like relationship, .................................. 2
Divorced, ...................................................................... 3
Separated, .................................................................... 4
Widowed, or ................................................................. 3
Single, never married?................................................ 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
BOX H2
IF CHILD LIVES WITH RESPONDENT AT LEAST SOME OF THE TIME (G4=1|2) GO TO H2. ELSE GO TO H4.
H2.
How many adults are there in the household, including you?
IF NEEDED: By adults we mean anyone 18 years of age or older. Household members
include those that are there at least four nights a week, most weeks, for the past 6
months. (NLTS K4A)
|
|
| NUMBER (0-20)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
H3.
How many children are now living in the household, including {YOUTH}? [CAN
INCLUDE YOUTH’S CHILDREN.]
IF NEEDED: By children we mean anyone less than 18 years of age. Household
members include those that are there at least four nights a week, most
weeks, for the past 6 months. (NLTS K2A, rev)
|
|
| NUMBER (0-20)
[H: 0-20; S: 0-10]
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
53
Draft dated 10.10.11
BOX H4
IF RESPONDENT IS YOUTH’S PARENT (A13=1,2), GO TO H5. ELSE GO TO H4.
H4.
Does {YOUTH}’s mother or father (FILL IF PC3 != 5: or legal guardian) live in this
household?
IF NEEDED: Who lives in this household? Is that {YOUTH}’s mother, father, or legal
guardian? (NLTS K5B, REV)
CODE ONE ONLY
MOTHER ....................................................................... 1
FATHER ........................................................................ 2
BOTH MOTHER AND FATHER .................................... 3
LEGAL GUARDIAN ....................................................... 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
BOX H5
IF CHILD LIVES WITH RESPONDENT AT LEAST SOME OF THE TIME (G4=1|2) GO TO H5.
H5.
What is the highest year or grade you finished in school? (NLTS K8)
CODE ONE ONLY
8TH GRADE OR LESS ................................................. 1
9TH GRADE OR ABOVE, NOT A HIGH
SCHOOL GRADUATE .................................................. 2
HIGH SCHOOL GRADUATE OR GED ......................... 3
POST HIGH SCHOOL EDUCATION, NO
COLLEGE DEGREE ..................................................... 4
VOCATIONAL-TECHNICAL (VOC-TECH)
DEGREE OR CERTIFICATE ........................................ 5
2-YEAR COLLEGE DEGREE/AA DEGREE ................. 6
4-YEAR COLLEGE DEGREE/BA, BS DEGREE .......... 7
SOME POST BA, BS WORK, NO GRADUATE
DEGREE ....................................................................... 8
MASTER’S DEGREE, E.G. MSW, MA, MFA,
MPH, MBA..................................................................... 9
PHD, MD, JD, LLB, OR OTHER
PROFESSIONAL GRADUATE DEGREE ..................... 10
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 100)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
54
Draft dated 10.10.11
H6.
Do you have a paid job now? (NLTS K9A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
BOX H7
IF RESPONDENT IS MARRIED OR PARTNERED H1 = 1|2, GO TO H7_INTRO.
H7INTRO
H7.
My next questions are about your {spouse/ partner}.
What is the highest year or grade your {spouse/ partner} finished in school? (NLTS K10)
CODE ONE ONLY
8TH GRADE OR LESS ................................................. 1
9TH GRADE OR ABOVE, NOT A HIGH
SCHOOL GRADUATE .................................................. 2
HIGH SCHOOL GRADUATE OR GED ......................... 3
POST HIGH SCHOOL EDUCATION, NO
COLLEGE DEGREE ..................................................... 4
VOCATIONAL-TECHNICAL (VOC-TECH)
DEGREE OR CERTIFICATE ........................................ 5
2-YEAR COLLEGE DEGREE/AA DEGREE ................. 6
4-YEAR COLLEGE DEGREE/BA, BS DEGREE .......... 7
SOME POST BA, BS WORK, NO GRADUATE
DEGREE ....................................................................... 8
MASTER’S DEGREE, E.G. MSW, MA, MFA,
MPH, MBA..................................................................... 9
PHD, MD, JD, LLB, OR OTHER
PROFESSIONAL GRADUATE DEGREE ..................... 10
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 100)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
H8.
Does your {spouse/ partner} have a paid job now? (NLTS K11A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
55
Draft dated 10.10.11
H9_INTRO My next questions are about government benefits you or others in your household
may have received.
H9.
Did you or anyone in the household receive money from TANF (Temporary
Assistance to Needy Families) or the state welfare program anytime in the past 2
years? (NLTS K12A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
H10.
Did you, or anyone in the household, receive benefits in the past two years from the
Supplemental Nutrition Assistance Program (SNAP), which used to be called food
stamps? { PROGRAM IS ALSO KNOWN AS [SNAP/STATE NAME] IN [STATE]}. It puts
money on a card that you can use to buy food. (NLTS K13A REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
H11.
Did you or anyone in the household get money for {YOUTH} from the Supplemental
Security Income or SSI program in the past 2 years? (NLTS K14A)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
H12.
Household income is an important factor that goes into many research questions including how family finances affect students’ ability to go to college or pursue other
goals after high school. This information is critically important to the success of this
study and will be kept completely confidential.
What was your total household income from all sources before taxes and deductions
in calendar year 2011? Please include all income such as income from work,
investments, money from public assistance, retirement, and alimony for all household
members, before taxes. (HSLS, REV)
SPECIFY: _____________ (STRING 6) ..................... 99 GO TO I1_INTRO
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
56
Draft dated 10.10.11
H13.
We understand that you may not be able to provide an exact number for your family’s
income. However, it would be extremely helpful if you could tell us which of the
following ranges best describes your total household income from all sources before
taxes and deductions in calendar year 2011. Was it…
IF NEEDED: Please include all income such as income from work, investments,
money from public assistance, retirement, and alimony for all household members,
before taxes. (HSLS, REV)
CODE ONE ONLY
$60,000 or less, or ....................................................... 1
H13a.
more than $60,000? ..................................................... 2
GO TO H13b
DON’T KNOW ............................................................... d
GO TO I1_INTRO
REFUSED ..................................................................... r
GO TO I1_INTRO
Was it… (NLTS K15B, REV)
CODE ONE ONLY
H13b.
$10,000 or less, or ....................................................... 1
GO TO I1_INTRO
$10,001 to $20,000, ...................................................... 2
GO TO I1_INTRO
$20,001 to $30,000, ...................................................... 3
GO TO I1_INTRO
$30,001 to $40,000 ....................................................... 4
GO TO I1_INTRO
$40,001 to $50,000, or ................................................. 5
GO TO I1_INTRO
$50,001 to $60,000? ..................................................... 6
GO TO I1_INTRO
DON’T KNOW ............................................................... d
GO TO I1_INTRO
REFUSED ..................................................................... r
GO TO I1_INTRO
Was it… (NLTS K15E, REV)
CODE ONE ONLY
$60,001 to $70,000, ...................................................... 1
$70,001 to $80,000, ...................................................... 2
$80,001 to $90,000, ...................................................... 3
$90,001 to $100,000, .................................................... 4
$100,001 to $110,000, .................................................. 5
$110,001 to $120,000, or ............................................. 6
Over $120,000? ............................................................ 7
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
NLTS 2012 Baseline Parent Interview
57
Draft dated 10.10.11
I. CONTACT INFORMATION FOR FOLLOW UP
I1_INTRO
I1.
We are now at the last section of the survey. As you may remember, we will
contact you for the next survey in 2014. Your answers to these questions will help
us make sure we don’t lose touch with you.
Is there another telephone number where we can reach you, besides [FILL FROM
PC2]?
YES ............................................................................... 1
I1a.
NO ................................................................................. 0
GO TO I2
DON’T KNOW ............................................................... d
GO TO I2
REFUSED ..................................................................... r
GO TO I2
What is that number?
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
DON’T KNOW ............................................................... d
GO TO I2
REFUSED ..................................................................... r
GO TO I2
International Phone (STRING 30)
I1b.
Is that a number a land line or cell phone?
LANDLINE ..................................................................... 1
GO TO I2
CELL PHONE................................................................ 2
I2.
DON’T KNOW ............................................................... d
GO TO I2
REFUSED ..................................................................... r
GO TO I2
Do you have an e-mail address where we may send you study-related information?
IF NEEDED:
This may include an email to verify your contact information, an
invitation to complete the survey, or a reminder about the survey.
YES ............................................................................... 1
DOES NOT HAVE AN EMAIL ADDRESS ..................... 2
GO TO I3
NO ................................................................................. 0
GO TO I3
DON’T KNOW ............................................................... d
GO TO I3
REFUSED ..................................................................... r
GO TO I3
NLTS 2012 Baseline Parent Interview
58
Draft dated 10.10.11
I2a.
What is the email address you check most often?
(STRING (150)
EMAIL
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
I3.
May we email you through Facebook if we are unable to reach you by mail, phone, or
your regular email address?
YES ............................................................................... 1
DOES NOT HAVE A FACEBOOK ACCOUNT .............. 2
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I4.
In case we have difficulty reaching you in the future, I would like to collect contact
information for {YOUTH’s} {other parent/parents/your spouse or partner}. (FILL
“YOUTH’s other parent” IF G5a = 1. ELSE FILL “YOUTH’s parents” IF G5a = 2. ELSE
FILL “your spouse” IF H1 = 1. FILL “your partner” IF H1 =2.)
What is this person’s full name?
_____________________________ (STRING (100)
FIRST NAME
(STRING (100)
MIDDLE INITIAL/NAME
(STRING (100)
LAST NAME
DON’T KNOW ............................................................... d
GO TO I5
REFUSED ..................................................................... r
GO TO I5
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I5.
Is [NAME from I4]’s mailing address (where mail is sent) the same as yours or is it a
different address?
[CATI FILL ADDRESS FROM A9a OR SAMPLE FILE (IF A9a=blank)]
SAME AS SPOUSE OR PARTNER .............................. 1
GO TO I6
DIFFERENT MAILING ADDRESS ................................ 2
NLTS 2012 Baseline Parent Interview
59
Draft dated 10.10.11
I5a.
What is the address where [NAME from I4] gets mail sent?
PROBE FOR AND RECORD BOTH PO BOX AND STREET ADDRESS
PROBE: Where does {he/she} stay most often?
(STRING (200))
ADDRESS 1
(STRING (200))
ADDRESS 2
(STRING (200))
CITY
(STRING (50))
STATE/TERRITORY
| | | | | |-| | |
ZIP CODE (+ 4 IF NEEDED)
|
|
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I6.
What is the best telephone number at which to reach {him/her}:
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
DOES NOT HAVE A TELEPHONE NUMBER .............. 1
GO TO I8
DON’T KNOW ............................................................... d
GO TO I8
REFUSED ..................................................................... r
GO TO I8
International Phone (STRING (NUM))
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I6a.
Is that a number a land line or cell phone?
LANDLINE ..................................................................... 1
CELL PHONE................................................................ 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I7.
Is there another phone number where we can reach {him/her}?
YES ............................................................................... 1
NO ................................................................................. 0
GO TO I8
DON’T KNOW ............................................................... d
GO TO I8
REFUSED ..................................................................... r
GO TO I8
NLTS 2012 Baseline Parent Interview
60
Draft dated 10.10.11
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I7a.
What is that number?
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
DON’T KNOW ............................................................... d
GO TO I8
REFUSED ..................................................................... r
GO TO I8
International Phone (STRING 30)
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I8.
Does [SPOUSE /PARTNER NAME] have an e-mail address at which we can reach
{him/her}? IF NEEDED: Our contact would include things like an email to verify
contact information, an invitation to complete the survey.
YES ............................................................................... 1
DOES NOT USE EMAIL ............................................... 2
GO TO I9
NO – NOT OK TO CONTACT THIS WAY .................... 0
GO TO I9
DON’T KNOW ............................................................... d
GO TO I9
REFUSED ..................................................................... r
GO TO I9
ALL RESPONDENTS WHO PREVIOUSLY IDENTIFIED A SPOUSE OR PARTNER IN ITEM H1 OR ANOTHER PARENT IN G4A
I8a.
What is the email address {he/she} checks most often?
(STRING (500)
EMAIL
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
I9.
In case we have trouble reaching (either of) you directly when we do the next survey,
we’d like to get the contact information for another person who will always be able to
reach you. Can you give me the name of a friend or relative, who does not live with
you, who would be able to reach you if you move or change your telephone number?
(STRING (100))
FIRST NAME
(STRING (100))
MIDDLE INITIAL/NAME
(STRING (100))
LAST NAME
DON’T KNOW ............................................................... d
GO TO END1
REFUSED ..................................................................... r
GO TO END1
NLTS 2012 Baseline Parent Interview
61
Draft dated 10.10.11
RESPONDENTS WHO GAVE A CONTACT IN I9.
I10.
Is this person a relative, a friend, or some other person in your life?
IF NEEDED: What is your relationship with this person?
CODE ONE ONLY
YOUTH .......................................................................... 1
OTHER SON OR DAUGHTER ..................................... 2
BROTHER / SISTER ..................................................... 3
GRAND MOTHER / GRANDFATHER .......................... 4
AUNT / UNCLE ............................................................. 5
COUSIN ........................................................................ 6
OTHER RELATIVE ....................................................... 7
FRIEND ......................................................................... 8
CASE MANAGER – SPECIFY NAME OF AGENCY .... 9
(STRING (150))
OTHER NON-RELATIVE .............................................. 10
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
RESPONDENTS WHO GAVE A CONTACT IN I9.
I11.
What is [NAME]’s mailing address?
PROBE FOR AND RECORD BOTH PO BOX AND STREET ADDRESS
PROBE: Where does {he/she} stay most often?
(STRING (200)
ADDRESS 1
(STRING (200)
ADDRESS 2
(STRING (200)
CITY
(STRING (50)
STATE/TERRITORY
|
|
|
|
|
|-|
|
|
|
|
ZIP CODE (+ 4 IF NEEDED)
NLTS 2012 Baseline Parent Interview
62
Draft dated 10.10.11
RESPONDENTS WHO GAVE A CONTACT IN I9.
I12.
What is the best telephone number at which to reach (NAME)?
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
DOES NOT HAVE A TELEPHONE NUMBER .............. 1
GO TO I13
DON’T KNOW ............................................................... d
GO TO I13
REFUSED ..................................................................... r
GO TO I13
International Phone (STRING 30)
RESPONDENTS WHO GAVE A CONTACT IN I9.
I12a.
Is that number a land line or cell phone?
LANDLINE ..................................................................... 1
CELL PHONE................................................................ 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
RESPONDENTS WHO GAVE A CONTACT IN I9.
I12b.
Is there another telephone number where we can reach (NAME)?
YES ............................................................................... 1
NO ................................................................................. 0
GO TO I13
DON’T KNOW ............................................................... d
GO TO I13
REFUSED ..................................................................... r
GO TO I13
RESPONDENTS WHO GAVE A CONTACT IN I9.
I12c.
What is that number?
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
DON’T KNOW ............................................................... d
GO TO I13
REFUSED ..................................................................... r
GO TO I13
International Phone (STRING 30)
I13.
Does (NAME) have an e-mail address where we can reach {him/her}, should we need
help contacting you for the next part of the study?
YES ............................................................................... 1
NO ................................................................................. 0
GO TO END1
DON’T KNOW ............................................................... d
GO TO END1
REFUSED ..................................................................... r
GO TO END1
NLTS 2012 Baseline Parent Interview
63
Draft dated 10.10.11
I13a.
What is the email address (he / she) checks most often?
(STRING (500)
EMAIL
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
END1
Those are all the questions I have for you in this survey. We will be mailing your $20
check soon. If you have any questions about the study, or if your contact information
changes, please call us toll-free at: 866-964-7962. You can also visit our website at:
http://ies.ed.gov/ncee/nlts.
If it is possible to speak with [YOUTH], can you pass the telephone to {him/her} or tell
me the best number to reach {him/her} at right now?
YES, WILL TAKE CATI ................................................. 1
GO TO END2
YES, PROVIDE NUMBER ............................................ 2
I14.
NO ................................................................................. 0
GO TO I15
DON’T KNOW ............................................................... d
GO TO I15
REFUSED ..................................................................... r
GO TO I15
What is that number?
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
GO TO I15
DON’T KNOW ............................................................... d
GO TO I15
REFUSED ..................................................................... r
GO TO I15
GO TO I15
International Phone (STRING 30)
I15.
INTERVIEWER: CODE RESPONSE:
CALL DIFFERENT NUMBER........................................ 1
CALL AT DIFFERENT TIME SET CALLBACK ............. 2
YOUTH REQUIRES PROXY RESPONSE ................... 3
YOUTH REFUSES AT THIS TIME ............................... 4
END 2
Thanks for taking time to answer these questions today. Have a nice day!
CONTINUE WITH YOUTH INTERVIEW OR TERMINATE BASED ON ABOVE (END1=1).
NLTS 2012 Baseline Parent Interview
64
Draft dated 10.10.11
Mathematica Reference No.: 06876.341
National Longitudinal
Transition Study
Student Baseline Questionnaire
October 10, 2011
NLTS2012
Baseline Interview for Youth
SECTIONS OF THE STUDENT QUESTIONNAIRE
Section Letter
Section Name
Begins on Page
J
Introduction and Informed Consent
2
K
Student Enrollment & Experiences at School
7
L
Student’s IEP Experience
13
M
Activities and Experience Out of School
16
N
Employment
18
O
Independent Living Skills
46
P
Student’s Self Advocacy
48
Q
Expectations for the Future
51
R
Contact Information for Follow Up
53
ADMINISTRATIVE NOTES:
THIS INSTRUMENT IS DESIGNED TO BE INTERVIEWER-ADMINISTERED OVER THE TELEPHONE
WITH AN ESTIMATED DURATION OF 30 MINUTES.
AT THE BASELINE, THE STUDENT’S INTERVIEW SURVEY WILL IMMEDIATELY FOLLOW THE
PARENT’S CONSENT AND INTERVIEW. AT BASELINE, PARENTS WILL ALWAYS BE INTERVIEWED
BEFORE STUDENTS. IF THE STUDENT CANNOT CONSENT TO THE STUDY, HE/SHE MUST
ASSENT PRIOR TO THE INTERVIEW.
PROXIES WILL BE ALLOWED AND ASKED OBJECTIVE ITEMS ONLY (AS DESIGNATED AT EACH
ITEM). IF THE STUDENT IS UNABLE TO COMPLETE THE QUESTIONNAIRE ON HIS/HER OWN,
PROXY WILL BE PERSON MOST KNOWLEDGEABLE ABOUT THE STUDENT’S EXPERIENCES IN
AND OUT OF SCHOOL.
DESIGN NOTES:
WHEN AN ITEM IS NOT ASKED OF ALL RESPONDENTS, THE UNIVERSE WILL PRECEDE THE
ITEM NUMBER (E.G. IT IS DESIGNATED AS “IEP ONLY” OR “504 ONLY” OR ONLY FOR STUDENTS
OF SPECIFIC AGE RANGES).
THE CATI PROGRAM SHALL CALCULATE AGE OF STUDENT FROM SAMPLE DATA
VARIABLE FOR DATE OF BIRTH AND USE THIS VARIABLE OR DATA FROM PARENT ITEM
A2A (IF SAMPLE INFO DEEMED INCORRECT).TO DETERMINE WHETHER THE ITEM IS
ASKED.
CATI WILL DRAW ON VARIABLES FROM THE SAMPLE FILE FOR INITIAL STATUS OF IEP,
504, OR NOT.
CATI WILL DRAW ON ITEM proxy1 RESPONSE 2 TO IDENTIFY WHEN A PROXY INTERVIEW
IS BEING CONDUCTED.
WHEN AN ITEM IS NOT ADMINISTERED TO PROXY RESPONDENTS, CATI WILL
AUTOMATICALLY PROCEED TO THE NEXT ITEM IN THE SEQUENCE.
EACH ITEM DRAWN FROM A PRE-EXISTING INSTRUMENT WILL HAVE, AT THE END OF THE
QUESTION TEXT, THE SOURCE INSTRUMENT AND ITEM REFERENCE NUMBER. IF THE
ORIGINAL SOURCE HAS BEEN MODIFIED, THE TEXT, ‘REV” WILL FOLLOW.
GUIDELINES FOR ADMINISTRATION ARE NOTED THROUGHOUT – ITEMS IN ALL CAPS ARE NOT
READ ALOUD, VERBIAGE UNDERLINED IS EMPHASIZED. STANDARDIZED PROBES AND
DEFINITIONS ARE PROVIDED FOR APPLICABLE ITEMS, AS NEEDED.
Prepared by Mathematica Policy Research
1
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
J. INTRODUCTION AND INFORMED CONSENT
Hi, my name is _____. I’m calling on behalf of the U.S. Department of
Education, who is sponsoring the National Longitudinal Transition Study.
Through this important project, we hope to learn more about issues youth
face today as they transition from school to adult life and how schools can
better support students in reaching their goals. We are inviting you to be
part of this study.
CONTINUE ................................................................... 1
HUNG UP DURING INTRODUCTION................................... 2
DECLINES STUDY PARTICIPATION ........................... 0
TERMINATE
INTERVIEWER RECORD REPONSES WITHOUT READING ALOUD:
IS THIS INTERVIEW BEING CONDUCTED WITH THE YOUTH HIM/HERSELF
OR WITH HIS/HER PROXY?
CONDUCTED WITH STUDENT HIM/HERSELF .......... 1
CONDUCTED WITH PROXY FOR STUDENT ............. 2
INTERVIEWER: WHAT IS THE NAME OF THE PROXY?
(STRING (150)
ALL PROXIES.
INTERVIEWER: WHAT IS THE RELATIONSHIP OF THE PROXY TO THE
YOUTH?
PARENT ........................................................................ 1
SIBLING ........................................................................ 2
OTHER FAMILY MEMBER ........................................... 3
SOMEONE FROM YOUTH’S SCHOOL........................ 4
SOMEONE FROM AN AGENCY/SERVICE
PROVIDER .................................................................... 5
OTHER (SPECIFY) ....................................................... 99
(STRING (NUM))
Prepared by Mathematica Policy Research
2
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
Before we begin, I need to tell you some important things about this
study. Please feel free to ask me any questions before we move
forward. To begin, this is a research study. The U.S. Department of
Education is paying for the study and Mathematica Policy Research is
carrying it out. The purpose is to see what helps students move from
school to adulthood. You are one of 15,000 students being asked to
take part in the study from across the United States.
This is what being in the study will mean for you. An interviewer has
talked to your parent (or legal guardian) about your family,
experiences, and supports you get from school and other places.
He/she will be interviewed again in 2014 and will be paid $20 for each
interview.
If you agree, I will complete your interview over telephone. It will take
about 30 minutes. The questions will be about you, school, and your
plans for the future. Your parent (or guardian) can help you answer
questions or answer for you, if needed. An interviewer will talk to you
again in 2014. You will get a $10 gift card for each interview
completed. Do you agree to take part in this interview?
AGREED - CONTINUE ................................................. 1
DISAGREE/DECLINES THIS PORTION ...................... 2
DECLINES STUDY PARTICIPATION ........................... 0
TERMINATE
The researchers will ask math or language arts teacher to do a survey
to learn more about your class, if you agree to let them do so. Do we
have your permission to contact your math or language arts teacher
for that survey?
AGREED - CONTINUE ................................................. 1
DISAGREE/DECLINES THIS PORTION ...................... 2
DECLINES STUDY PARTICIPATION ........................... 0
TERMINATE
BOX S_INF_CONS3
IF STUDENT HAS IEP FROM SAMPLE INFO, ASK S_INF_CONS3. ELSE ASK S_INF_CONS4.
The researchers will ask a staff member at your school to do two
surveys to learn about your IEP. These would be completed by the
person who knows most about your IEP. One will be completed now
and another will be two years from now. Do we have your permission
to contact this staff person for that survey?
AGREED - CONTINUE ................................................. 1
DISAGREE/DECLINES THIS PORTION ...................... 2
DECLINES STUDY PARTICIPATION ........................... 0
Prepared by Mathematica Policy Research
3
TERMINATE
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
The researchers would like to collect your school transcripts to see
what courses you have taken. They will do this in 2014, with your
permission. Do you give permission for them to access your school
records at that time?
AGREED - CONTINUE ................................................. 1
DISAGREE/DECLINES THIS PORTION ...................... 2
DECLINES STUDY PARTICIPATION ........................... 0
TERMINATE
When you are around 16 to 18 years old, we will ask you to take a
special test called an academic assessment. This test is only for this
study and will not count towards any of your classes in school.
IF NEEDED: If you are in school, the test will take place during the
school day. If not, the researchers will make an appointment with you
to take the test somewhere else. The test will take between 15 and
45 minutes. Do we have your permission to complete that
assessment?
AGREED - CONTINUE ................................................. 1
DISAGREE/DECLINES THIS PORTION ...................... 2
DECLINES STUDY PARTICIPATION ........................... 0
TERMINATE
To learn more about how students are doing in the future, the
researchers may want to look at databases on college enrollment,
financial aid for college, or the Social Security Administration’s
records about jobs or benefits. If the researchers decide to use data
from the Social Security Administration, we would need
{your/NAME’s} social security number.
If we need [your/your child’s] social security number, we will ask for it
during the second interview in 2014. You can decide to give it to us
then, or not. If you give us the number, we will keep it private and will
permanently erase it as soon as we link it to the information needed.
We did want to let you know now, however, that we may ask for it. Do
you have any questions about this?
NO, CONTINUE ............................................................ 1
YES, QUESTION .......................................................... 2
I WILL NEVER GIVE YOU A SSN................................. 3
DECLINES STUDY PARTICIPATION ........................... 0
Prepared by Mathematica Policy Research
4
TERMINATE
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
The information you provide will be kept confidential. It will not be
shared. All reports will be in summary form only. Your name will never
be used. There are no special risks to you if you take part in this
study. There is nothing experimental about this study. If you feel
uncomfortable answering any of the questions you can stop and
nothing bad will happen to you.
READ IF AGE < 18: If you are not 18 years old yet, or have a legal
guardian, your parent or legal guardian agreed for you to be in this
study. Even if your parent or legal guardian agreed, you must agree
also. When you turn 18 or no longer have a legal guardian, you must
agree again, for yourself.
If you have any questions about your rights as a research volunteer,
you can call the Institutional Review Board. They looked at this study
to make sure your rights are protected. You can ask questions or drop
out of the study at any time by calling Mathematica Policy Research.
IF NEEDED: Public/Private Ventures telephone number is
(215) 557-4482. Ask for Melissia Billarrial.
IF NEEDED: Mathematica’s toll-free number is 866-964-7962.
I will mail you a letter describing what we just discussed, so you will
have it for your records. If you would like to see the consent form in
writing before we continue with the interview, we can email (or fax) it
to you.
Do you have any questions for me before we begin the interview?
[ANSWER QUESTIONS, AS NEEDED].
AGREES, CONTINUE ................................................... 1
J9.
NOT AT THIS TIME – CALL LATER ............................ 2
SCHEDULE CALLBACK
WITHIN 1 WEEK
DECLINED TO TAKE PART IN STUDY........................ 3
CONSENT NOT
GRANTED, TERMINATE.
SET CASE DISPOSITION
AS SUPERVISOR
REVIEW
I’d like to begin by asking for some basic information about where you live and
how we can best reach you in the future. Let’s start with the address where
you get your mail. We will send your $10 gift card to this address. The school
listed it as [ADDRESS ON SAMPLE FILE]. Is that address correct?
YES ............................................................................... 1
GO TO J11
NO ................................................................................. 0
Prepared by Mathematica Policy Research
5
Draft Dated 10-10-11
NLTS2012
J10.
Baseline Interview for Youth
What is your mailing address?
PROBE FOR AND RECORD BOTH P.O. BOX AND STREET ADDRESS
PROBE: Where do you stay most often?
(STRING (150)
ADDRESS 1
(STRING (150)
ADDRESS 2
(STRING (150)
CITY
(STRING (30)
STATE/TERRITORY
| | | | | |-| | |
ZIP CODE (+ 4 IF NEEDED)
|
|
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
J11.
What is the best telephone number at which to reach {you/him/her}?
| | | |-| | | |-| | | |
(RANGE)
(RANGE)
(RANGE)
|
DOES NOT HAVE A TELEPHONE NUMBER .............. 1
GO TO
DON’T KNOW ............................................................... d
GO TO
REFUSED ..................................................................... r
GO TO
International Phone (STRING 30)
J11a.
Is that number a land line or cell phone?
LANDLINE ..................................................................... 1
GO TO
CELL PHONE ................................................................ 0
J11b.
DON’T KNOW ............................................................... d
GO TO
REFUSED ..................................................................... r
GO TO
Would it be ok for us to send {you/him/her} a text message when we try to
contact {you/him/her} for the next survey?
YES ............................................................................... 1
NO - DOES NOT USE TEXT MESSAGING .................. 2
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
6
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
K. STUDENT ENROLLMENT & EXPERIENCES AT SCHOOL
The next questions are about {your/his/her} experiences in school and life
outside of school. There are no right or wrong answers, we want to better
understand {your/his/her} experiences.
K1.
{Are you/Is NAME} attending or enrolled in middle school, junior high, or high
school at this time? (YTD, A1, REV)
PROBE:
(Do you/Does NAME) go to school?
PROBE:
At school they teach (you/him/her) how to do things, like how to
read, write, or do math?
PROBE IF SUMMER:
(Are you/Is NAME) off school for the summer. Will
(you/he/she) be going back to school in the fall?
INTERVIEWER: CODE “YES” IF ENROLLED IN SCHOOL BUT ON
BREAK/VACATION.
YES ............................................................................... 1
GO TO G2
NO ................................................................................. 0
DON’T KNOW ............................................................... d
GO TO G2
REFUSED ..................................................................... r
GO TO G2
Prepared by Mathematica Policy Research
7
Draft Dated 10-10-11
NLTS2012
K1a.
Baseline Interview for Youth
Why did {you/he/she} leave school?
CODE ALL THAT APPLY
ACADEMIC DIFFICULTY, POOR GRADES, NOT
DOING WELL .............................................................................1
DISLIKE OF SCHOOL EXPERIENCE .......................................2
SCHOOL TOO DANGEROUS ...................................................3
FAILED REQUIRED TEST/FAILED GRADUATION EXAM .......4
GOT GED ...................................................................................5
GRADUATED .............................................................................6
LACK OF APPROPRIATE CURRICULUM ................................7
POOR RELATIONSHIPS WITH TEACHERS
AND SCHOOL STAFF ...............................................................8
POOR RELATIONSHIPS WITH FELLOW STUDENTS .............9
LANGUAGE DIFFICULTY ..........................................................10
ECONOMIC REASONS .............................................................11
LACK OF CHILDCARE ..............................................................12
LACK OF TRANSPORTATION ..................................................13
PROBLEMS WITH BEHAVIOR ..................................................14
SUBSTANCE ABUSE ................................................................15
ILLNESS/DISABILITY ................................................................16
PREGNANCY .............................................................................17
ENTERED CRIMINAL JUSTICE SYSTEM/INCARCERATED ...18
NEEDED AT HOME ...................................................................19
RELIGION ..................................................................................20
MOVED ......................................................................................21
PARENT/GUARDIAN INFLUENCE............................................22
FRIENDS WERE DROPPING OUT ...........................................23
MARRIAGE ................................................................................24
MILITARY, JOINED ARMED FORCES ......................................25
EMPLOYMENT, SEEK OR ACCEPT JOB .................................26
OTHER (SPECIFY) ....................................................................99
(STRING 150)
DON’T KNOW ............................................................................d
REFUSED ..................................................................................r
Prepared by Mathematica Policy Research
8
Draft Dated 10-10-11
NLTS2012
K2.
Baseline Interview for Youth
Next I will read a list of statements about how some student feel about their
classes. For each, please tell me whether you agree or disagree with the
statements about your classes, overall, this year (2011-2012)? (DC Choice, Q16,
REV)
AGREE A
LOT
AGREE
A LITTLE
DISAGREE A
LITTLE
DISAGREE
A LOT
DK
REF
a. Class work was hard to learn .................
1
2
3
4
d
r
b. I had trouble keeping up with the
homework ...............................................
1
2
3
4
d
r
I need more help from my teachers than
I get .........................................................
1
2
3
4
d
r
d. Teachers encourage me to do my best ..
1
2
3
4
d
r
c.
K3.
How strongly do you agree or disagree with the following statements about
your school?
AGREE A
LOT
AGREE
A LITTLE
DISAGREE A
LITTLE
DISAGREE
A LOT
DK
REF
a. I feel close to people at this school.
(Wested, A11) .........................................
1
2
3
4
d
r
b. I am happy to be at this school.
(Wested, A12) .........................................
1
2
3
4
d
r
I feel like I am part of this school.
(Wested, A13) .........................................
1
2
3
4
d
r
d. The teachers at this school treat
students fairly. (Wested, A14) ................
1
2
3
4
d
r
e. I feel safe in my school. (Wested, A15) ..
1
2
3
4
d
r
c.
K4.
How strongly do you agree or disagree with the following statements about
your school? At my school, there is a teacher or some other adult who...
AGREE
A LOT
AGREE A
LITTLE
DISAGREE
A LITTLE
DISAGREE
A LOT
DK
REF
a. really cares about me. (Wested, A16) ................
1
2
3
4
d
r
b. tells me when I do a good job. (Wested, A17) ..
1
2
3
4
d
r
c. notices when I’m not there. (Wested, A18) .......
1
2
3
4
d
r
d. always wants me to do my best. (Wested, A19)
1
2
3
4
d
r
e. listens to me when I have something to say.
(Wested, A20) .......................................................
1
2
3
4
d
r
1
2
3
4
d
r
f.
believes that I will be a success. (Wested,
A21) ......................................................................
Prepared by Mathematica Policy Research
9
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL. SKIP FOR PROXIES.
K5.
{Have you/Has NAME} had any of the following things happen during this
school year (2011-2012)? (NLTS2, R6a-d)
YES
NO
DK
REF
a. Have you been teased or called names at school?.....................
1
0
d
r
b. Have other students made up something about you to make
other students not like you anymore? .........................................
1
0
d
r
Have other students said they would not be your friend unless
you did what they told you to do? ................................................
1
0
d
r
d. Have you been teased or threatened through use of email, text
messaging, or other electronic methods? This is sometimes
called cyber bullying. (NEW) .......................................................
1
0
d
r
e. Have you had things stolen from your locker, desk, or other
places at school? .........................................................................
1
0
d
r
Have you been physically attacked or in fights at school or on
the way to or from school? ..........................................................
1
0
d
r
g. Have you bullied or picked on other students? ...........................
1
0
d
r
c.
f.
YOUTH ENROLLED IN SCHOOL. SKIP FOR PROXIES.
K6.
Since school started this year, how often have you… [FILL EACH STATEMENT
BELOW].
NEVER
A FEW
TIMES
ONCE A
WEEK
ALMOST
EVERY
DAY
EVERY
DAY
DK
REF
a. gone to a class late? (HSLS, rev) .............
1
2
3
4
5
d
r
b. cut or skipped class? (HSLS, rev) ............
1
2
3
4
5
d
r
c. been late for school? (HSLS, rev).............
1
2
3
4
5
d
r
d. gotten in trouble for acting out in class?
(NEW) ..........................................................
1
2
3
4
5
d
r
e. ASK IF IEP ONLY: been held or
restrained by a teacher or classroom
aide because you were misbehaving in
class? (NEW) ..............................................
1
2
3
4
5
d
r
Prepared by Mathematica Policy Research
10
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL. SKIP FOR PROXIES.
K7.
During the past school year (2011-2012), how often did a health or emotional
problem cause {you/him/her} to miss a day of school? Would you say…
(NLTS2, Q2, rev)
INTERVIEWER: IF INTERVIEW TAKES PLACE DURING VACATION, ASK
YOUTH TO ANSWER FOR THE LAST MONTH HE/SHE WAS IN
SCHOOL.
CODE ONE ONLY
Never, ............................................................................ 1
1-2 times, ....................................................................... 2
3-5 times, ....................................................................... 3
6-10 times, or ................................................................ 4
More than 10 times? ...................................................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
K8.
In total, about how many hours per week do you usually spend completing
homework? (NEW)
IF NEEDED: ANY LOCATION, HOME OR STUDY HALL. FOR FRACTIONS OF AN
HOUR, ROUND UP IF 30 MINUTES OR MORE. ROUND DOWN IF FEWER THAN
30 MINUTES.
|
|
| HOURS (0-168)
DOES NOT HAVE HOMEWORK ASSIGNED .............. 98
CHOOSES NOT TO DO HOMEWORK ASSIGNED ..... 96
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS GT 20 You said you usually spend {HOURS} hours a week doing
homework. Is this correct?
HARD CHECK: IF HOURS GT 168 That is more hours than there are in a week. How many
hours {do you/ does he/she} usually spend doing homework in a week?
Prepared by Mathematica Policy Research
11
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN GRADE 9 OR HIGHER OR AGE 14 OR OVER AND IN AN UNGRADED OR
MULTIGRADE CLASS. SKIP FOR PROXIES.
K9.
My next questions are about school activities and services. For each, please
tell me whether you have received the following kinds of instruction or help
from school staff this year (2011-2012). Have school staff provided you with…
IF PARTICIPATED ASK: How useful was [FILL PROGRAM/SERVICE NAME]
either in helping you stay in school or prepare for life after school? Was it very
useful, somewhat useful, or not useful to you? (NEW)
A:
TAKEN
PART
Have school staff provided you with…
B: HOW USEFUL
VERY
USEFUL
SOMEWHAT
USEFUL
USEFUL
NOT
YES
NO
DK
REF
a. Extra help before or after school in academic
subjects? ...................................................................
1
0
1
2
3
d
r
b. Academic instruction on weekends? .....................
1
0
1
2
3
d
r
c. Help completing college applications? ..................
1
0
1
2
3
d
r
d. Guidance about which courses to take? ...............
1
0
1
2
3
d
r
e. Grade 10+: Help reviewing college entrance test
results and suggesting re-testing if necessary?...
1
0
1
2
3
d
r
Grade 10+: Help arranging or taking you on
visits to colleges or college fairs? ..........................
1
0
1
2
3
d
r
g. Help identifying possible career options? .............
1
0
1
2
3
d
r
1
0
1
2
3
d
r
Reproductive health or pregnancy prevention
education or services? ............................................
1
0
1
2
3
d
r
Teen parenting instruction? ....................................
1
0
1
2
3
d
r
k. Child care for the children of students? ................
1
0
1
2
3
d
r
l.
Substance abuse counseling or education? .........
1
0
1
2
3
d
r
m. Instruction on appropriate use of social
networking sites? .....................................................
1
0
1
2
3
d
r
ACADEMIC SUPPORTS
COLLEGE & CAREER PREP ACTIVITIES
f.
INDEPENDENT LIVING & LIFE SKILLS
h. Help learning to manage money? ...........................
i.
j.
Prepared by Mathematica Policy Research
12
Draft Dated 10-10-11
NLTS2012
K10.
Baseline Interview for Youth
Has anyone provided guidance on the sequence of high school courses you
should take to prepare for what you plan to do after high school. (OVAE)
YES ............................................................................... 1
K10a.
NO ................................................................................. 0
GO TO K11
DON’T KNOW ............................................................... d
GO TO K11
REFUSED ..................................................................... r
GO TO K11
Is there a written plan summarizing this list of high school courses? (OVAE)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ASK IF YOUTH AGE IS >16 YRS OLD
K11.
[Have you / Has YOUTH] taken any of the following college placement tests…
(HSLS student, rev)
YES
NO
DK
REF
a. The PSAT?...........................................................................................
1
0
d
r
b. The ACT? .............................................................................................
1
0
d
r
c. The SAT? .............................................................................................
1
0
d
r
d. The placement test for a local college, such as accuplacer or
other tests used for community colleges? ......................................
1
0
d
r
L. STUDENT’S IEP EXPERIENCE
BOX L1
IF PARENT VARIABLES E1 A|B|C|D = 1 OR D27 = 1, GO TO L1. ELSE, GO TO M1
YOUTH WHO CURRENTLY HAVE AN IEP OR THEIR PROXIES
L1.
During this school year, or last school year, did {you/he/she} go to a meeting
at school about an Individualized Education Plan, or IEP, for special education
programs or services? (NLTS2, R7a)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
13
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH AGE >16 WHO CURRENTLY HAVE AN IEP OR THEIR PROXIES.
L2.
Did {you/NAME} meet with adults at school to set goals for what {you/he/she}
will do after high school and make a plan for how to achieve them? Sometimes
this is called a transition plan. (NLTS2, R7b)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH AGE 16+ WHO ATTENDED AN IEP OR TRANSITION MEETING AND SKIPPED FOR
PROXIES.
L2a.
Which of the following best describes your role in your {“IEP AND
TRANSITION PLANNING” IF L1 = 1, ELSE “IEP PLANNING”}? (NLTS E3B)
CODE ONE ONLY
You did not participate ................................................... 1
You were present in discussions but participated
very little or not at all ..................................................... 2
You provided some input ............................................... 3
You took a leadership role, helping set the
direction of the discussions, goals and plans ................ 4
DOESN’T KNOW ABOUT ANY GOALS ....................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ASKED OF YOUTH WITH IEPS (AND THEIR PROXIES) ONLY, NO LONGER IN SCHOOL ONLY
L3.
Before you left school, did someone from your school to make a short
summary of your goals, skills, and any needs for support? This list would be
created to help you pursue your goals after leaving school. (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO M1
DON’T KNOW ............................................................... d
GO TO M1
REFUSED ..................................................................... r
GO TO M1
Prepared by Mathematica Policy Research
14
Draft Dated 10-10-11
NLTS2012
L3a.
Baseline Interview for Youth
How often would you say you have you used this summary? Would you say
you have not used it, you have used it a little, or you have used it a lot? (NEW)
NOT USED IT AT ALL ................................................... 1
GO TO M1
USED IT A LITTLE ........................................................ 2
USED IT A LOT ............................................................. 3
L3b.
DON’T KNOW ............................................................... d
GO TO M1
REFUSED ..................................................................... r
GO TO M1
How did you use this summary since leaving school? (NEW)
APPLY FOR JOB/TALK TO EMPLOYERS ................... 1
APPLY FOR EDUCATION OR TRAINING
PROGRAMS ................................................................. 2
WORKING WITH VOC REHAB OR OTHER
EMPLOYMENT COUNSELOR...................................... 3
GETTING SUPPORT SERVICES ................................. 4
OTHER (SPECIFY) ....................................................... 99
(STRING (NUM))
DON’T KNOW ............................................................... d
GO TO M1
REFUSED ..................................................................... r
GO TO M1
Prepared by Mathematica Policy Research
15
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
M. ACTIVITIES AND EXPERIENCE OUT OF SCHOOL
YOUTH ENROLLED IN SCHOOL OR THEIR PROXIES
M1.
During past 12 months, that is from [CATI INSERT NAME OF MONTH 12
MONTHS PRIOR TO CURRENT MONTH] until now, {have you/ has he/she}
participated in any of the following school activities outside of class? (NLTS2,
P5 REV) (NLTS2, P5)
CODE ALL THAT APPLY
School sports team ........................................................ 1
Music, dance, art, or theater .......................................... 2
Student government ...................................................... 3
Academic subject matter club (math, science,
computer) ...................................................................... 4
Volunteer or community service group .......................... 5
Vocational or career-focused student organization ....... 6
Other school-sponsored clubs or activities .................... 7
NONE OF THESE ......................................................... 8
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
M2.
During the past 12 months, have {have you/ has he/she} taken part in any of
the following non-school activities? (NLTS2, P6 REV)
CODE ALL THAT APPLY
Organized sports supervised by an adult ...................... 1
Music, dance, art, or theater lessons............................. 2
A religious youth group or religious instruction .............. 3
Math, science, or computer camps or lessons .............. 4
Volunteer or community service group .......................... 5
Scouting or another group or club activity ..................... 6
Another camp or type of non-school activity.................. 7
NONE OF THESE ......................................................... 8
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
16
Draft Dated 10-10-11
NLTS2012
M3.
Baseline Interview for Youth
During the past 12 months, about how many days a week did {you/he/she}
usually get together with friends outside of school and outside of organized
activities or groups? (NLTS2, P10)
CODE ONE ONLY
Never, ............................................................................ 1
Sometimes, but not every week, ................................... 2
1 day a week, ................................................................ 3
2 or 3 days a week, ....................................................... 4
4 or 5 days a week, or ................................................... 5
6 or 7 days a week? ...................................................... 6
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ALL YOUTH BUT NOT THEIR PROXIES.
M4.
How often do you use each of the following to communicate with friends? How
about [FILL ITEM]? Do you use that… (NLTS2, P13b REV)
Several
times a
day
Once a
day
Several
times a
week
Once a
week, or
less
Never?
DK
REF
a. Texting ..............................................
1
2
3
4
5
d
r
b. Instant messaging ...........................
1
2
3
4
5
d
r
c. Email .................................................
1
2
3
4
5
d
r
d. Talking on a telephone (either
cellular, landline, Skype, or video
phone) ...............................................
1
2
3
4
5
d
r
e. Facebook, Twitter (sending or
receiving tweets) and other social
media ................................................
1
2
3
4
5
d
r
M5.
How often {do you/does he/she} use a computer for… (NLTS2, P13a2 - REV)
At least
once a
day
Once a
day
Several
times a
week
Once a
week, or
less
Never?
DK
REF
a. Homework and school
assignments?....................................
1
2
3
4
5
d
r
b. Playing games? ................................
1
2
3
4
5
d
r
c. Using the internet - to read a book,
news-related website, or search for
information? ......................................
1
2
3
4
5
d
r
Prepared by Mathematica Policy Research
17
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
N. EMPLOYMENT
NINTRO.
Now I would like to ask a few questions about {your/his/her} work
experience.
REVIEWERS GUIDE TO INCOME SERIES IS AS FOLLOWS:
Item Start
Asked of…
Descriptor of sequence
N1
All Youth
School sponsored work in the past 12 months
N5
Youth in
school
Youth doing work other than school sponsored jobs in the past 12 months
N7
N19
N30
N45
Youth with a job now other than school sponsored work
Youth who do not have a job now but had one in the past 12 months
Youth who
left school
in the past
12 months
Youth who have a job now
Youth who do not have a job now but who had a job since leaving school
BOX N1
IF YOUTH WAS NOT IN SECONDARY SCHOOL THIS SCHOOL YEAR (PARENT A11 = 0, ) GO
TO BOX N5.
IF IN SCHOOL (PARENT A11 ≠ 0) AND (PARENT VAR B1≠ 7 TO 11), GO TO N1. ELSE GO TO
BOX N5.
N1.
In the past 12 months, {have you/has NAME} taken part in any schoolsponsored work activities, like a work-study or co-op job, an internship, or a
school-based business? (NLTS2, T1a, REV)
PROBE:
This may include working in the school store, bank, or café.
YES ............................................................................... 1
N1a.
NO ................................................................................. 0
GO TO N5
DON’T KNOW ............................................................... d
GO TO N5
REFUSED ..................................................................... r
GO TO N5
Did {you/he/she} get credit for that work activity? (NLTS2, T1b)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
18
Draft Dated 10-10-11
NLTS2012
N1b.
Baseline Interview for Youth
Did {you/he/she} get paid for that work activity? (NLTS2, T1c)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
N2.
About how many hours a week {have you/has he/she} usually worked in this
school-sponsored job? (NLTS2, T2c, REV)
IF MORE THAN ONE JOB, COMBINE ALL JOBS. IF WORKED LESS THAN 1
HOUR PER WEEK, CODE AS 1 HOUR.
|
|
| NUMBER (0-80)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
N3.
About how long {have you/ has he/she} worked in this (school sponsored) job?
IF UNSURE, PROBE FOR SEASONS, HOLIDAYS, ETC. (NEW)
|
|
| NUMBER (0-52)
WEEKS ......................................................................... 1
MONTHS ....................................................................... 2
YEARS .......................................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
N4.
Is that work activity related to a particular job or
career you are interested in?
YES ............................................................................... 1
NO - THE WORK IS NOT IN A CAREER/JOB I’M
INTERESTED IN. .......................................................... 0
I DON’T HAVE A PARTICULAR JOB/CAREER
INTEREST ..................................................................... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
19
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
BOX N5
IF STUDENT K1=0 AND PARENT B12 IS IN THE LAST 12 MONTHS, GO TO N29.
ELSE, IF N1=1, SAY:
“My next questions are about paid work other than school-sponsored jobs.” GO TO N5.
ALL YOUTH ENROLLED IN SCHOOL OR THEIR PROXIES.
N5.
At any time in the past 12 months, did {you/NAME} do any work for pay, other
than work around the house {IF D31 = 1: or a school-sponsored job}? That
could include being a babysitter or working for a neighbor. (NLTS T2a, REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N55
DON’T KNOW ............................................................... d
GO TO N55
REFUSED ..................................................................... r
GO TO N55
YOUTH ENROLLED IN SCHOOL WHO WORKED IN THE PAST 12 MONTHS OR THEIR PROXIES.
N6.
Did {you/he/she} do this work only during the summer, the school year, or
both? (NLTS T2b)
IF ASKED, THE SCHOOL YEAR IS FROM SEPTEMBER TO MAY AND SUMMER
IS FROM JUNE TO AUGUST.
CODE ONE ONLY
ONLY DURING THE SUMMER .................................... 1
ONLY DURING THE SCHOOL YEAR .......................... 2
GO TO N6b
BOTH ............................................................................ 3
DON’T KNOW ............................................................... d
GO TO N7
REFUSED ..................................................................... r
GO TO N7
Prepared by Mathematica Policy Research
20
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL WHO WORKED DURING THE SUMMER OR THEIR PROXIES.
N6b.
About how many hours a week {have you/has he/she} usually worked during
the summer? (NLTS2, T2c, REV)
IF MORE THAN ONE JOB, COMBINE ALL JOBS. IF YOUTH IS WORKING THIS
SUMMER AND LAST SUMMER, CODE THIS SUMMER. IF WORKED LESS THAN
1 HOUR PER WEEK, CODE AS 1 HOUR.
|
|
| NUMBER (0-80)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
IF N6 = 1, GO TO N7. IF N6 = 3, GO TO N6b.
SOFT CHECK: IF HOURS IS LT 10 OR GT 40 You said you usually worked {HOURS} a week.
Is that correct?
YOUTH ENROLLED IN SCHOOL WHO WORKED DURING THE SCHOOL YEAR OR THEIR PROXIES.
N6b.
How many hours a week {have you/has he/she} usually worked during the
school year? (NLTS2, T2d, REV)
IF MORE THAN ONE JOB, COMBINE ALL JOBS. IF NO LONGER IN SCHOOL
AND ASKED, WE MEAN DURING SEPTEMBER TO MAY. IF WORKED
DIFFERENT HOURS IN 2 SCHOOL YEARS, CODE MOST RECENT SCHOOL
YEAR. IF WORKED LESS THAN 1 HOUR PER WEEK, CODE AS 1 HOUR.
|
|
| NUMBER (0-60)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS IS LT 5 OR GT 30 You said you worked (hours) a week. Is that
correct?
ALL YOUTH ENROLLED IN SCHOOL OR THEIR PROXIES.
N7.
{Do you/Does NAME} have a paid job now, other than work around the house
{IF A31 = 1: or a school sponsored job}? That could include being a babysitter
or working for a neighbor. (NLTS2, T3a - REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N19
DON’T KNOW ............................................................... d
GO TO N19
REFUSED ..................................................................... r
GO TO N19
Prepared by Mathematica Policy Research
21
Draft Dated 10-10-11
NLTS2012
N8.
Baseline Interview for Youth
How many different paid jobs {do you/ does he/she} have now? (NLTS2, T3b)
|
|
| NUMBER (0-10)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF GT 2 You said you have {NUMBER} jobs right now. Is that correct?
N9.
Thinking about [IF N8=1: the job] [IF N8>1, d, r: all the jobs] {you have/he/she
has} now {IF N8 = 1: not counting {your/his/her} school sponsored job}, about
how many hours a week {do you/ does he/she} usually work? (NLTS2, T3c)
|
|
| HOURS (0-80)
GO TO N10
DON’T KNOW ............................................................... d
GO TO N9a
REFUSED ..................................................................... r
GO TO N9a
SOFT CHECK: IF HOURS LT 5 OR GT 30 You said you usually work about {NUMBER} hours
a week. Is that correct?
N9a.
[IF N8=1: In the job {you have/he/she has} now] [IF N8>1, d, r: Taking all
{your/his/her} jobs together], {IF N8 = 1: not counting {your/his/her} school
sponsored job}, {do you/ does he/she} usually work 35 hours or more per
week? (NLTS2, T3d REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
N10.
[IF STUDENT WORKS MORE THAN ONE JOB, FILL: Thinking about the job
where you work the most hours] About how long {have you/ has he/she}
worked there? (NEW)
IF UNSURE, PROBE FOR SEASONS, HOLIDAYS, ETC.
|
|
| NUMBER (0-52)
WEEKS ......................................................................... 1
MONTHS ....................................................................... 2
YEARS .......................................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS LT 10 OR GT 40 You said you usually work {NUMBER} hours a
week at that job. Is that correct?
Prepared by Mathematica Policy Research
22
Draft Dated 10-10-11
NLTS2012
N11.
Baseline Interview for Youth
What kind of job is this? Is it an informal job you do for family or friends (such
as babysitting or yardwork), or is formal job for an employer at a business,
government agency, or other organization? (NEW)
INFORMAL – WITHIN HOUSEHOLD OR FOR
FAMILY ......................................................................... 1
FORMAL EMPLOYMENT ............................................. 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
N12.
About how much {are you/is {NAME}} paid for this job, before taxes or
deductions are taken out? (NLTS2, T3F1, rev)
PROBE: Is that per hour?
|.|
|
| PER HOUR ........................................ 1
|
|
| PER WEEK ........................................ 2
|
|,|
|
|
| PER MONTH ............................... 3
|
|,|
|
|
| PER YEAR .................................. 4
|
|
|
|,|
|
|
MINIMUM WAGE .......................................................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
CHECK: IF LESS THAN MINIMUM WAGE OR >$20 AN HOUR: You told me ${response} per
hour. Is that correct?
Prepared by Mathematica Policy Research
23
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL WITH A JOB NOW OR THEIR PROXIES.
N13.
How {do you/does he/she} usually get to this job? (NLTS T3g, rev)
PROBE:
IF MENTIONS MORE THAN ONE, PROBE FOR MOST COMMON
MODE OF TRANSPORTATION TO WORK.
CODE ONE ONLY
WALKS OR RIDES A BIKE ........................................... 1
DRIVES HIM/HERSELF ................................................ 2
GETS RIDE FROM FAMILY MEMBER ......................... 3
GETS RIDE FROM FRIEND/COWORKER................... 4
CARPOOLS .................................................................. 5
TAKES PUBLIC TRANSPORTATION, E.G., US,
TRAIN, SUBWAY, TAXI ................................................ 6
SERVICE AGENCY PROVIDES
TRANSPORTATION ..................................................... 7
USES DIAL-A-VAN SERVICE ....................................... 8
OTHER (SPECIFY) ....................................................... 99
(STRING 50)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO REPORT HAVING
FORMAL EMPLOYMENT NOW
N14.
Did you tell your employer that you have any kind of learning problem,
disability, or other special need… (NLTS T8j1, REV)
CODE ONE ONLY
Before you got your job, ................................................ 1
GO TO N16
After you started the job, or ........................................... 2
GO TO N16
Have you not told them at all? ....................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
24
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO HAVE A JOB NOW
N15.
Do you think your employer is aware that you have any kind of learning
problem, disability, or other special need? (NLTS T8j2, REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WITH A JOB NOW OR THEIR
PROXIES.
N16.
At {your/his/her} job, do most of the other workers have disabilities? (NLTS2,
T8I)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO HAVE A JOB NOW OR
THEIR PROXIES
N17.
Was there someone, either from {your/his/her} school or from an agency, who
went with {you/him/her} to this job, who helped {you/him/her} to learn
{your/his/her} job? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WITH A JOB NOW OR THEIR
PROXIES.
N18.
{Have you/ Has/{he/she}} received any accommodations or other help from
{your/his/her} employer because {you have/he has/she has} any kind of
learning problem, disability, or other special need? (NLTS2, T8K)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N55
DON’T KNOW ............................................................... d
GO TO N55
REFUSED ..................................................................... r
GO TO N55
Prepared by Mathematica Policy Research
25
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WITH A JOB NOW WHO
RECEIVE ACCOMMODATIONS AT WORK OR THEIR PROXIES.
N18a.
What accommodations or other help have {you/he/she} received? (NLTS2,
T8M)
CODE ALL THAT APPLY
NONE ................................................................................................................................... 0
LARGE PRINT OR BRAILLE MATERIALS OR LARGE PRINT COMPUTER ..................... 1
WRITTEN MATERIALS ON TAPE ....................................................................................... 2
COMPUTER HARDWARE ADAPTED FOR YOUTH’S NEEDS (E.G.,
ALTERNATIVE KEYBOARD, SWITCH INTERFACE, SPEECH RECOGNITION
SOFTWARE, COMPUTER PERIPHERALS) ....................................................................... 3
HEADSETS TO ALLOW HANDS-FREE PHONE USE OR TO MAGNIFY SOUND............. 4
DIFFERENT EQUIPMENT (OTHER THAN COMPUTER) OR CHANGES TO
EQUIPMENT USED ON THE JOB ...................................................................................... 5
TTY, TTD, OR VIDEOPHONE AVAILABLE ......................................................................... 6
ALTERED WORK STATION ................................................................................................ 7
A READER OR INTERPRETER .......................................................................................... 8
JOB COACH—HELPS MONITOR PROGRESS, OFFERS ADVICE TO IMPROVE
PERFORMANCE ................................................................................................................. 9
A PERSONAL AIDE OR ASSISTANT TO HELP ON THE JOB ........................................... 10
MORE TRAINING, TRAINING TAILORED TO INDIVIDUAL NEEDS .................................. 11
MORE OR DIFFERENT SUPERVISION OR MENTORING ................................................ 12
DIFFERENT EXPECTATIONS FOR PRODUCTIVITY OR PERFORMANCE ..................... 13
INSTRUCTIONS ARE MODIFIED IN FORM OR IN THE WAY THEY ARE
COMMUNICATED (E.G., PICTORIAL INSTRUCTIONS, VERBAL INSTRUCTIONS
INSTEAD OF/IN ADDITION TO WRITTEN)......................................................................... 14
FLEXIBLE TIMES FOR ARRIVING AT AND LEAVING WORK ........................................... 15
SHORTER SHIFT ................................................................................................................ 16
SLOWER PACE FOR GETTING THE JOB DONE .............................................................. 17
MORE BREAKS, LONGER BREAKS .................................................................................. 18
MORE PAID SICK LEAVE OR PAID TIME OFF FOR MEDICAL NEEDS, THERAPY
APPOINTMENTS, ETC. ....................................................................................................... 19
REARRANGED EQUIPMENT OR FURNITURE TO IMPROVE ACCESSIBILITY............... 20
MADE CHANGES TO THE BUILDING (E.G., WIDENED DOORS, MADE
RESTROOMS ACCESSIBLE) ............................................................................................. 21
TRANSPORTATION ASSISTANCE (E.G., TO GET BETWEEN BUILDINGS AT
THE WORK SITE) ................................................................................................................ 22
PARKING ACCOMMODATIONS ......................................................................................... 23
EMERGENCY PLAN ACCOUNTS FOR DISABLED WORKER (E.G.,
EVACUATION PLAN) .......................................................................................................... 24
OTHER (SPECIFY) .............................................................................................................. 99
(STRING 50)
DON’T KNOW d
REFUSED
r
Prepared by Mathematica Policy Research
26
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
CHECKPOINT: ALL DISABILITIES
IF NO RESPONSES IN 11-14: Have there been any accommodations in the training or supervision you receive
or in your work assignments?
IF NO RESPONSES IN 15-18: Have there been any accommodations in your work schedule, like getting to
arrive or leave work at flexible times, or getting more time to get your work done?
CHECKPOINT: IF DISABILITY IS ORTHOPEDIC, OTHER HEALTH IMPAIRED—OTHER THAN ADD (IF OHI ON
SAMPLE FILE OR B1a NE2 AND B1a1 NE1), MULTIPLE, VISUAL, OR DEAF/BLIND, PROBE:
IF NO RESPONSES IN 8-10: Has there been any person assigned to help you, like a person who helps you get
around your work site or reads materials to you?
IF NO RESPONSES IN 1-7: Have there been any adaptations to the equipment you use, like giving you a
special workstation or different computers or other equipment, because of your disability?
IF NO RESPONSES IN 19-20: Have there been any adaptations to your workplace, like rearranging furniture
or changing doorways or restrooms because of your disability?
IF NO RESPONSES IN 21-24: Have you had any services or supports to help you get around at work, like help
with transportation or parking?
CHECKPOINT: IF DISABILITY IS HEARING IMPAIRED, PROBE:
IF NO RESPONSES IN CATEGORY 2. Has there been any person assigned to help you, like a sign language
interpreter?
BOX N19:
GO TO N55.
ALL YOUTH ENROLLED IN SCHOOL WHO DO NOT HAVE A JOB NOW BUT WORKED IN
THE PAST 12 MONTHS OR THEIR PROXIES.
N19.
About how long {did you/he/she} work at {your/his/her} last job? (NEW)
IF UNSURE, PROBE FOR SEASONS, HOLIDAYS, ETC.
|
|
| NUMBER (0-52)
WEEKS ......................................................................... 1
MONTHS ....................................................................... 2
YEARS .......................................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
N20.
How many hours a week did {you/he/she} usually work at that job during the
school year? (NLTS2, T3c, REV)
|
|
| HOURS (0-80)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS LT 5 OR GT 30 You said you usually work {NUMBER} hours a
week at that job. Is that correct?
Prepared by Mathematica Policy Research
27
Draft Dated 10-10-11
NLTS2012
N20a.
Baseline Interview for Youth
How many hours a week did {you/he/she} usually work at that job during the
summer? (NLTS2, T3c, REV)
|
|
| HOURS (0-80)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS LT 10 OR GT 40 You said you usually work {NUMBER} hours a
week at that job. Is that correct?
ALL YOUTH ENROLLED IN SCHOOL WHO DO NOT HAVE A JOB NOW BUT WORKED IN
THE PAST 12 MONTHS OR THEIR PROXIES.
N21.
What kind of job is this? Is it an informal job you do for family or friends (such
as babysitting or yardwork), or is formal job for an employer at a business,
government agency, or other organization? (NEW)
INFORMAL – WITHIN HOUSEHOLD OR FOR
FAMILY ......................................................................... 1
FORMAL EMPLOYMENT ............................................. 2
Response category ....................................................... 8
GO TO N35
DON’T KNOW ............................................................... d
GO TO N35
REFUSED ..................................................................... r
N22.
About how much {were you/was {NAME}} paid for this job, before taxes or
deductions were taken out? (NLTS2, T3F1, rev)
PROBE:
Is that per hour?
|
|
| |.|
|,| |
|
|
| PER HOUR ........................................ 1
| PER WEEK ........................................ 2
|
|
|,|
|
|
| PER MONTH ............................... 3
|
|
|,|
|
|
| PER YEAR .................................. 4
MINIMUM WAGE .......................................................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
CHECK: IF LESS THAN MINIMUM WAGE OR >$20 AN HOUR: You told me ${response} per
hour. Is that correct?
Prepared by Mathematica Policy Research
28
Draft Dated 10-10-11
NLTS2012
N23.
Baseline Interview for Youth
How did {you/he/she} usually get to this job? (NLTS T3g, rev)
PROBE:
IF MENTIONS MORE THAN ONE, PROBE FOR MOST COMMON
MODE OF TRANSPORTATION TO WORK.
CODE ONE ONLY
WALKS OR RIDES A BIKE ........................................... 1
DRIVES HIM/HERSELF ................................................ 2
GETS RIDE FROM FAMILY MEMBER ......................... 3
GETS RIDE FROM FRIEND/COWORKER................... 4
CARPOOLS .................................................................. 5
TAKES PUBLIC TRANSPORTATION, E.G.,
BUS, TRAIN, SUBWAY, TAXI ....................................... 6
SERVICE AGENCY PROVIDES
TRANSPORTATION ..................................................... 7
USES DIAL-A-VAN SERVICE ....................................... 8
OTHER (SPECIFY) ....................................................... 99
(STRING 50)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO DO NOT HAVE A JOB
NOW BUT WORKED AT FORMAL EMPLOYMENT SETTING IN THE PAST 12 MONTHS
N24.
Did you tell your employer that you have any kind of learning problem,
disability, or other special need… (NLTS T8j1, REV)
CODE ONE ONLY
Before you got your job, ................................................ 1
GO TO N26
After you started the job, or ........................................... 2
GO TO N26
Have you not told them at all? ....................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
29
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO DO NOT HAVE A JOB
NOW BUT WORKED IN THE PAST 12 MONTHS
N25.
Do you think your employer is aware that you have any kind of learning
problem, disability, or other special need? (NLTS T8j2, REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO DO NOT HAVE A JOB
NOW BUT WORKED IN THE PAST 12 MONTHS OR THEIR PROXIES.
N26.
At {your/his/her} job, did most of the other workers have disabilities? (NLTS2,
T8I)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO DO NOT HAVE A JOB
NOW BUT WORKED IN THE PAST 12 MONTHS OR THEIR PROXIES
N27.
Was there someone, either from {your/his/her} school or from an agency, who
went with {you/him/her} to this job, who helped {you/him/her} learn
{your/his/her} job? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO DO NOT HAVE A JOB
NOW BUT WORKED IN THE PAST 12 MONTHS OR THEIR PROXIES.
N28.
Did {you/he/she} receive any accommodations or other help from your
employer because {you have/he has/she has} any kind of learning problem,
disability, or other special need? (NLTS2, T8K)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N55
DON’T KNOW ............................................................... d
GO TO N55
REFUSED ..................................................................... r
GO TO N55
Prepared by Mathematica Policy Research
30
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH ENROLLED IN SCHOOL WITH AN IEP OR 504 PLAN WHO DO NOT HAVE A JOB
NOW BUT WORKED IN THE PAST 12 MONTHS AND RECEIVED ACCOMMODATIONS AT
WORK OR THEIR PROXIES.
N28a.
What accommodations or other help did {you/he/she} receive? (NLTS2, T8M)
CODE ALL THAT APPLY
NONE ............................................................................................................................................ 0
LARGE PRINT OR BRAILLE MATERIALS OR LARGE PRINT COMPUTER ............................. 1
WRITTEN MATERIALS ON TAPE ............................................................................................... 2
COMPUTER HARDWARE ADAPTED FOR YOUTH’S NEEDS (E.G., ALTERNATIVE
KEYBOARD, SWITCH INTERFACE, SPEECH RECOGNITION SOFTWARE,
COMPUTER PERIPHERALS) ...................................................................................................... 3
HEADSETS TO ALLOW HANDS-FREE PHONE USE OR TO MAGNIFY SOUND .................... 4
DIFFERENT EQUIPMENT (OTHER THAN COMPUTER) OR CHANGES TO
EQUIPMENT USED ON THE JOB ............................................................................................... 5
TTY, TTD, OR VIDEOPHONE AVAILABLE ................................................................................. 6
ALTERED WORK STATION ......................................................................................................... 7
A READER OR INTERPRETER ................................................................................................... 8
JOB COACH—HELPS MONITOR PROGRESS, OFFERS ADVICE TO IMPROVE
PERFORMANCE .......................................................................................................................... 9
A PERSONAL AIDE OR ASSISTANT TO HELP ON THE JOB ................................................... 10
MORE TRAINING, TRAINING TAILORED TO INDIVIDUAL NEEDS .......................................... 11
MORE OR DIFFERENT SUPERVISION OR MENTORING ........................................................ 12
DIFFERENT EXPECTATIONS FOR PRODUCTIVITY OR PERFORMANCE ............................. 13
INSTRUCTIONS ARE MODIFIED IN FORM OR IN THE WAY THEY ARE
COMMUNICATED (E.G., PICTORIAL INSTRUCTIONS, VERBAL INSTRUCTIONS
INSTEAD OF/IN ADDITION TO WRITTEN) ................................................................................. 14
FLEXIBLE TIMES FOR ARRIVING AT AND LEAVING WORK ................................................... 15
SLOWER PACE FOR GETTING THE JOB DONE ...................................................................... 16
MORE BREAKS, LONGER BREAKS ........................................................................................... 17
MORE PAID SICK LEAVE OR PAID TIME OFF FOR MEDICAL NEEDS, THERAPY
APPOINTMENTS, ETC................................................................................................................. 18
REARRANGED EQUIPMENT OR FURNITURE TO IMPROVE ACCESSIBILITY ...................... 19
MADE CHANGES TO THE BUILDING (E.G., WIDENED DOORS, MADE RESTROOMS
ACCESSIBLE) .............................................................................................................................. 20
TRANSPORTATION ASSISTANCE (E.G., TO GET BETWEEN BUILDINGS AT THE
WORK SITE) ................................................................................................................................. 21
PARKING ACCOMMODATIONS .................................................................................................. 22
EMERGENCY PLAN ACCOUNTS FOR DISABLED WORKER (E.G., EVACUATION
PLAN) ............................................................................................................................................ 23
OTHER (SPECIFY) ....................................................................................................................... 99
(STRING 50)
DON’T KNOW d
REFUSED
r
Prepared by Mathematica Policy Research
31
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
CHECKPOINT: ALL DISABILITIES
IF NO RESPONSES IN 11-14: Have there been any accommodations in the training or supervision you receive
or in your work assignments?
IF NO RESPONSES IN 15-18: Have there been any accommodations in your work schedule, like getting to
arrive or leave work at flexible times, or getting more time to get your work done?
CHECKPOINT: IF DISABILITY IS ORTHOPEDIC, OTHER HEALTH IMPAIRED—OTHER THAN ADD (IF OHI ON
SAMPLE FILE OR B1a NE2 AND B1a1 NE1), MULTIPLE, VISUAL, OR DEAF/BLIND, PROBE:
IF NO RESPONSES IN 8-10: Has there been any person assigned to help you, like a person who helps you get
around your work site or reads materials to you?
IF NO RESPONSES IN 1-7: Have there been any adaptations to the equipment you use, like giving you a
special workstation or different computers or other equipment, because of your disability?
IF NO RESPONSES IN 19-20: Have there been any adaptations to your workplace, like rearranging furniture
or changing doorways or restrooms because of your disability?
IF NO RESPONSES IN 21-24: Have you had any services or supports to help you get around at work, like help
with transportation or parking?
CHECKPOINT: IF DISABILITY IS HEARING IMPAIRED, PROBE:
IF NO RESPONSES IN CATEGORY 2. Has there been any person assigned to help you, like a sign language
interpreter?
BOX N29:
GO TO N55.
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS OR THEIR PROXIES.
N29.
{do you/ does NAME} have a paid job now, other than work around the house
{IF A31= 1: or a school sponsored job}? That could include being a babysitter
or working for a neighbor. (NLTS2, T3a, rev)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N44
DON’T KNOW ............................................................... d
GO TO N44
REFUSED ..................................................................... r
GO TO N44
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH A JOB NOW OR THEIR
PROXIES.
N30.
{Did you/{NAME} have this job while in high school? (NLTS2, T3b)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
32
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH A JOB NOW OR THEIR
PROXIES.
N31.
How many different paid jobs {do you/does he/she} have now? (NLTS2, T3b)
|
|
| NUMBER (0-10)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF GT 2 You said you have {NUMBER} jobs right now. Is that correct?
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH A JOB NOW OR THEIR
PROXIES.
N32.
Thinking about [IF N31=1: the job] [IF N31>1, d, r: all the jobs] {you have/he/she
has} now {IF N1 = 1: not counting {your/his/her} school sponsored job}, about
how many hours a week {do you/ does he/she} usually work? (NLTS2, T3c)
|
|
| HOURS (0-80)
GO TO N33
DON’T KNOW ............................................................... d
GO TO N32a
REFUSED ..................................................................... r
GO TO N32a
SOFT CHECK: IF HOURS LT 5 OR GT 30 You said you usually work about {NUMBER} hours
a week. Is that correct?
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT KNOW THEIR USUAL
WEEKLY HOURS OR THEIR PROXIES.
N32a.
[IF N31 =1: In the job {you have/he/she has} now] [IF N31 >1, d, r: Taking all
{your/his/her} jobs together], {IF N1= 1: not counting {your/his/her} school
sponsored job}, {do you/ does he/she} usually work 35 hours or more per
week? (NLTS2, T3d REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
33
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DON’T KNOW WHEN THEIR
JOB STARTED OR THEIR PROXIES.
N33.
[IF STUDENT WORKS MORE THAN ONE JOB, FILL: Thinking about the job
where you work the most hours] About how long {have you/ has he/she}
worked there? (NEW)
IF UNSURE, PROBE FOR SEASONS, HOLIDAYS, ETC.
|
|
| NUMBER (0-52)
WEEKS ......................................................................... 1
MONTHS ....................................................................... 2
YEARS .......................................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH A JOB NOW 0R THEIR
PROXIES.
N34.
Since leaving school, how many hours a week {have/has} {you/he/she} usually
worked at that job? (NLTS2, T3c, REV)
|
|
| HOURS (0-80)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS LT 10 OR GT 40 You said you usually work {NUMBER} hours a
week at that job. Is that correct?
N35.
What kind of job is this? Is it an informal job you do for family or friends (such
as babysitting or yardwork), or is formal job for an employer at a business,
government agency, or other organization? (NEW)
INFORMAL – WITHIN HOUSEHOLD OR FOR
FAMILY ......................................................................... 1
FORMAL EMPLOYMENT ............................................. 2
Response category ....................................................... 8
GO TO N44
DON’T KNOW ............................................................... d
GO TO N44
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
34
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH A JOB NOW OR THEIR
PROXIES.
N36.
About how much {are you/is {NAME}} paid for this job, before taxes or
deductions are taken out? (NLTS2, T3F1, rev)
PROBE:
Is that per hour?
|.|
|
| PER HOUR ........................................ 1
|
|
| PER WEEK ........................................ 2
|
|,|
|
|
| PER MONTH ............................... 3
|
|,|
|
|
| PER YEARS ................................ 4
|
|
|
|,|
|
|
MINIMUM WAGE .......................................................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
CHECK: IF LESS THAN MINIMUM WAGE OR >$20 AN HOUR: You told me ${response} per
hour. Is that correct?
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH A JOB NOW OR THEIR
PROXIES.
N37.
How do you usually get to this job? (NLTS T3g, rev)
PROBE:
IF MENTIONS MORE THAN ONE, PROBE FOR MOST COMMON
MODE OF TRANSPORTATION TO WORK.
CODE ONE ONLY
WALKS OR RIDES A BIKE ........................................... 1
DRIVES HIM/HERSELF ................................................ 2
GETS RIDE FROM FAMILY MEMBER ......................... 3
GETS RIDE FROM FRIEND/COWORKER................... 4
CARPOOLS .................................................................. 5
TAKES PUBLIC TRANSPORTATION, E.G.,
BUS, TRAIN, SUBWAY, TAXI ....................................... 6
SERVICE AGENCY PROVIDES
TRANSPORTATION ..................................................... 7
USES DIAL-A-VAN SERVICE ....................................... 8
OTHER (SPECIFY) ....................................................... 99
(STRING 50)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
35
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS , WHO
REPORTED HAVING A FORMAL JOB NOW
N38.
Did you tell your employer that you have any kind of learning problem,
disability, or other special need… (NLTS T8j1, REV)
CODE ONE ONLY
Before you got your job, ................................................ 1
GO TO N40
After you started the job, or ........................................... 2
GO TO N40
Have you not told them at all? ....................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH
A JOB NOW
N39.
Do you think your employer is aware that you have any kind of learning
problem, disability, or other special need? (NLTS T8j2, REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH AN IEP OR 504 PLAN WITH
A JOB NOW OR THEIR PROXIES.
N40.
At {your/his/her} job, do most of the other workers have disabilities? (NLTS2,
T8I)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
36
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH
A JOB NOW OR THEIR PROXIES
N41.
Was there someone, either from {your/his/her} school or from an agency, who
went with {you/him/her} to this job, who helped {you/him/her} learn
{your/his/her} job? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH AN IEP OR 504 PLAN WITH
A JOB NOW OR THEIR PROXIES.
N42.
{Have you/Has/{he/she}} received any accommodations or other help from
{your/his/her} employer because {you have/he has/she has} any kind of
learning problem, disability, or other special need? (NLTS2, T8K)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N55
DON’T KNOW ............................................................... d
GO TO N55
REFUSED ..................................................................... r
GO TO N55
Prepared by Mathematica Policy Research
37
Draft Dated 10-10-11
NLTS2012
N43.
Baseline Interview for Youth
What accommodations or other help have {you/he/she} received?
(NLTS2, T8M)
CODE ALL THAT APPLY
NONE ....................................................................................................................................................... 0
LARGE PRINT OR BRAILLE MATERIALS OR LARGE PRINT COMPUTER ........................................ 1
WRITTEN MATERIALS ON TAPE .......................................................................................................... 2
COMPUTER HARDWARE ADAPTED FOR YOUTH’S NEEDS (E.G., ALTERNATIVE
KEYBOARD, SWITCH INTERFACE, SPEECH RECOGNITION SOFTWARE, COMPUTER
PERIPHERALS) ....................................................................................................................................... 3
HEADSETS TO ALLOW HANDS-FREE PHONE USE OR TO MAGNIFY SOUND ................................ 4
DIFFERENT EQUIPMENT (OTHER THAN COMPUTER) OR CHANGES TO EQUIPMENT
USED ON THE JOB ................................................................................................................................ 5
TTY, TTD, OR VIDEOPHONE AVAILABLE ............................................................................................ 6
ALTERED WORK STATION .................................................................................................................... 7
A READER OR INTERPRETER .............................................................................................................. 8
JOB COACH—HELPS MONITOR PROGRESS, OFFERS ADVICE TO IMPROVE
PERFORMANCE ..................................................................................................................................... 9
A PERSONAL AIDE OR ASSISTANT TO HELP ON THE JOB .............................................................. 10
MORE TRAINING, TRAINING TAILORED TO INDIVIDUAL NEEDS ..................................................... 11
MORE OR DIFFERENT SUPERVISION OR MENTORING .................................................................... 12
DIFFERENT EXPECTATIONS FOR PRODUCTIVITY OR PERFORMANCE ........................................ 13
INSTRUCTIONS ARE MODIFIED IN FORM OR IN THE WAY THEY ARE
COMMUNICATED (E.G., PICTORIAL INSTRUCTIONS, VERBAL INSTRUCTIONS
INSTEAD OF/IN ADDITION TO WRITTEN) ............................................................................................ 14
FLEXIBLE TIMES FOR ARRIVING AT AND LEAVING WORK .............................................................. 15
SLOWER PACE FOR GETTING THE JOB DONE ................................................................................. 16
MORE BREAKS, LONGER BREAKS ...................................................................................................... 17
MORE PAID SICK LEAVE OR PAID TIME OFF FOR MEDICAL NEEDS, THERAPY
APPOINTMENTS, ETC. .......................................................................................................................... 18
REARRANGED EQUIPMENT OR FURNITURE TO IMPROVE ACCESSIBILITY .................................. 19
MADE CHANGES TO THE BUILDING (E.G., WIDENED DOORS, MADE RESTROOMS
ACCESSIBLE) ......................................................................................................................................... 20
TRANSPORTATION ASSISTANCE (E.G., TO GET BETWEEN BUILDINGS AT THE
WORK SITE) ............................................................................................................................................ 21
PARKING ACCOMMODATIONS ............................................................................................................. 22
EMERGENCY PLAN ACCOUNTS FOR DISABLED WORKER (E.G., EVACUATION
PLAN) ...................................................................................................................................................... 23
OTHER (SPECIFY) .................................................................................................................................. 99
(STRING 50)
DON’T KNOW .......................................................................................................................................... d
REFUSED ................................................................................................................................................ r
Prepared by Mathematica Policy Research
38
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
CHECKPOINT: ALL DISABILITIES
IF NO RESPONSES IN 11-14: Have there been any accommodations in the training or supervision you receive
or in your work assignments?
IF NO RESPONSES IN 15-18: Have there been any accommodations in your work schedule, like getting to
arrive or leave work at flexible times, or getting more time to get your work done?
CHECKPOINT: IF DISABILITY IS ORTHOPEDIC, OTHER HEALTH IMPAIRED—OTHER THAN ADD (IF OHI ON
SAMPLE FILE OR B1a NE2 AND B1a1 NE1), MULTIPLE, VISUAL, OR DEAF/BLIND, PROBE:
IF NO RESPONSES IN 8-10: Has there been any person assigned to help you, like a person who helps you get
around your work site or reads materials to you?
IF NO RESPONSES IN 1-7: Have there been any adaptations to the equipment you use, like giving you a
special workstation or different computers or other equipment, because of your disability?
IF NO RESPONSES IN 19-20: Have there been any adaptations to your workplace, like rearranging furniture
or changing doorways or restrooms because of your disability?
IF NO RESPONSES IN 21-24: Have you had any services or supports to help you get around at work, like help
with transportation or parking?
CHECKPOINT: IF DISABILITY IS HEARING IMPAIRED, PROBE:
IF NO RESPONSES IN CATEGORY 2. Has there been any person assigned to help you, like a sign language
interpreter?
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WITH AN IEP OR 504 PLAN WITH
A JOB NOW WHO RECEIVE ACCOMMODATIONS AT WORK OR THEIR PROXIES.
IF PARENT VARIABLES (A25 = 1 OR D2 A|B|C = 1 OR E2b = 1) AND YOUTH N33=1 AND
N42 = 1 AND PARENT B12 is in the last 12 months
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT HAVE A JOB NOW
OR THEIR PROXIES.
N44.
{Have/has}{you/he/she} had a paid job since leaving school? (NLTS, T3a, REV)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N55
DON’T KNOW ............................................................... d
GO TO N55
REFUSED ..................................................................... r
GO TO N55
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT HAVE A JOB NOW BUT HAD
ONE SINCE LEAVING WHO DON’T KNOW WHEN THEIR JOB STARTED OR THEIR PROXIES.
N45.
About how long {did you/ he/she} work there? (NEW)
IF UNSURE, PROBE FOR SEASONS, HOLIDAYS, ETC.
|
|
| NUMBER (0-52)
WEEKS ......................................................................... 1
MONTHS ....................................................................... 2
YEARS .......................................................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
39
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT HAVE A JOB NOW
BUT HAD ONE SINCE LEAVING OR THEIR PROXIES.
N46.
How many hours a week did {you/he/she} usually work at that job since leaving
school? (NLTS2, T3c, REV)
|
|
| HOURS (0-80)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
SOFT CHECK: IF HOURS LT 10 OR GT 40 You said you usually work {NUMBER} hours a
week at that job. Is that correct?
N47.
What kind of job is this? Is it an informal job you do for family or friends (such
as babysitting or yardwork), or is formal job for an employer at a business,
government agency, or other organization? (NEW)
INFORMAL – WITHIN HOUSEHOLD OR FOR
FAMILY ......................................................................... 1
FORMAL EMPLOYMENT ............................................. 2
Response category ....................................................... 8
GO TO N49
DON’T KNOW ............................................................... d
GO TO N49
REFUSED ..................................................................... r
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT HAVE A JOB NOW BUT HAD
ONE SINCE LEAVING OR THEIR PROXIES.
N48.
About how much {were you/was {NAME}} paid for this job, before taxes or
deductions were taken out? (NLTS2, T3F1, rev)
PROBE:
Is that per hour?
|.|
|
| PER HOUR ........................................ 1
|
|
| PER WEEK ........................................ 2
|
|,|
|
|
| PER MONTH ............................... 3
|
|,|
|
|
| PER YEAR .................................. 4
|
|
|
|,|
|
|
MINIMUM WAGE .......................................................... 5
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
CHECK: IF LESS THAN MINIMUM WAGE OR >$20 AN HOUR: You told me ${response} per
hour. Is that correct?
Prepared by Mathematica Policy Research
40
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT HAVE A JOB NOW
BUT HAD ONE SINCE LEAVING OR THEIR PROXIES.
N49.
How did {you/he/she} usually get to this job? (NLTS T3g, rev)
PROBE:
IF MENTIONS MORE THAN ONE, PROBE FOR MOST COMMON
MODE OF TRANSPORTATION TO WORK.
CODE ONE ONLY
WALKS OR RIDES A BIKE ........................................... 1
DRIVES HIM/HERSELF ................................................ 2
GETS RIDE FROM FAMILY MEMBER ......................... 3
GETS RIDE FROM FRIEND/COWORKER................... 4
CARPOOLS .................................................................. 5
TAKES PUBLIC TRANSPORTATION, E.G., US,
TRAIN, SUBWAY, TAXI ................................................ 6
SERVICE AGENCY PROVIDES
TRANSPORTATION ..................................................... 7
USES DIAL-A-VAN SERVICE ....................................... 8
OTHER (SPECIFY) ....................................................... 99
________________________________(STRING 50)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO DO NOT HAVE A JOB NOW
BUT HAD ONE SINCE LEAVING WITH AN IEP OR 504 PLAN
N50.
Did you tell your employer that you have any kind of learning problem,
disability, or other special need… (NLTS T8j1, REV)
CODE ONE ONLY
Before you got your job, ................................................ 1
GO TO N52
After you started the job, or ........................................... 2
GO TO N52
Have you not told them at all? ....................................... 3
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
41
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO
DO NOT HAVE A JOB NOW BUT REPORT FORMAL EMPLOYMENT SINCE LEAVING
N51.
Do you think your employer is aware that you have any kind of learning
problem, disability, or other special need? (NLTS T8j2, REV)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO
DO NOT HAVE A JOB NOW BUT HAD ONE SINCE LEAVING OR THEIR PROXIES.
N52.
At {your/his/her} job, did most of the other workers have disabilities?
(NLTS2, T8I)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO
DO NOT HAVE A JOB NOW BUT HAD ONE SINCE LEAVING OR THEIR PROXIES.
N53.
Was there someone, either from your school or from an agency, who went with
you to this job, who helped you learn your job? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO
DO NOT HAVE A JOB NOW BUT HAD ONE SINCE LEAVING OR THEIR PROXIES.
N54.
Did {you/he/she} receive any accommodations or other help from your
employer because {you have/he has/she has} any kind of learning problem,
disability, or other special need? (NLTS2, T8K)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO N55
DON’T KNOW ............................................................... d
GO TO N55
REFUSED ..................................................................... r
GO TO N55
Prepared by Mathematica Policy Research
42
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WITH AN IEP OR 504 PLAN WHO LEFT SCHOOL IN THE LAST 12 MONTHS WHO
DO NOT HAVE A JOB NOW BUT HAD ONE SINCE LEAVING AND RECEIVED
ACCOMMODATIONS AT WORK OR THEIR PROXIES.
N54a.
What accommodations or other help did {you/he/she} receive? (NLTS2, T8M)
CODE ALL THAT APPLY
NONE ............................................................................................................................................ 0
LARGE PRINT OR BRAILLE MATERIALS OR LARGE PRINT COMPUTER .............................. 1
WRITTEN MATERIALS ON TAPE ................................................................................................ 2
COMPUTER HARDWARE ADAPTED FOR YOUTH’S NEEDS (E.G.,
ALTERNATIVE KEYBOARD, SWITCH INTERFACE, SPEECH RECOGNITION
SOFTWARE, COMPUTER PERIPHERALS).......................................................................... 3
HEADSETS TO ALLOW HANDS-FREE PHONE USE OR TO MAGNIFY SOUND ..................... 4
DIFFERENT EQUIPMENT (OTHER THAN COMPUTER) OR CHANGES TO
EQUIPMENT USED ON THE JOB ......................................................................................... 5
TTY, TTD, OR VIDEOPHONE AVAILABLE .................................................................................. 6
ALTERED WORK STATION ......................................................................................................... 7
A READER OR INTERPRETER.................................................................................................... 8
JOB COACH—HELPS MONITOR PROGRESS, OFFERS ADVICE TO IMPROVE
PERFORMANCE .................................................................................................................... 9
A PERSONAL AIDE OR ASSISTANT TO HELP ON THE JOB .................................................... 10
MORE TRAINING, TRAINING TAILORED TO INDIVIDUAL NEEDS ........................................... 11
MORE OR DIFFERENT SUPERVISION OR MENTORING ......................................................... 12
DIFFERENT EXPECTATIONS FOR PRODUCTIVITY OR PERFORMANCE .............................. 13
INSTRUCTIONS ARE MODIFIED IN FORM OR IN THE WAY THEY ARE
COMMUNICATED (E.G., PICTORIAL INSTRUCTIONS, VERBAL
INSTRUCTIONS INSTEAD OF/IN ADDITION TO WRITTEN) ............................................... 14
FLEXIBLE TIMES FOR ARRIVING AT AND LEAVING WORK .................................................... 15
SLOWER PACE FOR GETTING THE JOB DONE ....................................................................... 16
MORE BREAKS, LONGER BREAKS ............................................................................................ 17
MORE PAID SICK LEAVE OR PAID TIME OFF FOR MEDICAL NEEDS, THERAPY
APPOINTMENTS, ETC. ......................................................................................................... 18
REARRANGED EQUIPMENT OR FURNITURE TO IMPROVE ACCESSIBILITY ....................... 19
MADE CHANGES TO THE BUILDING (E.G., WIDENED DOORS, MADE
RESTROOMS ACCESSIBLE) ................................................................................................ 20
TRANSPORTATION ASSISTANCE (E.G., TO GET BETWEEN BUILDINGS AT
THE WORK SITE) .................................................................................................................. 21
PARKING ACCOMMODATIONS .................................................................................................. 22
EMERGENCY PLAN ACCOUNTS FOR DISABLED WORKER (E.G., EVACUATION
PLAN) ..................................................................................................................................... 23
OTHER (SPECIFY) ....................................................................................................................... 99
___________________________________________________________________(STRING 50)
DON’T KNOW................................................................................................................................ d
REFUSED...................................................................................................................................... r
Prepared by Mathematica Policy Research
43
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
CHECKPOINT: ALL DISABILITIES
IF NO RESPONSES IN 11-14: Have there been any accommodations in the training or supervision you receive
or in your work assignments?
IF NO RESPONSES IN 15-18: Have there been any accommodations in your work schedule, like getting to
arrive or leave work at flexible times, or getting more time to get your work done?
CHECKPOINT: IF DISABILITY IS ORTHOPEDIC, OTHER HEALTH IMPAIRED—OTHER THAN ADD (IF OHI ON
SAMPLE FILE OR B1a NE2 AND B1a1 NE1), MULTIPLE, VISUAL, OR DEAF/BLIND, PROBE:
IF NO RESPONSES IN 8-10: Has there been any person assigned to help you, like a person who helps you get
around your work site or reads materials to you?
IF NO RESPONSES IN 1-7: Have there been any adaptations to the equipment you use, like giving you a
special workstation or different computers or other equipment, because of your disability?
IF NO RESPONSES IN 19-20: Have there been any adaptations to your workplace, like rearranging furniture
or changing doorways or restrooms because of your disability?
IF NO RESPONSES IN 21-24: Have you had any services or supports to help you get around at work, like help
with transportation or parking?
CHECKPOINT: IF DISABILITY IS HEARING IMPAIRED, PROBE:
IF NO RESPONSES IN CATEGORY 2. Has there been any person assigned to help you, like a sign language
interpreter?
YOUTH AGE 15 AND OVER OR THEIR PROXIES.
N55.
{Have you/Has he/she} had a job in the past that {you/he/she} {don’t/doesn’t}
work at anymore? (NEW)
YES ............................................................................... 1
NO ................................................................................. 0
GO TO Section O_Intro
DON’T KNOW ............................................................... d
GO TO Section O_Intro
REFUSED ..................................................................... r
GO TO Section O_Intro
YOUTH AGE 15 AND OVER OR THEIR PROXIES.
N55a.
When {you/he/she} left {your/his/her} most recent former job,... (NLTS2, T12d,
REV)
CODE ONE ONLY
Did {you/he/she} quit, .................................................... 1
{Were you/Was he/she} fired, ........................................ 2
GO TO Section O _Intro
{Were you/Was he/she} laid off, or ................................ 3
GO TO Section O _Intro
Was it a temporary job that ended? .............................. 4
GO TO Section O _Intro
HAVE NOT LEFT A JOB ............................................... 5
GO TO Section O _Intro
DON’T KNOW ............................................................... d
GO TO Section O _Intro
REFUSED ..................................................................... r
GO TO Section O _Intro
Prepared by Mathematica Policy Research
44
Draft Dated 10-10-11
NLTS2012
N55b.
Baseline Interview for Youth
What was the main reason {you/he/she} quit? (NLTS2, T12e)
CODE ONE ONLY
CAN MAKE MORE MONEY ON DISABILITY ................ 15 GO TO Section O _Intro
DIDN’T GET ALONG WITH COWORKERS OR
BOSS ............................................................................ 6
GO TO Section O _Intro
DIDN’T LIKE THE HOURS/KIND OF WORK/
CONDITIONS ................................................................ 4
GO TO Section O _Intro
EMPLOYER WOULDN’T PROVIDE
ACCOMMODATION ...................................................... 10 GO TO Section O _Intro
FAMILY REASONS (PREGNANCY, CARE FOR
FAMILY) ........................................................................ 12 GO TO Section O _Intro
FOUND A BETTER JOB ............................................... 1
GO TO Section O _Intro
ILLNESS OR DISABILITY INTERFERED WITH
JOB ............................................................................... 9
GO TO Section O _Intro
JOB INTERFERED WITH SCHOOL ............................. 8
GO TO Section O _Intro
MOVED ......................................................................... 13 GO TO Section O _Intro
PARENTS DIDN’T WANT YOUTH TO WORK ............. 11 GO TO Section O _Intro
TRANSPORTATION PROBLEMS/HARD TO
GET TO JOB ................................................................. 14 GO TO Section O _Intro
WAGES TOO LOW ....................................................... 5
GO TO Section O _Intro
WANTED TO LOOK FOR A BETTER JOB ................... 2
GO TO Section O _Intro
WANTED TO START OWN BUSINESS/WORK
FOR SELF ..................................................................... 3
GO TO Section O _Intro
WENT BACK TO SCHOOL ........................................... 7
GO TO Section O _Intro
DON’T KNOW ............................................................... d
GO TO Section O _Intro
REFUSED ............................................................................ r
GO TO Section O _Intro
Prepared by Mathematica Policy Research
45
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
O. INDEPENDENT LIVING SKILLS
The next questions ask about {your/NAMEs} life today and
{your/his/her} expectations for {your/his/her} future. Remember,
there are no right or wrong answers.
O1.
(Do you/Does he/she) have…
YES
NO
DK
REF
a. An allowance, or have other money {you/he/she} can
decide how to spend? This could include money
earned from a job. (NLTS2, P16a) ...................................
1
0
d
r
b. A savings account? (NLTS2, P16b).................................
1
0
d
r
c. A checking account where {you write/ he/she writes}
checks or use{s} a debit card? (NLTS2, P16c) ..............
1
0
d
r
YOUTH AGE WHO INDICATE THEY HAVE A CHECKING ACCOUNT (O1C=1).
O2.
Have you ever overdrawn this checking account?
IF NEEDED: By this we mean have you ever spent more than was available in
the account and it resulted in a balance that was less than zero.
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
O3.
{Do You/Does {NAME}} get any bills in {your/his/her} own name that {you
are/he/she is} responsible for paying? (YTD, VIII.B3)
IF NEEDED: This could include a bill for a cell phone, electricity, internet
access, credit card, rent, or a magazine subscription.
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
46
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH AGE 15 AND OVER WHO ARE NOT BLIND OR VISUALLY IMPAIRED BUT NOT
THEIR PROXIES.
O4.
Do you have a driver’s license or learner’s permit? (YTD, VIII.B1)
YES ............................................................................... 1
GO TO O5
NO ................................................................................. 0
DON’T KNOW ............................................................... d
GO TO O5
REFUSED ..................................................................... r
GO TO O5
YOUTH AGE 15 AND OVER WHO ARE NOT BLIND OR VISUALLY IMPAIRED WHO DO NOT
HAVE A DRIVERS LICENSE BUT NOT THEIR PROXIES.
O4a.
How likely do you think it is that you will get a driver’s license? Do you think
you… (YTD, VIII.B2)
CODE ONE ONLY
Definitely will, ................................................................. 1
Probably will, ................................................................. 2
Probably won’t, or .......................................................... 3
Definitely won’t? ............................................................ 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH AGE 18 AND OVER OR THEIR PROXIES.
O5.
{Are you/Is {NAME}} registered to vote? (NLTS2, U9)
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
47
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
P. STUDENT’S SELF-ADVOCACY
P1.
Now I am going read some statements. For each, please tell me the answer
that best tells how you act in that situation. There are no right or wrong
answers. (SDS/ 30, 14, 15, 18, REV)
If your disability limits you from actually performing the activity, but you have
control over the activity – such as a personal care attendant, answer as if you
performed that activity.
I do not
do even
if I have
the
chance
I do
sometimes
when I
have the
chance
I do
most of
the time
I have
the
chance
I do
every
time I
have the
chance
DON’T
KNOW
REFUSED
a. My friends and I choose activities
that we want to do (SDS14) ...............
1
2
3
4
d
r
b. I write letters, texts, or talk on the
phone to friends and family
(SDS15) .............................................
1
2
3
4
d
r
c. I go to restaurants that I like
(SDS18) .............................................
1
2
3
4
d
r
d. I choose gifts to give to family and
friends (SDS30) .................................
1
2
3
4
d
r
e. I go to movies, concerts, and
dances (SDS19).................................
1
2
3
4
d
r
f. I plan weekend activities that I like
to do (SDS12) ....................................
1
2
3
4
d
r
g. I volunteer in things that I am
interested in (SDS17).........................
1
2
3
4
d
r
P2.
Next, I am going to read you two statements. I want you to tell me the one that
best describes you. Choose only one answer. There are no right or wrong
answers. Which of the following statements best describes you? (SDS47)
CODE ONE ONLY
Trying hard at school doesn't do me much good ........... 1
Trying hard at school will help me get a good job ......... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
48
Draft Dated 10-10-11
NLTS2012
P3.
Baseline Interview for Youth
(READ IF NECESSARY) Which of the following statements best describes you?
(SDS49)
CODE ONE ONLY
It is no use to keep trying because that won't
change things ................................................................ 1
I keep trying even after I get something wrong.............. 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
P4.
(READ IF NECESSARY) Which of the following statements best describes you?
(SDS51)
CODE ONE ONLY
I don't know how to make friends .................................. 1
I know how to make friends ........................................... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
P5.
(READ IF NECESSARY) Which of the following statements best describes you?
(SDS53)
CODE ONE ONLY
I do not make good choices .......................................... 1
I can make good choices ............................................... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
P6.
(READ IF NECESSARY) Which of the following statements best describes you?
(SDS57)
CODE ONE ONLY
My choices will not be honored ..................................... 1
I will be able to make choices that are important
to me ............................................................................. 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
49
Draft Dated 10-10-11
NLTS2012
P7.
Baseline Interview for Youth
(READ IF NECESSARY) Which of the following statements best describes you?
(SDS55)
CODE ONE ONLY
I will have a hard time making new friends .................... 1
I will be able to make friends in new situations.............. 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
P8.
(READ IF NECESSARY) Which of the following statements best describes you?
(SDS44)
CODE ONE ONLY
I usually agree with people when they tell me I
can't do something ........................................................ 1
I tell people when I think I can do something that
they tell me I can’t ......................................................... 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
P9.
Now I am going to read some statements. Please tell me whether you think
each of these describes how you feel about yourself or not. There are no right
or wrong answers. Choose answer that best fits you.
PROBE: You agree or you don’t agree?
CODE ONE FOR EACH ROW
AGREE
DON’T
AGREE
DON’T
KNOW
REFUSED
a. I know what I do best (SDS65) .................................
1
2
d
r
b. I like myself (SDS68) ................................................
1
2
d
r
c. I am confident in my abilities (SDS72) ......................
1
2
d
r
d. Other people like me (SDS71). .................................
1
2
d
r
e. It is better to be yourself than to be popular
(SDS63) ....................................................................
1
2
d
r
f. I know how to make up for my limitations (SDS70) ..
1
2
d
r
g. I am loved because I give love (SDS64)...................
1
2
d
r
Prepared by Mathematica Policy Research
50
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
Q. EXPECTATIONS FOR THE FUTURE
ALL YOUTH BUT NOT THEIR PROXIES.
Q1.
As things stand now, how far do you think you will get in school?
CODE ONE ONLY
LESS THAN HIGH SCHOOL (WILL NOT
GRADUATE OR GET GED) .......................................... 1
HIGH SCHOOL DIPLOMA OR GED ............................. 2
TECHNICAL OR TRADE SCHOOL .............................. 3
2 YEAR COLLEGE ....................................................... 4
4-YEAR COLLEGE ....................................................... 5
MASTER’S DEGREE, PHD, OR OTHER
ADVANCED DEGREE .................................................. 6
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
YOUTH WITH AN IEP OR 504 PLAN ONLY – WHO HAVE NOT HAD A PAID JOB TO DATE
Q2
How likely {do you/does he/she} think it is that {you/he/she} will get a paid job
by the time you are 30 years old? {Do you/Does he/she} think {you/he/she}…
(NLTS2, V13, REV)
IF ASKED: MEANS ANY PAID JOB, DOES NOT NEED TO MAKE ENOUGH TO
SUPPORT SELF. (READ CATEGORIES IF NECESSARY)
CODE ONE ONLY
Definitely will, ................................................................. 1
Probably will, ................................................................. 2
Probably won’t, or .......................................................... 3
GO TO Q4
Definitely won’t? ............................................................ 4
GO TO Q4
DON’T KNOW ............................................................... d
GO TO Q4
REFUSED ..................................................................... r
GO TO Q4
Prepared by Mathematica Policy Research
51
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH WITH AN IEP OR 504 PLAN BUT NOT THEIR PROXIES.
Q3.
By the time you are 30 years old, how likely do you think it is that you will earn
enough to support yourself without financial help from your family or
government benefit programs? Do you think you… (NLTS2, V14)
(READ CATEGORIES IF NECESSARY)
CODE ONE ONLY
Definitely will, ................................................................. 1
Probably will, ................................................................. 2
Probably won’t, or .......................................................... 3
Definitely won’t? ............................................................ 4
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
ALL YOUTH AND PROXIES
Q4.
When {you are/he/she is} 30 years old, {do you/does he/she} think {you/he/she}
will be living: (NEW)
CODE ONE ONLY
On my own - without friends of family,........................... 1
At home with parents, .................................................... 2
With a relative, ............................................................... 3
With friends, .................................................................. 4
With a spouse or partner, .............................................. 5
In military housing, ........................................................ 6
In a group home or with supervision,............................. 7
In a larger facility with paid staff (an institution), or........ 8
Somewhere else? (SPECIFY) ....................................... 99
(STRING 150)
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
52
Draft Dated 10-10-11
NLTS2012
Baseline Interview for Youth
YOUTH AGE 15+ BUT NOT THEIR PROXIES.
Q5.
People sometimes face challenges deciding what to do after high school.
Which, if any, are challenges you are facing in deciding what to do after high
school? (NEW)
AGREE
DISAGREE
DK
REF
a. I do not know what kind of jobs I would like or what I
would be good at doing. ..............................................
1
0
d
r
b. I am not getting enough help from school staff in
deciding what to do in learning about different
careers. ........................................................................
1
0
d
r
I do not know what further education is needed for
jobs I might want. .........................................................
1
0
d
r
d. I am not getting enough help from my teachers or
school counselors about what schools I might want to
attend after high school. ..............................................
1
0
d
r
e. I don’t know where to get help paying for college or
other types of schools. .................................................
1
0
d
r
1
0
d
r
c.
f.
Are there any other challenges you face in deciding
what to do after high school? (SPECIFY) ....................
_______________________________(STRING 500)
R. CONTACT INFORMATION FOR FOLLOW UP
R1.
These are the final questions in this survey. As you may
remember, we will contact you for the next survey in two years.
To help us make sure we don’t lose touch with you, it is helpful
for us to make sure we have all of your contact information.
At the start of this interview, you mentioned the best telephone number to
reach you was [CATI: FILL NUMBER FROM J11]. Is there another telephone
number where we can reach {you/him/her}?
YES ............................................................................... 1
NO ................................................................................. 0
GO TO R2
DON’T KNOW ............................................................... d
GO TO R2
REFUSED ..................................................................... r
GO TO R2
Prepared by Mathematica Policy Research
53
Draft Dated 10-10-11
NLTS2012
R1a.
Baseline Interview for Youth
What is that number?
| | | |-| | | |-|
(RANGE)
(RANGE)
| | |
(RANGE)
|
DON’T KNOW ............................................................... d
GO TO IR
REFUSED ..................................................................... r
GO TO R2
International Phone (STRING (NUM))
R1b.
Is that a land line or cell phone?
LANDLINE ..................................................................... 1
GO TO I2
CELL PHONE ................................................................ 2
R1c.
DON’T KNOW ............................................................... d
GO TO I2
REFUSED ..................................................................... r
GO TO I2
Would it be ok for us to send {you/him/her} a text message when we try to
contact {you/him/her} for the next survey?
YES ............................................................................... 1
DOES NOT USE TEXT MESSAGING ON
PHONE .......................................................................... 2
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
R2.
How about email – {do you/ does he/she} have an e-mail address at where we
can send study related information to {you/him/her} at this email address?
This may include things like an email to verify {your/his/her} contact
information, an invitation to complete the survey, or a reminder about the
survey.
YES ............................................................................... 1
NO ................................................................................. 0
GO TO R3
DON’T KNOW ............................................................... d
GO TO R3
REFUSED ..................................................................... r
GO TO R3
Prepared by Mathematica Policy Research
54
Draft Dated 10-10-11
NLTS2012
R2a.
Baseline Interview for Youth
What is the email address {you/he/she} check{s} most often?
(STRING (500))
EMAIL
R3.
DON’T KNOW ............................................................... d
GO TO R3
REFUSED ..................................................................... r
GO TO R3
{Do you/Does he/she} have a Facebook account?
YES ............................................................................... 1
R3a.
NO ................................................................................. 0
GO TO R3
DON’T KNOW ............................................................... d
GO TO R3
REFUSED ..................................................................... r
GO TO R3
May we send you a message{you/him/her} through Facebook if we are unable
to reach {you/him/her} by mail, phone, or {your/his/her} regular email address?
YES ............................................................................... 1
NO ................................................................................. 0
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
R4.
In case we have trouble reaching you directly when we do the next survey, we
would like to get the contact information for another person who will always be
able to each you. Can you give me the name of a friend or relative who does
not live with {you/him/her} and would know how to reach {you/him/her} if
{you/he/she} move{s} or change{s} {your/his/her} telephone number? What is
that person’s name?
(STRING 100)
FIRST NAME
(STRING 100)
MIDDLE INITIAL/NAME
(STRING 100)
LAST NAME
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
55
Draft Dated 10-10-11
NLTS2012
R4a.
Baseline Interview for Youth
Is this person a relative, a friend, or some other person in {your/his/her} life?
IF NEEDED: What is {your/his/her} relationship with this person?
CODE ONE ONLY
MOTHER/FATHER........................................................ 1
BROTHER/SISTER ....................................................... 2
GRAND MOTHER/GRANDFATHER............................. 3
AUNT/UNCLE ............................................................... 4
COUSIN ........................................................................ 5
OTHER RELATIVE ....................................................... 6
FRIEND ......................................................................... 7
CASE MANAGER – SPECIFY NAME OF
AGENCY ....................................................................... 8
(STRING 150)
OTHER NON-RELATIVE .............................................. 98
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
R5.
What is {NAME FROM I5}’s mailing address?
COLLECT/CONFIRM CURRENT CONTACT INFORMATION FOR RESPONDENT
(STRING 100)
ADDRESS 1
(STRING 100)
ADDRESS 2
(STRING 200)
CITY
(STRING 30)
STATE/TERRITORY
| | | | | |-| | |
ZIP CODE (+ 4 IF NEEDED)
|
|
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
Prepared by Mathematica Policy Research
56
Draft Dated 10-10-11
NLTS2012
R6.
Baseline Interview for Youth
What is the best telephone number at which to reach {NAME FROM I5}?
|
|
|
|-|
(RANGE)
|
|
|-|
|
(RANGE)
|
|
|
(RANGE)
DOES NOT HAVE A TELEPHONE NUMBER .............. 1
GO TO R7
DON’T KNOW ............................................................... d
GO TO R7
REFUSED ..................................................................... r
GO TO R7
International Phone (STRING (NUM))
R6a.
Is that a land line or cell phone?
LANDLINE ..................................................................... 1
CELL PHONE ................................................................ 2
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
R7.
Is there another telephone number where we can reach {NAME}?
YES ............................................................................... 1
R7a.
NO ................................................................................. 0
GO TO R8
DON’T KNOW ............................................................... d
GO TO R8
REFUSED ..................................................................... r
GO TO R8
What is that number?
|
|
|
(RANGE)
|-|
|
|
|-|
|
(RANGE)
|
|
|
(RANGE)
DON’T KNOW ............................................................... d
GO TO R8
REFUSED ..................................................................... r
GO TO R8
International Phone (STRING (NUM))
R7b.
Is that a landline or cell phone?
LANDLINE ..................................................................... 1
CELL PHONE ................................................................ 2
DON’T KNOW ............................................................... d
GO TO R10
REFUSED ..................................................................... r
GO TO R10
Prepared by Mathematica Policy Research
57
Draft Dated 10-10-11
NLTS2012
R8.
Baseline Interview for Youth
Does {NAME} have an email address we can use in case we need (his/ her)
help to contact you for the next part of the study?
YES ............................................................................... 1
R9.
NO ................................................................................. 0
GO TO R10
DON’T KNOW ............................................................... d
GO TO R10
REFUSED ..................................................................... r
GO TO R10
What is the email address (he/she) checks most often?
(STRING (500))
EMAIL
DON’T KNOW ............................................................... d
REFUSED ..................................................................... r
R10.
Thank you for answering all these questions. As I said earlier, we will send you
a $10 gift card to thank you for your time. Would you prefer a gift card to
amazon.com (where you can make purchase or download music) , a $10 gift
card to Target, or a $10 gift card to AMC movie theaters? (NEW)
CODE ONE ONLY
A $10 CARD FOR AMAZON.COM,............................... 1
A $10 CARD FOR USE AT TARGET ............................ 2
A $10 CARD FOR AMC MOVIE THEATRES................ 3
This is the end of our survey. You should receive your $10 gift card in the next
few weeks. If you have any questions about the study, or if your contact
information changes, please call us toll-free at 866-964-7963. You can also visit
our website at: http://ies.ed.gov/ncee/nlts. Thanks for taking time to answer
these questions today.
Prepared by Mathematica Policy Research
58
Draft Dated 10-10-11
| File Type | application/pdf |
| File Title | Microsoft Word - APP L PARENT STUDENT FIN_101011.docx |
| Author | hmatulewicz |
| File Modified | 2011-10-11 |
| File Created | 2011-10-11 |