This file contains a listing of every question that will be asked of household parent respondents in the Early Childhood Longitudinal Study, Kindergarten Class of 2022-23 (ECLS-K:2023) preschool field test. For each question, the question wording is provided, along with the item section and number, the construct the item measures, and the specific research question in Part C of this OMB submission for which the item is intended to provide information. This document is based on web specifications in the OMB package approved in November 2019 (#1850-0750 v.19). See attachment E for a discussion of the differences between the web specifications and the paper surveys. Each worksheet in this file pertains to one data collection instrument. Below is a list of the worksheet name and the instrument to which the worksheet pertains. The instruments themselves are provided in Attachment B1 and Attachment B2 of this submission. |
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Worksheet Name | ECLS-K:2023 Preschool Field Test Data Collection Instrument | ||
Screener | Preschool Field Test Household Screener | ||
Parent Survey | Preschool Field Test Parent Survey | ||
Fall Follow-up Survey | Preschool Field Test Fall Follow-up Survey |
Section | Item # | Item Wording | Construct | Research Question | Changes in the web specs from the approved November 2019 OMB package | |
Screener | MyECLS | Are there any children age 10 or younger living in this household? 1 Yes 2 No |
Whether there are children age 10 or younger in the household | NA | ||
Screener | SCR020 | How many children age 10 or younger live in this household? Include small children, foster children, babies, and those living away at school (if they have no other permanent home). | Number of children age 10 or younger | NA | ||
Screener | SCR030 | Please list the first names of all the children age 10 or younger who live in this household. You may provide nicknames or initials if you prefer. Be sure to include all small children, foster children, and babies. Start with the youngest child. Only list children who are age 10 or younger. Enter one child on each line. Enter names until you have listed all children age 10 or younger in this household, then click Next. Youngest child Child {NUMBER}. |
Current household child roster | NA | Based on usability findings, changed "Start with the youngest child who is age 10 or younger" to "Start with the youngest child. Only list children who are age 10 or younger". This was done for the web specifications, rather than for the paper version. Also added "Youngest child" before "Child{NUMBER}". Also added underlining for "age 10 or younger." |
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Screener | SCR040 | How old is {SCR030} in years? For babies less than 1 year old, enter 0. | Current household child roster | 1, 2, 5 | ||
Screener | SCR050 | What is {SCR030}'s sex? 1 Male 2 Female |
Current household child roster | 1, 2, 5 | ||
Screener | SCR060 | Is {SCR030} currently… Select All That Apply 1 Not in school? 2 In public or private school, including preschools? 3 In child care in a home or center? 4 Homeschooled INSTEAD of attending a public school or private school (including preschools) for some or all classes? |
School or preschool enrollment | 1 | ||
Screener | SCR070 | What is {SCR030}'s current grade or grade equivalent? Note: Throughout the survey, click the blue "i" icon for more information about an item. 0 Child care for infants or toddlers in a home or center 1 Preschool or child care for preschool-aged children in a home or center 2 Kindergarten 3 First 4 Second 5 Third 6 Fourth 7 Fifth or above 8 None of these |
Current grade/equivalent | 1 | Added "Note: Throughout the survey, click the blue "i" icon for more information about an item." as a note. Placed instructional text that was on the screen into help text to create more room on the screen. This text was: "Child care for infants or toddlers in a home or center includes early childhood education programs, child care, nursery school, or day care in a center, or child care with a relative or nonrelative other than a parent/guardian. Preschool or child care for preschool-aged children in a home or center includes early childhood education programs, child care, or day care in a center, nursery school, preschool, prekindergarten, or child care with a relative or nonrelative other than a parent/guardian. Kindergarten includes Transitional Kindergarten (TK), Early Transitional Kindergarten (ETK), Readiness Kindergarten, Transitional or Prefirst Grade, or a program that is a kindergarten equivalent but is ungraded or has multiple grades." |
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Screener | SCR080 | What grade or grade equivalent will {SCR030} be in fall 2020? Note: Throughout the survey, click the blue "i" icon for more information about an item. 0 Child care for infants or toddlers in a home or center 1 Preschool or child care for preschool-aged children in a home or center 2 Kindergarten 3 First 4 Second 5 Third 6 Fourth 7 Fifth or above 8 None of these |
Expected grade/equivalent next fall | 1 | Added a note to the screen about the blue "i" icon so that any respondents who do not see SCR070 will see it on SCR080. The note says: "Note: Throughout the survey, click the blue "i" icon for more information about an item." Placed instructional text that was on the screen into help text to create more room on the screen. This text was: "Child care for infants or toddlers in a home or center includes early childhood education programs, child care, or day care in a center, or child care with a relative or nonrelative other than a parent/guardian. Preschool or child care for preschool-aged children in a home or center includes early childhood education programs, child care, or day care in a center, nursery school, preschool, prekindergarten, or child care with a relative or nonrelative other than a parent/guardian. Kindergarten includes Transitional Kindergarten (TK), Early Transitional Kindergarten (ETK), Readiness Kindergarten, Transitional or Prefirst Grade, or a program that is a kindergarten equivalent but is ungraded or has multiple grades." Also, added transitional text "Now we want to ask about your plans for the fall." Transitional text is not included in attachment D, but we are noting this change that came out of usability testing that suggested respondents were not distinguishing this question from the previous question so this text was added in addition to underlining "fall 2020." |
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Screener | SCR095 | {Does/Did} {SCR030} go to a public school for kindergarten? 1 Yes 2 No |
Kindergarten identification for catchment area information | NA | ||
Screener | SCR100 | What public school {does/did} {SCR030} attend for kindergarten? Select the public school {SCR030} {attends/attended} for kindergarten from the list below. If you don’t find a match, select “School not on list” and then type in the full school name. If {SCR030} {has attended/went to} more than one kindergarten, please select or enter the last one attended.” |
Kindergarten identification for catchment area information | NA | ||
Screener | SCR100OS | What public school {does/did} {SCR030} attend for kindergarten? | Other specify for kindergarten identification for catchment area information | NA | ||
Screener | SCR105 | Has {SCR030} always lived at this address? 1 Yes 2 No |
Mobility | NA | ||
Screener | SCR106a | In what month did {SCR030} start living at this address? 1 January 2 February 3 March 4 April 5 May 6 June 7 July 8 August 9 September 10 October 11 November 12 December |
Mobility | NA | ||
Screener | SCR106b | In what year did {SCR030} start living at this address? | Mobility | NA | ||
Screener | SCR110a | This survey is part of the Early Childhood Longitudinal Study, which is conducted by the U.S. Department of Education, National Center for Education Statistics. The next questions should take you about 30 minutes to complete. To show our appreciation for your time, you will receive $10 after you finish the questions. {You may stop and start the survey as needed to work with your schedule.} Before we begin, please enter your name. First Name: |
Parent survey introduction and information for reminder mailings | NA | Changed "sponsored" to "conducted" | |
Screener | SCR110b | Last Name: | Information for reminder mailings | NA | ||
Screener | SCR111a | To allow your answers to be saved so that you can stop and start the survey as needed to work with your schedule, please {enter/confirm} your contact information. Email Address: |
Email address to allow login if exit survey before finishing and contact information was not provided earlier | NA | ||
Screener | SCR111b | To allow your answers to be saved so that you can stop and start the survey as needed to work with your schedule, please {enter/confirm} your contact information. Or Mobile Number: By providing my mobile phone number, I agree to receive a text message to log back into this survey. Message and data rates may apply. |
Mobile number to allow login if exit survey before finishing and contact information was not provided earlier | Added the word "Or" because in usability testing respondents wanted it to be clear that they did not have to enter both pieces of contact information. This also matches the management system. Also added a note about text messaging. |
Section | Item # | Item Wording | Construct | Research Question | Changes in the web specs from the approved November 2019 OMB package |
INQ - Introduction | INQ001 | We would like to collect some information about {CHILD}'s care and home experiences. Your answers will be extremely valuable in better understanding the development of young children and their involvement in early care and education. All of the information you provide may be used only for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required by law (20 U.S.C. §9573 and 6 U.S.C. §151). Are you a person in the household who knows about {CHILD}’s care and education? 1 Yes, I can answer questions about {CHILD}'s care and education. 2 No, I am not able to answer questions about {CHILD}'s care and education. |
Introduction | NA | Added question text and response codes that were in the specifications, but inadvertently left out of attachment D previously. |
INQ005a | We would like to contact a parent or adult who lives in this household and knows about {CHILD}'s care and education. Please provide the contact information for such a person, in this household, so that we can contact him or her for the survey. First Name: |
Alternate respondent selection | NA | ||
INQ005b | Last Name: | Alternate respondent selection | NA | ||
INQ005c | Email Address: | Alternate respondent selection | NA | ||
INQ005d | Please confirm the mailing address. Address Line 1: Address Line 2: |
Alternate respondent selection | NA | ||
INQ005e | City: | Alternate respondent selection | NA | ||
INQ005f | State: Please select a state, district, or territory. |
Alternate respondent selection | NA | ||
INQ005g | Zip code: | Alternate respondent selection | NA | ||
INQ010 | We asked you earlier for {CHILD’s} first name so that we can ask questions about {CHILD} in the following survey. If there is a typo, or you gave a nickname or initials for this child, you may correct it here before continuing. What is {CHILD}'s first name? First Name: |
Child name | NA | ||
INQ015 | How old is {CHILD} in years? Years: |
Child age | NA | ||
PSQ - Preschool Skills | PSQ020 | Can {CHILD} identify the colors red, yellow, blue, and green by name? This can be done in any language. 1 No, none of them 2 Yes, some of them 3 Yes, all of them |
Ratings of child competence in literacy, language, and mathematics | 2 | |
PSQ025 | Can {CHILD} correctly recognize the letters of the alphabet? This can be done in any language. 1 No, none of them 2 Yes, some of them 3 Yes, most of them 4 Yes, all of them |
Ratings of child competence in literacy, language, and mathematics | 2 | ||
PSQ030 | Can {CHILD} write {his/her} first name, even if some of the letters are backwards? This can be done in any language. 1 Yes 2 No |
Ratings of child competence in literacy, language, and mathematics | 2 | ||
PSQ035 | How often can {CHILD} explain things {he/she} has seen or done so that you get a very good idea of what happened? This can be done in any language. 1 Never 2 Sometimes 3 About half the time 4 Usually 5 Always |
Ratings of child competence in literacy, language, and mathematics | 2 | ||
PSQ040 | How high can {CHILD} count? This can be done in any language. 1 This child cannot count. 2 Up to 5 3 Up to 10 4 Up to 20 5 Up to 50 6 Up to 100 or more |
Ratings of child competence in literacy, language, and mathematics | 2 | Added period to end of first response category. | |
PSQ045 | Can {CHILD} identify basic shapes such as a triangle, rectangle, circle, or square? This can be done in any language. 1 No, none of them 2 Yes, some of them 3 Yes, most of them 4 Yes, all of them |
Ratings of child competence in literacy, language, and mathematics | 2 | ||
PSQ050 a-d | Please select whether {CHILD} does the following. Have you observed that {CHILD}... | Child language use | 2 | ||
PSQ050a | Tries repeatedly to communicate information which has not been understood? 1 Yes 2 No |
Child language use | 2 | ||
PSQ050b | Asks questions about information which is unclear? 1 Yes 2 No |
Child language use | 2 | ||
PSQ050c | Responds to questions in a thoughtful way that makes sense? 1 Yes 2 No |
Child language use | 2 | ||
PSQ050d | Rephrases questions or asks follow-up questions if {he/she} does not get the information {he/she} wanted. 1 Yes 2 No |
Child language use | 2 | ||
PSQ055 | Please select the words your child uses in English. If {CHILD} uses a different pronunciation of a word, that’s OK. Does {CHILD} say... Select All That Apply. 1 hungry 2 baby 3 doctor 4 down 5 bird 6 fruit 7 triangle 8 turtle 9 plant 10 last 11 caterpillar 12 castle 13 excited 14 stamp 15 parent 16 lucky 17 furniture 18 drip 19 measure 20 calm 21 lonely 22 dive 23 skeleton 24 uncomfortable 25 courage |
Child vocabulary | 2 | Changed from separate items PSQ055 1-25 to one item PSQ055 with 25 response codes. | |
PLQ - Primary Language(s) Spoken | PLQ060 | What is the primary language spoken in your home? 1 English 2 A language other than English 3 Two or more languages are spoken the same amount |
Primary home language | 1, 2 | |
PLQ060a | You mentioned a language other than English as your primary language spoken at home. What is it? 1 Spanish 2 A European language other than Spanish such as French, German, or Russian 3 A Chinese language or dialect 4 A Filipino language 5 A Southeast Asian language such as Vietnamese, Thai, or Khmer 6 A South Asian language such as Hindi or Tamil 7 Another Asian language such as Japanese or Korean 8 A Middle Eastern language such as Arabic or Farsi 9 An African language such as Swahili or Amharic 91 Other language (Please specify): |
Primary home language | 1, 2 | Deleted duplicate words "such as" in "such as such as" Changed code 91 from "Another language" to "Other language" |
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PLQ060aOS | You mentioned a language other than English as your primary language spoken at home. What is it? |
Other specify field for primary home language | |||
PLQ060b | You mentioned that two or more languages are spoken equally at home. What are these languages? Select one or more choices below for the languages that are spoken in your home. If more than one language falls in the same category below, select that category. If there is not a choice for the language(s) spoken in your home, type the language(s) in under “Other languages (Please specify).” 0 English 1 Spanish 2 A European language other than Spanish such as French, German, or Russian 3 A Chinese language or dialect 4 A Filipino language 5 A Southeast Asian language such as Vietnamese, Thai, or Khmer 6 A South Asian language such as Hindi or Tamil 7 Another Asian language such as Japanese or Korean 8 A Middle Eastern language such as Arabic or Farsi 9 An African language such as Swahili or Amharic 91 Other language(s) (Please specify): |
Primary home language | 1, 2 | Deleted extra words "more than" in "You mentioned that more than two or more languages." Deleted duplicate words "such as" in "such as such as" Changed "Another language" to "Other language" |
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PLQ060bOS | You mentioned that two or more languages are spoken equally at home. What are these languages? Select one or more choices below for the languages that are spoken in your home. If more than one language falls in the same category below, select that category. If there is not a choice for the language(s) spoken in your home, type the language(s) in under “Other language(s) (Please specify).” |
Other specify field for primary home language | Deleted extra words "more than" in "You mentioned that more than two or more languages." Changed "Another language" to "Other language" |
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HEQ - Home Environment, Activities, and Cognitive Stimulation | HEQ010 a-i | In a typical week, how often do you or any other family members do the following things with {CHILD}? | Home learning activities | 2 | |
HEQ010a | Tell stories to {CHILD} 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010b | Sing songs with {CHILD} 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010c | Help {CHILD} to do arts and crafts 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010d | Involve {CHILD} in household chores, like cooking, cleaning, setting the table, or caring for pets 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010e | Play games or do puzzles with {CHILD} 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010f | Talk about nature or do science projects with {CHILD} 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010g | Build something or play with construction toys with {CHILD} 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010h | Play a sport or exercise together 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ010i | Practice reading, writing or working with numbers 1 Not at all 2 Once or twice a week 3 3-6 times a week 4 Every day |
Home learning activities | 2 | ||
HEQ020 | How often do you or other family members use a language other than English when doing any of the activities listed in the previous question? 1 Always 2 Most of the time 3 Sometimes 4 Never |
Language other than English used in the home for home learning activities | 2 | ||
HEQ030 | In a typical week, how often do you or any other family members read books to {CHILD}? Include only times family members have read books to the child. Do not include times when the child reads or looks at books by him or herself. Please include reading of books in any language. 1- Not at all 2- Once or twice a week 3 - 3-6 times a week 4- Every day |
Reading to the child | 2 | ||
HEQ036 | Generally, how long is {CHILD} read to at each of these times? Please include reading in any language. Minutes: |
Reading to the child | 2 | ||
HEQ036a-c | How often do you and {CHILD} do the following: | Reading to the child | 2 | ||
HEQ036a | When you and your child are reading together, how often does she or he start talking about the story or something it has reminded her or him of? 1 Almost never 2 Rarely 3 Sometimes 4 Often 5 Very often 6 Almost always |
Reading to the child | 2 | ||
HEQ036b | When you and your child are reading books with pictures together, how often do you spend time talking about the pictures? 1 Almost never 2 Rarely 3 Sometimes 4 Often 5 Very often 6 Almost always |
Reading to the child | 2 | ||
HEQ036c | How often do you and your child talk about a book you read sometime in the past? 1 Almost never 2 Rarely 3 Sometimes 4 Often 5 Very often 6 Almost always |
Reading to the child | 2 | ||
HEQ060 | Now, please think about the past week. How often did {CHILD} look at picture books in the past week? 1 Never 2 Once or twice a week 3 3 to 6 times a week 4 Every day |
Reading to the child | 2 | ||
HEQ070 | Read to or pretend to read to {himself/herself} or to others? 1 Never 2 Once or twice a week 3 3 to 6 times a week 4 Every day |
Reading to the child | 2 | ||
HEQ071 a-l | How often does {CHILD}: | Math activities | 2 | ||
HEQ071a | Count objects? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071b | Add or subtract things? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071c | Write numbers? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071d | Match or identify shapes? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071e | Play cards or board games? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071f | Play with jigsaw puzzles? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071g | Play with blocks or construction toys? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071h | Identify or create patterns? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071i | Put objects in order (for example, small to large)? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071j | Measure things (for example, using a ruler, in cooking, etc.)? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071k | Keep score in games? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ071l | Answer/ask questions about "How many things are there?" (for example, "How many plates are on the table?")? 0 Never/almost never 1 Less than once a week 2 Once a week to several times a week 3 Every day or almost every day |
Math activities | 2 | ||
HEQ072 | How often do you play number games or talk about numbers with {CHILD}? 1 Never 2 Once a month 3 Less than once a week 4 Once a week 5 2-3 times a week 6 Every day 7 More than once a day |
Math activities | 2 | ||
HEQ073 | How much does {CHILD} enjoy number or math activities like counting objects, making patterns, measuring things, etc.? 1 Not at all 2 A little 3 A fair amount 4 Much 5 Very much |
Math activities | 2 | ||
HEQ075 a-h | How much do you agree or disagree with the following statements about what it is usually like living in your home? | Amount of chaos in the home | 2, 5 | ||
HEQ075a | We almost always seem to be rushed. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075b | We are usually able to stay on top of things. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075c | No matter how hard we try, we always seem to be running late. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075d | No matter what our family plans, it usually doesn't seem to work out. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075e | You can't hear yourself think. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075f | It is a good place to relax. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075g | The atmosphere is calm. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ075h | In the morning, we have a regular routine. 1 Strongly disagree 2 3 4 5 Strongly agree |
Amount of chaos in the home | 2, 5 | ||
HEQ272 a-h | Do you have the following in your home that {CHILD} may use? | Media engagement and usage | 2 | ||
HEQ272a | Smartphone 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272b | Cell phone (for example, not a smartphone or other phone that can also access the internet) 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272c | Tablet (for example, iPad or other tablet) 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272d | Laptop or desktop computer 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272e | Reading device (for example, Kindle or Fire) 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272f | iPod 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272g | Electronic assistant or smart speaker (for example, Alexa, Google Assistant, or Siri) 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ272h | Game system (for example, Playstation, Wii, or Xbox, or handheld devices such as a Nintendo DS, or Sony PSP) 1 Yes, {CHILD} shares this with other family member(s) 2 Yes, {CHILD} has {his/her} own 3 No |
Media engagement and usage | 2 | ||
HEQ273a | On any given weekday, how much time does {CHILD} spend watching shows, movies, and videos? Hours: |
Media engagement and usage-hours | 2 | ||
HEQ273b | On any given weekday, how much time does {CHILD} spend watching shows, movies, and videos? Minutes: |
Media engagement and usage-minutes | 2 | ||
HEQ274a | On any given weekday, how much time does {CHILD} spend playing video, computer, or mobile games? Hours: |
Media engagement and usage-hours | 2 | ||
HEQ274b | On any given weekday, how much time does {CHILD} spend playing video, computer, or mobile games? Minutes: |
Media engagement and usage-minutes | 2 | ||
HEQ275 | How often does {CHILD} have a TV, smartphone, tablet, or laptop in {his/her} room overnight? 1 Every night 2 Most nights 3 Some nights 4 Hardly ever 5 Never |
Media engagement and usage | 2 | ||
HEQ276 a-b | When {CHILD} is doing the following, how often do you or another adult in the household do it with {him/her}? | Media engagement and usage | 2 | ||
HEQ276a | Watching {his/her} shows, movies, and videos 1 Most of the time 2 Some of the time 3 Hardly ever 4 Never 5 {CHILD} does not do this |
Media engagement and usage | 2 | ||
HEQ276b | Playing video, computer, or mobile games 1 Most of the time 2 Some of the time 3 Hardly ever 4 Never 5 {CHILD} does not do this |
Media engagement and usage | 2 | ||
HEQ277 | Do you have Internet (cable, Wifi, wireless, or DSL) in your home? 1 Yes 2 No |
Media engagement and usage | 2 | ||
HEQ278 | Does {CHILD} use any electronic or digital device(s) to get on the Internet in your home? 1 Yes 2 No |
Media engagement and usage | 2 | Added "electronic or" in front of "digital" because respondents did not understand digital. | |
HEQ279 | Do you ever use any type of software, app, or device to monitor or limit {CHILD}'s access to the Internet? 1 Yes 2 No |
Media engagement and usage | 2 | ||
HEQ285 | Are there family rules about how many hours {CHILD} may spend on screen time? Screen time refers to the amount of time the child is using a TV, computer, or any other digital device in which the child is looking at a screen during use. 1 Yes 2 No |
Media engagement and usage | 2 | ||
HEQ285a | In what ways do you limit {CHILD}'s screen time? Select All That Apply. 1 With a device or app 2 Ask my child to end screen time 3 Redirect my child to other activity 4 Take away the device from my child 91 Other (Please specify): |
Media engagement and usage | 2 | Made "Please Select All That Apply" in attachment D be "Select All That Apply" (this matches the original Attachment B1). | |
HEQ285aOS | In what ways do you limit {CHILD}'s screen time? | Other specify for media engagement and usage | |||
HEQ288 | Now we'd like to ask you about some of the activities your child might do. Has {CHILD} ever participated in any of the following activities? Select All That Apply. 1 Organized athletic activities, like basketball, soccer, baseball, swimming, or gymnastics 2 Dance groups, classes, or lessons 3 Music, for example, piano, instrumental music, or singing lessons 4 Drama groups, classes, or lessons 5 Art groups, classes, or lessons, for example, painting, drawing, sculpture 6 Craft groups, classes, or lessons 7 Language groups, classes, or lessons (to learn English or another language) |
Children's organized activities | 2 | ||
HEQ289 | In the past month, that is, since {CURRENT DATE -1 MONTH}, has anyone in your family done the following with {CHILD}? Select All That Apply. 1 Visited a library or bookstore (Do not count visiting a library or bookstore online. We are asking about in person visits to a library or bookstore.) 2 Gone to a play, concert, or other live show 3 Visited an art gallery, museum, or historical site 4 Visited a zoo, aquarium, or petting farm 5 Attended an athletic or sporting event in which {CHILD} was not a player 6 Gone to a park |
Outings | 2 | Replaced "{MONTH} {DAY}" with "{CURRENT DATE -1 MONTH}" to be make the display instruction clear for programming. Changed "...has anyone in your family visited the following..." to "...has anyone in your family done the following..." |
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HEQ520 | In a typical week, please indicate the number of days your family eats any meal together. By family, we mean at least one adult and one child. Days: |
Eating a meal together | 2 | Added "Days:" | |
HEQ521 | In a typical week, please indicate the number of days your family eats the evening meal together. By family, we mean at least one adult and one child. Days: |
Eating the evening meal together | 2 | Added "Days:" | |
HEQ540 | During a typical week, how often does {CHILD} play outside actively (for example, running, jumping, or swinging? 1 Never 2 Once or twice 3 3 to 6 times 4 Every day |
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HEQ545 | How safe is it for children to play outside during the day in your neighborhood? 1 Not at all safe 2 Somewhat safe 3 Very safe |
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HEQ550 | Does {CHILD} usually go to bed at about the same time each night, or does {his/her} bedtime vary a lot from night to night? 1 Has usual bedtime 2 Bedtime varies |
Whether child has a regular bedtime | 2 | ||
HEQ600a | On an average weeknight, how many hours of sleep does {CHILD} get? Hours: |
Sleep-hours | 2 | ||
HEQ600b | On an average weeknight, how many hours of sleep does {CHILD} get? Minutes: |
Sleep-minutes | 2 | ||
KSQ - Kindergarten Selection and Choice | KSQ005 | Some parents know in advance where their children will attend kindergarten. Do you know where {CHILD} will attend kindergarten? 1 Yes 2 No |
School where child is expected to attend kindergarten | 4 | The KSQ section was moved to an earlier section (here) in the survey to make it more likely that school information is obtained in the field test, even if respondents break off early in the survey. |
KSQ010 | What is the name of the school where {CHILD} will attend {kindergarten/next year}? Select the school from the list below. If you don't find the school, select "School not on list" and then type in the full school name. If you are considering more than one school, enter the name of the school that is most likely. |
School where child is expected to attend kindergarten | 4 | ||
KSQ010OS | What is the name of the school where {CHILD} will attend {kindergarten/next year}? | Other specifiy for school where child is expected to attend kindergarten | 4 | ||
KSQ015a | What is the mailing address of the school? Address Line 1: Address Line 2: |
School where child is expected to attend kindergarten | 4 | ||
KSQ015b | City: | School where child is expected to attend kindergarten | 4 | ||
KSQ015c | State: Please select a state, district, or territory. |
School where child is expected to attend kindergarten | 4 | ||
KSQ015d | Zip code: | School where child is expected to attend kindergarten | 4 | ||
KSQ020 | How did you learn about the school where {CHILD} will attend kindergarten? Select All That Apply. 1 It is the assigned school for our neighborhood 2 Word of mouth/recommendation from family, friends, etc. 3 District/school website 4 Looked at school's profile online 5 Looked at school's ratings online from other parents 91 Other (specify) |
How respondent learned of selected kindergarten | 4 | ||
KSQ020OS | How did you learn about the school where {CHILD} will attend kindergarten? | Other specify for how respondent learned of selected kindergarten | |||
KSQ025 | Even though many factors matter when choosing a kindergarten, which three factors below are the most important to you? Please choose only three choices. 1 Offers convenient hours (for example, is a full day kindergarten program, or offers before- or after-school care) 2 Offers services for children with special needs 3 Teaches children how to get along well with others 4 Is in a convenient location (close to your home, work, or public transportation) 5 Has a warm and nurturing teacher(s) 6 Provides a safe and clean environment 7 Provides transportation 8 Is free or is the least expensive option 8 Teaches children letters, numbers, and other academic skills 10 Accepts payment from a tuition assistance/voucher program in my state 11 Also serves my other children (for example, the program is located in a school where an older sibling is enrolled) 12 Offers specialized programs or curriculum (for example, drama, arts, foreign languages, Montessori, modified calendar, etc.) 13 Is in an elementary school that feeds into a desired middle or high school 14 Has a good reputation or high rating (for example, heard good things about the school from friends, family, neighbors, etc.) 15 Very good value 16 Promotes racial/cultural inclusivity 17 A language other than English is used as the teaching language 18 It is the assigned public school for the neighborhood |
Reasons for choosing kindergarten | 4 | Changed response codes from letters to numbers | |
SSQ Social Skills, Problem Behaviors, and Approaches Toward Learning | SSQ010 a-n | Please indicate how often {CHILD} acts this way. | Approaches to Learning | 2, 5 | |
SSQ010a | Keeps working at something until {he/she} is finished 1 Never 2 Sometime 3 Often 4 Very often |
Approaches to Learning | 2, 5 | ||
SSQ010b | Shows interest in a variety of things 1 Never 2 Sometime 3 Often 4 Very often |
Approaches to Learning | 2, 5 | ||
SSQ010c | Concentrates on a task and ignores distractions 1 Never 2 Sometime 3 Often 4 Very often |
Approaches to Learning | 2, 5 | ||
SSQ010d | Helps with chores 1 Never 2 Sometime 3 Often 4 Very often |
Approaches to Learning | 2, 5 | ||
SSQ010e | Is eager to learn new things 1 Never 2 Sometime 3 Often 4 Very often |
Approaches to Learning | 2, 5 | ||
SSQ010f | Is creative in work or in play 1 Never 2 Sometime 3 Often 4 Very often |
Approaches to Learning | 2, 5 | ||
SSQ010g | Item wording is redacted due to copyright | Social interaction | 2, 5 | ||
SSQ010h | Item wording is redacted due to copyright | Social interaction | 2, 5 | ||
SSQ010i | Item wording is redacted due to copyright | Social interaction | 2, 5 | ||
SSQ010j | Item wording is redacted due to copyright | Self-control | 2, 5 | ||
SSQ010k | Item wording is redacted due to copyright | Self-control | 2, 5 | ||
SSQ010l | Item wording is redacted due to copyright | Self-control | 2, 5 | ||
SSQ010m | Item wording is redacted due to copyright | Self-control | 2, 5 | ||
SSQ010n | Item wording is redacted due to copyright | Self-control | 2, 5 | ||
SSQ020 a-f | Please rate how true each of these statements is for {CHILD}. | Attention Focusing | 2, 5 | ||
SSQ020a | When practicing an activity, has a hard time keeping {her/his} mind on it. 1 Extremely untrue of your child 2 3 4 5 6 7 Extremely true of your child |
Attention Focusing | 2, 5 | ||
SSQ020b | Will move from one task to another without completing any of them. 1 Extremely untrue of your child 2 3 4 5 6 7 Extremely true of your child |
Attention Focusing | 2, 5 | ||
SSQ020c | When drawing or coloring in a book, shows strong concentration. 1 Extremely untrue of your child 2 3 4 5 6 7 Extremely true of your child |
Attention Focusing | 2, 5 | ||
SSQ020d | When building or putting something together, becomes very involved in what {he/she} is doing, and works for long periods of time. 1 Extremely untrue of your child 2 3 4 5 6 7 Extremely true of your child |
Attention Focusing | 2, 5 | ||
SSQ020e | Is easily distracted when listening to a story. 1 Extremely untrue of your child 2 3 4 5 6 7 Extremely true of your child |
Attention Focusing | 2, 5 | ||
SSQ020f | Sometimes becomes absorbed in a picture book and looks at it for a long time. 1 Extremely untrue of your child 2 3 4 5 6 7 Extremely true of your child |
Attention Focusing | 2, 5 | ||
SSQ025 a-f | Please rate how true each of these statements is for {CHILD}. | Inhibitory Control | 2, 5 | ||
SSQ025a | Can wait before entering into new activities if asked to 1 Extremely untrue of your child 2 3 4 5 Extremely true of your child |
Inhibitory Control | 2, 5 | ||
SSQ025b | Plans for new activities or changes in routine to make sure {he/she} has what will be needed 1 Extremely untrue of your child 2 3 4 5 Extremely true of your child |
Inhibitory Control | 2, 5 | ||
SSQ025c | Has trouble sitting still when {he/she} is told to (story time, etc.) 1 Extremely untrue of your child 2 3 4 5 Extremely true of your child |
Inhibitory Control | 2, 5 | ||
SSQ025d | Is good at following instructions 1 Extremely untrue of your child 2 3 4 5 Extremely true of your child |
Inhibitory Control | 2, 5 | ||
SSQ025e | Approaches places that {he/she} thinks might be "risky" slowly and cautiously 1 Extremely untrue of your child 2 3 4 5 Extremely true of your child |
Inhibitory Control | 2, 5 | ||
SSQ025f | Can easily stop an activity when told "no" 1 Extremely untrue of your child 2 3 4 5 Extremely true of your child |
Inhibitory Control | 2, 5 | ||
SSQ030 a-e | How much do you agree or disagree with the following statements about {CHILD}? | Affective empathy | 2, 5 | Changed "." to "?" | |
SSQ030a | My child becomes sad when other children are sad. 1 Strongly disagree 2 3 Neither disagree nor agree 4 5 Strongly agree |
Affective empathy | 2, 5 | ||
SSQ030b | My child gets upset seeing another child being punished for being naughty. 1 Strongly disagree 2 3 Neither disagree nor agree 4 5 Strongly agree |
Affective empathy | 2, 5 | ||
SSQ030c | My child seems to react to the moods of people around them. 1 Strongly disagree 2 3 Neither disagree nor agree 4 5 Strongly agree |
Affective empathy | 2, 5 | ||
SSQ030d | My child gets upset when another person is acting upset. 1 Strongly disagree 2 3 Neither disagree nor agree 4 5 Strongly agree |
Affective empathy | 2, 5 | ||
SSQ030e | My child cries or gets upset when seeing another child cry. 1 Strongly disagree 2 3 Neither disagree nor agree 4 5 Strongly agree |
Affective empathy | 2, 5 | ||
FSQ -Family Structure | FSQ010 | Please confirm the names or initials of the household members you already told us about before and add the first names of all the other people who normally live here, including both adults and children. Please do not include anyone staying here temporarily who usually lives somewhere else. We ask for first names so that we can ask questions about each person in the survey. If there is a typo, or you gave a nickname or initials, you may correct it here before continuing. Please list each person in your household on a separate line, until you have listed all the people in your household. Don't forget… -your spouse or partner, or -someone who is temporarily away from home or living in a dorm at school, or -any babies or small children. To add additional members of the household, press the enter key. When you are finished, select the Next button. First name Household member 1 {DISPLAY FIRST NAME OF RESPONDENT} Household member 2 {DISPLAY FIRST NAME OF SAMPLED CHILD} Household member 3 {DISPLAY FIRST NAMES OF ALL OTHER CHILDREN LISTED IN SCREENER, IF APPLICABLE} |
Current household roster | 1, 2, 5 | Changed: {DISPLAY FIRST NAME OF RESPONDENT} {DISPLAY FIRST NAME OF SAMPLED CHILD} {DISPLAY FIRST NAMES OF ALL OTHER CHILDREN LISTED IN SCREENER, IF APPLICABLE} to Household member 1 {DISPLAY FIRST NAME OF RESPONDENT} Household member 2 {DISPLAY FIRST NAME OF SAMPLED CHILD} Household member 3 {DISPLAY FIRST NAMES OF ALL OTHER CHILDREN LISTED IN SCREENER, IF APPLICABLE} |
FSQ030 | How old {are you/is {NAME}}? For babies less than 1 year old, enter 0. Age: |
Current household roster | 1, 2, 5 | Added "Age:" | |
FSQ040 | {Are you/Is {NAME}} male or female? 1 Male 2 Female |
Current household roster | 1, 2, 5 | Changed "female?}." to "female?" | |
FSQ110 | Do you have a spouse or partner who lives in this household? 1 Yes 2 No |
Marital status of the primary caregivers | 1, 2, 5 | ||
FSQ120 | Who in the household is your spouse or partner? Select the name of the person who is your spouse/partner. If name not listed, select "not on list." 1 {DISPLAY HH MEMBER NAME 1} 2 {DISPLAY HH MEMBER NAME 2} 3 {DISPLAY HH MEMBER NAME 3} 4 {DISPLAY HH MEMBER NAME 4} 5 {DISPLAY HH MEMBER NAME 5} 6 {DISPLAY HH MEMBER NAME 6} 7 {DISPLAY HH MEMBER NAME 7} 8 {DISPLAY HH MEMBER NAME 8} 36 Not on list |
Marital status of the primary caregivers | 1, 2, 5 | Deleted "number next to the" in the second sentence so that it just reads "Select the name of the person who is your spouse/partner. " Updated response code (36) for response option "Not on list" |
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FSQ120a | What is the first name of your spouse or partner? First name: |
Marital status of the primary caregivers | 1, 2, 5 | ||
FSQ120b | How old is {NAME}? Age: |
Current household roster | 1, 2, 5 | Added "Age:" | |
FSQ120c | Is {NAME} male or female? 1 Male 2 Female |
Current household roster | 1, 2, 5 | ||
FSQ130 | What is {your/{NAME}'s} relationship to {CHILD}? 1 Mother/female guardian 2 Father/male guardian 3 Other parent/guardian 4 Sister 5 Brother 6 Girlfriend or female partner of {CHILD}'s parent/guardian 7 Boyfriend or male partner of {CHILD}'s parent/guardian 8 Other partner of {CHILD}'s parent/guardian 9 Grandmother 10 Grandfather 11 Aunt 12 Uncle 13 Cousin 14 Other relative 15 Other non-relative |
Relationship of household member to child | 1, 2, 5 | ||
FSQ140 | {Are you/Is {NAME}} {CHILD}'s… 1 Biological or birth mother 2 Adoptive mother 3 Step mother 4 Foster mother or legal female guardian 5 Other female parent or guardian |
Relationship of household member to child | 1, 2, 5 | There was a spec change on code 4 from “guardian, or” to “guardian”. This change was already in attachment D. | |
FSQ150 | {Are you/Is {NAME}} {CHILD}'s… 1 Biological or birth father 2 Adoptive father 3 Step father 4 Foster father or legal male guardian 5 Other male parent or guardian |
Relationship of household member to child | 1, 2, 5 | ||
FSQ155 | {Are you/Is {NAME}} {CHILD}'s… 1 Biological or birth parent 1 Adoptive parent 3 Step parent 4 Foster parent or legal guardian 5 Other parent or guardian |
Relationship of household member to child | 1, 2, 5 | ||
FSQ160 | {Are you/Is {NAME}} {CHILD}'s… 1 Full sister 2 Half sister 3 Step sister 4 Adoptive sister 5 Foster sister |
Relationship of household member to child | 1, 2, 5 | ||
FSQ170 | {Are you/Is {NAME}} {CHILD}'s… 1 Full brother 2 Half brother 3 Step brother 4 Adoptive brother 5 Foster brother |
Relationship of household member to child | 1, 2, 5 | ||
FSQ180 | {Are you/Is {NAME}} a… 1 Girlfriend or female partner of {CHILD}'s parent/guardian 2 Boyfriend or male partner of {CHILD }'s parent/guardian 3 Other partner of {CHILD}'s parent/guardian 4 Female guardian 5 Male guardian 6 Other guardian 7 Daughter/son of {CHILD}'s parent's partner 8 Other relative of {CHILD}'s parent's partner 91 Other non-relative (Please specify): |
Relationship of household member to child | 1, 2, 5 | Deleted "{CHILD}" in stem because {CHILD} was repeated in so many of the response categories. Added the word "a" to make the question work better (changed stem to "{Are you/Is {NAME}} a …"). | |
FSQ180OS | {Are you/Is {NAME}} {CHILD}'s… | Other specify for relationship of household member to child | 1, 2, 5 | ||
FSQ190 | {Are you/Is {NAME}} Hispanic or Latina/Latino? A person who is Hispanic or Latino/Latina is of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race. 1 Yes 2 No |
Ethnicity of child, parent figures, or respondent and respondent's spouse (if no mother or father figures) | 1, 2, 5 | Changed "A person who is Hispanic or Latino" to "A person who is Hispanic or Latino/Latina" | |
FSQ195 | What is {your/{NAME}'s} race? You may name one or more races to indicate what {you/NAME} {consider/considers} {yourself/himself/herself/themself} to be. For the purposes of this study, Hispanic origins are not races. Select All That Apply. 1 American Indian or Alaska Native 2 Asian 3 Black or African American 4 Native Hawaiian or other Pacific Islander 5 White |
Race of child, parent figures, or respondent and respondent's spouse (if no mother or father figures) | 1, 2, 5 | ||
FSQ200 | {FILL 1} currently married, separated, divorced, widowed, in a domestic partnership, or {FILL 2} never been married? 1 Married 2 Separated 3 Divorced 4 Widowed 5 Never married 6 Civil unions/domestic parthership I don't know (Please explain): |
Marital status of the primary caretakers | 1, 2, 5 | Fill instructions that were referenced in this question in OMB attachment B1 are now shown as part of item FSQ200. Replaced "Don't know" with "I don't know (Please explain):" and added an other specify field. An other specify field was added based on findings from usability testing that relationships that are not fully established are hard to classify. The other specify field will provide more information about these relationships. |
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FSQ200OS | {FILL 1} currently married, separated, divorced, widowed, in a domestic partnership, or {FILL 2} never been married? Please explain: |
Other specify for marital status | An other specify field was added based on findings from usability testing that relationships that are not fully established are hard to classify. The other specify field will provide more information about these relationships. | ||
CCQ - Child Care | CCQ010 | Is {CHILD} now receiving care from a relative on a regular basis? This may include grandparents, brothers and sisters, or any relatives other than {you/{CHILD}'s {parents/guardians}}. Care from a relative would be with any relative other than the child’s parents and would take place in a private home. It may be free or cost money. It should be a regular child care arrangement rather than occasional babysitting or back-up care. If you are separated or divorced, please do not include visitation with a parent who does not have custody. 1 Yes 2 No |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | |
CCQ015 | Has {CHILD} ever received care from a relative on a regular basis? 1 Yes 2 No |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | ||
CCQ020a | How old was {CHILD} in years and months when {he/she} first received care from any relative on a regular basis? Years: |
Type and amount of ECE arrangements (relative)-years | 1, 2, 3 | Added "Years:" | |
CCQ020b | How old was {CHILD} in years and months when {he/she} first received care from any relative on a regular basis? Months: |
Type and amount of ECE arrangements (relative)-months | 1, 2, 3 | Added "Months:" | |
CCQ060 | How many different regular care arrangements do you currently have with relatives? Please do not include care from a parent or guardian who lives in the home or elsewhere. 1 One 2 Two 3 Three 4 Four 5 Five or more |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | ||
CCQ065 | {We’d like to know more about the relative who provides the most care for {CHILD} now.} Who is the relative who cares for {CHILD}? Please do not include care from a parent or guardian who lives in the home or elsewhere. 1 Grandparent 2 Aunt 3 Uncle 4 Brother 5 Sister 6 Another relative |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | ||
CCQ085 | How many days each week does {CHILD} receive care from {{his/her} RELATIVE}/that relative}? Days: |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | Added "Days:" | |
CCQ090 | How many hours each week does {CHILD} receive care from {{his/her} RELATIVE}/that relative}? Enter the hours each week in whole hours. Hours: |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | Added "Hours:" | |
CCQ095 | How long has {CHILD} received care from {his/her} relative in the last year? 1 One to two months 2 Three to five months 3 Six to eight months 4 Nine to eleven months 5 Twelve months |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | ||
CCQ096 | What language does {CHILD}’s relative speak most when caring for {CHILD}? 0 English 1 Spanish 2 A European language other than Spanish such as French, German, or Russian 3 A Chinese language or dialect 4 A Filipino language 5 A Southeast Asian language such as Vietnamese, Thai, or Khmer 6 A South Asian language such as Hindi or Tamil 7 Another Asian language such as Japanese or Korean 8 A Middle Eastern language such as Arabic or Farsi 9 An African language such as Swahili or Amharic 91 Another language (Please specify): |
Characteristics of providers (relative) | 1, 2, 3 | Deleted duplicate words "such as" in "such as such as" | |
CCQ096OS | What language does {CHILD}’s relative speak most when caring for {CHILD}? | Other specify for characteristics of providers (relative) | 1, 2, 3 | ||
CCQ097 | Is this relative 18 years of age or older? 1 Yes 2 No |
Characteristics of providers (relative) | 1, 2, 3 | ||
CCQ098 | Head Start is a federally sponsored preschool program mainly for children from low-income families. {Is the regular care arrangement that {CHILD} has with a relative/Are any of the regular care arrangements that {CHILD} has with relatives} Head Start?} Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is related to the child but is not his or her parent. If your child participates in a home Head Start program where and a parent is the caregiver, select no. 1 Yes 2 No Don't know |
Head Start (relative) | 1, 2, 3 | ||
CCQ099 | Is the relative who provides the most care for {CHILD} providing the care as part of a Head Start program? Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is related to the child but is not his or her parent. 1 Yes 2 No |
Head Start (relative) | 1, 2, 3 | ||
CCQ100 | How many days each week does {CHILD} receive care from a relative in Head Start? Days: |
Head Start (relative) | 1, 2, 3 | Added "Days:" | |
CCQ101 | How many hours each week does {CHILD} receive care from this relative in Head Start? Enter the hours each week in whole hours. Hours: |
Head Start (relative) | 1, 2, 3 | Added "Hours:" | |
CCQ110 | How many hours each week does {CHILD} receive care from {these/this} other {relatives/relative}? Do not include care from a parent or guardian who lives in the household or in another home. Enter the hours each week in whole hours. Hours: |
Type and amount of ECE arrangements (relative) | 1, 2, 3 | Added new instruction," Enter the hours each week in whole hours." Added "Hours:" to match specs. |
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CCQ115 | Is {CHILD} now receiving care in a private home on a regular basis from someone who is not related to {him/her} (including care provided before or after school)? This includes home child care providers, regular sitters, or neighbors. {It does not include child care centers.} Non-relative care is provided by someone not related to the child and is located in a private home. The private home may be the child’s home, the caregiver’s home, or another home. If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a care arrangement, if the care is given on a regularly scheduled basis. If neither parent lives in the household, do not include care provided by guardians who live with the child (they are treated the same as parents). Non-relative care arrangements or programs may or may not have a charge or fee. 1 Yes 2 No |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | Deleted "/" after "not related to" in question text | |
CCQ120 | Has {CHILD} ever received care in a private home from a nonrelative on a regular basis? 1 Yes 2 No |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | ||
CCQ125a | How old was {CHILD} in years and months when {he/she} first received regular care in a private home from any nonrelative? Years: |
Type and amount of ECE arrangements (nonrelative)-years | 1, 2, 3 | Added "Years:" | |
CCQ125b | How old was {CHILD} in years and months when {he/she} first received regular care in a private home from any nonrelative? Months: |
Type and amount of ECE arrangements (nonrelative)-months | 1, 2, 3 | Added "Months:" | |
CCQ165 | How many different regular care arrangements do you currently have with nonrelatives? 1 One 2 Two 3 Three 4 Four 5 Five or more |
affective empathy | 1, 2, 3 | ||
CCQ170 | Is that care provided in your home or another home? 1 Own home 2 Other home 3 Both/Varies |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | ||
CCQ185 | How many days each week does {CHILD} receive care from that person? Days: |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | ||
CCQ190 | How many hours each week does {CHILD} receive care from that person? Hours: Enter the hours each week in whole hours. |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | Changed order of text by moving "Enter the hours each week in whole hours." to the bottom to match specs. | |
CCQ191 | How long has {CHILD} received care from the nonrelative in the last year? 1 One to two months 2 Three to five months 3 Six to eight months 4 Nine to eleven months 5 Twelve months |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | ||
CCQ192 | What language does {CHILD}’s nonrelative speak most when caring for {CHILD}? 0 English 1 Spanish 2 A European language other than Spanish such as French, German, or Russian 3 A Chinese language or dialect 4 A Filipino language 5 A Southeast Asian language such as Vietnamese, Thai, or Khmer 6 A South Asian language such as Hindi or Tamil 7 Another Asian language such as Japanese or Korean 8 A Middle Eastern language such as Arabic or Farsi 9 An African language such as Swahili or Amharic 91 Another language (Please specify): |
Characteristics of providers (nonrelative) | 1, 2, 3 | Deleted duplicate words "such as" in "such as such as" | |
CCQ192OS | What language does {CHILD}’s nonrelative speak most when caring for {CHILD}? | Other specify for characteristics of providers (nonrelative) | 1, 2, 3 | ||
CCQ193 | Is this nonrelative 18 years of age or older? 1 Yes 2 No |
Characteristics of providers (nonrelative) | 1, 2, 3 | ||
CCQ194 | {Head Start is a federally sponsored preschool program mainly for children from low-income families.} {Is the regular care arrangement that {CHILD} has with a nonrelative /Are any of the regular care arrangements that {CHILD} has with nonrelatives} Head Start? Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is not his or her parent and is not related to the child. 1 Yes 2 No |
Head Start (nonrelative) | 1, 2, 3 | ||
CCQ195 | Is the nonrelative who provides the most care for {CHILD} now providing the care as part of a Head Start program? Head Start is a federally funded early childhood education program designed to improve the school readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is not his or her parent and is not related to the child. 1 Yes 2 No |
Head Start (nonrelative) | 1, 2, 3 | ||
CCQ196 | How many days each week does {CHILD} receive care from that person in Head Start? Days: |
Head Start (nonrelative) | 1, 2, 3 | Added "Days:" | |
CCQ197 | How many hours each week does {CHILD} receive care from that person in Head Start? Enter the hours each week in whole hours. Hours: |
Head Start (nonrelative) | 1, 2, 3 | Added "Hours:" | |
CCQ205 | How many hours each week does {CHILD} receive care from {this nonrelative/these nonrelatives}? Enter the hours each week in whole hours. Hours: |
Type and amount of ECE arrangements (nonrelative) | 1, 2, 3 | Added "Hours:" Also, added "Enter the hours each week in whole hours." | |
CCQ260 | Is {CHILD} now attending a day care center, nursery school, preschool, prekindergarten, or a before- or after-school program at a school or in a center on a regular basis? Please include any type of formal program that provides care and supervision. It may be in a child's school or in another location, such as a church or a free-standing building. Head Start programs, nursery schools, preschools, and prekindergarten programs that include children who are now in kindergarten (some of which may be sponsored by the state) are also included. 1 Yes 2 No |
Type and amount of ECE arrangements (center) | 1, 2, 3 | ||
CCQ265 | Has {CHILD} ever attended a day care center, nursery school, preschool, prekindergarten, or before- or after-school program at a school or in a center on a regular basis? 1 Yes 2 No |
Type and amount of ECE arrangements (center) | 1, 2, 3 | Changed "afterschool" to "after-school" in question text | |
CCQ275a | How old was {CHILD} in years and months when {he/she} first attended any day care center, nursery school, preschool, prekindergarten, or before- or after-school program on a regular basis? Years: |
Type and amount of ECE arrangements (center)-years | 1, 2, 3 | Added "Years:" | |
CCQ275b | How old was {CHILD} in years and months when {he/she} first attended any day care center, nursery school, preschool, prekindergarten, or before- or after-school program on a regular basis? Months: |
Type and amount of ECE arrangements (center)-months | 1, 2, 3 | Added "Months:" | |
CCQ280 | How many different day care centers, nursery schools, preschools, prekindergartens, or before- or after-school care programs does {CHILD} currently go to on a regular basis? 1 One 2 Two 3 Three 4 Four 5 Five or more |
Type and amount of ECE arrangements (center) | 1, 2, 3 | Because of a finding from usabilty testing that some types of child care asked about in earlier questions were not included in CCQ280, the words "nursery schools, preschools, prekindergartens," were added. | |
CCQ285 | Where is the program that {CHILD} attends {most} located? For example, is it in its own building, a school, a place of worship, or some other place? 1 Its own building 2 A public elementary, junior high, or high school 3 A private elementary, junior high, or high school 4 A college or university 5 A church, mosque, synagogue, or other place of worship 6 Your home 7 Another home 8 A community center 9 A public library 10 A building or storefront that shares walls with other businesses 11 More than one place 12 Some other place |
Type and amount of ECE arrangements (center) | 1, 2, 3 | ||
CCQ295 | How many days each week does {CHILD} go to that program? Days: |
Type and amount of ECE arrangements (center) | 1, 2, 3 | Added "Days:" | |
CCQ300 | How many hours each week does {CHILD} go to that program? Enter the hours each week in whole hours. Hours: |
Type and amount of ECE arrangements (center) | 1, 2, 3 | ||
CCQ305 | How long has {CHILD} received care at that program in the last year? 1 One to two months 2 Three to five months 3 Six to eight months 4 Nine to eleven months 5 Twelve months |
Type and amount of ECE arrangements (center) | 1, 2, 3 | ||
CCQ310 | What language does {CHILD}’s main care provider or teacher at that program speak most when caring for {CHILD}? 0 English 1 Spanish 2 A European language other than Spanish such as French, German, or Russian 3 A Chinese language or dialect 4 A Filipino language 5 A Southeast Asian language such as Vietnamese, Thai, or Khmer 6 A South Asian language such as Hindi or Tamil 7 Another Asian language such as Japanese or Korean 8 A Middle Eastern language such as Arabic or Farsi 9 An African language such as Swahili or Amharic 91 Another language (Please specify): |
Characteristics of providers (center) | 1, 2, 3 | Deleted duplicate words "such as" in "such as such as" | |
CCQ310OS | What language did {CHILD}’s main care provider or teacher at that program speak most when caring for {CHILD}? | Other specify for characteristics of providers (center) | 1, 2, 3 | ||
CCQ320 | When {CHILD}'s teacher sends home notes or newsletters, are these in a language that you speak? 1 Yes 2 No |
Whether the ECE provides translated materials | 1, 2, 3 | ||
CCQ325 | {Is/Are any of } {CHILD}’s care arrangement{s} in a day care center, nursery school, preschool, or prekindergarten program Head Start? Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a center setting. 1 Yes 2 No |
Head Start (center) | 1, 2, 3 | ||
CCQ326 | Is the care arrangement in a day care center, nursery school, preschool, or prekindergarten program where {CHILD} spends the most time a Head Start program? Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a center setting. 1 Yes 2 No |
Head Start (center) | 1, 2, 3 | ||
CCQ327 | How many days each week does {CHILD} receive care from Head Start? Days: |
Head Start (center) | 1, 2, 3 | Added "Days:" | |
CCQ328 | How many hours each week does {CHILD} receive care from Head Start? Enter the hours each week in whole hours. Hours: |
Head Start (center) | 1, 2, 3 | Added "Hours:" | |
CCQ329 | {Is the day care center, nursery school, preschool, or prekindergarten program}/{Are any of the day care centers, nursery schools, preschools, or prekindergarten programs} a state-sponsored preschool or state-sponsored prekindergarten program? 1 Yes 2 No |
State-sponsored ECE program | 1, 2, 3 | Changed "state sponsored prekindergarten" to "state-sponsored prekindergarten". | |
CCQ375 | You said that {CHILD} attended {NUMBER} other day care {center/centers} or before- or after-school {program/programs} on a regular basis. How many hours each week does {CHILD} attend {this program/these programs}? Enter the hours each week in whole hours. Hours: |
Type and amount of ECE arrangements (center) | 1, 2, 3 | Added "Hours:" Also, added "Enter the hours each week in whole hours." | |
CCQ500 a-e | Please answer the following questions about the child care arrangement that {CHILD} spends the most time in right now. | Parent endorsement of the ECE setting | 1, 2, 3 | ||
CCQ500a | I feel welcome and comfortable with the people at {CHILD}’s arrangement. 1 Strongly disagree 2 Disagree 3 Not sure 4 Agree 5 Strongly agree |
Parent endorsement of the ECE setting | 1, 2, 3 | ||
CCQ500b | {CHILD}’s arrangement has been a good place for {him/her} to be. 1 Strongly disagree 2 Disagree 3 Not sure 4 Agree 5 Strongly agree |
Parent endorsement of the ECE setting | 1, 2, 3 | ||
CCQ500c | The people at {CHILD}’s arrangement are doing good things for {him/her}. 1 Strongly disagree 2 Disagree 3 Not sure 4 Agree 5 Strongly agree |
Parent endorsement of the ECE setting | 1, 2, 3 | ||
CCQ500d | I have confidence in the people at {CHILD}’s arrangement. 1 Strongly disagree 2 Disagree 3 Not sure 4 Agree 5 Strongly agree |
Parent endorsement of the ECE setting | 1, 2, 3 | ||
CCQ500e | {CHILD}’s arrangement is doing a good job of preparing {him/her} for school. 1 Strongly disagree 2 Disagree 3 Not sure 4 Agree 5 Strongly agree |
Parent endorsement of the ECE setting | 1, 2, 3 | ||
CCQ550 | About how far would you say it is from your home to the child care arrangement {CHILD} attends? 1 Less than ⅛th mile (less than 3 blocks) 2 ⅛th mile to ¼ mile (3-5 blocks) 3 More than ¼ mile, but less than ½ mile (6-9 blocks) 4 ½ mile to less than 1 mile (10-19 blocks) 5 One mile to 2.5 miles 6 2.6 miles to 5 miles 7 5.1 miles to 7.5 miles 8 7.6 miles to 10 miles 9 10.1 miles or more |
Distance to ECE setting | 1, 2, 3 | ||
CCQ555 | About how far would you say it is from your home to the child care arrangement {CHILD} attends? 1 Less than 5 minutes away 2 Between 5-10 minutes away 3 Between 11-15 minutes away 4 Between 16-20 minutes away 5 Between 21-30 minutes away 6 More than 30 minutes away |
Distance to ECE setting | 1, 2, 3 | Changed "11 and 15" to "11-15", "16 and 20" to "16-20", and "21 and 30" to "21-30" to be consistent with other response options. The response option of 21-30 was already correct in the OMB specifications, but was corrected in attachment D. | |
CCQ555a | How do you usually take {CHILD} to the child care arrangement {he/she} attends? 1 Walking 2 Driving 3 Public transportation 91 Other (Please specify): |
How long to ECE setting | 1, 2, 3 | ||
CCQ555aOS | How do you usually take {CHILD} to the child care arrangement {he/she} attends? | Other specify for how long to ECE setting | 1, 2, 3 | ||
CCQ560 | Even though many factors matter when choosing child care or a preschool, which THREE factors below were the MOST IMPORTANT to you? Please choose only three choices. For me, the THREE (3) MOST IMPORTANT factors were that the child care or program… 1 Offers convenient hours (for example, is a full-day program, or offers before- or after-school care) 2 Offers services for children with special needs 3 Teaches children how to get along well with others 4 Is in a convenient location (close to your home, work, or public transportation) 5 Has a warm and nurturing caregiver(s)/teacher(s) 6 Provides a safe and clean environment 7 Provides transportation 8 Is free or was the least expensive option 9 Teaches children letters, numbers, and other academic skills 10 Accepts payment from a child care assistance program in my state 11 Also serves my other children (for example, the program is located in a school where an older sibling is enrolled 12 Teaching philosophy (for example, Montessori, Reggio Emilia, etc.) 13 Provides specialized programs (for example, dual language instruction) 14 Offered in same location as kindergarten 15 Has good reputation or high rating (for example, heard good things about the school from friends, family, neighbors, etc.) 16 Very good value 17 Promotes racial/cultural inclusivity 18 A language other than English is used as the teaching language |
Reasons for choosing child care | 1, 2, 3 | Changed one instance of "three" and two instances of "most important" in question text to all capital letters for emphasis. Changed lettered response codes to numbered response codes. Changed "Reggio Emelia" to "Reggio Emilia" in response 12. |
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CCQ565 | Now please choose the TWO things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program. Please choose only two choices. The TWO (2) things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program are: 1 Offer more convenient hours 2 Be in a more convenient location 3 It is not helping my child learn (for example, I wish my child got more practice developing social skills or academic school skills) 4 The way the caregiver/teacher interacts with my child (for example, I wish my child’s caregiver/teacher was more warm and affectionate) 5 The environment at my child’s child care/preschool program (for example, I wish the program was more inviting with more books and toys for my child) 6 The way my child’s caregiver/teacher communicates with me about my child (for example, I wish my child’s caregiver/teacher talked to me more about my child’s progress) 7 The cost 8 None. If there is nothing you would change about your child care/preschool program, please mark here. 91 Other (Please specify): |
Improvements that the parent would make in the child care | 1, 2, 3 | Deleted duplicate words "in a" in response 2 "Be in a more in a convenient location". In response 3, changed "development" to "developing". This spec will appear to be different from OMB, but it is not. Response 8 (None) will display under "Other" in the web survey as shown in the original OMB specifications. However, in SpecWriter it will appear as if "Other" (coded 91) is the last code because of the need for codes to appear in numeric order. The programming instructions place it in the correct order, though, so this actually matches OMB. Changed letter values for responses to number codes. |
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CCQ565hOS | Now please choose the TWO things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program. Please choose only two choices. The TWO (2) things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program are: |
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CCQ570 | Has anyone in any of {CHILD}’s care arrangements contacted you or another adult in your household about any behavior problems {he/she/{CHILD}} is having, such as: Select All That Apply. 1 Biting 2 Being aggressive 3 Not following directions 4 Being overly active 5 Being impulsive or having little or not self-control 6 Another behavior problem 7 None of these |
How behavior problems are handled in the ECE setting | 1, 2, 3, 5 | ||
CCQ575 | How helpful was this care arrangement(s) in providing tips or assistance in dealing with {CHILD}’s problem behaviors? 1 Very helpful 2 Somewhat helpful 3 Not at all helpful 4 Did not receive assistance or tips |
How behavior problems are handled in the ECE setting | 1, 2, 3, 5 | ||
CCQ580 | Have you ever been asked to remove {CHILD} from care for the day due to one or more behavior issues {he/she/{CHILD}} was having, such as biting, being aggressive, not following directions, being overly active, being impulsive, or having little or no self-control? 1 Yes 2 No |
Whether the child has ever been asked to leave the ECE program for the day | 1, 2, 3, 5 | Changed "he/she" to "{he/she/{CHILD}}" | |
CCQ585 | Have you ever been asked to remove {CHILD} from care and not return to the care setting? 1 Yes 2 No |
Whether the child has ever been asked to leave the ECE program and not return | 1, 2, 3, 5 | ||
CCQ590 | You reported before that {CHILD} has received {his/her/{CHILD}’s} current care from {a relative {and}/a non-relative {and}/ a day care center, nursery school, preschool, prekindergarten, or before- or after-school program} for less than twelve months. Where else was {CHILD} in care in the last year? 1 Head Start program (Head Start is a federally sponsored prekindergarten program mainly for children from low income families) 2 Preschool in a public school 3 An early education center, child care center, parochial child care center, or nursery school other than Head Start 4 An in-home child care program or family child care program 5 An “extended-day” program, that is, before- or after-school care at the child’s regular school 6 Care by a parent 7 Care by another member of your family or household 8 Care by someone other than a member of your family or household 91 Other (Please specify): |
Child care type if in current care for less than a year | 1, 2, 3, 5 | Changed "pre-kindergarten" to "prekindergarten" in response option 1 | |
CCQ590OS | Where else was {CHILD} in care in the last year? | Other specify for child care type if in current care for less than a year | |||
CHQ -Child's Health and Well-Being | CHQ004 | Would you say {CHILD}'s health is … 1 Excellent, 2 Very good, 3 Good, 4 Fair, or 5 Poor? |
Overall health | 1, 2 | |
CHQ060 | In a typical week, on how many days does {CHILD} get exercise that causes rapid breathing, perspiration, and a rapid heartbeat for 20 continuous minutes or more? Days: |
Exercise | 1, 2 | Added "Days:" | |
CHQ086 | How tall is {CHILD} without shoes? Your best guess is fine. 1 Answer in feet and inches 2 Answer in meters and centimeters Don't know |
Height | 1, 2 | Added "Your best guess is fine." as a result of usability testing as respondents were answering “don’t know” because they thought that we needed the precise numbers. | |
CHQ086a | [Please answer for how tall {CHILD} is in feet and inches without shoes?] Feet: |
Height-feet | 1, 2 | Added "Feet:" | |
CHQ086b | [Please answer for how tall {CHILD} is in feet and inches without shoes?] And Inches: |
Height-inches | 1, 2 | Added "Inches:" | |
CHQ086c | [Please answer for how tall {CHILD} is in meters and centimeters without shoes?] Meters: |
Height-meters | 1, 2 | Added "Meters:" | |
CHQ086d | [Please answer for how tall {CHILD} is in meters and centimeters without shoes?] And Centimeters: |
Height-centimeters | 1, 2 | Added "Centimeters:" | |
CHQ087 | How much does {CHILD} weigh without shoes? Your best guess is fine. 1 Answer in pounds 2 Answer in kilograms Don't know |
Weight | 1, 2 | Added "Your best guess is fine." as a result of usability testing as respondents were answering “don’t know” because they thought that we needed the precise numbers. | |
CHQ087a | [Please answer for how much {CHILD} weighs in pounds without shoes?] Pounds: |
Weight-pounds | 1, 2 | Added "Pounds:" | |
CHQ087b | [Please answer for how much {CHILD} weighs in kilograms without shoes?] Kilograms: |
Weight-kilograms | 1, 2 | Added "Kilograms:" | |
CHQ095 a-g | Please answer the following questions based on how {CHILD} compares to other children of the same age. | Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095a | {CHILD} is independent and takes care of {himself/herself} 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095b | {CHILD} pays attention 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095c | {CHILD} learns, thinks, and solves problems 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095d | {CHILD} shows good coordination in moving {his/her} arms and legs? 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095e | {CHILD} behaves and relates to other children 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095f | {CHILD} behaves and relates to adults 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | ||
CHQ095g | {CHILD}'s overall activity level is 1 Better than other children {his/her} age 2 As well as other children 3 Slightly less well than other children 4 Much less well than other children |
Perception of child compared to other similar-aged children | 1, 2 | Note: The question appears to have a change in the compare document, but was not really a change for the OMB specification. This appears as a difference in the compare document only because an error was corrected in the pdf specification to match the original specification in Word. | |
CHQ110 | Does {CHILD} have any emotional or psychological difficulties? 1 Yes 2 No |
Emotional or psychological difficulties | 1, 2 | ||
CHQ111 | Do you think this is a mild problem, a moderate problem, or a severe problem? 1 Mild problem 2 Moderate problem 3 Severe problem |
Emotional or psychological difficulties | 1, 2 | ||
CHQ116 | Has a health, education, or early intervention professional told you that {CHILD} is "at risk" for problems with health, physical disabilities, learning, or behavior? 1 Yes 2 No |
Whether a health, education, or early intervention profession indicted child is at-risk | 1, 2 | ||
CHQ117 | Has {CHILD} ever been diagnosed with a disability? 1 Yes 2 No |
Disability | 1, 2 | ||
CHQ118 | Has {CHILD} ever received services from a program called Early Intervention Services or have an Individualized Family Service Plan (IFSP)? Early Intervention Services are services to a family with a child who has been identified as having a developmental delay and/or a specific health condition when the child is between birth and age 3. An Individualized Family Service Plan or IFSP is a plan developed to support children and families involved in early intervention (birth to age 3). 1 Yes 2 No |
Disability | 1, 2 | A space was added between"Individualized Family Service Plan" and "(IFSP)" in attachment B1. This change was already in attachment D. | |
CHQ118a | Is {CHILD} currently receiving services from a program called Early Intervention Services or have an Individualized Family Service Plan (IFSP)? Early Intervention Services are services to a family with a child who has been identified as having a developmental delay and/or a specific health condition when the child is between birth and age 3. An Individualized Family Service Plan or IFSP is a plan developed to support children and families involved in early intervention (birth up to age 3). 1 Yes 2 No |
Disability | 1, 2 | ||
CHQ119 | Has {CHILD} ever received any services through an Individualized Education Program (IEP)? An Individualized Education Program (IEP) is a plan for children age 3 or older identified as needing special education and related services. 1 Yes 2 No |
Disability | 1, 2 | ||
CHQ119a | Is {CHILD} currently receiving any services through an Individualized Education Program (IEP)? An Individualized Education Program (IEP) is a plan for children age 3 or older identified as needing special education and related services. 1 Yes 2 No |
Disability | 1, 2 | ||
CHQ121 | Has {CHILD} ever received any services through a 504 plan? A 504 plan is a formal plan schools use to provide accommodations to children with disabilities. A 504 plan does not include individualized instruction, and children do not have to qualify for special education services to be eligible for a 504 plan. 1 Yes 2 No |
Disability | 1, 2 | ||
CHQ121a | Is {CHILD} currently receiving any services through a 504 plan? A 504 plan is a formal plan schools use to provide accommodations to children with disabilities. A 504 plan does not include individualized instruction, and children do not have to qualify for special education services to be eligible for a 504 plan. 1 Yes 2 No |
Disability | 1, 2 | ||
DWQ - Discipline, Warmth, and Emotional Supportiveness | DWQ010 a-h | Please think about whether each statement is completely true, mostly true, somewhat true, or not at all true. | Parental warmth | 5 | |
DWQ010a | {CHILD} and I often have warm, close times together. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parental warmth | 5 | ||
DWQ010b | Most of the time I feel that {CHILD} likes me and wants to be near me. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parental warmth | 5 | ||
DWQ010c | Even when I'm in a bad mood, I show {CHILD} a lot of love. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parental warmth | 5 | ||
DWQ010d | I express affection by hugging, kissing, and holding {CHILD}. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parental warmth | 5 | ||
DWQ010e | Being a parent is harder than I thought it would be. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parenting stress | 5 | ||
DWQ010f | {CHILD} does things that really bother me. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parenting stress | 5 | ||
DWQ010g | I find myself giving up more of my life to meet {CHILD}'s needs than I ever expected. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parenting stress | 5 | ||
DWQ010h | I often feel angry with {CHILD}. 1 Completely true 2 Mostly true 3 Somewhat true 4 Not at all true |
Parenting stress | 5 | ||
DWQ100 | Do you ever spank {CHILD}? 1 Yes 2 No |
Disciplinary practices | 5 | ||
DWQ101 | Sometimes kids do as they are told and sometimes they don't. About how many times, if any, have you spanked {CHILD} in the past week? |
Disciplinary practices | 5 | ||
PPQ - Parent's Psychological Well-Being and Health | PPQ225 | During the past 12 months, would you say that you experienced a lot of stress, a moderate amount of stress, relatively little stress, or almost no stress at all? 1 A lot of stress 2 A moderate amount of stress 3 Relatively little stress 4 Almost no stress at all |
Life stress | 5 | |
PEQ - Parent Education | PEQ020 | What is the highest grade or year of school that {you/{NAME}} {have/has} completed? 0 Never went to school 1 1st grade 2 2nd grade 3 3rd grade 4 4th grade 5 5th grade 6 6th grade 7 7th grade 8 8th grade 9 9th grade 10 10th grade 11 11th grade 12 12th grade but no diploma 13 High school equivalent/GED 14 High school diploma 15 Voc/tech program after high school but no voc/tech diploma 16 Voc/tech program after high school, diploma 17 Some college but no degree 18 Associate's degree 19 Bachelor's degree 20 Graduate or professional school but no degree 21 Master's (MA, MS) 22 Doctorate degree (PhD, EdD) 23 Professional degree after bachelor's degree (medicine/MD; dentistry/DDS; Law/JD/LLB; etc.) |
Parent education | 1 | Deleted the single quote between right brackets in "{you/{NAME}'}". |
EMQ - Parent Employment | EMQ200 | Which best describes {your/{NAME}'s} current employment situation? 1 Working part-time 2 Working full-time 3 A stay-at-home parent or guardian 4 Not working |
Parent employment | 1 | |
PAQ - Parent Income and Assets | PAQ110 | In studies like this, households are sometimes grouped according to income. What was the total income of all persons in your household over the past year, including salaries or other earnings, interest, retirement, and so on for all household members? 1 $5,000 or less 2 $5,001 to $10,000 3 $10,001 to $15,000 4 $15,001 to $20,000 5 $20,001 to $25,000 6 $25,001 to $30,000 7 $30,001 to $35,000 8 $35,001 to $40,000 9 $40,001 to $45,000 10 $45,001 to $50,000 11 $50,001 to $55,000 12 $55,001 to $60,000 13 $60,001 to $65,000 14 $65,001 to $70,000 15 $70,001 to $75,000 16 $75,001 to $100,000 17 $100,001 to $200,000 18 $200,001 or more |
Annual family income | 1 | |
PAQ120 | What was your total household income last year, to the nearest thousand? Total Income: |
Annual family income | 1 | ||
PAQ135 | Do any of the child care or early care and education programs that {CHILD} attends charge tuition or a fee? 1 Yes 2 No |
Tuition | 1 | ||
PAQ140 | Do you use a child care subsidy voucher that pay for part or all of the cost of tuition for {CHILD}'s current child care or early care and education program? 1 Yes 2 No |
Tuition | 1 | ||
CMQ - Mobility and Tracking Updates | CMQ001 | Are you, or another parent or guardian, planning to move with {CHILD} before the fall of 2020? 1 Yes 2 No |
Plans to move before the child begins kindergarten | NA | |
CMQ025a | Please confirm the mailing address where you would like to have the money sent for completing this survey. Address Line 1: Address Line 2: |
Confirmation of address | NA | ||
CMQ025b | City: | Confirmation of address | NA | ||
CMQ025c | State: Please select a state, district, or territory. |
Confirmation of address | NA | ||
CMQ025d | Zip code: | Confirmation of address | NA | ||
CMQ026a | Please enter your contact information. Email Address: |
Confirmation of address | NA | ||
CMQ026b | Or Mobile Number: By providing my mobile phone number I agree to receive a text message to log back into this survey. Message and data rates may apply. |
Cell number | NA | Added the word "Or" because in usability testing respondents wanted it to be clear that they did not have to enter both pieces of contact information. This also matches the management system. Also added a note about text messaging. |
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CMQ030 | We would like to contact you in the fall to ask a few brief questions about where {CHILD} ended up going to kindergarten. Do we have permission to text you? 1 Yes 2 No |
Permission to text | NA | ||
Section | Item # | Item Wording | Construct | Research Question | Changes in the web specs from the approved November 2019 OMB package | |||
Fall Follow-up Survey | FFS001 | Does {CHILD} still live with you? 1 Yes 2 No |
Mobility | NA | ||||
Fall Follow-up Survey | FFS005 | Is {CHILD} currently… Select All That Apply 1 Not in school? 2 In public or private school, including preschools? 3 In child care in a center INSTEAD of attending a public or private school? 4 In child care in a home INSTEAD of attending a public or private school? 5 Homeschooled INSTEAD of attending a public or private school (including preschools) for some or all classes? |
School or preschool enrollment | 1 | ||||
Fall Follow-up Survey | FFS010 | What is {CHILD}’s current grade or equivalent? 1 Preschool or child care for preschool-aged children in a home or center 2 Kindergarten 3 First 4 Second 5 Third 6 Fourth 7 Fifth or above 8 None of these |
Current grade/equivalent | 1, 4 | Placed instructional text that was on the screen into help text to create more room. This text was: "Preschool or child care for preschool-aged children in a home or center includes early childhood education programs, child care, or day care in a center, nursery school, preschool, prekindergarten, or child care with a relative or nonrelative other than a parent/guardian. Kindergarten includes Transitional Kindergarten (TK), Early Transitional Kindergarten (ETK), Readiness Kindergarten, Transitional or Prefirst Grade, or a program that is a kindergarten equivalent but is ungraded or has multiple grades." |
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Fall Follow-up Survey | FFS011 | Have you moved since {DATE OF LAST INTERVIEW}? 1 Yes 2 No | Mobility | NA | ||||
Fall Follow-up Survey | FFS012a | Do you still live in {STATE}? 1 Yes 2 No | Mobility | NA | ||||
Fall Follow-up Survey | FFS012b | What state do you now live in? Start by typing the first letter of the state, district, or territory name. If you find a match in the list, select it from the list. If you live in another country, select “Moved out of the country.” If you don’t find a match, select “Not on list.” State: |
Mobility | NA | ||||
Fall Follow-up Survey | FFS013a | Do you still live in {COUNTY}? 1 Yes 2 No | Mobility | NA | ||||
Fall Follow-up Survey | FFS013b | What county do you now live in? Start by typing the first letter of the county name. If you find a match in the list, select it from the list. If you don’t find a match, select “Not on list.” County: |
Mobility | NA | ||||
Fall Follow-up Survey | FFS015 | Is {CHILD} attending {SCHOOL NAMED IN SPRING PARENT SURVEY}? 1 Yes 2 No | Whether child is attending school named in parent survey last spring | 4 | ||||
Fall Follow-up Survey | FFS020 | Does {CHILD} go to a public or private school for kindergarten? 1 Public school (or both public and homeschooled) 2 Private school 3 Homeschooled only 4 Not in school |
School enrollment | 4 | The words "(or both public and homeschooled)" were added to category 1 to help clairfy the item. This addition helps direct respondents whose children attend public school and are also homeschooled. The word "only" has been added to category 3 to also help clarify the item. This addition helps direct respondents who only homeschool their child (i.e., the child does not also attend school) to use this category, while those whose child attends public school and is also homeschooled will select category 1. |
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Fall Follow-up Survey | FFS025 | What is the name of the public school where {CHILD} attends kindergarten? Select the school from the list below. If you don’t find the school, select “School not on list” and then type in the full school name. {DISPLAY LIST OF UP TO 25 SCHOOLS} |
School child attends | 4 | ||||
Fall Follow-up Survey | FFS025OS | What is the name of the public school where {CHILD} attends kindergarten? | Other specify for school child attends | 4 |
File Type | application/vnd.openxmlformats-officedocument.spreadsheetml.sheet |
File Modified | 0000-00-00 |
File Created | 0000-00-00 |