Instrument 12_CLEAN Parent-Guardian Reports to Questions about Children

V IQI Parent/Guardian Reports on Children

April 2021

PARENT/GUARDIAN REPORTS TO QUESTIONS ABOUT CHILDREN

The purpose of the Baseline/Follow-up Parent Report to Questions about Children is to capture children’s skills at baseline and follow-up in the impact evaluation and process study based on parent observation and interactions. Parent/guardians would be asked to complete a report on their child.

1. Introduction

Thank you for participating in the Variations in Implementation of Quality Interventions (VIQI) Project! As part of this study, we would like you to answer some questions about your child. This information is crucial to helping us understand the impacts of early care and education centers on children.

Your participation is completely voluntary, and you may skip any questions you do not wish to answer. You may stop the survey at any time. Your responses to these questions will be kept private to the extent permitted by law and will not be shared with your center. There are no direct benefits to you or your child for participating. Participation does not involve any risks other than what you would encounter in daily life. There is a small risk that your information could be lost, stolen, or misused, even though we follow strict rules to protect your information. The study team will follow strict procedures to protect your responses, and your responses will only be used for research and program improvement purposes. Your responses will be stored in password protected computer files and in locked research facilities. The data will be used only by the research team and other researchers bound by the same security requirements described here. We also may share de-identified responses with researchers looking at other education research topics who agree that they will protect your information.

Please complete this questionnaire within the next [X] days. Once complete, please send it back to [ADDRESS]. It will take approximately 6 minutes to complete. If you have any questions, please contact your project liaison at [PHONE] or [email].

Thank you!

An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. The OMB number for this information collection is 0970-0508 and the expiration date is XX/XX/XXXX. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to [Contractor Contact Name]; [Contractor Contact Address].

NOTE: THE ITEMS LISTED HERE ARE PLACEHOLDERS. MANY OF THESE ITEMS ARE DRAWN FROM SURVEYS OF EARLY CHILDHOOD TEACHERS AND PARENTS/GUARDIANS PREVIOUSLY USED IN STUDIES OF CURRICULUM-BASED INTERVENTIONS. THE SURVEY INCLUDES MULTIPLE ITEMS AND SCALES FOR CERTAIN CONSTRUCTS. ONCE PROJECT EXPERTS ARE CONSULTED AND PRE-TESTING IS COMPLETED, DECISIONS WILL BE MADE AND SCALES WILL BE ADJUSTED TO ENSURE A SET OF ITEMS THAT TAKES ABOUT SIX MINUTES TO COMPLETE.

PLACEHOLDERS FOR ITEMS ABOUT CHILDREN’S POSITIVE SOCIAL SKILLS

For each behavior, please select how often the behavior occurs for [child name] – never, seldom, often, or almost always.

	Never	Seldom	Often	Almost Always
Follows your directions.	1	2	3	4
Completes tasks without bothering others	1	2	3	4
Makes friends easily.	1	2	3	4
Participates appropriately in class.	1	2	3	4
Pays attention to your instructions.	1	2	3	4
Interacts well with other children.	1	2	3	4
Stays calm when teased.	1	2	3	4
Joins activities that have already started.	1	2	3	4
Ignores classmates when they are distracting.	1	2	3	4
Invites others to join in activities.	1	2	3	4
Takes criticism without getting upset.	1	2	3	4
Participates in games or group activities.	1	2	3	4
Uses appropriate language when upset.	1	2	3	4
Resolves disagreements with you calmly.	1	2	3	4
Follows classroom rules.	1	2	3	4
Starts conversations with peers.	1	2	3	4
Responds appropriately when pushed or hit.	1	2	3	4
Introduces herself/himself to others.	1	2	3	4
Makes compromise during a conflict.	1	2	3	4
Stays calm when disagreeing with others.	1	2	3	4

Prosocial Behavior Subscale from the Social Competence Scale (CPPRG, 1995)

Shares with others

Is helpful to others

Resolves problems with other children on his or her own

Listens to other people’s point of view

Cooperates

Understands other people’s feelings

Expresses needs and feelings appropriately

Response options: Almost never (score of 1), Rarely (score of 2), Sometimes (score of 3),

Often (score of 4), Very often (score of 5), Almost always (score of 6)

Next, please answer a few questions thinking about [CHILD]’s social skills.

Select one per row. [CHILD]…

	Never	Rarely	Sometimes	Most of the time	All of the time	I don’t know
Is cheerful, happy
Is curious and exploring, likes new experiences
Does neat, careful work
Gets along well with other children
Can get over being upset quickly
Is admired and well-liked by other children
Shows concern for other people’s feelings
Is easily comforted when he/she gets angry
Is helpful and cooperative
Is considerate and thoughtful of other children
Tends to give, lend, and share

Source: Positive Behavior Scale (PBS; Quint, Bos, & Polit, 1997)

PLACEHOLDERS FOR ITEMS ABOUT CHILDREN’S CHALLENGING BEHAVIORS

For each behavior, please select how often the behavior occurs for [child name] – never, seldom, often, or almost always.

	Never	Seldom	Often	Almost Always
Acts without thinking.	1	2	3	4
Bullies others.	1	2	3	4
Has difficulty waiting for a turn.	1	2	3	4
Fidgets or moves around too much.	1	2	3	4
Forces others to act against their will.	1	2	3	4
Withdraws from others.	1	2	3	4
Has temper tantrums.	1	2	3	4
Breaks into or stops group activities.	1	2	3	4
Is aggressive toward people or objects.	1	2	3	4
Gets embarrassed easily.	1	2	3	4
Cheats in games or activities.	1	2	3	4
Acts lonely.	1	2	3	4
Is inattentive.	1	2	3	4
Fights with others.	1	2	3	4
Says bad things about self.	1	2	3	4
Disobeys rules or requests.	1	2	3	4
Has low energy or is lethargic.	1	2	3	4
Gets distracted easily.	1	2	3	4
Talks back to adults.	1	2	3	4
Acts sad or depressed.	1	2	3	4
Lies or does not tell the truth.	1	2	3	4
Acts anxious with others.	1	2	3	4

Emotion Regulation Subscale from the Social Competence Scale (CPPRG, 1995)

Copes well with disappointment or frustration

Accepts things not going his or her way

Feelings are easily hurt (R)

Whines or complains (R)

Controls temper when there is a disagreement

Stops and calms down when frustrated or upset

Aggressive/Oppositional Items from the Teacher Observation of Child Adaptation-Revised (TOCA-R) (Werthamer-Larsson, Kellam, & Wheeler, 1991)

Breaks things on purpose

Stubborn

Yells at others

Knowingly breaks rules

Fights with other children

Ignores or refuses to obey adults

Hits, pushes or shoves

Internalizing/Withdrawn Items (from TOCA-R and other behavior problem scales developed for young children)

Invites others to play (R)

Low energy, lethargic or inactive

Keeps to him or herself, tends to withdraw

Sad, unhappy

Avoids playing with other children

Response options: Almost never (score of 1), Rarely (score of 2), Sometimes (score of 3),

Often (score of 4), Very often (score of 5), Almost always (score of 6)

PLACEHOLDERS FOR ITEMS ABOUT CHILDREN’S APPROACHES TO LEARNING

Please report on whether each behavior describes [child name] not at all, a little, moderately well, well, or very well. Please select the most appropriate response to each question.

	Not at all	A little	Moderately well	Well	Very well
Completes work.	1	2	3	4	5
Well organized.	1	2	3	4	5
Functions well even with distractions.	1	2	3	4	5
Works well without adult support.	1	2	3	4	5
A self-starter.	1	2	3	4	5

Approaches to Learning (items from ECLS-K)

The parent indicates how frequently the child exhibited the following behaviors or characteristics. The response scale included four points ranging from “1 = never” to “4 = very often.”

• Keep working at something until {he/she} is finished?

• Show interest in a variety of things?

• Concentrate on a task and ignore distractions?

• Help with chores?

• Eager to learn new things?

• Creative in work or in play?

Behavior Rating Inventory of Executive Functioning-Preschool (BRIEF-P; Gioia, Espy, & Isquith, 2002) is a 63-item parent/ teacher completed rating scale for children aged from 2 to 5 years with items composing five executive domains: Inhibit (16 items), Shift (10 items), Emotional Control (10 items), Working Memory (17 items), and Plan/ Organize (10 items). The scales are summarized in three overlapping indexes: Inhibitory Self-Control (Inhibit and Emotional Control), Flexibility (Shift and Emotional Control), and Emergent Metacognition (Working Memory and Plan/Organize). Teachers are asked to rate each item as to whether it is never, sometimes, or often a problem for the child (e.g., “Is impulsive”).  

 

BRIEF-P (63 items) – Parent and Teacher Reported Versions	Never	Sometimes	Often
Overreacts to small problems	□1	□2	□3
When given two things to do, remembers only the first or last	□1	□2	□3
Is unaware of how his/her behavior affects or bothers others	□1	□2	□3
When instructed to clean up, puts things away in a disorganized, random way	□1	□2	□3
Becomes upset with new situations	□1	□2	□3
Has explosive, angry outbursts	□1	□2	□3
Has trouble carrying out the actions needed to complete tasks (such as trying one puzzle piece at a time, cleaning up to earn a reward)	□1	□2	□3
Does not stop laughing at funny things or events when others stop	□1	□2	□3
Needs to be told to begin a task even when willing to do it	□1	□2	□3
Has trouble adjusting to new people (such as babysitter, teacher, friend, or day care worker)	□1	□2	□3
Becomes upset too easily	□1	□2	□3
Has trouble concentrating on games, puzzles, or play activities	□1	□2	□3
Has to be more closely supervised than similar playmates	□1	□2	□3
When sent to get something, forgets what he/she is supposed to get	□1	□2	□3
Is upset by a change in plans or routine (for example, order of daily activities, adding last minute errands to schedule, change in driving route to store)	□1	□2	□3
Has outbursts for little reason	□1	□2	□3
Repeats the same mistakes over and over even after help is given	□1	□2	□3
Acts wilder or sillier than others in groups (such as birthday parties, play group)	□1	□2	□3
Cannot find clothes, shoes, toys, or books even when he/she has been given specific instructions	□1	□2	□3
Takes a long time to feel comfortable in new places or situations (such as visiting distant relatives or new friends)	□1	□2	□3
Mood changes frequently	□1	□2	□3
Makes silly mistakes on things he/she can do	□1	□2	□3
Is fidgety, restless, or squirmy	□1	□2	□3
Has trouble following established routines for sleeping, eating, or play activities	□1	□2	□3
Is bothered by loud noises, bright lights, or certain smells	□1	□2	□3
Small events trigger big reactions	□1	□2	□3
Has trouble with activities or tasks that have more than one step	□1	□2	□3
Is impulsive	□1	□2	□3
Has trouble thinking of a different way to solve a problem or complete an activity when stuck	□1	□2	□3
Is disturbed by changes in the environment (such as new furniture, things in room moved around, or new clothes)	□1	□2	□3
Angry or tearful outbursts are intense but end suddenly	□1	□2	□3
Needs help from adult to stay on task	□1	□2	□3
Does not notice when his/her behavior causes negative reactions	□1	□2	□3
Leaves messes that others have to clean up even after instruction	□1	□2	□3
Has trouble changing activities	□1	□2	□3
Reacts more strongly to situations than other children	□1	□2	□3
Forgets what he/she is doing in the middle of an activity	□1	□2	□3
Does not realize that certain actions bother others	□1	□2	□3
Gets caught up in the small details of a task or situation and misses the main idea	□1	□2	□3
Has trouble “joining in” at unfamiliar social events (such as birthday parties, picnics, holiday gatherings)	□1	□2	□3
Is easily overwhelmed or overstimulated by typical daily activities	□1	□2	□3
Has trouble finishing tasks (such as games, puzzles, pretend play activities)	□1	□2	□3
Gets out of control more than playmates	□1	□2	□3
Cannot find things in room or play area even when given specific instructions	□1	□2	□3
Resists change of routine, foods, places, etc.	□1	□2	□3
After having a problem, will stay disappointed for a long time	□1	□2	□3
Cannot stay on the same topic when talking	□1	□2	□3
Talks or plays too loudly	□1	□2	□3
Does not complete tasks even after given directions	□1	□2	□3
Acts overwhelmed or overstimulated in crowded, busy situations (such as lots of noise, activity, or people)	□1	□2	□3
Has trouble getting started on activities or tasks even after instructed	□1	□2	□3
Acts too wild or out of control	□1	□2	□3
Does not try as hard as his/her ability on activities	□1	□2	□3
Has trouble putting the breaks on his/her actions even after being asked	□1	□2	□3
Unable to finish describing an event, person, or story	□1	□2	□3
Completes tasks or activities too quickly	□1	□2	□3
Is unaware when he/she does will and not well	□1	□2	□3
Gets easily sidetracked during activities	□1	□2	□3
Has trouble remembering something, even after a brief period of time	□1	□2	□3
Becomes too silly	□1	□2	□3
Has a short attention span	□1	□2	□3
Plays carelessly or recklessly in situations where he/she could be hurt	□1	□2	□3
Is unaware when he/she performs a task right or wrong	□1	□2	□3

 

PLACEHOLDER FOR ITEMS ABOUT PARENT’S REPORTS ON CHILDREN’S SKILLS

The first set of questions ask you about different skills [CHILD] might have. This is not a test and there are no right or wrong answers. Please do your best to answer based on what you know about [CHILD].

1. How often can [CHILD] recognize the beginning sound of a word? For example, can [CHILD] tell you that the word "ball" starts with the "buh" sound?

   1. Always

   2. Most of the time 

   3. About half the time 

   4. Sometimes  

   5. Never 

   6. I don’t know

SOURCE: National Survey of Children’s Health

2. How many letters of the alphabet can [CHILD] recognize?

1. All of them  

2. Most of them 

3. About half of them 

4. Some of them 

5. None of them 

6. I don’t know

SOURCE: National Survey of Children’s Health

3. Can [CHILD] rhyme words? 

1. Yes 

2. No 

3. I don’t know

SOURCE: National Survey of Children’s Health

4. How often can [CHILD] explain things he or she has seen or done so that you get a very good idea of what happened? 

1. Always 

2. Most of the time 

3. About half the time 

4. Sometimes 

5. Never 

6. I don’t know

SOURCE: National Survey of Children’s Health

5. How often can [CHILD] write her or his first name, even if some of the letters aren't quite right or are backwards?

1. Always 

2. Most of the time 

3. About half the time 

4. Sometimes 

5. Never 

6. I don’t know

SOURCE: National Survey of Children’s Health

6. Does [CHILD] ask questions like "who," "what," "when," and "where"?

   1. Yes 

   2. No 

   3. I don’t know

SOURCE: National Survey of Children’s Health

7. Does [CHILD] ask questions like "why" and "how"?

   1. Yes

   2. No

   3. I don’t know

SOURCE: National Survey of Children’s Health

8. Does [CHILD] tell a story with a beginning, middle, and end? 

   1. Yes

   2. No

   3. I don’t know

SOURCE: National Survey of Children’s Health

9. Does [CHILD] read story books on her or his own now? Select the option that best applies. 

1. Reads the written words  

2. Pretends to read and it sounds like a connected story 

3. Pretends to read and tells what is in each picture, without much connection between them 

4. Does both - reads written words and pretends to read 

5. I don't know 

Source: ECLS-B 2006-2007 Preschool Parent Interview

10. How high can [CHILD] count?

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 

7. I don’t know

SOURCE: National Survey of Children’s Health

11. How often can [CHILD] identify basic shapes, such as a triangle, circle, or square? 

1. Always 

2. Most of the time 

3. About half the time 

4. Sometimes 

5. Never

6. I don’t know

SOURCE: National Survey of Children’s Health

12. Can [CHILD] identify the colors red, yellow, blue, and green by name? Would you say…. 

1. All of them 

2. Some of them 

3. None of them 

4. I don’t know

Source: ECLS-B 2006-2007 Preschool Parent Interview

13. [prior to when the center was closed] To what extent does [CHILD] seem excited about going to [CENTER NAME]?

    1. Quite a bit

    2. Somewhat

    3. A little

    4. Not at all

    5. I don’t know

Source: Health Behavior Questionnaire (HBQ; Armstrong and Goldstein, 2003)

14. [prior to when the center was closed] To what extent does [CHILD] seem frustrated about going to [CENTER NAME]?

    1. Quite a bit

    2. Somewhat

    3. A little

    4. Not at all

    5. I don’t know

Source: Health Behavior Questionnaire (HBQ; Armstrong and Goldstein, 2003)

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