Att D-8a Spring First Child-Lvl Special Ed Teacher Web Redacted v30

Early Childhood Longitudinal Study, Kindergarten Class of 2023-24 (ECLS-K:2024) April 2024 Materials Revision Request

Att D-8a Spring First Child-Lvl Special Ed Teacher Web Redacted v30

OMB: 1850-0750

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Early Childhood Longitudinal Study,
Kindergarten Class of 2023-24
(ECLS-K:2024)
Kindergarten and First-Grade National Data
Collection and Transfer School Recruitment
OMB# 1850-0750 v.30

Attachment D-8a
Spring First Grade
Special Education Teacher Child-Level
Web Survey
National Center for Education Statistics
U.S. Department of Education

April 2024
Note: Some items in this survey are copyright protected and as
such are redacted in public review copies.
Page 1 of 58

SPB.
Box SPB1001. / Grid Spec

Notes: QUESTION STEMS ON LARGE AND SMALL BROWSERS:
QUESTION STEMS FOR ITEMS THAT ARE DISPLAYED TOGETHER IN GRIDS
ON LARGE FORMATS (SUCH AS A DESKTOP) ARE PRESENTED ONLY ONCE
IN THE TEACHER SURVEY SPECIFICATIONS BELOW. WHEN VIEWING
THESE QUESTIONS IN A SMALLER FORMAT (SUCH AS A MOBILE PHONE),
QUESTION STEMS REPEAT ON SEPARATE SCREENS TO MAKE THE INTENT
OF THE ITEM CLEAR.
ON LARGE FORMAT DISPLAYS, QUESTIONS IN A GRID ARE SKIPPED AS A
GROUP WHEN THE NEXT BUTTON IS USED. GRIDS HAVE BEEN DIVIDED IN
THE SPECIFICATIONS BELOW SO THAT ONLY 4 OR 5 ITEMS ARE SHOWN
ON A SCREEN FOR MOST GRIDS (SOME GRIDS HAVE MORE ITEMS). ON
MOBILE, QUESTIONS IN GRIDS ARE PRESENTED ONE AT A TIME. IF THE
"SAVE AND EXIT" BUTTON IS USED IN THE MIDDLE OF GRID QUESTIONS,
AND SOME OF THE GRID QUESTIONS HAVE BEEN ANSWERED, THE
REMAINING QUESTIONS IN A GRID WILL BE ASSIGNED SK.FOR GRIDS
THAT HAVE BEEN DIVIDED INTO SMALLER GROUPS OF ITEMS, THIS SK
ASSIGNMENT TO THE REMAINING QUESTIONS IN A GRID WILL ONLY
APPLY TO THE DEFINED GRID SET IN THE SMALLER GROUP. ELSE, IF
THERE IS A BREAK OFF OR TIMEOUT IN THE MIDDLE OF GRID QUESTIONS,
NO ANSWERS IN THE GRID WILL BE SAVED OR AUTOMATICALLY
ASSIGNED SK.
TEXT IN RESPONSE OPTIONS IN GRID ITEMS SHOULD BE TOP ALIGNED.

ContextHeader: Source:

Copyright: No

Page 2 of 58

Notes: SPECIFICATION FOR SKIPPED NONRESPONSE QUESTIONS AND TEACHER
SURVEY PROBE:

Box SPB1002. / Spec Skip

IF “TEACHER SURVEY PROBE” IS USED IN THE SPEC AND THE
RESPONDENT DOES NOT ANSWER A QUESTION BUT CLICKS THE “Next”
BUTTON, RELOAD THE PAGE AND DISPLAY THE FOLLOWING TEXT AT THE
TOP WITH ALL ANSWER CATEGORIES SHOWN AGAIN ALONG WITH
CHOICES FOR DON’T KNOW AND REFUSED: “It looks like you haven’t
answered the question yet. Please consider providing an answer to continue.”
ELSE IF A RESPONDENT DOES NOT ANSWER A QUESTION BUT CLICKS
THE “Next” BUTTON, ASSIGN EMPTY THE VALUE “SK” FOR SKIPPED.
SK ANSWERS SKIP TO THE NEXT QUESTION UNLESS OTHERWISE
SPECIFIED.
NOTE: SOME QUESTIONS SHOW DON’T KNOW OPTION AS A RESPONSE
CATEGORY: SIB050, SIB060, SIB210, SIB220, EGB020, EGB050

ContextHeader: Source:

Copyright: No

Box SPB1003. / Soft Edit

Notes: SPECIFICATION FOR SOFT EDIT MESSAGES:
SOFT EDIT MESSAGES SPECIFIED IN PROGRAMMER INSTRUCTIONS
BELOW WILL BE DISPLAYED ON THE SAME SCREEN AS THE ITEM. WHEN
PROGRAMMER SPECIFICATIONS ARE CREATED, THESE MESSAGES WILL
BE SHOWN IN A DIFFERENT FORMAT AS WHAT IS SHOWN BELOW (THEY
WILL BE DISPLAYED AS A FOLLOWUP ITEM), BUT THE CONTENT AND
PLACEMENT OF THE TEXT ON THE SAME SCREEN AS THE ITEM WILL NOT
CHANGE.

ContextHeader: Source:

Copyright: No

Page 3 of 58

Box SPB1004. / OS Spec

Notes: FOR SMALL BROWSERS, THE OTHER SPECIFY ENTRY FIELD WILL BE ON
THE NEXT SCREEN. IF THE BROWSER SIZE IS SMALL, REDISPLAY THE
QUESTION STEM AND LABEL THE OTHER SPECIFY FIELD WITH THE
RESPONSE OPTION FROM THE PREVIOUS QUESTION (E.G., Other
language) AND “(Please specify):”.

ContextHeader: Source:

Copyright: No

Box SPB1005. / Child Name

Notes: SPECIFICATION FOR CHILD'S NAME:
ACCORDING TO STUDY CONVENTION, "{CHILD}" INDICATES A FILL FOR
CHILD'S FIRST NAME. THERE ARE OTHER PLACES IN THE SPECIFICATION
WHERE CHILD'S LAST NAME IS NEEDED. "{CHILD'S LAST NAME}" IS USED
TO INDICATE A FILL FOR CHILD'S LAST NAME. THEREFORE, WHEN THE
CHILD'S FIRST AND LAST NAME ARE NEEDED, THE SPECIFICATION WILL
INDICATE "{CHILD} {CHILD'S LAST NAME}".
DISPLAY {CHILD} {CHILD'S LAST NAME} AS A RUNNING HEADER ON EVERY
SCREEN IN SMALL FONT. RIGHT- JUSTIFY CHILD'S FIRST AND LAST NAME
IN THE TOP RIGHT CORNER OF THE SCREEN ON A LINE ABOVE THE CHILD
ID AND THE QUESTION NUMBER.

ContextHeader: Source:

Copyright: No

Page 4 of 58

Box SPB1006. / Footer

Notes: ON THE FIRST PAGE OF THE BLAISE INSTRUMENT, AS A FOOTER,

DISPLAY THE FOLLOWING LANGUAGE: "Click “Save and Exit” if you need to
take a break. When you’ve completed the survey, click “Finish” on the last
screen. You will be taken back to MyECLS. Exit MyECLS by selecting "Logout"
and closing ALL browser windows or screens to keep your responses secure.
For example, if you used Chrome or Safari to open the website, make sure no
Chrome or Safari windows or screens are open after you end the session. Not
closing all browsers may allow someone else to see your responses.”

ContextHeader: Source:

Copyright: No

SPB1007. / INB000
INB000

Question “Thank you for launching the ECLS survey about {CHILD}!
Here are some tips to keep in mind when completing the survey:
•Complete the survey on a desktop or laptop computer using Chrome, Edge, or
Safari, if possible.
•Use the “Next” and “Back” buttons at the bottom of the screen to move through
the survey. Do not use your browser arrows.
•If you need to stop the survey before finishing and return at a later time,
please select “Save and Exit.” When you return to the survey, you will be taken
where you left off.
• To protect your privacy, you will be logged off if you are idle for 10 minutes.
•Some questions in the survey have additional information to help you, if
needed. To view this additional information, select the blue "i” icon.
•You may skip any questions that you do not want to answer.
Please click on the “Next” button below to start the survey.”
Continue ____________________________________________ 1

ContextHeader: Source: New

Copyright: No

Display Instructions: DISPLAY A BLUE ICON AFTER THE WORD “ICON” IN THE FIFTH BULLET
BELOW.

Page 5 of 58

SPB1008. / SIB010
SIB010

Question “Is {CHILD} currently receiving gifted/talented services through an
IEP, or has {CHILD} received such services during this school year?”
InstResp “Throughout the survey, click the blue “i” icon for more information
about an item."
Yes ________________________________________________ 1
No _________________________________________________ 2
UP TO 2 RESPONSES ALLOWED.

Notes: USE TEACHER SURVEY PROBE AFTER EMPTY.
DISPLAY “IEP” IN BOLD THE FIRST TIME IT APPEARS IN HELP TEXT.
HELP FOR STEM: IEP: An IEP is an individualized education program.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 1. NOTE:

SOURCES THROUGHOUT THE SURVEY WERE BASED ON THE FIRST
TIME AN ITEM APPEARED IN THE ECLS-K:2011 UNLESS AN IMPROVED
VERSION OF THE ITEM WAS USED FROM A LATER ROUND. IF AN
IMPROVED VERSION OF AN ITEM WAS USED FROM A LATER ROUND OF
THE ECLS-K:2011, THAT ROUND WAS CITED INSTEAD.
Copyright: No

SPB1009. / SIB020
SIB020

Question "Is {CHILD} currently receiving special education services through an
IEP due to a disability, or has {CHILD} received such services during this
school year?"
Yes ________________________________________________ 1
No _________________________________________________ 2 (SPB1072)
UP TO 2 RESPONSES ALLOWED.

Notes: USE TEACHER SURVEY PROBE AFTER EMPTY. IF THE ANSWER IS
REFUSED, SKIP TO QUESTION TYB900a.

DISPLAY “IEP” IN BOLD THE FIRST TIME IT APPEARS IN HELP TEXT.
HELP FOR STEM: IEP: An IEP is an individualized education program.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 2
Copyright: No

Page 6 of 58

SPB1010. / SIB030
SIB030

Question “In what capacity or capacities do you currently teach or provide
services to {CHILD}?”
InstResp “Select all that apply.”
Provide instruction directly to {CHILD} _____________________ 1
Provide related services directly to {CHILD}

2

Provide consultation services directly to {CHILD}

3

Provide indirect consultation services (for example,
consultation to {CHILD}’s teacher)

4

Provide case management ______________________________ 5
None of the above_____________________________________ 6
Other {(Please specify):/(Please specify on next
screen.)}

91

UP TO 7 RESPONSES ALLOWED.

Notes:
IF MORE THAN ONE CODE IS SELECTED AND ONE OF THEM IS CODE 6,
DISPLAY HARD ERROR CHECK MESSAGE, “You selected “None of the
above” but also selected another option on the list. Please check your
responses and update your answer. Then, select “Next” to continue.
USE TEACHER SURVEY PROBE AFTER EMPTY.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item 3
to make the item 'select all that apply.'
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

DISPLAY “(Please specify):” FOR LARGE BROWSERS. ELSE DISPLAY
"(Please specify on next screen.)” FOR SMALL BROWSERS.

Box SPB1011. / Box 1

Notes: IF ONE OF THE CODES IN QUESTION SIB030 IS 91, GO TO QUESTION
SIB030OS. ELSE GO TO SIB040.

ContextHeader: Source:

Copyright: No

Page 7 of 58

SPB1012. / SIB030OS
SIB030OS

[0 to 0]

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 3
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

SPB1013. / SIB040
SIB040

Question “Which best describes the extent to which you teach or provide
services to {CHILD} using virtual methods in the current school year?"
Provide all services to {CHILD} using virtual
methods (for example, fully remote, web-based,
online, or distance learning)

1

Provide some combination of virtual and in-person
services to {CHILD} (for example, blended or hybrid
learning)

2

Do not provide any services to {CHILD} virtually (i.e.,
all services are provided in person)

3

Other {(Please specify):/(Please specify on next
screen.)}

91

UP TO 4 RESPONSES ALLOWED.

Notes: USE TEACHER SURVEY PROBE AFTER EMPTY.
ContextHeader: Source:

Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

IN STEM, UNDERLINE ‘CURRENT SCHOOL YEAR.’
DISPLAY “(Please specify):” FOR LARGE BROWSERS. ELSE DISPLAY
"(Please specify on next screen.)” FOR SMALL BROWSERS.

Page 8 of 58

Box SPB1014. / Box 2

Notes: IF ONE OF THE CODES IN QUESTION SIB040 IS 91, GO TO QUESTION
SIB040OS. ELSE GO TO SIB050.

ContextHeader: Source:

Copyright: No

SPB1015. / SIB040OS
SIB040OS

[0 to 0]

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 3
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

Page 9 of 58

SPB10. / SIB050
SIB050

Question “When was {CHILD} first determined eligible for special education or
related services?”
SaVisible “True”
Before kindergarten ____________________________________ 1
During transitional kindergarten __________________________ 2
During kindergarten ____________________________________ 3
During transitional first grade ____________________________ 4
During first grade______________________________________ 5
DON'T KNOW

-8

UP TO 5 RESPONSES ALLOWED.

Notes: DISPLAY DON’T KNOW OPTION (SaVisible “True”)
BOLD “Transitional Kindergarten” AND “Transitional First Grade” IN HELP
TEXT.
HELP FOR CODE 2: Transitional Kindergarten: A transitional kindergarten (TK)
program is an extra year of school before kindergarten starts. It is different from
preschool, Head Start, or prekindergarten. TK may be for children who are too
young to start kindergarten or need more time to be ready for kindergarten.
Schools have different names for these programs (for example, early
transitional kindergarten (ETK), readiness kindergarten, or a kindergarten
equivalent in a classroom without grades or one with multiple grades), but all
are types of kindergarten. The program may be in a public or private school, or
an early childhood setting such as a nursery school, early childhood learning
center, or day care center. It may be a full- or part-day program and have
regular and/or special education.
HELP FOR CODE 4: Transitional First Grade: Transitional first (or pre-first)
grade is a school program between kindergarten and first grade. The name of
this program may vary by school (for example, a K-1 class or placement). It is
for children who have attended kindergarten, but need more time to be ready
for first grade. Children in this program may be part of a regular first-grade
classroom or in a separate classroom.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item 4
to add transitional kindergarten and first grade
Copyright: No

Display Instructions: DISPLAY “determined eligible” IN UNDERLINED TEXT.

Page 10 of 58

SPB11. / SIB060
SIB060

Question “Did {CHILD} have an IEP or Individualized Family Service Plan
(IFSP) last school year (2023-24)?”
SaVisible “True”
Yes ________________________________________________ 1
No _________________________________________________ 2 (SPB1022)
DON'T KNOW

-8

UP TO 2 RESPONSES ALLOWED.

Notes: DISPLAY DON'T KNOW OPTION (SaVisible "True") 2 (No) AND SK AND
DON’T KNOW SKIP TO SIB110.

DISPLAY “IEP” AND “IFSP” IN BOLD IN HELP TEXT.
HELP FOR STEM: IEP: An IEP is an individualized education program.
IFSP: An IFSP is a written document that outlines the child’s current level of
functioning or need, the early intervention services the child and family will
receive, the outcomes the child and the family are expected to achieve, as well
as other information about early intervention services.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item 5
to add IFSP
Copyright: No

SPB1018. / SIB070
SIB070

Question “Did you provide education activities or programs to {CHILD} last
school year (2023-24)?”
Yes ________________________________________________ 1 (SPB1022)
No _________________________________________________ 2 (SPB1019)
UP TO 2 RESPONSES ALLOWED.

ContextHeader: Source:

Copyright: No

Page 11 of 58

SPB1019. / SIB080
SIB080

Question “To what extent were you involved in planning {CHILD}’s transition
from last school year’s early intervention or special education program to this
school year’s program?”
Not at all ____________________________________________ 1
Somewhat ___________________________________________ 2
Extensively __________________________________________ 3
UP TO 3 RESPONSES ALLOWED.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item 6
to add early intervention
Copyright: No

SPB1020. / SIB090
SIB090

Question “To what extent did you communicate with the person(s) who
provided early intervention or special education services to {CHILD} last school
year?”
Not at all ____________________________________________ 1
Somewhat ___________________________________________ 2
Extensively __________________________________________ 3
UP TO 3 RESPONSES ALLOWED.

ContextHeader: Source: Adapted ECLS-K:2011 Spring Kindergarten questionnaire, item 7 to
add early intervention
Copyright: No

Page 12 of 58

SPB1021. / SIB100
SIB100

Question “Have you reviewed {CHILD}’s records related to early intervention or
special education services provided before this school year?”
Yes. ________________________________________________ 1
No, I don't have access to the records. _____________________ 2
No, I have access to the records but have not
reviewed them.

3

UP TO 3 RESPONSES ALLOWED.

ContextHeader: Source: Adapted ECLS-K:2011 Spring First-Grade questionnaire, item 7, to
add early intervention to the stem.
Copyright: No

Page 13 of 58

SPB1022. / SIB110
SIB110

Question “What is {CHILD}’s primary disability as identified on {CHILD}’s IEP?”
InstResp “Please select the category below into which the child’s primary
disability fits best. Select only one.”
Autism ______________________________________________ 1
Deaf-blindness _______________________________________ 2
Developmental delay___________________________________ 3
Emotional disturbance__________________________________ 4
Hearing impairments (including deafness)

5

Intellectual disability ___________________________________ 6
Orthopedic impairments ________________________________ 7
Other health impairments _______________________________ 8
Specific learning disabilities _____________________________ 9
Speech or language impairments ________________________ 10
Traumatic brain injury _________________________________ 11
Visual impairments (including blindness)

12

Multiple disabilities (children included in this
category should be those who have more than one
primary disability which do not include
deaf-blindness or developmental delay)

13

No classification is given. ______________________________ 14
UP TO 14 RESPONSES ALLOWED.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 9
Copyright: No

Display Instructions: DISPLAY "primary" IN UNDERLINED TEXT.

Page 14 of 58

SPB1023. / SIB120
SIB120

Question “What are {CHILD}’s other disabilities, if any, as identified on
{CHILD}’s IEP?”
InstResp “Select all that apply.”
{Autism}_____________________________________________ 1
{Deaf-blindness} ______________________________________ 2
{Developmental delay} _________________________________ 3
{Emotional disturbance} ________________________________ 4
{Hearing impairments (including deafness)}

5

{Intellectual disability} __________________________________ 6
{Orthopedic impairments} _______________________________ 7
{Other health impairments} ______________________________ 8
{Specific learning disabilities} ____________________________ 9
{Speech or language impairments} _______________________ 10
{Traumatic brain injury} ________________________________ 11
{Visual impairments (including blindness)}

12

{Multiple disabilities (children included in this
category should be those who have more than one
primary disability which do not include
deaf-blindness or developmental delay)}

13

{No classification is given}______________________________ 14
No other disabilities. __________________________________ 15

Page 15 of 58

UP TO 15 RESPONSES ALLOWED.

Notes: DISPLAY RESPONSE CODE 15 ABOVE RESPONSE CODE 1.
CODE ALL THAT APPLY FOR 1-14.
IF CODE 15 IS SELECTED WITH ANY ANSWER CHOICES 1-13, DISPLAY
ERROR MESSAGE "You selected both "No other disabilities" and one or more
disabilities. Please select {CHILD}'s other disabilities in this question. If
{CHILD} has none, please select only "No other disabilities.””
IF CODE 14 IS SELECTED AND CODE 15 IS SELECTED, DISPLAY ERROR
MESSAGE "You selected both "No other disabilities" and "No classification is
given". If {CHILD} has no other disabilities, please select only "No other
disabilities". If {CHILD} has other, non-classified disabilities, please select only
"No classification is given.””

ContextHeader: Source: New.

Copyright: No

Display Instructions: IF QUESTION SIB110 IS NOT EQUAL TO SK, DISPLAY ALL CODES 1-15 IN
QUESTION SIB120 EXCEPT FOR THE CODE CHOSEN FOR 1- 14IN
QUESTION SIB110. ELSE IF QUESTION SIB110 = SK, DISPLAY ALL
CODES 1-15.

SPB1024. / SIB130
SIB130

Question “During this school year, has {CHILD} received any special education
or related services because of attention deficit disorder (ADD) or attentiondeficit/hyperactivity disorder (ADHD)?”
Yes ________________________________________________ 1
No _________________________________________________ 2
UP TO 2 RESPONSES ALLOWED.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item 11
Copyright: No

Page 16 of 58

SPB1025. / SIB140
SIB140

Question “During this school year, which of the following describe(s) the IEP
goals for {CHILD}?”
InstResp “Select all that apply.”
Reading_____________________________________________ 1
Mathematics _________________________________________ 2
Language Arts ________________________________________ 3
Science _____________________________________________ 4
Auditory processing____________________________________ 5
Listening comprehension _______________________________ 6
Oral expression _______________________________________ 7
Voice/speech articulation _______________________________ 8
Language pragmatics __________________________________ 9
Social skills _________________________________________ 10
General appropriateness of behavior _____________________ 11
Adaptive behavior or self-help skills ______________________ 12
Fine motor skills _____________________________________ 13
Gross motor skills ____________________________________ 14
Orientation and mobility _______________________________ 15
None of the above____________________________________ 16
Other {(Please specify):/(Please specify on next
screen.)}

91

Page 17 of 58

UP TO 17 RESPONSES ALLOWED.

Notes: DISPLAY CODES 1-4 UNDER HEADER "Academics", DISPLAY CODES 5-9
UNDER HEADER "Speech and language", DISPLAY CODES 10-11 UNDER
HEADER "Social", DISPLAY CODE 12 UNDER HEADER "Life Skills",
DISPLAY CODES 13-15 UNDER HEADER "Physical/Mobility", DISPLAY
CODES 91 AND 16 UNDER HEADER "Other/None".

IF MORE THAN ONE CODE IS SELECTED AND ONE OF THEM IS CODE 16,
DISPLAY HARD ERROR CHECK MESSAGE, “You selected “None of the
above” but also selected another option on the list. Please check your
responses and update your answer. Then, select “Next” to continue.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 12
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

DISPLAY “(Please specify):” FOR LARGE BROWSERS. ELSE DISPLAY
"(Please specify on next screen.)” FOR SMALL BROWSERS.

Box SPB1026. / Box 3

Notes: IF ONE OF THE CODES IN QUESTION SIB140 IS 91, GO TO QUESTION
SIB140OS. ELSE GO TO SIB150.

ContextHeader: Source:

Copyright: No

Page 18 of 58

SPB1027. / SIB140OS
SIB140OS

[0 to 0]

ContextHeader: Source:

Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

Page 19 of 58

SPB1028. / SIB150
SIB150

Question “During this school year, which of the following related services have
been provided through the school to {CHILD}?”
InstResp “Select all that apply.”
Audiology ___________________________________________ 1
Counseling services ___________________________________ 2
Occupational therapy __________________________________ 3
Physical therapy ______________________________________ 4
Psychological services _________________________________ 5
Health services _______________________________________ 6
Social work services ___________________________________ 7
Special transportation __________________________________ 8
Speech or language therapy _____________________________ 9
Orientation services __________________________________ 10
Mobility services _____________________________________ 11
Rehabilitation services ________________________________ 12
No related services were provided. _______________________ 13
Other {(Please specify):/(Please specify on next
screen.)}

91

UP TO 14 RESPONSES ALLOWED.

Notes:
IF CODE 13 IS SELECTED WITH ANY ANSWER CHOICES 1-12 or 91
DISPLAY ERROR MESSAGE “You selected both “No related services were
provided” and one or more related services. Please select the related services
{CHILD} received. If {CHILD} received none, please select only “No related
services were provided.”"

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 13
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

DISPLAY “(Please specify):” FOR LARGE BROWSERS. ELSE DISPLAY
"(Please specify on next screen.)” FOR SMALL BROWSERS.

Page 20 of 58

Box SPB1029. / Box 4

Notes: IF ONE OF THE CODES IN QUESTION SIB150 IS 91, GO TO QUESTION
SIB150OS. ELSE GO TO SIB160.

ContextHeader: Source:

Copyright: No

SPB1030. / SIB150OS
SIB150OS

[0 to 0]

ContextHeader: Source:

Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

Page 21 of 58

SPB1031. / SIB160

SIB160

Question “During this school year, has {CHILD} received any of the following?”
InstResp “Select all that apply.”
Adaptive physical education _____________________________ 1
Assistance from classroom aides (for example,
teacher aide, behavioral assistant, special education
aide)

2

Interpreter for the deaf or hard of hearing (oral or
sign)

3

Use of Braille during instruction by teacher or student

4

Use of American Sign Language during instruction
by teacher or student

5

Use of Manual English during instruction by teacher
or student

6

Use of Cued Speech during instruction by teacher or
student

7

Mental health services, personal/group counseling,
therapy, or psychiatric care provided to the child

8

Tutoring/remediation from special education teacher

9

Training, counseling, and other supports/services
provided to child's family

10

Creative arts therapies (CAT) provided to the child
(for example, visual, music, dance, drama therapy)

11

None of the above____________________________________ 12
UP TO 12 RESPONSES ALLOWED.

Notes: IF MORE THAN ONE CODE IS SELECTED AND ONE OF THEM IS CODE 12,
DISPLAY HARD ERROR CHECK MESSAGE, “You selected “None of the
above” but also selected another option on the list. Please check your
responses and update your answer. Then, select “Next” to continue.

ContextHeader: Source: Adapted ECLS-K:2011 Spring Kindergarten questionnaire, item 14, by
consolidating response options related to the use of Braille, ASL, Manual
English, and Cued Speech, and by adding a response option for Creative Arts
Therapies
Copyright: No

Page 22 of 58

SPB1032. / SIB170
SIB170

Question “During this school year, has {CHILD}’s primary placement been a
general education classroom?”
Yes ________________________________________________ 1
No _________________________________________________ 2
UP TO 2 RESPONSES ALLOWED.

Notes: USE TEACHER SURVEY PROBE AFTER EMPTY.
ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 15
Copyright: No

SPB1033. / SIB180
SIB180

Question “During this school year, approximately how many hours per week of
direct special education and related services (that is, service provided directly
to the child, from a teacher or another adult) has {CHILD} received?”
InstResp “Please round to the nearest hour.”
Pre-Unit “Hours:”
Watermark “Hours per week”
|

|

|

|

[0 to 168]

Notes: IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR MESSAGE, "You have

entered {DISPLAY RESPONSE AT SIB180}. Please confirm. If this is correct,
select Next to continue."

ContextHeader: Source: ECLS-K:2011 Spring Second-Grade questionnaire, item 15
Copyright: No

Display Instructions: DISPLAY “hours per week” IN THE QUESTION STEM IN UNDERLINED TEXT.

Page 23 of 58

SPB1034. / SIB240SR

Check to see if:

Soft Range: 0- 60

If not, display:
@I[UNLIKELY RESPONSE. VERIFY AND RE-ENTER.]@I

SPB1035. / SIB190
SIB190

Question “Of the hours of direct special education and related services reported
above, approximately how many of those hours per week were the
instruction/services provided outside of a general education classroom but
within the school setting?”
InstResp “Please round to the nearest hour.”
Pre-Unit “Hours:”
Watermark “Hours per week”
|

|

|

|

[0 to 168]

Notes: IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR MESSAGE, "You have

entered {DISPLAY RESPONSE AT SIB190}. Please confirm. If this is correct,
select Next to continue."
IF RESPONSE FOR SIB190 (HOURS OF INSTRUCTION OUTSIDE
GENERAL ED) > RESPONSE FOR SIB180 (HOURS OF DIRECT SPECIAL
ED), DISPLAY SOFT ERROR MESSAGE: "The response you entered for
hours of direct special education provided outside the general education
classroom is greater than the response entered for hours of direct special
education. Are you sure this is correct? When it is correct, select Next to
continue."

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 17
Copyright: No

Display Instructions: DISPLAY "hours per week" IN UNDERLINED TEXT.

Page 24 of 58

SPB1037. / SIB200
SIB200

Question “During this school year, what teaching practices and methods have
you and/or other special education service providers used with {CHILD}?”
InstResp “Select all that apply.”
One-on-one instruction _________________________________ 1
Small-group instruction _________________________________ 2
Large-group instruction _________________________________ 3
Co-teaching __________________________________________ 4
Cooperative learning ___________________________________ 5
Peer tutoring _________________________________________ 6
Computer-based instruction _____________________________ 7
Direct instruction ______________________________________ 8
Cognitive strategies ____________________________________ 9
Self-management ____________________________________ 10
Behavior management ________________________________ 11
Instruction received through a sign interpreter

12

None of the above____________________________________ 13
UP TO 13 RESPONSES ALLOWED.

Notes: IF MORE THAN ONE CODE IS SELECTED AND ONE OF THEM IS CODE 13,
DISPLAY HARD ERROR CHECK MESSAGE, “You selected “None of the
above” but also selected another option on the list. Please check your
responses and update your answer. Then, select “Next” to continue.
BOLD “Co-teaching” IN HELP TEXT.
HELP FOR CODE 4: Co-teaching is when a general education teacher and a
special education service provider share the teaching responsibility, with the
special education service provider providing specialized differentiated lessons
for students with special needs. The two teachers participate in lesson or
activity planning together and work together in the same classroom to instruct
both students with and without disabilities.

ContextHeader: Source: ECLS-K:2011 Spring Fifth-Grade questionnaire, item 19
Copyright: No

Page 25 of 58

SPB26. / SIB210
SIB210

Question “During this school year, which of the following best describes the
curriculum materials used with {CHILD} in the general education classroom?”
SaVisible “True”
General education curriculum materials were used
without modification.

1

General education curriculum materials were used
with some modifications.

2

General education curriculum materials were used
with substantial modifications.

3

Specially-designed commercial materials were used.

4

Teacher-designed materials were used. ____________________ 5
Child not in this setting. _________________________________ 6
DON'T KNOW

-8

UP TO 6 RESPONSES ALLOWED.

Notes: DISPLAY DON'T KNOW OPTION (SaVisible "True").
IF RESPONSE FOR SIB170 = 1 (CHILD'S PRIMARY PLACEMENT IS IN
GENERAL EDUCATION) THEN FOR SIB210 DO NOT DISPLAY RESPONSE
CODE 6 (CHILD NOT IN THIS SETTING). ELSE, AT SIB210 DISPLAY ALL
RESPONSE CODES 1-6.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 19
Copyright: No

Display Instructions: DISPLAY "best" and “general education classroom” in UNDERLINED TEXT.

Page 26 of 58

SPB27. / SIB220
SIB220

Question “During this school year, which of the following best describes the
curriculum materials used with {CHILD} in the special education classroom or
program?”
SaVisible “True”
General education curriculum materials were used
without modification.

1

General education curriculum materials were used
with some modifications.

2

General education curriculum materials were used
with substantial modifications.

3

Specially-designed commercial materials were used.

4

Teacher-designed materials were used. ____________________ 5
Child not in this setting. _________________________________ 6
DON'T KNOW

-8

UP TO 6 RESPONSES ALLOWED.

Notes: DISPLAY DON'T KNOW OPTION (SaVisible “True”).
ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 19
Copyright: No

Display Instructions: DISPLAY "best" and “special education classroom” in UNDERLINED TEXT.

SPB1040. / SIB230
SIB230

Question “Did {CHILD} use any assistive technologies this year?”

Yes ________________________________________________ 1
No _________________________________________________ 2 (SPB1044)
UP TO 2 RESPONSES ALLOWED.

Notes: SK SKIPS TO SIB250.
ContextHeader: Source: Westat, new
Copyright: No

Page 27 of 58

SPB1041. / SIB240
SIB240

Question “During this school year, which of the following assistive technologies
and devices has {CHILD} used?”
InstResp “Select all that apply.”
Vans, vehicles ________________________________________ 1
Wheelchair __________________________________________ 2
Walker ______________________________________________ 3
White cane __________________________________________ 4
Electronic with voice output (for example, Touch
Talker)

5

Electronic without voice output (for example, device
with visual display or printed speech output)

6

Non-electronic (for example, manual printing board)

7

Hearing aids _________________________________________ 8
FM loops ____________________________________________ 9
TTYs/TDDs _________________________________________ 10
Cochlear implants ____________________________________ 11
Real-time captioning __________________________________ 12
Braille texts _________________________________________ 13
Electronic Braille devices ______________________________ 14
Digital texts _________________________________________ 15
Magnifying devices ___________________________________ 16
Close-captioned television (CCTV) _______________________ 17
Tape recorder _______________________________________ 18
Calculator __________________________________________ 19
Electronic spelling devices _____________________________ 20
Used solely by individual child___________________________ 21
Shared with other children______________________________ 22
Reading____________________________________________ 23
Writing _____________________________________________ 24
Mathematics ________________________________________ 25
No assistive technologies or devices were used.

26

Other assistive technologies or devices {(Please
specify):/(Please specify on next screen.)}

91

Page 28 of 58

UP TO 27 RESPONSES ALLOWED.

Notes: DISPLAY CODES 1-4 UNDER HEADER "Mobility aids", DISPLAY CODES 5-7
UNDER HEADER "Communication aids", DISPLAY CODES 8-12 UNDER
HEADER "Hearing assistance", DISPLAY CODES 13-17 UNDER HEADER
"Visual aids", DISPLAY CODES 18-20 UNDER HEADER "Learning aids (noncomputer)", DISPLAY CODES 21-22 UNDER HEADER "Computer hardware
designed or adapted for children with disabilities (for example, alternate
keyboards, switch interface)", DISPLAY CODES 23-25 UNDER HEADER
"Computer software designed for children with disabilities", DISPLAY CODES
91 AND 26 UNDER HEADER "Other/None".

IF CODE 26 IS SELECTED, CODES 1-25 MAY NOT BE SELECTED.
DISPLAY ERROR CHECK MESSAGE, "You selected both "No assistive
technologies or devices were used" and one or more assistive technologies or
devices. Please select the assistive technologies or devices {CHILD} has used.
If {CHILD} used none, please select only "No assistive technologies or devices
were used.""

ContextHeader: Source: ECLS-K:2011 Spring Second-Grade questionnaire, item 19, modified
to add yes/no skip
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

AVOID WRAPPING WITHIN AN ITEM.
DISPLAY “(Please specify):” FOR LARGE BROWSERS. ELSE DISPLAY
"(Please specify on next screen.)” FOR SMALL BROWSERS.

Box SPB1042. / Box 5

Notes: IF ANY CODES IN QUESTION SIB240 = 91, GO TO SIB240OS. ELSE, GO
TO QUESTION SIB250.

ContextHeader: Source:

Copyright: No

Page 29 of 58

SPB1043. / SIB240OS
SIB240OS

[0 to 0]

ContextHeader: Source:

Copyright: No

Display Instructions: DISPLAY OTHER SPECIFY FIELD ON SAME PAGE AS 20b FOR LARGE
BROWSERS.

SPB1044. / SIB250
SIB250

Question “During this school year, does {CHILD} have a computer, laptop, or
word processing device assigned to {him/her/them} for use full time?”
Yes ________________________________________________ 1
No _________________________________________________ 2
UP TO 2 RESPONSES ALLOWED.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item
21, to add ‘During this school year’
Copyright: No

Display Instructions: IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "them" following
"device assigned to" (DO NOT USE THE DEFAULT FILL OF CHILD'S
NAME).

Page 30 of 58

SPB1045. / SIB260
SIB260

Question “During this school year, on average, how often have you met with
{CHILD}'s general education teacher(s) to discuss {his/her/their} program or
progress?”
Every day or several times a week

1

Once a week or several times a month

2

Once a month

3

A few times over the school year

4

Once during this school year

5

Never during this school year

6

(SPB1047)

Not applicable because I am {CHILD}’s general
education teacher

7

(SPB1047)

Not applicable to my work with {CHILD}

8

(SPB1047)

UP TO 8 RESPONSES ALLOWED.

Notes: CODES 6, 7, 8, and SK SKIPS TO SIB280.
ContextHeader: Source: ECLS-K:2011 Spring Second-Grade questionnaire, item 21, modified
stem to accommodate autofill
Copyright: No

Display Instructions: ADD EXTRA SPACE (LINE BREAK) BETWEEN RESPONSE CODES 7 AND 8.
IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "their" following "to
discuss" (DO NOT USE THE DEFAULT FILL OF CHILD'S NAME).

Page 31 of 58

SPB1046. / SIB270
SIB270

Question “On average, how long were the meetings with the general education
teacher(s) to discuss {CHILD}'s program or progress?”
1 to 5 minutes ________________________________________ 1
6 to 15 minutes _______________________________________ 2
16 to 30 minutes ______________________________________ 3
31 to 45 minutes ______________________________________ 4
46 to 60 minutes ______________________________________ 5
More than 60 minutes __________________________________ 6
UP TO 6 RESPONSES ALLOWED.

ContextHeader: Source: Adapted ECLS-K:2011 Spring Kindergarten questionnaire, item 23, by
disaggregating original response options into finer grained categories
Copyright: No

SPB1047. / SIB280
SIB280

Question “During this school year, approximately how often have you
communicated with {CHILD}’s parents about {CHILD}’s program or progress
(by phone, in person, or in writing, including e-mail)?”
Every day or several times a week ________________________ 1
Once a week or several times a month _____________________ 2
Once a month ________________________________________ 3
A few times over the school year _________________________ 4
Once during this school year_____________________________ 5
Never during this school year ____________________________ 6
UP TO 6 RESPONSES ALLOWED.

ContextHeader: Source: ECLS-K:2011 Spring Second-Grade questionnaire, item 23
Copyright: No

Page 32 of 58

SPB1046. / SIB270

Page 33 of 58

Student Teacher Relationship
Teachers rate 15 items from the Student-Teacher Relationship Scale (STRS) to measure the teacher’s
perception of the closeness and conflict in his/her relationship with the student. The items from the
STRS are not listed because the scale is copyright protected.

Page 34 of 58

SPB1049. / CCB010a
CCB010a

Question “Now we would like to ask about your relationship with {CHILD}. For
each statement, please select the category that most applies to your
relationship with {CHILD}.
X xxxxx xx xxxxxxxxxxxx, xxxx xxxxxxxxxxxx xxxx xxxx xxxxx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would…with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 35 of 58

SPB1050. / CCB010b
CCB010b

Question “Xxxx xxxxx xxx X xxxxxx xxxx xx xx xxxxxxxxxx xxxx xxxx xxxxx.”

Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 36 of 58

SPB1051. / CCB010c
CCB010c

Question “Xx xxxxx, xxxx xxxxx xxxx xxxx xxxxxxx xxxx xx.”

Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 37 of 58

SPB1052. / CCB010d
CCB010d

Question “Xxxx xxxxx xx xxxxxxxxxxxxx xxxx xxxxxxxx xxxxxxxxx xx xxxxx xxxx xx.”

Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 38 of 58

SPB1053. / CCB010e
CCB010e

Question “Xxxx xxxxx xxxxxx {xxx/xxx/xxxxx} xxxxxxxxxxxx xxxx xx.”

Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "their" following "This
child values" (DO NOT USE THE DEFAULT FILL OF CHILD'S NAME).

Page 39 of 58

SPB1054. / CCB010f
CCB010f

Question “{(Continued) }For each statement, please select the category that
most applies to your relationship with {CHILD}.
Xxxx X xxxxxx xxxx xxxxx, {xx xxxxx/xxx xxxxx/xxxx xxxx} xxxx xxxxx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "they beam" following
"this child," (DO NOT USE THE DEFAULT FILL OF CHILD'S NAME).

Page 40 of 58

SPB1055. / CCB010g
CCB010g

Question “Xxxx xxxxx xxxxxxxxxxxxx xxxxxx xxxxxxxxxxx xxxxx
{xxxxxxx/xxxxxxx/xxxxxxxx}.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "themself" following
"information about" (DO NOT USE THE DEFAULT FILL OF CHILD'S NAME).

Page 41 of 58

SPB1056. / CCB010h

CCB010h

Question “Xxxx xxxxx xxxxxx xxxxxxx xxxxx xx xx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 42 of 58

SPB1057. / CCB010i
CCB010i

Question “Xx xx xxxx xx xx xx xxxx xxxx xxxx xxxx xxxxx xx xxxxxxx.”

Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 43 of 58

SPB1058. / CCB010j
CCB010j

Question “Xxxx xxxxx xxxxxxx xxxxx xx xx xxxxxxxxx xxxxx xxxxx xxxxxxxxxxx.”

Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 44 of 58

SPB1059. / CCB010k
CCB010k

Question “{(Continued) }For each statement, please select the category that
most applies to your relationship with {CHILD}.
Xxxxxxx xxxx xxxx xxxxx xxxxxx xx xxxxxx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 45 of 58

SPB1060. / CCB010l
CCB010l

Question “Xxxx xxxx xxxxx xx xx x xxx xxxx, X xxxx xx’xx xx xxx x xxxx
xxx xxxxxxxxx xxx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 46 of 58

SPB1061. / CCB010m
CCB010m

Question “Xxxx xxxxx’x xxxxxxxx xxxxxx xx xxx xx xxxxxxxxxxxxx xx xxx xxxxxx
xxxxxxxx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 47 of 58

SPB1062. / CCB010n

CCB010n

Question “Xxxx xxxxx xx xxxxxx xx xxxxxxxxxxxx xxxx xx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

Page 48 of 58

SPB1063. / CCB010o
CCB010o

Question “Xxxx xxxxx xxxxxx xxxxxx {xxx/xxx/xxxxx} xxxxxxxx xxx xxxxxxxxxxx xxxx
xx.”
Definitely does not apply ________________________________ 1
Not really ____________________________________________ 2
Neutral, not sure ______________________________________ 3
Applies sometimes ____________________________________ 4
Definitely applies ______________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships

and children's success in the first years of school. School Psychology Review,
33(3): 444-458.
Copyright: Yes

Display Instructions: IF THE BROWSER SIZE IS LARGE, DISPLAY CCB010a - CCB010e,

CCB010f - CCB010j AND CCB010k - CCB010o ON SEPARATE SCREENS IN
THREE GRIDS. FOR GRID CCB010a - CCB010e, DISPLAY “Now we
would...with {CHILD}.” AT TOP OF THE GRID. FOR GRIDS CCB010fCCB010j AND CCB010k-CCB010o, DISPLAY "For each statement, please
select the category that most applies to your relationship with {CHILD}." AT
THE TOP OF THE GRID.

IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "their" following "openly
shares" (DO NOT USE THE DEFAULT FILL OF CHILD'S NAME).

Page 49 of 58

SPB1064. / EGB010
EGB010

Question “Now we would like to ask about {CHILD}’s educational goals. During
this school year, has {CHILD} received formal individual evaluations in any of
the following areas for purposes of developing IEP goals?”
InstResp “Select all that apply.”
Psychological ________________________________________ 1
Speech/language _____________________________________ 2
Vision ______________________________________________ 3
Hearing _____________________________________________ 4
Learning style ________________________________________ 5
Motor skills __________________________________________ 6
Academics __________________________________________ 7
No evaluations for developing IEP goals were
conducted this year.
Other {(Please specify):/(Please specify on next
screen.)}

8
91

UP TO 9 RESPONSES ALLOWED.

Notes:
IF MORE THAN ONE CODE IS SELECTED AND ONE OF THEM IS CODE 8,
DISPLAY HARD ERROR CHECK MESSAGE, “You selected “No evaluations
for developing IEP goals were conducted this year” but also selected another
option on the list. Please check your responses and update your answer.
Then, select “Next” to continue.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 25. Transition
text was added as part of the item, and ‘no evaluations for developing IEP
goals were conducted this year’ was added as a response option.
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

DISPLAY “(Please specify):” FOR LARGE BROWSERS. ELSE DISPLAY
"(Please specify on next screen.)” FOR SMALL BROWSERS.

Page 50 of 58

Box SPB1065. / Box 7

Notes: IF ANY CODE IN QUESTION EGB010= 91, GO TO EGB010OS. ELSE, GO
TO EBG020.

ContextHeader: Source:

Copyright: No

SPB1066. / EGB010OS
EGB010OS

[0 to 0]

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 25.
Copyright: No

Display Instructions: DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON ONE PAGE FOR
LARGE BROWSERS.

Page 51 of 58

SPB52. / EGB020
EGB020

Question “To what extent is {CHILD} expected to achieve the same general
education goals as other children at {his/her/their} grade level this school year?”
SaVisible “True”
{CHILD} is expected to attain grade level
achievement for all of the academic content
standards.

1

{CHILD} is expected to attain grade level
achievement for some of the academic content
standards.

2

{CHILD} is expected to attain grade level
achievement for only a few of the academic content
standards.

3

{CHILD} is not expected to attain grade level
achievement for any of the academic content
standards.

4

There are no academic content standards at this
grade level.

5

DON'T KNOW

-8

UP TO 5 RESPONSES ALLOWED.

Notes: DISPLAY DON'T KNOW OPTION (SaVisible “True”).
ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 26.
Copyright: No

Display Instructions: IN RESPONSE OPTION 1, DISPLAY “all” IN UNDERLINED TEXT. IN

RESPONSE OPTION 2, DISPLAY “some” IN UNDERLINED TEXT. IN
RESPONSE OPTION 3, DISPLAY “only a few” IN UNDERLINED TEXT. IN
RESPONSE OPTION 4, display “not” AND “any” IN UNDERLINED TEXT.

IF GENDER IS MISSING IN THE PRELOAD, DISPLAY "their" following "other
children at" (DO NOT USE THE DEFAULT FILL OF CHILD'S NAME).

Page 52 of 58

SPB53. / EGB030
EGB030

Question “What percentage of {CHILD}’s current IEP goals have been met or
nearly met at this point in the school year?”
76 to 100 percent

1

51 to 75 percent

2

26 to 50 percent

3

1 to 25 percent

4

0 percent ____________________________________________ 5
UP TO 5 RESPONSES ALLOWED.

ContextHeader: Source: ECLS-K:2011 Spring Kindergarten questionnaire, item 27.
Copyright: No

SPB1069. / EGB040
EGB040

Question “Which of the following best expresses the likelihood that {CHILD} will
continue to receive some level of special education services (through an IEP) in
the next school year?”
Definitely will continue in special education

1

Very likely to continue in special education

2

Likely to continue in special education _____________________ 3
Unlikely to continue in special education ___________________ 4
Very unlikely to continue in special education

5

Definitely will not continue in special education (will
be dismissed from services)

6

UP TO 6 RESPONSES ALLOWED.

ContextHeader: Source: Adapted from ECLS-K:2011 Spring Kindergarten questionnaire, item
28, modified response options.
Copyright: No

Display Instructions: DISPLAY "not" IN CODE 6 IN UNDERLINED TEXT.

Page 53 of 58

SPB54. / EGB050
EGB050

Question “During this school year, to what extent has {CHILD} participated in
any grade-level assessment administered as part of the school's testing
program?”
SaVisible “True”
{Child} did not participate in the school's testing or
assessment program.

1

{Child} participated in alternate assessments and no
regular assessments.

2

{Child} participated in some alternate assessments
and some regular assessments.

3

{Child} participated fully in the school's regular
testing or assessment program.

4

There is no testing or assessment program at this
grade level.

5

DON'T KNOW

-8

UP TO 5 RESPONSES ALLOWED.

Notes: DISPLAY DON'T KNOW OPTION (SaVisible “True”).
ContextHeader: Source: ECLS-K:2011 Spring Second-Grade Questionnaire, item 28.
Copyright: No

Page 54 of 58

SPB55. / EGB060
EGB060

Question “How far in school do you expect {CHILD} to go?"

Receive less than a high school diploma

1

(SPB1074)

Graduate from high school

2

(SPB1074)

Attend a vocational or technical school after high
school

3

(SPB1074)

Attend two or more years of college

4

(SPB1074)

Finish a four- or five-year college degree

5

(SPB1074)

Earn a master's degree or equivalent

6

(SPB1074)

Finish a Ph.D., MD, or other advanced degree

7

(SPB1074)

UP TO 7 RESPONSES ALLOWED.

Notes: HELP FOR STEM: This question is about how far in school you realistically

expect {CHILD} to go, not how far you hope {CHILD} will go. If this is difficult to
answer, make your best guess.
IF ANY CODE IN QUESTION EGB060 = 1-7 or SK, GO TO TYB900b.

ContextHeader: Source: New item.
Copyright: No

SPB1072. / TYB900a
TYB900a

Question “Thank you very much for answering these questions about {CHILD}.
Because {CHILD} did not receive special education services during this school
year, no additional information is needed. Please click "Finish" to complete
your survey for {CHILD} and then check to see if there are any more children
assigned to you.”
Continue ____________________________________________ 1

Notes: INCLUDE FINISH BUTTON THAT ROUTES BACK TO MANAGEMENT
SYSTEM TEACHER LANDING PAGE.

ContextHeader: Source: New item.
Copyright: No

Page 55 of 58

Box SPB1073. / Box 56

Notes: CASE WITH A CHILD WHO DOES NOT RECEIVE SPECIAL EDUCATION
SERVICES (QUESTION SIB020 = 2/RF/DK) HAS ROUTED BACK TO
MANAGEMENT SYSTEM. THIS SURVEY IS COMPLETE.

ContextHeader: Source:

Copyright: No

SPB1074. / TYB900b
TYB900b

Question “Thank you for answering questions about {CHILD} and for taking the
time to participate in the Early Childhood Longitudinal Study. Please select
“Finish” to complete your survey for {CHILD} and return to the MyECLS
website. You can then check to see if there are any more children for whom a
survey needs to be completed.
NOTE: This survey contains copyrighted material that was adapted and used
with permission. Do not use or reproduce without permission.
Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships and
children's success in the first years of school. School Psychology Review,
33(3): 444-458. Used with permission.”
Continue ____________________________________________ 1

Notes: INCLUDE FINISH BUTTON THAT ROUTES BACK TO MANAGEMENT
SYSTEM TEACHER LANDING PAGE.

ContextHeader: Source: New item.
Copyright: No

Display Instructions: DISPLAY “NOTE: This survey contains copyrighted material that was adapted
and used with permission. Do not use or reproduce without permission.” IN
BOLD TEXT.
DISPLAY “School Psychology Review, 33” IN ITALICS.

Page 56 of 58

Box SPB1075. / Box 57

Notes: CASE WITH COMPLETED SPECIAL EDUCATION TEACHER SURVEY HAS

ROUTED BACK TO THE MANAGEMENT SYSTEM SO THAT THE TEACHER
MAY SELECT ANOTHER SURVEY ASSIGNED TO THEM, IF APPLICABLE.

ContextHeader: Source:

Copyright: No

[End of SPB]

Page 57 of 58

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