Att B-2 Sp K Parent Survey Eng Span_red_rev 2024_0201

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

Att B-2 Sp K Parent Survey Eng Span_red_rev 2024_0201

OMB: 1850-0750

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Early Childhood Longitudinal Study,
Kindergarten Class of 202-2
(ECLS-K:202)
Kindergarten and First-Grade National Data
Collection and Transfer School Recruitment

OMB# 1850-0750 v.29

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U.S. Department of Education

October 2022
revised April 2023
revised October 2023

Note: Some items in this survey are copyright protected and as
such are redacted in public review copies.

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

INQ

Introduction

__________________________________________________________

Grid Spec

(all sections)

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 PARENT
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. 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.

__________________________________________________________

Spec Skip

(all sections)

SPECIFICATION FOR SKIPPED NONRESPONSE
QUESTIONS AND PARENT SURVEY PROBE:

IF “PARENT 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."

IF “PARENT SURVEY PROBE” IS USED IN THE
SPEC AND THE RESPONDENT DOES NOT
ANSWER A QUESTION BUT CLICKS THE
“Siguiente” 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: "Parece que todavía no
ha contestado la pregunta. Por favor considere
dar una respuesta para continuar."

ELSE IF A RESPONDENT DOES NOT ANSWER A
QUESTION BUT CLICKS THE “Next” BUTTON,
ASSIGN EMPTY THE VALUE “SK” FOR SKIPPED.

ELSE IF A RESPONDENT DOES NOT ANSWER A
QUESTION BUT CLICKS THE “Siguiente”
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: INQ060b,
SPQ015, SPQ025, SPQ041, SPQ060, SPQ099,
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230,
FSQ200, CHQ130, CHQ250a, CHQ255a,
CHQ257a, CHQ264a, CHQ271, CHQ272a,
CHQ275a, CHQ276b, CHQ285, CHQ305a,
CHQ305c, CHQ375a, CHQ375c, PEQ020,
EMQ300, EMQ305a, EMQ305b, WPQ030,
CMQ170a, AND CMQ525e.

__________________________________________________________

Soft Edit

(all sections)

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

__________________________________________________________

OS Spec

(all sections)

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):".

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., Otro idioma) AND "(Por favor
especifique):".

__________________________________________________________

Footer

(All sections)

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.”

ON THE FIRST PAGE OF THE BLAISE INSTRUMENT,
AS A FOOTER, DISPLAY THE FOLLOWING
LANGUAGE:
"Haga clic en “Guardar y Salir” si necesita un
descanso. Cuando haya completado la encuesta,
haga clic en “Terminar” en la última pantalla. Eso
le va a llevar de nuevo a MyECLS. Para salir de
MyECLS, seleccione "Cerrar sesión" y cierre
TODAS las ventanas o pantallas de su navegador
para mantener seguras sus respuestas. Por
ejemplo, si usted usó Chrome o Safari para abrir la
página, asegúrese de que no quede abierta
ninguna ventana ni pantalla de Chrome o Safari
después que usted termine la sesión. No cerrar
todos los navegadores puede permitir que otra
persona vea sus respuestas."

__________________________________________________________

INQ001

QUESTION TEXT:
Question "Thank you for launching the ECLS
survey about {CHILD}!

"¡Gracias por iniciar la encuesta de ECLS acerca
de {CHILD}!

Here are some tips to keep in mind when
completing the survey:

Aquí hay algunos consejos para tener en cuenta
al completar la encuesta:

•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.

• Complete la encuesta en una computadora de
escritorio o portátil usando Chrome, Edge o
Safari, si es posible.
• Utilice los botones de "Siguiente" y de
"Volver" de la encuesta. No utilice las flechas de
su
navegador.
• Si necesita interrumpir la encuesta antes de
terminar y regresar más tarde, seleccione
"Guardar y salir". Cuando regrese, la encuesta
continuará en el lugar hasta donde usted llegó.
• Para proteger su privacidad, será
desconectado(a) de su sesión si permanece
inactivo(a) durante 10 minutos.
• Algunas preguntas de la encuesta tienen
información adicional para ayudarle, si es
necesario. Para ver esta información adicional,
seleccione el ícono azul "i".
• Puede saltar cualquier pregunta que no desee
responder.
Haga clic en el botón "Siguiente" a continuación
para comenzar la encuesta".

Please click on the “Next” button below to start
the survey.”

Haga clic en el botón "Siguiente" a continuación
para comenzar la encuesta".

__________________________________________________________

Box 1

FOR ALL CASES, DEFINE TWO HOUSEHOLD
TYPES ACCORDING TO INFORMATION IN THE
PRELOAD:
1) NEW HOUSEHOLDS: THOSE WHO ARE NEW
TO THE STUDY IN SPRING KINDERGARTEN OR
WERE IN THE STUDY IN FALL KINDERGARTEN
BUT DO NOT HAVE A COMPLETE OR PARTIALLY
COMPLETE FALL KINDERGARTEN PARENT
SURVEY. A PARTIALLY COMPLETE PARENT
SURVEY IS ONE THAT COMPLETED THE
SURVEY AT LEAST THROUGH QUESTION
FSQ200.
2) CONTINUING FALL KINDERGARTEN
HOUSEHOLDS: THOSE WITH A COMPLETE OR
PARTIALLY COMPLETE FALL KINDERGARTEN
PARENT SURVEY.
IF IT IS A CONTINUING FALL KINDERGARTEN
HOUSEHOLD AND THERE IS A FIRST NAME
FOR THE RESPONDENT OF THE MOST RECENT
PARENT SURVEY, GO TO INQ001b.
ELSE GO TO INQ002.
NOTE: PREVIOUS ROUND RESPONDENTS WHO
DID NOT PROVIDE A FIRST NAME ARE ASKED
TO INDICATE IF THEY KNOW THE MOST
ABOUT THE CHILD’S CARE, EDUCATION, AND
HEALTH IN INQ002 BECAUSE IT IS NOT
KNOWN IF THEY ARE THE SAME RESPONDENT
AS IN THE PREVIOUS ROUND.

__________________________________________________________

INQ001b
DISPLAY INSTRUCTIONS:
FOR “{PREVIOUS ROUND RESPONDENT’S FIRST
NAME}” DISPLAY THE PREVIOUS ROUND
RESPONDENT’S FIRST NAME FROM THE PRELOAD.
FOR “{PREVIOUS ROUND RESPONDENT’S LAST
NAME}” DISPLAY THE PREVIOUS ROUND
RESPONDENT’S LAST NAME FROM THE PRELOAD IF IT
IS NOT MISSING OR SK. ELSE, USE A NULL DISPLAY.
IF INQ001 = 1, FLAG PERSON SHOWN IN THE
DISPLAY AS THE RESPONDENT.

QUESTION TEXT:
Question “First, we would like to collect some
information about {CHILD}'s school and home
experiences.

"Primero, nos gustaría reunir algo de
información sobre las experiencias de {CHILD}
en la escuela y en su hogar.

Are you {PREVIOUS ROUND RESPONDENT’S
FIRST NAME} {PREVIOUS ROUND
RESPONDENT’S LAST NAME}?”

¿Es usted{PREVIOUS ROUND RESPONDENT’S
FIRST NAME} {PREVIOUS ROUND
RESPONDENT’S LAST NAME}?"

CODES
1

Yes

Box 2

Sí

INQ002

PROGRAMMER INSTRUCTIONS:
IF INQ001 = 1, FLAG PERSON SHOWN IN THE
DISPLAY AS THE RESPONDENT AND USE THE
FIRST NAME FOR THE RESPONDENT IN THE
PRELOAD.

__________________________________________________________

INQ002
DISPLAY INSTRUCTIONS:
DISPLAY “First, we would like to collect some
information about {CHILD}'s school and home
experiences.” IF INQ001b WAS NOT ASKED.

DISPLAY “Primero, nos gustaría reunir algo de
información sobre las experiencias de {CHILD} en la
escuela y en su hogar.” IF INQ001b WAS NOT ASKED.

QUESTION TEXT:
Question "{First, we would like to collect some
information about {CHILD}'s school and home
experiences.} Are you the parent or guardian
in the household who knows the most about
{CHILD}’s care, education, and health?"

"{Primero, nos gustaría reunir algo de
información sobre las experiencias de {CHILD}
en la escuela y en su hogar.} ¿Es usted el
padre, madre, guardián o tutor en el hogar que
más sabe sobre el cuidado, la educación y la
salud de {CHILD}?"

CODES
1

Yes

No, another parent or guardian in the household
knows the most about {CHILD}'s care, education,
and health.
No, {CHILD} does not live in this household.

PROGRAMMER INSTRUCTIONS:
NOTE: IF INQ002 = 2 OR 3, ANSWER WILL BE
EXTRACTED TO THE MANAGEMENT SYSTEM FOR
RESPONDENT FOLLOW UP.

Sí, soy el padre, madre, guardián o tutor en
el hogar que más sabe sobre el cuidado, la
educación y la salud de {CHILD}.
No, otro padre, madre, guardián o tutor en el
hogar sabe más sobre el cuidado, la
educación y la salud de {CHILD} .
No, {CHILD} no vive en este hogar.

__________________________________________________________

Box 2

IF INQ002 = 2 OR 3 (NOT THE PERSON WHO
KNOWS THE MOST ABOUT THE CHILD OR
CHILD DOES NOT LIVE IN THE HOUSEHOLD)
AND (IT IS ONE OF THE DISTRICTS NOTED IN
THE PRELOAD THAT DISALLOWS COLLECTION
OF TRACING DATA), GO TO CMQ800.
ELSE, FOR BOTH NEW AND CONTINUING
HOUSEHOLDS, IF INQ002 = 2 OR 3 (NOT THE
PERSON WHO KNOWS THE MOST ABOUT THE
CHILD OR CHILD DOES NOT LIVE IN THE
HOUSEHOLD), GO TO INQ005a.
ELSE GO TO INQ005g TO ASK FOR THE
RESPONDENT’S RELATIONSHIP TO THE CHILD.

__________________________________________________________

INQ005a
DISPLAY INSTRUCTIONS:
IF INQ002=2 DISPLAY “{lives in this household}” FOR
THE FIRST DISPLAY AND “{, in this household,}” FOR
THE SECOND DISPLAY. ELSE IF INQ002 = 3 DISPLAY
“lives with {CHILD}” FOR THE FIRST DISPLAY AND
USE A NULL DISPLAY FOR THE SECOND DISPLAY.

IF INQ002=2 DISPLAY “{vive en este hogar}” FOR
THE FIRST DISPLAY AND “{, en este hogar,}” FOR
THE SECOND DISPLAY. ELSE IF INQ002 = 3 DISPLAY
“vive con {CHILD}” FOR THE FIRST DISPLAY AND
USE A NULL DISPLAY FOR THE SECOND DISPLAY.

FOR FIRST NAME, ALLOW 0 – 100 CHARACTERS TO
BE ENTERED.
DISPLAY INQ005a – e TOGETHER.

QUESTION TEXT:
Question “We would like to contact the parent
or guardian who {lives in this household/lives
with {CHILD}} and knows the most about
{CHILD}'s care, education, and health. Please
provide the contact information for that
person{, in this household,} so that we can
contact them for the survey.

“Nos gustaría comunicarnos con el padre,
madre, guardián o tutor que {vive en este
hogar/vive con {CHILD}} y que más sabe
acerca del cuidado, la educación y la salud de
{CHILD}. Por favor proporcione la información
de contacto de esa persona {, en este hogar,}
para que podamos contactarla para la encuesta.

First Name: "

Primer nombre: "

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

__________________________________________________________

INQ005b
DISPLAY INSTRUCTIONS:
FOR LAST NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY INQ005a – e TOGETHER.

QUESTION TEXT:
Question "Last Name:"
ENTER TEXT
PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

"Apellido:"

__________________________________________________________

INQ005c
DISPLAY INSTRUCTIONS:
FOR EMAIL, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY INQ005a – e TOGETHER.

QUESTION TEXT:
Question "Email Address:"

"Dirección de correo electrónico (email):"

Watermark: "name@domain.com"

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
PROGRAM SHOULD VALIDATE EMAIL ADDRESS.
APPLY EDIT MASK TO VALIDATE EMAIL SO THAT
IT HAS A PERIOD AND AN @ SIGN
(E.G.,NAME@DOMAIN.COM).
IF THE EMAIL ADDRESS DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE FOLLOWING
MESSAGE "The email address should contain the
"@" sign and at least one period. Please check
and when the address is correct, select Next to
continue."
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

IF THE EMAIL ADDRESS DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE FOLLOWING
MESSAGE " La dirección electrónica debería tener
el símbolo "@" y por lo menos un punto. Por favor
confirme, y cuando la dirección sea la correcta,
seleccione Siguiente para continuar.”
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

__________________________________________________________

INQ005d
DISPLAY INSTRUCTIONS:
DISPLAY INQ005a – e TOGETHER.

QUESTION TEXT:
Question “Mobile Number:”

“Teléfono celular:”

“This person doesn’t have a mobile phone.”

“Esta persona no tiene teléfono celular.”

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn’t have a mobile phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene teléfono celular.” AS A RADIO
BUTTON.

FOR MOBILE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE PHONE NUMBER SO THAT IT
IS IN THIS FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE "El número de teléfono debe tener 10
dígitos ((XXX)-XXX-XXXX). Por favor verifíquelo y
póngalo de nuevo."

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

__________________________________________________________

INQ005e
DISPLAY INSTRUCTIONS:
DISPLAY INQ005a – e TOGETHER.

QUESTION TEXT:
Question “Landline Number:”

“Teléfono de la casa:”

“This person doesn’t have a landline phone.”

“Esta persona no tiene teléfono de la casa.”

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn’t have a landline phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene teléfono de la casa.” AS A RADIO
BUTTON.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE PHONE NUMBER SO THAT IT
IS IN THIS FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE "El número de teléfono debe tener 10
dígitos ((XXX)-XXX-XXXX). Por favor verifíquelo y
póngalo de nuevo."

__________________________________________________________

INQ005f1
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 1, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY INQ005f1 – f5 TOGETHER.
IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY “{confirm}” AND THE PRELOADED
ADDRESS ASSOCIATED WITH THIS RESPONDENT.
ELSE DISPLAY “enter” AND USE A NULL DISPLAY FOR
THE ADDRESS.

IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY “{confirme/ponga” AND THE
PRELOADED ADDRESS ASSOCIATED WITH THIS
RESPONDENT. ELSE DISPLAY “ponga” AND USE A
NULL DISPLAY FOR THE ADDRESS.

QUESTION TEXT:
Question "Please {confirm/enter} the mailing
address.
Address Line 1:"

"Por favor {confirme/ponga} la dirección postal.
Dirección línea 1:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.
IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "The zip code
must be 5 digits. Please update your response
and enter again."

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

INQ005f2
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 2, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY INQ005f1 – f5 TOGETHER.
IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY “{confirm}” AND THE PRELOADED
ADDRESS ASSOCIATED WITH THIS RESPONDENT.
ELSE DISPLAY “enter” AND USE A NULL DISPLAY FOR
THE ADDRESS.

IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY “{confirme/ponga}” AND THE
PRELOADED ADDRESS ASSOCIATED WITH THIS
RESPONDENT. ELSE DISPLAY “ponga” AND USE A
NULL DISPLAY FOR THE ADDRESS.

QUESTION TEXT:
Question "Address Line 2:"

"Dirección, línea 2:"

Watermark “Apartment number"

Watermark “Número de apartamento"

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

__________________________________________________________

INQ005f3
DISPLAY INSTRUCTIONS:
IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT. ELSE USE A
NULL DISPLAY FOR THE ADDRESS.
FOR CITY, ALLOW 0 – 50 CHARACTERS TO BE
ENTERED.
DISPLAY INQ005f1 – f5 TOGETHER.

QUESTION TEXT:
Question "City:"
ENTER TEXT
PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

"Ciudad:"

__________________________________________________________

INQ005f4
DISPLAY INSTRUCTIONS:
IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT. ELSE USE A
NULL DISPLAY FOR THE ADDRESS.
FOR STATE/DISTRICT/TERRITORY HAVE DROP DOWN
BOX WITH STATE NAMES, THE DISTRICT OF
COLUMBIA, AND THE U.S. TERRITORIES.
DISPLAY INQ005f1 – f5 TOGETHER.

QUESTION TEXT:
Question "Please select a state, district, or
territory:"

"Por favor seleccione un estado, distrito o
territorio:”

Watermark "Select a state"

Watermark "Seleccione un estado"

PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER WILL BE EXTRACTED TO THE
MANAGEMENT SYSTEM FOR RESPONDENT
FOLLOW UP.

__________________________________________________________

INQ005f5
DISPLAY INSTRUCTIONS:
IF INQ002=2 AND THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT IS NOT
MISSING, DISPLAY THE PRELOADED ADDRESS
ASSOCIATED WITH THIS RESPONDENT. ELSE USE A
NULL DISPLAY FOR THE ADDRESS.
FOR ZIP CODE, ALLOW 0 – 5 CHARACTERS TO BE
ENTERED.
DISPLAY INQ005f1 – f5 TOGETHER.

QUESTION TEXT:
Question "ZIP code:"

"Código postal:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

Box 3

GO TO CMQ800 TO THANK THIS RESPONDENT
AND INITIATE A NEW CONTACT FOR THE NEW
RESPONDENT.

__________________________________________________________

INQ005g
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.

DISPLAY “(Especifique:)” FOR LARGE BROWSERS.
ELSE DISPLAY “(Especifique en la siguiente pantalla.)”
FOR SMALL BROWSERS.

QUESTION TEXT:
Question "What is your relationship to
{CHILD}?"

"Qué relación o parentesco tiene usted con
{CHILD}?"

InstResp "Note: Throughout the survey, click
the blue “i” icon for more information about an
item."

InstResp “Nota: A lo largo de la encuesta, haga
clic en el símbolo azul "I" para buscar más
información sobre una pregunta.”

CODES
1

Biological parent

Box 4

Padre/Madre biológico/a

Adoptive parent

Box 4

Padre/Madre adoptivo/a

Step parent

Box 4

Padrastro/Madrastra

Foster parent

Box 4

Padre /Madre foster

Sibling

Box 4

Hermano/a

Grandparent

Box 4

Abuelo/a

Other relative

Box 4

Otro pariente

Other nonrelative

Box 4

Otra persona que no es pariente

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

INQ005gOS

Otro(a) padre/madre o tutor
{(Especifique):/(Especifique en la siguiente
pantalla.)}

PROGRAMMER INSTRUCTIONS:
DISPLAY CODE 91 ABOVE CODE 5.
AUTOCODE FSQ130 FOR THE RESPONDENT
BASED ON INQ005g.
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE. DON’T KNOW AND
RATHER NOT ANSWER IN THE PARENT SURVEY
PROBE SKIP TO Box 4.
BOLD, ON FIRST INSTANCE ONLY IN HELP TEXT,
"Biological parent", "Adoptive parent", "Step
parent", "Foster parent", "Sibling",
"Grandparent", "Other Relative", "Other
Nonrelative", “Other parent or

BOLD, ON FIRST INSTANCE ONLY IN HELP TEXT, "
Padre/Madre biológico(a)", " Padre/Madre
adoptive/a ", " Padrastro/Madrastra ", " Padre
/Madre foster ", " Hermano/a ", " Abuelo/a ", "
Otro pariente ", " Otra persona que no es pariente
", “Otro(a) padre/madre o tutor”.
HELP FOR CODE 1: Padre/Madre biológico(a): Un
padre/madre relacionado con el niño(a). Puede
ser quien dio a luz al niño(a), pero también puede
aplicarse a una madre/padre que usó una madre
subrogada o sustituta o vientre de alquiler, o a
alguien que donó óvulos o esperma para tener al
niño(a).

guardian”.
HELP FOR CODE 1: Biological Parent: A parent
biologically related to the child. This may be the
parent who gave birth to the child, but could
also apply to a parent who used a surrogate, egg
donor, or sperm donor to
have the child.
HELP FOR CODE 2: Adoptive Parent: A parent
who has legally adopted {CHILD}.
HELP FOR CODE 3: Step Parent: A parent other
than {CHILD}'s biological or adoptive parent
who is married to {CHILD}'s biological or
adoptive parent.
HELP FOR CODE 4: Foster Parent: A parent with
whom {CHILD} is placed temporarily, usually
through a social service agency and/or a court.
HELP FOR CODE 5: Sibling: Include biological
(full, half), step, adoptive, and foster siblings as
defined below.
Full Sibling: A person with whom {CHILD}
shares the same biological parents.
Half Sibling: A person with whom {CHILD}
shares one biological parent.
Step Sibling: A person to whom {CHILD} is
related by the marriage of one biological parent.
Adoptive Sibling: A person to whom {CHILD} is
related given that they are in the same family in
which the
person or {CHILD} has been legally adopted by
the family.
Foster Sibling: A person to whom {CHILD} is
unrelated except that they are in the same
family in which the person or {CHILD} have
been taken into the home on a temporary basis
and the parents have legal responsibility for
{CHILD}.
HELP FOR CODE 6: Grandparent: A parent of
{CHILD}'s biological, adoptive, or step parent.
HELP FOR CODE 7: Other Relative: Refers to
relationships that are not listed, such as great
grandparent, child of a parent’s sibling (e.g.,
niece or nephew), and sibling of {CHILD}’s
parent (e.g., aunt or uncle).
HELP FOR CODE 8: Other Nonrelative: Refers to
the relationship between two people when there

HELP FOR CODE 2: Padre/Madre adoptivo/a: Padre
o madre que ha adoptado legalmente a {CHILD}.
HELP FOR CODE 3: Padrastro/Madrastra: Padre o
madre que no es la madre o el padre biológico(a)
ni adoptivo(a) de {CHILD} y que está casado(a)
con la madre o el padre biológico(a) o adoptivo(a)
de {CHILD}.
HELP FOR CODE 4: Padre/madre foster: Padre o
madre padre bajo cuyo cuidado han puesto a
{CHILD} de manera temporal, generalmente por
medio de una agencia de servicios sociales y/o
una corte.
HELP FOR CODE 5: Hermano o hermana: Esto
incluye a hermanas y hermanos biológicos(as) (de
ambos padres, medio hermanos(a)), hermanastros
y hermanastras, hermanos(as) adoptivos(as) y
hermanos(as) foster, como se definen a
continuación.
Hermano o hermana de padre y madre: Una
persona que tiene la misma madre y el mismo
padre biológicos que {CHILD}.
Medio hermano o media hermana: Una persona
que tiene la misma madre biológica o el mismo
padre biológico que {CHILD}.
Hermanastro o hermanastra: Una persona con
quien {CHILD} está emparentado a través del
matrimonio de uno de sus padres biológicos.
Hermana o hermano adoptivo(a): Una persona con
quien {CHILD} está emparentado(a) dado que
ambos están en la misma familia la cual ha
adoptado legalmente a uno(a) de ellos dos.
Hermana o hermano foster: Una persona sin
relación de parentesco con {CHILD}, excepto que
están en la misma familia porque ya sea la
persona o {CHILD} forma parte del hogar de
manera temporal y los padres/madres tienen
responsabilidad legal por {CHILD}.
HELP FOR CODE 6: Abuelo o abuela: Padre o
madre de la madre o el padre biológico(a),
adoptivo(a) o madrastra/padrastro de {CHILD}.
HELP FOR CODE 7: Otro pariente: Se refiere a
parentescos que no están en la lista, por ejemplo,

is no family relationship through blood, marriage,
or adoption. The category could be used to refer
to a person who is not a parent to {CHILD}, but
is a partner to {CHILD}’s parent and living
together with that parent as married. The
category could also be used to refer to the
partner’s children who are not related to
{CHILD}’s parent. An example of this is when the
child's parent and the parent's partner (who is
not the child's parent) live together as married
and the partner's daughter lives with them. The
relationship of the partner's daughter to
the child would be siblings if they were married,
but since the parent and the partner are not
married, the daughter is an "other nonrelative."
HELP FOR CODE 91: Other Parent or Guardian: A
person acting as the parent of {CHILD}, but does
not fit into one of the other categories. For
example, in a household with two parents, one of
the parents may not be biologically related to
{CHILD} and not legally in charge of {CHILD}
but is another parent to {CHILD}.

bisabuelo(a), hijo o hija de un hermano o
hermana de uno de los padres/madres (por ej.,
sobrina o sobrino) y hermano o hermana de la
madre o el padre de {CHILD} (por ej., tía o tío).
HELP FOR CODE 8: Otra persona que no es
pariente: Si uno de los códigos de arriba
correspondientes a personas no parientes no
describe mejor la relación de la persona con
{CHILD} y no hay una relación de familia de
sangre, por matrimonio, adopción o de pareja (por
ejemplo, viviendo juntos como casados), use esta
opción.
Se refiere a la relación entre dos personas cuando
no hay parentesco de sangre, por matrimonio ni
adopción. Esta categoría podría usarse para
referirse a una persona que no es una madre o
padre de {CHILD}, pero es la pareja de la madre
o el padre de {CHILD} y están viviendo juntos
como si estuvieran casados(a). Esta categoría
también podría usarse para referirse a los
hijos(as) de esa pareja que no tienen parentesco
con el padre o la madre de {CHILD}. Un ejemplo
de esto es cuando la madre o el padre del niño(a)
y su pareja (que no es ni madre ni padre del
niño(a)) viven juntos como si estuvieran
casados(as) y la hija de esa pareja viven con
ellos. La relación de la hija de la pareja con el
niño(a) sería de hermanos o hermanas si sus
padres o madres estuvieran casados(as), pero
como no lo están, la hija es "otra persona que no
es pariente".
HELP FOR CODE 91: Otro tipo de padre/madre o
tutor(a): Una persona que se desempeña como
madre o padre de {CHILD}, pero no le
corresponde ninguna de las otras categorías. Por
ejemplo, en un hogar con dos madres o padres,
uno o una de ellos puede no tener parentesco
biológico con {CHILD} y no estar legalmente a
cargo de {CHILD} aunque es el otro papá o la otra
mamá de {CHILD}.

__________________________________________________________

INQ005gOS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE FOR LARGE BROWSERS.

ENTER TEXT

__________________________________________________________

Box 4

IF INQ001b = 1 (THE SPRING KINDERGARTEN
RESPONDENT IS THE SAME AS THE
RESPONDENT IN THE MOST RECENT PARENT
SURVEY) AND THE RESPONDENT’S LAST NAME
IS MISSING IN THE PRELOAD, GO TO INQ005k
TO ASK FOR THE RESPONDENT’S LAST NAME.
(NOTE: CASES THAT RECEIVE INQ001b HAVE
A FIRST NAME SO THIS SKIP IS FOR PERSONS
WITH A FIRST NAME BUT NOT A LAST NAME.)
ELSE IF INQ001b = 1 (THE SPRING
KINDERGARTEN RESPONDENT IS THE SAME
AS THE RESPONDENT IN THE MOST RECENT
PARENT SURVEY) AND THE RESPONDENT’S
LAST NAME IS NOT MISSING IN THE PRELOAD,
GO TO BOX 5. (NOTE: THESE CASES HAD A
FIRST AND LAST NAME IN THE PRELOAD.)
ELSE GO TO INQ005j.

__________________________________________________________

INQ005j
DISPLAY INSTRUCTIONS:
ALLOW 0 - 100 CHARACTERS TO BE ENTERED.
DISPLAY "your" IN QUESTION STEM IN UNDERLINED
TEXT.
DISPLAY INQ005j AND INQ005k TOGETHER.

DISPLAY "su" IN QUESTION STEM IN UNDERLINED
TEXT.
DISPLAY " "Pedimos el primer nombre de cada
persona para poder hacer preguntas sobre cada uno
en la encuesta. " IN InstResp FORMAT.

QUESTION TEXT:
Question "What is your name? We ask for first
names so that we can ask questions about
each person in the survey.

"¿Cuál es su nombre? Pedimos el primer
nombre de cada persona para poder hacer
preguntas sobre cada uno en la encuesta.

First Name:"

Primer nombre:”

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
USE THE ANSWER IN INQ005j AS THE
RESPONDENT’S FIRST NAME.
FOR NEW HOUSEHOLDS, FLAG PERSON NAMED
IN INQ005j AS THE RESPONDENT.

__________________________________________________________

INQ005k
DISPLAY INSTRUCTIONS:
IF INQ005j WAS NOT ASKED DISPLAY “{Please enter
or confirm your last name.}” ELSE USE A NULL
DISPLAY.

IF INQ005j WAS NOT ASKED DISPLAY “{Por favor
ponga o confirme su apellido.}” ELSE USE A NULL
DISPLAY.

FOR LAST NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY INQ005j and INQ005k TOGETHER.

QUESTION TEXT:
Question "{Please enter or confirm your last
name.}
Last Name:"

"{Por favor ponga o confirme su apellido.}
Apellido:"

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
USE THE ANSWER IN INQ005k AS THE
RESPONDENT’S LAST NAME.
__________________________________________________________

Box 5

IF THE MYECLS WEBSITE INDICATES THAT
EXPLICIT CONSENT IS REQUIRED FOR THE
CHILD TO PARTICIPATE AND WAS ALREADY
ANSWERED AS YES OR NO (CONSENT = 2 FOR
"OBTAINED" OR 3 FOR "REFUSED"), GO TO
BOX 6 BECAUSE CONSENT HAS ALREADY BEEN
OBTAINED.
ELSE IF THE MYECLS WEBSITE INDICATES
THAT EXPLICIT CONSENT IS REQUIRED FOR
THE CHILD, GO TO INQ010a.
ELSE GO TO Box 6.

__________________________________________________________

INQ010a
DISPLAY INSTRUCTIONS:
DISPLAY INQ010a, INQ010b, AND INQ010c ON THE
SAME SCREEN.

QUESTION TEXT:
Question "We need your permission before we
can include {CHILD} in the study activities.
Please select one of the choices below and
confirm or enter your full name. Without your
permission, we will be unable to include
{CHILD} in the study. We would like to collect
your survey responses, even if you do not
permit {CHILD} to take part in the study's
child activities.
Do you give your permission for {CHILD} to
participate in the ECLS-K:2024?"

"Necesitamos su permiso para poder incluir a
{CHILD} en las actividades del estudio. Por
favor seleccione una de las opciones a
continuación y confirme su nombre o ponga su
nombre completo. Sin su permiso nosotros no
podremos incluir a {CHILD} en el estudio.
Queremos obtener sus respuestas a la
encuesta, aunque usted no permita que
{CHILD} tome parte en las actividades del
estudio.
¿Da usted permiso para que {CHILD} participe
en el estudio ECLS-K:2024?"

CODES
1

Yes, I give permission for {CHILD} to participate.

No, I do not give permission for {CHILD} to
participate.

PROGRAMMER INSTRUCTIONS:
NOTE: ANSWER IN INQ010a WILL BE USED IN
THE MANAGEMENT SYSTEM. IN THE
MANAGEMENT SYSTEM, IF INQ010a = 1
(CONSENT GIVEN), C_CONSENT WILL BE
UDPDATED TO BE C_CONSENT = 2 (OBTAINED).
ELSE IF INQ010a = 2 (CONSENT NOT GIVEN),
C_CONSENT WILL BE UPDATED TO C_CONSENT
= 3 (REFUSED).

Sí, doy mi permiso para que {CHILD}
participe en el estudio.
No, no doy mi permiso para que {CHILD}
participe.

__________________________________________________________

INQ010b
DISPLAY INSTRUCTIONS:
IF INQ005j WAS ASKED AND IS NOT SK DISPLAY
THIS FIRST NAME.
ELSE IF INQ001b =1 (SAME RESPONDENT AS IN
PREVIOUS ROUND) DISPLAY THE FIRST NAME OF THE
RESPONDENT FROM THE PRELOAD.
ELSE USE A NULL DISPLAY FOR FIRST NAME.
FOR FIRST NAME, ALLOW FOR CHANGES AND ALLOW
0 – 100 CHARACTERS TO BE ENTERED. DISPLAY
INQ010a, INQ010b, AND INQ010c ON THE SAME
SCREEN.

QUESTION TEXT:
Question "Please enter or confirm your name
from the previous question.

"Por favor ponga o confirme su nombre como
está en la pregunta anterior.

First Name: "

Primer nombre: "

ENTER TEXT

__________________________________________________________

INQ010c
DISPLAY INSTRUCTIONS:
IF INQ005k WAS ASKED AND IS NOT SK DISPLAY
THIS LAST NAME.
ELSE IF INQ001b =1 (SAME RESPONDENT AS IN
PREVIOUS ROUND) AND (THE LAST NAME OF THAT
RESPONDENT IS NOT MISSING IN THE PRELOAD)
DISPLAY THE LAST NAME OF THE RESPONDENT FROM
THE PRELOAD. ELSE USE A NULL DISPLAY.
FOR LAST NAME, ALLOW FOR CHANGES AND ALLOW
0 – 100 CHARACTERS TO BE ENTERED.
DISPLAY INQ010a, INQ010b, AND INQ010c ON THE
SAME SCREEN.

QUESTION TEXT:
Question "Last Name:"

"Apellido:"

ENTER TEXT

__________________________________________________________

Box 6

IF THE CHILD’S FIRST, MIDDLE, AND LAST
NAME ARE IN THE PRELOAD FROM SCHOOL
RECORDS, GO TO INQ020a. ELSE, GO TO
INQ020b.

__________________________________________________________

INQ020a
DISPLAY INSTRUCTIONS:
DISPLAY THE CHILD’S FIRST, MIDDLE, AND LAST
NAME FROM THE PRELOAD IN THE QUESTION STEM.

QUESTION TEXT:
Question “Now we would like to ask some
questions about {CHILD}. Our records show
that {CHILD's FIRST, MIDDLE, AND LAST
NAME} is {CHILD}'s full name. Is that correct?"

“Ahora quisiéramos hacerle algunas preguntas
sobre {CHILD}. En nuestros registros, el
nombre completo de {CHILD} aparece como
{CHILD's FIRST, MIDDLE, AND LAST
NAME}.¿Correcto?

CODES
1

Yes

Box 6b

Sí

INQ020b

__________________________________________________________

INQ020b
DISPLAY INSTRUCTIONS:
DISPLAY “Now we would like to ask some questions
about {CHILD}.” IF INQ020a WAS NOT ASKED. ELSE
USE A NULL DISPLAY.

DISPLAY “Ahora quisiéramos hacerle algunas
preguntas sobre {CHILD}.” IF INQ020a WAS NOT
ASKED. ELSE USE A NULL DISPLAY.

DISPLAY CHILD’S FIRST NAME FROM THE PRELOAD
IN THE RESPONSE FIELD AND ALLOW FOR CHANGES.
FOR NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY INQ020b-d TOGETHER.

QUESTION TEXT:
Question “{Now we would like to ask some
questions about {CHILD}.} If necessary,
please make any corrections to {CHILD}'s
name here.

“{Ahora quisiéramos hacerle algunas preguntas
sobre {CHILD}.} Si hace falta hacer alguna
corrección al nombre de {CHILD}, por favor
corríjalo aquí."

First Name:”

Primer nombre:"

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
IF INQ020b IS ASKED AND THE NAME IS NOT
EMPTY, USE THIS NAME IN THE REST OF THE
SURVEY AND IN THE ROSTER IN FSQ. ELSE USE
THE NAME OF THE CHILD FROM THE PRELOAD.

__________________________________________________________

INQ020c
DISPLAY INSTRUCTIONS:
DISPLAY THE CHILD’S MIDDLE NAME FROM THE
PRELOAD IN THE RESPONSE FIELD AND ALLOW FOR
CHANGES.
FOR NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY INQ020b-d TOGETHER.

QUESTION TEXT:
Question “Middle name:”

“Segundo nombre:”

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: If there is no middle name,
please skip this.

HELP FOR STEM: Si no tiene Segundo nombre,
puede dejarlo en blanco.

__________________________________________________________

INQ020d
DISPLAY INSTRUCTIONS:
DISPLAY THE CHILD’S LAST NAME FROM THE
PRELOAD IN THE RESPONSE FIELD AND ALLOW FOR
CHANGES.
FOR NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY INQ020b-d TOGETHER.

QUESTION TEXT:

Question “Last Name:”
ENTER TEXT

“Apellido:”

__________________________________________________________

Box 6b

IF IT IS A FALL K CONTINUING HOUSEHOLD
AND THE FALL KINDERGARTEN PRELOAD FOR
GENDER (INQ050b) IS NOT MISSING (DOES
NOT EQUAL SKIPPED), THEN GO TO BOX 7.
ELSE GO TO INQ050b.

__________________________________________________________

INQ050b

QUESTION TEXT:
Question “What is {CHILD}’s gender?”

“¿De qué género es {CHILD}?"

CODES
1

Male

Masculino

Female

Femenino

Another gender

Otro género

PROGRAMMER INSTRUCTIONS:
IF INQ050b IS ASKED AND IS NOT SK, USE
THIS GENDER IN THE REST OF THE SURVEY.
ELSE USE THE GLOBAL SPECS FOR
INSTRUCTIONS ON MISSING GENDER.

__________________________________________________________

Box 7

IF IT IS A FALL K CONTINUING HOUSEHOLD
AND THE FALL KINDERGARTEN PRELOAD FOR
DATE OF BIRTH (INQ060b) IS NOT MISSING
(DOES NOT EQUAL SKIPPED, DON’T KNOW,
REFUSED, OR RATHER NOT ANSWER), THEN
GO TO BOX 8.
ELSE GO TO INQ060b.

__________________________________________________________

INQ060b
DISPLAY INSTRUCTIONS:
DISPLAY INQ060b AS DATETYPE FIELD WITH TWO
DIGITS FOR MONTH AND DAY AND FOUR DIGITS FOR
YEAR.

QUESTION TEXT:
Question “What is {CHILD}'s date of birth?”

“¿Cuál es la fecha de nacimiento de {CHILD}?”

Watermark “MM/DD/YYYY”

Watermark “DD/MM/YYYY”

“Don’t know”

“No sé”

“Rather not answer”

“Prefiero no contester”

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Please enter the two-digit
month, two-digit day, and four-digit year (for
example, 01/31/2018).

HELP FOR STEM: Por favor ponga dos dígitos para
el día, dos dígitos para el mes, y cuatro dígitos
para el año (por ejemplo, 31/01/2018).

ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “No sé” AS
A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Rather
not answer” AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Prefiero no
contester” AS A RADIO BUTTON. IF "SK" FOR
SKIPPED, USE PARENT SURVEY PROBE.

IF "SK" FOR SKIPPED, USE PARENT SURVEY
PROBE.
"Don't know" AND "Rather not answer" IN THE
SPECIAL ANSWERS OR PARENT SURVEY PROBE
SKIP TO INQ090.
SOFT RANGE FOR YEAR IS 2016 TO 2019. IF
YEAR IS OUTSIDE THIS RANGE, DISPLAY
MESSAGE: "You have entered {DISPLAY
RESPONSE AT INQ060b}. Please confirm. If this
is correct, select Next to continue."

"No sé" AND "Prefiere no contester" IN THE
SPECIAL ANSWERS OR PARENT SURVEY PROBE
SKIP TO INQ090.
SOFT RANGE FOR YEAR IS 2016 TO 2019. IF YEAR
IS OUTSIDE THIS RANGE, DISPLAY MESSAGE:
"Usted ha puesto {DISPLAY RESPONSE AT
INQ060b.YEAR}. Por favor confirme. Si es
correcto, seleccione Siguiente para continuar."

__________________________________________________________

INQ080

QUESTION TEXT:
Question “So {CHILD} is {AGE CALCULATED
FROM DATE OF BIRTH AT INQ060b} years old.
Is that correct?”

“Entonces {CHILD} tiene {AGE CALCULATED
FROM DATE OF BIRTH AT INQ060b} años.
¿Correcto?"

CODES
1

Yes

Box 8

Sí
No

PROGRAMMER INSTRUCTIONS:
USING INQ060b CALCULATE THE CHILD’S AGE
AND DISPLAY IT IN THE QUESTION STEM.
__________________________________________________________

INQ090

QUESTION TEXT:
Question “How old is {CHILD}?”

“¿Qué edad tiene {CHILD}?”

Watermark “Enter age”

Pre-unit “Años:”

Pre-unit “Years:”

Watermark “Ponga la edad”

ENTER NUMBER
Range

0 to 30

Soft Range

4 to 8

PROGRAMMER INSTRUCTIONS:

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT INQ090}. Please confirm. If this is
correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto{DISPLAY RESPONSE
AT INQ090}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

Box 8

IF FALL K NON-RESPONDENT, GO TO SPQ
(SUPPLEMENTARY ITEMS FOR NON-RESPONSE
HOUSEHOLDS).
ELSE GO TO SECTION PIQ (PARENT'S
INVOLVEMENT WITH CHILD'S SCHOOL).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

SPQ

Supplementary Items for Non-Response Households

__________________________________________________________

SPQ001
DISPLAY INSTRUCTIONS:
DISPLAY “the year before kindergarten” AND “regular
basis” IN THE FIRST SENTENCE IN UNDERLINED TEXT.
DISPLAY “not” IN THE THIRD SENTENCE IN
UNDERLINED TEXT.

DISPLAY “el año antes de empezar el kindergarten”
AND “de manera regular” IN THE FIRST SENTENCE IN
UNDERLINED TEXT.
DISPLAY “no” IN THE THIRD SENTENCE IN
UNDERLINED TEXT.
DISPLAY "babysitting" IN ITALICIZED TEXT IN THE
QUESTION STEM AND HELP TEXT.

QUESTION TEXT:
Question “Now, we would like to ask you about
all the child care {CHILD} received the year
before kindergarten on a regular basis. This
includes child care with relatives, nonrelatives,
day care centers, or before- or after-school
programs at a school or in a center. This does
not include care provided by parents and
guardians, or occasional babysitting or back-up
care providers.
Did {CHILD} receive child care on a regular
basis anytime in the year before kindergarten
including care provided before or after school?

“Ahora quisiéramos preguntarle acerca de todo
el cuidado infantil que recibió {CHILD} de
manera regular el año antes de empezar el
kindergarten. Esto incluye cuidado por parte de
un pariente, cuidado de alguien que no es
pariente, cuidado en un centro de cuidado
infantil, o programa de antes o después de la
escuela en una escuela o en un centro. No
incluye cuidado por parte de un padre, madre o
tutor, ni babysitting ocasional ni ningún arreglo
alternativo por si acaso.
¿Recibió {CHILD} cuidado infantil de manera
regular en cualquier momento del año antes de
kindergarten, incluyendo cuidado antes o
después de la escuela?”

CODES
1

Yes

Sí
SPQ060

PROGRAMMER INSTRUCTIONS:
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE.
BOLD “Regular basis” IN HELP TEXT.
HELP FOR STEM: Regular basis: An arrangement
or program occurring on a routine schedule. It
may be for any number of hours as long as it is
used on a regular basis. Do not include
occasional babysitting or “backup” arrangements.

BOLD “De manera regular” IN HELP TEXT.
HELP FOR STEM: De manera regular: Un arreglo o
programa que se lleva a cabo en un horario de
rutina. Puede ser por cualquier cantidad de horas
siempre que se use con regularidad. No incluya
babysitting ocasional ni algún arreglo alternativo
por si acaso.

__________________________________________________________

SPQ002
DISPLAY INSTRUCTIONS:
DISPLAY "the year before" IN UNDERLINED TEXT

DISPLAY "del año antes" IN UNDERLINED TEXT.
DISPLAY "babysitting" IN ITALICIZED TEXT IN THE
QUESTION STEM AND HELP TEXT.

QUESTION TEXT:
Question “Did {CHILD} receive child care on a
regular basis anytime in the year before
{he/she/they} started kindergarten? Please
select all that apply.”
CODES
1

“¿Recibió {CHILD} cuidado infantil de manera
regular en cualquier momento del año antes de
empezar el kindergarten? Por favor seleccione
todo lo que corresponda.”

Code All That Apply
From a relative (for example, grandparents,
siblings, or any relatives other than {CHILD’s}
parent(s) or guardian(s)).
From someone not related to {CHILD}, within a
private home (for example, family or in-home
child care providers, regular sitters, or
neighbors)? This does not include child care
Within a day care center or a before- or after-care
school program at a school or non-school setting.

¿De un pariente (por ejemplo, abuelos,
hermanos o cualquier pariente aparte de los
padres/madres o tutores de {CHILD})?
¿De alguien que no es pariente de {CHILD},
en un hogar particular (por ejemplo,
proveedores de cuidado infantil en el hogar o
familiares, babysitters habituales o vecinos)?
Esto no incluye los centros de cuidado infantil.
¿Dentro de una guardería o un programa
para antes o después de la escuela en una
escuela o en un centro o en un lugar que no
es una escuela?

PROGRAMMER INSTRUCTIONS:
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE.
BOLD FIRST INSTANCES ONLY OF "Regular
basis", “Care from a relative”, “Care from
someone not related to {CHILD}”, “Nonrelatives
who live in {CHILD}’s household”, AND “Care
within a day care center or before- or afterschool program at a school or non-school
setting”.
Regular basis: An arrangement or program
occurring on a routine schedule. It may have
been for any number of hours as long as it was
used on a regular basis. Do not include
occasional babysitting or “back-up”
arrangements.
HELP FOR CODE 1: Care from a relative would
have been with any relative other than
{CHILD}’s parents or guardians and would have
taken place in a private home. It may have been

BOLD FIRST INSTANCES ONLY OF "De manera
regular", “Cuidado por parte de un pariente ”,
“Cuidado por parte de un pariente”, “Cuidado de
alguien que no es pariente de {CHILD} que vive
en su hogar”, AND “Cuidado en un centro de
cuidado infantil o programa de antes o después de
la escuela en una escuela o en un lugar que no
sea una escuela”.
De manera regular: Un arreglo o programa que se
lleva a cabo en un horario de rutina. Puede ser por
cualquier cantidad de horas siempre que se use
con regularidad. No incluya babysitting ocasional
ni algún arreglo alternativo por si acaso.
HELP FOR CODE 1: Cuidado por parte de un
pariente puede ser con cualquier pariente distinto
a los padres de {CHILD} y ocurriría en un hogar
privado. Puede ser gratuito o tener un costo
monetario. Debe ser un arreglo de cuidado
habitual en lugar de un arreglo ocasional como
babysitting o un arreglo alternativo por si acaso.

free or cost money. It should be a regular child
care arrangement rather than occasional
babysitting or back-up care. If parents are
separated or divorced, please do not include
visitation with the parent who did not have
custody.
HELP FOR CODE 2: Care from someone not
related to {CHILD} refers to care in a private
home that may have been {CHILD}’s home, the
caregiver’s home, or another home. It may have
been free or cost money. This does not include
child care centers. Nonrelatives who live in
{CHILD}'s household and provide care on a
regularly scheduled basis are eligible to be
counted if they are not guardians to {CHILD}
and there is at least one parent or guardian in
the household. If neither parent lives in the
household, do not include care provided by
guardians who live with {CHILD} (they are
treated the same as parents).
HELP FOR CODE 3: Care within a day care
center or before- or after-school program at a
school or non-school setting includes any type of
formal program that provides care and
supervision. It may have been in a child's school
or in another location, such as a church or a freestanding building. Head Start programs, nursery
schools, preschools, and prekindergarten
programs (some of which may be sponsored by
the state) are also included.

Si los padres están separados o divorciados, por
favor no incluya las visitas con un padre que no
tiene custodia.
HELP FOR CODE 2: Cuidado de alguien que no es
pariente de {CHILD} se refiere al cuidado en una
casa particular que podría ser la casa de {CHILD},
la casa de la persona que cuida a {CHILD} o en
otra casa. Puede ser con pago o sin pago. Esto no
incluye centros de cuidado infantil. Las personas
que no son parientes que viven en el hogar de
{CHILD} y proporcionan cuidado en un horario
habitual son elegibles para contarlos en esta
pregunta si no son tutores o guardianes de
{CHILD} y hay al menos un padre, madre,
guardián o tutor en el hogar. Si ninguna madre y
ningún padre vive en el hogar, no incluya el
cuidado que le dan los tutores que viven con
{CHILD} (porque se les trata como si fueran
padres/madres).
HELP FOR CODE 3: Cuidado en un centro de
cuidado infantil o programa de antes-o-después de
la escuela en una escuela o en un lugar que no
sea una escuela incluye cualquier tipo de
programa formal que provea cuidado y
supervisión. Puede ser en la escuela del niño(a) o
en otro lugar, como una iglesia o un edificio
independiente. Programas de Head Start, centros
de cuidado infantil, guarderías o jardines de la
infancia, programas preescolares y prekínder, que
incluyen niños que están ahora en kindergarten
(de los cuales algunos pueden ser patrocinados
por el estado) también están incluidos.

__________________________________________________________

Box 1

IF SPQ002 = 1, GO TO SPQ015. ELSE GO TO
BOX 2.

__________________________________________________________

SPQ015
DISPLAY INSTRUCTIONS:
DISPLAY “the year before” AND “relatives” IN
UNDERLINED TEXT.

DISPLAY “el año antes” AND “parientes” IN
UNDERLINED TEXT.
DISPLAY "babysitting" IN ITALICIZED TEXT IN THE
QUESTION STEM AND HELP TEXT.

QUESTION TEXT:
Question “Were any of the regular care
arrangements that {CHILD} had with relatives
in the year before kindergarten Head Start?
Head Start is a federally sponsored preschool
program primarily for children from lowincome families.
SaVisible “True”

“Era Head Start alguno de los arreglos
habituales de cuidado infantil que {CHILD}
tenía con parientes durante el año antes de que
entrara al kindergarten? Head Start es un
programa preescolar patrocinado por el
gobierno federal principalmente para niños de
familias con ingresos bajos".
SaVisible “True”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
“True”).

BOLD FIRST INSTANCE OF “Head Start” AND BOLD
“Arreglos habituales de cuidado” IN HELP TEXT.

BOLD FIRST INSTANCE OF “Head Start” AND
BOLD “Regular care arrangements” IN HELP
TEXT.

HELP FOR STEM: Head Start es un programa de
educación temprana patrocinado por el gobierno
federal para mejorar la preparación escolar de
niños de bajos recursos que suelen tener entre 3 y
5 años de edad. Head Start se puede ofrecer en
una variedad de lugares (en centros u hogares).

HELP FOR STEM: 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 {CHILD} was cared for by
someone who is related to {CHILD} but is not
their parent.
If {CHILD} participated in a home Head Start
program where a parent was the caregiver,
select no.
If {CHILD} was in Head Start in another care

Para esta pregunta estamos interesados en los
servicios de Head Start en un programa de
cuidado infantil familiar en un hogar privado
donde {CHILD} era cuidado por alguien que no
era ninguno de sus padres y no era un pariente de
{CHILD}.
Si {CHILD} participó en un programa de Head
Start en un hogar donde su madre o padre
proporcionaba el cuidado, seleccione no.
Si {CHILD} estaba en Head Start en otro tipo de
cuidado infantil, responda a eso en otra pregunta.
Arreglos regulares de cuidado: Un arreglo o

type, please answer for that in another question.
Regular care arrangements: An arrangement or
program occurring on a routine schedule. It may
have been for any number of hours as long as it
was used on a regular basis. Do not include
occasional babysitting or “back-up”
arrangements.

programa que sigue un horario de rutina. Puede
haber sido por cualquier cantidad de horas
siempre que se lo haya usado de manera regular.
No incluya babysitting ocasional ni algún arreglo
alternativo por si acaso.

__________________________________________________________

Box 2

IF SPQ002 = 2, GO TO SPQ025. ELSE GO TO
BOX 3.

__________________________________________________________

SPQ025
DISPLAY INSTRUCTIONS:
DISPLAY “Head Start...families” IF SPQ015 WAS NOT
ASKED. ELSE, USE A NULL DISPLAY.

DISPLAY “Head Start...familias” IF SPQ015 WAS NOT
ASKED. ELSE, USE A NULL DISPLAY.

DISPLAY “the year before” AND “nonrelatives”
INUNDERLINED TEXT.

DISPLAY “el año antes” AND “personas que no eran
parientes” IN UNDERLINED TEXT.
DISPLAY "babysitting" IN ITALICIZED TEXT IN THE
QUESTION STEM AND HELP TEXT.

QUESTION TEXT:
Question “Were any of the regular care
arrangements that {CHILD} had with
nonrelatives in the year before kindergarten
Head Start? {Head Start is a federally
sponsored preschool program primarily for
children from low-income families.}
SaVisible “True”

“¿Era Head Start alguno de los arreglos
regulares de cuidado que {CHILD} tenía con
personas que no eran parientes durante el año
antes de que entrara al kindergarten? {Head
Start es un programa preescolar patrocinado
por el gobierno federal principalmente para
niños de familias con ingresos bajos.}
InstResp “Si {CHILD} estuvo en Head Start
bajo otro tipo de cuidado, conteste a eso en
otra pregunta.”
SaVisible “True”

CODES
1

Yes

Sí

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
“True”).

BOLD “Head Start” AND “arreglos regulares de
cuidado” IN HELP TEXT.

BOLD “Head Start” AND “Regular care
arrangements” IN HELP TEXT.

related to {CHILD}.
If {CHILD} was in Head Start in another care
type, please answer for that in another question.
Regular care arrangements: An arrangement or
program occurring on a routine schedule. It may
have been for any number of hours as long as it
was used on a regular basis. Do not include
occasional babysitting or “back-up”
arrangements.

Si {CHILD} estaba en Head Start en otro tipo de
cuidado infantil, responda a eso en otra pregunta."
Arreglos regulares de cuidado: Un arreglo o
programa que sigue un horario de rutina. Puede
haber sido por cualquier cantidad de horas
siempre que se lo haya usado de manera regular.
No incluya babysitting ocasional ni algún arreglo
alternativo por si acaso.

__________________________________________________________

Box 3

IF SPQ002 = 3, GO TO SPQ041. ELSE GO TO
SPQ060.

__________________________________________________________

SPQ041
DISPLAY INSTRUCTIONS:
DISPLAY “Head Start...families” IF SPQ015 AND
SPQ025 WERE NOT ASKED. ELSE, USE A NULL
DISPLAY.

DISPLAY “Head Start...familias” IF SPQ015 AND
SPQ025 WERE NOT ASKED. ELSE, USE A NULL
DISPLAY.

DISPLAY “the year before” AND “day care center,
nursery school, preschool, or prekindergarten
program” IN UNDERLINED TEXT.

DISPLAY “el año antes ” AND "un centro de cuidado
infantil, guardería o nursery, programa preescolar o
prekinder " IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Were any of {CHILD}’s care
arrangements in a day care center, nursery
school, preschool, or prekindergarten program
in the year before kindergarten Head Start?
{Head Start is a federally sponsored preschool
program primarily for children from lowincome families.}
SaVisible “True”

“¿Era Head Start alguno de los arreglos de
cuidado de {CHILD} en un centro de cuidado
infantil, guardería o nursery, programa
preescolar o prekinder en el año antes de
kindergarten? {Head Start es un programa
preescolar patrocinado por el gobierno federal,
principalmente para niños de familias con
ingresos bajos.}”
SaVisible “True”

CODES
1

Yes

Sí

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
“True”).
BOLD “Head Start” IN HELP TEXT.
HELP FOR STEM: 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.

BOLD “Head Start” IN HELP TEXT.
HELP FOR STEM: Head Start es un programa de
educación temprana patrocinado por el gobierno
federal para mejorar la preparación escolar de
niños de bajos recursos que suelen tener entre 3 y
5 años de edad. Head Start se puede ofrecer en
una variedad de lugares (en centros u hogares).
Para esta pregunta, estamos interesados en los
servicios de Head Start en un centro.

__________________________________________________________

SPQ060
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY POUNDS
AND OUNCES ON ONE LINE. HORIZONTALLY. ON
LARGE
BROWSERS UNDERNEATH THAT LINE DISPLAY "Or".
THEN ON LARGE BROWSERS DISPLAY GRAMS.
IF THE BROWSER SIZE IS NOT LARGE DISPLAY
POUNDS ABOVE OUNCES VERTICALLY. IF THE
BROWSER SIZE
IS NOT LARGE UNDERNEATH POUNDS DISPLAY "Or."
THEN DISPLAY GRAMS.

IF THE BROWSER SIZE IS LARGE, DISPLAY POUNDS
AND OUNCES ON ONE LINE. HORIZONTALLY. ON
LARGE BROWSERS UNDERNEATH THAT LINE DISPLAY
"O". THEN ON LARGE BROWSERS DISPLAY GRAMS.
IF THE BROWSER SIZE IS NOT LARGE DISPLAY
POUNDS ABOVE OUNCES VERTICALLY. IF THE
BROWSER SIZE IS NOT LARGE UNDERNEATH
POUNDS DISPLAY "O." THEN DISPLAY GRAMS.
DISPLAY “O” IN BOLD TEXT.

DISPLAY “Or” IN BOLD TEXT.
ALLOW ENTRIES IN ALL FIELDS.
FOR THE FIRST DISPLAY, DISPLAY “he” IF THE CHILD
IS MALE (INQ050b = 1). ELSE DISPLAY “she” IF THE
CHILD IS FEMALE (INQ050b = 2). ELSE DISPLAY
“they” IF THE CHILD IS ANOTHER GENDER (INQ050b
= 3). ELSE DISPLAY THE CHILD’S NAME IF GENDER
IS MISSING (INQ050b = SK) AS SHOWN IN THE
GLOBAL SPECS.
FOR THE SECOND DISPLAY, DISPLAY “was” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “were” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).

QUESTION TEXT:
Question “Now we have some questions about
{CHILD}'s health. Some items in this section
may be seen as sensitive and you may skip
any questions that you do not want to answer...
How much did {CHILD} weigh when
{he/she/they} {was/were} born?

"Ahora tenemos algunas preguntas sobre la
salud de {CHILD}. Algunas preguntas de esta
sección pueden resultar delicadas y usted puede
saltar cualquier pregunta que no desee
responder.
¿Cuánto pesó {CHILD} al nacer?

Please answer in either pounds and ounces or
grams. Your best guess is fine.”

Por favor responda en libras y onzas, o gramos.
Puede dar un cálculo aproximado."

SaVisible “True”

SaVisible "True"

Pre-unit “Pounds:”
Watermark: “Enter pounds"
DON'T KNOW

Pre-unit "Libras:"
Watermark: "Ponga las libras"
NO SÉ

Pre-unit "Ounces:"
Watermark: "Enter ounces"

Pre-unit "Onzas:"
Watermark: "Ponga las onzas"

DON'T KNOW

NO SÉ

"Or"

"O"

Pre-unit "Grams:"
Watermark: "Enter grams"
DON'T KNOW

Pre-unit "Gramos:"
Watermark: "Ponga los gramos"
NO SÉ

ENTER NUMBER
DON'T KNOW

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
Range for pounds 0 to 13
Soft Range for pounds 1 to 10
Range for ounces 0 to 208
Soft Range for ounces 0 to 160
Range for grams 0 to 6322
Soft Range for grams 453 to 4535
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT SPQ060}. Please confirm. If this
is correct, select Next to continue". DISPLAY
DON'T KNOW OPTION (SaVisible "True").

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT SPQ060}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar".

__________________________________________________________

SPQ090
DISPLAY INSTRUCTIONS:
FOR THE FIRST DISPLAY, DISPLAY “he” IF THE CHILD
IS MALE (INQ050b = 1). ELSE DISPLAY “she” IF THE
CHILD IS FEMALE (INQ050b = 2). ELSE DISPLAY
“they” IF THE CHILD IS ANOTHER GENDER (INQ050b
= 3). ELSE DISPLAY THE CHILD’S NAME IF GENDER
IS MISSING (INQ050b = SK) AS SHOWN IN THE
GLOBAL SPECS.
FOR THE SECOND DISPLAY, DISPLAY “was” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “were” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).

QUESTION TEXT:
Question “Was {CHILD} born more than two
weeks before {he/she/they} {was/were} due?”

"¿{CHILD} nació más de dos semanas antes de
tiempo?”

CODES
1

Yes

SPQ099

Sí

SPQ106

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO SPQ106.

__________________________________________________________

SPQ099
DISPLAY INSTRUCTIONS:
FOR THE FIRST DISPLAY, DISPLAY “was” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “were” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).
FOR THE SECOND DISPLAY, DISPLAY “he” IF THE
CHILD IS MALE (INQ050b = 1). ELSE DISPLAY “she”
IF THE CHILD IS FEMALE (INQ050b = 2). ELSE
DISPLAY “they” IF THE CHILD IS ANOTHER GENDER
(INQ050b = 3). ELSE DISPLAY THE CHILD’S NAME IF
GENDER IS MISSING (INQ050b = SK) AS SHOWN IN
THE GLOBAL SPECS.

QUESTION TEXT:
Question "How many days or weeks early
{was/were} {he/she/they}? Please answer in
either days or weeks. If you are reporting in
weeks, please round to the nearest week.”

"¿Cuántos días o semanas se adelantó? Por
favor, conteste en días o semanas."

Pre-unit "Days:"

Watermark: "Ponga cuántos días"

Watermark: "Enter days"

"O"

"Or"

Pre-unit "Semanas:"

Pre-unit "Weeks:"

Watermark: "Ponga cuántas semanas"

Watermark: "Enter weeks"

ENTER NUMBER
PROGRAMMER INSTRUCTIONS:
SK SKIPS TO SPQ106.
Range for days 0 to 31.
Range for weeks 0 to 20.

Pre-unit "Días:"

__________________________________________________________

SPQ106

QUESTION TEXT:
Question “Was {CHILD} a twin, triplet, or
other child born as part of a multiple birth?”

"¿Fue {CHILD} un gemelo, mellizo, trillizo, o
fue un bebé nacido de otro parto múltiple?”

CODES
1

Yes, a twin

Sí, gemelo(a) o mellizo(a)

Yes, a triplet

Sí, trillizo(a)

Yes, a multiple birth with four or more babies

Sí, un parto múltiple con cuatro o más bebés

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: For twins, triplets, and other
multiple births, please answer for how many
children were born together even if one or more
were stillborn or did not survive.

HELP FOR STEM: Para gemelos, mellizos, trillizos
y otros partos múltiples, por favor conteste en
relación a cuántos niños nacieron juntos, aunque
uno o más hayan nacido sin vida o no hayan
podido sobrevivir.

__________________________________________________________

SPQ152

QUESTION TEXT:
Question “What was {CHILD}'s sex at birth?”

“¿De qué sexo era {CHILD} al nacer?”

CODES
1

Male

Masculino

Female

Femenino

__________________________________________________________

SPQ153
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.
DISPLAY “(Please specify):” FOR LARGE BROWSERS.
ELSE DISPLAY “(Please specify on next screen.)” FOR
SMALL BROWSERS.

DISPLAY “(Por favor especifique):” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question "Now we would like to ask about the
language, or languages, spoken in your home.
What languages are spoken in your home?
Please select all that apply.”

CODES

"Ahora quisiéramos preguntarle acerca del
idioma o los idiomas que se hablan en su hogar.
¿Qué idiomas se hablan en su hogar? Por favor
seleccione todo lo que corresponda.”

Code All That Apply

English

Inglés

Spanish

Español

A European language other than Spanish, for
example, French, German, or Russian
A Chinese language or dialect

Un idioma europeo que no es español, como
francés, alemán o ruso
Un idioma o dialecto chino

A Filipino language

Un idioma filipino

A Southeast Asian language, for example,
Vietnamese, Thai, or Khmer
A South Asian language, for example, Hindi or
Tamil
Another Asian language, for example, Japanese or
Korean
A Middle Eastern language, for example, Arabic or
Farsi
An African language, for example, Swahili or
Amharic
A sign language, for example, American Sign
Language (ASL) or a sign language from another
country or culture
Other language(s) {(Please specify):/(Please
specify on next screen.)}

Un idioma del sudeste asiático, como
vietnamita, tailandés o jemer
Un idioma del sur de Asia, como el hindi o
tamil
Otro idioma asiático, como japonés o coreano

7
8
9
10

Un idioma del Medio Oriente, como árabe o
farsi
Un idioma africano, como suajili o amhárico
Un lenguaje de señas, por ejemplo, el
lenguaje de señas americano (ASL) o un
lenguaje de señas de otro país o cultura
Otro(s) idioma(s) {(Por favor
especifique):/(Por favor especifique en la
pantalla siguiente.)

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO BOX 5.
BOLD 'Regularly" IN FIRST INSTANCE ONLY OF
HELP TEXT
HELP FOR STEM: Regularly: A language, other
than English, that is spoken on regular basis
(that is, occurring at least weekly) by at least

BOLD ‘Regularmente’ IN FIRST INSTANCE ONLY
OF HELP TEXT
HELP FOR STEM: Regularmente: Un idioma,
aparte de inglés, que al menos un miembro del
hogar habla de manera regular (es decir, al menos
cada semana).

one household member.
__________________________________________________________

Box 4

IF ONLY ONE CODE IS SELECTED IN SPQ153
AND IT IS ENGLISH (SPQ153 = 0) GO TO BOX
6. ELSE IF ANY CODE IN SPQ153 = 91, GO TO
SPQ153OS. ELSE IF MORE THAN ONE CODE IN
SPQ153 IS SELECTED, GO TO SPQ160 TO ASK
ABOUT THE PRIMARY LANGUAGE. ELSE GO TO
BOX 6.

__________________________________________________________

SPQ153OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE FOR LARGE BROWSERS.

ENTER TEXT

__________________________________________________________

SPQ160
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES ON ONE PAGE.
DISPLAY CODES 3 – 13 BASED ON ANSWER{S} 1-91
IN SPQ153.

QUESTION TEXT:
Question "What is the primary language
spoken in your home?"

"¿Cuál es el idioma principal que se habla en su
hogar?"

CODES
1

English

Box 6

Inglés

Two or more languages are spoken the same
amount
{Spanish}

Box 5

Dos o más idiomas se hablan por igual

Box 6

{Español}

Box 6

{A European language other than Spanish, for
example, French, German, or Russian}
{A Chinese language or dialect}

Box 6

{Un idioma europeo que no es español, como
francés, alemán o ruso}
{Un idioma o dialecto chino}

{A Filipino language}

Box 6

{Un idioma filipino}

{A Southeast Asian language, for example,
Vietnamese, Thai, or Khmer}
{A South Asian language, for example, Hindi or
Tamil}
{Another Asian language, for example, Japanese
or Korean}
{A Middle Eastern language, for example, Arabic
or Farsi}
{An African language, for example, Swahili or
Amharic}
{A sign language, for example, American Sign
Language (ASL) or a sign language from another
country or culture}
{OTHER SPECIFY ANSWER FROM SPQ153}

Box 6

{Un idioma del sudeste asiático, como
vietnamita, tailandés o jemer}
{Un idioma del sur de Asia, como el hindi o el
tamil}
{Otro idioma asiático, como japonés o
coreano}
{Un idioma del medio oriente, como árabe o
farsi}
{Un idioma africano como, suajili o amhárico}

3
4

8
9
10

11
12

Box 6
Box 6
Box 6

Box 6
Box 6

Box 6

{Un lenguaje de señas, por ejemplo, el
lenguaje de señas americano (ASL) o un
lenguaje de señas de otro país o cultura}
{OTHER SPECIFY ANSWER FROM SPQ153}

PROGRAMMER INSTRUCTIONS:
HELP FOR CODE 2: Two or more languages
spoken the same amount: If there is more than
one language spoken in your home and they are
spoken the same amount of time, choose this
category. English may be one of these
languages, but does not have to be.

HELP FOR CODE 2: Dos idiomas o más se hablan
por igual: Si en su hogar se habla más de un
idioma y se hablan por igual cantidad de tiempo,
escoja esta opción. Inglés puede ser uno de esos
idiomas, pero no es necesario que lo sea.

__________________________________________________________

Box 5

IF SPQ153 INDICATES THAT MORE THAN TWO
LANGUAGES ARE SPOKEN IN THE HOME
(MORE THAN TWO CODES 0 - 10 WERE
SELECTED) INCLUDING SELECTION OF OTHER
LANGUAGES SPOKEN (SPQ153 = 91) AS ONE
OF THOSE, GO TO SPQ162. ELSE GO TO BOX 6.

__________________________________________________________

SPQ162
DISPLAY INSTRUCTIONS:
DISPLAY CODES 1 – 11 BASED ON ANSWER{S} 1-91
IN SPQ153.

IF SPQ153 = 91 BUT NO TEXT WAS ENTERED
DISPLAY "Otro idioma"

IF SPQ153 = 91 BUT NO TEXT WAS ENTERED
DISPLAY "Another language"

QUESTION TEXT:
Question “You mentioned that more than two
or more languages are spoken equally at
home. What are these languages?”
Select one or more choices below. If more than
one language falls in the same category below
(for example, if you speak two different African
languages), 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 (Please specify).””

CODES

"Usted mencionó que hablan dos o más idiomas
por igual en su hogar. ¿Qué idiomas son esos?
Seleccione una o más de las siguientes
opciones. Si hay más de un idioma que cae en
una misma opción de las siguientes (por
ejemplo, si usted habla dos idiomas africanos
diferentes), seleccione esa opción.”

Code All That Apply

English

Inglés

{Spanish}

Español

2
3

{A European language other than Spanish, for
example, French, German, or Russian}
{A Chinese language or dialect}

Un idioma europeo que no es español, como
francés, alemán o ruso
Un idioma o dialecto chino

{A Filipino language}

Un idioma filipino

Un idioma del sudeste asiático, como
vietnamita, tailandés o jemer
Aun idioma del sur de Asia, como el hindi o
tamil
Otro idioma asiático, como japonés o coreano

7
8

9
10

__________________________________________________________

Box 6

GO TO PIQ (PARENT'S INVOLVEMENT WITH
CHILD'S SCHOOL).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

PIQ

Parent's Involvement with Child's School

__________________________________________________________

PIQ124
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “Before the start of this school year,
did you or another family member do any of
the following activities in preparation for
{CHILD’s} first day of school? Please select all
that apply.”

CODES

Code All That Apply

Have {CHILD} meet {his/her/their} new teacher

Talk to teachers yourself at the school

Talk to the principal/school administrator

Take {CHILD} to visit the school grounds

Talk to {CHILD} about what kindergarten will be
like
Talk to or meet with other kindergarten parents

Volunteer at the school

Read books to {CHILD} that talked about starting
kindergarten
Review parent resource materials provided by the
school, such as the school’s newsletter or postings
to the school’s website

“Antes del comienzo de este año escolar, ¿usted
o algun otro miembro de la familia hizo alguna
de las siguientes actividades como preparación
para el primer día de escuela de {CHILD}? Por
favor seleccione todas lo que corresponda.”

Obtain information or advice from preschools or
other early care and education centers about
preparing children for the first day of kindergarten

Obtain information or advice from community
services or family support/resource centers about
preparing children for the first day of kindergarten

Search online for information about preparing
children for the first day of kindergarten

Anything else? {(Please specify):/(Please specify
on next screen.)}

Hizo a {CHILD} conocer a su nuevo(a)
maestro(a)
Habló usted con maestros en la escuela
Habló con el director/administrador de la
escuela
Llevó a {CHILD} a visitar la escuela
Habló con {CHILD} acerca de cómo será el
kindergarten
Habló o se reunió con otros padres/madres
de niños del kindergarten
Hizo trabajo voluntario en la escuela
Leyó a {CHILD} libros acerca de comenzar
kindergarten
Revisó los materiales de recursos para
padres/ madres que proporciona la escuela,
como el boletín de noticias de la escuela o
publicaciones en la página de internet de la
escuela
Obtuvo información o asesoramiento de
preescolares u otros centros de cuidado y
educación temprana sobre cómo preparar a
los niños para su primer día de kindergarten
Obtuvo información o asesoramiento de
servicios comunitarios o centros de
apoyo/recursos para familias acerca de
preparar a los niños para el primer día de
kindergarten
Buscó información en internet acerca de
cómo preparar a los niños para el primer día
de kindergarten
¿Alguna otra cosa? {(Por favor
especifique):/(Por favor especifique en la
pantalla siguiente.)}

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: If {CHILD} is repeating
kindergarten this year, please think about
experiences before the start of the current
school year.

HELP FOR STEM: Si {CHILD} está repitiendo
kindergarten este año, por favor piense en sus
experiencias antes del comienzo del año escolar
actual.

__________________________________________________________

Box 1

IF ANY ANSWER TO PIQ124 = 91 (OTHER), GO
TO PIQ124os. ELSE GO TO PIQ126.

__________________________________________________________

PIQ124OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.

ENTER TEXT

__________________________________________________________

PIQ126

QUESTION TEXT:
Question “Has {CHILD} ever had a home visit
from {his/her/their} kindergarten teacher?”

“¿Alguna vez ha tenido {CHILD} una visita al
hogar de su maestro o maestra de
kindergarten?”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
BOLD “Home visit” IN HELP TEXT.

BOLD “Visita al hogar” IN HELP TEXT.

HELP FOR STEM: Home visit: Some kindergarten
teachers visit children in their homes to get to
know them and help prepare for school.

HELP FOR STEM: Visita al hogar: Algunos
maestros de kindergarten visitan a los niños en
sus hogares para conocerlos y ayudarlos a
prepararse para la escuela.

__________________________________________________________

PIQ127
DISPLAY INSTRUCTIONS:
FOR THE FIRST DISPLAY, DISPLAY “he” IF THE CHILD
IS MALE (INQ050b = 1). ELSE DISPLAY “she” IF THE
CHILD IS FEMALE (INQ050b = 2). ELSE DISPLAY
“they” IF THE CHILD IS ANOTHER GENDER (INQ050b
= 3). ELSE DISPLAY THE CHILD’S NAME IF GENDER
IS MISSING (INQ050b = SK) AS SHOWN IN THE
GLOBAL SPECS.

FOR THE SECOND DISPLAY, DISPLAY “es” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “son”IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).

FOR THE SECOND DISPLAY, DISPLAY “is” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “are” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).

QUESTION TEXT:
Question “Now we have some questions about
{CHILD}'s school. Please select all that apply
in the next question. Since the beginning of
the school year, have any of {CHILD}’s
teachers or {his/her/their} school contacted
your household about any behavior problems
{he/she/they} {is/are} having, such as:”

CODES

“Ahora tenemos algunas preguntas sobre la
escuela de {CHILD}. Por favor seleccione todo
lo que corresponda en la siguiente pregunta.
Desde el comienzo del año escolar, ¿alguno de
los maestros de {CHILD} o su escuela
contactaron a su hogar por algún problema de
comportamiento que {CHILD} estuviera
teniendo, tal como:”

Code All That Apply

Biting

Morder

Being aggressive

Ser agresivo(a)

Not following directions

No seguir instrucciones

Inappropriate behavior for the situation

Comportamiento inapropiado para la situación

Being overly active

Ser excesivamente activo(a)

Being impulsive or having little or no self-control

Being sad or upset

Ser impulsivo(a) o tener poco o nada de
autocontrol
Estar triste o molesto(a)

8
9

Making repetitive or unusual movements or noises
(for example, stimming)
Avoiding work

Hacer movimientos o ruidos repetitivos o
inusuales (por ejemplo, stimming)
Evitar hacer trabajo

Another behavior problem

Otro problema de comportamiento

None of the above

Ninguno de estos

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 11, 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

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 11, DISPLAY HARD ERROR
CHECK MESSAGE, “Usted seleccionó “Ninguno de
estos” pero también seleccionó otra opción de la
lista. Por favor vea sus respuestas y corrija su

your answer. Then, select “Next” to continue.”

respuesta. Luego seleccione “Siguiente” para
continuar."

__________________________________________________________

PIQ130

QUESTION TEXT:
Question “Since the beginning of this school
year, have you or the other adults in your
household done any of the following activities?
Please select all that apply.”
CODES

Code All That Apply

Attended an open house or a back-to-school night

Attended a meeting of a PTA, PTO, or ParentTeacher Organization
Gone to a regularly-scheduled parent-teacher
conference with {CHILD}'s teacher or meeting
with {CHILD}'s teacher

Attended a school or class event, such as a play,
sports event, or science fair

Served as a volunteer in {CHILD}’s classroom or
elsewhere in the school
None of the above

“Desde que comenzó este año escolar, ¿usted o
alguno de los demás adultos en su hogar ha
hecho alguna de las siguientes actividades? Por
favor seleccione todo lo que corresponda.”

Asistió a un open house or a una reunión
nocturna por el regreso a clases
Asistió a una reunión del PTA, PTO u
Organización de Padres y Maestros
Fue a una cita con el maestro o la maestra de
{CHILD} como parte de las reuniones
regulares de padres y maestros, o a una cita
con el maestro o la maestra de {CHID}
Asistió a un evento de la escuela o de la
clase, por ejemplo, a una obra de teatro, un
evento deportivo o una feria de ciencias
Fue voluntario(a) en el salón de clase de
{CHILD} o en alguna otra parte de la escuela
Ninguna de estas actividades

PROGRAMMER INSTRUCTIONS:
BOLD “A meeting of a PTA, PTO, or ParentTeacher Organization” IN HELP TEXT.

BOLD “Una reunión del PTA, PTO u Organización
de Padres y Maestros” IN HELP TEXT.

HELP FOR CODE 2: A meeting of a PTA, PTO, or
Parent-Teacher Organization. These are
meetings of parents and school staff who work
together to help students and the school. The
PTA is the Parent Teacher Association and is
usually associated with the state or national
PTA. A PTO is a Parent-Teacher Organization
that is independent from a state or national
organization.

HELP FOR CODE 2: Una reunión del PTA, PTO u
Organización de Padres y Maestros. Son reuniones
de padres y personal de la escuela que trabajan
juntos para ayudar a los estudiantes y la escuela.
La PTA es la Asociación de Padres y Maestros y
suele estar asociada a la PTA estatal o nacional.
Una PTO es una organización de padres y
maestros de una organización estatal o nacional.

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.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 6, DISPLAY HARD ERROR
CHECK
MESSAGE, “Usted seleccionó “Ninguna de estas
actividades” pero también seleccionó otra opción
de la lista. Por favor vea sus respuestas y corrija
su respuesta. Luego seleccione “Siguiente” para
continuar.”

__________________________________________________________

PIQ185

QUESTION TEXT:
Question “During this school year, how many
times have you or other adults in your
household gone to meetings or participated in
activities at {CHILD}'s school?”

"Durante este año escolar, ¿cuántas veces
usted o alguno de los demás adultos en su
hogar ha ido a reuniones o ha participado en
actividades en la escuela de {CHILD}?"

Pre-unit “Times:”

Pre-unit “Veces:”

Watermark “Times”

Watermark “Veces”

ENTER NUMBER
Range

0 to 999

Soft Range

0 to 180

PROGRAMMER INSTRUCTIONS:
IF ANY ANSWERS IN PIQ130 = 1, 2, 3, 4, OR 5,
SOFT RANGE: 1 TO 180. ELSE, SOFT RANGE = 0
TO 180.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “You have entered {DISPLAY
RESPONSE AT PIQ185}. Please confirm. If this is
correct, select Next to continue.”

IF SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE: “Usted ha puesto {DISPLAY RESPONSE
AT PIQ185}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar.”

__________________________________________________________

PIQ190
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230 ON SAME
SCREEN IN A GRID. WHEN ITEMS ARE DISPLAYED IN
A GRID, USE A DARK COLUMN SEPARATOR LINE IN
FRONT OF THE COLUMN FOR THE "Don't know"
DISPLAY.

IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230 ON SAME
SCREEN IN A GRID. WHEN ITEMS ARE DISPLAYED IN
A GRID, USE A DARK COLUMN SEPARATOR LINE IN
FRONT OF THE COLUMN FOR THE "No sé" DISPLAY.

QUESTION TEXT:
Question “How well has {CHILD}'s school done
with each of the following activities during this
school year?

“¿Qué tan bien la escuela de {CHILD} ha hecho
cada una de las siguientes cosas durante este
año escolar?

The school lets you know between report cards
how {CHILD} is doing in school.”

La escuela lo/la mantiene informado(a) sobre
cómo le está yendo a {CHILD} en el tiempo
entre una entrega de calificaciones y la
siguiente .”

SaVisible "True"

CODES
1

Does this very well

Lo hace muy bien

Just OK

Lo hace más o menos bien

Doesn't do this at all

Nunca hace eso

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

PIQ200
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230 ON SAME
SCREEN IN A GRID. WHEN ITEMS ARE DISPLAYED IN
A GRID, USE A DARK COLUMN SEPARATOR LINE IN
FRONT OF THE COLUMN FOR THE "Don't know"
DISPLAY.

QUESTION TEXT:
Question “The school helps you understand
what children at {CHILD}'s age are like.”

“La escuela le ayuda a entender cómo son los
niños de la edad de {CHILD}.”

SaVisible "True"

CODES
1

Does this very well

Lo hace muy bien

Just OK

Lo hace más o menos bien

Doesn't do this at all

Nunca hace eso

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

PIQ210
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230 ON SAME
SCREEN IN A GRID. WHEN ITEMS ARE DISPLAYED IN
A GRID, USE A DARK COLUMN SEPARATOR LINE IN
FRONT OF THE COLUMN FOR THE "Don't know"
DISPLAY.

QUESTION TEXT:
Question “The school makes you aware of
chances to volunteer at the school.”

“La escuela le informa de posibilidades de hacer
trabajo voluntario en la escuela.”

SaVisible "True"

CODES
1

Does this very well

Lo hace muy bien

Just OK

Lo hace más o menos bien

Doesn't do this at all

Nunca hace eso

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

PIQ220
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230 ON SAME
SCREEN IN A GRID. WHEN ITEMS ARE DISPLAYED IN
A GRID, USE A DARK COLUMN SEPARATOR LINE IN
FRONT OF THE COLUMN FOR THE "Don't know"
DISPLAY.

QUESTION TEXT:
Question “The school provides workshops,
materials, or advice about how to help
{CHILD} learn at home.”

“La escuela organiza talleres, provee materiales
o consejos acerca de cómo ayudar a {CHILD} a
aprender en casa.”

SaVisible "True"

CODES
1

Does this very well

Lo hace muy bien

Just OK

Lo hace más o menos bien

Doesn't do this at all

Nunca hace eso

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

PIQ230
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ190, PIQ200, PIQ210, PIQ220, PIQ230 ON SAME
SCREEN IN A GRID. WHEN ITEMS ARE DISPLAYED IN
A GRID, USE A DARK COLUMN SEPARATOR LINE IN
FRONT OF THE COLUMN FOR THE "Don't know"
DISPLAY.

QUESTION TEXT:
Question “The school provides information on
community services to help {CHILD} or your
family.”

“La escuela le da información sobre servicios
comunitarios para ayudar a {CHILD} o a su
familia.”

SaVisible "True"

CODES
1

Does this very well

Lo hace muy bien

Just OK

Lo hace más o menos bien

Doesn't do this at all

Nunca hace eso

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

PIQ231a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ231a-c ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Please answer the questions below
about {CHILD}'s school.

“Por favor responda las siguientes preguntas
acerca de la escuela de {CHILD}.

At this school, all students are treated equally.”

En esta escuela, todos los estudiantes son
tratados de igual manera.”

CODES
1

Strongly agree

Muy de acuerdo

Agree

De acuerdo

Disagree

En desacuerdo

Strongly disagree

Muy en desacuerdo

__________________________________________________________

PIQ231b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ231a-c ON SAME SCREEN IN A GRID.

QUESTION TEXT:

Question “This school teaches with materials
that show a wide variety of students (for
example, children of different races and
ethnicities, children who speak different
languages, and children from different
countries).”

“Esta escuela enseña usando materiales que
muestran estudiantes muy variados (por
ejemplo, niños de distintas razas y grupos
étnicos, niños que hablan distintos idiomas y
niños de diferentes países).”

CODES
1

Strongly agree

Muy de acuerdo

Agree

De acuerdo

Disagree

En desacuerdo

Strongly disagree

Muy en desacuerdo

__________________________________________________________

PIQ231c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ231a-c ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “This school thinks it is important to
show respect for all students’ backgrounds,
beliefs, values, and ways of life.”

“Esta escuela considera importante demostrar
respeto por el origen, creencias, valores y
modos de vida de todos los estudiantes.”

CODES
1

Strongly agree

Muy de acuerdo

Agree

De acuerdo

Disagree

En desacuerdo

Strongly disagree

Muy en desacuerdo

__________________________________________________________

PIQ400

QUESTION TEXT:
Question “ When {CHILD}'s teacher sends
home notes or newsletters, are these in a
language that you speak?”

“Cuando el maestro o la maestra de {CHILD}
manda a la casa notas o boletines de noticias,
¿están en un idioma que usted habla?”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: This question is about whether
schools are trying to communicate with parents
in a language that they speak, whether it is
English or another language.

HELP FOR STEM: Esta pregunta es para saber si
las escuelas están tratando de comunicarse con
los padres/madres en un idioma que ellos hablan,
ya sea inglés u otro idioma.

__________________________________________________________

PIQ415

QUESTION TEXT:
Question “This year, have any of the following
reasons made it harder for you to participate
in activities at {CHILD}'s school? Please select
all that apply.”
CODES

“En este año ¿se le hizo más difícil participar en
actividades en la escuela de {CHILD} debido a
alguna de las siguientes razones? Por favor
seleccione todo lo que corresponda."

Code All That Apply

Inconvenient meeting times

Las reuniones son a horas inconvenientes.

No child care keeps your family from going to
school meetings or event

Family members can't get time off from work

Problems with safety going to the school

The school does not make your family feel
welcome
Problems with transportation to the school

You don't hear about things going on at school
that you might want to be involved in

Another reason

No tiene quien cuide al niño para que su
familia pueda ir a las reuniones o eventos en
la escuela.
Los miembros de la familia no pueden
ausentarse del trabajo.
Hay problemas de seguridad para llegar a la
escuela.
La escuela no hace que su familia se sienta
bien recibida.
Tiene problemas de transporte para llegar a
la escuela.
No se entera de las cosas que están pasando
en la escuela en las que podría estar
interesado(a) en participar.
Otra razón

You do not find it hard to participate in activities
at {CHILD}’s school

No le resulta difícil participar en actividades
en la escuela de {CHILD}.

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 9, DISPLAY HARD
ERROR CHECK MESSAGE, “You selected “I do
not find it hard to participate in activities at
{CHILD}’s school” but also selected another
option on the list. Please check your responses
and update your answer. Then, select “Next” to
continue.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 9, DISPLAY HARD ERROR
CHECK
MESSAGE, “Usted seleccionó “No se me hace
difícil participar en actividades en la escuela de
{CHILD}” pero también seleccionó otra opción de
la lista. Por favor revise lo que contestó y corrija
su respuesta. Luego seleccione "Siguiente" para
continuar.”

__________________________________________________________

Box 2

IF THE PRELOAD SHOWS IT IS A FALL K
CONTINUING HOUSEHOLD AND PLQ060 = 2 13 FROM FALL K (PRIMARY LANGUAGE IS NOT
ONLY ENGLISH), GO TO PIQ470.
ELSE IF IT IS A FALL K NON-RESPONDENT
AND SPQ160 = 2 - 13 (PRIMARY LANGUAGE IS
NOT ONLY ENGLISH), GO TO PIQ470.
ELSE, GO TO PIQ550.

__________________________________________________________

PIQ470

QUESTION TEXT:
Question “This year, has it been harder for you
to participate in activities at {CHILD}'s school
because you or members of your family speak
a language other than English and meetings
are conducted only in English?”

“En este año ¿se le hizo más difícil participar en
actividades en la escuela de {CHILD} debido a
que usted o algún miembro de su familia habla
otro idioma y las reuniones se llevan a cabo
solamente en inglés?”

CODES
1

Yes

Sí

__________________________________________________________

PIQ550

QUESTION TEXT:
Question “How often do you check that
{CHILD} has completed all of {his/her/their}
homework?”

“¿Con qué frecuencia controla que {CHILD}
haya completado todas las tareas escolares?”

CODES
1

Never

Nunca

Rarely

Rara vez

Sometimes

A veces

Always

Siempre

Not applicable. {CHILD} does not have homework.

No corresponde. {CHILD} no tiene tareas
escolares.

__________________________________________________________

PIQ585a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ585a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Now I have some questions about
{CHILD} and school. How often would you say
that {CHILD}…

“Ahora tengo algunas preguntas sobre {CHILD}
y la escuela. ¿Con qué frecuencia diría que
{CHILD}…

Makes up reasons to stay home from school?”

¿Inventa razones para faltar a la escuela? "

CODES
1

Almost never

Casi nunca

Rarely

Rara vez

Sometimes

A veces

A lot

Muchas veces

Almost always

Casi siempre

__________________________________________________________

PIQ585b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ585a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Seems to dread going to school?”

“¿Parece que le espanta la idea de ir a la
escuela?”

CODES
1

Almost never

Casi nunca

Rarely

Rara vez

Sometimes

A veces

A lot

Muchas veces

Almost always

Casi siempre

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: By “dread” we mean having a
lot of fear or anxiety about going to school.

HELP FOR STEM: Por “espantar” nos referimos a
que tiene mucho miedo o ansiedad de ir a la
escuela.

__________________________________________________________

PIQ585c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ585a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Becomes upset when it’s time to go
to school in the morning?”

“¿Se altera por la mañana cuando es hora de ir
a la escuela?”

CODES
1

Almost never

Casi nunca

Rarely

Rara vez

Sometimes

A veces

A lot

Muchas veces

Almost always

Casi siempre

__________________________________________________________

PIQ585d
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ585a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Asks to stay home from school?”

“¿Pide faltar a la escuela?”

CODES
1

Almost never

Casi nunca

Rarely

Rara vez

Sometimes

A veces

A lot

Muchas veces

Almost always

Casi siempre

__________________________________________________________

PIQ585e
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PIQ585a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Complains about going to school?”

“¿Se queja de tener que ir a la escuela?”

CODES
1

Almost never

Casi nunca

Rarely

Rara vez

Sometimes

A veces

A lot

Muchas veces

Almost always

Casi siempre

__________________________________________________________

Box 3

GO TO SECTION FSQ (FAMILY STRUCTURE).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

FSQ

Family Structure

__________________________________________________________

FSQ005a
DISPLAY INSTRUCTIONS:
FOR BOTH LARGE AND SMALL BROWSERS DISPLAY
FSQ005a, b, AND c ON THE SAME SCREEN.
DISPLAY "other" AND "18 and older" IN UNDERLINED
TEXT. PLACE RESPONSE FIELD ON SAME LINE AS
QUESTION TEXT. DISPLAY "[CHILD} and you: 2" AND
ALIGN THE NUMBER "2" IN THIS TEXT WITH THE
RESPONSE FIELDS FOR FSQ005a, b, AND c.

DISPLAY "otros" AND "18 años o más" IN
UNDERLINED TEXT. PLACE RESPONSE FIELD ON
SAME LINE AS QUESTION TEXT. DISPLAY "[CHILD}
and you: 2" AND ALIGN THE NUMBER "2" IN THIS
TEXT WITH THE RESPONSE FIELDS FOR FSQ005a, b,
AND c.
DISPLAY "18 años o más " IN UNDERLINED TEXT.

DISPLAY "18 and older" IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Now we would like to know a bit
about {CHILD}’s household to better
understand how children’s
home experiences may relate to early learning.
In addition to you and {CHILD}, how many
other people or family members live in the
household?

“Ahora nos gustaría saber un poco sobre el
hogar de {CHILD} para comprender mejor cómo
las experiencias de los niños en sus hogares
pueden relacionarse con el aprendizaje en la
primera infancia.
Además de usted y {CHILD}, ¿cuántas personas
o familiares más viven en el hogar?

Watermark "Enter number"

Watermark "Ponga el número"

[CHILD} and you: 2"

{CHILD} y usted: 2

Number of other household members age 18
and older:”

Número de otros miembros del hogar de 18
años o más:”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 10

PROGRAMMER INSTRUCTIONS:

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT FSQ005a}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT FSQ005a}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

FSQ005b
DISPLAY INSTRUCTIONS:
FOR BOTH LARGE AND SMALL BROWSERS DISPLAY
FSQ005a, b, AND c ON THE SAME SCREEN.
DISPLAY "17 and younger" IN UNDERLINED TEXT.
PUT RESPONSE FIELD ON SAME LINE AS QUESTION
TEXT.

DISPLAY "17 años o menores " IN UNDERLINED TEXT.
PUT RESPONSE FIELD ON SAME LINE AS QUESTION
TEXT.

ADD DARK SEPARATOR LINE ONE LINE UNDER
QUESTION TEXT.

QUESTION TEXT:
Question “Number of other household
members age 17 and younger:”

"Número de otros miembros del hogar de 17
años o menores:”

Watermark "Enter number"

Watermark "Ponga el número"

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 10

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT FSQ005b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT FSQ005b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

FSQ005c
DISPLAY INSTRUCTIONS:
FOR BOTH LARGE AND SMALL BROWSERS DISPLAY
FSQ005a, b, AND c ON THE SAME SCREEN.
FOR THE RESPONSE AREA IN FSQ005c, CREATE A
HOUSEHOLD TOTAL BY ADDING THE NUMBER 2 (FOR
THE CHILD AND RESPONDENT) PLUS THE NUMBER
OF HOUSEHOLD MEMBERS IN FSQ005a (NUMBER OF
OTHER HOUSEHOLD MEMBERS AGE 18 AND OLDER)
PLUS THE NUMBER OF HOUSEHOLD MEMBERS IN
FSQ005b (NUMBER OF OTHER HOUSEHOLD MEMBERS
AGE 17 AND YOUNGER). IF THERE ARE ANY
CHANGES TO FSQ005a OR FSQ005b AFTER A
RESPONDENT BACKS UP FROM FSQ005c, CALCULATE
THIS TOTAL IN FSQ005c AGAIN.
COUNT SK ANSWERS IN FSQ005a AND FSQ005b AS
ZERO IN THE SUM. PUT RESPONSE FIELD ON SAME
LINE AS QUESTION TEXT AND CHANGE THE FILL
COLOR TO GRAY. DISPLAY THE INTRESP ON THE
NEXT LINE AFTER THE SUM OF NUMBER.

QUESTION TEXT:
Question “Total number of household
members, including {CHILD} and you:

"Número total de miembros del hogar,
incluyendo a {CHILD} y a usted:"

Include any spouses, partners, babies, young
children, and people who are only temporarily
away from home, such as living in a dorm.
Please do not include anyone staying here
temporarily who usually lives somewhere else.”

InstResp "Incluya esposos o esposas, parejas,
bebés, niños pequeños y personas que solo
estén temporalmente fuera de casa, por
ejemplo, viviendo en un dormitorio
universitario. No incluya a nadie que se esté
quedando ahí temporalmente pero que
generalmente vive en otro lado.

InstResp “If the total is correct, please select
the Next button. Otherwise, change the
numbers of household members who are 18
and older or 17 and younger until the total is
correct.”

Si el total es correcto, seleccione el botón de
"Siguiente". De lo contrario, cambie el número
de miembros del hogar de 18 años o más y el
número de los menores de 17 años hasta que el
total sea correcto."

ENTER NUMBER
Range

2 to 30

Soft Range

2 to 10

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT FSQ005c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT FSQ005c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

FSQ010
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY “table”,
“to the row”, “in this table”. ELSE IF THE BROWSER
SIZE IS NOT LARGE, DISPLAY “screens, “on this
screen”, and “on the screens that follow”.

IF THE BROWSER SIZE IS LARGE, DISPLAY “tabla”,
“en la línea”, “en esta tabla”. ELSE IF THE BROWSER
SIZE IS NOT LARGE, DISPLAY “las pantallas, “en esta
pantalla”, and “en las pantallas a continuación”.

DISPLAY “Initial” FOR ANY DISTRICTS NOTED IN
THE PRELOAD THAT DISALLOW COLLECTION OF
TRACING DATA. ELSE DISPLAY “name”.

DISPLAY “inicial” FOR ANY DISTRICTS NOTED IN THE
PRELOAD THAT DISALLOW COLLECTION OF TRACING
DATA. ELSE DISPLAY “nombre”.

DISPLAY “Initials” FOR ANY DISTRICTS NOTED IN
THE PRELOAD THAT DISALLOW COLLECTION OF
TRACING DATA. ELSE DISPLAY “First name”.

DISPLAY “Iniciales” FOR ANY DISTRICTS NOTED IN
THE PRELOAD THAT DISALLOW COLLECTION OF
TRACING DATA. ELSE DISPLAY “primer nombre”.

IN THE HELP TEXT, DISPLAY “We'll be asking more
about some of these people later in the survey, so
please use initials that will make sense to you.” FOR
ANY DISTRICTS NOTED IN THE PRELOAD THAT
DISALLOW COLLECTION OF TRACING DATA. ELSE
DISPLAY “If you would prefer not to list first names,
you can use initials or nicknames. We'll be asking
more about some of these people later in the survey,
so please use names, nicknames, or initials that will
make sense to you.”

IN THE HELP TEXT, DISPLAY “Le preguntaremos más
sobre algunas de estas personas más adelante en
la encuesta. Por eso, por favor use iniciales que luego
usted recuerde quiénes son” FOR ANY DISTRICTS
NOTED IN THE PRELOAD THAT DISALLOW
COLLECTION OF TRACING DATA. ELSE DISPLAY “Si
prefiere no poner primeros nombres, puede usar
iniciales o sobrenombres/apodos. Le preguntaremos
más sobre algunas de estas personas más adelante en
la encuesta. Por eso, por favor use nombres,
sobrenombres/apodos que luego usted recuerde
quiénes son.”

DISPLAY INITIALS/FIRST NAME, AGE, AND GENDER
(FSQ010, FSQ030, AND FSQ040) ON THE SAME
SCREEN.
IF THE BROWSER SIZE IS LARGE, DISPLAY A GRID
WITH COLUMN HEADERS OF "Initials/First name",
"Age", AND "Gender". GRID ROWS SHOULD BE
"Parent/Guardian" AND THE NUMBER OF THE ROW, A
FIELD TO ENTER THE FIRST NAME, A FIELD TO ENTER
AGE, AND A FIELD TO ENTER GENDER.
IF THE BROWSER SIZE IS NOT LARGE, DISPLAY
THESE FIELDS VERTICALLY ON A SEPARATE SCREEN
FOR EACH PARENT/GUARDIAN. DISPLAY
"Parent/Guardian" AND THE NUMBER OF
PARENT/GUARDIANS ABOVE “Initials/First name”.
FOR PARENT/GUARDIAN 1, DISPLAY THE FIRST NAME
OF THE RESPONDENT FROM INQ005j (FIRST NAME
COLLECTED IN THE CURRENT PARENT SURVEY) IF IT
IS NOT EMPTY. ELSE DISPLAY THE FIRST NAME OF
THE RESPONDENT FROM INQ010b IF IT IS NOT
EMPTY. DO NOT ALLOW CHANGES. ELSE IF THE
RESPONDENT NAME IS EMPTY, DISPLAY THE WORD
"You."
IF THE BROWSER SIZE IS LARGE, AT THE BOTTOM
OF THE GRID, ADD A BUTTON THAT SAYS "Add a
person". IF THE BROWSER SIZE IS NOT LARGE,

IF THE BROWSER SIZE IS LARGE, DISPLAY A GRID
WITH COLUMN HEADERS OF “Inicial/Primer nombre”,
“Edad”, AND "Género". GRID ROWS SHOULD BE
"Padre/Madre/Tutor" AND THE NUMBER OF THE ROW,
A FIELD TO ENTER THE FIRST NAME, A FIELD TO
ENTER AGE, AND A FIELD TO ENTER GENDER.
IF THE BROWSER SIZE IS NOT LARGE, DISPLAY
THESE FIELDS VERTICALLY ON A SEPARATE SCREEN
FOR EACH HOUSEHOLD MEMBER. DISPLAY
“Padre/Madre/Tutor” AND THE NUMBER OF THE
HOUSEHOLD MEMBER ABOVE “Iniciales/Primer
nombre”.
FOR HOUSEHOLD MEMBER 1, DISPLAY THE FIRST
NAME OF THE RESPONDENT FROM INQ005j (FIRST
NAME COLLECTED IN THE CURRENT PARENT SURVEY)
IF IT IS NOT EMPTY. ELSE DISPLAY THE FIRST NAME
OF THE RESPONDENT FROM INQ010b IF IT IS NOT
EMPTY. DO NOT ALLOW CHANGES. ELSE IF THE
RESPONDENT NAME IS EMPTY, DISPLAY THE WORD
"Usted."
IF THE BROWSER SIZE IS LARGE, AT THE BOTTOM
OF THE GRID, ADD A BUTTON THAT SAYS "Añadir
una persona". IF THE BROWSER SIZE IS NOT LARGE,
AFTER THE SCREEN FOR HOUSEHOLD MEMBER 1,

AFTER THE SCREEN FOR PARENT/GUARDIAN 1,
DISPLAY A SCREEN THAT HAS “If needed, select the
button below to add a person and then select “Next.”
Otherwise, select “Next” to move to the next
question.”” AND A BUTTON UNDER THAT THAT SAYS
“Add a person”. IF 6 PERSONS HAVE BEEN ADDED TO
FSQ010, DO NOT DISPLAY THE "Add a person"
BUTTON BECAUSE NO ADDITIONAL PERSONS CAN BE
ADDED.
THE “Add a person” BUTTON SHOULD BE ONE ROW
ABOVE THE “Next” AND “Back” BUTTONS."
IF THE BROWSER SIZE IS LARGE, STARTING WITH
PARENT/GUARDIAN 2, DISPLAY IN InstResp FORMAT
“If a person was added in error, select the “Remove
this person” box and the person will be removed after
a button is selected.” AND A CHECKBOX AT THE END
OF EACH ROW THAT SAYS “Remove thIs person”.
IF THE BROWSER SIZE IS NOT LARGE, STARTING
WITH PARENT/GUARDIAN 2, DISPLAY IN InstResp.
FORMAT “If a person was added in error, select the
“Remove this person” box and the person will be
removed after a button is selected.” AND DISPLAY
“Remove this person” AT THE BOTTOM OF THE
SCREEN AND A CHECKBOX THAT SAYS “Remove this
person”.
UNDERLINE THE TEXT : "Do not add any other
household members who are not parents or
guardians." AND BOLD BOTH INSTANCES OF "not".
UNDERLINE THE TEXT : "Do not add any other
parents or guardians who do not live in this
household." AND BOLD BOTH INSTANCES OF "not".''
DISPLAY "parents or guardians" AND "partner or
spouse" IN UNDERLINED TEXT IN SENTENCES THAT
BEGINS WITH "Now we are requesting..." AND "If
{CHILD} has any other...".

DISPLAY A SCREEN THAT HAS “Si es necesario,
seleccione el botón de más abajo para añadir una
persona y luego seleccione "Siguiente". En caso
contrario, seleccione "Siguiente" para pasar a la
siguiente pregunta.” AND A BUTTON UNDER THAT
THAT SAYS “Añadir una persona”.
IF THE BROWSER SIZE IS LARGE, STARTING WITH
HOUSEHOLD MEMBER 2, DISPLAY IN InstResp
FORMAT “Si se añadió a una persona por error,
seleccione el botón "Eliminar a esta persona" y la
persona será quitada de la lista después que usted
seleccione cualquier otro botón.” AND A BUTTON AT
THE END OF EACH ROW THAT SAYS “Eliminar esta
persona”. IF THE BROWSER SIZE IS NOT LARGE,
STARTING WITH HOUSEHOLD MEMBER 2, DISPLAY IN
InstResp FORMAT “Si se añadió a una persona por
error, seleccione el botón "Eliminar a esta persona" y
la persona será quitada de la lista después que usted
seleccione cualquier otro botón.” AND DISPLAY
“Eliminar esta persona” AT THE BOTTOM OF THE
SCREEN AND A BUTTON THAT SAYS "Eliminar esta
persona”.
IF THE BROWSER SIZE IS NOT LARGE, STARTING
WITH HOUSEHOLD MEMBER 2, DISPLAY IN InstResp.
FORMAT “Si se añadió a una persona por error,
seleccione el botón "Eliminar a esta persona" y la
persona será quitada de la lista después que usted
seleccione cualquier otro botón.” AND DISPLAY
“Remove this person” AT THE BOTTOM OF THE
SCREEN AND A BUTTON THAT SAYS “Eliminar esta
persona”.
UNDERLINE THE TEXT "No añada ningún otro
miembro del hogar que no sea padre/madre o tutor
de {CHILD}." AND BOLD BOTH INSTANCES OF "no".
UNDERLINE THE TEXT "No añada ningún otro
padre/madre o tutor que no viva en este hogar." AND
BOLD BOTH INSTANCES OF "no".
DISPLAY "Padre/Madre/Tutor" AND "una pareja o
esposo(a)" IN UNDERLINED TEXT IN SENTENCES
THAT BEGINS WITH "Ahora estamos pidiéndole..."
AND "Si {CHILD} tiene otros...".

QUESTION TEXT:
Question "Thank you for providing information
about the total number of people living in
[CHILD]’s household.

"Gracias por darnos información acerca del
número total de personas que viven en el hogar
de {CHILD}.

Now we are requesting characteristics only
about yourself, {CHILD}’s parents or
guardians, and partners or spouses of
{CHILD}’s parents or guardians who may live
in this household.

Ahora estamos pidiéndole solamente
características de usted, de los padres/madres o
tutores de {CHILD} y de las parejas o
esposos/esposas de los padres/madres o tutores
de {CHILD} que vivan en este hogar.

This information will help us ask better
questions about {CHILD}’s parental figures
later in the survey.
In the {table/screens} below, please:

Esta información nos ayudará a hacer mejores
preguntas sobre las figuras maternas y paternas
de {CHILD} más adelante en la encuesta. En
{la tabla/las pantallas} a continuación, por
favor:

• Add your age and gender {to the row/on this
screen} with your {initial/first name}.

•Agregue su edad y género {a la línea/en esta
pantalla} con su {inicial/nombre}.

If {CHILD} has any other parents or guardians
who live in this household, or if you or another
parent or guardian has a partner or spouse
that live in {CHILD}'s household even if they
are not {CHILD}’s parent or guardian:

Si {CHILD} tiene otros padres/madres o tutores
que viven en este hogar o si usted u otro
padre/madre o tutor tiene una pareja o
esposo(a) que vive en el hogar de {CHILD}
aunque esa persona no sea un padre/madre o
tutor de {CHILD}:.

• Use the “Add a person" button to include
their information {in this table/on the screens
that follow}.
Do not add any other household members who
are not parents or guardians.
Do not add any other parents or guardians who
do not live in this household.
When you are finished, select "Next" to move
to the next question."
“{If a person was added in error, select the
“Remove this person” box and the person will
be removed after a button is selected.}”
“{Initials/First name}”
Parent/Guardian # {DISPLAY FIRST NAME OF
RESPONDENT}

•Use el botón de “Añadir una persona” para
incluir la información de esa persona {en esta
tabla/en las pantallas que siguen}.
No añada ningún otro miembro del hogar que
no sea padre/madre o tutor de {CHILD}.
No añada ningún otro padre/madre o tutor que
no viva en este hogar.
Cuando termine, seleccione “Siguiente” para
pasar a a siguiente pregunta."
“{Si una persona fue añadida por error,
seleccione la caja de “Eliminar esta persona” y
la persona será quitada después que usted
seleccione cualquier otra caja.}”
“{Iniciales/Primer nombre}”
Padre/Madre/Tutor # {DISPLAY FIRST NAME OF
RESPONDENT}

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
ALLOW UP TO 6 ROWS FOR
PARENTS/GUARDIANS (THIS NUMBER OF ROWS
INCLUDES THE ROWS FOR THE RESPONDENT).
HELP FOR INITIALS/FIRST NAME: {We'll be
asking more about some of these people later in
the survey, so please use initials that will make
sense to you}./{If you would prefer not to list
first names, you can use initials or nicknames.
We'll be asking more about some of these
people later in the survey, so please use names,

HELP FOR FIRST NAME: {Le preguntaremos más
sobre algunas de estas personas más adelante en
la encuesta. Por eso, por favor use iniciales que
luego usted recuerde quiénes son}/{Si prefiere no
poner primeros nombres, puede usar iniciales o
sobrenombres/apodos. Le preguntaremos más
sobre algunas de estas personas más adelante en
la encuesta. Por eso, por favor use nombres,
sobrenombres/apodos que luego usted recuerde
quiénes son.}

nicknames, or initials that will make sense to
you.}
__________________________________________________________

Box 1

ASK FSQ030 FOR EACH PERSON LISTED IN
FSQ010.

__________________________________________________________

FSQ030
DISPLAY INSTRUCTIONS:
DISPLAY FIRST NAME, AGE, AND GENDER (FSQ010,
FSQ030, AND FSQ040) ON THE SAME SCREEN.

QUESTION TEXT:
Question "Age"

“Edad”
Watermark "Ponga la edad"

ENTER NUMBER
Range

0 to 120

Soft Range

18 to 100

PROGRAMMER INSTRUCTIONS:
SOFT RANGE FOR RESPONDENT'S AGE
(HOUSEHOLD MEMBER 1) IS 18 TO 100. IF AGE
IS OUTSIDE THIS RANGE, DISPLAY MESSAGE:
"Your age was entered as less than 18 or greater
than 100. Please confirm. If this is correct,
select Next to continue." HARD RANGE FOR
PERSONS OTHER THAN THE RESPONDENT IS: 0
to 120.

"Su edad quedó registrada como menos de 18 o
más de 100. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."" HARD
RANGE FOR PERSONS OTHER THAN THE
RESPONDENT IS: 0 to 120.

__________________________________________________________

Box 2

ASK FSQ040 FOR EACH PERSON LISTED IN
FSQ010.

__________________________________________________________

FSQ040
DISPLAY INSTRUCTIONS:
DISPLAY FIRST NAME, AGE, AND GENDER (FSQ010,
FSQ030, AND FSQ040) ON THE SAME SCREEN.

QUESTION TEXT:
Question "Gender"

"Género"

CODES
1

Male

Masculino

Female

Femenino

Another gender

Otro género

PROGRAMMER INSTRUCTIONS:

DISPLAY "Rather not answer" IN THE
DROPDOWN LIST AND BACK CODE AS A
SPECIAL ANSWER.

DISPLAY "Prefiero no contester" IN THE
DROPDOWN LIST AND BACK CODE AS A SPECIAL
ANSWER.

__________________________________________________________

FSQ050
DISPLAY INSTRUCTIONS:
DISPLAY A LIST OF HOUSEHOLD MEMBERS THAT
SHOW HOUSEHOLD MEMBER NUMBER, FIRST NAME,
AGE, AND GENDER FOR EACH PERSON FROM
FSQ010, FSQ030, AND FSQ040. DISPLAY AS
“Name:”, “Age:”, AND “Gender:” THE LIST SHOULD
SHOW HOUSEHOLD MEMBERS IN THE SAME ORDER
THAT THEY WERE LISTED IN FSQ010. THIS LIST
CANNOT BE EDITED.

DISPLAY A LIST OF HOUSEHOLD MEMBERS THAT
SHOW HOUSEHOLD MEMBER NUMBER, FIRST NAME,
AGE, AND SEX FOR EACH PERSON FROM FSQ010,
FSQ030, AND FSQ040. DISPLAY AS “Nombre:”,
“Edad:”, AND “Sexo:” THE LIST SHOULD SHOW
HOUSEHOLD MEMBERS IN THE SAME ORDER THAT
THEY WERE LISTED IN FSQ010. THIS LIST CANNOT
BE EDITED.

QUESTION TEXT:
Question “Please confirm the initials or first
names, ages, and genders of yourself,
parents/guardians, and spouse/partners in
{CHILD}'s household. Is this information
correct?”
InstResp “If you would like to add household
members or change information, please select
"No" to go back and make changes.”

“Por favor, confirme las iniciales o el nombre, la
edad y el género de usted, padres/tutores, y de
esposos/esposas/parejas en el hogar de
{CHILD}. ¿Es correcta esta información?”,
InstResp “Si desea añadir miembros del hogar o
cambiar la información, seleccione "No" para
regresar y hacer cambios.”

{LIST OF HOUSEHOLD MEMBERS SHOWING
INITIALS, FIRST NAMES, AGES, AND
GENDERS}

CODES
1

Yes

FSQ110

Sí

FSQ010

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO FSQ110.

__________________________________________________________

FSQ110

QUESTION TEXT:
Question "Do you have a spouse or partner
who lives in this household?"

"¿Tiene usted esposo(a) o pareja que vive en
este hogar?"

CODES
1

Yes

FSQ120

Sí

Box 4

PROGRAMMER INSTRUCTIONS:
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE.

__________________________________________________________

FSQ120
DISPLAY INSTRUCTIONS:
DISPLAY HOUSEHOLD MEMBERS OVER 16 YEARS OF
AGE AS RESPONSE CATEGORY CHOICES, INCLUDE
THOSE WITH MISSING ANSWERS FOR AGE AND
DISPLAY "(AGE UNKNOWN)" NEXT TO THE NAME.
ALSO DISPLAY "NOT ON LIST." DO NOT DISPLAY THE
RESPONDENT'S NAME. FLAG PERSON SELECTED AT
FSQ120 AS "RESPONDENT'S SPOUSE/PARTNER". FOR
THE FIRST DISPLAY, DISPLAY “initials” FOR ANY
DISTRICTS NOTED IN THE PRELOAD THAT DISALLOW
COLLECTION OF TRACING DATA. ELSE DISPLAY
“name”. FOR THE SECOND DISPLAY, DISPLAY “initials
are” FOR ANY DISTRICTS NOTED IN THE PRELOAD
THAT DISALLOW COLLECTION OF TRACING DATA.
ELSE DISPLAY “name is”.

QUESTION TEXT:
Question “Who in the household is your spouse
or partner?”

"¿Cuál de los miembros de este hogar es su
esposo(a) o pareja?"

InstResp “Select the {initials/name} of the
person who is your spouse/partner. If the
{initials are/name is} not listed, select “not on
list.””

InstResp: "Seleccione {el nombre/las iniciales}
de la persona que es su esposo(a)/pareja. Si
{las iniciales/el nombre} no aparece(n) en la
lista”

CODES
1

{DISPLAY HH MEMBER INITIALS/NAME 1}

{DISPLAY HH MEMBER INITIALS/NAME 2}

{DISPLAY HH MEMBER INITIALS/NAME 3}

{DISPLAY HH MEMBER INITIALS/NAME 4}

{DISPLAY HH MEMBER INITIALS/NAME 5}

Not on list

PROGRAMMER INSTRUCTIONS:
DISPLAY HOUSEHOLD MEMBERS OVER 16
YEARS OF AGE AS RESPONSE CATEGORY
CHOICES, INCLUDE THOSE WITH MISSING
ANSWERS FOR AGE AND DISPLAY "(AGE
UNKNOWN)" NEXT TO THE NAME. DO NOT
DISPLAY THE RESPONDENT'S INITIALS/NAME
OR THE CHILD’S NAME.
LINES FOR 5 HH MEMBERS ARE SHOWN, (THERE
ARE 6 POSSIBLE HOUSEHOLD MEMBERS BUT
THE RESPONDENT IS NOT DISPLAYED SO 5
ROWS ARE SHOWN). ALSO DISPLAY "NOT ON
LIST." BECAUSE THERE ARE 6 HOUSEHOLD

MEMBERS TOTAL, "NOT ON LIST" IS ROW 7 TO
INDICATE WHAT THE MAXIMUM NUMBER ROW
IS FOR THE ROSTER.)
__________________________________________________________

Box 3

IF FSQ120 = NOT ON LIST, AUTOCODE
FSQ110 = 1 (SPOUSE/PARTNER IS IN
HOUSEHOLD) AND GO TO FSQ120a. ELSE GO
TO BOX 4.

__________________________________________________________

FSQ120a
DISPLAY INSTRUCTIONS:
FOR INITIALS/FIRST NAME, ALLOW 0 – 100
CHARACTERS TO BE ENTERED.
DISPLAY “are the initials” FOR ANY DISTRICTS NOTED
IN THE PRELOAD THAT DISALLOW COLLECTION OF
TRACING DATA. ELSE DISPLAY “is the first name”.
DISPLAY "Initials" FOR ANY DISTRICS NOTED IN THE
PRELOAD THAT DISALLOW COLLECTION OF TRACING
DATA. ELSE DISPLAY "First name".

DISPLAY “son las iniciales” FOR ANY DISTRICTS
NOTED IN THE PRELOAD THAT DISALLOW
COLLECTION OF
TRACING DATA. ELSE DISPLAY “es el primer nombre”.
DISPLAY "Initials" FOR ANY DISTRICS NOTED IN THE
PRELOAD THAT DISALLOW COLLECTION OF TRACING
DATA. ELSE DISPLAY "First name".

QUESTION TEXT:
Question "What {are the initials/is the first
name} of your spouse or partner?

"¿Cuáles son las iniciales/¿Cuál es el primer
nombre"} de su esposo(a) o pareja?"

{Initials/First name}:"

{Iniciales/Primer nombre}:"

ENTER TEXT
PROGRAMMER INSTRUCTIONS:

PROGRAM SHOULD ADD NAME OF
SPOUSE/PARTNER TO LIST OF HOUSEHOLD
MEMBERS TO HAVE A COMPLETE LIST OF
HOUSEHOLD MEMBERS FOR LATER DISPLAYS. IF
FSQ120a IS LEFT BLANK, ADD INITIALS/NAME
OF SPOUSE PARTNER AS "your spouse/partner"
AND USE THESE INITIALS/THIS NAME FOR THE
SPOUSE/PARTNER THROUGHOUT THE SURVEY.

PROGRAM SHOULD ADD NAME OF
SPOUSE/PARTNER TO LIST OF HOUSEHOLD
MEMBERS TO HAVE A COMPLETE LIST OF
HOUSEHOLD MEMBERS FOR LATER DISPLAYS. IF
FSQ120a IS LEFT BLANK, ADD INITIALS/NAME OF
SPOUSE PARTNER AS "su esposo(a)/pareja" AND
USE THESE INITIALS/THIS NAME FOR THE
SPOUSE/PARTNER THROUGHOUT THE SURVEY.

__________________________________________________________

FSQ120b
DISPLAY INSTRUCTIONS:
DISPLAY THE INITIALS/NAME OF THE
SPOUSE/PARTNER IN FSQ120a.

QUESTION TEXT:
Question "How old is {INITIALS/NAME}?"

"¿Qué edad tiene {INITIALS/NAME}?"

Pre-unit "Age:"

Pre-unit "Edad:"

ENTER NUMBER
Range

0 to 120

Soft Range

18 to 100

PROGRAMMER INSTRUCTIONS:
PROGRAM SHOULD ADD AGE TO FSQ030 TO
HAVE A COMPLETE LIST OF AGES OF ALL
HOUSEHOLD MEMBERS.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "The age was entered as less than 18
or greater than 100. Please confirm. If this is
correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "La edad quedó registrada como menos
de 18 o más de 100. Por favor confirme. Si es
correcto, seleccione, seleccione Siguiente para
continuar."

__________________________________________________________

FSQ120c
DISPLAY INSTRUCTIONS:
DISPLAY THE INITIALS/NAME OF THE
SPOUSE/PARTNER IN FSQ120a.

QUESTION TEXT:
Question "What is {INITIALS/NAME}’s gender?"

"¿Cuál es el género de {INITIALS/NAME}?"

"Rather not answer"

"Prefiero no contester"

CODES
1

Male

Masculino

Female

Femenino

Another gender

Otro género

PROGRAMMER INSTRUCTIONS:
PROGRAM SHOULD ADD GENDER TO FSQ040 TO
HAVE A COMPLETE LIST OF GENDERS FOR ALL
HOUSEHOLD MEMBERS.

ADD A SPECIAL ANSWER TO DISPLAY "Prefiero no
contester" AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY "Rather
not answer" AS A RADIO BUTTON.
__________________________________________________________

Box 4

LOOP 2.
ASK FSQ130 - FSQ130OS TO OBTAIN
RELATIONSHIP DATA FOR ALL PERSONS
(OTHER THAN- THE RESPONDENT WHOSE
RELATIONSHIP WAS COLLECTED IN ING005g)
LISTED IN FSQ010.

__________________________________________________________

FSQ130
DISPLAY INSTRUCTIONS:
ASK FSQ130 - FSQ130OS FOR EACH PERSON LISTED
IN FSQ010 OTHER THAN THE RESPONDENT.
DISPLAY "{INITIALS/NAME}'s" USING THE
INITIALS/NAME OF THE HOUSEHOLD MEMBER THAT
IS BEING LOOPED ON.
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE FOR LARGE BROWSERS.

DISPLAY "{INITIALS/NAME}'s" USING THE
INITIALS/NAME OF THE HOUSEHOLD MEMBER THAT
IS BEING LOOPED ON.
DISPLAY “(Especifique):” FOR LARGE
BROWSERS.ELSE DISPLAY “(Especifique en la
siguiente pantalla.)” FOR SMALL BROWSERS.

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

QUESTION TEXT:
Question "What is {INITIALS/NAME}'s
relationship to {CHILD}?"

"¿Qué relación o parentesco tiene
{INITIALS/NAME} con {CHILD}?"

CODES
1

Biological parent

Box 5

Padre/ Madre biológico(a)

Adoptive parent

Box 5

Padre/Madre adoptivo(a)

Step parent

Box 5

Padrastro/Madrastra

Foster parent

Box 5

Padre/Madre foster

Sibling

Box 5

Hermano(a)

Grandparent

Box 5

Abuelo(a)

Other relative

Box 5

Otro(a) pariente

Other nonrelative

Box 5

Otro(a) no pariente

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

FSQ130OS

Otro(a) padre/madre o tutor{( Especifique):/(
Especifique en la siguiente pantalla

PROGRAMMER INSTRUCTIONS:
DISPLAY CODE 91 ABOVE CODE 5.
IF THIS QUESTION IS SK (SKIPPED) FOR THE
RELATIONSHIP OF THE RESPONDENT OR THE
RESPONDENT'S SPOUSE/PARTNER TO THE
CHILD, USE PARENT SURVEY PROBE.
BOLD, ON FIRST INSTANCE ONLY IN HELP TEXT,
"Biological parent", "Adoptive parent", "Step
parent", "Foster parent", "Sibling",
"Grandparent", "Other Relative", "Other
Nonrelative", “Other parent or guardian”.
HELP FOR CODE 1: Biological Parent: A parent

biologically related to the child. This may be the
parent who gave birth to the child, but could
also apply to a parent who used a surrogate, egg
donor, or sperm donor to have the child.
HELP FOR CODE 2: Adoptive Parent: A parent
who has legally adopted {CHILD}.
HELP FOR CODE 3: Step Parent: A parent other
than {CHILD}'s biological or adoptive parent
who is married to {CHILD}'s biological or
adoptive parent.
HELP FOR CODE 4: Foster Parent: A parent with
whom {CHILD} is placed temporarily, usually
through a social service agency and/or a court.
HELP FOR CODE 5: Sibling: Include biological
(full, half), step, adoptive, and foster siblings as
defined below.
Full Sibling: A person with whom {CHILD}
shares the same biological parents.
Half Sibling: A person with whom {CHILD}
shares one biological parent.
Step Sibling: A person to whom {CHILD} is
related by the marriage of one biological parent.
Adoptive Sibling: A person to whom {CHILD} is
related given that they are in the same family in
which the person or {CHILD} has been legally
adopted by the family.
Foster Sibling: A person to whom {CHILD} is
unrelated except that they are in the same
family in which the person or {CHILD} have
been taken into the home on a temporary basis
and the parents have legal responsibility for
{CHILD}.
HELP FOR CODE 6: Grandparent: A parent of
{CHILD}'s biological, adoptive, or step parent.
HELP FOR CODE 7: Other Relative: Refers to
relationships that are not listed, such as great
grandparent, child of a parent’s sibling (e.g.,
niece or nephew), and sibling of {CHILD}’s
parent (e.g., aunt or uncle).
HELP FOR CODE 8: Other Nonrelative: Refers to
the relationship between two people when there

HELP FOR CODE 2: Padre/Madre adoptivo/a: Padre
o madre que ha adoptado legalmente a {CHILD}.
HELP FOR CODE 3: Padrastro/Madrastra: Padre o
madre que no es la madre o el padre biológico(a)
ni adoptivo(a) de {CHILD} y que está casado(a)
con la madre o el padre biológico(a) o adoptivo(a)
de {CHILD}.
HELP FOR CODE 4: Padre/madre foster: Padre o
madre padre bajo cuyo cuidado han puesto a
{CHILD} de
manera temporal, generalmente por medio de una
agencia de servicios sociales y/o una corte.
HELP FOR CODE 5: Hermano o hermana: Esto
incluye a hermanas y hermanos biológicos(as) (de
ambos padres, medio hermanos(a)), hermanastros
y hermanastras, hermanos(as) adoptivos(as) y
hermanos(as) foster, como se definen a
continuación.
Hermano o hermana de padre y madre: Una
persona que tiene la misma madre y el mismo
padre biológicos que {CHILD}.
Medio hermano o media hermana: Una persona
que tiene la misma madre biológica o el mismo
padre biológico que {CHILD}.
Hermanastro o hermanastra: Una persona con
quien {CHILD} está emparentado a través del
matrimonio de uno de sus padres biológicos.
Hermana o hermano adoptivo(a): Una persona con
quien {CHILD} está emparentado(a) dado que
ambos están en la misma familia la cual ha
adoptado legalmente a uno(a) de ellos dos.
Hermana o hermano foster: Una persona sin
relación de parentesco con {CHILD}, excepto que
están en la misma familia porque ya sea la
persona o {CHILD} forma parte del hogar de
manera temporal y los padres/madres tienen
responsabilidad legal por {CHILD}.
HELP FOR CODE 6: Abuelo o abuela: Padre o
madre de la madre o el padre biológico(a),
adoptivo(a) o madrastra/padrastro de {CHILD}.
HELP FOR CODE 7: Otro pariente: Se refiere a
parentescos que no están en la lista, por ejemplo,

is no family relationship through blood,
marriage, or adoption. The category could be
used to refer to a person who is not a parent to
{CHILD}, but is a partner to {CHILD}’s parent
and living together with that parent as married.
The category could also be used to refer to the
partner’s children who are not related to
{CHILD}’s parent. An example of this is when
the child's parent and the parent's partner (who
is not the child's parent) live together as
married and the partner's daughter lives with
them. The relationship of the partner's daughter
to the child would be siblings if they were
married, but since the parent and the partner
are not married, the daughter is an "other
nonrelative."
HELP FOR CODE 91: Other Parent or Guardian: A
person acting as the parent of {CHILD}, but
does not fit into one of the other categories. For
example, in a household with two parents, one
of the parents may not be biologically related to
{CHILD} and not legally in charge of {CHILD}

bisabuelo(a), hijo o hija de un hermano o
hermana de uno de los padres/madres (por ej.,
sobrina o sobrino) y hermano o hermana de la
madre o el padre de {CHILD} (por ej., tía o tío).
HELP FOR CODE 8: Otra persona que no es
pariente: Se refiere a la relación entre dos
personas cuando no hay parentesco de sangre, por
matrimonio ni adopción. Esta categoría podría
usarse para referirse a una persona que no es una
madre o padre de {CHILD}, pero es la pareja de
la madre o el padre de {CHILD} y están viviendo
juntos como si estuvieran casados(a). Esta
categoría también podría usarse para referirse a
los hijos(as) de esa pareja que no tienen
parentesco con el padre o la madre de {CHILD}.
Un ejemplo de esto es cuando la madre o el padre
del niño(a) y su pareja (que no es ni madre ni
padre del niño(a)) viven juntos como si estuvieran
casados(as) y la hija de esa pareja viven con
ellos. La relación de la hija de la pareja con el
niño(a) sería de hermanos o hermanas si sus
padres o madres estuvieran casados(as), pero
como no lo están, la hija es "otra persona que no
es pariente".
HELP FOR CODE 91: Otro tipo de padre/madre o
tutor(a): Una persona que se desempeña como
madre o padre de {CHILD}, pero no le
corresponde ninguna de las otras categorías. Por
ejemplo, en un hogar con dos madres o padres,
uno o una de ellos puede no tener parentesco
biológico con {CHILD} y no estar legalmente a
cargo de {CHILD} aunque es el otro papá o la otra
mamá de {CHILD}.

__________________________________________________________

FSQ130OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE FOR LARGE BROWSERS.

ENTER TEXT

__________________________________________________________

Box 5

END LOOP 2.
ASK FSQ130 - FSQ130os FOR NEXT PERSON
IN FSQ010.
IF NO NEXT PERSON, GO TO BOX 6.

__________________________________________________________

Box 6

LOOP 3.
IN CONTINUING HOUSEHOLDS CHECK THE
PRELOAD FOR RACE OR ETHNICITY DATA
(FSQ190 OR FSQ195) FOR THE RESPONDENT
(IF RESPONDENT IS THE SAME AS FALL K
(INQ001b = 1) AND FOR THE FOCAL CHILD.
THESE ARE THE ONLY HOUSEHOLD MEMBERS
WHOSE PREVIOUS RACE OR ETHNICITY DATA
WILL BE USED TO DRIVE SKIPS.
IF THERE ARE ANY MISSING ETHNICITY DATA
(FSQ190) (IN THE PRELOAD FOR CONTINUING
FALL KINDERGARTEN HOUSEHOLDS OR FOR
NEW HOUSEHOLDS) FOR THE RESPONDENT,
THE FOCAL CHILD, THE FOCAL CHILD’S
PARENTS (CODES 1, 2, 3, 4, OR 91 AT
INQ005g OR FSQ130), OR THE RESPONDENT'S
SPOUSE/PARTNER (SELECTED AT FSQ120) IF
NOT ALREADY LOOPED ON AS A PARENT,
CONTINUE WITH FSQ190.
ELSE IF THERE ARE NO PARENTS IN THE
HOUSEHOLD (NO HOUSEHOLD MEMBERS
WITH CODES 1, 2, 3, 4 OR 91 AT INQ005g OR
FSQ130), AND THERE ARE ANY MISSING
ETHNICITY DATA (FSQ190) (IN THE PRELOAD
FOR CONTINUING FALL KINDERGARTEN
HOUSEHOLDS OR NEW HOUSEHOLDS) FOR
THE FOCAL CHILD, THE RESPONDENT, OR THE
RESPONDENT'S SPOUSE/PARTNER (SELECTED
AT FSQ120), CONTINUE WITH FSQ190.
ELSE IF IT IS A CONTINUING HOUSEHOLD
AND (THE RESPONDENT IS THE SAME AS IN
FALL K (INQ001b = 1)) AND ETHNICITY DATA
ARE NOT MISSING FROM THE PRELOAD
((FSQ190 = 1 OR 2), GO TO BOX 7 TO GET
THE ETHNICITY/RACE SUBGROUP.
ELSE IF IT IS A CONTINUING HOUSEHOLD
AND THE FOCAL CHILD HAS RACE AND
ETHNICITY DATA IN THE PRELOAD AND IS
HISPANIC (FSQ190 = 1) BUT FALL K FSQ192
ABOUT THE HISPANIC SUBGROUP WAS SK OR
NOT ASKED, GO TO FSQ191.
ELSE IF IT IS A CONTINUING HOUSEHOLD

AND THE FOCAL CHILD HAS RACE AND
ETHNICITY DATA AND IS ASIAN (FSQ195 = 2)
BUT FALL K FSQ197b ABOUT THE ASIAN
SUBGROUP WAS SK OR NOT ASKED, GO TO
FSQ197a.
ELSE IF IT IS A CONTINUING HOUSEHOLD
AND THE FOCAL CHILD HAS RACE AND
ETHNICITY DATA AND IS NATIVE HAWAIIAN
OR OTHER PACIFIC ISLANDER (FSQ195 = 4)
BUT FALL K FSQ198b ABOUT THE NATIVE
HAWAIIAN OR OTHER PACIFIC ISLANDER
SUBGROUP WAS SK OR NOT ASKED, GO TO
FSQ198a.
WHEN ALL PERSONS WITH MISSING
ETHNICITY OR RACE DATA HAVE BEEN ASKED
ABOUT GO TO BOX 11.
NOTE: ETHNICITY AND RACE SUBGROUP
QUESTIONS ARE ASKED ABOUT THE CHILD
AND OTHER HOUSEHOLD MEMBERS IN LOOP
3. SUBGROUP QUESTIONS WERE ONLY ASKED
ABOUT THE CHILD IN FALL K. FOR THE CHILD
IF THERE ARE DATA IN THE PRELOAD FOR THE
MAIN ETHNICITY AND RACE QUESTIONS
(FSQ190 OR FSQ195) AND THE APPLICABLE
SUBGROUP QUESTIONS (FSQ192 IF FSQ190 =
1; FSQ197b IF FSQ195 = 2; FSQ198b IF
FSQ195 = 4), ALL RACE AND ETHNICITY
QUESTIONS FOR THE CHILD WILL BE SKIPPED
IN THE CURRENT ROUND.
IF THERE ARE DATA IN THE PRELOAD FOR THE
RESPONDENT AND THE RESPONDENT IS THE
SAME AS IN FALL K, INTRODUCTORY
SUBGROUP QUESTIONS (FSQ191, FSQ197a,
AND FSQ198a) WILL BE ASKED TO
REESTABLISH THE RACE AND EITHNICITY
BEFORE ASKING FOR THE SUBGROUP.
OTHERWISE, FOR THE CHILD IF THERE ARE
DATA IN THE PRELOAD FOR THE MAIN
ETHNICITY AND RACE QUESTIONS (FSQ190
OR FSQ195) BUT NOT THE APPLICABLE
SUBGROUP QUESTIONS (FSQ192, FSQ197b,
FSQ198b), INTRODUCTORY SUBGROUP
QUESTIONS (FSQ191, FSQ197a, AND
FSQ198a) ARE ASKED IN THE CURRENT
ROUND, IF APPLICABLE, TO REESTABLISH THE
ETHNICITY OR RACE BEFORE ASKING FOR THE
SUBGROUP. OTHERWISE, IF THERE ARE NOT
DATA IN THE PRELOAD FOR THE MAIN
ETHNICITY AND RACE QUESTIONS (FSQ190

OR FSQ195), THE SUBGROUP QUESTIONS
WOULD HAVE BEEN SKIPPED IN FALL
KINDERGARTEN SO THE MAIN ETHNICITY AND
RACE QUESTIONS AND THE SUBGROUP
QUESTIONS, IF APPLICABLE, ARE ASKED
AGAIN IN SPRING KINDERGARTEN.

_________________________________________________________

FSQ190
DISPLAY INSTRUCTIONS:
DISPLAY "We have a few more questions about
{CHILD} and the people listed in your table." THE
FIRST TIME THE QUESTION IS ASKED. ELSE USE A
NULL DISPLAY.

DISPLAY "Tenemos algunas preguntas más acerca de
{CHILD} y las personas que aparecen en la lista."
THE FIRST TIME THE QUESTION IS ASKED. ELSE USE
A NULL DISPLAY.

BOLD 'Hispanic or {Latino/Latina} {Latino/a}" IN THE
THIRD SENTENCE.

BOLD “{hispano o latino}" IN InstResp.

ASK ABOUT EACH PERSON ENUMERATED ON THE
HOUSEHOLD ROSTER WHO IS THE RESPONDENT,
THE FOCAL CHILD, THE FOCAL CHILD’S PARENTS
(CODES 1, 2, 3, 4, OR 91 AT INQ005g OR FSQ130),
OR THE RESPONDENT'S SPOUSE/PARTNER
(SELECTED AT FSQ120) IF NOT ALREADY LOOPED ON
AS A PARENT.
IF THERE ARE NO PARENTS IN THE HOUSEHOLD (NO
HOUSEHOLD MEMBERS WITH CODES 1, 2, 3, 4, OR
91 AT INQ005g OR FSQ130), AND THERE ARE ANY
MISSING ETHNICITY OR RACE DATA FOR THE FOCAL
CHILD, THE RESPONDENT, OR THE RESPONDENT'S
SPOUSE/PARTNER (SELECTED AT FSQ120),
CONTINUE WITH FSQ190.
DISPLAY "Are you" IF LOOPING ON THE
RESPONDENT. OTHERWISE, DISPLAY "Is
{INITIALS/NAME}" USING THE NAME OF THE
HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
DISPLAY “Latino” IF THE PERSON IS MALE
ACCORDING TO THE CURRENT PARENT SURVEY
(FSQ040 = 1 OR FSQ120c = 1) OR IF THE LOOP IS
ABOUT THE CHILD AND THE CHILD IS MALE
(INQ050b = 1). DISPLAY “Latina” IF THE PERSON IS
FEMALE ACCORDING TO THE CURRENT PARENT
SURVEY (FSQ040 = 2 OR FSQ120c = 2) OR IF THE
LOOP IS ABOUT THE CHILD AND THE CHILD IS
FEMALE (INQ050b = 2). ELSE DISPLAY “Latino/a”.
NOTE: IF THE RESPONDENT IS A PARENT (CODES 1,
2, 3, 4, OR 91 AT INQ005g), ASK THIS QUESTION AS
“Are you” AND DO NOT ASK THE QUESTION AGAIN
USING “{INITIALS/NAME}” ABOUT THE SAME
PERSON.

ASK ABOUT EACH PERSON ENUMERATED ON THE
HOUSEHOLD ROSTER WHO IS THE RESPONDENT,
THE FOCAL CHILD, THE FOCAL CHILD’S PARENTS
(CODES 1, 2, 3, 4, OR 91 AT INQ005g OR FSQ130),
OR THE RESPONDENT'S SPOUSE/PARTNER
(SELECTED AT FSQ120) IF NOT ALREADY LOOPED ON
AS A PARENT.
IF THERE ARE NO PARENTS IN THE HOUSEHOLD (NO
HOUSEHOLD MEMBERS WITH CODES 1, 2, 3, 4, OR
91 AT INQ005g OR FSQ130), AND THERE ARE ANY
MISSING ETHNICITY OR RACE DATA FOR THE FOCAL
CHILD, THE RESPONDENT, OR THE RESPONDENT'S
SPOUSE/PARTNER (SELECTED AT FSQ120),
CONTINUE WITH FSQ190.
DISPLAY "usted" IF LOOPING ON THE
RESPONDENT.OTHERWISE, DISPLAY
"{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.
DISPLAY “Latino” IF THE PERSON IS MALE
ACCORDING TO THE CURRENT PARENT SURVEY
(FSQ040 = 1 OR FSQ120c = 1) OR IF THE LOOP IS
ABOUT THE CHILD AND THE CHILD IS MALE
(INQ050b = 1).
DISPLAY “Latina” IF THE PERSON IS FEMALE
ACCORDING TO THE CURRENT PARENT SURVEY
(FSQ040 = 2 OR FSQ120c = 2) OR IF THE LOOP IS
ABOUT THE CHILD AND THE CHILD IS FEMALE
(INQ050b = 2). ELSE DISPLAY “Latino/a”.
NOTE: IF THE RESPONDENT IS A PARENT (CODES 1,
2, 3, 4, OR 91 AT INQ005g), ASK THIS QUESTION AS
“usted” AND DO NOT ASK THE QUESTION AGAIN
USING “{INITIALS/NAME}” ABOUT THE SAME
PERSON.

QUESTION TEXT:
Question "{We have a few more questions
about {CHILD} and the people listed in your
table.}

"{"Tenemos algunas preguntas más acerca de
{CHILD} y las personas que aparecen en la
lista.

{Are you/Is {INITIALS/NAME}} Hispanic or
{Latino/Latina} {Latino/a}? A person who is
Hispanic or {Latino/Latina} {Latino/a} is of
Cuban, Dominican, Mexican, Puerto Rican,
South or Central American, or other Spanish
culture or origin, regardless of race."

¿Es {usted/{INITIALS/NAME} {hispano o
latino/hispana o latina} {latino/a}? Una
persona que es hispana o latina es de cultura u
origen cubano, dominicano, mexicano,
puertorriqueño, sudamericano o
centroamericano, o de otra cultura u origen
(ascendencia) español, sin importar la raza.”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
IF THIS QUESTION IS SK (SKIPPED) FOR THE
CHILD, USE PARENT SURVEY PROBE. DON’T
KNOW AND RATHER NOT ANSWER SKIP TO
FSQ195.
__________________________________________________________

Box 7

IF LOOPING ON THE RESPONDENT IN A
CONTINUING HOUSEHOLD AND (THE
RESPONDENT IS THE SAME AS IN FALL K
(INQ001b = 1)) AND (FSQ190 = 1 (HISPANIC)
FOR THE RESPONDENT IN THE PRELOAD), GO
TO FSQ191. ELSE IF LOOPING ON A
HOUSEHOLD MEMBER WHO IS NOT THE CHILD
AND FSQ190 = 1 (HISPANIC) IN THE CURRENT
SURVEY, GO TO FSQ192. ELSE IF LOOPING ON
A HOUSEHOLD MEMBER WHO IS NOT THE
CHILD GO TO BOX 8.
IF LOOPING ON THE CHILD AND FSQ190 = 1
(HISPANIC) FOR THE CHILD IN THE CURRENT
SURVEY GO TO FSQ192. ELSE IF THE
PRELOAD IN A CONTINUING HOUSEHOLD
SHOWS THAT THE CHILD IS HISPANIC
(FSQ190 = 1) AND THE HISPANIC SUBGROUP
IS MISSING FROM FALL K (FSQ192 = SK OR
WAS NOT ASKED), GO TO FSQ191. ELSE GO
TO BOX 8.

__________________________________________________________

FSQ191
DISPLAY INSTRUCTIONS:
DISPLAY "your" AND "Are you" IF LOOPING ON THE
RESPONDENT. OTHERWISE, DISPLAY
"{INITIALS/NAME" AND "Is {INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON. DISPLAY “Latino” IF THE PERSON
IS MALE ACCORDING TO THE CURRENT PARENT
SURVEY (FSQ040 = 1 OR FSQ120c = 1) OR IF THE
LOOP IS ABOUT THE CHILD AND THE CHILD IS MALE
(INQ050b = 1). DISPLAY “Latina” IF THE PERSON IS
FEMALE ACCORDING TO THE CURRENT PARENT
SURVEY (FSQ040 = 2 OR FSQ120c = 2) OR IF THE
LOOP IS ABOUT THE CHILD AND THE CHILD IS
FEMALE (INQ050b = 2). ELSE DISPLAY “Latino/a”.
NOTE: IF THE RESPONDENT IS A PARENT (CODES 1,
2, 3, 4, OR 91 AT INQ005g), ASK THIS QUESTION AS
“Are you” AND DO NOT ASK THE QUESTION AGAIN
USING “{INITIALS/NAME}” ABOUT THE SAME
PERSON.

DISPLAY "su grupo étnico y raza" AND "usted" IF
LOOPING ON THE RESPONDENT.OTHERWISE,
DISPLAY "el grupo étnico y la raza de
{INITIALS/NAME}" AND "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.
DISPLAY “Latino” IF THE PERSON IS MALE
ACCORDING TO THE CURRENT PARENT SURVEY
(FSQ040 = 1 OR FSQ120c = 1) OR IF THE LOOP IS
ABOUT THE CHILD AND THE CHILD IS MALE
(INQ050b = 1).
DISPLAY “Latina” IF THE PERSON IS FEMALE
ACCORDING TO THE CURRENT PARENT SURVEY
(FSQ040 = 2 OR FSQ120c = 2) OR IF THE LOOP IS
ABOUT THE CHILD AND THE CHILD IS FEMALE
(INQ050b = 2). ELSE DISPLAY “Latino/a”.
NOTE: IF THE RESPONDENT IS A PARENT (CODES 1,
2, 3, 4, OR 91 AT INQ005g), ASK THIS QUESTION AS
“usted” AND DO NOT ASK THE QUESTION AGAIN
USING “{INITIALS/NAME}” ABOUT THE SAME
PERSON.

QUESTION TEXT:
Question “Though we may have asked you
about {your/INITIALS/{NAME}'s} ethnicity
and race before, we have a few more
questions. {Are you/Is {INTIALS/NAME}
Hispanic or {Latino/Latina}{Latino/a}?”

“Aunque tal vez le hayamos preguntado antes
sobre {su grupo étnico y raza/el grupo étnico y
la raza de {INITIALS/NAME}, tenemos algunas
preguntas más. ¿Es {usted/{INITIALS/NAME}}
{hispano o latino/hispana o latina}
{latino/a}?”

CODES
1

Yes

FSQ192

Sí

Box 8

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO Box 8.

__________________________________________________________

FSQ192
DISPLAY INSTRUCTIONS:
DISPLAY "your" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.

DISPLAY "usted" IF LOOPING ON THE
RESPONDENT.OTHERWISE, DISPLAY
"{INITIALS/NAME}" USING THE NAME OF THE
HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.

NOTE: IF THE RESPONDENT IS A PARENT FIGURE,
ASK THIS QUESTION AS "your" AND DO NOT ASK
THE QUESTION AGAIN USING "{INITIALS/NAME}"
ABOUT THE SAME PERSON.

QUESTION TEXT:
Question “Which of the following Spanish,
Hispanic, or Latino groups best describes
{your/{INITIALS/{NAME}'s} origin? Please
select all that apply.”

CODES

“¿Cuál de los siguientes grupos españoles,
hispanos o latinos describe mejor el origen de
{usted/{INITIALS/NAME}}? Por favor
seleccione todo lo que corresponda.”

Code All That Apply

Cuban

Cubano

Mexican, Mexican American, or Chicano

Mexicano, mexicano americano, o chicano

Puerto Rican

Puertorriqueño

Other Spanish/Hispanic/Latino group

Otro grupo español, hispano o latino

__________________________________________________________

Box 8

IF LOOPING ON A HOUSEHOLD MEMBER WHO
IS NOT THE CHILD AND THERE ARE MISSING
DATA FOR FSQ195 (RACE) IN THE CURRENT
SURVEY OR THE PRELOAD, GO TO FSQ195.
ELSE IF LOOPING ON A HOUSEHOLD MEMBER
WHO IS NOT THE CHILD GO TO BOX 9.
IF LOOPING ON THE CHILD AND THE CHILD
HAS MISSING RACE DATA FOR FSQ195 IN THE
CURRENT SURVEY OR THE PRELOAD, GO TO
FSQ195. ELSE GO TO BOX 9.

__________________________________________________________

FSQ195
DISPLAY INSTRUCTIONS:
ASK ABOUT EACH PERSON ENUMERATED ON THE
HOUSEHOLD ROSTER WHO IS THE RESPONDENT,
THE FOCAL CHILD, THE FOCAL CHILD’S PARENTS
(CODES 1, 2, 3, 4, OR 91 AT INQ005g OR FSQ130),
OR THE RESPONDENT'S SPOUSE/PARTNER
(SELECTED AT FSQ120) IF NOT ALREADY LOOPED ON
AS A PARENT.
IF THERE ARE NO PARENTS IN THE HOUSEHOLD (NO
HOUSEHOLD MEMBERS WITH CODES 1, 2, 3, 4, OR
91 AT INQ005g OR FSQ130), AND THERE ARE ANY
MISSING ETHNICITY OR RACE DATA FOR THE FOCAL
CHILD, THE RESPONDENT, OR THE RESPONDENT'S
SPOUSE/PARTNER (SELECTED AT FSQ120),
CONTINUE WITH FSQ195.

DISPLAY "su raza" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "la raza de {INITIALS/NAME}"
USING THE NAME OF THE HOUSEHOLD MEMBER
THAT IS BEING LOOPED ON.
NOTE: IF THE RESPONDENT IS A PARENT FIGURE,
ASK THIS QUESTION AS "su raza" AND DO NOT ASK
THE QUESTION AGAIN USING "{INITIALS/NAME}"
ABOUT THE SAME PERSON.

DISPLAY "your" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.
NOTE: IF THE RESPONDENT IS A PARENT FIGURE,
ASK THIS QUESTION AS "your" AND DO NOT ASK
THE QUESTION AGAIN USING "{INITIALS/NAME}"
ABOUT THE SAME PERSON.

QUESTION TEXT:
Question "Which of the following describes
{your/{INITIALS/{NAME}'s} race? You may
choose more than one. Please select all that
apply."

CODES

"¿Cuál de las siguientes opciones describe {su
raza/la raza de {INITIALS/NAME}}? Puede
elegir más de una. Por favor seleccione todo lo
que corresponda."

Code All That Apply

American Indian or Alaska Native

Indígena de las Américas o nativo de Alaska

Asian

Asiático(a)

Black or African American

Negro(a) o afroamericano(a)

Native Hawaiian or other Pacific Islander

Nativo(a) de Hawái o de otras islas del

White

Pacífico
Blanco(a)

PROGRAMMER INSTRUCTIONS:
IF THIS QUESTION IS SK (SKIPPED) FOR THE
CHILD, USE PARENT SURVEY PROBE.
HELP FOR STEM: For the purposes of this study,
Hispanic origins are not races.
BOLD IN HELP TEXT: "American Indian or Alaska

BOLD IN HELP TEXT: "Indígena de las Américas o
nativo de Alaska", "Asiático", "Negro o
afroamericano", "Nativo de Hawái o de otras islas
"Blanco(a)"
HELP FOR STEM: Para los propósitos de este
estudio, los orígenes hispanos no son razas.

Native", "Asian", "Black or African American",
"Native Hawaiian or Other Pacific Islander",
"White"
HELP FOR CODE 1: American Indian or Alaska
Native: A person having origins in any of the
original peoples of North and South America
(including Central America), and who maintains
tribal affiliation or community attachment.
Example tribes include Navajo Nation, Blackfeet
Tribe, Mayan, Aztec, Native Village of Barrow
Inupiat Traditional Government, and Nome
Eskimo Community.
HELP FOR CODE 2: Asian: A person having
origins in any of the original peoples of the Far
East, Southeast Asia, or the Indian subcontinent
including, for example, Cambodia, China, India,
Japan, Korea, Malaysia, Pakistan, the Philippine
Islands, Thailand, Laos, and Vietnam.
HELP FOR CODE 3: Black or African American: A
person having origins in any of the black racial
groups of Africa. This includes, for example,
African Americans and people from Jamaica,
Haiti, Nigeria, Ethiopia, and Somalia.
HELP FOR CODE 4: Native Hawaiian or Other
Pacific Islander: A person having origins in any
of the original peoples of Hawaii, Guam, Samoa,
the Marianas, Tonga, Fiji, the Marshall Islands,
or other Pacific Islands.
HELP FOR CODE 5: White: A person having
origins in any of the original peoples of Europe,
the Middle East, or North Africa. This includes,
for example, people from Germany, Ireland,
England, Italy, Lebanon, and Egypt.

HELP FOR CODE 1: Indígena de las Américas o
nativo de Alaska: Una persona con orígenes en
cualquiera de los pueblos originarios de América
del Norte y América del Sur (incluyendo América
Central) y que mantiene afiliación tribal o conexión
con su comunidad. Ejemplos de tribus incluyen
Navajo Nation, Blackfeet Tribe, mayas, aztecas,
Native Village of Barrow Inupiat Traditional
Government y Nome Eskimo Community.
HELP FOR CODE 2: Asiático: Una persona con
orígenes en cualquiera de los pueblos originarios
del Lejano Oriente, el sudeste de Asia o el
subcontinente indio, incluyendo, por ejemplo,
Camboya, China, India, Japón, Corea, Malasia,
Pakistán, las Islas Filipinas, Tailandia, Laos y
Vietnam. HELP FOR CODE 3: Negro o
afroamericano: Una persona con orígenes en
cualquiera de los grupos de raza negra de África.
Esto incluye, por ejemplo, personas
afroamericanas y personas de Jamaica, Haití,
Nigeria, Etiopía y Somalia.
HELP FOR CODE 4: Nativo de Hawái o de otras
islas del Pacífico: Una persona con orígenes en
cualquiera de los pueblos originarios de Hawái,
Guam, Samoa, las Marianas, Tonga, Fiji, las Islas
Marshall u otras islas del Pacífico.
HELP FOR CODE 5: Blanco: Una persona con
orígenes en cualquiera de los pueblos originarios
de Europa, el Medio Oriente o el norte de África.
Esto incluye, por ejemplo, personas de Alemania,
Irlanda, Inglaterra, Italia, Líbano y Egipto.

__________________________________________________________

Box 9

IF LOOPING ON THE RESPONDENT IN A
CONTINUING HOUSEHOLD AND (THE
RESPONDENT IS THE SAME AS IN FALL K
(INQ001b = 1)) AND (FSQ195 = 2 (ASIAN)
FOR THE RESPONDENT IN THE PRELOAD), GO
TO FSQ197a. ELSE IF LOOPING ON A
HOUSEHOLD MEMBER WHO IS NOT THE CHILD
AND FSQ195 = 2 (ASIAN) IN THE CURRENT
SURVEY OR THE PRELOAD, GO TO FSQ197b.
ELSE IF LOOPING ON A HOUSEHOLD MEMBER
WHO IS NOT THE CHILD GO TO BOX 10.
IF LOOPING ON THE CHILD AND FSQ195 = 2
(ASIAN) FOR THE CHILD GO TO FSQ197b.
ELSE IF THE PRELOAD IN A CONTINUING
HOUSEHOLD SHOWS THAT THE CHILD IS
ASIAN (FSQ195 = 2) AND THE ASIAN
SUBGROUP IS MISSING FROM FALL K
(FSQ197B = SK OR WAS NOT ASKED), GO TO
FSQ197a. ELSE GO TO BOX 10.

__________________________________________________________

FSQ197a
DISPLAY INSTRUCTIONS:
DISPLAY “Though we may…questions” IF FSQ191
WAS NOT ASKED. ELSE USE A NULL DISPLAY.
DISPLAY "your" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.
NOTE: IF THE RESPONDENT IS A PARENT FIGURE,
ASK THIS QUESTION AS "your" AND DO NOT ASK THE
QUESTION AGAIN USING "{INITIALS/NAME}" ABOUT
THE SAME PERSON.

DISPLAY “Aunque tal vez le hayamos preguntado…”IF
FSQ196a WAS NOT ASKED. ELSE USE A NULL
DISPLAY.
DISPLAY "su raza" AND "usted" IF LOOPING ON THE
RESPONDENT. OTHERWISE, DISPLAY "la raza de
{INITIALS/NAME}" AND "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.

QUESTION TEXT:
Question “{Though we may have asked you
about {your/{INITIALS/{NAME}'s} race
before, we have a few more questions.} {Are
you/Is {INITIALS/NAME} a member of an
Asian group?”

“{Aunque tal vez le hayamos preguntado antes
sobre {su raza/la raza de {INITIALS/NAME}},
tenemos algunas preguntas más.} ¿Es
{usted/{INITIALS/NAME}} miembreo de un
grupo asiático?”

CODES
1

Yes

FSQ197b

Sí

Box 10

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO Box 10.

__________________________________________________________

FSQ197b
DISPLAY INSTRUCTIONS:
DISPLAY "your" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON. NOTE: IF THE RESPONDENT IS A
PARENT FIGURE, ASK THIS QUESTION AS "your" AND
DO NOT ASK THE
QUESTION AGAIN USING "{INITIALS/NAME}" ABOUT
THE SAME PERSON.

DISPLAY "usted" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.

QUESTION TEXT:
Question “Which of the following Asian groups
best describes {your/{INITIALS/{NAME}'s}
origin? Please select all that apply.”

CODES

“¿Cuál de los siguientes grupos asiáticos
describe mejor el origen de
{usted/{INITIALS/NAME}} Por favor seleccione
todo lo que corresponda?”

Code All That Apply

Asian Indian

Indio asiático

Chinese

Chino

Filipino

Hmong

Hmong (Pobladores del sudeste de Asia)

Japanese

Japonés

Korean

Coreano

Vietnamese

Vietnamita

Other Asian

Otro grupo asiático

__________________________________________________________

Box 10

IF LOOPING ON THE RESPONDENT IN A
CONTINUING HOUSEHOLD AND (THE
RESPONDENT IS THE SAME AS IN FALL K
(INQ001b = 1)) AND (FSQ195 = 4 (NATIVE
HAWAIIAN OR OTHER PACIFIC ISLANDER) FOR
THE RESPONDENT IN THE PRELOAD), GO TO
FSQ198a. ELSE IF LOOPING ON A HOUSEHOLD
MEMBER WHO IS NOT THE CHILD AND FSQ195
= 4 (NATIVE HAWAIIAN OR OTHER PACIFIC
ISLANDER) IN THE CURRENT SURVEY, GO TO
FSQ198b. ELSE IF LOOPING ON A HOUSEHOLD
MEMBER WHO IS NOT THE CHILD GO TO BOX
11.
IF LOOPING ON THE CHILD AND FSQ195 = 4
(NATIVE HAWAIIAN OR OTHER PACIFIC
ISLANDER) GO TO FSQ198b. ELSE IF THE
PRELOAD IN A CONTINUING HOUSEHOLD
SHOWS THAT THE CHILD IS NATIVE
HAWAIIAN OR OTHER PACIFIC ISLANDER
(FSQ195 = 4) AND THE NATIVE HAWAIIAN OR
OTHER PACIFIC ISLANDER SUBGROUP DATA
FOR THE CHILD IS MISSING FROM FALL K
(FSQ198b = SK OR WAS NOT ASKED), GO TO
FSQ198a. ELSE GO TO BOX 11.

__________________________________________________________

FSQ198a
DISPLAY INSTRUCTIONS:
Add display instruction: DISPLAY "Are you" IF
LOOPING ON THE RESPONDENT. OTHERWISE,
DISPLAY "Is {INITIALS/NAME}" USING THE
NAME OF THE HOUSEHOLD MEMBER THAT IS BEING
LOOPED ON.
NOTE: IF THE RESPONDENT IS A PARENT FIGURE,
ASK THIS QUESTION AS "your" AND DO NOT ASK
THE QUESTION AGAIN USING "{INITIALS/NAME}"
ABOUT THE SAME PERSON.

DISPLAY "usted" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.

QUESTION TEXT:
Question “Is {Are you/Is {INTIALS/NAME}} a
member of a Pacific Islander group?”

“¿Es {usted/{INITIALS/NAME} miembro de un
grupo de las islas del Pacífico?”

CODES
1

Yes

FSQ198b

Sí

Box 11

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO Box 11.

__________________________________________________________

FSQ198b
DISPLAY INSTRUCTIONS:
DISPLAY THE CHILD'S NAME IN UNDERLINED TEXT.
DISPLAY "your" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON. NOTE: IF THE RESPONDENT IS A
PARENT FIGURE, ASK THIS QUESTION AS "your" AND
DO NOT ASK THE QUESTION AGAIN USING
"{INITIALS/NAME}" ABOUT THE SAME PERSON.

DISPLAY "usted" IF LOOPING ON THE RESPONDENT.
OTHERWISE, DISPLAY "{INITIALS/NAME}" USING
THE NAME OF THE HOUSEHOLD MEMBER THAT IS
BEING LOOPED ON.

QUESTION TEXT:
Question “Which of the following Pacific
Islander groups best describes
{your/{INITIALS/NAME}'s} origin? Please
select all that apply.”

CODES

“¿Cuál de los siguientes grupos de las islas del
Pacífico describe mejor el origen de
{usted/{INITIALS/NAME}? Por favor seleccione
todo lo que corresponda.”

Code All That Apply

Guamanian or Chamorro

Guameño o chamorro

Native Hawaiian

Nativo de Hawái

Samoan

Samoano

Other Pacific Islander

De otra isla del Pacífico

__________________________________________________________

Box 11

END LOOP 3.
ASK FSQ190 – FSQ198b FOR NEXT PERSON
WHO IS THE RESPONDENT, THE FOCAL CHILD,
THE FOCAL CHILD'S PARENTS (CODES 1, 2, 3,
4, OR 91 AT INQ005g OR FSQ130), OR THE
RESPONDENT'S SPOUSE/PARTNER (SELECTED
AT FSQ120) IF NOT ALREADY LOOPED ON AS A
PARENT, OR RESPONDENT, OR RESPONDENT'S
SPOUSE/PARTNER (IF NO PARENT FIGURES)
WHOSE ETHNICITY OR RACE DATA ARE
MISSING. WHEN ALL PERSONS WITH MISSING
ETHNICITY OR RACE DATA HAVE BEEN ASKED
ABOUT, CONTINUE WITH FSQ198c.

__________________________________________________________

FSQ198c

QUESTION TEXT:
Question "We have just a few more questions
about this household’s members.
How many siblings does {CHILD} have in this
household?"
Pre-unit “Number of siblings”

"Tenemos unas pocas preguntas más sobre los
miembros de este hogar. ¿Cuántos hermanos y
hermanas tiene {CHILD} en este hogar?
Pre-unit “Número de hermanos y hermanas”
Watermark "Ponga el número"

Watermark “Enter number”
ENTER NUMBER
Range

0 to 30

Soft Range

0 to 10

PROGRAMMER INSTRUCTIONS:
BOLD, ON FIRST INSTANCE ONLY IN HELP TEXT,
"Siblings".
HELP FOR STEM: Siblings: Include biological
(full, half), adoptive, step, and foster brothers,
sisters, or other siblings.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT FSQ198c}. Please confirm. If this
is correct, select Next to continue."

HELP FOR STEM: Hermanos/Hermanas: Incluye a
los hermanos biológicos (de padre y madre,
medios hermanos) adoptivos, hermanastros y
hermanos Foster.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT FSQ198c}. Por favor confirme. Si es correcto,
seleccione, seleccione Siguiente para continuar."

__________________________________________________________

FSQ199

QUESTION TEXT:
How many grandparents does {CHILD} have in
this household?

"¿Cuántos abuelos y abuelas tiene {CHILD} en
este hogar?"

Pre-unit “Number of grandparents”

Pre-unit “Número de abuelos y abuelas”

Watermark “Enter number”

Watermark "Ponga el número"

ENTER NUMBER
Range

0 to 8

Soft Range

0 to 4

PROGRAMMER INSTRUCTIONS:
BOLD FIRST INSTANCES ONLY OF
“Grandparents” IN HELP TEXT.
HELP FOR STEM: Grandparents: Parents of
{CHILD}'s biological, adoptive, or step parents.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT FSQ199}. Please confirm. If this
is correct, select Next to continue."

HELP FOR STEM: Abuelos y Abuelas: Madres o
padres de los padres/madres biológicos(as),
adoptivos(as) o padrastros/madrastras.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT FSQ199}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

FSQ200

QUESTION TEXT:
Question "How would you describe your
current relationship status?"

"¿Cómo describiría su situación de pareja
actualmente?"

SaVisible “True”
CODES
1

Married

Box 12

Casado(a)/Casados

Separated

Box 12

Separado(a)/Separados

Divorced

Box 12

Divorciado(a)/Divorciados

Widowed

Box 12

Viudo(a)

Never married

Box 12

Civil union/domestic partnership

Box 12

Nunca ha estado casado(a)/Nunca han estado
casados
En unión civil/Sociedad doméstica

Other {(Please explain):/(Please explain on next
screen.)}
DON'T KNOW

FSQ200OS

__________________________________________________________

FSQ200OS
DISPLAY INSTRUCTIONS:
DISPLAY OTHER SPECIFY FIELD ON SAME PAGE AS
FSQ200 ON LARGE BROWSERS.

ENTER TEXT

Otro {(Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}:
DON'T KNOW

__________________________________________________________

Box 12

IDENTIFY THE 4 "KEY" PARENT FIGURES IN
THE HOUSEHOLD. THIS PERSON OR PERSONS
SHOULD BE CHOSEN AS FOLLOWS:
1) THE KEY PARENT FIGURES SHOULD BE
CHOSEN ONLY FROM AMONG CURRENT
MEMBERS OF THE
HOUSEHOLD.
2) SELECT UP TO 4 KEY PARENT FIGURES
USING THIS ORDERED PRIORITY:
1. TAKE HH MEMBERS WITH RELATION = 1
(BIOLOGICAL PARENT) STARTING FROM THE
LOWEST PERSON NUMBER (PERSON NUMBER
CORRESPONDS TO THE ORDER THE PERSON
WAS ENTERED IN THE ROSTER).
2. IF THERE ARE NOT 4 KEY PARENT FIGURES
YET, TAKE HH MEMBERS WITH RELATION = 2
(ADOPTIVE PARENT) STARTING FROM THE
LOWEST PERSON NUMBER.
3. IF THERE ARE NOT 4 KEY PARENT FIGURES
YET, TAKE HH MEMBERS WITH RELATION = 3
(STEP PARENT) STARTING FROM THE LOWEST
PERSON NUMBER.
4. IF THERE ARE NOT 4 KEY PARENT FIGURES
YET, TAKE HH MEMBERS WITH RELATION = 4
(FOSTER PARENT) STARTING FROM THE
LOWEST PERSON NUMBER.
5. IF THERE ARE NOT 4 KEY PARENT FIGURES
YET, TAKE HH MEMBERS WITH RELATION = 91
(OTHER PARENT OR GUARDIAN) STARTING
FROM THE LOWEST PERSON NUMBER.
6. IF THERE ARE NOT 4 KEY PARENT FIGURES
YET, AND RESPONDENT IS A KEY PARENT,
TAKE RESPONDENT’S SPOUSE/PARTNER
(SPOUSE/PARTNER IS DEFINED AS THE
PERSON SELECTED AT FSQ120) IF THIS
PERSON IS NOT ALREADY A KEY PARENT.
7. IF THERE IS NOT EVEN ONE KEY PARENT
FIGURE YET, TAKE RESPONDENT AND
SPOUSE/PARTNER (AT THIS POINT, THE

RESPONDENT AND SPOUSE/PARTNER MUST
HAVE RELATION NOT IN (1, 2, 3, 4, 91)).

__________________________________________________________

Box 13

IF THE RESPONDENT IS A PARENT (INQ005g
= 1, 2, 3, 4, OR 91) GO TO BOX 14. ELSE IF
THERE ARE KEY PARENTS ACCORDING TO BOX
12 THAT ARE NOT THE RESPONDENT AND
HAVE INITIALS OR A NAME IN FSQ010 GO TO
FSQ202. ELSE GO TO BOX 14.

__________________________________________________________

FSQ202

QUESTION TEXT:
Question "How would you describe
{INITIALS/NAME}’s current relationship
status?"
SaVisible “True”

"¿Como describiría la situación de pareja de
{INITIALS/NAME} actualmente?"
Savisible “True”

CODES
1

Married

Box 14

Casado(a)/Casados

Separated

Box 14

Separado(a)/Separados

Divorced

Box 14

Divorciado(a)/Divorciados

Widowed

Box 14

Viudo(a)

Never married

Box 14

Civil union/domestic partnership

Box 14

Nunca ha estado casado(a)/Nunca han estado
casados
En unión civil/Sociedad doméstica

Other {(Please explain):/(Please explain on next
screen.)}
DON'T KNOW

FSQ202OS

PROGRAMMER INSTRUCTIONS:
DISPLAY THE INITIALS OR NAME FROM FSQ010
FOR THE FIRST KEY PARENT FIGURE
ACCORDING TO BOX 12 WHO IS NOT THE
RESPONDENT. THE RESPONDENT’S MARITAL
STATUS WAS ASKED ABOUT IN FSQ200. THE
PRIORITIES IN BOX 12, STEP 2, SHOULD BE
USED TO SELECT THE PARENT FIGURE FOR THIS
QUESTION (E.G., IF THERE IS A BIOLOGICAL
PARENT IN THE HOUSEHOLD WHO IS NOT THE
RESPONDENT, MARITAL STATUS WILL BE ABOUT
THE FIRST PARENT FIGURE WHO IS A
BIOLOGICAL PARENT (BOX 12, STEP 2, POINT
1). ELSE IF THERE IS AN ADOPTIVE PARENT IN
THE HOUSEHOLD WHO IS NOT THE
RESPONDENT, MARITAL STATUS WILL BE ASKED
ABOUT THE FIRST PARENT FIGURE WHO IS AN
ADOPTIVE PARENT (BOX 12, STEP 2, POINT 2).
ELSE, SELECTION OF THE PARENT FIGURE FOR
THE MARITAL STATUS QUESITON WOULD
CONTINUE ACCORDING TO BOX 12, STEP 2,
POINTS 3-7.)

Otro {(Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}:
DON'T KNOW

__________________________________________________________

FSQ202OS
DISPLAY INSTRUCTIONS:
DISPLAY OTHER SPECIFY FIELD ON SAME PAGE AS
FSQ200 FOR LARGE BROWSERS.

ENTER TEXT

__________________________________________________________

Box 14

GO TO SECTION HEQ.

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

HEQ

Home Environment, Activities, and Cognitive Stimulation

__________________________________________________________

HEQ071a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS SMALL, DISPLAY “Now we
would like to ask about {CHILD’S} home
environment. How often does {CHILD}:” FOR
HEQ071a. FOR HEQ071b-i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE SMALL BROWSER
SCREEN.

QUESTION TEXT:

Question “Now we would like to ask about
{CHILD}'s home environment. How often does
{CHILD}:

“Ahora nos gustaría preguntar acerca del
ambiente del hogar de CHILD}. ¿Con qué
frecuencia {CHILD}:

Count objects?”

¿Cuenta objetos?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.
IF THE BROWSER SIZE IS SMALL, DISPLAY “Now we
would like to ask about {CHILD’S} home
environment. How often does {CHILD}:” FOR
HEQ071a. FOR HEQ071b-i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE SMALL BROWSER
SCREEN.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN
TWO GRIDS. FOR THE GRID WITH HEQ071a – e,
DISPLAY “Ahora nos gustaría preguntar acerca del
ambiente del hogar de {CHILD}. ¿Con qué frecuencia
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “Add or subtract things?”

“¿Suma o resta cosas?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “Write numbers?”

“¿Escribe números?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071d
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “Match or identify shapes?”

“¿Agrupa o identifica figuras geométricas?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071e
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “Play with blocks or construction
toys?”

“¿Juega con bloques o juguetes para construir?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071f
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “{(Continued) }How often does
{CHILD}:

“{(Continuación) }¿Con qué frecuencia
{CHILD}:

Identify or create patterns?”

¿Identifica o crea patrones?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071g
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

IF BROWSER SIZE IS LARGE, DISPLAY “Continuación”.

QUESTION TEXT:
Question “Put objects in order (for example,
small to large)?”

"¿Pone objetos en orden (por ejemplo, de
menor a mayor)?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071h
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “Measure things (for example, using
a ruler, in cooking, etc.)?”

“¿Mide cosas (por ejemplo, usando una regla,
cuando cocina, etc.)?”

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ071i
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Now we would like to ask
about {CHILD’S} home environment. How often does
{CHILD}:” AT THE TOP OF THE GRID. FOR THE GRID
WITH ITEMS HEQ071f – i DISPLAY “How often does
{CHILD}:” AT THE TOP OF THE GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ071a – e AND HEQ071f – i ON SEPARATE
SCREENS IN TWO GRIDS. FOR THE GRID WITH
HEQ071a – e, DISPLAY “Ahora nos gustaría preguntar
acerca del ambiente del hogar de {CHILD}. ¿Con qué
frecuencia {CHILD}:” AT THE TOP OF THE GRID. FOR
THE GRID WITH ITEMS HEQ071f – i DISPLAY “¿Con
qué frecuencia {CHILD}:” AT THE TOP OF THE GRID.

QUESTION TEXT:
Question “Answer/ask questions about “How
many things are there?” (for example, “How
many plates are on the table?”)?”

“¿Hace/contesta preguntas sobre “¿Cuántas
cosas hay?" (por ejemplo “¿Cuántos platos hay
en la mesa?”)?"

CODES
1

Never or almost never

Nunca o casi nunca

Less than once a week

Menos de una vez por semana

Once a week

Una vez por semana

Several times a week

Varias veces a la semana

Every day or almost every day

Todos los días o casi todos los días

__________________________________________________________

HEQ073

QUESTION TEXT:
Question “How much does {CHILD} enjoy
number or math activities like counting
objects, making patterns, measuring things,
etc.?”

“¿Qué tanto le gusta a {CHILD} hacer
actividades con números o de matemáticas,
como contar objetos, hacer patrones, medir
cosas, etc.?”

CODES
1

Not at all

Nada

A little

Un poco

A fair amount

Más o menos

Much

Mucho

Very much

Muchísimo

__________________________________________________________

HEQ075a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.

QUESTION TEXT:
Question “How much do you agree or disagree
with the following statements about what it is
usually like living in your home?

“¿Qué tan de acuerdo o en desacuerdo está con
las siguientes afirmaciones sobre cómo es
generalmente la vida en su hogar?

We almost always seem to be rushed.”

Parece que casi siempre andamos con prisa.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ075b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.

QUESTION TEXT:
Question “We are usually able to stay on top of
things.”

“Usualmente podemos estar al día con las
cosas.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ075c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.

QUESTION TEXT:
Question “No matter how hard we try, we
always seem to be running late.”

“Por más que nos esforcemos, parece que
siempre se nos hace tarde.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ075d
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.

QUESTION TEXT:
Question “No matter what our family plans, it
usually doesn’t seem to work out.”

“Sin importar lo planeado por la familia,
normalmente las cosas no funcionan.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ075e
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

QUESTION TEXT:
Question “{(Continued) }How much do you
agree or disagree with the following
statements about what it is usually like living
in your home?

“Es un buen lugar para relajarse.”

It is a good place to relax.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ075f
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.

QUESTION TEXT:
Question “The atmosphere is calm.”

“Es un ambiente tranquilo.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ075g
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ075a – d AND HEQ075e – g ON SEPARATE
SCREENS IN TWO GRIDS.

QUESTION TEXT:
Question “In the morning, we have a regular
routine.”

“En la mañana tenemos una rutina regular.”

CODES
1

Strongly disagree

Muy en desacuerdo

Disagree

En desacuerdo

Neither disagree nor agree

Ni en desacuerdo ni de acuerdo

Agree

De acuerdo

Strongly agree

Muy de acuerdo

__________________________________________________________

HEQ210
DISPLAY INSTRUCTIONS:
DISPLAY “past week” IN UNDERLINED TEXT.

DISPLAY “última semana” IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Now we have some questions about
{CHILD}'s activities at home. In the past
week, how often did {CHILD} read to
{himself/herself/themselves} or to others
outside of school? Please include reading in
any language.”

“Ahora tenemos algunas preguntas sobre las
actividades de {CHILD} en casa. En la última
semana, ¿con qué frecuencia {CHILD} leyó por
su cuenta o le leyó a alguien más fuera de la
escuela?” Por favor incluya leer en cualquier
idioma.”

CODES
1

Never

Once or twice a week

Una a dos veces por semana

3 to 6 times a week

De 3 a 6 veces a la semana

Every day

Todos los días

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO HEQ272a.

HEQ272a

Nunca

__________________________________________________________

HEQ215

QUESTION TEXT:
Question “Generally, how long did {CHILD}
read to {himself/herself/themself} at each of
these times? Please include reading in any
language.”
Pre-unit “Minutes:”
Watermark “Enter minutes”

"Generalmente, ¿cuánto tiempo le leen a
{CHILD} en cada una de esas ocasiones?" Por
favor incluya leerle en cualquier idioma."
Pre-unit "Minutos:"
Watermark “Ponga los minutos”

ENTER NUMBER
Range

1 to 120

Soft Range

1 to 60

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT HEQ215}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT HEQ215). Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

HEQ272a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ272a – b IN A GRID.
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her”
IF THE CHILD IS FEMALE. ELSE DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.

QUESTION TEXT:
Question “Do you have the following in your
home that {CHILD} may use?

“¿Tiene en su hogar las siguientes cosas que
{CHILD} puede usar?

Smartphone”

¿Teléfono inteligente o smartphone?”

CODES
1
2

Yes, {CHILD} shares this with other family
member(s)
Yes, {CHILD} has {his/her/their} own

Sí, {CHILD} lo comparte con otros miembros
de la familia (s)
Sí, {CHILD} tiene uno propio

__________________________________________________________

HEQ272b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ272a – b IN A GRID.
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her”
IF THE CHILD IS FEMALE. ELSE DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.

QUESTION TEXT:
Question “Laptop, desktop computer, or tablet
(for example, iPad or other tablet)”

“Computadora portátil o de escritorio, o tableta
(por ejemplo, iPad u otra tableta)”

CODES
1

Yes, {CHILD} shares this with other family
member(s)
Yes, {CHILD} has {his/her/their} own

Sí, {CHILD} lo comparte con otros miembros
de la familia (s)
Sí, {CHILD} tiene uno propio

__________________________________________________________

HEQ273a
DISPLAY INSTRUCTIONS:
DISPLAY HEQ273a AND HEQ273b TOGETHER
VERTICALLY.

QUESTION TEXT:
Question “On any given weekday, how much
time does {CHILD} spend watching shows,
movies, and videos? If less than an hour, enter
'0' in the "Hours" section. If {CHILD} does not
watch shows, movies, or videos, enter '0' in
both the “Hours” and "Minutes" section.”
Pre-unit “Hours:”
Watermark "Enter hours"

"En un día determinado de entresemana,
¿cuánto tiempo pasa {CHILD} mirando
programas, películas y videos? Si pasa menos
de una hora, ponga ‘0’ en la sección “horas”. Si
{CHILD} no mira programas, películas o videos,
ponga ‘0’ en ambas secciones: “Horas” y
“Minutos”.
Pre-Unit "Horas:"
Watermark "Horas por día de entresemana"

ENTER NUMBER
Range

0 to 24

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: “Include shows, movies, and
videos watched on any TV, digital devices such
as a cellphone, iPod, iPad, other tablet, laptop,
or desktop computer. Include shows or movies
on live TV; shows or movies that were recorded
earlier on a DVR; shows, movies, or videos on
demand; and shows, movies, or videos that you
downloaded or streamed on sites like Netflix,
Amazon Prime Video, Hulu, or YouTube.”

HELP FOR STEM: “Incluya programas, películas y
videos por televisión, en aparatos digitales o
electrónicos como en un teléfono celular, IPod,
IPad, otra tableta, laptop o computadora portátil,
o computadora de escritorio. Incluya programas o
películas en televisión en vivo; programas o
películas que se grabaron previamente en un
DVR; programas, películas o videos a pedido (on
demand); y programas, películas o videos que
usted descargó o mira en línea de sitios como
Netflix, Amazon Prime, Hulu, o YouTube”

__________________________________________________________

HEQ273b
DISPLAY INSTRUCTIONS:
DISPLAY HEQ273a AND HEQ273b TOGETHER
VERTICALLY.

QUESTION TEXT:
Pre-unit “Minutes:”

Pre-unit “Minutos:”

Watermark "Enter minutes"

Watermark "Ponga los minutos"

ENTER NUMBER
Range

0 to 180

__________________________________________________________

Box 1

IF HEQ272a-b ARE BOTH CODE 3 (‘No’), GO
TO HEQ277. ELSE GO TO HEQ274a.

__________________________________________________________

HEQ274a
DISPLAY INSTRUCTIONS:
DISPLAY HEQ274a AND HEQ274b TOGETHER
VERTICALLY.

QUESTION TEXT:
Question “On any given weekday, how much
time does {CHILD} spend playing video,
computer, or mobile games? If less than an
hour, enter '0' in the "Hours" section. If
{CHILD} does not play video, computer, or
mobile games, enter '0' in both the “Hours”
and "Minutes" sections.”
Pre-unit “Hours:”
Watermark "Enter hours"

“En un día determinado de entresemana,
¿cuánto tiempo pasa {CHILD} jugando juegos
de video, de computadora o en un dispositivo
móvil?” Si pasa menos de una hora, escriba ‘0’
en la sección “Horas.” Si {CHILD} no juega
juegos de video, de computadora o de
teléfono/tableta, escriba ‘0’ en la sección de
“Horas” y de “Minutos”.
Pre-unit "Horas:"
Watermark “Ponga las horas”

ENTER NUMBER
Range

0 to 24

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: “Include games played on any
digital device, including systems like Playstation,
Wii, or Xbox; or on handheld devices such as a
Nintendo DS, Sony PSP, iPod, iPad, tablet, or
cellphone; or games played on a TV, laptop, or
computer. Count any type of video, computer, or
mobile game, including those that are
educational.”

HELP FOR STEM: “Incluya juegos jugados en
cualquier dispositivo digital, incluyendo sistemas
como Playstation, Wii o Xbox, o dispositivos de
mano, tales como Nintendo DS, Sony PSP, iPod,
iPad, tableta o teléfono celular, o juegos jugados
en una televisión, una laptop o una computadora
de escritorio. Incluya cualquier tipo de juego de
video, de computadora o en un dispositivo móvil,
incluyendo aquellos que son educativos.”

__________________________________________________________

HEQ274b
DISPLAY INSTRUCTIONS:
DISPLAY HEQ274a AND HEQ274b TOGETHER
VERTICALLY.

QUESTION TEXT:
Pre-unit “Minutes:”

Pre-unit “Minutos:”

Watermark "Enter minutes"

Watermark "Ponga los minutos"

ENTER NUMBER
Range

0 to 180

__________________________________________________________

HEQ274c

QUESTION TEXT:
Question “In an average week, how often does
{CHILD} use a home computer or other digital
device to play with programs that teach
{him/her/them} something, like math or
reading skills?”

“En una semana promedio, ¿con qué frecuencia
usa {CHILD} la computadora u otro aparato
digital para jugar con programas que le
enseñan algo como habilidades en matemáticas
o lectura?”

CODES
1

Never

Nunca

Once or twice a week

Una a dos veces por semana

3 to 6 times a week

De 3 a 6 veces a la semana

Every day

Todos los días

PROGRAMMER INSTRUCTIONS:
BOLD “Digital device” THE FIRST INSTANCE
ONLY IN HELP TEXT.

BOLD “Dispositivo digital” THE FIRST INSTANCE
ONLY IN HELP TEXT.

HELP FOR STEM: Digital device: By digital
device, we mean any type of computer, laptop,
cell phone, smart phone, tablet (such as iPad or
other tablet), iPod, reading device (such as
Kindle or Fire), electronic assistant or smart
speaker (for example, Alexa, Google Assistant,
or Siri), or game system (including those such
as Playstation, Wii, or Xbox, or handheld devices
such as a Nintendo DS or Sony PSP).

HELP FOR STEM: Dispositivo digital: Al decir
dispositivo digital nos referimos a cualquier tipo
de computadora, portátil, teléfono celular,
teléfono inteligente, tableta (como iPad u otra
tableta), iPod, dispositivo de lectura (como Kindle
o Fire), asistente electrónico o altavoz inteligente
(por ejemplo, Alexa, Google Assistant o Siri), o
sistema de juegos (incluyendo tales como
Playstation, Wii o Xbox, o dispositivos de mano
tales como un Nintendo DS o Sony.

__________________________________________________________

HEQ277

QUESTION TEXT:
Question “Do you have Internet (cable, Wifi,
wireless, or DSL) in your home?”

“¿Tiene internet (por cable, wifi, inalámbrico o
DSL) en su hogar?"

CODES
1

Yes

HEQ278

Sí

HEQ285

__________________________________________________________

HEQ278

QUESTION TEXT:
Question “Does {CHILD} use any digital
device(s) to get on the Internet in your home?”

“¿Usa {CHILD} algún aparato electrónico o
digital para entrar a Internet en su casa?”

CODES
1

Yes

Sí

__________________________________________________________

HEQ285

QUESTION TEXT:
Question “Are there family rules about how
many hours {CHILD} may spend on screen
time?”

"¿Tiene alguna regla su familia para {CHILD}
acerca de cuánto tiempo se le permite a
{CHILD} pasar frente a una pantalla?"

CODES
1

Yes

HEQ285a

Sí

HEQ288

PROGRAMMER INSTRUCTIONS:
BOLD "Screen time" IN HELP TEXT.
HELP FOR STEM: 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.

BOLD “El tiempo frente a una pantalla” IN HELP
TEXT.
HELP FOR STEM: El tiempo frente a una pantalla:
El tiempo frente a una pantalla se refiere a la
cantidad de tiempo que el niño(a) pasa frente a
una televisión, una computadora u otro dispositivo
digital en el que el niño(a) está mirando una
pantalla mientras lo usa.

__________________________________________________________

HEQ285a

QUESTION TEXT:
Question “In what ways do you limit
{CHILD}'s screen time? Please select all that
apply.”
CODES

“¿De qué maneras limita usted el tiempo de
pantalla de {CHILD}? Por favor seleccione todas
las respuestas que correspondan.”

Code All That Apply

With a device or app

HEQ288

Con un dispositivo o app

Ask {CHILD} to end screen time

HEQ288

Redirect {CHILD} to other activity

HEQ288

Le digo a {CHILD} que pare de usar la
pantalla
Dirijo a {CHILD} a que haga otra actividad

Take away the device from {CHILD}

HEQ288

Le quito el aparato a {CHILD}

Other

HEQ288

Otra manera

PROGRAMMER INSTRUCTIONS:
BOLD "Screen time:" IN HELP TEXT
HELP FOR STEM: 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.

__________________________________________________________

HEQ288

QUESTION TEXT:
Question “Now we'd like to ask you about
some of the activities your child might do.
Outside of school hours, has {CHILD} ever
participated in any of the following activities?
Please select all that apply.”
CODES

"Ahora quisiéramos preguntarle sobre algunas
actividades que tal vez hace su niño(a). ¿Fuera
de las horas de clase, alguna vez {CHILD} ha
participado en alguna de las siguientes
actividades? Por favor seleccione todo lo que
corresponda.”

Code All That Apply

Organized athletic activities, like basketball,
soccer, baseball, swimming, or gymnastics

Dance groups, classes, or lessons

Actividades atléticas organizadas, como
básquetbol, fútbol, soccer, béisbol, natación o
gimnasia
Grupo, clases o lecciones de baile o danzas

Music, for example, piano, instrumental music, or
singing lessons
Drama groups, classes, or lessons

Lecciones de música, por ejemplo, de piano,
música instrumental o lecciones de canto
Grupos, clases o lecciones de drama o teatro

Art groups, classes, or lessons, for example,
painting, drawing, sculpture
Craft groups, classes, or lessons

Grupos, clases o lecciones de arte, por
ejemplo, de pintura, dibujo o escultura
Grupos, clases o lecciones de manualidades

Language groups, classes, or lessons (to learn
English or another language)
None of the above

Grupos, clases o lecciones de idiomas (para
aprender inglés u otro idioma)
Ninguna de estas actividades

4
5
6
7
8

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 8, 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.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 8, DISPLAY HARD ERROR
CHECK
MESSAGE, “Usted seleccionó “Ninguna de estas
actividades” pero también seleccionó otra opción
de la lista. Por favor revise lo que contestó y
corrija su respuesta. Luego seleccione "Siguiente"
para continuar.”

__________________________________________________________

HEQ289
DISPLAY INSTRUCTIONS:
DISPLAY "month" in UNDERLINED TEXT.

DISPLAY "mes" in UNDERLINED TEXT.

DISPLAY {CURRENT DATE - 1 MONTH},” WITH DATE
AS "Month, day" WITH MONTH SPELLED OUT. USE
BLAISE DATE OPERATOR TO SUBTRACT 1 MONTH.

DISPLAY {CURRENT DATE - 1 MONTH},” WITH DATE
AS "Mes, día" WITH MONTH SPELLED OUT. USE
BLAISE DATE OPERATOR TO SUBTRACT 1 MONTH.

QUESTION TEXT:
Question “In the past month, that is, since
{MONTH} {DAY}, has anyone in your family
done the following things with {CHILD}?
Please select all that apply.”

CODES
1

“En el último mes, o sea, desde el {DAY} de
{MONTH}, ¿alguien de su familia ha hecho
alguna de las siguientes cosas con {CHILD}?
Por favor seleccione todo lo que corresponda.”

Code All That Apply

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.)
Gone to a play, concert, or other live show

Visited an art gallery, museum, or historical site

Visited a zoo, aquarium, or petting farm

Attended an athletic or sporting event in which
{CHILD} was not a player

Gone to a park, beach, or nature preserve

None of these

Ha ido a una biblioteca o librería (no cuente
visitar una biblioteca o librería en internet.

Ha ido a una obra de teatro, concierto u otro
show en vivo.
Ha ido a una galería de arte, un museo o un
lugar histórico.
Ha ido a un zoológico, un acuario o una
granja para niños.
Ha asistido a un evento atlético o deportivo
en el que {CHILD} no era uno de los
jugadores
Ha ido a un parque, a una playa o a una
reserva natural
Ninguna de estas actividades

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 7, DISPLAY HARD
ERROR CHECK MESSAGE, “You selected “None of
these” but also selected another option on the
list. Please check your responses and update
your answer. Then, select “Next” to continue.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 7, DISPLAY HARD ERROR
CHECK
MESSAGE, “Usted seleccionó “Ninguna de estas
actividades” pero también seleccionó otra opción
de la lista. Por favor revise lo que contestó y
corrija su respuesta. Luego seleccione "Siguiente"
para continuar.”

__________________________________________________________

HEQ391
DISPLAY INSTRUCTIONS:
IF BROWSER IS LARGE, DISPLAY HEQ391 AND
HEQ392 ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Outside of school hours, has
{CHILD} ever participated in:

“Fuera del horario escolar, ¿alguna vez ha
participado {CHILD} en:

Religious activities or instruction at a church,
mosque, synagogue, or other place of worship.

Actividades o instrucción religiosa en una
iglesia, mezquita, sinagoga u otro centro
religioso?”

CODES
1

Yes

Sí

__________________________________________________________

HEQ392
DISPLAY INSTRUCTIONS:
IF BROWSER IS LARGE, DISPLAY HEQ391 AND
HEQ392 ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Volunteer work or community
service?”

“¿Trabajo voluntario o servicio comunitario?”

CODES
1

Yes

Sí

__________________________________________________________

HEQ399

QUESTION TEXT:
Question “During a typical week, how often
does {CHILD} play outside actively (for
example, running, jumping, or swinging)?”

“Durante una semana normal, ¿con qué
frecuencia {CHILD} juega afuera activamente
(por ejemplo, corre, brinca o se columpia)?”

CODES
1

Never

Nunca

Once or twice a week

Una a dos veces por semana

3 to 6 times a week

De 3 a 6 veces a la semana

Every day

Todos los días

__________________________________________________________

HEQ400

QUESTION TEXT:
Question “Now we have some questions about
your neighborhood. How safe is it for children
to play outside during the day in your
neighborhood?”

“Ahora tenemos algunas preguntas acerca de su
vecindario. ¿Qué tan seguro es que los niños
jueguen afuera durante el día en su vecindario?”

CODES
1

Not at all safe

Nada seguro

Somewhat safe

Algo seguro

Very safe

Muy seguro

__________________________________________________________

HEQ455

QUESTION TEXT:
Question “Do you have the following places or
activities in your neighborhood or in the area
nearby your home? Please select all of the
things that you have, regardless of whether
you use them or not.”
CODES

“¿En su vecindario o en el área cercana a su
hogar, ¿tienen las siguientes instalaciones o
actividades? Por favor seleccione todas las
cosas que tenga, al margen de si ustedes las
utilice o no.”

Code All That Apply

A recreation center

Un centro recreativo

Organized activities such as Little League or soccer

A community or neighborhood association

Actividades organizadas como Little League o
fútbol (soccer)
Una asociación comunitaria o del vecindario

A visual or performing arts center

Un centro de artes visuales o artes escénicas

A community pool

Una alberca o piscina de la comunidad

A community park or playground area

Un parque o patio de juegos de la comunidad

A library or bookmobile

Una biblioteca o bookmobile (biblioteca móvil)

A program that has after-school activities for
children (for example, a Boys’ or Girls’ Club of
America)

A grocery store

n programa con actividades para niños
después de la escuela (por ejemplo, un Club
de Niños o de Niñas (Boys’ o Girls’ Club of
America)
Una tienda de comestibles

A hospital

Un hospital

None of the above

Ninguno de los anteriores

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 10, 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.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 10, DISPLAY HARD ERROR
CHECK
MESSAGE, “Usted seleccionó “Ninguno de los
anteriores” pero también seleccionó otra opción de
la lista. Por favor revise lo que contestó y corrija
su respuesta. Luego seleccione "Siguiente" para
continuar.”

__________________________________________________________

HEQ460
DISPLAY INSTRUCTIONS:
DISPLAY 'five days" IN UNDERLINED TEXT.

DISPLAY “cinco días” IN UNDERLINED TEXT.

DISPLAY “NOT" IN UNDERLINED TEXT.

DISPLAY “SIN" IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Now we have some questions about
meals and your family. During the last five
days {CHILD} was in school, how many
breakfasts did {he/she/they} eat that were
NOT school breakfasts?”
Pre-unit “Breakfasts:”
Watermark “Number of breakfasts”

“Ahora tenemos algunas preguntas sobre las
comidas y su familia. En los últimos cinco días
que fue {CHILD} a la escuela, ¿cuántos días
desayunó SIN contar desayunos en la escuela?”
Pre-unit “Desayunos:”
Watermark “Número de desayunos”

ENTER NUMBER
Range

0 to 5

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: By breakfast we mean
breakfasts eaten at home, at childcare, or at
school, but not part of a school breakfast
program. Please count only one breakfast per
day.

HELP FOR STEM: Por “desayunar” nos referimos a
desayunar en la casa, la guardería o donde lo
cuidan, o en la escuela, pero que no sea parte del
programa de desayunos escolares. Por favor sólo
cuente un desayuno por día.

__________________________________________________________

HEQ520
DISPLAY INSTRUCTIONS:
DISPLAY “typical week” AND “any meal” IN
UNDERLINED TEXT.

DISPLAY “semana normal” AND “comida” IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “In a typical week, on how many
days does your family eat any meal together?”

“En una semana normal, ¿en cuántos días su
familia come junta cualquier comida?”

Pre-unit “Days:”

Pre-unit “Días:”

Watermark "Number of days"

Watermark "Número de días"

ENTER NUMBER
Range

0 to 7

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: By family, we mean at least
one adult and one child.

HELP FOR STEM: Por familia, queremos decir por
lo menos un adulto y un niño.

__________________________________________________________

HEQ580
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ580 AND HEQ590 ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “How often does someone in your
family talk with {CHILD} about…

“¿Con qué frecuencia alguien en su familia
habla con {CHILD} acerca de…

{His/Her/Their} ethnic or racial heritage?”

La ascendencia racial o étnica de {CHILD}?”

CODES
1

Never

Nunca

Almost never

Casi nunca

Several times a year

Varias veces al año

Several times a month

Varias veces al mes

Several times a week or more

Varias veces a la semana o más

__________________________________________________________

HEQ590
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
HEQ580 AND HEQ590 ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Your family's religious beliefs or
traditions?”

“Las creencias religiosas o tradiciones de su
familia?”

CODES
1

Never

Nunca

Almost never

Casi nunca

Several times a year

Varias veces al año

Several times a month

Varias veces al mes

Several times a week or more

Varias veces a la semana o más

__________________________________________________________

HEQ595

QUESTION TEXT:
Question “On weeknights during the school
year, does {CHILD} usually go to bed at about
the same time each night?”

“En las noches, entresemana, durante el año
escolar, ¿se va a dormir {CHILD} normalmente
a la misma hora cada noche?”

CODES
1

Yes, {CHILD} has a usual bedtime.

Sí, {CHILD} tiene horario fijo para acostarse.

No, {CHILD}'s bedtime varies a lot from night to
night.

No, la hora de dormir de {CHILD} cambia
mucho cada noche.

__________________________________________________________

HEQ600a
DISPLAY INSTRUCTIONS:
DISPLAY HEQ600a AND HEQ600b TOGETHER
VERTICALLY ON SCREEN.

QUESTION TEXT:
Question “On an average school night, how
many hours of sleep does {CHILD} get?”

“En una noche normal de entresemana,
¿cuántas horas duerme {CHILD}?”

Pre-unit “Hours:”

Pre-unit “Horas:”

Watermark "Enter hours"

Watermark "Ponga las horas "

ENTER NUMBER
Range

0 to 15

Soft Range

1 to 12

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT HEQ600a}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT HEQ600a}. Por favor confirme. Si es correcto,
seleccione siguiente para continuar."

__________________________________________________________

HEQ600b
DISPLAY INSTRUCTIONS:
DISPLAY HEQ600a AND HEQ600b TOGETHER
VERTICALLY ON SCREEN.

QUESTION TEXT:
Pre-unit “Minutes:”

Pre-unit “Minutos:”

Watermark "Enter minutes"

Watermark "Ponga los minutos"

ENTER NUMBER
Range

0 to 59

__________________________________________________________

Box 2

GO TO SECTION SSQ (SOCIAL SKILLS,
PROBLEM BEHAVIORS, AND APPROACHES TO
LEARNING).

Section SSQ Social Skills, Problem Behaviors and Approaches Toward Learning
Thirty-four items ask parents to rate their child on social-emotional skills including ability to exercise selfcontrol (for example, fighting, arguing, anger); ability to interact with others (for example, playing, making
friends); being sad or lonely (for example, depression, low self-esteem); being impulsive or overactive;
positive behaviors (for example, listening, cooperating); problem behaviors (worrying); and approaches to
learning (for example, selfdirection, organization, eagerness to learn). The social skills and behavior items
are adapted from the Social Skills Rating Scale (SSRS) and the Social Skills Improvement System (SSIS) by
Gresham and Elliot (1990, 2008) published by NCS Pearson. These items (a-i, k, l, n, p, q, s, t, u, w, y, z1, z2,
z3, z4, z5, z6, z7, z8, z9) are copyright protected and are not listed (they are submitted directly to OMB for
review). The approaches to learning items were created for the Early Childhood Longitudinal Study,
Kindergarten Class of 1998-99 (ECLS-K) by Atkins-Burnett. They are not copyright protected and,
therefore, are listed below.

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

SSQ

Social Skills, Problem Behaviors, and Approaches Toward
Learning

__________________________________________________________

SSQ010a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD}’s social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "Next we would like to ask about
{CHILD}’s social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.
"

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.

" Ahora quisiéramos preguntarle sobre las
habilidades sociales y el comportamiento de
{CHILD}.
Por favor indique con qué frecuencia {CHILD}
actúa de las siguientes maneras.
"

GroupCopyRight "Source: Social Skills Rating
System (SSRS). Copyright © 1990, NCS
Pearson, Inc. Adapted with permission. All
rights reserved."
CopyRight "Source: Social Skills Rating System
(SSRS). Copyright © 1990, NCS Pearson, Inc.
Adapted with permission. All rights reserved."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
"
GroupCopyRight "Source: Social Skills Rating
System (SSRS). Copyright © 1990, NCS
Pearson, Inc. Adapted with permission. All
rights reserved."

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.

CopyRight "Source: Social Skills Rating System
(SSRS). Copyright © 1990, NCS Pearson, Inc.
Adapted with permission. All rights reserved."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010d
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.”AT THE TOP OF THE GRID. FOR THE GRIDS
WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4, AND Z5Z9 DISPLAY “Por favor indique con qué frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010e
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE GRIDS
WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4, AND Z5Z9 DISPLAY “Por favor indique con qué frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “Continuación”.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
"

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.”
"

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010f
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010g
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.”AT THE TOP OF THE GRID. FOR
THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, yZ4, AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.

GroupCopyRight "Source: Social Skills
Improvement System (SSIS). Copyright ©
2008, NCS Pearson, Inc. Adapted with
permission. All rights reserved."
CopyRight "Source: Social Skills Improvement
System (SSIS). Copyright © 2008, NCS
Pearson, Inc. Adapted with permission. All
rights reserved."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010h
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010i
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE GRIDS
WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4, AND Z5Z9 DISPLAY “Por favor indique con qué frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “Continuación”.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
"

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.”
"

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010j
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
FOR THE FIRST DISPLAY, DISPLAY “he” IF THE CHILD
IS MALE (INQ050b = 1). ELSE DISPLAY “she” IF THE
CHILD IS FEMALE (INQ050b = 2). ELSE DISPLAY
“they” IF THE CHILD IS ANOTHER GENDER (INQ050b
= 3). ELSE DISPLAY THE CHILD’S NAME IF GENDER
IS MISSING (INQ050b = SK) AS SHOWN IN THE
GLOBAL SPECS.
FOR THE SECOND DISPLAY, DISPLAY “is” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “are” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).

QUESTION TEXT:
Question "Keeps working at something until
{he/she/they} {is/are} finished."

"No para de hacer algo hasta que lo termina."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010k
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010l
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010m
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
Shows interest in a variety of things."

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes maneras.”
AT THE TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY
“Continuación”.

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.”
Muestra interés en una variedad de cosas."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010n
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
FOR THE FIRST AND THIRD DISPLAY, RESPECTIVELY,
DISPLAY “he” AND “his” IF THE CHILD IS MALE
(INQ050b = 1). ELSE DISPLAY “she” AND “her” IF
THE CHILD IS FEMALE (INQ050b = 2). ELSE DISPLAY
“they” AND “their” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3). ELSE DISPLAY THE CHILD’S
NAME IF GENDER IS MISSING (INQ050b = SK) AS
SHOWN IN THE GLOBAL SPECS.

FOR THE SECOND DISPLAY, DISPLAY “does” IF THE
CHILD IS MALE (INQ050b = 1), FEMALE (INQ050b =
2), OR THE GENDER IS MISSING (INQ050b = SK).
ELSE DISPLAY “do” IF THE CHILD IS ANOTHER
GENDER (INQ050b = 3).

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010o
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "Concentrates on a task and ignores
distractions."

"Se concentra en una tarea e ignora las
distracciones."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010p
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010q
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE GRIDS
WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4, AND Z5Z9 DISPLAY “Por favor indique con qué frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “Continuación”.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
"
GroupCopyRight "Source: Social Skills
Improvement System (SSIS). Copyright ©
2008, NCS Pearson, Inc. Adapted with
permission. All rights reserved."

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.”
“

CopyRight "Source: Social Skills Improvement
System (SSIS). Copyright © 2008, NCS
Pearson, Inc. Adapted with permission. All
rights reserved."
CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010r
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "Helps with chores."

"Ayuda con los quehaceres de la casa."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010s
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.”AT THE TOP OF THE GRID. FOR
THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, yZ4, AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia
{CHILD} actúa de las siguientes maneras.”AT THE
TOP OF EACH GRID.

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010t
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010u
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE GRIDS
WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4, AND Z5Z9 DISPLAY “Por favor indique con qué frecuencia
{CHILD} actúa de las siguientes maneras.” AT THE
TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “Continuación”.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
"

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.”
"

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010v
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.” AT THE TOP OF THE GRID.
FOR THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x,
y-Z4, AND Z5-Z9 DISPLAY “Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "Is eager to learn new things."

"Tiene ansias de aprender cosas nuevas."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010w
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.” AT THE TOP OF THE GRID.
FOR THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x,
y-Z4, AND Z5-Z9 DISPLAY “Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “

“

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010x
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question "Is creative in work or in play."

"Muestra creatividad en su trabajo o en el
juego."

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010y
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
"

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes maneras.”
AT THE TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY
“Continuación”.

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.
"

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z1
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID. IF BROWSER
SIZE IS LARGE, DISPLAY “Continuación” IN ITALICS.

QUESTION TEXT:
Question "
"

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z2
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z3
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z4
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.” AT THE TOP OF THE GRID.
FOR THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x,
y-Z4, AND Z5-Z9 DISPLAY “Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z5
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY
“Continuación” IN ITALICS.

QUESTION TEXT:
Question "{(Continued) }Please indicate how
often {CHILD} acts in the following ways.
"

"{(Continuación) }Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.
"

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z6
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora quisiéramos
preguntarle sobre las habilidades sociales y el
comportamiento de {CHILD}. Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Por favor indique con qué
frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z7
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.” AT THE TOP OF THE GRID.
FOR THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x,
y-Z4, AND Z5-Z9 DISPLAY “Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z8
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.” AT THE TOP OF THE GRID.
FOR THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x,
y-Z4, AND Z5-Z9 DISPLAY “Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ010z9
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Next we would like
to ask about {CHILD’s} social skills and behavior.
Please indicate how often {CHILD} acts in the
following ways.” AT THE TOP OF THE GRID. FOR THE
GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x, y-Z4,
AND Z5-Z9 DISPLAY “Please indicate how often
{CHILD} acts in the following ways.” AT THE TOP OF
EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
SSQ010a-d, e-h, i-l, m-p, q-t, u-x, y-Z4, AND Z5-Z9
ON SEPARATE SCREENS IN EIGHT GRIDS. FOR THE
GRID WITH SSQ010a-d, DISPLAY “Ahora
quisiéramos preguntarle sobre las habilidades
sociales y el comportamiento de {CHILD}. Por favor
indique con qué frecuencia {CHILD} actúa de las
siguientes maneras.” AT THE TOP OF THE GRID.
FOR THE GRIDS WITH SSQe-h, i-l, m-p, q-t, and u-x,
y-Z4, AND Z5-Z9 DISPLAY “Por favor indique con
qué frecuencia {CHILD} actúa de las siguientes
maneras.” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question "

CODES
1

Never

Nunca

Sometimes

A veces

Often

Frecuentemente

Very often

Muy frecuentemente

__________________________________________________________

SSQ027a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
SSQ027a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Now please rate how much each of
these statements is like {CHILD}.

“Ahora por favor indique en qué medida cada
una de estas afirmaciones se parece a {CHILD}.

Plays with single toy for long periods of time.”

Juega con un solo juguete por largos períodos
de tiempo.”

CODES
1

Not at all like {CHILD}

No se parece nada {CHILD}

Somewhat unlike {CHILD}

Algo distinto a {CHILD}

Neither like nor unlike {CHILD}

Ni parecido ni distinto a {CHILD}

Somewhat like {CHILD}

Algo parecido a {CHILD}

A lot like {CHILD}

Muy parecido a {CHILD}

__________________________________________________________

SSQ027b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
SSQ027a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Persists at a task until successful.”

“Persiste en una tarea hasta que logra hacerla.”

CODES
1

Not at all like {CHILD}

No se parece nada {CHILD}

Somewhat unlike {CHILD}

Algo distinto a {CHILD}

Neither like nor unlike {CHILD}

Ni parecido ni distinto a {CHILD}

Somewhat like {CHILD}

Algo parecido a {CHILD}

A lot like {CHILD}

Muy parecido a {CHILD}

__________________________________________________________

SSQ027c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
SSQ027a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Goes from toy to toy quickly.”

“Pasa rápidamente de un juguete a otro.”

CODES
1

Not at all like {CHILD}

No se parece nada {CHILD}

Somewhat unlike {CHILD}

Algo distinto a {CHILD}

Neither like nor unlike {CHILD}

Ni parecido ni distinto a {CHILD}

Somewhat like {CHILD}

Algo parecido a {CHILD}

A lot like {CHILD}

Muy parecido a {CHILD}

__________________________________________________________

SSQ027d
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
SSQ027a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “Gives up easily when difficulties are
encountered.”

“Abandona con facilidad cuando se le presentan
dificultades.”

CODES
1

Not at all like {CHILD}

No se parece nada {CHILD}

Somewhat unlike {CHILD}

Algo distinto a {CHILD}

Neither like nor unlike {CHILD}

Ni parecido ni distinto a {CHILD}

Somewhat like {CHILD}

Algo parecido a {CHILD}

A lot like {CHILD}

Muy parecido a {CHILD}

__________________________________________________________

SSQ027e
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
SSQ027a-e ON SAME SCREEN IN A GRID.

QUESTION TEXT:
Question “With a difficult toy, gives up quite
easily."

“Con un juguete difícil de usar se da por
vencido(a) con facilidad."

CODES
1

Not at all like {CHILD}

No se parece nada {CHILD}

Somewhat unlike {CHILD}

Algo distinto a {CHILD}

Neither like nor unlike {CHILD}

Ni parecido ni distinto a {CHILD}

Somewhat like {CHILD}

Algo parecido a {CHILD}

A lot like {CHILD}

Muy parecido a {CHILD}

__________________________________________________________

Box 1

GO TO SECTION CFQ (CRITICAL FAMILY
PROCESSES).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

CFQ

Critical Family Processes

__________________________________________________________

CFQ350

QUESTION TEXT:
Question “The next questions are about events
that may have happened during {CHILD}'s
life. These things can happen in any family,
but some people may feel uncomfortable with
these questions. Remember, you may skip any
questions that you do not want to answer.
Since {CHILD} was born, how often has it
been very hard to get by on your family's
income, for example, to cover the basics like
food or housing?”

“Las siguientes preguntas son acerca de
eventos que puedan haber sucedido durante la
vida de {CHILD}. Estas son cosas que pueden
suceder en cualquier familia, pero algunas
personas pueden sentirse incómodas con estas
preguntas. Recuerde que puede dejar sin
responder cualquier pegunta que no desee
contestar.
Desde que nació {CHILD}, ¿con qué frecuencia
ha sido muy difícil arreglárselas con el ingreso
de su familia, por ejemplo, para cubrir gastos
básicos como los alimentos o la vivienda?”

CODES
1

Never

Nunca

Rarely

Rara vez

Somewhat often

Con cierta frecuencia

Very often

Muy frecuentemente

__________________________________________________________

CFQ360a
DISPLAY INSTRUCTIONS:
DISPLAY "ever" IN UNDERLINED TEXT.

QUESTION TEXT:
Question “To the best of your knowledge, has
{CHILD} ever experienced any of the
following? Please select all that apply.”

CODES

“Por lo que usted sabe, ¿alguna vez ha pasado
{CHILD} por alguna de las siguientes cosas?
Por favor seleccione todo lo que corresponda.”

Code All That Apply

A parent or guardian divorced or separated

A parent or guardian died

Uno de sus padres/madres o tutores se
divorció o se separó
Uno de sus padres/madres o tutores falleció

{CHILD} witnessed violence in {his/her/their}
neighborhood
{CHILD} was a victim of violence or abuse

{CHILD} fue testigo de violencia en su
vecindario
{CHILD} fue víctima de violencia o de abuso

{CHILD} was treated or judged unfairly because
of {his/her/their} race/ethnicity
CHILD} was treated or judged unfairly because of
{his/her/their} physical appearance or disability

{CHILD} fue tratado(a) o juzgado(a) de
manera injusta debido a su raza/grupo étnico
{CHILD} fue tratado(a) o juzgado(a) de
manera injusta debido a su apariencia física o
discapacidad
{CHILD} pasó por algún otro evento
seriamente negativo
Ninguno de los anteriores

4
5
6

CHILD} experienced some other serious negative
event
None of the above

PROGRAMMER INSTRUCTIONS:
IF CODE 8 (NONE OF THE ABOVE) IS SELETED
DO NOT ALLOW OTHER CODES TO BE SELECTED.
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 8, 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.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 8, DISPLAY HARD ERROR
CHECK MESSAGE, “Usted seleccionó "Ninguna de
las anteriores" pero también seleccionó otra
opción de la lista. Por favor verifique lo que
respondió y corrija su respuesta. Luego seleccione
"Siguiente" para continuar."

__________________________________________________________

Box 1

GO TO SECTION CHQ (CHILD HEALTH AND
WELL-BEING).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

CHQ

Child's Health and Well-Being

__________________________________________________________

CHQ010

QUESTION TEXT:
Question “Now we would like to ask about
{CHILD}’s health and well-being.

“Ahora quisiéramos hablar sobre la salud y el
bienestar de {CHILD}.

How long has it been since {CHILD}'s last visit
to a dentist or dental hygienist for dental care?”

¿Cuánto tiempo hace desde la última vez que
{CHILD} fue a un dentista o higienista dental
para recibir atención dental?”

CODES
1

Never been to dentist or dental hygienist for
dental care
Less than 6 months

Nunca fue a un dentista o higienista dental
para recibir atención dental
Menos de 6 meses

6 months to less than 1 year

6 meses o más pero menos de 1 año

1 year to 2 years

De 1 a 2 años

More than 2 years

Más de 2 años

__________________________________________________________

CHQ020

QUESTION TEXT:
Question “How long has it been since
{CHILD}'s last visit to a clinic, health center,
hospital, doctor's office, or other place for
routine health care?”

“¿Cuánto tiempo hace desde la última vez que
{CHILD} fue a una clínica, centro médico,
hospital, consultorio médico o a otro lugar para
un examen médico de rutina?”

CODES
1

Never had routine health care

Nunca recibió atención de rutina

Less than 6 months

Menos de 6 meses

6 months to less than 1 year

6 meses o más pero menos de 1 año

1 year to 2 years

De 1 a 2 años

More than 2 years

Más de 2 años

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Routine health care may
include check-ups or immunization
appointments.

HELP FOR STEM: Atención médica de rutina puede
incluir citas para exámenes médicos o para
vacunas.

__________________________________________________________

CHQ020a

QUESTION TEXT:
Question “Has {CHILD} missed a well-child
check-up since the coronavirus pandemic
began in March 2020?”

“¿Se ha saltado {CHILD} un examen médico de
rutina desde que empezó la pandemia del
coronavirus en marzo de 2020?”

CODES
1

Yes

CHQ020b

Sí

CHQ020c

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ020c.

__________________________________________________________

CHQ020b
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.

DISPLAY “(Por favor especifique)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “What prevented you from going to a
well-child check-up? Please select all that
apply.”

CODES

“¿Qué le impidió ir a un examen médico de
rutina? Por favor seleccione todo lo que
corresponda.”

Code All That Apply

Cost

Costo

Difficulty getting an appointment (for example,
because the doctor's office was closed, there were
no appointments because of the pandemic)

Unable to get time away from work

Dificultades para conseguir una cita (por
ejemplo, porque el consultorio médico estaba
cerrado, no se conseguía cita por la
pandemia)
No pudo ausentarse del trabajo

Inability to find childcare

No consiguió cuidado infantil

Concern over exposure to coronavirus (COVID-19)

Caring for family members

Preocupación de contagiarse del coronavirus
(COVID-19)
Tuvo que cuidar a algún miembro de la familia

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

Otro {(Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}:

__________________________________________________________

Box 1a

IF CHQ020b = 91, GO TO CHQ020bOS. ELSE,
GO TO CHQ020c.

__________________________________________________________

CHQ020bOS
DISPLAY INSTRUCTIONS:
IF BROWSER SIZE IS LARGE, DISPLAY ITEM CHQ345
and CHQ345OS ON THE SAME SCREEN.

ENTER TEXT

__________________________________________________________

CHQ020c
DISPLAY INSTRUCTIONS:
IN THE FIRST SENTENCE, DISPLAY "virtual" IN
UNDERLINED TEXT.

IN THE FIRST SENTENCE, DISPLAY "virtual" IN
UNDERLINED TEXT.

QUESTION TEXT:

Question “Since March 2020, did {CHILD} ever
have a virtual visit to a dentist or dental
hygienist to discuss dental problems or care?”

“Desde marzo de 2020, ¿alguna vez tuvo
{CHILD} una visita virtual con un dentista o
higienista dental para hablar de problemas
dentales o cuidado de los dientes?”

CODES
1

Yes

Sí

__________________________________________________________

CHQ020d
DISPLAY INSTRUCTIONS:
IN THE FIRST SENTENCE, DISPLAY "virtual" IN
UNDERLINED TEXT.

IN THE FIRST SENTENCE, DISPLAY "virtual" IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “Since March 2020, did {CHILD} ever
have a virtual visit to a clinic, health center,
hospital, doctor's office, or other place for
virtual routine health care?”

“Desde marzo de 2020, ¿alguna vez tuvo
{CHILD} una visita virtual con personal de una
clínica, centro de salud, hospital, consultorio
médico u otro lugar para atención médica
virtual de rutina?”

CODES
1

Yes

Sí

__________________________________________________________

CHQ021

QUESTION TEXT:
Question “Has {CHILD} had an ear infection
since entering kindergarten?”

“¿Ha tenido {CHILD} una infección de oído
desde que entró al kindergarten?”

CODES
1

Yes

CHQ023

Sí
No

__________________________________________________________

CHQ022

QUESTION TEXT:
Question “Has {CHILD} had an ear ache since
entering kindergarten?”

“¿Ha tenido {CHILD} un dolor de oído desde
que entró al kindergarten?”

CODES
1

Yes

CHQ024

Sí

CHQ030

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ030.
__________________________________________________________

CHQ023

QUESTION TEXT:
Question “Since entering kindergarten, how
many times did a doctor, nurse, or other
medical professional tell you that {CHILD} had
an ear infection?”

“Desde que entró a kindergarten, ¿cuántas
veces le ha dicho un doctor, enfermera u otro
personal médico que {CHILD} tenía una
infección de oído?”

Pre-unit “Times:”

Pre-unit “Veces:”

Watermark “Number of times”

Watermark “Número de veces”

ENTER NUMBER
Range

0 to 15

Soft Range

0 to 12

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ023}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ023). Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

Box 1b

IF CHQ023 GE 1, GO TO CHQ024. ELSE, GO
TO CHQ030.

__________________________________________________________

CHQ024
DISPLAY INSTRUCTIONS:
DISPLAY “ear infections” IF CHQ021 = 1. ELSE,
DISPLAY “ear aches”

DISPLAY “las infecciones” IF CHQ021 = 1. ELSE,
DISPLAY “los dolores”

QUESTION TEXT:
Question “How have {CHILD}’s {ear
infections/ear aches} been treated by your
doctor, nurse, or other medical professional
since {she/he/they} entered kindergarten?
Please select all that apply.”

CODES

“¿Qué tratamiento para {las infecciones de
oído/los dolores de oído} recibió {CHILD} de su
doctor, enfermera u otro personal médico desde
que entró al kindergarten? Por favor seleccione
todo lo que corresponda.”

Code All That Apply

No treatment/watch and wait

2
3

Decongestants, antihistamines, or allergy
medication
Antibiotics

Ningún tratamiento/Tenerle bajo observación
y esperar
Descongestionantes, antihistamínicos o
medicinas para la alergia
Antibióticos

Ear tubes were put into {CHILD}’s ears

Le colocaron tubos en los oídos a {CHILD}

Analgesics (for example, fever reducer or pain
reliever)
Ear drops

Analgésicos (por ejemplo, para bajarle la
fiebre o calmarle el dolor)
Gotas para los oídos

Flushing the ear, irrigation, or taking out ear wax

Took out tonsils or adenoids

Enjuague de oído, irrigación o sacar la cera
del oído
Le sacaron las amígdalas o las adenoides

Chiropractic treatments

Tratamientos quiroprácticos

{CHILD} did not go to a doctor, nurse, or medical
professional
Other

{CHILD} no fue a un doctor, enfermera ni
otro personal médico
Otro

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 10, DISPLAY HARD
ERROR CHECK MESSAGE, “You selected
“{CHILD} did not go to a doctor, nurse, or other
medical professional” but also selected another
option on the list. Please check your responses
and update your answer. Then, select “Next” to
continue.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 10, DISPLAY HARD ERROR
CHECK
“Usted seleccionó “{CHILD} no fue a un medico,
enfermera u otro personal médico” pero también
seleccionó otra opción de la lista. Por favor revise
lo que contestó y corrija su respuesta. Luego
seleccione "Siguiente" para continuar.”

__________________________________________________________

Box 2

IF ONE OF THE CODES IN CHQ024 = 4, GO TO
CHQ025. ELSE, GO TO CHQ030.

__________________________________________________________

CHQ025

QUESTION TEXT:
Question “Have ear tubes been placed in the
right ear, left ear, or both ears when {CHILD}
has had surgery to place tubes in
{his/her/their} ears? Please consider all
surgeries since the start of kindergarten if
{CHILD} had more than one to place ear
tubes.”

“Cuando su niño(a) tuvo la cirugía para ponerle
tubos en los oídos, ¿le colocaron un tubito en el
oído derecho, uno en el oído izquierdo, o en
ambos oídos? Por favor tome en cuenta todas
las cirugías desde el comienzo de kindergarten
si es que {CHILD} tuvo más de una para
ponerle tubitos en los oídos.”

CODES
1

Right ear

Oído derecho

Left ear

Oído izquierdo

Both ears

Ambos oídos

__________________________________________________________

CHQ030
DISPLAY INSTRUCTIONS:
FOR "or STATE NAME FOR MEDICAID"; OBTAIN
STATE FROM PRELOAD. THEN DISPLAY NAME FOR
STATE MEDICAID PROGRAM, IF ANY, FROM
PRELOAD. ELSE, IF MISSING, DISPLAY “Medicaid.”

FOR "o STATE NAME FOR MEDICAID"; DISPLAY NAME
FOR STATE MEDICAID PROGRAM, IF ANY, FROM
PRELOAD. ELSE, IF MISSING, DISPLAY “Medicaid.”

QUESTION TEXT:
Question “Is {CHILD} now covered by a health
insurance plan which would pay any part of a
hospital, doctor's, or surgeon's bill? This
includes {Medicaid/{or STATE NAME FOR
MEDICAID}}.”

“¿Tiene actualmente {CHILD} un plan de
cobertura de salud que podría cubrir parte de
las cuentas de hospitales, doctores o cirujanos?
Esto incluye {Medicaid/ {o STATE NAME FOR
MEDICAID}}.”

CODES
1

Yes

Sí

__________________________________________________________

CHQ060

QUESTION TEXT:
Question “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?”

“En una semana normal, ¿cuántos días hace
{CHILD} ejercicios que (lo/la) hagan respirar
rápidamente, transpirar y que aceleren su
corazón durante 20 minutos seguidos o más?

Pre-unit “Days”

Pre-unit “Días”

Watermark “Number of days”

Watermark "Número de días"

ENTER NUMBER
Range

0 to 7

__________________________________________________________

CHQ125
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.

DISPLAY “(Especifique:)” FOR LARGE BROWSERS.
ELSE DISPLAY “(Especifique en la siguiente pantalla.)”
FOR SMALL BROWSERS.
FOR CATEGORY 7, DISPLAY ADDITIONAL TEXT
"(incluyendo trastorno de pánico, trastorno obsesivo
compulsivo, otros trastornos de ansiedad, trastorno
bipolar, depresión, trastorno de oposición desafiante
(ODD), trastornos de la alimentación, trastornos por
déficit sensorial y esquizofrenia)".

QUESTION TEXT:
Question “Now we have some questions about
diagnoses from a professional.

“Ahora tenemos algunas preguntas acerca de
diagnósticos hechos por un profesional.

Has {CHILD} ever been diagnosed by a
professional with any of the following? Please
select all that apply”

¿Alguna vez {CHILD} ha sido diagnosticado(a)
por un profesional con alguna de las siguientes
cosas? Por favor seleccione todo lo que
corresponda.”

CODES
1

Code All That Apply

Developmental delay

Discapacidad del aprendizaje (incluyendo
dislexia, discalculia y disgrafia)
Trastorno de déficit de atención (ADD) /
Trastorno de déficit de
atención/hiperactividad (ADHD)
Retraso en el desarrollo

Asperger’s syndrome/Autism/Pervasive
developmental disorder (PDD)/Other autism
spectrum disorder
Intellectual or cognitive disability

Síndrome de Asperger/Autismo/Trastorno
generalizado en el desarrollo (PDD)/Otro
trastorno del espectro autista
Discapacidad intelectual o cognitiva

Orthopedic impairment

Discapacidad ortopédica

Emotional disturbance (including panic disorder,
obsessive compulsive disorder, other anxiety
disorders, bipolar disorder, depression,
oppositional defiance disorder (ODD), eating
disorders, sensory deficit disorders, and
schizophrenia)
Traumatic brain injury

Disturbio emocional {DISPLAY FOR
CATEGORY 7}

Speech impairment (such as problems with
articulation or communication, voice disorders, or
stuttering)
None of the above

Problemas del habla (tal como problemas
con la expresión o comunicación, trastornos
de la voz, o tartamudeo)
Ninguno de estos

Other diagnosis of a social, emotional, or
behavioral issue {(Please specify):/(Please specify
on next screen.)}:

Otro diagnóstico de un problema social,
emocional o de comportamiento {(Por favor
especifique):/(Por favor especifique en la
pantalla siguiente.)}:

8
9

10
91

Learning disability (including dyslexia, dyscalculia,
and dysgraphia)
Attention deficit disorder (ADD) / Attentiondeficit/hyperactivity disorder (ADHD)

Lesión cerebral traumática

PROGRAMMER INSTRUCTIONS:
DISPLAY CODE 10 ABOVE CODE 91.
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 10, 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 IN HELP TEXT ON FIRST INSTANCE ONLY:
"Learning disability", "Attention deficit disorder
(ADD) / Attention-deficit/hyperactivity disorder
(ADHD)", "Developmental delay", "Asperger's
syndrome/autism/pervasive developmental
disorder (PDD)/Other autism spectrum disorder",
"Intellectual or cognitive disability", "Orthopedic
impairment", "Emotional disturbance",
"Traumatic brain Injury", AND “Speech
impairment.”
HELP FOR CODE 1: Learning disability: A
disorder in one or more psychological processes
for understanding or using language, which
shows up as difficulty learning to listen, think,
speak, read, write, spell, or do mathematical
calculations. Some names of learning
disabilities are dyslexia, dyscalculia, dysgraphia,
developmental aphasia, minimal brain
dysfunction, brain injury, and perceptual
disabilities. A commonly used acronym is "LD."
Children with "specific learning disorder" are
included here.
HELP FOR CODE 2: Attention deficit disorder
(ADD) / Attention-deficit/hyperactivity disorder
(ADHD): A childhood syndrome characterized by
short attention span that is inappropriate for the
child's age group, with or without hyperactivity.
Inattention means difficulty concentrating, easily
distracted, and not finishing things started.
Impulsivity means often acts before thinking,
shifts excessively from one activity to another,
needs a lot of supervision. Hyperactivity means
runs about or climbs on things excessively, has
difficulty staying seated, always on the go, as if
driven by a motor.
HELP FOR CODE 3: Developmental delay: A
condition in which a young child falls
significantly behind children of the same age in
physical, mental, speech , social/emotional,
and/or adaptive development. It does not simply

BOLD IN HELP TEXT ON FIRST INSTANCE ONLY:
"Discapacidad del aprendizaje", " Trastorno de
Déficit de atención (ADD por sus siglas en inglés)
/ Trastorno de Déficit de Atención e Hiperactividad
(ADHD por sus siglas en inglés)", "Retraso en el
Desarrollo ", " Síndrome de
Asperger/Autismo/Trastorno Generalizado en el
Desarrollo (PDD por sus siglas en inglés)/Otro
trastorno del espectro autista", " Discapacidad
intelectual/Discapacidad cognitiva", " Discapacidad
ortopédica", " Perturbación emocional", " Lesión
cerebral traumática", AND “Trastornos del habla
(como problemas de articulación o comunicación,
trastornos de la voz o tartamudeo).”
HELP FOR CODE 1: Discapacidad del aprendizaje:
Un trastorno en uno o más procesos psicológicos
que afectan el entendimiento o el uso del
lenguaje, que se evidencia como una dificultad
para escuchar, pensar, hablar, leer, escribir,
deletrear o hacer cálculos matemáticos. Algunos
problemas de aprendizaje son dislexia, discalculia,
disgrafía, afasia del desarrollo , mínima disfunción
cerebral , lesión cerebral, y discapacidades
perceptivas. Generalmente se lo llama por la sigla
“LD.” Aquí se incluyen los niños con “trastorno
específico del aprendizaje”.
HELP FOR CODE 2: Trastorno de Déficit de
atención (ADD por sus siglas en inglés) /
Trastorno de Déficit de Atención e Hiperactividad
(ADHD por sus siglas en inglés): Un síndrome
infantil caracterizado por falta de atención
inadecuada para la edad del niño(a), con o sin
hiperactividad. La falta de atención quiere decir
dificultad en concentrarse, se distrae fácilmente y
no termina las cosas que empieza. La impulsividad
quiere decir que a menudo actúa antes de pensar,
cambia excesivamente de una actividad a otra,
necesita mucha supervisión. Hiperactividad
quiere decir que corre mucho o se trepa encima de
cosas excesivamente, tiene dificultad para
permanecer sentado, siempre está en movimiento,
como si tuviera un motor.
HELP FOR CODE 3: Retraso en el Desarrollo: Un
problema en el cual un niño pequeño se retrasa
significativamente en comparación con sus
compañeros de la misma edad, en el desarrollo
físico, mental (cognitivo), del habla
(comunicación), social/emocional, desarrollo
adaptativo (comportamiento). Esto no quiere decir

mean that the child talked somewhat later than
some children or was smaller than average. If
the child's social behavior and relationships with
other people are generally consistent with the
child's delayed cognitive development, then the
classification of the condition as developmental
delay is probably appropriate.
HELP FOR CODE 4: Asperger’s
syndrome/Autism/Pervasive developmental
disorder (PDD)/Other autism spectrum disorder:
Asperger’s is a developmental disability with
symptoms that are less severe than autism but
include similar characteristics. Autism refers to
developmental disabilities that significantly
affecting verbal and nonverbal communication
as well as social interaction. There is often an
insistence on sameness, as shown by
stereotyped play, abnormal preoccupations, or
resistance to change. Characteristics often
associated with autism are a pervasive lack of
responsiveness to other people, and
engagement in repetitive activities and
stereotyped movements (such as hand-flapping
or rocking). With autism, the impaired social and
language development are not caused by
cognitive delay. Some children with autism are
actually advanced in selected areas. Pervasive
developmental disorder may include excessive
anxiety, inappropriate affect or emotions, odd
movement, speech abnormalities,
hypersensitivity to sensory stimuli, and selfmutilation. Children with "autism spectrum
disorder (ASD)" are included here.
HELP FOR CODE 5: Intellectual or cognitive
disability: The child's mental development is
significantly and noticeably behind what would
ordinarily be expected for a child of their age.
This significantly below average general
intellectual functioning exists at the same time
as problems in adaptive behavior, and
negatively affects the child’s educational
performance. "Intellectual developmental
disorder" and mental retardation would also be
included here.
HELP FOR CODE 6: Orthopedic impairment: A
physical impairment that is severe enough to
negatively affect a child’s educational
performance. Disabling physical problems such
as those resulting from polio, cerebral palsy,
amputations, and fractures or contractures from

simplemente que el niño(a) empezó a hablar más
tarde que otros niños o que era de menor tamaño
que el promedio. Si la conducta social del niño(a)
y las relaciones con otras personas son
generalmente consistentes con el retraso de su
desarrollo cognitivo, entonces la clasificación de la
condición como un retraso en el desarrollo
probablemente es apropiada.
HELP FOR CODE 4: Síndrome de
Asperger/Autismo/Trastorno Generalizado en el
Desarrollo (PDD por sus siglas en inglés)/Otro
trastorno del espectro autista: El síndrome de
Asperger es una discapacidad del desarrollo con
síntomas menos graves que el autismo, pero con
características similares. El autismo es una
discapacidad en el desarrollo que afecta
significativamente la comunicación verbal y no
verbal, así como la interacción social. Con
frecuencia también hay una insistencia en hacer lo
mismo, como se muestra en juegos
estereotipados, preocupaciones anormales o
resistencia al cambio. Otras características que se
asocian frecuentemente con el autismo son la
falta generalizada de capacidad de reacción a
otras personas, y hacer actividades repetitivas y
movimientos estereotipados (como aleteo con las
manos o balancearse). Con el autismo, la
discapacidad en el desarrollo social y el desarrollo
del habla o el lenguaje, no se deben a un retraso
cognitivo del niño(a). De hecho, algunos niños con
autismo están avanzados en determinadas áreas.
El Trastorno Generalizado del Desarrollo puede
incluir ansiedad excesiva, afecto o emociones
inapropiados, rarezas de movimientos motores,
anomalías del habla, hipersensibilidad a los
estímulos sensoriales y automutilación. Aquí se
incluyen los niños con “trastorno del espectro
autista (ASD por sus siglas en inglés)”.
HELP FOR CODE 5: Discapacidad
intelectual/Discapacidad cognitiva: El desarrollo
mental del niño(a) está retrasado de manera
significativa y evidente en comparación con lo que
se esperaría de un niño(a) de su edad. Este
funcionamiento intelectual general
significantemente por debajo del promedio existe
al mismo tiempo que los problemas de conducta
adaptativa, y afecta negativamente el desempeño
educativo del niño(a). También se incluirían aquí
el “Trastorno del desarrollo intelectual” y el
retraso mental.

burns would be considered as orthopedic
impairments.
HELP FOR CODE 7: Emotional disturbance: A
condition with one or more of the following
characteristics over a long period of time that
negatively affect a child's educational
performance: (a) an inability to learn that
cannot be explained by other factors; (b) an
inability to build or maintain satisfactory
interpersonal relationships; © inappropriate
behavior or feelings; (d) a general mood of
unhappiness or depression; or € a tendency to
develop physical symptoms or fears associated
with personal or school problems. Examples
include panic disorder, obsessive compulsive
disorder, other anxiety disorders (for example,
separation anxiety disorder or generalized
anxiety disorder), bipolar disorder, depression,
oppositional defiance disorder (ODD), eating
disorders, and schizophrenia. Sensory deficit
disorder (such as sensory deprivation problems,
sensory processing problems, sensory
integration problems, or sensory organization
problems) would also be included.
HELP FOR CODE 8: Traumatic brain injury: An
acquired injury to the brain caused by an
external force, resulting in total or partial
functional disability or psychosocial impairment,
or both, that adversely affects a child's
educational performance. It may result in
impairments in cognition; language; memory;
attention; reasoning; abstract thinking;
judgment; problem-solving; sensory, perceptual,
and motor abilities; psycho-social behavior;
physical functions; information processing; and
speech. The term does not apply to brain
injuries that are congenital (there at birth) or
degenerative (problem that grows worse over
time), or to brain injuries brought on by birth
trauma.
HELP FOR CODE 9: Speech impairment (such as
problems with articulation or communication,
voice disorders, or stuttering): Speech problems
include many issues a child may show when he
or she talks. The listener may not be able to
hear the child, the child may not speak clearly,
or the child may use sounds or say words the
listener is not familiar with.

HELP FOR CODE 6: Discapacidad ortopédica: Una
discapacidad corporal (o física) suficientemente
severa como para afectar negativamente el
desempeño educativo del niño(a). Los problemas
físicos incapacitantes tales como los que resultan
de la poliomielitis (que a menudo se llama polio o
parálisis infantil), parálisis cerebral, amputaciones
y fracturas o contracturas por quemaduras, se
considerarían como impedimentos ortopédicos.
HELP FOR CODE 7: Perturbación emocional:
Trastorno que presenta una o más de las
siguientes características durante un largo periodo
de tiempo y que afecta negativamente al
rendimiento educativo del niño: a) incapacidad
para aprender que no puede explicarse por otros
factores; b) incapacidad para establecer o
mantener relaciones interpersonales
satisfactorias; comportamiento o sentimientos
inadecuados; d) estado de ánimo general de
infelicidad o depresión; o tendencia a desarrollar
síntomas físicos o miedos asociados a problemas
personales o escolares. Algunos ejemplos son el
trastorno de pánico, el trastorno obsesivo
compulsivo, otros trastornos de ansiedad (por
ejemplo, el trastorno de ansiedad por separación o
el trastorno de ansiedad generalizada), el
trastorno bipolar, la depresión, el trastorno
negativista desafiante (TOD), los trastornos de la
conducta alimentaria y la esquizofrenia. También
se incluiría el trastorno por déficit sensorial (como
los problemas de privación sensorial, los
problemas de procesamiento sensorial, los
problemas de integración sensorial o los
problemas de organización sensorial).
HELP FOR CODE 8: Lesión cerebral traumática:
Lesión cerebral adquirida causada por una fuerza
externa, que provoca una discapacidad funcional
total o parcial o un deterioro psicosocial, o ambos,
que afecta negativamente al rendimiento
educativo del niño. Puede dar lugar a deficiencias
en la cognición, el lenguaje, la memoria, la
atención, el razonamiento, el pensamiento
abstracto, el juicio, la resolución de problemas, las
capacidades sensoriales, perceptivas y motoras, el
comportamiento psicosocial, las funciones físicas,
el procesamiento de la información y el habla. El
término no se aplica a las lesiones cerebrales
congénitas (de nacimiento) o degenerativas
(problema que empeora con el tiempo), ni a las
lesiones cerebrales provocadas por un
traumatismo al nacer.

HELP FOR CODE 9: Trastornos del habla (como
problemas de articulación o comunicación,
trastornos de la voz o tartamudeo): Los problemas
del habla incluyen muchas cuestiones que un niño
puede mostrar cuando habla. Es posible que el
oyente no pueda oír al niño, que el niño no hable
con claridad o que el niño utilice sonidos o diga
palabras con las que el oyente no esté
familiarizado.
__________________________________________________________

Box 3

IF CHQ125 = 91, GO TO CHQ125OS. ELSE,
GO TO BOX 4.

__________________________________________________________

CHQ125OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY
TOGETHER ON SAME PAGE.

ENTER TEXT

__________________________________________________________

Box 4

IF CHQ125 HAS A CODE OF 1 (LEARNING
DISABILITY), GO TO CHQ125a. ELSE IF
CHQ125 HAS A CODE OF 4
(ASPERGER’S/AUTISM/PDD), GO TO CHQ126.
ELSE IF CHQ125 HAS A CODE OF 7
(EMOTIONAL DISTURBANCE), GO TO CHQ127.
ELSE, GO TO BOX 6.

__________________________________________________________

CHQ125a
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “What type of learning disability does
{CHILD} have? Please select all that apply.”

CODES

“¿Qué tipo de discapacidad del aprendizaje
tiene {CHILD}? Por favor seleccione todo lo que
corresponda.”

Code All That Apply

Dyslexia

Dislexia

Dyscalculia

Discalculia

Dysgraphia

Disgrafia

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

Otro (Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}

PROGRAMMER INSTRUCTIONS:
BOLD IN HELP TEXT ON FIRST INSTANCE ONLY:
"Dyslexia", “Dyscalculia”, “Dysgraphia”
HELP FOR CODE 1: Dyslexia: Dyslexia is an
impairment of ability to recognize and
comprehend the written word.
HELP FOR CODE 2: Dyscalculia: Dyscalculia is
an impairment in ability to perform and
remember calculations in mathematics.

HELP FOR CODE 1: Dislexia: Dislexia es un
impedimento en la capacidad de reconocer y
comprender la palabra escrita.
HELP FOR CODE 2: Discalculia: Discalculia es un
impedimento en la capacidad de hacer cálculos en
las matemáticas.
HELP FOR CODE 3: Disgrafia: Disgrafia es un
impedimento en expresarse por escrito.

HELP FOR CODE 3: Dysgraphia: Dysgraphia is
an impairment in written expression.
__________________________________________________________

Box 5

IF CHQ125a = 91, GO TO CHQ125aOS. ELSE,
GO TO BOX 6.

__________________________________________________________

CHQ125aOS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.

ENTER TEXT

__________________________________________________________

Box 6

IF CHQ125 HAS A CODE OF 4
(ASPERGER’S/AUTISM/PDD), GO TO CHQ126.
ELSE IF CHQ125 HAS A CODE OF 7
(EMOTIONAL DISTURBANCE), GO TO CHQ127.
ELSE, GO TO BOX 8.

__________________________________________________________

CHQ126
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “What type of autism spectrum
disorder does {CHILD} have?”

Question “¿Qué tipo de trastorno del espectro
autista tiene {CHILD}?”

CODES
1

Asperger's syndrome

Síndrome de Asperger

Autism

Autismo

Pervasive developmental disorder (PDD)

Trastorno generalizado en el desarrollo (PDD)

Rett syndrome

Síndrome de Rett

Childhood disintegrative disorder (CDD)

Trastorno desintegrativo infantil (CDD)

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

Otro {(Por favor especifique):/( Por favor
especifique en la pantalla siguiente.)}:

PROGRAMMER INSTRUCTIONS:
BOLD, IN HELP TEXT ON FIRST INSTANCE ONLY:
"Autism", “Asperger’s syndrome”, “Pervasive
developmental disorder (PDD)”, “Rett
syndrome”, and “Childhood disintegrative
disorder (CDD)”.

BOLD, IN HELP TEXT ON FIRST INSTANCE ONLY:
"Autismo", “Síndrome de Asperger”, “Trastorno
generalizado en el desarrollo (PDD)”, “Síndrome
de Rett”, and “Trastorno desintegrativo infantil
(CDD)”.

HELP FOR CODE 1: Asperger’s syndrome:
Asperger’s is a developmental disability with
symptoms that are less severe than autism but
include similar characteristics.

HELP FOR CODE 1: Síndrome de Asperger: El
síndrome de Asperger es una discapacidad del
desarrollo con síntomas menos graves que el
autismo, pero con características similares.

HELP FOR CODE 2: Autism: Autism refers to
developmental disabilities that significantly
affecting verbal and nonverbal communication
as well as social interaction. There is often an
insistence on sameness, as shown by
stereotyped play, abnormal preoccupations, or
resistance to change. Characteristics often
associated with autism are a pervasive lack of
responsiveness to other people, and
engagement in repetitive activities and
stereotyped movements (such as hand-flapping
or rocking). With autism, the impaired social and
language development are not caused by

HELP FOR CODE 2: El autismo es una
discapacidad en el desarrollo que afecta
significativamente la comunicación verbal y no
verbal, así como la interacción social. Con
frecuencia también hay una insistencia en hacer lo
mismo, como se muestra en juegos
estereotipados, preocupaciones anormales o
resistencia al cambio. Otras características que se
asocian frecuentemente con el autismo son la
falta generalizada de capacidad de reacción a
otras personas, y hacer actividades repetitivas y
movimientos estereotipados (como aleteo con las
manos o balancearse). Con autismo, la

cognitive delay. Some children with autism are
actually advanced in selected areas. Pervasive
developmental disorder may include excessive
anxiety, inappropriate affect or emotions, odd
movement, speech abnormalities,
hypersensitivity to sensory stimuli, and selfmutilation. Children with "autism spectrum
disorder (ASD)" are included here.
HELP FOR CODE 3: Pervasive development
disorder (PDD): Pervasive developmental
disorder may include excessive anxiety,
inappropriate affect or emotions, odd movement,
speech abnormalities, hypersensitivity to
sensory stimuli, and self-mutilation.
HELP FOR CODE 4: Rett syndrome: Rett
syndrome is a genetic neurological disorder that
affects the way the brain develops and impairs
individuals’ ability to speak, walk, eat, and
breathe easily. This disorder primarily affects
girls. Over time, children with Rett syndrome
have increasing problems with the use of
muscles that control movement, coordination
and communication. Rett syndrome can also
cause seizures and intellectual disability.
Abnormal hand movements, such as repetitive
rubbing or clapping, often replace purposeful
hand use.
HELP FOR CODE 5: Childhood disintegrative
disorder (CDD): Childhood disintegrative
disorder, also known as Heller's syndrome and
disintegrative psychosis, is a rare condition
characterized by late onset (>3 years of age) of
developmental delays in language, social
function, and motor skills. Children with CDD
may lose social skills (for example, making eye
contact); lose bowel and bladder control; lose
the ability to understand what others are saying;
lose motor skills; exhibit odd body movements,
such as walking on tiptoe, flicking fingers for
long periods, or banging their head; lose the
ability to speak; or be unable to start a
conversation or keep one going.

discapacidad en el desarrollo social y el desarrollo
del habla o el lenguaje, no se deben a un retraso
cognitivo del niño(a). De hecho, algunos niños con
autismo están avanzados en determinadas áreas.
El Retraso o Trastorno Generalizado en el
Desarrollo (PDD) puede incluir ansiedad excesiva,
afecto o emociones inapropiadas, rarezas de
movimientos motores, anormalidades del habla,
hipersensibilidad a los estímulos sensoriales, y
auto-mutilación. Los niños con “trastorno del
espectro autista (ASD)” se incluyen aquí.
HELP FOR CODE 3: Retraso o Trastorno
Generalizado en el Desarrollo (PDD): El Retraso o
Trastorno Generalizado en el Desarrollo (PDD)
puede incluir ansiedad excesiva, afecto o
emociones inapropiadas, rarezas de movimientos
motores, anormalidades del habla,
hipersensibilidad a los estímulos sensoriales, y
auto-mutilación.
HELP FOR CODE 4: Síndrome de Rett: El síndrome
de Rett es un trastorno neurológico genético que
afecta al modo en que se desarrolla el cerebro y
es un impedimento a la capacidad de las personas
para hablar, andar, comer y respirar con facilidad.
Este trastorno afecta principalmente a las niñas.
Con el tiempo, los niños con síndrome de Rett
tienen cada vez más problemas con el uso de los
músculos que controlan el movimiento, la
coordinación y la comunicación. El síndrome de
Rett también puede causar convulsiones y
discapacidad intelectual. Los movimientos
anormales de las manos, como frotarse o aplaudir
repetidamente, suelen sustituir al uso
intencionado de las manos.
HELP FOR CODE 5: Trastorno desintegrativo
infantil (CDD): El trastorno desintegrativo infantil,
también conocido como síndrome de Heller y
psicosis desintegrativa, es una enfermedad rara
caracterizada por la aparición tardía (más de 3
años de edad) de retrasos en el desarrollo del
lenguaje, la función social y las habilidades
motoras. Los niños con CDD pueden perder
habilidades sociales (por ejemplo, establecer
contacto visual); perder el control de esfínteres;
perder la capacidad de entender lo que dicen los
demás; perder habilidades motoras; mostrar
movimientos corporales extraños, como caminar
de puntillas, chasquear los dedos durante largos
periodos o golpearse la cabeza; perder la
capacidad de hablar; o ser incapaces de iniciar

una conversación o mantenerla.
__________________________________________________________

Box 7

IF CHQ126 = 91, GO TO CHQ126OS. ELSE,
GO TO BOX 8.

__________________________________________________________

CHQ126OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.

ENTER TEXT

__________________________________________________________

Box 8

IF CHQ125 HAS A CODE OF 7 (EMOTIONAL
DISTURBANCE), GO TO CHQ127.
ELSE, GO TO BOX 10.

__________________________________________________________

CHQ127
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “What type of emotional disturbance
does {CHILD} have? Please select all that
apply.”

“¿Qué tipo de perturbación emocional tiene
{CHILD}? Por favor seleccione todo lo que
corresponda.”

CODES
1

Panic disorder

Trastorno de pánico

Separation anxiety disorder

Trastorno de ansiedad por separación

Obsessive compulsive disorder

Trastorno obsesivo compulsivo

Generalized anxiety disorder

Trastorno de ansiedad generalizada

Other anxiety disorder

Otro trastorno de ansiedad

Bipolar disorder

Trastorno bipolar

Depression

Depresión

Oppositional defiant disorder (ODD)

Trastorno de oposición desafiante

Eating disorders

Trastornos de la alimentación

Sensory deficit disorders (such as sensory
deprivation problems; sensory processing
problems; sensory integration problems; or
sensory organization problems)

Schizophrenia

Trastornos por déficit sensorial (como
problemas de privación sensorial, problemas
de procesamiento sensorial, problemas de
integración sensorial o problemas de
organización sensorial)
Esquizofrenia

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

Otro {(Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}:

PROGRAMMER INSTRUCTIONS:
BOLD, IN HELP TEXT ON FIRST INSTANCE ONLY:
"Panic disorder", “Separation anxiety disorder”,
“Obsessive compulsive disorder”, “Generalized
anxiety disorder”, “Other anxiety disorder”,
“Bipolar disorder”, “Depression”, “Oppositional
defiant disorder (ODD)”, “Eating disorder”,
“Sensory deficit disorder,” AND “Schizophrenia.”
HELP FOR CODE 1: Panic disorder: A disorder in
which there is the sudden onset of several
different physical signs, such as rapid heart rate,
shaking, sweating, nausea, dizziness, and

BOLD, IN HELP TEXT ON FIRST INSTANCE ONLY:
"Trastorno de pánico", “Trastorno de ansiedad por
separación”, “Trastorno obsesivo compulsivo”,
“Trastorno de ansiedad generalizada”, “Otro
trastorno de ansiedad”, “Trastorno bipolar”,
“Depresión”, “Trastorno de oposición desafiante
(ODD)”, “Trastorno de la alimentación”, “Trastorno
de déficit sensorial,” AND “Esquizofrenia.”
HELP FOR CODE 1: Trastorno de Pánico: Un
trastorno en que aparecen de manera repentina
diferentes señales físicas, como palpitaciones

difficulty breathing. A panic disorder may make
a child think that something horrible is about to
happen.
HELP FOR CODE 2: Separation anxiety disorder:
This is the fear a child has of being separated
from the child's parents which is far more than
would be expected for the child’s developmental
stage.
HELP FOR CODE 3: Obsessive compulsive
disorder: A child must have obsessions or
compulsions or both to have this disorder, and
these obsessions and/or compulsions must be
disabling to the child. Obsessions are thoughts
that aren’t visible to others but cause the child
distress. The thoughts occur over and over and
the child spends so much time on them that
they have a hard time taking care of themselves
or relating to others. Compulsions are mental
acts that a child feels driven to perform in
response to an obsession.
HELP FOR CODE 4: Generalized anxiety
disorder: Children who have this disorder worry
all the time over nothing, themselves, other’s
safety, their health, and/or the world to a far
greater extent than average. They often have
many physical signs of anxiety such as
headache, abdominal pain, cramps, diarrhea,
vomiting, and dizziness.
HELP FOR CODE 5: Other anxiety disorders: An
anxiety disorder that is not one of the specific
disorders in this list.
HELP FOR CODE 6: Bipolar disorder: A child with
bipolar disorder displays signs of major mood
changes, sometimes sad, as in depression, or
the opposite, mania. All bipolar disorders are a
combination of mania with or without
depression. Some signs of mania include inflated
self-esteem, decreased need for sleep,
distractibility and increased activity. Some signs
of depression are sleeping too much, poor
appetite, feelings of severe worthlessness,
hallucinations or strange beliefs about the past.
HELP FOR CODE 7: Depression: Some signs of
depression are frequent sadness, loss of interest
or enjoyment of activities, low energy, isolation
from friends, sleeping too much, poor appetite, a
severe sense of worthlessness, problems with

rápidas, temblores, sudores, nausea, mareo, y
dificultad para respirar. Un trastorno de pánico
puede hacer que un niño piense que algo horrible
va a pasar.
HELP FOR CODE 2: Trastorno de Ansiedad por
Separación: Este es el temor que tiene el niño(a)
de separarse de sus padres, que es mucho más
intenso de lo que se espera para el estado de
desarrollo del niño(a).
HELP FOR CODE 3: Trastorno Obsesivo
Compulsivo: Un niño debe tener obsesiones o
compulsiones, o ambas para tener este trastorno,
y estas obsesiones y/o compulsiones deben ser
incapacitantes para el niño(a). Las obsesiones
son pensamientos que no son visibles a otros pero
que le causan angustia al niño(a). Los
pensamientos ocurren una y otra vez y el niño(a)
pasa tanto tiempo pensando en ellos que le es
difícil cuidar de sí mismo o relacionarse con otros.
Las compulsiones son actos mentales que el
niño(a) siente que debe hacer en respuesta a una
obsesión.
HELP FOR CODE 4 Trastorno de Ansiedad
Generalizada: Los niños que tienen este trastorno
se preocupan siempre por cualquier cosa, por ellos
mismos, por la seguridad de otros, por su salud,
y/o por el mundo, en mucho mayor medida que el
promedio. Con frecuencia tienen muchas señales
de ansiedad como dolor de cabeza, dolor de
estómago, retortijones, diarrea, vómitos y mareos.
HELP FOR CODE 5 Otro Trastorno de Ansiedad:
Otro trastorno de ansiedad que no es uno de los
trastornos especificados en esta lista.
HELP FOR CODE 6: Desorden Bipolar: Un niño(a)
con desorden bipolar muestra síntomas de
cambios muy serios de estado de ánimo, a veces
triste, como con depresión, o lo opuesto, como
manía. Todos los desórdenes bipolares son una
combinación de manía con o sin depresión.
Algunos síntomas de manía pueden ser exagerada
confianza en sí mismo(a), menos necesidad de
dormir, distracción y aumento de actividad.
Algunos síntomas de depresión son dormir
demasiado, falta de apetito, sentimientos severos
de ser inútil, alucinaciones o creencias raras sobre
el pasado.

concentration, frequent complaints of physical
illnesses, and thoughts of suicide or destructive
behavior.
HELP FOR CODE 8: Oppositional defiant disorder
(ODD): ODD refers to children whose
uncooperative, defiant, or hostile behavior
disrupts daily life. All children show such
behavior in particular circumstances – such as
when they are tired, not feeling well, or under
unusual stress. However, identification of ODD
comes with such behavior that (1) occurs with
unusual frequency, (2) occurs in more than one
setting - such as home, school, church, or
supermarket, and (3) is not appropriate for the
age. Examples include the following: the child
has frequent temper tantrums; argues
excessively with adults; challenges rules or
authority; is defiant and refuses to comply with
adult requests and rules; purposely tries to
annoy or upset people; blames others for their
mistakes or misbehavior; is often touchy or
easily annoyed by others; has frequent anger
and resentment; talks in a mean and hateful
way when upset; or has a spiteful attitude and
seeks revenge.
HELP FOR CODE 9: Eating disorders: Eating
disorders are severe disturbances in eating
behaviors and related thoughts and emotions.
They include, for example, anorexia nervosa,
bulimia nervosa, binge eating disorder, pica,
rumination, and avoidant/restrictive food intake
disorders.
HELP FOR CODE 10: Sensory deficit disorders
(such as sensory deprivation problems; sensory
processing problems; sensory integration
problems; or sensory organization problems):
This should not be confused with attention
deficit disorder, vision problems, or hearing
problems. Sensory deficit disorder, sensory
processing disorder, and sensory integration
disorder are terms that refer to problems a child
may have correctly organizing or interpreting
sensory information. The child reacts to sensory
information (what is seen, heard, touched, etc.)
in an unexpected way. Some examples are
strong reactions to smelling certain perfumes,
oversensitivity to the touch of certain fabrics or
even to any fabric, or overreactions to loud
noises. When the level of sensitivity creates a
problem with age-appropriate behavior or

HELP FOR CODE 7: Depresión: Algunos síntomas
de depresión son tristeza frecuente, pérdida de
interés o placer en hacer actividades, poca
energía, mantenerse aislado de los amigos, dormir
demasiado, poco apetito, un profundo sentimiento
de sentirse inútil, problemas de concentración,
quejas frecuentes de enfermedades físicas, y
pensamientos de suicidio o conducta destructiva.
HELP FOR CODE 8: Trastorno de oposición
desafiante (ODD): El ODD se refiere a los niños
cuyo comportamiento poco colaborador, desafiante
u hostil perturba la vida cotidiana. Todos los niños
muestran este comportamiento en determinadas
circunstancias como cuando están cansados, no se
sienten bien o están sometidos a un estrés
inusual. Sin embargo, la identificación del ODD se
produce cuando el comportamiento (1) se produce
con una frecuencia inusual, (2) ocurre en más de
un entorno, como el hogar, la escuela, la iglesia o
el supermercado, y (3) no es apropiado para la
edad. Algunos ejemplos son los siguientes: el niño
tiene rabietas frecuentes; discute excesivamente
con los adultos; desafía las normas o la autoridad;
es desafiante y se niega a cumplir las peticiones y
normas de los adultos; intenta molestar o enfadar
a la gente a propósito; culpa a los demás de sus
errores o mal comportamiento; suele ser
susceptible o se enfada fácilmente con los demás;
tiene enfados y resentimientos frecuentes; habla
de forma mezquina y odiosa cuando está
enfadado; o tiene una actitud rencorosa y busca la
venganza.
HELP FOR CODE 9. Trastornos de la alimentación:
Los trastornos de la alimentación son alteraciones
graves de la conducta alimentaria y de los
pensamientos y emociones relacionados con ella.
Incluyen, por ejemplo, la anorexia nerviosa, la
bulimia nerviosa, el trastorno por atracón, la pica,
la rumiación y los trastornos de evitar o restringir
ingerir alimentos.
HELP FOR CODE 10: Trastornos por déficit
sensorial (como problemas de privación sensorial,
problemas de procesamiento sensorial, problemas
de integración sensorial o problemas de
organización sensorial): No deben confundirse con
el trastorno por déficit de atención, los problemas
de visión o los problemas auditivos. Trastorno por
déficit sensorial, trastorno de procesamiento

activities, or age-appropriate functioning at
home or school then it becomes a problem.
HELP FOR CODE 11: Schizophrenia: This is
severe mental disorder characterized by
incoherent or illogical thoughts. Children with
schizophrenia may have hallucinations (for
example, hear voices), delusions, and thinking
or behavior that interferes with their ability to
function.

sensorial y trastorno de integración sensorial son
términos que hacen referencia a los problemas
que puede tener un niño para organizar o
interpretar correctamente la información sensorial.
El niño reacciona a la información sensorial (lo
que ve, oye, toca, etc.) de forma inesperada.
Algunos ejemplos son las fuertes reacciones al
oler determinados perfumes, la hipersensibilidad
al tacto de ciertos tejidos o incluso a cualquier
tejido, o las reacciones exageradas a los ruidos
fuertes. Cuando el nivel de sensibilidad crea un
problema con el comportamiento o las actividades
propias de la edad, o con el funcionamiento
adecuado a la edad en casa o en la escuela,
entonces se convierte en un problema.
HELP FOR CODE 11: Esquizofrenia: Se trata de un
trastorno mental grave caracterizado por
pensamientos incoherentes o ilógicos. Los niños
con esquizofrenia pueden tener alucinaciones (por
ejemplo, oír voces), delirios y pensamientos o
comportamientos que interfieren en su capacidad
para funcionar.

__________________________________________________________

Box 9

IF CHQ127 = 91, GO TO CHQ127OS. ELSE,
GO TO BOX 10.

__________________________________________________________

CHQ127OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.

ENTER TEXT

__________________________________________________________

Box 10

IF CHQ125 = 10 OR SK (NO DISABILITIES OR
SKIPPED) GO TO CHQ200.
ELSE START LOOP 1
ASK CHQ130, CHQ131a, CHQ131b, CHQ135a,
AND CHQ135b (IF APPLICABLE ACCORDING TO
THE SKIPS BETWEEN THE ITEMS) FOR EACH
DIAGNOSIS IN CHQ125, UP TO 10 TIMES. THE
DIAGNOSIS LISTED AS AN “OTHER SPECIFY”
SHOULD ALSO BE PART OF THIS LOOP.
LOOPING ELIGIBILITY:
IF CHQ125 = 1, ASK ABOUT A LEARNING
DISABILITY.
IF CHQ125 = 2, ASK ABOUT ATTENTION
DEFICIT DISORDER (ADD)/ ATTENTIONDEFICIT/HYPERACTIVITY DISORDER (ADHD).
IF CHQ125 = 3, ASK ABOUT DEVELOPMENTAL
DELAY.
IF CHQ125 = 4, ASK ABOUT ASPERGER’S
SYNDROME/AUTISM/PERVASIVE
DEVELOPMENT DISORDER (PDD)/OTHER
AUTISM SPECTRUM DISORDER.
IF CHQ125 = 5, ASK ABOUT INTELLECTUAL
DISABILITY/COGNITIVE DISABILITY.
IF CHQ125 = 6, ASK ABOUT ORTHOPEDIC
IMPAIRMENT.
IF CHQ125 = 7, ASK ABOUT EMOTIONAL
DISTURBANCE.
IF CHQ125 = 8, ASK ABOUT TRAUMATIC
BRAIN INJURY.
IF CHQ125 = 9, ASK ABOUT SPEECH
IMPAIRMENT.
IF CHQ125 = 91, ASK ABOUT THE DIAGNOSIS
AS LISTED IN THE OTHER SPECIFY TEXT OF
CHQ125OS.

__________________________________________________________

CHQ130
DISPLAY INSTRUCTIONS:
IF CHQ125 = 1, DISPLAY “a learning disability”.
IF CHQ125 = 2, DISPLAY “attention deficit disorder
(ADD) / attention-deficit/hyperactivity disorder
(ADHD)”.
IF CHQ125 = 3, DISPLAY “developmental delay”.
IF CHQ125 = 4 AND THERE WAS AN ANSWER TO
CHQ126 DISPLAY ANSWER FROM CHQ126: IF
CHQ126 = 1 DISPLAY “Asperger’s syndrome”. ELSE IF
CHQ126 = 2 DISPLAY “autism”. ELSE IF CHQ126 = 3
DISPLAY “pervasive developmental disorder (PDD)”.
ELSE IF CHQ126 = 4 DISPLAY “Rett syndrome”. ELSE
IF CHQ126 = 5 DISPLAY “childhood disintegrative
disorder (CDD)”. ELSE IF CHQ126 = 91, DISPLAY
“{TEXT FROM OTHER SPECIFY}” FROM CHQ126OS.
ELSE IF CHQ126 = SK AND CHQ125 = 4 DISPLAY “an
autism spectrum disorder”.
IF CHQ125 = 5, DISPLAY “an intellectual or cognitive
disability”.
IF CHQ125 = 6, DISPLAY “orthopedic impairment”.
IF CHQ125 = 7, DISPLAY “an emotional disturbance”.
IF CHQ125 = 8, DISPLAY “a traumatic brain injury”.
IF CHQ125 = 9, DISPLAY “a speech impairment”.
IF CHQ125 = 91, DISPLAY “{TEXT FROM OTHER
SPECIFY}” FROM CHQ125OS.

IF CHQ125 = 1, DISPLAY “discapacidad del
aprendizaje”.
IF CHQ125 = 2, DISPLAY “trastorno de déficit de
atención (ADD) / trastorno de déficit de atención e
Hiperactividad (ADHD)”.
IF CHQ125 = 3, DISPLAY “retraso en el desarrollo”.
IF CHQ125 = 4 AND THERE WAS AN ANSWER TO
CHQ126 DISPLAY ANSWER FROM CHQ126: IF
CHQ126 = 1 DISPLAY “síndrome de Asperger”. ELSE
IF CHQ126 = 2 DISPLAY “autismo”. ELSE IF CHQ126
= 3 DISPLAY “trastorno generalizado en el desarrollo
(PDD)”. ELSE IF CHQ126 = 4 DISPLAY “síndrome de
Rett”. ELSE IF CHQ126 = 5 DISPLAY “trastorno
desintegrativo infantil (CDD)”. ELSE IF CHQ126 = 91,
DISPLAY “{TEXT FROM OTHER SPECIFY}” FROM
CHQ126OS. ELSE IF CHQ126 = SK AND CHQ125 = 4
DISPLAY “trastorno del espectro autista”.
IF CHQ125 = 5, DISPLAY “discapacidad intellectual o
cognitiva”.
IF CHQ125 = 6, DISPLAY “discapacidad ortopédica”.
IF CHQ125 = 7, DISPLAY “perturbación emocional”.
IF CHQ125 = 8, DISPLAY “lesión cerebral traumática”.
IF CHQ125 = 9, DISPLAY “trastorno del habla”.
IF CHQ125 = 91, DISPLAY “{TEXT FROM OTHER
SPECIFY}” FROM CHQ125OS.

QUESTION TEXT:
Question “How old was {CHILD} when the first
diagnosis of a problem related to {a learning
disability/attention deficit disorder (ADD) /
attention-deficit/hyperactivity disorder
(ADHD)/developmental delay/Asperger’s
syndrome/autism/pervasive development
disorder (PDD)/Rett syndrome/childhood
disintegrative disorder (CDD)/an autistic
spectrum disorder/an intellectual or cognitive
disability/orthopedic impairment/an emotional
disturbance/a traumatic brain injury/a speech
impairment/{TEXT FROM OTHER SPECIFY}
was made?”
SaVisible “True”

“¿Qué edad tenía {CHILD} cuando le
diagnosticaron por primera vez un problema
relacionado con {discapacidad del
aprendizaje/trastorno de déficit de atención
(ADD)/trastorno de déficit de atención e
Hiperactividad (ADHD)/retraso en el
desarrollo/síndrome de
Asperger/autismo/trastorno generalizado en el
desarrollo (PDD)/ síndrome de Rett/trastorno
desintegrativo infantil (CDD)/ trastorno del
espectro autista/ discapacidad intelectual o
cognitiva /discapacidad ortopédica/perturbación
emocional/lesión cerebral traumática/trastorno
del habla /{TEXT FROM OTHER SPECIFY}}?

SaVisible “True”
CODES
1

Answer in months

CHQ131a

Respuesta

Answer in years

CHQ131b

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON’T KNOW AND SK SKIP TO CHQ135a.

DON'T KNOW

__________________________________________________________

CHQ131a
DISPLAY INSTRUCTIONS:
DISPLAY THE FOLLOWING FOR THE PARTICULAR
LOOP THE R IS ON:

DISPLAY THE FOLLOWING FOR THE PARTICULAR
LOOP THE R IS ON:

IF CHQ125 = 1, DISPLAY “a learning disability”.

IF CHQ125 = 1, DISPLAY “discapacidad del
aprendizaje”.

IF CHQ125 = 2, DISPLAY “attention deficit disorder
(ADD) / attention-deficit/hyperactivity disorder
(ADHD)”.
IF CHQ125 = 3, DISPLAY “developmental delay”.
IF CHQ125 = 4 AND THERE WAS AN ANSWER TO
CHQ126 DISPLAY ANSWER FROM CHQ126: IF
CHQ126 = 1 DISPLAY “Asperger’s syndrome”. ELSE IF
CHQ126 = 2 DISPLAY “autism”. ELSE IF CHQ126 = 3
DISPLAY “pervasive developmental disorder (PDD)”.
ELSE IF CHQ126 = 4 DISPLAY “Rett syndrome”. ELSE
IF CHQ126 = 5 DISPLAY “childhood disintegrative
disorder (CDD)”. ELSE IF CHQ126 = 91, DISPLAY
“{TEXT FROM OTHER SPECIFY}” FROM CHQ126OS.
ELSE IF CHQ126 = SK AND CHQ125 = 4 DISPLAY “an
autism spectrum disorder”.
IF CHQ125 = 5, DISPLAY “an intellectual or cognitive
disability”.
IF CHQ125 = 6, DISPLAY “orthopedic impairment”.
IF CHQ125 = 7, DISPLAY “an emotional disturbance”.

IF CHQ125 = 2, DISPLAY “trastorno de déficit de
atención (ADD) / trastorno de déficit de atención e
Hiperactividad (ADHD)”.
IF CHQ125 = 3, DISPLAY “retraso en el desarrollo”.
IF CHQ125 = 4 AND THERE WAS AN ANSWER TO
CHQ126 DISPLAY ANSWER FROM CHQ126: IF
CHQ126 = 1 DISPLAY “síndrome de Asperger”. ELSE
IF CHQ126 = 2 DISPLAY “autismo”. ELSE IF CHQ126
= 3 DISPLAY “trastorno generalizado en el desarrollo
(PDD)”. ELSE IF CHQ126 = 4 DISPLAY “síndrome de
Rett”. ELSE IF CHQ126 = 5 DISPLAY “trastorno
desintegrativo infantil (CDD)”. ELSE IF CHQ126 = 91,
DISPLAY “{TEXT FROM OTHER SPECIFY}” FROM
CHQ126OS. ELSE IF CHQ126 = SK AND CHQ125 = 4
DISPLAY “”.
IF CHQ125 = 5, DISPLAY “discapacidad intelectual o
cognitiva”.
IF CHQ125 = 6, DISPLAY “discapacidad ortopédica”.

IF CHQ125 = 8, DISPLAY “a traumatic brain injury”.

IF CHQ125 = 7, DISPLAY “perturbación emocional”. IF
CHQ125 = 8, DISPLAY “lesión cerebral traumática.”

IF CHQ125 = 9, DISPLAY “a speech impairment”.

IF CHQ125 = 9, DISPLAY “trastorno del habla”.

IF CHQ125 = 91, DISPLAY “{TEXT FROM OTHER
SPECIFY}” FROM CHQ125OS.

“¿Qué edad tenía {CHILD} cuando le
diagnosticaron por primera vez un problema
relacionado con {discapacidad del
aprendizaje/trastorno de déficit de atención
(ADD)/trastorno de déficit de atención e
Hiperactividad (ADHD)/ retraso en el
desarrollo/síndrome de
Asperger/autismo/trastorno generalizado en el
desarrollo (PDD)/ síndrome de Rett/trastorno
desintegrativo infantil (CDD)/ trastorno del
espectro autista/ discapacidad intelectual o
cognitiva / discapacidad
ortopédica/perturbación emocional/lesión

Months:”

cerebral traumática/trastorno del habla /{TEXT
FROM OTHER SPECIFY}}?

Watermark “Enter age in months”

meses:”
Watermark “Ponga la edad en meses ”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ135a. ELSE GO TO BOX 11.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ131a}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ131a}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ131b
DISPLAY INSTRUCTIONS:
DISPLAY THE FOLLOWING FOR THE PARTICULAR
LOOP THE R IS ON:

DISPLAY THE FOLLOWING FOR THE PARTICULAR
LOOP THE R IS ON:

IF CHQ125 = 1, DISPLAY “a learning disability”.

IF CHQ125 = 1, DISPLAY “discapacidad del
aprendizaje”.

IF CHQ125 = 8, DISPLAY “a traumatic brain injury”.

IF CHQ125 = 7, DISPLAY “perturbación emocional”. IF
CHQ125 = 8, DISPLAY “lesión cerebral traumática.”

IF CHQ125 = 9, DISPLAY “a speech impairment”.

IF CHQ125 = 9, DISPLAY “trastorno del habla”.

IF CHQ125 = 91, DISPLAY “{TEXT FROM OTHER
SPECIFY}” FROM
CHQ125OS.

IF CHQ125 = 91, DISPLAY “{TEXT FROM OTHER
SPECIFY}” FROM CHQ125OS.

QUESTION TEXT:
Question “How old was {CHILD} when the first
diagnosis of a problem related to {a learning
disability/attention deficit disorder (ADD) /
attention-deficit/hyperactivity disorder
(ADHD)/developmental delay/
autism/Asperger’s syndrome/pervasive
development disorder (PDD)/Rett
syndrome/childhood disintegrative disorder
(CDD)/an autistic spectrum disorder/an
intellectual or cognitive disability/orthopedic
impairment/an emotional disturbance/a
traumatic brain injury/a speech

“¿Qué edad tenía {CHILD} cuando le
diagnosticaron por primera vez un problema
relacionado con {discapacidad del
aprendizaje/trastorno de déficit de atención
(ADD)/trastorno de déficit de atención e
Hiperactividad (ADHD)/ retraso en el
desarrollo/autismo/síndrome de
Asperger/trastorno generalizado en el desarrollo
(PDD)/ síndrome de Rett/trastorno
desintegrativo infantil (CDD)/ trastorno del
espectro autista/ discapacidad intelectual o
cognitiva / discapacidad

impairment/{TEXT FROM OTHER SPECIFY}}
was made?
Years:”
Watermark “Enter age in years”

ortopédica/perturbación emocional/lesión
cerebral traumática/trastorno del habla /{TEXT
FROM OTHER SPECIFY}}?
Años:”
Watermark “Ponga la edad en años”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ135a. ELSE GO TO BOX 11.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ131b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto{DISPLAY RESPONSE
AT CHQ131b. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ135a
DISPLAY INSTRUCTIONS:
DISPLAY CHQ135a AND CHQ135b TOGETHER ON ONE
PAGE

QUESTION TEXT:
Question “What was the month and year when
the diagnosis was made?”
If there was more than one diagnosis, report
the earliest.”
Pre-unit “Month:”

“¿En qué mes y año se hizo el diagnóstico? Si
hubo más de un diagnóstico, conteste sobre el
primero.”
Pre-unit “Meses:”
Watermark “Ponga el mes”

Watermark “Enter month”
ENTER NUMBER
Range

1 to 12

__________________________________________________________

CHQ135b
DISPLAY INSTRUCTIONS:
DISPLAY CHQ135a AND CHQ135b TOGETHER ON ONE
PAGE.

QUESTION TEXT:
Pre-unit “Year:”

Pre-unit “Año:”

Watermark “Enter year”

Watermark “Ponga el año”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ135b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ135b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

Box 11

END OF LOOP 1.
IF ALL CODES INDICATED IN CHQ125 HAVE
BEEN ASKED ABOUT IN LOOP 1 (ALL
DIAGNOSES THE CHILD HAS HAVE BEEN
ASKED ABOUT), GO TO CHQ200. ELSE, GO
BACK UP TO BOX 10 AND ASK ABOUT THE
NEXT DIAGNOSIS.

__________________________________________________________

CHQ200

QUESTION TEXT:
Question “For the next question, please base
your answer on how {CHILD} compares to
other children of the same age.
{CHILD} pronounces words, communicates
with, and understands others:”

“Para la siguiente pregunta, por favor conteste
basándose en cómo es {CHILD} en
comparación con otros niños y niñas de la
misma edad. {CHILD} pronuncia palabras, se
comunica con los demás y entiende a otros:”

CODES
1

Better than other children {his/her/their} age

Mejor que otros niños de su edad

As well as other children

Tan bien como otros niños

Slightly less well than other children

CHQ206

No tan bien como otros niños

Much less well than other children

CHQ206

Mucho peor que otros niños

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: If {CHILD} differs on any of
these, answer for the area in which the child has
the most difficulty.

HELP FOR STEM: Si {CHILD} difiere en cualquiera
de estas cosas, responda para el área en que el
niño tiene más dificultades.

__________________________________________________________

CHQ205

QUESTION TEXT:
Question “When {CHILD} was younger, did
{he/she/they} ever have unusual difficulty
pronouncing words, communicating with, or
understanding others, as compared to other
children {his/her/their} age?”

“Cuando {CHILD} era más pequeño(a), ¿alguna
vez tuvo alguna dificultad poco común para
pronunciar palabras, para comunicarse o para
entender a los demás, en comparación con
otros niños de su edad?”

CODES
1

Yes

Sí

__________________________________________________________

CHQ206

QUESTION TEXT:
Question “Did or does {CHILD} have any of
the following? Please select all that apply.”
CODES

“¿Tenía o tiene {CHILD} alguno de los
siguientes problemas? Por favor seleccione todo
lo que corresponda.”

Code All That Apply

Problem with talking too loudly

Hablar con voz demasiado alta

Problem with talking too softly

Hablar con voz demasiado baja

A problem chewing

Un problema para masticar

A problem swallowing

Un problema para tragar

A problem with stuttering

Un problema de tartamudeo

A cleft lip and/or palate

Paladar hendido o labio leporino

Abnormalities of the face or head

Anormalidades en la cara o la cabeza

Malformation of the ear

Malformación de la oreja

None of the above

Ninguna de las anteriores

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 9, 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.”

IF MORE THAN ONE CODE IS SELECTED AND ONE
OF THEM IS CODE 5, DISPLAY HARD ERROR
CHECK MESSAGE, “Usted seleccionó "Ninguna de
las anteriores" pero también seleccionó otra
opción de la lista. Por favor verifique lo que
respondió y corrija su respuesta. Luego seleccione
"Siguiente" para continuar."

__________________________________________________________

Box 12

IF (CHQ200 = 3 OR 4) OR (CHQ205 = 1) OR
(ANY CHQ206 = 1, 2, 3, 4, 5, 6, 7, OR 8), GO
TO CHQ210. ELSE, GO TO CHQ216.

__________________________________________________________

CHQ210
DISPLAY INSTRUCTIONS:
DISPLAY "professional" IN UNDERLINED TEXT

DISPLAY "profesional" IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Has {CHILD} ever been evaluated
by a professional because of {his/her/their}
ability to communicate?”

“¿Ha evaluado algún profesional a {CHILD}
debido a su capacidad para comunicarse?”

CODES
1

Yes

Sí
CHQ216

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: This includes health
professionals such as doctors, pediatricians, and
other licensed persons, including nurses or nurse
practitioners, optometrists, ophthalmologists,
ear-nose-throat (ENT) doctors, audiologists,
school or other psychologists, school or other
psychiatrists, psychiatric social workers, speechlanguage pathologists, etc. Do not include
teachers or some other non-health professional.

HELP FOR STEM: Esto incluye a profesionales de la
salud como médicos, pediatras y otras personas
con licencia para practicar, incluidas enfermeros o
enfermeras con práctica médica, optometristas,
oftalmólogos, otorrinolaringólogos, audiólogos,
psicólogos escolares o de otro tipo, psiquiatras
escolares o de otro tipo, trabajadores sociales
psiquiátricos, especialistas en el habla, etc. No
incluya maestros u otros profesionales que no se
dedican a la salud.

__________________________________________________________

CHQ215

QUESTION TEXT:
Question “Did you obtain a diagnosis or
diagnoses of a problem related to
{his/her/their} ability to communicate from a
professional?”

“¿Le dio un profesional un diagnóstico o
diagnósticos de algún problema relacionado con
la capacidad de comunicarse de {CHILD}?”

CODES
1

Yes

Sí

__________________________________________________________

CHQ216
DISPLAY INSTRUCTIONS:
DISPLAY "without" IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Which best describes {CHILD}’s
hearing? If {CHILD} has a hearing aid or other
assistive device, please consider
{his/her/their} hearing without the hearing aid
or assistive device.”

“¿Cuál de las siguientes opciones describe
mejor qué tan bien oye {CHILD}? Si {CHILD}
tiene un aparato para el oído o algún otro
dispositivo que le ayuda, por favor responda
qué tan bien oye sin su aparato para el oído o
dispositivo de ayuda.”

CODES
1

Excellent

CHQ221

Oye de manera excelente

Good

CHQ221

Oye bien

A little trouble hearing

Tiene muy poca dificultad para oír

Moderate trouble hearing

Tiene algo de dificultad para oír

A lot of trouble hearing

Tiene mucha dificultad para oír

Deaf

Es sordo(a)

__________________________________________________________

CHQ217
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand”, "without" AND
”whispers” IN UNDERLINED TEXT.

DISPLAY “oír y entender” AND “susurrando” IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “Please indicate whether the
following statement describes {CHILD}'s
hearing. If {CHILD} has a hearing aid or other
assistive device, please consider
{his/her/their} hearing without the hearing aid
or assistive device.
{CHILD} can usually hear and understand
what a person says without seeing their face if
that person whispers to {him/her/them} from
across a quiet room.”

“Por favor indique si la siguiente afirmación
describe cómo oye {CHILD}.”
{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le está susurrando algo desde el otro
extremo de un cuarto donde no hay ruido."

CODES
1

Yes

CHQ221

Sí
No

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: If {CHILD} has a hearing aid
or other assistive device, please consider
{his/her/their} hearing without the hearing aid
or assistive device.

HELP FOR STEM: Si {CHILD} tiene un aparato
para el oído o algún dispositivo que (lo/la) ayuda,
por favor responda qué tan bien oye sin su
aparato para el oído u otro dispositivo de ayuda.

__________________________________________________________

CHQ218
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand” AND ”talks in a
normal voice” IN UNDERLINED TEXT.

DISPLAY “oír y entender” AND “habla con voz
normal” IN UNDERLINED TEXT.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person talks in a normal voice
to {him/her/them} from across a quiet room.”

“{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le habla con voz normal desde el otro
extremo de un cuarto donde no hay ruido."

CODES
1

Yes

CHQ221

Sí
No

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: If {CHILD} has a hearing aid
or other assistive device, please consider
{his/her/their} hearing without the hearing aid
or assistive device.
IN HELP TEXT DISPLAY "without" IN
UNDERLINED TEXT.

HELP FOR STEM: Si {CHILD} tiene un aparato
para el oído o algún dispositivo que (lo/la) ayuda,
por favor responda qué tan bien oye sin su
aparato para el oído u otro dispositivo de ayuda.

__________________________________________________________

CHQ219
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand” AND ”shouts” IN
UNDERLINED TEXT.

DISPLAY “oír y entender” AND “grita” IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person shouts to
{him/her/them} from across a quiet room.”

“{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le grita desde el otro extremo de un
cuarto donde no hay ruido.”

CODES
1

Yes

CHQ221

Sí
No

HELP FOR STEM: Si {CHILD} tiene un aparato
para el oído o algún dispositivo que (lo/la) ayuda,
por favor responda qué tan bien oye sin su
aparato para el oído u otro dispositivo de ayuda.

__________________________________________________________

CHQ220
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand” AND ”speaks loudly”
IN UNDERLINED TEXT.

DISPLAY “oír y entender” AND “habla en voz alta” IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person speaks loudly into
{his/her/their} ears or better ear.”

“{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le habla en voz alta al oído o en el oído
que oye mejor.”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: If {CHILD} has a hearing aid
or other assistive device, please consider
{his/her/their} hearing without the hearing aid
or assistive device.

HELP FOR STEM: Si {CHILD} tiene un aparato
para el oído o algún dispositivo que (lo/la) ayuda,
por favor responda qué tan bien oye sin su
aparato para el oído u otro dispositivo de ayuda.

IN HELP TEXT DISPLAY "without" IN
UNDERLINED TEXT.
__________________________________________________________

CHQ221

QUESTION TEXT:
Question “Is {CHILD}’s hearing worse in one
ear?”

“¿Oye {CHILD} peor con un oído que con el
otro?”

CODES
1

Yes

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ235.

Sí
CHQ235

__________________________________________________________

CHQ222
DISPLAY INSTRUCTIONS:
DISPLAY “worse” AND "without" IN UNDERLINED
TEXT.

DISPLAY “peor” IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Which best describes {CHILD}'s
hearing in {his/her/their} worse ear? If
{CHILD} has a hearing aid or other assistive
device, please consider {his/her/their} hearing
without the hearing aid or assistive device.”

“¿Cuál de las siguientes opciones describe
mejor qué tan bien oye {CHILD} con el oído
con el que oye peor? Si {CHILD} tiene un
aparato para el oído o algún dispositivo que
(lo/la) ayuda, por favor responda qué tan bien
oye sin el aparato para el oído u otro dispositivo
de ayuda.”

CODES
1

Excellent

Oye de manera excelente

Good

Oye bien

A little trouble hearing

Tiene muy poca dificultad para oír

Moderate trouble hearing

Tiene algo de dificultad para oír

A lot of trouble hearing

Tiene mucha dificultad para oír

Deaf

Es sordo(a)

__________________________________________________________

CHQ235
DISPLAY INSTRUCTIONS:
DISPLAY “professional”, "vision and hearing
questions", AND "does" IN UNDERLINED TEXT

DISPLAY “profesional”, “preguntas sobre el oído y la
visión”, AND “incluye” IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Has {CHILD}'s hearing ever been
evaluated by a professional?”

“¿Alguna vez un profesional ha evaluado qué
tan bien oye {CHILD}?”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: This includes health
professionals such as doctors, pediatricians, and
other licensed persons, including nurses or nurse
practitioners, optometrists, ophthalmologists,
school or other psychologists, school or other
psychiatrists, psychiatric social workers, speech
pathologists, etc. Do not include teachers or
some other non-health professional.
For the hearing and vision questions, having
been evaluated at the school by a health
professional does count as being evaluated by a
professional.

HELP FOR STEM: Esto incluye a profesionales de
la salud como médicos, pediatras y otras personas
con licencia para practicar, incluidas enfermeros o
enfermeros con práctica médica, optometristas,
oftalmólogos, otorrinolaringólogos, audiólogos,
psicólogos escolares o de otro tipo, psiquiatras
escolares o de otro tipo, trabajadores sociales
psiquiátricos, especialistas en el habla, etc. No
incluya maestros u otros profesionales que no se
dedican a la salud.”
Para las preguntas sobre el oído y la visión, si le
evaluó un profesional de la salud en la escuela,
eso no cuenta como que haya sido evaluado por
un profesional.

__________________________________________________________

Box 13

IF CHQ235 = 1, GO TO CHQ245. ELSE, IF
CHQ215=1, GO TO BOX 15. ELSE, GO TO
CHQ285.

__________________________________________________________

CHQ245

QUESTION TEXT:
Question “Did you obtain a diagnosis of a
problem from a professional?”

“¿Algún profesional le diagnosticó un problema?”

CODES
1

Yes

Box 15

Awaiting evaluation

Box 15

Está esperando una evaluación

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO BOX 15.

Sí

__________________________________________________________

CHQ246
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “What was the diagnosis? Please
select all that apply.”

CODES

“¿Cuál fue el diagnóstico? Por favor seleccione
todo lo que corresponda.”

Code All That Apply

Ear wax

Cera en el oído

Ear canal deformity

Deformidad del conducto auditivo

Ear infection

Infección de oído

Fluid in the ear

Líquido en el oído

Eardrum problem

Problema en el tímpano

Illness

Enfermedad

Cytomegalovirus (CMV)

Citomegalovirus (CMV)

Ototoxic exposure to drugs or medicines

Exposición ototóxica a drogas o medicinas

Noise exposure

Exposición a ruido

Genetic cause

Causas genéticas

Injury or trauma to head and neck

Lesión o trauma a la cabeza y cuello

Ear or facial surgery

Cirugía del oído o facial

Nerve deafness

Sordera del nervio

Central auditory processing disorder

Trastorno de procesamiento auditivo central

Deafness

Sordera

Hearing loss, cause unknown

Pérdida del oído por causa desconocida

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

Otro {(Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}:

PROGRAMMER INSTRUCTIONS:
IN HELP TEXT, BOLD “Ear wax”, “Ear canal
deformity”, “Ear infection”, “Fluid in the ear”,
“Eardrum problem”, “Illness”, “Cytomegalovirus
(CMV)”, “Ototoxic exposure to drugs or
medicines”, “Noise exposure”, “Genetic cause”,
“Nerve deafness”, AND “Central auditory
processing disorder”.
HELP FOR CODE 1: Ear wax: This refers to

IN HELP TEXT, BOLD “Cera en el oído”,
“Deformidad del conducto auditivo”, “Infección de
oído”, “Líquido en el oído”, “Problema en el
tímpano”, “Enfermedad”, “Citomegalovirus
(CMV)”, “Exposición ototóxica a drogas o
medicinas”, “Exposición a ruido”, “Causas
genéticas”, “Sordera del nervio”, AND “Trastorno
de procesamiento auditivo central”.

external ear canal ear wax.
HELP FOR CODE 2: Ear canal deformity: This
refers to atresia or an ear canal that is not
normally formed. Cranial-facial disorder and
other ear canal deformities would be included in
this answer choice.
HELP FOR CODE 3: Ear infection: This includes
acute or recurrent episodes, meaning that the
infection begins and progresses quickly or keeps
coming back often with ear ache and fever.
Acute otitis media would be included in this
answer choice.
HELP FOR CODE 4: Fluid in the ear: This refers
to fluid behind the eardrum, runny ears, fluid, or
pus draining from the middle ear space, chronic
otitis media, or glue ear.
HELP FOR CODE 5: Eardrum problem: Examples
of eardrum problems are perforated, torn, or
ruptured eardrums.
HELP FOR CODE 6: Illness: Illnesses that may
be related to hearing problems are meningitis,
measles, mumps, rubella, scarlet fever, etc.
HELP FOR CODE 7: Cytomegalovirus (CMV):
Cytomegalovirus is a type of herpes virus.
HELP FOR CODE 8: Ototoxic exposure to drugs
or medicines: This refers to damage to the ears
by drugs or chemicals. It includes damage from
mycin drugs (Streptomycin, Gentamycin, etc.),
Salicylate, Lasix, and Cisplatin. It may result
from treatment of respiratory problems of
preterm infants, or as treatments due to
childhood cancer, etc.
HELP FOR CODE 9: Noise exposure: Examples of
noise exposure are gunfire, firecrackers, etc.
HELP FOR CODE 10: Genetic cause: Genetic
causes include congenital hearing loss that is
there at birth, hereditary hearing loss, and
syndromal hearing loss (for example, Down
syndrome, Usher’s syndrome, etc.).
HELP FOR CODE 13: Nerve deafness: This refers
to nerve hearing loss or sensori-neural hearing
loss.

HELP FOR CODE 1: Cera en el oído: Se refiere a la
cera en el conducto auditivo externo.
HELP FOR CODE 2: Deformidad del conducto
auditivo: Se refiere a la atresia o a un conducto
auditivo que no está formado normalmente. El
trastorno cráneo-facial y otras deformidades del
conducto auditivo se incluirían en esta opción de
respuesta.
HELP FOR CODE 3: Infección de oído: Esto
incluye episodios agudos o recurrentes, lo que
significa que la infección comienza y progresa
rápidamente o sigue volviendo a menudo con
dolor de oído y fiebre. La otitis media aguda se
incluiría en esta opción de respuesta.
HELP FOR CODE 4: Líquido en el oído: Esto se
refiere a líquido detrás del tímpano, oídos que
gotean, líquido o pus que drena del espacio del
oído medio, otitis media crónica u otitis media
adhesiva.
HELP FOR CODE 5: Problema en el tímpano:
Ejemplos de problemas de tímpano son la
perforación, el desgarro o la rotura de tímpano.
HELP FOR CODE 6: Enfermedad: Las
enfermedades que pueden estar relacionadas con
problemas de oído son la meningitis, el
sarampión, las paperas, la rubéola, la escarlatina,
etc.
HELP FOR CODE 7: Citomegalovirus (CMV): El
citomegalovirus es un tipo de virus de herpes.
HELP FOR CODE 8: Exposición ototóxica a drogas
o medicamentos: Se refiere a los daños
producidos en los oídos por fármacos o productos
químicos. Incluye los daños producidos por
fármacos con micina (estreptomicina,
gentamicina, etc.), salicilato, Lasix y cisplatino.
Puede ser consecuencia del tratamiento de
problemas respiratorios de niños prematuros, o de
tratamientos debidos al cáncer infantil, etc.
HELP FOR CODE 9: Exposición al ruido: Ejemplos
de exposición al ruido son los disparos de armas
de fuego, los petardos, etc.
HELP FOR CODE 10: Causas genéticas: Las causas
genéticas incluyen la hipoacusia congénita de
nacimiento, la hipoacusia hereditaria y la
hipoacusia sindrómica (por ejemplo, síndrome de

HELP FOR CODE 14: Central auditory processing
disorder: This refers to a problem with being
able to recognize, tell the difference between, or
understand sounds.

Down, síndrome de Usher, etc.).
HELP FOR CODE 13: Sordera de nervio: Se refiere
a la pérdida de audición de nervios o pérdida de
audición neurosensorial.
HELP FOR CODE 14: Trastorno de procesamiento
auditivo central: Se refiere a un problema para
reconocer, diferenciar o comprender sonidos.

__________________________________________________________

Box 14

If CHQ246 = 91, GO TO CHQ 246OS. ELSE,
GO TO BOX 15.

__________________________________________________________

CHQ246OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.

ENTER TEXT

__________________________________________________________

Box 15

ASK CHQ250a, CHQ250b (IF APPLICABLE),
CHQ250c (IF APPLICABLE), CHQ255a (IF
APPLICABLE), AND CHQ255b (IF APPLICABLE)
FOR THE FOLLOWING:
IF CHQ215 = 1 AND CHQ245 NE 1, ASK
ABOUT ABILITY TO COMMUNICATE.
IF CHQ215 NE 1 AND CHQ245 = 1, ASK
ABOUT HEARING.
IF CHQ215 = 1 AND CHQ245 = 1, ASK ABOUT
BOTH ABILITY TO COMMUNICATE AND
HEARING SEPARATELY IN A LOOP.
ELSE, GO TO CHQ285.

__________________________________________________________

CHQ250a
DISPLAY INSTRUCTIONS:
IF CHQ215 =1 AND CHQ245 NE 1, DISPLAY “ability to
communicate”. ELSE, IF CHQ215 NE 1 AND CHQ245
= 1, DISPLAY “hearing”. ELSE, IF CHQ215 = 1 AND
CHQ245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY
“hearing” THE SECOND TIME THE LOOP IS ASKED.

IF CHQ215 =1 AND CHQ245 NE 1, DISPLAY
“capacidad para comunicarse”. ELSE, IF CHQ215 NE 1
AND CHQ245 = 1,
DISPLAY “capacidad para oír”. ELSE, IF CHQ215 = 1
AND CHQ245 = 1 DISPLAY “capacidad para
comunicarse” THE FIRST TIME THE LOOP IS ASKED
AND DISPLAY “capacidad para oír” THE SECOND TIME
THE LOOP IS ASKED.

QUESTION TEXT:
Question “How old was {CHILD} when the first
diagnosis of a problem related to
{his/her/their} {ability to
communicate/hearing} was made?”

“¿Qué edad tenía {CHILD} cuando le
diagnosticaron por primera vez un problema
relacionado con su {capacidad para
comunicarse/capacidad para oír}?”

SaVisble “True”

CODES
1

Answer in months

CHQ250b

Respuesta

Answer in years

CHQ250c

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON’T KNOW AND SK SKIP TO 255a.

DON'T KNOW

__________________________________________________________

CHQ250b
DISPLAY INSTRUCTIONS:
IF CHQ215 =1 AND CHQ245 NE 1, DISPLAY “ability to
communicate”. ELSE, IF CHQ215 NE 1 AND CHQ245
= 1, DISPLAY “hearing”. ELSE, IF CHQ215 = 1 AND
CHQ245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY
“hearing” THE SECOND TIME THE LOOP IS ASKED.

QUESTION TEXT:
Question “How old was {CHILD}, in months,
when the first diagnosis of a problem related
to {his/her/their} {ability to
communicate/hearing} was made?”

“¿Qué edad tenía {CHILD} cuando le
diagnosticaron por primera vez un problema
relacionado con su {capacidad para
comunicarse/capacidad para oír}?”

Pre-unit: “Months:”

Pre-unit: “Meses:”

Watermark “Enter months”

Watermark “Ponga el mes”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ255a. ELSE GO TO BOX 16.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ250b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ250b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar.”

__________________________________________________________

CHQ250c
DISPLAY INSTRUCTIONS:
IF CHQ215 =1 AND CHQ245 NE 1, DISPLAY “ability to
communicate”. ELSE, IF CHQ215 NE 1 AND CHQ245
= 1, DISPLAY “hearing”. ELSE, IF CHQ215 = 1 AND
CHQ245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY
“hearing” THE SECOND TIME THE LOOP IS ASKED.

QUESTION TEXT:
Question “How old was {CHILD}, in years,
when the first diagnosis of a problem related
to {his/her/their} {ability to
communicate/hearing} was made?

“¿Qué edad tenía {CHILD} cuando le
diagnosticaron por primera vez un problema
relacionado con su {capacidad para
comunicarse/capacidad para oír}?

Years:”

Pre-unit: “Años:”

Watermark: “Enter years”

Watermark: “Ponga la edad en años”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ255a.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ250c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ250c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

Box 16

IF CHQ215 = 1 AND CHQ245 = 1, AND THE
FIRST LOOP IN BOX 15 FOR ABILITY TO
COMMUNICATE HAS BEEN ANSWERED BUT
NOT THE LOOP FOR HEARING, GO BACK TO
CHQ250a AND ASK ABOUT HEARING. ELSE, IF
CHQ245 = 1, GO TO CHQ256. ELSE, GO TO
CHQ285.

__________________________________________________________

CHQ255a
DISPLAY INSTRUCTIONS:
DISPLAY CHQ255a AND CHQ255b TOGETHER ON ONE
PAGE.
IF CHQ215 =1 AND CHQ245 NE 1, DISPLAY “ability to
communicate”. ELSE, IF CHQ215 NE 1 AND CHQ245
= 1, DISPLAY “hearing”. ELSE, IF CHQ215 = 1 AND
CHQ245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY
“hearing” THE SECOND TIME THE LOOP IS ASKED.

QUESTION TEXT:
Question “What was the month and year the
problem with {CHILD}'s {ability to
communicate /hearing} was diagnosed? If
there was more than one diagnosis, enter the
month and year for the earliest diagnosis.”
Pre-unit “Month:”
Watermark “Enter the month”

“¿En qué mes y año fue diagnosticado el
problema de {CHILD} con su {capacidad para
comunicarse/capacidad para oír}? Si hubo más
de un diagnóstico, conteste sobre el primero.”
Watermark: “Ponga el mes”
“No sé”

“Don’t know”

ENTER NUMBER
Range

1 to 12

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.
DON’T KNOW AND SK SKIP TO CHQ255b.

ADD A SPECIAL ANSWER TO DISPLAY “No sé” AS
A RADIO BUTTON.

__________________________________________________________

CHQ255b
DISPLAY INSTRUCTIONS:
DISPLAY CHQ255a AND CHQ255b TOGETHER ON ONE
PAGE.
IF CHQ215 =1 AND CHQ245 NE 1, DISPLAY “ability to
communicate”. ELSE, IF CHQ215 NE 1 AND CHQ245
= 1, DISPLAY “hearing”. ELSE, IF CHQ215 = 1 AND
CHQ245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY
“hearing” THE SECOND TIME THE LOOP IS ASKED.

QUESTION TEXT:
Pre-unit “Year:”

Pre-unit: “Año:”

Watermark “Enter the year”

Watermark: “Ponga el año”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

__________________________________________________________

Box 17

__________________________________________________________

CHQ256

QUESTION TEXT:
Question “Has {CHILD} ever worn a hearing
aid?”

“¿Ha usado {CHILD} alguna vez un aparato
para el oído?”

CODES
1

Yes, currently

Sí, actualmente lo usa

Yes, in the past

Sí, lo usó en el pasado

CHQ263

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Hearing Aid: A small
electronic sound amplifier worn in or behind the
ear that compensates for impaired hearing.

HELP FOR STEM: Aparato para el oído: Pequeño
amplificador electrónico de sonido que se lleva
dentro o detrás de la oreja y compensa las
deficiencias auditivas.

__________________________________________________________

CHQ257a

QUESTION TEXT:
Question “At what age was the
recommendation that {CHILD} wear a hearing
aid first made?”

“¿Qué edad tenía {CHILD} la primera vez que
le recomendaron que usara un aparato para el
oído?”

SaVisible “True”

CODES
1

Answer in months

CHQ257b

Respuesta

Answer in years

CHQ257c

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: This question asks the age at
which the recommendation to wear a hearing aid
was first made, not the age at which the child
first started wearing a hearing aid. Some
children may have started wearing a hearing aid
right after the recommendation was first made.
For other children, there may have been a
period of time between when the
recommendation was first made and when the
child started wearing a hearing aid.
DON’T KNOW AND SK SKIP TO CHQ258.
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

HELP FOR STEM: Esta pregunta se refiere a la
edad a la que le recomendaron el uso de un
aparato para el oído por primera vez, no a la edad
a la que empezó a usarlo. Algunos niños pueden
haber empezado a usar aparatos para el oído justo
después de que se les recomendara por primera
vez. En el caso de otros niños, puede haber
pasado algo de tiempo entre la primera
recomendación y el momento en que el niño
empezó a usar el aparato para el oído.

__________________________________________________________

CHQ257b

QUESTION TEXT:
Question “At what age, in months, was the
recommendation that {CHILD} wear a hearing
aid first made?”

“¿Cuántos meses de edad tenía {CHILD} la
primera vez que le recomendaron que usara un
aparato para el oído?”

Pre-unit “Months:”

Pre-unit “Meses:”

Watermark “Enter months”

Watermark “Ponga la edad en meses”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ257b}. Please confirm. If this
is correct, select Next to continue."
ALL ANSWERS SKIP TO CHQ258.

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto{DISPLAY RESPONSE
AT CHQ257b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ257c

QUESTION TEXT:
Question “At what age, in years, was the
recommendation that {CHILD} wear a hearing
aid first made?”

“¿Cuántos años de edad tenía {CHILD} la
primera vez que le recomendaron que usara un
aparato para el oído?”

Pre-unit “Years:”

Pre-unit “Años:”

Watermark “Enter years”

Watermark “Ponga la edad en años ”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ257c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ257c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ258

QUESTION TEXT:
Question “How often does {CHILD} use the
hearing aid(s) in school?”

“¿Con qué frecuencia usa {CHILD} en la
escuela (el/los) aparato(s) para oír?”

CODES
1

All of the time

Todo el tiempo

Most of the time

La mayor parte del tiempo

Sometimes

A veces

Rarely

Rara vez

Never

Nunca

__________________________________________________________

CHQ259
DISPLAY INSTRUCTIONS:
DISPLAY “when wearing {his/her} hearing aid[s}"
AND "hear and understand” AND ”whispers” IN
UNDERLINED TEXT.

DISPLAY “cuando usa su(s) aparato(s) para oír” AND
“oír y entender” AND “susurrando” IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “Please indicate whether the
following statement describes {CHILD}'s
hearing when wearing {his/her/their} hearing
aid{s}.
{CHILD} can usually hear and understand
what a person says without seeing their face if
that person whispers to {him/her/them} from
across a quiet room.”

“Por favor indique si la siguiente afirmación
describe qué tan bien oye {CHILD} cuando usa
su(s) aparato(s) para oír.
{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le está susurrando algo desde el otro
extremo de un cuarto donde no hay ruido."

CODES
1

Yes

CHQ270

Sí
No

__________________________________________________________

CHQ260
DISPLAY INSTRUCTIONS:
DISPLAY "hear and understand” AND "talks in a
normal voice” IN UNDERLINED TEXT.

DISPLAY “oír y entender” AND “habla con voz normal”
IN UNDERLINED TEXT.

QUESTION TEXT:

Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person talks in a normal voice
to {him/her/them} from across a quiet room.”

“{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le habla con voz normal desde el otro
extremo de un cuarto donde no hay ruido.”

CODES
1

Yes

CHQ270

Sí
No

__________________________________________________________

CHQ261
DISPLAY INSTRUCTIONS:
DISPLAY "hear and understand” AND "shouts” IN
UNDERLINED TEXT.

DISPLAY “oír y entender” AND “grita” IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person shouts to
{him/her/them} from across a quiet room.”

“{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le grita desde el otro extremo de un
cuarto donde no hay ruido.”

CODES
1

Yes

CHQ270

Sí
No

__________________________________________________________

CHQ262
DISPLAY INSTRUCTIONS:
DISPLAY "hear and understand” AND ”speaks loudly”
IN UNDERLINED TEXT.

DISPLAY “oír y entender” AND “habla en voz alta” IN
UNDERLINED TEXT.

DISPLAY “better” IF CHQ221 = 1. ELSE, USE A NULL
DISPLAY.

DISPLAY “mejor” IF CHQ221 = 1. ELSE, USE A NULL
DISPLAY.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person speaks loudly into
{his/her/their} {better} ear.”

“{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le habla en voz alta al oído {o al oído
con el que mejor escucha}.”

CODES
1

Yes

CHQ270

Sí

CHQ270

__________________________________________________________

CHQ263

QUESTION TEXT:
Question “Has a doctor or other health care
professional ever recommended that {CHILD}
wear a hearing aid?”

“¿Alguna vez un doctor o un profesional de la
salud ha recomendado que {CHILD} use un
aparato para el oído?”

CODES
1

Yes

Sí
CHQ270

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Hearing Aid: A small
electronic sound amplifier worn in or behind the
ear that compensates for impaired hearing.

HELP FOR STEM: Aparato para el oído: Pequeño
amplificador electrónico de sonido que se lleva
dentro o detrás de la oreja y compensa las
deficiencias auditivas.

__________________________________________________________

CHQ264a

QUESTION TEXT:
Question “At what age was the
recommendation that {CHILD} wear a hearing
aid first made?”

“¿Qué edad tenía {CHILD} la primera vez que
le recomendaron que usara un aparato para el
oído?”

SaVisible “True”

CODES
1

Answer in months

CHQ264b

Respuesta

Answer in years

CHQ264c

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisable
"True").
DON’T KNOW AND SK SKIP TO CHQ270.

DON'T KNOW

__________________________________________________________

CHQ264b

QUESTION TEXT:
Question “At what age, in months, was the
recommendation that {CHILD} wear a hearing
aid first made?”

“¿Cuántos meses de edad tenía {CHILD} la
primera vez que le recomendaron que usara un
aparato para el oído?”

Pre-unit “Months:”

Pre-unit “Meses:”

Watermark “Enter months”

Watermark “Ponga la edad en meses”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ264c. ELSE GO TO CHQ270.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ264b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ264b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ264c

QUESTION TEXT:
Question “At what age, in years, was the
recommendation that {CHILD} wear a hearing
aid first made?”

“Question “¿Cuántos años de edad tenía
{CHILD} la primera vez que le recomendaron
que usara un aparato para el oído?”

Pre-unit “Years:”

Pre-unit “Años:”

Watermark “Enter years”

Watermark “Ponga la edad en años”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ264c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ264c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ270

QUESTION TEXT:
Question “Does {CHILD} have a cochlear
implant?”

“¿Tiene {CHILD} un implante coclear?”

CODES
1

Yes, one ear only – right ear

CHQ271

Sí, en un solo oído – el derecho

Yes, one ear only – left ear

CHQ271

Sí, en un solo oído – el izquierdo

Yes, in both ears

CHQ273

Sí, en ambos oídos

CHQ285

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ285.
HELP FOR STEM: Cochlear Implants: An
electronic device that is surgically placed in the
inner ear which is designed to provide useful
hearing and improved communication ability to
individuals who are profoundly hearing impaired
and unable to understand speech with hearing
aids.

HELP FOR STEM: Implante coclear: Dispositivo
electrónico que se coloca quirúrgicamente en el
oído interno y que está diseñado para permitir oír
de manera útil y mejorar la capacidad de
comunicación de las personas con deficiencias
auditivas profundas que no son capaces de
entender el habla con aparatos para el oído.

__________________________________________________________

CHQ271

QUESTION TEXT:
Question “In what year was it implanted?”

“¿En qué año le pusieron el implante?”

Pre-unit “Year:”

Pre-unit “Años:”

Watermark “Enter year”

Watermark “Ponga el año”

“Don’t know”

“No sé”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “No sé” AS
A RADIO BUTTON.

DON’T KNOW AND SK SKIP TO CHQ272a. ELSE
GO TO CHQ277.
__________________________________________________________

CHQ272a

QUESTION TEXT:
Question “How old was {CHILD} when it was
implanted?”

“¿Qué edad tenía {CHILD} cuando le pusieron
el implante?”

SaVisible "True"

CODES
1

Answer in months

CHQ272b

Respuesta

Answer in years

CHQ272c

Respuesta en años

DON'T KNOW

CHQ277

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON’T KNOW AND SK SKIP TO CHQ277.

__________________________________________________________

CHQ272b

QUESTION TEXT:
Question “How old was {CHILD}, in months,
when it was implanted?”

“¿Cuántos meses de edad tenía {CHILD}
cuando le pusieron el implante?”

Pre-unit “Months:”

Pre-unit “Meses:”

Watermark “Enter months”

Watermark “Ponga la edad en meses”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
ALL ANSWERS SKIP TO CHQ277.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ272b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ272b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ272c

QUESTION TEXT:
Question “How old was {CHILD}, in years,
when it was implanted?”

“How old was {CHILD}, in years, when it was
implanted?”

Pre-unit “Years:”

Watermark “Enter years”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
ALL ANSWERS INCLUDING SK SKIP TO CHQ277.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ272c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ272c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ273
DISPLAY INSTRUCTIONS:
DISPLAY CHQ273 AND CHQ274 TOGETHER ON ONE
PAGE

QUESTION TEXT:
Question “In what years were they implanted?”

“¿En qué años le pusieron los implantes?”

Unit “and”

Unit “y”

Watermark “Enter year for left ear”

Watermark “Ponga el año para el oído izquierdo”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

__________________________________________________________

CHQ274
DISPLAY INSTRUCTIONS:
DISPLAY CHQ273 AND CHQ274 TOGETHER ON ONE
PAGE

QUESTION TEXT:
Watermark “Enter year for right ear”

“Ponga el año para el oído derecho”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ275a. ALL OTHER RESPONSES
GO TO CHQ277.
__________________________________________________________

CHQ275a

QUESTION TEXT:
Question “How old was {CHILD} when they
were implanted?”

“¿Qué edad tenía {CHILD} cuando le pusieron
los implantes?”

SaVisible "True"
CODES
1

Answer in months

CHQ275b

Respuesta

Answer in years

CHQ275c

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON'T KNOW AND SK SKIP TO CHQ277.

DON'T KNOW

__________________________________________________________

CHQ275b
DISPLAY INSTRUCTIONS:
DISPLAY CHQ275b AND CHQ276b TOGETHER ON ONE
PAGE

QUESTION TEXT:
Question “How old was {CHILD} when they
were implanted in the left ear?”

“¿Qué edad tenía {CHILD} cuando le pusieron
el implante en el oído izquierdo?”

Pre-unit “Age in months:”

Pre-unit “Edad en meses:”

Watermark “Enter age in months for left ear”

Watermark “Ponga la edad en meses para el
oído izquierdo”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ275c. ELSE GO TO CHQ276b.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ275b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ275b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ275c
DISPLAY INSTRUCTIONS:
DISPLAY CHQ275c AND CHQ276c TOGETHER ON ONE
PAGE

QUESTION TEXT:
Question “How old was {CHILD} when they
were implanted in the left ear?”

“¿Qué edad tenía {CHILD} cuando le pusieron
el implante en el oído izquierdo?”

Pre-unit “Age in years:”

Pre-unit “Edad en años:”

Watermark “Enter age in years for left ear”

Watermark “Ponga la edad en años para el oído
izquierdo”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ275c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ275c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar.

__________________________________________________________

CHQ276b
DISPLAY INSTRUCTIONS:
DISPLAY CHQ275b AND CHQ276b TOGETHER ON ONE
PAGE

QUESTION TEXT:
Question “And in the right ear?”

“¿Y en el oído derecho?”

Pre-unit “Age in months:”

Pre-unit “Edad en meses:”

Watermark “Enter age in months for right ear”

Watermark “Ponga la edad en meses para el
oído derecho”

“Don’t know”

“No sé”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “No sé” AS
A RADIO BUTTON.

DON’T KNOW AND SK SKIP TO CHQ276c. ELSE
GO TO CHQ277.

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ276b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ276b}. Please confirm. If this
is correct, select Next to continue."

__________________________________________________________

CHQ276c
DISPLAY INSTRUCTIONS:
DISPLAY CHQ275c AND CHQ276c TOGETHER ON ONE
PAGE

QUESTION TEXT:
Question “And in the right ear?”

“¿Y en el oído derecho?”

Pre-unit “Age in years:”

Pre-unit “Edad en años:”

Watermark “Enter age in years for right ear”

Watermark “Ponga la edad en años para el oído
derecho”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ276c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ276c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ277
DISPLAY INSTRUCTIONS:
DISPLAY "when wearing {his/her/their} cochlear
implant(s)", “hear and understand” AND ”whispers” IN
UNDERLINED TEXT.

DISPLAY "cuando usa {el/los} implantes(s)
coclear(es}", “oír y entender” AND ”susurrando” IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “Please indicate whether the
following statement describes {CHILD}'s
hearing when wearing {his/her/their} cochlear
implant(s).
{CHILD} can usually hear and understand
what a person says without seeing their face if
that person whispers to {him/her/them} from
across a quiet room.”

”Por favor indique si la siguiente afirmación
describe qué tan bien oye {CHILD} cuando usa
(el/los) implante(s) coclear(es).
{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le está susurrando algo desde el otro
extremo de un cuarto donde no hay ruido."

CODES
1

Yes

CHQ285

Sí
No

__________________________________________________________

CHQ278
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand” AND ”talks in a
normal voice” IN UNDERLINED TEXT.

DISPLAY “oír y entender”AND ” habla con voz normal”
IN UNDERLINED TEXT.

QUESTION TEXT:

Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person talks in a normal voice
to {him/her/them} from across a quiet room.”

"{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le habla con voz normal desde el otro
extremo de un cuarto donde no hay ruido."

CODES
1

Yes

CHQ285

Sí
No

__________________________________________________________

CHQ279
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand” AND ”shouts” IN
UNDERLINED TEXT.

DISPLAY “oír y entender” AND ”grita” IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person shouts to
{him/her/them} from across a quiet room.”

"{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le grita desde el otro extremo de un
cuarto donde no hay ruido."

CODES
1

Yes

CHQ285

Sí
No

__________________________________________________________

CHQ280
DISPLAY INSTRUCTIONS:
DISPLAY “hear and understand” AND ”speaks loudly”
IN UNDERLINED TEXT.

DISPLAY “oír y entender” AND ”habla en voz alta” IN
UNDERLINED TEXT.

DISPLAY “better” IF CHQ221 = 1. ELSE, USE A NULL
DISPLAY.

DISPLAY “mejor” IF CHQ221 = 1. ELSE, USE A NULL
DISPLAY.

QUESTION TEXT:
Question “{CHILD} can usually hear and
understand what a person says without seeing
their face if that person speaks loudly into
{his/her/their} {better} ear.”

"{CHILD} puede oír y entender generalmente lo
que dice una persona sin verle la cara si esa
persona le habla en voz alta al oído {con el que
mejor escucha}."

CODES
1

Yes

Sí

__________________________________________________________

CHQ285

QUESTION TEXT:
Question “Now I want to ask you about
{CHILD}’s vision. Without the use of
eyeglasses or contact lenses, does {CHILD}
have difficulty seeing objects in the distance,
things up close like letters on paper, or both?”

“Ahora quisiera preguntarle acerca de qué tan
bien ve {CHILD}. Sin usar lentes ni lentes de
contacto ¿tiene dificultad {CHILD} para ver de
lejos, para ver de cerca, como letras en un
papel, o ambas cosas?”

SaVisible "True"

CODES
1

Yes, seeing things up close

Sí, para ver de cerca

Yes, seeing things in the distance

Sí, para ver de lejos

Yes, both

Sí, ambas cosas

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

CHQ290

QUESTION TEXT:
Question “Has {CHILD}'s vision ever been
evaluated by an eye care professional?”

“¿Alguna vez un profesional de la vista le ha
examinado la vista a {CHILD}?”

CODES
1

Yes

Sí
CHQ311

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Eye Care Professional: This
includes optometrists and ophthalmologists.
Include a school nurse who gives a vision test,
but do not include teachers or some other nonhealth professional , or a doctor who simply
looks in the child’s eyes.

HELP FOR STEM: Profesional de la vista: Esto
incluye optometristas y oftalmólogos. Incluye a
una enfermera de escuela que mide la vista, pero
no incluye a los maestros u otros profesionales
que no son del cuidado de la salud, ni a un doctor
que simplemente le mira los ojos al niño(a).

SK SKIPS TO CHQ330.
__________________________________________________________

CHQ290b

QUESTION TEXT:

Question “Was a school nurse the only
professional who evaluated {CHILD}'s vision?”

“¿Fue una enfermera escolar el único
profesional que evaluó la vista de {CHILD}?”

CODES
1

Yes

Sí

__________________________________________________________

CHQ300
DISPLAY INSTRUCTIONS:
DISPLAY "vision-related" IN UNDERLINED TEXT.

DISPLAY "relacionado a la vista" IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “Did you obtain a diagnosis of a
vision-related problem from an eye care
professional?”

“¿Obtuvo un diagnóstico por un problema
relacionado a la vista por parte de un
profesional de la vista?"

CODES
1

Yes

Sí

CHQ330

Awaiting evaluation

CHQ330

Está esperando una evaluación

__________________________________________________________

CHQ301
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “What was the diagnosis? Please
select all that apply.”

CODES

“¿Cuál fue el diagnóstico? Por favor seleccione
todo lo que corresponda.”

Code All That Apply

Nearsightedness (Myopia)

Miopía

Farsightedness (Hyperopia)

Hipermetropía (hiperopía)

Color blindness or deficiency

Daltonismo o deficiencia cromática

Astigmatism

Astigmatismo

Crossed or wandering eye (Strabismus)

Ojo desviado (estrabismo)

Amblyopia or “lazy eye”

Ambliopía u "ojo vago"

Retinopathy

Retinopatía

Blindness

Ceguera

Condition requiring glasses – Specific condition
unspecified
Other {(Please specify):/(Please specify on next
screen.)}:

Problema que requiere lentes– No especifica
el problema específico
Otro {(Por favor especifique):/(Por favor
especifique en la pantalla siguiente.)}:

PROGRAMMER INSTRUCTIONS:
HELP FOR CODE 1: Nearsightedness (Myopia) is
when far objects appear blurred and objects that
are nearer are seen more clearly.

HELP FOR CODE 1: Miopía es cuando los objetos a
distancia se ven borrosos y los objetos más
cercanos se ven con más claridad.

HELP FOR CODE 2: Farsightedness (Hyperopia)
is when people have difficulty seeing things
close to them, but they can see objects far away
easier and more clearly.

HELP FOR CODE 2: Hipermetropía (hiperopía) es
cuando la gente tiene dificultad para ver las cosas
que tienen cerca, pero pueden ver mejor y más
claramente las cosas que están lejos.

__________________________________________________________

Box 18

IF CHQ301 = 91, CONTINUE WITH
CHQ301OS. OTHERWISE, GO TO CHQ305a.

__________________________________________________________

CHQ301OS
DISPLAY INSTRUCTIONS:
DISPLAY ALL CATEGORIES AND OTHER SPECIFY ON
ONE PAGE.

ENTER TEXT

__________________________________________________________

CHQ305a

QUESTION TEXT:
Question “How old was {CHILD} when the first
diagnosis of a problem was made?”

“¿Qué edad tenía {CHILD} la primera vez que
le diagnosticaron un problema?”

SaVisible "True"
CODES
1

Answer in months

CHQ305b

Respuesta

Answer in years

CHQ305c

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON'T KNOW AND SK SKIP TO CHQ310a.

DON'T KNOW

__________________________________________________________

CHQ305b

QUESTION TEXT:
Quesiton “How old was {CHILD}, in months,
when the first diagnosis of a problem was
made?”

“¿Cuántos meses de edad tenía {CHILD} la
primera vez que le diagnosticaron un
problema?”

Pre-unit “Months:”

Pre-unit “Meses:”

Watermark “Enter months”

Watermark “Ponga la edad en meses”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ310a. ELSE GO TO CHQ311.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ305b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ305b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ305c

QUESTION TEXT:
Question “How old was {CHILD}, in years,
when the first diagnosis of a problem was
made?”

“Cuántos meses de edad tenía {CHILD} la
primera vez que le diagnosticaron un
problema?”

Pre-unit “Years:”

Pre-unit “Años”

Watermark “Enter years”

Watermark “Ponga la edad en años”

“Don't know”

“No sé”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.
SK SKIPS TO CHQ310a. ELSE GO TO CHQ311.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ305c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ305c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ310a
DISPLAY INSTRUCTIONS:
DISPLAY CHQ310a AND CHQ310b ON ONE PAGE

QUESTION TEXT:
Question “What was the month and year the
diagnosis was made?
If there was more than one diagnosis, report
the earliest.”
Pre-unit “Month:”

“¿En qué mes y año le dieron el diagnóstico? Si
hubo más de un diagnóstico, conteste sobre el
primero.”
Pre-unit “Meses:”
Watermark “Ponga el mes”

Watermark “Enter month”

ENTER NUMBER
Range

1 to 12

__________________________________________________________

CHQ310b
DISPLAY INSTRUCTIONS:
DISPLAY CHQ310a AND CHQ310b ON ONE PAGE

QUESTION TEXT:
Pre-unit “Year:”

“Año:”

Watermark “Enter the year”

Watermark “Ponga el año”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ310b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ310b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ311

QUESTION TEXT:
Question “Has {CHILD} been prescribed
glasses or contact lenses to improve
{his/her/their} vision?”

“¿Le han recetado a {CHILD} lentes o lentes de
contacto para ver mejor?”

CODES
1

Yes

Sí
CHQ330

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ330.
__________________________________________________________

CHQ312

QUESTION TEXT:
Question “How often does {CHILD} wear
glasses or contact lenses?”

“¿Con qué frecuencia {CHILD} usa lentes o
lentes de contacto?”

CODES
1

All of the time

CHQ314

Todo el tiempo

Most of the time

CHQ314

La mayor parte del tiempo

Sometimes

CHQ314

A veces

Rarely

CHQ314

Rara vez

Never

CHQ314

Nunca

Child does not have glasses or contacts

CHQ330

No tiene lentes ni lentes de contacto

PROGRAMMER INSTRUCTIONS:

SK SKIPS TO CHQ330.

__________________________________________________________

CHQ314

QUESTION TEXT:
Question “Do {CHILD}’s glasses or contacts
help {him/her/them} see things up close, see
things in the distance, or both?”

“¿Los lentes de contacto de {CHILD} le ayudan
a ver las cosas de cerca, a ver las cosas de lejos
o ambas cosas?"

CODES
1

See things up close

Ver de cerca

See things in the distance

Ver de lejos

Both

Ambas cosas

__________________________________________________________

CHQ330

QUESTION TEXT:
Question “Would you say {CHILD}'s health is
...”

“Diría que la salud de {CHILD} es ...”

CODES
1

Excellent

Excelente

Very good

Muy buena

Good

Buena

Fair, or

Regular, o

Poor?

Mala?

__________________________________________________________

Box 19

IF CHILD DOES NOT HAVE ANY DISABILITIES
AND THEIR HEALTH IS GOOD TO EXCELLENT,
THAT IS:
CHQ125 = 10 OR SK (HAS NO REPORTED
DIAGNOSIS)
AND
CHQ200=1, 2, SK (COMMUNICATION) AND
CHQ216=1, 2, SK (HEARING) AND
CHQ285= 4, DK, SK (VISION) AND
CHQ330=1, 2, 3, SK (HEALTH), GO TO BOX 21.
OTHERWISE, CONTINUE WITH CHQ340.

__________________________________________________________

CHQ340
DISPLAY INSTRUCTIONS:
DISPLAY “During this school year” IN UNDERLINED
TEXT.

DISPLAY “Durante este año escolar” IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “During this school year, has
{CHILD} received therapy services or taken
part in a program for children with disabilities?”

“Durante este año escolar, ¿recibió {CHILD}
alguna vez servicios de terapia o asistió a un
programa para niños con discapacidades?”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Children with disabilities
include children with developmental delays,
communication impairments, or special health
care needs.

HELP FOR STEM: Niños con discapacidades incluye
a niños con retrasos del desarrollo, problemas de
comunicación o necesidades especiales de salud.

__________________________________________________________

CHQ341
DISPLAY INSTRUCTIONS:
DISPLAY “Prior to this school year” IN UNDERLINED
TEXT.

DISPLAY “Antes de este año escolar” IN UNDERLINED
TEXT.

QUESTION TEXT:
Question “Prior to this school year, did
{CHILD} ever receive therapy services or take
part in a program for children with disabilities?”

"Antes de este año escolar, ¿recibió {CHILD}
alguna vez servicios de terapia o asistió a un
programa para niños con discapacidades?"

CODES
1

Yes

Sí
Box 21

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Children with disabilities
include children with developmental delays,
communication impairments, or special health
care needs.
SK SKIPS TO BOX 21.

HELP FOR STEM: Niños con discapacidades incluye
a niños con retrasos del desarrollo, problemas de
comunicación o necesidades especiales de salud.

__________________________________________________________

CHQ345
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.

DISPLAY “(Por favor especifique:)” FOR LARGE
BROWSERS. ELSE DISPLAY “(Por favor especifique en
la pantalla siguiente.)” FOR SMALL BROWSERS.

QUESTION TEXT:
Question “For each of the following services,
select if {CHILD} or your family ever received
this service before this school year to help with
{CHILD}'s special needs. Please select all that
apply.”

CODES

“Para cada uno de los siguientes servicios, por
favor dígame si {CHILD} o su familia han
recibido este servicio alguna vez antes de este
año escolar para ayudar con las necesidades
especiales de {CHILD}. Por favor seleccione
todo lo que corresponda.”

Code All That Apply

Speech or language therapy

Terapia del habla o del lenguaje

Occupational therapy

Terapia ocupacional

Physical therapy

Terapia física

Creative arts therapy

Terapia de artes creativas

Vision services

Servicios para la vista

Hearing services

Servicios para problemas para oír

Social work services

Servicios sociales

Psychological services

Servicios psicológicos

Home visits

Visitas a su hogar

Parent support or training

Apoyo o entrenamiento para padres

Special class with other children some or all of
whom also had special needs
Private tutoring or school for learning problems

Instruction in Braille

Clases especiales donde algunos o todos los
niños tienen necesidades especiales
Clases particulares o educación particular
para problemas de aprendizaje
Instrucción en Braille

Instruction in sign language, Cued Speech, ASL,
total communication (TOCO)

Any other service {(Please specify):/(Please
specify on next screen.)}

Enseñanza en lenguaje de señas, hablar con
clave, Lenguaje de Señas Americano (ASL),
comunicación total (TOCO)
Algún otro servicio {(Por favor
especifique):/(Por favor especifique en la
pantalla siguiente.)}

PROGRAMMER INSTRUCTIONS:
BOLD “Speech or language therapy”
“Occupational therapy “, "Physical therapy”,
“Creative arts therapy”, “Vision services”, “Social
work services”, “Psychological services”, “Home
visits”, “Parent support or training”, “Special

BOLD “Terapia del habla o del lenguaje” “Terapia
ocupacional “, “Terapia física”, “Terapia de artes
creativas”, “Terapia de artes creativas”, “Servicios
sociales”, “Servicios psicológicos”, “Visitas a
domicilio”, “Apoyo o entrenamiento para padres”,

class with other children some or all of whom
also had special needs”, “Private tutoring or
schooling for learning problems”, “Instruction in
Braille”, AND “Instruction in sign language, Cued
speech, ASL, TOCO” IN HELP TEXT.
HELP FOR CODE 1: Speech or language therapy:
Therapy provided by a teacher or speechlanguage pathologist to treat the child’s speech
or language impairments, including, for
example, articulation, voice quality, fluency,
and/or language usage.
HELP FOR CODE 2: Occupational therapy:
Therapy involving the evaluation or treatment of
the child’s level of independence in daily living
activities. The goal of occupational therapy is to
promote maximum independence in daily living.
Therapy can include the use of work, play, or
self-care activities to improve functional ability,
promote health, prevent injury or further
disability. Therapy should be provided only by a
therapist who has been certified by the
American Occupational Therapy Association or
by an occupational therapy assistant who
provides therapy under the supervision of a
certified occupational therapist.
HELP FOR CODE 3: Physical therapy: Therapy
involving the evaluation or treatment of health
problems resulting from injury or disease. It is
also sometimes called physiotherapy. Physical
therapists assess joint motion, muscle strength
and endurance, how well the heart and lungs
work, and how well children can do activities
required for daily living. Treatment includes
therapeutic exercise, cardiovascular endurance
training, and training in activities of daily living,
as well as the use of massage, light, cold, heat,
electricity, and mechanical devices to treat
physical disorders. Physical therapy does not
include the use of X-Ray technology. Therapy
should be provided only by a therapist who has
been state-certified to provide such services.
HELP FOR CODE 4: Creative arts therapy:
Examples of creative arts therapy are visual,
music, dance, and drama therapy.
HELP FOR CODE 5: Vision services: Therapy
combines health and education professions to
improve the child’s independence in daily living
and access to educational materials. Health

“Clase especial con otros niños, algunos o todos
ellos con necesidades especiales”, “Clases
particulares o educación particular para problemas
de aprendizaje”, “Instrucción en Braille”, AND
“Enseñanza en lenguaje de señas, hablar con
clave, American Sign Language, comunicación
total” IN HELP TEXT.
HELP FOR CODE 1: Terapia del habla o del
lenguaje: Terapia proporcionada por un(a)
maestro(a) o un especialista del habla para tratar
las deficiencias del habla o del lenguaje del
niño(a), incluyendo, por ejemplo, la expresión, la
calidad de la voz, la fluidez y/o el uso del lenguaje.
HELP FOR CODE 2: Terapia ocupacional: Terapia
que implica la evaluación o el tratamiento del
nivel de independencia del niño en las actividades
de la vida diaria. El objetivo de la terapia
ocupacional es promover la máxima
independencia en la vida diaria. La terapia puede
incluir el uso de trabajo, juego o actividades de
autocuidado para mejorar la capacidad funcional,
promover la salud, prevenir lesiones o una mayor
discapacidad. La terapia debe ser proporcionada
únicamente por un terapeuta certificado por la
Asociación Americana de Terapia Ocupacional o
por un asistente de terapia ocupacional que
proporcione terapia bajo la supervisión de un
terapeuta ocupacional certificado.
HELP FOR CODE 3: Terapia física: Terapia que
implica la evaluación o el tratamiento de
problemas de salud derivados de lesiones o
enfermedades. A veces también se denomina
fisioterapia. Los fisioterapeutas evalúan el
movimiento de las articulaciones, la fuerza y la
resistencia muscular, el funcionamiento del
corazón y los pulmones y la capacidad de los niños
para realizar las actividades necesarias para la
vida diaria. El tratamiento incluye ejercicio
terapéutico, entrenamiento de la resistencia
cardiovascular y entrenamiento en actividades de
la vida diaria, así como el uso de masajes, luz,
frío, calor, electricidad y dispositivos mecánicos
para tratar trastornos físicos. La fisioterapia no
incluye el uso de tecnología de rayos X. La terapia
debe ser proporcionada únicamente por un
terapeuta que haya sido certificado por el Estado
para prestar tales servicios.
HELP FOR CODE 4: Terapia de artes creativas:
Ejemplos de terapia de artes creativas son la

professionals include medical doctors such as
ophthalmologists and health service providers
such as optometrists. They test the child’s ability
to focus and coordinate the eyes, judge depth,
and see colors accurately. They prescribe
eyeglasses, contact lenses, low vision aids, and
vision therapy. Teachers of the visually impaired
are state-certified to teach students who are
visually impaired or blind.
HELP FOR CODE 7: Social work services:
Services that provide support to children and
their families to meet individual human needs.
Particular attention is paid to the needs and
empowerment of children and their families who
are disadvantaged, vulnerable, or at risk. Social
workers try to focus on the well being of the
student and his/her family within their school
and community. Services should be provided
only by a social worker who has been certified
by the state to provide such services.
HELP FOR CODE 8: Psychological services:
Services that involve the assessment of
academic skills and learning aptitudes,
personality and emotional development, social
skills and school climates, and eligibility for
special education. Treatment involves one-onone interaction with students or parents to
resolve personal conflicts and problems in
learning and adjustment, psychological
counseling for students and parents, social skills
training, and assistance through separation and
loss. Within school systems, psychological
services are typically provided by certified school
psychologists. However, assessment and
treatment can be extended to the health
community and include services provided by
clinical psychologists, psychiatric social workers,
or psychiatrists (who are medical doctors).
HELP FOR CODE 9: Home visits: These are
formal visits to the homes of students by a
certified health or education professional. Home
visits can involve therapy or education services.
Home visits are typically made by teachers of
preschool or kindergarten age students with
disabilities, occupational or physical therapists,
school social workers, school psychologists, or
regular classroom teachers.
HELP FOR CODE 10: Parent support or training:
This is help provided by the schools or other

terapia visual, la música, la danza y el teatro.
HELP FOR CODE 5: Servicios para la vista: La
terapia combina profesiones de la salud y la
educación para mejorar la independencia del niño
en la vida diaria y el acceso a materiales
educativos. Entre los profesionales de la salud se
incluyen médicos como los oftalmólogos y
proveedores de servicios de salud como los
optometristas. Prueban la capacidad del niño para
enfocar y coordinar los ojos, juzgar la profundidad
y ver los colores con precisión. Prescriben lentes,
lentes de contacto, ayudas para problemas de
visión y terapia visual. Los maestros de los niños
con discapacidades de la vista están certificados
por el Estado para enseñar a estudiantes ciegos o
con discapacidad visual.
HELP FOR CODE 7: Servicios sociales: Servicios
que proporcionan apoyo a los niños y sus familias
para satisfacer las necesidades humanas
individuales. Se presta especial atención a las
necesidades y la capacitación de los niños y sus
familias desfavorecidos, vulnerables o en situación
de riesgo. Los trabajadores sociales intentan
centrarse en el bienestar del alumno y su familia
dentro de su escuela y su comunidad. Los
servicios deben ser prestados únicamente por un
trabajador social que haya sido certificado por el
Estado para prestar tales servicios.
HELP FOR CODE 8: Servicios psicológicos:
Servicios que implican la evaluación de las
habilidades académicas y las aptitudes de
aprendizaje, la personalidad y el desarrollo
emocional, las habilidades sociales y el clima
escolar, y la elegibilidad para la educación
especial. El tratamiento implica la interacción
individual con los estudiantes o los padres para
resolver conflictos personales y problemas de
aprendizaje y adaptación, asesoramiento
psicológico para los estudiantes y los padres,
formación en habilidades sociales y asistencia en
situaciones de separación y pérdida. En los
sistemas escolares, los servicios psicológicos
suelen ser prestados por psicólogos escolares
titulados. Sin embargo, la evaluación y el
tratamiento pueden ampliarse a la comunidad
sanitaria e incluir servicios prestados por
psicólogos clínicos, trabajadores sociales
psiquiátricos o psiquiatras (que son médicos).
HELP FOR CODE 9: Visitas a domicilio: Se trata de

organizations to parents who have students with
unique educational needs, such as a student
with a disability. Parent support ranges from
providing information or referrals to helping
parents access community services for their
child. Parent training can involve learning to use
special instructional techniques, assistive
devices (such as low vision aids) or other
equipment needed by a child, or general
understanding of the unique educational needs
of their child.
HELP FOR CODE 11: Special class with other
children some or all of whom also had special
needs: This is a classroom with a smaller
number of students than in a regular classroom.
Students in special classes have unique learning
needs often resulting from a disability or limited
English proficiency. All students in these
classrooms require individual attention to their
educational needs.
ELP FOR CODE 12: Private tutoring or schooling
for learning problems: This is education or
training to helpwith a specific learning problem
or need. The term “private” suggests either that
there is a cost associated with the service or
education is not provided by the public school
system. Individuals, organizations, or businesses
in school, home, or community settings can
provide private tutoring to improve the student’s
educational achievement, typically in math or
reading. Special schools are available to
students with particular needs such as emotional
problems, learning disabilities, blindness, or
deafness. Such schools charge parents for their
child’s education. However, the education of
students with disabilities may be subsidized by
their home school district if the district cannot
provide a similar appropriate education.
HELP FOR CODE 13: Instruction in Braille:
Braille is a touch system of reading using as the
basic graphic symbol a cell composed of six
dots, two dots wide and three dots high. The
dots are “read” by running the hand over the
paper rather than looking at it. Teachers receive
special training to teach Braille.
HELP FOR CODE 14: Instruction in sign
language, Cued speech, ASL, TOCO: These are
ways to replace communication without using
only speech. Manual communication is a system

visitas formales a los domicilios de los alumnos
por parte de un profesional sanitario o educativo
certificado. Las visitas a domicilio pueden incluir
servicios terapéuticos o educativos. Las visitas a
domicilio suelen ser realizadas por profesores de
alumnos con discapacidad en edad preescolar o
jardín de infancia, terapeutas ocupacionales o
físicos, trabajadores sociales escolares, psicólogos
escolares o profesores de aula ordinarios.
HELP FOR CODE 10: Apoyo o entrenamiento para
padres: Se trata de la ayuda proporcionada por las
escuelas u otras organizaciones a los padres que
tienen alumnos con necesidades educativas
únicas, como un alumno con una discapacidad. El
apoyo a los padres va desde proporcionar
información o derivaciones hasta ayudarles a
acceder a los servicios comunitarios para su hijo.
La formación de los padres puede consistir en
aprender a utilizar técnicas pedagógicas
especiales, dispositivos de ayuda (como ayudas
para la baja visión) u otros equipos que necesite
el niño, o en la comprensión general de las
necesidades educativas singulares de su hijo.
HELP FOR CODE 11: Clase especial con otros
niños, algunos o todos ellos con necesidades
especiales: Se trata de una clase con un número
menor de alumnos que en una clase normal. Los
alumnos de las clases especiales tienen
necesidades de aprendizaje únicas, a menudo
derivadas de una discapacidad o de un dominio
limitado del inglés. Todos los alumnos de estas
aulas requieren una atención individualizada a sus
necesidades educativas.
HELP FOR CODE 12: Clases particulares o
educación particular para problemas de
aprendizaje: Se trata de educación o
entrenamiento para ayudar con un problema o
necesidad específica de aprendizaje. El término
"privado" sugiere que hay un costo asociado al
servicio o que la educación no la proporciona el
sistema escolar público. Las personas,
organizaciones o empresas del ámbito escolar,
doméstico o comunitario pueden ofrecer clases
particulares para mejorar el rendimiento educativo
del alumno, normalmente en matemáticas o
lectura. Hay escuelas especiales para alumnos con
necesidades especiales, como problemas
emocionales, dificultades de aprendizaje, ceguera
o sordera. Estas escuelas cobran a los padres por
la educación de sus hijos. Sin embargo, la

of teaching individuals with hearing impairments
by using sign language and fingerspelling. Sign
language is a general term for using the hands
to form words and phrases. There are many
forms of sign language, including American Sign
Language (ASL), Signed English, Sign Exact
English (SEE), etc. Cued Speech uses hand
signals to symbolize sounds. TOCO refers to
total communication. TOCO uses a combination
of oral and manual ways to communicate and
includes speech, sign language, lip-reading,
natural gestures, fingerspelling, residual
hearing, reading and writing.

educación de los estudiantes con discapacidades
puede ser subvencionada por su distrito escolar de
origen si el distrito no puede proporcionar una
educación apropiada similar.
HELP FOR CODE 13: Instrucción en Braille: El
Braille es un sistema táctil de lectura que utiliza
como símbolo gráfico básico una celda compuesta
por seis puntos, de dos de ancho y tres de alto.
Los puntos se "leen" pasando la mano sobre el
papel en lugar de mirarlo. Los profesores reciben
una formación especial para enseñar Braille.
HELP FOR CODE 14: Enseñanza en lenguaje de
señas, hablar con clave, Lenguaje de Signos
Americano, comunicación total: Son formas de
sustituir la comunicación sin utilizar sólo el habla.
La comunicación manual es un sistema de
enseñanza a personas con deficiencias auditivas
que utiliza el lenguaje de signos y el deletreo con
los dedos. El lenguaje de signos es un término
general para referirse al uso de las manos para
formar palabras y frases. Existen muchas formas
de lenguaje de signos, como el lenguaje de signos
americano (ASL), el inglés con signos, el inglés
exacto con signos (SEE), etc. El lenguaje de
signos utiliza las manos para simbolizar sonidos.
TOCO hace referencia a la comunicación total.
TOCO utiliza una combinación de formas orales y
manuales para comunicarse e incluye el habla, el
lenguaje de signos, la lectura de labios, los gestos
naturales, el deletreo con los dedos, la audición
residual, la lectura y la escritura.

__________________________________________________________

Box 20

IF CHQ345 = 91, GO TO CHQ345OS. ELSE, GO
TO CHQ375a.

__________________________________________________________

CHQ345OS
DISPLAY INSTRUCTIONS:
IF BROWSER SIZE IS LARGE, DISPLAY ITEM CHQ345
and CHQ345OS ON THE SAME SCREEN.

ENTER TEXT

__________________________________________________________

CHQ375a
DISPLAY INSTRUCTIONS:
DISPLAY “this service” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). OTHERWISE,
DISPLAY “the earliest of these services.”

DISPLAY “este servicio” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). OTHERWISE,
DISPLAY “el primero de estos servicios.”

QUESTION TEXT:
Question “How old was {CHILD} when {this
service/the earliest of these services} began?”

“¿Qué edad tenía {CHILD} cuando empezó
{este servicio/el primero de estos servicios}?

SaVisible "True"

CODES
1

Answer in months

CHQ375b

Respuesta

Answer in years

CHQ375c

Respuesta en años

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON'T KNOW AND SK SKIP TO CHQ380a.

DON'T KNOW

__________________________________________________________

CHQ375b
DISPLAY INSTRUCTIONS:
DISPLAY “this service” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). OTHERWISE,
DISPLAY “the earliest of these services.”

DISPLAY “este servicio” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). OTHERWISE,
DISPLAY “el primero de estos servicios.”

QUESTION TEXT:
Question “How old was {CHILD}, in months,
when {this service/the earliest of these
services} began?”

“¿Cuántos meses de edad tenía {CHILD}
cuando empezó {este servicio/el primero de
estos servicios}?”

Pre-unit “Months:”

Pre-unit “Meses:”

Watermark “Enter months”

Watermark “Ponga la edad en meses”

ENTER NUMBER
Range

0 to 99

Soft Range

0 to 96

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CHQ380a. ELSE GO TO CHQ385.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ375b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ375b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ375c
DISPLAY INSTRUCTIONS:
DISPLAY “this service” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). OTHERWISE,
DISPLAY “the earliest of these services.”

DISPLAY “este servicio” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). OTHERWISE,
DISPLAY “el primero de estos servicios.”

QUESTION TEXT:
Question “How old was {CHILD}, in years,
when {this service/the earliest of these
services} began?”

“¿Cuántos años de edad tenía {CHILD} cuando
empezó {este servicio/el primero de estos
servicios}?”

Pre-unit “Years:”

Pre-unit “Años:”

Watermark “Enter years”

Watermark “Ponga la edad en años”

“Don't know”

“No sé”

ENTER NUMBER
Range

0 to 30

Soft Range

0 to 8

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.
SK SKIPS TO CHQ380a. ELSE GO TO CHQ385.
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ375c}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ375c}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar.”

__________________________________________________________

CHQ380a
DISPLAY INSTRUCTIONS:
DISPLAY CHQ380a AND CHQ380b TOGETHER ON ONE
PAGE
DISPLAY "{{CHILD}} first received {NAME OF
SINGLE SERVICE}}" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). FOR “{NAME OF
SINGLE SERVICE}” DISPLAY THE NAME OF THE
SERVICE CODED AT CHQ345A-M OR FOR CHQ345n
THE OTHER SPECIFY TEXT IN CHQ345nOS. ELSE, IF
CHQ340 = 1 AND EVERY ITEM AT CHQ345/ LETTERS
A-N = 2 OR SK. DISPLAY "{{CHILD} first received
this service}." OTHERWISE, DISPLAY "the first of
these services began."

DISPLAY "recibió {{CHILD}} por primera vez {NAME
OF SINGLE SERVICE}}" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). FOR “{NAME OF
SINGLE SERVICE}” DISPLAY THE NAME OF THE
SERVICE CODED AT CHQ345A-M OR FOR CHQ345n
THE OTHER SPECIFY TEXT IN CHQ345nOS. ELSE, IF
CHQ340 = 1 AND EVERY ITEM AT CHQ345/ LETTERS
A-N = 2 OR SK. DISPLAY " recibió {{CHILD} por
primera vez este servicio}." OTHERWISE, DISPLAY "el
primero de estos servicios."

QUESTION TEXT:
Question “What was the month and year when
{{CHILD} first received {{NAME OF SINGLE
SERVICE}/{this service}/{the first of these
services began}}?

"¿En qué mes y año recibió {{CHILD} por
primera vez {{NAME OF SINGLE
SERVICE}/{este servicio}/{el primero de estos
servicios}}?"

Pre-unit “Month:”

Pre-unit “Meses:”

Watermark “Enter the month”

Watermark “Ponga el mes”

ENTER NUMBER
Range

1 to 12

__________________________________________________________

CHQ380b
DISPLAY INSTRUCTIONS:
DISPLAY "{{CHILD}} first received {NAME OF
SINGLE SERVICE}}" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). FOR “{NAME OF
SINGLE SERVICE}” DISPLAY THE NAME OF THE
SERVICE CODED AT CHQ345A-M OR FOR CHQ345n
THE OTHER SPECIFY TEXT IN CHQ345nOS. . ELSE, IF
CHQ340 = 1 AND EVERY ITEM AT CHQ345/ LETTERS
A-N = 2 OR SK. DISPLAY "{{CHILD} first received
this service}." OTHERWISE, DISPLAY "the first of
these services began."

DISPLAY "recibió {{CHILD}} por primera vez {NAME
OF SINGLE SERVICE}}" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N). FOR “{NAME OF
SINGLE SERVICE}” DISPLAY THE NAME OF THE
SERVICE CODED AT CHQ345A-M OR FOR CHQ345n
THE OTHER SPECIFY TEXT IN CHQ345nOS. . ELSE, IF
CHQ340 = 1 AND EVERY ITEM AT CHQ345/ LETTERS
A-N = 2 OR SK. DISPLAY "recibió {{CHILD} por
primera vez este servicio}." OTHERWISE, DISPLAY "el
primero de estos servicios."

QUESTION TEXT:
Pre-unit “Year:”

Pre-unit “Año:”

Watermark “Enter the year”

Watermark “Ponga el año”

ENTER NUMBER
Range

0 to 9999

Soft Range

2016 to 2024

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ380b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto{DISPLAY RESPONSE
AT CHQ380b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ385
DISPLAY INSTRUCTIONS:
DISPLAY "this service" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N) OR IF CHQ340 = 1
AND EVERY ITEM AT CHQ345 = 2 OR SK.
OTHERWISE, DISPLAY "any of these services."

DISPLAY “este servicio” IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N) OR IF CHQ340 = 1
AND EVERY ITEM AT CHQ345 = 2 OR SK.
OTHERWISE, DISPLAY “alguno de estos servicios.”

QUESTION TEXT:
Question “Is {CHILD} still receiving {this
service/any of these services}?”

“¿Está {CHILD} recibiendo todavía {este
servicio/alguno de estos servicios}?"

CODES
1

Yes

CHQ420

Sí
No

__________________________________________________________

CHQ390a
DISPLAY INSTRUCTIONS:
DISPLAY "{CHILD} last received {NAME OF SINGLE
SERVICE}" IF ONLY ONE ITEM CODED 1 (YES) FOR
CHQ345/LETTERS A-M OR FOR CHQ345n THE OTHER
SPECIFY TEXT IN CHQ345nOS. OR IF CHQ340 = 1
AND EVERY ITEM AT CHQ345 = 2 OR SK.
OTHERWISE, DISPLAY "the last of these services was
received."

DISPLAY "la última vez que {{CHILD} recibió {NAME
OF SINGLE SERVICE}" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-M OR FOR CHQ345n
THE OTHER SPECIFY TEXT IN CHQ345nOS. OR IF
CHQ340 = 1 AND
EVERY ITEM AT CHQ345 = 2 OR SK. OTHERWISE,
DISPLAY "el último de estos servicios."

DISPLAY "this service" FOR {NAME OF SINGLE
SERVICE} IF CHQ340 = 1 AND EVERY ITEM AT
CHQ345 = 2 OR SK. OTHERWISE, DISPLAY THE NAME
OF THE SERVICE CODED AT CHQ345.

DISPLAY "este servicio" FOR {NAME OF SINGLE
SERVICE} IF CHQ340 = 1 AND EVERY ITEM AT
CHQ345 = 2 OR SK. OTHERWISE, DISPLAY THE NAME
OF THE SERVICE CODED AT CHQ345.

DISPLAY ITEMS CHQ390a AND CHQ390b ON ONE
PAGE FOR LARGE BROWSERS.

QUESTION TEXT:
Question “What was the month and year when
{{CHILD} last received {NAME OF SINGLE
SERVICE}/the last of these services was
received}?”
Pre-unit “Month:”
Watermark “Enter month”

¿En qué mes y año fue la última vez que
{{CHILD} recibió {NAME OF SINGLE
SERVICE}/recibió el último de estos servicios}?
Pre-unit “Meses:”
Watermark “Ponga el mes”

ENTER NUMBER
Range

1 to 12

__________________________________________________________

CHQ390b
DISPLAY INSTRUCTIONS:
DISPLAY "{CHILD} last received {NAME OF SINGLE
SERVICE}" IF ONLY ONE ITEM CODED 1 (YES) FOR
CHQ345/LETTERS A-N) OR IF CHQ340 = 1 AND
EVERY ITEM AT CHQ345 = 2 OR SK. OTHERWISE,
DISPLAY "the last of these services was received."

DISPLAY "la última vez que {{CHILD} recibió {NAME
OF SINGLE SERVICE}" IF ONLY ONE ITEM CODED 1
(YES) FOR CHQ345/LETTERS A-N) OR IF CHQ340 = 1
AND EVERY ITEM AT CHQ345 = 2 OR SK.
OTHERWISE, DISPLAY “el último de estos servicios.”

DISPLAY "this service" FOR {NAME OF SINGLE
SERVICE} IF CHQ340 = 1 AND EVERY ITEM AT
CHQ345 = 2 OR SK. OTHERWISE, DISPLAY THE NAME
OF THE SERVICE CODED AT CHQ345.

DISPLAY “este servicio” FOR {NAME OF SINGLE
SERVICE} IF CHQ340 = 1 AND EVERY ITEM AT
CHQ345 = 2 OR SK. OTHERWISE, DISPLAY THE NAME
OF THE SERVICE CODED AT CHQ345.

QUESTION TEXT:
Pre-unit “Year:”

Pre-unit “Año:”

Watermark “Enter year”

Watermark “Ponga el año”

ENTER NUMBER
Range

0 to 9999

Soft Range

2013 to 2022

PROGRAMMER INSTRUCTIONS:
IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT CHQ390b}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT CHQ390b}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

CHQ420
DISPLAY INSTRUCTIONS:
DISPLAY 'this school year' IN UNDERLINED TEXT.

DISPLAY “este año escolar” IN UNDERLINED TEXT.

QUESTION TEXT:
Question “During this school year, did
{CHILD} receive any services for children with
special needs such as speech or occupational
therapy or did {he/she} participate in a special
education program?”

“Durante este año escolar, ¿recibió {CHILD}
algún servicio para niños con necesidades
especiales, por ejemplo, terapia ocupacional o
del habla, o participó en un programa de
educación especial?”

CODES
1

Yes

CHQ430

Sí

Box 21

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO BOX 21.
__________________________________________________________

CHQ430
DISPLAY INSTRUCTIONS:
DISPLAY 'this school year' IN UNDERLINED TEXT.

DISPLAY “este año escolar” IN UNDERLINED TEXT.

QUESTION TEXT:
Question “Overall, how satisfied are you with
the progress {CHILD} has made in the special
services or special education program this
school year?”

“En general, ¿qué tan satisfecho(a) está con la
manera en que {CHILD} ha progresado en el
programa de {servicios especiales/educación
especial} en este año escolar?”

CODES
1

Completely satisfied

Completamente satisfecho(a)

Very satisfied

Muy satisfecho(a)

Fairly satisfied

Más o menos satisfecho(a)

Somewhat dissatisfied

Un poco insatisfecho(a)

Very dissatisfied

Muy insatisfecho(a)

__________________________________________________________

Box 21

GO TO SECTION PPQ (PARENT’S
PSYCHOLOGICAL WELL-BEING AND HEALTH).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

PPQ

Parent's Psychological Well-Being and Health

__________________________________________________________

Box 1

IF RESPONDENT IS A PARENT (INQ005g = 1,
2, 3, 4, OR 91) OR THERE IS NO PARENT IN
THE HOUSEHOLD (INQ005g AND FSQ130 NE
1, 2, 3, 4, OR 91), CONTINUE WITH PPQ100.
OTHERWISE, GO TO BOX 2.

__________________________________________________________

PPQ100
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “A continuación aparecen algunas
afirmaciones que tal vez pueden reflejar cómo se
sintió acerca de sí mismo(a) y de su vida durante la
última semana. Para cada afirmación, por favor
indique con qué frecuencia se sintió o se comportó de
esta manera en la última semana.” AT THE TOP OF
THE GRID. FOR THE GRIDS WITH ITEMS PPQ140,
PPQ150, PPQ160, AND PPQ170, AND ITEMS PPQ180,
PPQ190, PPQ200, AND PPQ210, DISPLAY “En la
última semana, ¿con qué frecuencia” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question “Next are some statements that may
relate to how you have felt about yourself and
your life during the past week. Some items in
this section may be seen as sensitive and you
may skip any questions that you do not want
to answer. For each statement, please indicate
how often in the past week you felt or behaved
this way.
How often during the past week have you…
Felt that you were bothered by things that
don't usually bother you?”

“A continuación aparecen algunas afirmaciones
que tal vez pueden reflejar cómo se sintió
acerca de sí mismo(a) y de su vida durante la
última semana. Algunas preguntas de esta
sección pueden ser delicadas, así que puede
dejar sin responder cualquier pregunta que no
desee contestar. Para cada afirmación, por favor
indique con qué frecuencia se sintió o se
comportó de esta manera en la última semana.
En la última semana, ¿con qué frecuencia…
Sintió que le molestaban cosas que no suelen
molestarlo(a)?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ110
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Quesiton “Felt that you did not feel like eating,
that your appetite was poor?”

“¿Sintió que no tenía ganas de comer, o que no
tenía apetito?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ120
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt that you could not shake off the
blues even with help from your family or
friends?”

"¿Sintió que no lograba sacarse la tristeza de
encima, ni siquiera con la ayuda de sus amigos
o familiares?"

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ130
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt that you had trouble keeping
your mind on what you were doing?”

"¿Sintió que tenía dificultad para concentrarse
en lo que estaba haciendo?"

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ140
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

QUESTION TEXT:
Question “{(Continued) }How often during the
past week have you…

{(Continuación) }En la última semana, ¿con
qué frecuencia...

Felt depressed?”

Se sintió deprimido(a)?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ150
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt that everything you did was an
effort?”

“Sintió que todo lo que hacía le costaba
esfuerzo?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ160
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt fearful?”

“Se ha sentido con miedo?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ170
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt that your sleep was restless?”

“¿Ha sentido que su sueño era inquieto?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ180
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.
IF BROWSER SIZE IS LARGE, DISPLAY “(Continued)”.

QUESTION TEXT:
Question “{(Continued) }How often during the
past week have you…

{(Continuación) }En la última semana, con qué
frecuencia…

Felt that you talked less than usual?”

Sintió que hablaba menos que de costumbre?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ190
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt lonely?”

“¿Se ha sentido solo(a)?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ200
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

QUESTION TEXT:
Question “Felt sad?”

“¿Se ha sentido triste?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ210
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “Next are some statements that may relate
to how you have felt about yourself and your life
during the past week. For each statement, please
indicate how often in the past week you felt or
behaved this way.” AT THE TOP OF THE GRID. FOR
THE GRIDS WITH ITEMS PPQ140, PPQ150, PPQ160,
AND PPQ170, AND ITEMS PPQ180, PPQ190, PPQ200,
AND PPQ210, DISPLAY “How often during the past
week have you” AT THE TOP OF EACH GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ITEMS
PPQ100, PPQ110, PPQ120, AND PPQ130, ITEMS
PPQ140, PPQ150, PPQ160, AND PPQ170, AND ITEMS
PPQ180, PPQ190, PPQ200, AND PPQ210, ON
SEPARATE SCREENS IN THREE GRIDS. FOR THE GRID
WITH PPQ100, PPQ110, PPQ120, AND PPQ130,
DISPLAY “A continuación, aparecen algunas
afirmaciones que tal vez pueden reflejar cómo se
sintió acerca de sí mismo(a) y de su vida durante la
última semana. Para cada afirmación, por favor
indique con qué frecuencia se sintió o se comportó de
esta manera en la última semana.” AT THE TOP OF
THE GRID. FOR THE GRIDS WITH ITEMS PPQ140,
PPQ150, PPQ160, AND PPQ170, AND ITEMS PPQ180,
PPQ190, PPQ200, AND PPQ210, DISPLAY “En la
última semana, ¿con qué frecuencia” AT THE TOP OF
EACH GRID.

QUESTION TEXT:
Question “Felt that you could not get going?”

“¿Sintió que no lograba empezar a hacer cosas?”

CODES
1

Never

Nunca

Some of the time

Pocas veces

A moderate amount of time

Algunas veces

Most of the time

Casi siempre

__________________________________________________________

PPQ220

QUESTION TEXT:
Question “Now, we would like to ask you about
your health. In general, would you say that
your health is…”

“Ahora quisiéramos preguntarle sobre su salud.
En general, ¿diría que su salud es …”

CODES
1

Excellent

Excelente

Very good

Muy buena

Good

Buena

Fair, or

Regular, o

Poor?

Mala?

__________________________________________________________

PPQ225

QUESTION TEXT:
Question “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?”

"Durante los últimos 12 meses, ¿diría que usted
sufrió mucho estrés, una cantidad moderada de
estrés, relativamente poco estrés o casi nada de
estrés?"

CODES
1

A lot of stress

Mucho estrés

A moderate amount of stress

Una cantidad moderada de estrés

Relatively little stress

Relativamente poco estrés

Almost no stress at all

Casi nada de estrés

__________________________________________________________

PPQ230

QUESTION TEXT:
Question “Does any impairment or health
problem now keep you from working at a job
or business?”

"¿Tiene actualmente algún impedimento o
problema de salud que no le permita trabajar
en su trabajo o negocio?”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
BOLD "Impairment/health problem" IN HELP
TEXT.

BOLD "Impedimento/problema de salud" IN HELP
TEXT.

HELP FOR STEM: Impairment/health problem:
An ongoing health problem that limits one's
strength or mental alertness. Examples might be
a heart condition, severe asthma, sickle cell
anemia, leukemia, or autism.

HELP FOR STEM: Impedimento/problema de
salud: Un problema de salud continuo que limita
su fuerza o su agudeza mental. Por ejemplo, una
afección cardiaca, asma grave, anemia falciforme,
leucemia o autismo.

__________________________________________________________

PPQ240

QUESTION TEXT:
Question “Are you limited in the kind or
amount of work you can do because of any
impairment or health problem?”

“¿Tiene alguna limitación en el tipo o la
cantidad de trabajo que puede hacer debido a
algún impedimento o problema de salud?"

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
BOLD "Impairment/health problem" IN HELP
TEXT ONLY

BOLD "Impedimento/problema de salud" IN HELP
TEXT.

__________________________________________________________

PPQ500a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PPQ500a and PPQ500b ON ONE SCREEN IN A GRID.

QUESTION TEXT:
Question “As a reminder, some items in this
section may be seen as sensitive and you may
skip any questions that you do not want to
answer.

“Le recordamos que algunas preguntas en esta
sección pueden ser delicadas y que usted puede
dejar sin responder cualquier pregunta que no
desee contestar.

Over the past year, did any of the following
things happen to you?

En el último año, ¿le sucedió alguna de las
siguientes cosas?

You were unfairly stopped, searched,
questioned, physically threatened, or abused
by the police because of your race or ethnicity.”

La policía le detuvo, registró, interrogó,
amenazó físicamente o le abusó injustamente
debido a su raza o grupo étnico.”

CODES
1

Yes

Sí

__________________________________________________________

PPQ500b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
PPQ500a and PPQ500b ON ONE SCREEN IN A GRID.

QUESTION TEXT:

Question “You were unfairly prevented from
moving into a neighborhood because the
landlord or realtor refused to sell or rent you a
house or apartment because of your race or
ethnicity.”

“Le impidieron injustamente mudarse a un
vecindario porque el dueño de una vivienda o
un agente de bienes raíces se negó a venderle o
alquilarle una casa o un apartamento debido a
su raza o grupo étnico?”

CODES
1

Yes

Sí

__________________________________________________________

PPQ510a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY PPQ510a,
PPQ510b, and PPQ510c ON ONE SCREEN IN A GRID.

QUESTION TEXT:
Question “Over the past year, how often were
you concerned about {CHILD} …

“En el último año, ¿con qué frecuencia le
preocupó que a {CHILD} …

Being mistreated by adults because of
{his/her/their} race or ethnicity?”

Adultos le maltrataran debido a su raza o grupo
étnico?”

CODES
1

Never

Nunca

Rarely

Rara vez

Some of the time

Parte del tiempo

Most of the time

La mayor parte del tiempo

__________________________________________________________

PPQ510b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY PPQ510a,
PPQ510b, and PPQ510c ON ONE SCREEN IN A GRID.
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her”
IF THE CHILD IS FEMALE. ELSE DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.

QUESTION TEXT:
Question “Being punished more harshly than
others because of {his/her/their} race or
ethnicity?”

“Le castigaran más severamente que a otros
debido a su raza o grupo étnico?”

CODES
1

Never

Nunca

Rarely

Rara vez

Some of the time

Parte del tiempo

Most of the time

La mayor parte del tiempo

__________________________________________________________

PPQ510c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY PPQ510a,
PPQ510b, and PPQ510c ON ONE SCREEN IN A GRID.
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her”
IF THE CHILD IS FEMALE. ELSE DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her”
IF THE CHILD IS FEMALE. ELSE DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.

QUESTION TEXT:
Question “Being excluded from events or
groups because of {his/her/their} race or
ethnicity?”

“Le excluyeran de eventos o grupos debido a su
raza o grupo étnico?”

CODES
1

Never

Nunca

Rarely

Rara vez

Some of the time

Parte del tiempo

Most of the time

La mayor parte del tiempo

__________________________________________________________

PPQ520
DISPLAY INSTRUCTIONS:
DISPLAY “he” IF THE CHILD IS MALE. DISPLAY “she”
IF THE CHILD IS FEMALE. ELSE DISPLAY “they” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her”
IF THE CHILD IS FEMALE. ELSE DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER OR THE CHILD'S
GENDER IS MISSING.

QUESTION TEXT:
Question “In the past year, did you talk to
{CHILD} about advantages and challenges
{he/she/they} may face because of
{his/her/their} race and ethnicity.”

“En el último año, ¿le habló a {CHILD} acerca
de las ventajas y retos que puede enfrentar
debido a su raza y grupo étnico.”

CODES
1

Yes

Sí

__________________________________________________________

Box 2

GO TO SECTION FDQ (FOOD SECURITY).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

FDQ

Food Security

__________________________________________________________

FDQ130a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ130a, FDQ130b, FDQ130c, ON ONE SCREEN IN A
GRID.
DISPLAY “you”, “I”, “my”, AND “I”, IF THE
RESPONDENT IS THE ONLY HOUSEHOLD MEMBER
AGE 18 OR OVER ((FSQ030 IS GREATER THAN OR
EQUAL TO 18 FOR THE RESPONDENT) AND
((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS FOR
ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)) OR IF THERE ARE NO
HOUSEHOLD MEMBERS 18 OR OVER ((FSQ030 IS
LESS THAN OR EQUAL TO 17 FOR THE RESPONDENT)
AND ((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS
FOR ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)). OTHERWISE, DISPLAY
“your household”, “We”, “our”, AND “we”. NOTE:
PARENT FIGURES IN FSQ010 WITH AGE = SK ARE
COUNTED AS BEING AGE 18 OR OVER.

DISPLAY “usted”, “me” AND "quedarme", IF THE
RESPONDENT IS THE ONLY HOUSEHOLD MEMBER
AGE 18 OR OVER ((FSQ030 IS GREATER THAN OR
EQUAL TO 18 FOR THE RESPONDENT) AND
((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS FOR
ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)) OR IF THERE ARE NO
HOUSEHOLD MEMBERS 18 OR OVER ((FSQ030 IS
LESS THAN OR EQUAL TO 17 FOR THE RESPONDENT)
AND ((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS
FOR ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)). OTHERWISE, DISPLAY
“su hogar”, “Nos”, AND “quedarnos”. NOTE: PARENT
FIGURES IN FSQ010 WITH AGE = SK ARE COUNTED
AS BEING AGE 18 OR OVER.
DISPLAY “frecuentemente” “algunas veces,” AND
“nunca” AS UNDERLINED TEXT.

DISPLAY “often,” “sometimes,” AND “never” AS
UNDERLINED TEXT
DISPLAY CURRENT MONTH

QUESTION TEXT:
Question “These next questions are about
whether your family is able to afford the food
that you need. For each statement, please
indicate if the statement was often true,
sometimes true, or never true for {you/your
household} in the last 12 months, that is,
since last {CURRENT MONTH}, 2023.
{I/We} worried whether {my/our} food would
run out before {I/we} got money to buy more.”

“Las siguientes preguntas son acerca de si su
familia tiene suficiente dinero para comprar la
comida que necesitan. Para cada afirmación,
por favor indique si fue frecuentemente cierta,
algunas veces cierta, o nunca fue cierta con
respecto a {usted/su hogar} en los últimos 12
meses, es decir desde {CURRENT MONTH} de
2023.
{Me/Nos} preocupaba el
{quedarme/quedarnos} sin comida antes de
volver a tener dinero para comprar más.”

CODES
1

Often true

Frecuentemente cierto

Sometimes true

Algunas veces cierto

Never true

Nunca cierto

__________________________________________________________

FDQ130b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ130a, FDQ130b, FDQ130c, ON ONE SCREEN IN A
GRID.
DISPLAY “I” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “we”. NOTE: PARENT FIGURES IN FSQ010
WITH AGE = SK ARE COUNTED AS BEING AGE 18 OR
OVER.

DISPLAY "compraba" AND "tenía" IF THE
RESPONDENT IS THE ONLY HOUSEHOLD MEMBER
AGE 18 OR OVER ((FSQ030 IS GREATER THAN OR
EQUAL TO 18 FOR THE RESPONDENT) AND
((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS FOR
ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)) OR IF THERE ARE NO
HOUSEHOLD MEMBERS 18 OR OVER ((FSQ030 IS
LESS THAN OR EQUAL TO 17 FOR THE RESPONDENT)
AND ((FSQ005a = 0) AND (FSQ030 IS 17 OR LESS
FOR ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY "comprábamos" AND "teníamos". NOTE:
PARENT FIGURES IN FSQ010 WITH AGE = SK ARE
COUNTED AS BEING AGE 18 OR OVER.

QUESTION TEXT:
Question “The food that {I/we} bought just
didn’t last, and {I/we} didn’t have money to
get more.”

“La comida que {compraba/comprábamos}
simplemente no duraba, y no {tenía/teníamos}
dinero para comprar más."

CODES
1

Often true

Frecuentemente cierto

Sometimes true

Algunas veces cierto

Never true

Nunca cierto

__________________________________________________________

FDQ130c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ130a, FDQ130b, FDQ130c, ON ONE SCREEN IN A
GRID.
DISPLAY “I” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “We”. NOTE: PARENT FIGURES IN FSQ010
WITH AGE = SK ARE COUNTED AS BEING AGE 18 OR
OVER.

DISPLAY “tenía” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “teníamos”. NOTE: PARENT FIGURES IN
FSQ010 WITH AGE = SK ARE COUNTED AS BEING
AGE 18 OR OVER.

QUESTION TEXT:
Question “{I/We} couldn’t afford to eat
balanced meals.”

“No {tenía/teníamos} suficiente dinero para
tener una alimentación más balanceada."

CODES
1

Often true

Frecuentemente cierto

Sometimes true

Algunas veces cierto

Never true

Nunca cierto

__________________________________________________________

Box 1

IF (FDQ130a = 1 OR 2) OR (FDQ130b = 1 OR
2) OR (FDQ130c = 1 OR 2), THEN GO TO
FDQ140. ELSE, GO TO FDQ192a.

__________________________________________________________

FDQ140
DISPLAY INSTRUCTIONS:
DISPLAY “you" IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “you or other adults in your household”.
NOTE: PARENT FIGURES IN FSQ010 WITH AGE = SK
ARE COUNTED AS BEING AGE 18 OR OVER.

DISPLAY “usted” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “usted o algún otro adulto en su hogar”.
NOTE: PARENT FIGURES IN FSQ010 WITH AGE = SK
ARE COUNTED AS BEING AGE 18 OR OVER.

QUESTION TEXT:
Question “In the last 12 months, did {you/you
or other adults in your household} ever cut the
size of your meals or skip meals because there
wasn't enough money for food?”

“En los últimos 12 meses, ¿alguna vez
{usted/usted o algún otro adulto en su hogar}
comió de menos o se quedó sin comer porque
no tenían dinero suficiente para comprar
comida?"

CODES
1

Yes

Sí
FDQ160

__________________________________________________________

FDQ150

QUESTION TEXT:
Question “How often did this happen?”

“¿Con qué frecuencia pasó esto?”

CODES
1

Almost every month

Casi todos los meses

Some months, but not every month

Algunos meses, pero no todos

In only 1 or 2 months

Solo en 1 o 2 meses

__________________________________________________________

FDQ160

QUESTION TEXT:
Question “In the last 12 months, did you ever
eat less than you felt you should because
there wasn't enough money for food?”

“En los últimos 12 meses, ¿alguna vez comió
menos de lo que sintió que debería comer
porque no había suficiente dinero para comprar
comida?"

CODES
1

Yes

Sí

__________________________________________________________

FDQ170

QUESTION TEXT:

Question “In the last 12 months, were you
ever hungry but didn't eat because there
wasn't enough money for food?”

“En los últimos 12 meses, ¿alguna vez tuvo
hambre pero no comió porque no había
suficiente dinero para comprar comida?”

CODES
1

Yes

Sí

__________________________________________________________

FDQ180

QUESTION TEXT:
Question “In the last 12 months, did you lose
weight because there wasn't enough money for
food?”

“En los últimos 12 meses, ¿bajó de peso porque
no había suficiente dinero para comprar
comida?”

CODES
1

Yes

Sí

__________________________________________________________

Box 2

IF (FDQ140=1) OR (FDQ160 =1) OR (FDQ170
= 1) OR (FDQ180=1), ASK FDQ190.
OTHERWISE, GO TO FDQ192a.

__________________________________________________________

FDQ190
DISPLAY INSTRUCTIONS:
DISPLAY “you" IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “you or other adults in your household”.
NOTE: PARENT FIGURES IN FSQ010 WITH AGE = SK
ARE COUNTED AS BEING AGE 18 OR OVER.

DISPLAY “usted” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “usted u otros adultos en su hogar”. NOTE:
PARENT FIGURES IN FSQ010 WITH AGE = SK ARE
COUNTED AS BEING AGE 18 OR OVER.

QUESTION TEXT:
Question “In the last 12 months, did {you/you
or other adults in your household} ever not eat
for a whole day because there wasn't enough
money for food?”

“En los últimos 12 meses, ¿alguna vez
{usted/usted u otros adultos en su hogar} no
comieron en todo el día porque no había
suficiente dinero para comprar comida?”

CODES
1

Yes

Sí
FDQ192a

__________________________________________________________

FDQ191

QUESTION TEXT:
Question “How often did this happen?”

“¿Con qué frecuencia pasó esto?”

CODES
1

Almost every month

Casi todos los meses

Some months, but not every month

Algunos meses, pero no todos

In only 1 or 2 months

Solo en 1 o 2 meses

__________________________________________________________

FDQ192a
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ192a, FDQ192b, FDQ192c, ON ONE SCREEN IN A
GRID.
DISPLAY “I,” AND “I was” IF THE RESPONDENT IS
THE ONLY HOUSEHOLD MEMBER AGE 18 OR OVER
((FSQ030 IS GREATER THAN OR EQUAL TO 18 FOR
THE RESPONDENT) AND ((FSQ005A = 0) AND
(FSQ030 IS 17 OR LESS FOR ALL HOUSEHOLD
MEMBERS OTHER THAN THE RESPONDENT IN
FSQ010)) OR IF THERE ARE NO HOUSEHOLD
MEMBERS 18 OR OVER ((FSQ030 IS LESS THAN OR
EQUAL TO 17 FOR THE RESPONDENT) AND
((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS FOR
ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)). OTHERWISE, DISPLAY
“We” AND “we were”. NOTE: PARENT FIGURES IN
FSQ010 WITH AGE = SK ARE COUNTED AS BEING
AGE 18 OR OVER.
DISPLAY “children living in the household who are
under 18 years old” AND “the children” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”
AND “{CHILD}”. DISPLAY “often,” “sometimes,”
“never”, AND “{{CHILD}/children living in the
household who are under 18 years old}” AS
UNDERLINED TEXT.

DISPLAY “Tuve,” AND “me estaba” IF THE
RESPONDENT IS THE ONLY HOUSEHOLD MEMBER
AGE 18 OR OVER ((FSQ030 IS GREATER THAN OR
EQUAL TO 18 FOR THE RESPONDENT) AND
((FSQ005A = 0) AND (FSQ030 IS 17 OR LESS FOR
ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)) OR IF THERE ARE NO
HOUSEHOLD MEMBERS 18 OR OVER ((FSQ030 IS
LESS THAN OR EQUAL TO 17 FOR THE RESPONDENT)
AND ((FSQ005a = 0) AND (FSQ030 IS 17 OR LESS
FOR ALL HOUSEHOLD MEMBERS OTHER THAN THE
RESPONDENT IN FSQ010)). OTHERWISE, DISPLAY
“Tuvimos” AND “nos estábamos”. NOTE: PARENT
FIGURES IN FSQ010 WITH AGE = SK ARE COUNTED
AS BEING AGE 18 OR OVER.
DISPLAY “los niños que viven en su hogar y tienen
menos de 18 años AND “los niños” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”
AND “{CHILD}”.
DISPLAY “frecuentemente cierta,” “algunas veces
cierta,” “nunca fue cierta”, AND “{{CHILD}/ los niños
que viven en su hogar y tienen menos de 18 años }”
AS UNDERLINED TEXT.

DISPLAY CURRENT MONTH

QUESTION TEXT:
Question “Please select whether the statement
was often true, sometimes true, or never true
in the last 12 months, that is, since last
{CURRENT MONTH}, 2023, for
{{CHILD}/children living in the household who
are under 18 years old}.

“Por favor indique si la afirmación fue
frecuentemente cierta, algunas veces cierta, o
nunca fue cierta con respecto a {CHILD}/los
niños que viven en su hogar y tienen menos de
18 años} en los últimos 12 meses, es decir
desde {CURRENT MONTH} de 2023.”

{I/We} relied on only a few kinds of low-cost
food to feed {{CHILD}/the children} because
{I was/we were} running out of money to buy
food.”

{Tuve/Tuvimos} que depender de una variedad
limitada de alimentos baratos para alimentar a
{{CHILD}/los niños} porque {me estaba/nos
estábamos} quedando sin dinero para comprar
comida."

CODES
1

Often true

Frecuentemente cierto

Sometimes true

Algunas veces cierto

Never true

Nunca cierto

__________________________________________________________

FDQ192b
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ192a, FDQ192b, FDQ192c, ON ONE SCREEN IN A
GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ192a, FDQ192b, FDQ192c, ON ONE SCREEN IN A
GRID.

DISPLAY “I” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “We”. NOTE: PARENT FIGURES IN FSQ010
WITH AGE = SK ARE COUNTED AS BEING AGE 18 OR
OVER.

DISPLAY “Yo”, “pude”, AND “tenia” IF THE
RESPONDENT IS THE ONLY HOUSEHOLD MEMBER
AGE 18 OR OVER OR IF THERE ARE NO HOUSEHOLD
MEMBERS 18 OR OVER OR WITH AN AGE OTHER
THAN DK OR RF. OTHERWISE, DISPLAY “Nosotros",
“pudimos”, AND "teníamos". NOTE- HOUSEHOLD
MEMBERS WITH AGE = SK ARE COUNTED AS BEING
AGE 18 OR OVER.
DISPLAY “los niños” IF IF NUMBER OF CHILDREN AGE
17 AND YOUNGER OTHER THAN THE FOCAL CHILD IS
GREATER THAN OR EQUAL TO ONE (FSQ005b >= 1).
OTHERWISE, DISPLAY “{CHILD}”.

DISPLAY “the children” IF NUMBER OF CHILDREN AGE
17 AND YOUNGER OTHER THAN THE FOCAL CHILD IS
GREATER THAN OR EQUAL TO ONE (FSQ005b >= 1).
OTHERWISE, DISPLAY “{CHILD}”.

QUESTION TEXT:
Question “{I/We} couldn't feed {{CHILD}/the
children} a balanced meal because {I/we}
couldn't afford that.”

“{Yo/Nosotros} no {pude/pudimos} darle a
{{CHILD}/ los niños} una alimentación
balanceada porque no {tenía/teníamos} el
dinero suficiente."

CODES
1

Often true

Frecuentemente cierto

Sometimes true

Algunas veces cierto

Never true

Nunca cierto

__________________________________________________________

FDQ192c
DISPLAY INSTRUCTIONS:
IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ192a, FDQ192b, FDQ192c, ON ONE SCREEN IN A
GRID.

IF THE BROWSER SIZE IS LARGE, DISPLAY ALL ITEMS
FDQ192a, FDQ192b, FDQ192c, ON ONE SCREEN IN A
GRID.

DISPLAY “I” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD MEMBER AGE 18 OR OVER ((FSQ030 IS
GREATER THAN OR EQUAL TO 18 FOR THE
RESPONDENT) AND ((FSQ005A = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)) OR IF THERE
ARE NO HOUSEHOLD MEMBERS 18 OR OVER
((FSQ030 IS LESS THAN OR EQUAL TO 17 FOR THE
RESPONDENT) AND ((FSQ005a = 0) AND (FSQ030 IS
17 OR LESS FOR ALL HOUSEHOLD MEMBERS OTHER
THAN THE RESPONDENT IN FSQ010)). OTHERWISE,
DISPLAY “we”. NOTE: PARENT FIGURES IN FSQ010
WITH AGE = SK ARE COUNTED AS BEING AGE 18 OR
OVER.

DISPLAY “yo” AND “tenía” IF THE RESPONDENT IS
THE ONLY HOUSEHOLD MEMBER AGE 18 OR OVER OR
IF THERE ARE NO HOUSEHOLD MEMBERS 18 OR
OVER OR WITH AN AGE OTHER THAN DK OR RF.
OTHERWISE, DISPLAY “nosotros” AND “teníamos”.
NOTE- HOUSEHOLD MEMBERS WITH AGE = SK ARE
COUNTED AS BEING AGE 18 OR OVER.
DISPLAY “Los niños no estaban” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD} no
estaba”.

DISPLAY “The children were” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1).
OTHERWISE, DISPLAY “{CHILD} was”.

QUESTION TEXT:
Question “{{CHILD} was/The children were}
not eating enough because {I/we} just
couldn't afford enough food.”

“{{CHILD} no estaba/Los niños no estaban}
comiendo suficiente porque {yo/nosotros}
simplemente no {tenía/teníamos} con qué
comprar suficiente comida.”

CODES
1

Often true

Frecuentemente cierto

Sometimes true

Algunas veces cierto

Never true

Nunca cierto

__________________________________________________________

Box 3

IF (FDQ192a = 1 OR 2) OR (FDQ192b = 1 OR
2) OR (FDQ192c = 1 OR 2), GO TO FDQ210.
ELSE, GO TO BOX 4.

__________________________________________________________

FDQ210
DISPLAY INSTRUCTIONS:
DISPLAY “any of the children’s” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}’s”.

DISPLAY “alguno de los niños” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”.

DISPLAY CURRENT MONTH

QUESTION TEXT:

Question “In the last 12 months, that is, since
last {CURRENT MONTH}, 2023, did you ever
cut the size of {CHILD}'s/any of the
children's} meals because there wasn't enough
money for food?”

“En los últimos 12 meses, es decir, desde
{CURRENT MONTH} de 2023, ¿alguna vez usted
le dio menos de comer a {{CHILD}/alguno de
los niños} porque no tenía dinero suficiente
para comprar comida?”

CODES
1

Yes

Sí

__________________________________________________________

FDQ240
DISPLAY INSTRUCTIONS:
DISPLAY “were any of the children” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “was
{CHILD}”.

DISPLAY “alguno de los niños” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”.

QUESTION TEXT:
Question “In the last 12 months, {was
{CHILD}/were any of the children} ever
hungry but you just couldn't afford more food?”

“En los últimos 12 meses, ¿alguna vez,
{{CHILD}/alguno de los niños} se quedó con
hambre porque no tenían dinero suficiente para
comprar comida?"

CODES
1

Yes

Sí

__________________________________________________________

FDQ242
DISPLAY INSTRUCTIONS:
DISPLAY “any of the children” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”.

DISPLAY “alguno de los niños” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”.

QUESTION TEXT:
Question “In the last 12 months, did
{{CHILD}/any of the children} ever skip a
meal because there wasn't enough money for
food?”

“En los últimos 12 meses, ¿alguna vez
{{CHILD}/alguno de los niños} se quedó sin
comer una comida porque no tenían dinero
suficiente para comprar comida?”

CODES
1

Yes

Sí

FDQ250

__________________________________________________________

FDQ243

QUESTION TEXT:
Question “How often did this happen?”

“¿Con qué frecuencia pasó esto?”

CODES
1

Almost every month

Casi todos los meses

Some months, but not every month

Algunos meses, pero no todos

In only 1 or 2 months

Solo en 1 o 2 meses

__________________________________________________________

FDQ250
DISPLAY INSTRUCTIONS:
DISPLAY “any of the children” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”.

DISPLAY “alguno de los niños” IF NUMBER OF
CHILDREN AGE 17 AND YOUNGER OTHER THAN THE
FOCAL CHILD IS GREATER THAN OR EQUAL TO ONE
(FSQ005b >= 1). OTHERWISE, DISPLAY “{CHILD}”.

QUESTION TEXT:
Question “In the last 12 months, did
{CHILD}/any of the children} ever not eat for
a whole day because there wasn't enough
money for food?”

“En los últimos 12 meses, ¿alguna vez
{CHILD}/alguno de los niños} no comió en todo
el día porque no había suficiente dinero para
comida?"

CODES
1

Yes

Sí

__________________________________________________________

Box 4

GO TO SECTION HRQ (HISTORICAL ROSTER).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

HRQ

Historical Roster

__________________________________________________________

HRQ010
DISPLAY INSTRUCTIONS:
DISPLAY “not” IN UNDERLINED TEXT.

DISPLAY “no” IN UNDERLINED TEXT.

QUESTION TEXT:

Question “Now we have some question about
{CHILD}'s parents. Some items in this section
may be seen as sensitive and you may skip
any questions that you do not want to answer.
Does {CHILD} have any biological or adoptive
parents who are not currently living in your
household? Please include parents who are
deceased. ”

“Ahora tenemos algunas preguntas sobre los
padres de {CHILD}. Algunas preguntas de esta
sección pueden resultar delicadas y usted puede
saltar cualquier pregunta que no desee
responder.
¿Tiene {CHILD} algún padre o madre biológico
o adoptivo que no esté viviendo actualmente en
su hogar? Por favor incluya padres o madres
que hayan fallecido.”

CODES
1

Yes

PROGRAMMER INSTRUCTIONS:
SK CONTINUES TO BOX 3.

Sí
Box 3

__________________________________________________________

HRQ015

QUESTION TEXT:
Question ‘Which biological or adoptive
parent(s) are not currently living in your
household? Please include parents who are
deceased. Please select all that apply.”
CODES

"¿Cuál de los padres o madres biológicos o
adoptivos no están viviendo actualmente en su
hogar? Por favor incluya padres o madres que
hayan fallecido. Por favor seleccione todo lo que
corresponda.”

Code All That Apply

Biological female parent

Madre biológica

Biological male parent

Padre biológico

Biological parent of another gender

Padre o madre biológico(a) de otro género

Adoptive female parent

Madre adoptiva

Adoptive male parent

Padre adoptivo

Adoptive parent of another gender

Padre o madre adoptivo(a) de otro género

PROGRAMMER INSTRUCTIONS:
SK CONTINUES TO BOX 3.
__________________________________________________________

Box 1

LOOP 1
ASK HRQ030 ONE TIME FOR EACH
BIOLOGICAL FEMALE PARENT (HRQ015 = 1),
BIOLOGICAL MALE PARENT (HRQ015 = 2),
BIOLOGICAL PARENT OF ANOTHER GENDER
(HRQ015 = 3), ADOPTIVE FEMALE PARENT
(HRQ015 = 4), ADOPTIVE MALE PARENT
(HRQ015 = 5), ADOPTIVE PARENT OF
ANOTHER GENDER (HRQ015 = 6) WHO IS NOT
CURRENTLY LIVING IN THE HOUSEHOLD.

__________________________________________________________

HRQ030
DISPLAY INSTRUCTIONS:
DISPLAY "We would like to ask a few questions about
{CHILD}'s {biological/adoptive}{female parent/male
parent/parent of another gender}." THE FIRST TIME
THE QUESTION IS ASKED. ELSE, USE A NULL
DISPLAY.

DISPLAY " "Quisiéramos hacerle algunas preguntas
sobre {la madre/el padre/la madre o el padre de otro
género} {biológico(a)/adoptivo(a)}. THE FIRST TIME
THE QUESTION IS ASKED. ELSE, USE A NULL
DISPLAY.

DISPLAY “biological” IF HRQ015 = 1, 2, OR 3.
DISPLAY “adoptive” IF HRQ015 = 4, 5, or 6.

DISPLAY “biológico(a)” IF HRQ015 = 1, 2, OR 3.
DISPLAY “adoptivo(a)” IF HRQ015 = 4, 5, or 6.

DISPLAY “female parent" IF LOOPING ON
BIOLOGICAL OR ADOPTIVE FEMALE PARENT NOT
CURRENTLY LIVING IN THE HOUSEHOLD (HRQ015 =
1 OR 4). DISPLAY “male parent" IF LOOPING ON
BIOLOGICAL OR ADOPTVE MALE PARENT NOT
CURRENTLY LIVING IN THE HOUSEHOLD (HRQ015 =
2 OR 5). DISPLAY "parent of another gender" IF
LOOPING ON PARENT OF ANOTHER GENDER (HRQ015
=3 or 6).

DISPLAY “la madre" IF LOOPING ON BIOLOGICAL OR
ADOPTIVE FEMALE PARENT NOT CURRENTLY LIVING
IN THE HOUSEHOLD (HRQ015 = 1 OR 4). DISPLAY “el
padre" IF LOOPING ON BIOLOGICAL OR
ADOPTVE MALE PARENT NOT CURRENTLY LIVING IN
THE HOUSEHOLD (HRQ015 = 2 OR 5). DISPLAY "la
madre o el padre de otro género" IF LOOPING ON
PARENT OF ANOTHER GENDER (HRQ015 =3 or 6).

DISPLAY "{We…helpful.}" IF THERE ARE NO
BIOLOGICAL PARENTS IN THE HOUSEHOLD (NO
HOUSEHOLD MEMBER WITH A CODE '1' AT INQ005g
OR FSQ130). OTHERWISE, USE A NULL DISPLAY.
DISPLAY "for adoptive parents" IF THE RESPONDENT
IS AN ADOPTIVE PARENT (INQ005g OR FSQ130 IS
CODED '2' FOR THE PERSON FLAGGED AS THE
RESPONDENT).

DISPLAY "{Entendemos…útil.}" IF THERE ARE NO
BIOLOGICAL PARENTS IN THE HOUSEHOLD (NO
HOUSEHOLD MEMBER WITH A CODE '1' AT INQ005g
OR FSQ130). OTHERWISE, USE A NULL DISPLAY.
DISPLAY " para padres adoptivos." IF THE
RESPONDENT IS AN ADOPTIVE PARENT (INQ005g OR
FSQ130 IS CODED '2' FOR THE PERSON FLAGGED AS
THE RESPONDENT).

QUESTION TEXT:
{We would like to ask a few questions about
{CHILD}'s {biological/adoptive}{female
parent/male parent/parent of another
gender}.}
{We understand that some of these questions
may be difficult {for adoptive parents} to
answer; however, these are standard
questions we ask when a child does not live
with all parents. Any information you can
provide will be helpful.}
Is {CHILD}'s {biological/adoptive}{female
parent/male parent/parent of another gender}
currently living?

{Quisiéramos hacerle algunas preguntas sobre
{la madre/el padre/la madre o el padre de otro
género} {biológico(a)/adoptivo(a)}.}
{Entendemos que algunas de estas preguntas
podrían ser difíciles de contestar {para padres
adoptivos}. Sin embargo, éstas son preguntas
establecidas que se hacen cuando un(a) niño(a)
no vive con sus padres biológicos. Cualquier
información que pueda proporcionar será útil.}
¿Está vivo(a) actualmente {la madre/el
padre/la madre o el padre de otro género}
{biológico(a)/adoptivo(a)} de {CHILD}?"

SaVisible "True"

CODES
1

Yes

Sí

The {biological/adoptive} {female parent/male
parent/parent of another gender} is unknown

No
Box 2

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
__________________________________________________________

Box 2

END LOOP 1
ASK HRQ030 FOR NEXT BIOLOGICAL FEMALE
PARENT (HRQ015 = 1), BIOLOGICAL MALE
PARENT (HRQ015 = 2), BIOLOGICAL PARENT
OF ANOTHER GENDER (HRQ015 = 3),
ADOPTIVE FEMALE PARENT (HRQ015 = 4),
ADOPTIVE MALE PARENT (HRQ015 = 5), OR
ADOPTIVE PARENT OF ANOTHER GENDER
(HRQ015 = 6) WHO IS NOT CURRENTLY
LIVING IN THE HOUSEHOLD. IF THERE ARE NO
MORE PARENTS TO BE ASKED ABOUT, GO TO
BOX 3.

__________________________________________________________

Box 3

GO TO SECTION NRQ (NON-RESIDENT
PARENT).

No conocen {a la madre}
{biológica/adoptiva} {al padre}
{biológico/adoptivo} {a la madre o al padre}
{{biológico(a)/adoptivo(o)} de otro género}.
DON'T KNOW

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

NRQ

Non-Resident Parent Questions

__________________________________________________________

Box 1

IF RESPONDENT REPORTS THAT THERE ARE
NO BIOLOGICAL OR ADOPTIVE PARENTS WHO
DO NOT LIVE IN THE HOUSEHOLD OR THE
RESPONDENT SKIPPED THAT QUESTION
(HRQ010 = 2 OR SK) OR THE QUESTION
ABOUT WHICH BIOLOGICAL OR ADOPTVE
PARENTS DO NOT LIVE IN THE HOUSEHOLD
WAS SKIPPED (HRQ015 = SK), GO TO BOX 5.
OTHERWISE, CONTINUE WITH BOX 2.

__________________________________________________________

Box 2

QUESTION TEXT:
LOOP 1
ASK BOX 3 - BOX 4 ONE TIME FOR EACH
BIOLOGICAL FEMALE PARENT, BIOLOGICAL
MALE PARENT, BIOLOGICAL PARENT OF
ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, AND
ADOPTIVE PARENT OF ANOTHER GENDER NOT
LIVING IN THE HOUSEHOLD.
DETERMINE LOOPING ELIGIBILITY:
1. BIOLOGICAL FEMALE PARENT NOT IN
HOUSEHOLD: HRQ015 = 1
2. BIOLOGICAL MALE PARENT NOT IN
HOUSEHOLD: HRQ015 = 2
3. BIOLOGICAL PARENT OF ANOTHER GENDER
NOT IN HOUSEHOLD: HRQ015 = 3
4. ADOPTIVE FEMALE PARENT NOT IN
HOUSEHOLD: HRQ015 = 4
5. ADOPTIVE MALE PARENT NOT IN
HOUSEHOLD: HRQ015 =5
6. ADOPTIVE PARENT OF ANOTHER GENDER
NOT IN HOUSEHOLD: HRQ015 =6

__________________________________________________________

Box 3

QUESTION TEXT:
IF ASKING ABOUT BIOLOGICAL FEMALE
PARENT NOT IN HOUSEHOLD AND
BIOLOGICAL FEMALE PARENT IS NOT LIVING
OR RESPONDENT DOES NOT KNOW WHO THE
BIOLOGICAL FEMALE PARENT IS (HRQ015 = 1
AND HRQ030=2, 3, DK, OR SK), GO TO BOX 4.
IF ASKING ABOUT BIOLOGICAL FEMALE
PARENT NOT IN HOUSEHOLD AND
BIOLOGICAL FEMALE PARENT IS STILL LIVING
(HRQ015 = 1 AND HRQ030=1), GO TO
NRQ040 FOR THE BIOLOGICAL FEMALE
PARENT.
IF ASKING ABOUT BIOLOGICAL MALE PARENT
NOT IN HOUSEHOLD AND BIOLOGICAL MALE
PARENT IS NOT LIVING OR RESPONDENT
DOES NOT KNOW WHO THE BIOLOGICAL MALE
PARENT IS (HRQ015 = 2 AND HRQ030=2, 3,
DK, OR SK), GO TO BOX 4.
IF ASKING ABOUT BIOLOGICAL MALE PARENT
NOT IN HOUSEHOLD AND BIOLOGICAL MALE
PARENT IS STILL LIVING (HRQ015 = 2 AND
HRQ030=1), GO TO NRQ040 FOR THE
BIOLOGICAL MALE PARENT.
IF ASKING ABOUT BIOLOGICAL PARENT OF
ANOTHER GENDER NOT IN HOUSEHOLD AND
BIOLOGICAL PARENT OF ANOTHER GENDER IS
NOT LIVING OR RESPONDENT DOES NOT
KNOW WHO THE BIOLOGICAL PARENT OR
ANOTHER GENDER IS (HRQ015 = 3 AND
HRQ030=2, 3, DK, OR SK), GO TO BOX 4.
IF ASKING ABOUT BIOLOGICAL PARENT OF
ANOTHER GENDER NOT IN HOUSEHOLD AND
BIOLOGICAL PARENT OF ANOTHER GENDER IS
STILL LIVING (HRQ015 = 3 AND HRQ030=1),
GO TO NRQ040 FOR THE BIOLOGICAL PARENT
OF ANOTHER GENDER.
IF ASKING ABOUT THE ADOPTIVE FEMALE
PARENT NOT IN HOUSEHOLD AND ADOPTIVE
FEMALE PARENT IS NOT LIVING (HRQ015 = 4
AND HRQ030=2, 3, DK, OR SK), GO TO BOX 4.

IF ASKING ABOUT THE ADOPTIVE FEMALE
PARENT NOT IN HOUSEHOLD AND ADOPTIVE
FEMALE PARENT IS STILL LIVING (HRQ015 = 4
AND HRQ030=1) GO TO NRQ040 TO ASK FOR
THE ADOPTIVE FEMALE PARENT. IF ASKING
ABOUT THE ADOPTIVE MALE PARENT NOT IN
HOUSEHOLD AND ADOPTIVE MALE PARENT IS
NOT LIVING (HRQ015 = 5 AND HRQ030=2, 3,
DK, OR SK), GO TO BOX 4.
IF ASKING ABOUT THE ADOPTIVE MALE
PARENT NOT IN HOUSEHOLD AND ADOPTIVE
MALE PARENT IS STILL LIVING (HRQ015 = 5
AND HRQ030=1) GO TO NRQ040 TO ASK FOR
THE ADOPTIVE MALE PARENT. IF ASKING
ABOUT THE ADOPTIVE PARENT OF ANOTHER
GENDER AND ADOPTIVE PARENT OF ANOTHER
GENDER IS NOT LIVING (HRQ015 = 6 AND
HRQ030 = 2, DK, OR SK), GO TO BOX 4.
IF ASKING ABOUT THE ADOPTIVE PARENT OF
ANOTHER GENDER NOT IN HOUSEHOLD AND
ADOPTIVE PARENT OF ANOTHER GENDER IS
STILL LIVING (HRQ015 = 6 AND HRQ030 = 1)
GO TO NRQ040 TO ASK THE ADOPTIVE
PARENT OF ANOTHER GENDER. ELSE, GO TO
BOX 4.

__________________________________________________________

NRQ040
DISPLAY INSTRUCTIONS:
IF THE LOOP IS ABOUT THE BIOLOGICAL FEMALE
PARENT, DISPLAY “biological” AND “female parent” IN
THE STEM AND ANSWER CATEGORIES 5, 6, AND 8.
IN ANSWER CATEGORY 5 DISPLAY “Biological” WITH
THE FIRST LETTER CAPITALIZED.

IF THE LOOP IS ABOUT THE BIOLOGICAL FEMALE
PARENT, DISPLAY “madre” AND “biológica” IN THE
STEM AND ANSWER CATEGORIES 5, 6, AND 8. IN
ANSWER CATEGORY 5 DISPLAY “Biological” WITH THE
FIRST LETTER CAPITALIZED.

IF THE LOOP IS ABOUT THE BIOLOGICAL MALE
PARENT, DISPLAY “biological” AND “male parent” IN
THE STEM AND ANSWER CATEGORIES 5, 6, AND 8.
IN ANSWER CATEGORY 5 DISPLAY “Biological” WITH
THE FIRST LETTER CAPITALIZED.

IF THE LOOP IS ABOUT THE BIOLOGICAL MALE
PARENT, DISPLAY “padre” AND “biológico” IN THE
STEM AND ANSWER CATEGORIES 5, 6, AND 8. IN
ANSWER CATEGORY 5 DISPLAY “El” IN ANSWER
CATEGORY 8 DISPLAY “al” IN FRONT OF “padre”

IF THE LOOP IS ABOUT THE BIOLOGICAL PARENT OF
ANOTHER GENDER, DISPLAY "biological" AND "parent
of another gender" IN THE STEM AND ANSWER
CATEGORIES 5, 6, AND 8, IN ANSWER CATEGORY 5
DISPLAY "Biological" WITH THE FIRST LETTER
CAPITALIZED.

IF THE LOOP IS ABOUT THE BIOLOGICAL PARENT OF
ANOTHER GENDER, DISPLAY "Madre o padre de otro
género" AND "biológico o biológica" IN THE STEM AND
ANSWER CATEGORIES 5, 6, AND 8, IN ANSWER
CATEGORY 5 DISPLAY "Madre" WITH THE FIRST
LETTER CAPITALIZED.

IF THE LOOP IS ABOUT THE ADOPTIVE FEMALE
PARENT, DISPLAY “adoptive” AND “female parent” IN
THE STEM AND ANSWER CATEGORIES 5, 6, AND 8.
IN ANSWER CATEGORY 5 DISPLAY “Adoptive” WITH
THE FIRST LETTER CAPITALIZED. DISPLAY “female
parent” IN ANSWER CATEGORY 7.

IF THE LOOP IS ABOUT THE ADOPTIVE FEMALE
PARENT, DISPLAY “madre” AND “adoptiva” IN THE
STEM AND ANSWER CATEGORIES 5, 6, AND 8. IN
ANSWER CATEGORY 5 DISPLAY “La” IN FRONT OF
“madre” WITH THE FIRST LETTER CAPITALIZED.
DISPLAY “madre” IN ANSWER CATEGORY 7.

IF THE LOOP IS ABOUT THE ADOPTIVE MALE PARENT,
DISPLAY “adoptive” AND “male parent” IN THE STEM
AND ANSWER CATEGORIES 5, 6, AND 8. IN ANSWER
CATEGORY 5 DISPLAY “Adoptive” WITH THE FIRST
LETTER CAPITALIZED. DISPLAY “male parent” IN
ANSWER CATEGORY 7.

IF THE LOOP IS ABOUT THE ADOPTIVE MALE PARENT,
DISPLAY “padre” AND “adoptivo” IN THE STEM AND
ANSWER CATEGORIES 5, 6, AND 8. IN ANSWER
CATEGORY 5 DISPLAY “El” WITH THE FIRST LETTER
CAPITALIZED. DISPLAY “padre” IN ANSWER
CATEGORY 7.

IF THE LOOP IS ABOUT ADOPTIVE PARENT OF
ANOTHER GENDER, DISPLAY "adoptive" AND "parent
of another gender" IN THE STEM AND ANSWER
CATEGORIES 5, 6, AND 8, IN ANSWER CATEGORY 5
DISPLAY "Adoptive" WITH THE FIRST LETTER
CAPITALIZED.

IF THE LOOP IS ABOUT ADOPTIVE PARENT OF
ANOTHER GENDER, DISPLAY "madre o padre de otro
género" AND "adoptive o adoptiva" IN THE STEM AND
ANSWER CATEGORIES 5, 6, AND 8, IN ANSWER
CATEGORY 5 DISPLAY "Madre" WITH THE FIRST
LETTER CAPITALIZED.

QUESTION TEXT:
Question “How long has it been since {CHILD}
last had a visit, a phone call, a video call, an email, a text or other electronic message, or
received a card or letter from {his/her/their}
{biological/adoptive} {male parent/female
parent/parent of another gender}?”
SaVisible "True"

CODES

“¿Cuánto tiempo hace desde la última vez que
{CHILD} tuvo una visita, una llamada
telefónica, una llamada con video, un correo
electrónico, un texto u otro mensaje
electrónico, o recibió una tarjeta o carta de su
{padre/madre/madre o padre de otro género}
{biológica/adoptiva}{biológico/adoptivo}{biológ
ico o biológica} {adoptivo o adoptiva}?”

Less than one month

Menos de un mes

More than a month but less than a year

Más de un mes, pero menos de un año

More than a year

Más de un año

No contact since birth

Ningún contacto desde que nació

{Biological/Adoptive} {male parent/female
parent/parent of another gender} is deceased

{CHILD} has had no contact with {his/her/their}
{biological/adoptive} {male parent/female
parent/parent of another gender} since adoption

{{CHILD} does not have an adoptive{male
parent/female parent/parent of another gender}}
{CHILD}’s {biological/adoptive} {male
parent/female parent/parent of another gender}
is not known or was only a donor
DON'T KNOW
Box 4

{El padre/La madre/Madre o padre de otro
género}
{biológica/adoptiva}{biológico/adoptivo}
{biológico
o biológica}{adoptivo o adoptiva} murió
{CHILD} no ha tenido contacto con su
{padre/madre/madre o padre de otro
género} {biológico(a)/adoptivo(a)}desde su
adopción
{CHILD} no tiene {padre/madre/madre o
padre de otro género} adoptivo(a)
No se conoce {al padre/a la madre/a la
madre o al padre de otro género} o solo fue
donante
DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DISPLAY CODE 7 IF HRQ015 = 4, 5, OR 6 (AN
ADOPTIVE NONRESIDENT PARENT WAS
REPORTED) AND THE LOOP IS FOR AN
ADOPTIVE FEMALE PARENT, MALE PARENT, OR
PARENT OF ANOTHER GENDER.
__________________________________________________________

Box 4

ASK NRQ040 FOR THE NEXT NONRESIDENTIAL
PARENT. IF NO NEXT NONRESIDENTIAL
PARENT, GO TO BOX 5.

__________________________________________________________

Box 5

GO TO SECTION PEQ (Parent Education and
Human Capital).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

PEQ

Parent Education

__________________________________________________________

Box 1

LOOP 1
ASK PEQ020 FOR 4 “KEY” PARENT FIGURES AS
DEFINED IN BOX 12 OF FSQ AND UP TO 6
NONRESIDENTIAL BIOLOGICAL/ADOPTIVE
PARENTS (EVEN IF DECEASED).
ALWAYS ASK ABOUT THE NONRESIDENTIAL
PARENT(S) LAST. DEFINE NONRESIDENT
PARENTS AS FOLLOWS:
ALWAYS ASK ABOUT THE NON-RESIDENTIAL
PARENT(S) LAST. DEFINE NON-RESIDENT
PARENTS AS FOLLOWS:
1.NONRESIDENT BIOLOGICAL FEMALE PARENT
(IF HRQ030=1 OR 2 FOR A BIOLOGICAL
FEMALE PARENT).
2.NONRESIDENT BIOLOGICAL MALE PARENT
(IF HRQ030=1 OR 2 FOR A BIOLOGICAL MALE
PARENT).
3.NONRESIDENT BIOLOGICAL PARENT OF
ANOTHER GENDER (IF HRQ030=1 OR 2 FOR A
BIOLOGICAL PARENT OF ANOTHER GENDER).
4.NONRESIDENT ADOPTIVE FEMALE PARENT
(IF HRQ030 = 1 OR 2 FOR AN ADOPTIVE
FEMALE PARENT).
5.NONRESIDENT ADOPTIVE MALE PARENT (IF
HRQ030 = 1 OR 2 FOR AN ADOPTIVE MALE
PARENT).
6.NONRESIDENT ADOPTIVE PARENT OF
ANOTHER GENDER (IF HRQ030=1 OR 2 FOR
AN ADOPTIVE PARENT OF ANOTHER GENDER).
NOTE: FOR RESIDENT PARENTS/RESPONDENT,
LOOP 1 WILL BE ASKED A MINIMUM OF 1 TIME
AND A MAXIMUM OF 4 TIMES. FOR
NONRESIDENT PARENTS, LOOP 1 WILL BE
ASKED A MINIMUM OF 0 TIMES AND A
MAXIMUM OF 6 TIMES.

__________________________________________________________

PEQ020
DISPLAY INSTRUCTIONS:
DISPLAY "Now we would… parent(s)." THE FIRST
TIME PEQ020 IS SHOWN ONLY.

DISPLAY "Ahora quisiéramos preguntarle... de
{CHILD}." THE FIRST TIME PEQ020 IS SHOWN ONLY.

DISPLAY "you" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.

DISPLAY "usted" IF CURRENT CYCLE OF LOOP 1
ISASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S FIRST
NAME) IF CURRENT CYCLE OF LOOP IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY “{CHILD}’s {biological/adoptive} {female
parent/male parent/parent of another gender}}” IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT PARENT.

DISPLAY “{{la madre/el padre /madre o padre de
otro género}
{biológica/adoptiva}{biológico/adoptivo} {biológico o
biológica} {adoptivo o adoptiva} de {CHILD}}” IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT PARENT.

DISPLAY "biological" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A NON-RESIDENT BIOLOGICAL
PARENT. OTHERWISE, DISPLAY "adoptive" IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT ADOPTIVE PARENT.
DISPLAY “female parent” IF THE NONRESIDENTIAL
FEMALE PARENT IS BEING ASKED ABOUT. DISPLAY
“male parent” IF THE NONRESIDENTIAL MALE
PARENT IS BEING ASKED ABOUT. DISPLAY "parent of
another gender" IF THE NONRESIDENTIAL PARENT OF
ANOTHER GENDER IS BEING ASKED ABOUT.
DISPLAY "have" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY “had” IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT BIOLOGICAL PARENT AND HRQ030 =
2 FOR THAT PARENT. OTHERWISE, DISPLAY "has".

DISPLAY "biológico(a)" IF CURRENT CYCLE OF LOOP 1
IS ASKING ABOUT A NON-RESIDENT BIOLOGICAL
PARENT. OTHERWISE, DISPLAY "adoptivo(a)" IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT ADOPTIVE PARENT.
DISPLAY “madre” IF THE NONRESIDENTIAL FEMALE
PARENT IS BEING ASKED ABOUT. DISPLAY “padre” IF
THE NONRESIDENTIAL MALE PARENT IS BEING
ASKED ABOUT. DISPLAY "madre o padre de otro
género" IF THE NONRESIDENTIAL PARENT OF
ANOTHER GENDER IS BEING ASKED ABOUT.
DISPLAY "ha" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY “había”
IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT BIOLOGICAL PARENT AND HRQ030 =
2 FOR THAT PARENT. OTHERWISE, DISPLAY "ha".

QUESTION TEXT:
Question "{Now we would like to ask about the
education of {CHILD}'s parent(s).}

"{Ahora quisiéramos preguntarle acerca de la
educación de los padres y madres de {CHILD}.}

What is the highest grade or year of school or
degree that {you/{INITIALS/NAME}/{CHILD}’s
{biological/adoptive} {female parent/male
parent/parent of another gender}}
{have/has/had} completed?"

¿Cuál es el grado o año escolar o título más alto
que {{usted/{INITIALS/NAME}/{{la madre/el
padre /madre o padre de otro género}
{biológica/adoptiva}{biológico/adoptivo}
{biológico o biológica} {adoptivo o adoptiva}}
de {CHILD}} {ha/había} completado?"

CODES
0

Never went to school

Nunca fue a la escuela

1st grade

1º grado

2nd grade

2º grado

3rd grade

3º grado

4th grade

4º grado

5th grade

5º grado

6th grade

6º grado

7th grade

7º grado

8th grade

8º grado

9th grade

9º grado

10th grade

10º grado

11th grade

11º grado

12th grade but no diploma

12º grado

High school equivalent/GED

Equivalente a High school /GED

High school diploma

Diploma de High school

Vocational or technical program after high school
but no vocational/technical diploma
Vocational or technical program after high school,
diploma
Some college but no degree

Programa vocacional/técnico posterior a high
school pero sin diploma vocacional/técnico
Diploma de programa vocacional/técnico
posterior a high school
Algo de college pero sin título

Associate's degree

Grado asociado

Bachelor's degree

Título de bachelor

Graduate or professional school but no degree

Master's degree (MA, MS)

Estudios de posgrado o profesionales pero sin
obtener título
Maestría (MA, MS)

Doctorate degree (Ph.D, Ed.D)

Doctorado (Ph.D, Ed.D)

Professional degree after bachelor's degree
(Medicine/MD; Dentistry/DDS; Law/JD/LLB; etc.)

Don't know

Título profesional posterior al título de
bachelor (medicina/MD;
odontología/DDS;leyes/JD/LLB;etc.))
No sé

Rather not answer

Prefiere no contestar

PROGRAMMER INSTRUCTIONS:
DISPLAY ‘Don't know’ AND ‘Rather not answer’
AT THE TOP OF CODE 0 WHEN THE QUESTION
IS ASKED. CONVERT THE ‘Don't know’ AND
‘Rather not answer’ TO SPECIAL ANSWERS DK
AND RF IN THE SAVED VARIABLE.

DISPLAY ‘No sé’ AND ‘Prefiere no contestar’ AT
THE TOP OF CODE 0 WHEN THE QUESTION IS
ASKED. CONVERT THE ‘No sabe’ AND ‘Prefiere no
contestar’TO SPECIAL ANSWERS DK AND RF IN
THE SAVED VARIABLE.

IN HELP TEXT BOLD "Highest Grade or Year of
School Completed", "12th grade but no
diploma", "High school equivalent/GED", "High
school diploma", "Vocational/technical program
after high school but no voc/tech diploma",
"Vocational/technical program after high school,
diploma", "Some college but no degree",
"Associate's degree", "Bachelor's degree",
"Graduate or professional school but no degree",

IN HELP TEXT BOLD “Grado o año escolar más alto
completado", "Grado 12 pero sin diploma ",
"Equivalente de high school/GED ", "Diploma de
high school", " Programa vocacional/técnico
después de high school pero sin diploma
vocacional/técnico", " Programa vocacional/técnico
después de high school, diploma", " Algunos
estudios universitarios pero sin título", "Grado
asociado", "Título de Bachelor/Licenciatura",

"Master's (MA, MS)", "Doctorate Degree (Ph.D.,
Ed.D.)", "Professional degree after bachelor's
degree (Medicine/MD; Dentistry/DDS,
Law/JD/LLB)"

"Estudios profesionales o de posgrado pero sin
título", "Maestría (MA, MS)", "Doctorado (Ph.D.,
EdD)", " Título profesional después del bachelor
(Medicina/MD; Odontología/DDS, Leyes/JD/LLB)"

HELP FOR STEM: Highest Grade or Year of
School Completed: Please select the highest
grade or year of school that was finished, even if
took more or less time to reach that year of
school than expected.

HELP FOR STEM: Grado o año escolar más alto
completado: seleccione el grado o año escolar más
alto que haya terminado, incluso si tomó más o
menos tiempo alcanzar ese año escolar de lo
esperado.

HELP FOR CODE 12: 12th grade but no
diploma: Select this if the 12th grade was
finished, but there was not a high school
diploma or GED. High school typically refers to
grades 9-12.

HELP FOR CODE 12: Grado 12 pero sin diploma:
Seleccione esto si el grado 12 se terminó, pero no
hubo un diploma de high school o GED. High
school generalmente se refiere a los grados 9-12.

HELP FOR CODE 13: High school
equivalent/GED: Select this if a person has a
high-school equivalency diploma or GED from
passing the General Educational Development
Test and does not have a diploma received from
a high school. High school typically refers to
grades 9-12.
HELP FOR CODE 14: High school diploma: A
certificate showing that the courses required for
high school graduation were completed. High
school typically refers to grades 9-12.
HELP FOR CODE 15: Vocational/technical
program after high school but no voc/tech
diploma: Select this if a person attended a
vocational or technical program, but did not earn
a degree/diploma/certificate of successful
completion of the program. These programs are
training or education for a trade and are
completed after high school (high school
typically refers to grades 9-12), but do not
include college. Examples include secretarial
school, mechanical or computer training school,
etc. Some community colleges offer vocational
training, but this would be considered “1-2 years
of college" or "associate's degree" and not
vocational or trade school.
HELP FOR CODE 16: Vocational/technical
program after high school, diploma: Select this
if a person attended a vocational or technical
program, and earned a
degree/diploma/certificate of successful
completion of the program. These programs are
work or education for a trade and are completed

HELP FOR CODE 13: Equivalente de high
school/GED: seleccione esta opción si una persona
tiene un diploma de equivalencia de high school o
GED al aprobar la Prueba de Desarrollo Educativo
General y no recibió un diploma de high school.
High school generalmente se refiere a los grados
9-12.
HELP FOR CODE 14: Diploma de high school: un
certificado que muestra que una persona terminó
los cursos requeridos para graduarse de la high
school. High school generalmente se refiere a los
grados 9-12.
HELP FOR CODE 15: Programa vocacional/técnico
después de high school pero sin diploma
vocacional/técnico: Seleccione esto si una persona
asistió a un programa vocacional o técnico, pero
no obtuvo un título/diploma/certificado de
finalización exitosa del programa. Estos son
programas que dan entrenamiento o estudios para
un oficio y se completan después de high school
(high school generalmente se refiere a los grados
9-12), pero no incluyen el college o la
universidad. Los ejemplos incluyen escuela de
secretariado, escuela de entrenamiento para
mecánicos o para técnicos en computación, etc.
Algunos colleges o universidades comunitarias
ofrecen entrenamiento vocacional, pero esto se
consideraría "1-2 años de universidad" o "grado
asociado" y no escuela vocacional o de oficios.
HELP FOR CODE 16: Programa vocacional/técnico
después de high school, diploma: Seleccione esto
si una persona asistió a un programa vocacional o
técnico y obtuvo un título/diploma /certificado de
finalización exitosa del programa. Estos son

after high school (high school typically refers to
grades 9-12), but do not include college.
Examples include secretarial school, mechanical
or computer training school, etc. Some
community colleges offer vocational training, but
this would be considered "1-2 years of college"
or "associate's degree" and not vocational or
trade school.
HELP FOR CODE 17: Some college but no
degree: Select this if a person does not have a
4-year college (bachelor's) degree, but has
completed a class for credit at a college or
university.

programas de trabajo o estudios para un oficio y
se completan después de high school (high school
generalmente se refiere a los grados 9-12), pero
no incluyen el college o la universidad. Los
ejemplos incluyen escuela de secretariado,
escuela de entrenamiento para mecánicos o para
técnicos en computación, etc. Algunos colleges o
universidades comunitarias ofrecen entrenamiento
vocacional, pero esto se consideraría "1-2 años de
universidad" o "grado asociado" y no escuela
vocacional o de oficios.

HELP FOR CODE 18: Associate's degree: A 2year college degree typically earned at a
community college (rather than a trade school).

HELP FOR CODE 17: Algunos estudios
universitarios pero sin título: seleccione esta
opción si una persona no tiene un título
universitario (licenciatura/bachelor) de 4 años,
pero ha completado una clase para obtener
créditos en un college o universidad.

HELP FOR CODE 19: Bachelor's degree: A 4year college degree earned at a university or 4year college. It is sometimes called an
"undergraduate degree."

HELP FOR CODE 18: Grado asociado: un título
universitario de 2 años típicamente obtenido en
un college comunitario (en lugar de una escuela
vocacional).

HELP FOR CODE 20: Graduate or professional
school but no degree: Select this if a person
went to graduate or professional school and got
some credit toward a degree beyond a bachelor's
degree (for example, a master's, doctorate, or
other professional degree). However, the person
did not complete the program or earn the degree.

HELP FOR CODE 19: Título de
Bachelor/Licenciatura: Un título universitario de 4
años obtenido en una universidad o college de 4
años. A veces se llama título subgraduado.

HELP FOR CODE 21: Master's (MA, MS): Studies
beyond a bachelor's degree, but not a Ph.D. or
Ed.D.
HELP FOR CODE 22: Doctorate Degree (Ph.D.,
Ed.D.): Studies beyond a master's degree that
result in a doctorate degree.
HELP FOR CODE 23: Professional degree after
bachelor's degree (Medicine/MD; Dentistry/DDS,
Law/JD/LLB): Any other graduate degrees
earned with academic studies beyond the
bachelor's.

HELP FOR CODE 20: Estudios profesionales o de
posgrado pero sin título: Seleccione esta opción si
una persona asistió a una escuela de posgrado o
profesional y obtuvo algún crédito para obtener un
título más allá de un bachelor (por ejemplo, una
maestría, doctorado u otro título profesional). Sin
embargo, la persona no completó el programa ni
obtuvo el título.
HELP FOR CODE 21: Maestría (MA, MS): Estudios
más allá de un bachelor, pero no un doctorado. O
Ed.D.
HELP FOR CODE 22: Doctorado (Ph.D., EDD):
Estudios más allá de una maestría que resultan en
un doctorado.
HELP FOR CODE 23: Título profesional después del
bachelor (Medicina/MD; Odontología/DDS,
Leyes/JD/LLB): cualquier otra licenciatura
obtenida con estudios académicos más allá del
bachelor.

__________________________________________________________

PEQ050
DISPLAY INSTRUCTIONS:
DISPLAY “Are you” IF CURRENT CYCLE OF LOOP IS
ASKING ABOUT THE RESPONDENT. DISPLAY “Is
{INITIAL/NAME}” (AND THAT PERSON’S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT. DISPLAY “{CHILD}’s
{biological/adoptive} {female parent/male
parent/parent of another gender }}” IF CURRENT
CYCLE OF LOOP 1 IS ASKING ABOUT A NONRESIDENT PARENT.

DISPLAY “¿Está usted” IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT THE RESPONDENT. DISPLAY “¿Está
{INITIAL/NAME}” (AND THAT PERSON’S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT. DISPLAY “{la madre/el padre /la
madre o el padre de otro género}
{biológico(a)/adoptivo(a)} de {CHILD}” IF CURRENT
CYCLE OF LOOP 1 IS ASKING ABOUT A NONRESIDENT
PARENT.

DISPLAY "biological" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A NON-RESIDENT BIOLOGICAL
PARENT. OTHERWISE, DISPLAY "adoptive" IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NON-RESIDENT ADOPTIVE PARENT.

DISPLAY "biológico(a)” IF CURRENT CYCLE OF OF
LOOP 1 IS ASKING ABOUT A NONRESIDENT
BIOLOGICAL PARENT. OTHERWISE, DISPLAY
"adoptive(a)" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A NONRESIDENT ADOPTIVE PARENT.

QUESTION TEXT:
Question “{Are you/Is {INITIALS/NAME}/Is
{CHILD}’s {biological/adoptive} {female
parent/male parent/parent of another
gender}} currently attending or enrolled in
any courses from a school, college, or
university?”

“{¿Está {usted/{INITIALS/NAME}/{la madre /el
padre/la madre o el padre de otro género}
{biológico(a)/adoptivo(a)} de {CHILD}}
asistiendo o matriculado(a) en algún curso de
una escuela, college o universidad
actualmente?”

CODES
1

Yes

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO BOX 3.

Sí
Box 3

__________________________________________________________

PEQ060
DISPLAY INSTRUCTIONS:
DISPLAY “Are you” IF CURRENT CYCLE OF LOOP IS
ASKING ABOUT THE RESPONDENT. DISPLAY “Is
{NAME}” (AND THAT PERSON’S FIRST NAME) IF
CURRENT CYCLE OF LOOP IS ASKING ABOUT A
PARENT FIGURE WHO IS NOT THE RESPONDENT.
DISPLAY “{CHILD}’s {biological/adoptive} {female
parent/male parent/parent of another gender}}” IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NON-RESIDENT PARENT.
DISPLAY "biological" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A NON-RESIDENT BIOLOGICAL
PARENT. OTHERWISE, DISPLAY "adoptive" IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NON- RESIDENT ADOPTIVE PARENT.

DISPLAY “Are you” IF CURRENT CYCLE OF LOOP IS
ASKING ABOUT THE RESPONDENT. DISPLAY “Is
{NAME}” (AND THAT PERSON’S FIRST NAME) IF
CURRENT CYCLE OF LOOP IS ASKING ABOUT A
PARENT FIGURE WHO
IS NOT THE RESPONDENT. DISPLAY “{CHILD}’s
{biological/adoptive} {female parent/male
parent/parent of another gender}}” IF CURRENT
CYCLE OF LOOP 1 IS ASKING ABOUT A NONRESIDENT PARENT.
DISPLAY "biological" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A NON-RESIDENT BIOLOGICAL
PARENT. OTHERWISE, DISPLAY "adoptive" IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NON- RESIDENT ADOPTIVE PARENT.

QUESTION TEXT:
Question “{Are you/Is {NAME}}/Is {CHILD}’s
{biological/adoptive} {female parent/male
parent/parent of another gender}} currently
taking courses full time or part time?”

“{¿Está {usted/{NAME}/ {la madre /el padre/la
madre o el padre de otro género} biológico(a) o
adoptivo(a) de {CHILD}} tomando cursos a
tiempo completo o tiempo parcial?”

CODES
1

Full-time

Tiempo completo

Part-time

Tiempo parcial

PROGRAMMER INSTRUCTIONS:
DISPLAY “Full-time” AND “Part-time” IN BOLD IN
HELP TEXT.

DISPLAY “Tiempo completo” AND “Tiempo parcial”
IN BOLD IN HELP TEXT.

HELP FOR STEM: Full-time: A person is
considered to be attending school full-time if he
or she is carrying a full load of class hours in a
semester or quarter. This is typically 12 credit
hours or more.

HELP FOR STEM: A tiempo completo: Se considera
que una persona asiste a la escuela a tiempo
completo si lleva una carga completa de horas de
clase en un semestre o trimestre. Se trata
normalmente de 12 horas de crédito o más.

Part-time: A person is considered to be
attending school part-time if he or she is
carrying less than a full load
of class hours in a semester or quarter. This is
typically less than 12 credit hours.

A tiempo parcial: Se considera que una persona
asiste a la escuela a tiempo parcial si lleva menos
de una carga completa de horas de clase en un
semestre o trimestre. Normalmente son menos de
12 créditos.

__________________________________________________________

Box 3

END LOOP 1
ASK PEQ020 – PEQ060 (IF APPLICABLE) FOR
NEXT “KEY” PARENT FIGURE AS DEFINED IN
BOX 12 OF FSQ IN THE CURRENT SURVEY AND
FOR UP TO 4 NONRESIDENTIAL
BIOLOGICAL/ADOPTIVE PARENTS AS DEFINED
AT THE BEGINNING OF LOOP 1.
IF NO NEXT “KEY” PARENT FIGURE OR
NONRESIDENTIAL BIOLOGIAL/ADOPTIVE
PARENT, GO TO BOX 4.

__________________________________________________________

Box 4

GO TO SECTION EMQ (PARENT EMPLOYMENT).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

EMQ

Parent Employment

__________________________________________________________

Box 1

LOOP 1
ASK EMQ005-EMQ215 FOR 4 “KEY” PARENT
FIGURES AS DEFINED IN BOX 12 OF FSQ.

__________________________________________________________

EMQ005
DISPLAY INSTRUCTIONS:
DISPLAY "your" and “you” IF CURRENT CYCLE OF
LOOP 1 IS ASKING ABOUT THE RESPONDENT.
DISPLAY "{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY "usted" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.

QUESTION TEXT:
Question “Which best describes
{your/{INITIALS/NAME}’s} current
employment situation? {Are you/Is
{INITIALS/NAME}}…”

"¿Cuál describe mejor la situación laboral actual
de (usted/{INITIALS/NAME}? ¿Está
{usted/{INITIALS/NAME}}…"

CODES
1

Working 35 or more hours per week, counting all
jobs
Working less than 35 hours per week, counting all
jobs
Actively looking for work

Not in the labor force

Trabajando 35 o más horas por semana,
contando todos los trabajos
Trabajando menos de 35 horas por semana,
contando todos los trabajos
Buscando trabajo activamente
EMQ210

No está en la fuerza laboral

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO EMQ210.
HELP FOR CODE 1: Working for 35 hours or
more per week, counting all jobs: This includes
if you are currently on vacation or leave but you
are still employed for 35 hours or more per week.
HELP FOR CODE 2: Working less than 35 hours
per week, counting all jobs: This includes if you
are currently on vacation or leave but you are
still employed for less than 35 hours per week.
HELP FOR CODE 3: Actively looking for work:
For example, in the past month, engaged in
activities such as: checked with a public
employment agency, checked with a private
employment agency, checked with an employer
directly or sent a resume to an employer,
checked with friend or relative, or places or
answered ads/send resume related to an ad.
HELP FOR CODE 4: Not in the labor force: Not
working, and not actively looking for work.

HELP FOR CODE 1: Trabajar durante 35 horas o
más por semana, contando todos los trabajos:
Esto incluye si usted es Actualmente está de
vacaciones o de licencia, pero todavía está
empleado durante 35 horas o más por semana.
HELP FOR CODE 2: Trabajar menos de 35 horas
por semana, contando todos los trabajos: Esto
incluye si usted es
Actualmente de vacaciones o de licencia, pero
todavía está empleado por menos de 35 horas por
semana.
HELP FOR CODE 3: Buscar trabajo activamente:
Por ejemplo, en el último mes, participó en
actividades tales como: consultó con una agencia
pública de empleo, consultó con una agencia de
empleo privada, consultó con un empleador
directamente o envió un currículum vitae a un
empleador, verificó con un amigo o pariente, o
lugares o respondió anuncios / enviar currículum
relacionado con un anuncio.
HELP FOR CODE 4: No en la fuerza laboral: No

trabajar y no buscar trabajo activamente.
__________________________________________________________

Box 1b

QUESTION TEXT:
SET EMQLANG AS CURRENT ACTIVE
LANGUAGE ONLY ONCE. GO TO EMQ126 IF
EMQLang = ESP. ELSE GO TO EMQ125.

__________________________________________________________

EMQ125
DISPLAY INSTRUCTIONS:
DISPLAY “What is {your/{INITIALS/NAME}’s}
current” IF CURRENTLY EMPLOYED OR ON LEAVE
FROM A JOB (EMQ005 = 1 or 2). ELSE DISPLAY “In
{your/{INITIALS/NAME}’s} most recent job, what
was {your/{INITIALS/NAME}’s}”.
DISPLAY "your" and “you” IF CURRENT CYCLE OF
LOOP 1 IS ASKING ABOUT THE RESPONDENT.
DISPLAY "{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.
DISPLAY “have” AND “work” IF (CURRENT CYCLE OF
LOOP 1 IS ASKING ABOUT THE RESPONDENT) AND
(THE RESPONDENT IS CURRENTLY EMPLOYED OR ON
LEAVE FROM A JOB (EMQ005 = 1 or 2)). ELSE ELSE
DISPLAY “had” AND “worked” IF CURRENT CYCLE OF
LOOP 1 IS ASKING ABOUT THE RESPONDENT.
DISPLAY “has” AND “works” IF (CURRENT CYCLE OF
LOOP IS ASKING ABOUT A PARENT FIGURE WHO IS
NOT THE RESPONDENT) AND (THIS PARENT FIGURE
IS CURRENTLY EMPLOYED OR ON LEAVE FROM A JOB
(EMQ005 = 1 or 2)). ELSE DISPLAY “had” AND
“worked” IF CURRENT CYCLE OF LOOP IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY “¿Cuál es el título del puesto de {su trabajo
actual/el trabajo {actual de {INITIALS/NAME}” IF
CURRENTLY EMPLOYED OR ON LEAVE FROM A JOB
(EMQ005 = 1 OR 2). ELSE DISPLAY “En el trabajo
más reciente, ¿cuál era el título del puesto de trabajo
{suyo/de {INITIALS/NAME}}”.
DISPLAY "su trabajo actual", “suyo”, “Usted”, AND
“de usted” IF CURRENT CYCLE OF LOOP 1 IS ASKING
ABOUT THE RESPONDENT. ELSE DISPLAY “el trabajo
actual de {INITIALS/NAME}” AND “de
{INITIALS/NAME}”.
DISPLAY "{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.
DISPLAY “tiene” AND “trabaja” IF (CURRENT CYCLE
OF LOOP 1 IS ASKING ABOUT THE RESPONDENT)
AND (THE RESPONDENT IS CURRENTLY EMPLOYED
OR ON LEAVE FROM A JOB (EMQ005 = 1 or 2). ELSE
ELSE DISPLAY “tenía” AND “trabajaba” IF CURRENT
CYCLE OF LOOP 1 IS ASKING ABOUT THE
RESPONDENT.
DISPLAY “título del puesto de trabajo” IN BOLD TEXT.

DISPLAY “job title” IN BOLD TEXT.

QUESTION TEXT:
Question “{What is {your/{INITIALS/NAME}’s}
current/In {your/{INITIALS/NAME}’s} most
recent job, what was
{your/{INITIALS/NAME}’s}} job title (for
example, 4th-grade teacher, apprentice
plumber)?

“{¿Cuál es el título del puesto de {su trabajo
actual/el trabajo actual de
{INITIALS/NAME}/En el trabajo más reciente,
¿cuál era el título del puesto de trabajo
{suyo/de {INITIALS/NAME}}, (por ejemplo,
maestro de 4º grado, aprendiz de plomero)?

If {you/{INITIALS/NAME}} {have/has/had}
more than one job, describe the one at which
{you/{INITIALS/NAME}}
{work/works/worked} the most hours.

Si {usted/{INITIALS/NAME}} {tiene/tenía}
más de un trabajo, describe el trabajo en el que
{usted/{INITIALS/NAME}} {trabaja/trabajaba}
más horas.

Start by typing the job title and select the
closest match from the options returned. If
you are unable to find a close match for
{your/{INITIALS/NAME}’s} job title, click “Job
title not listed.”

Comience a escribir el título del puesto de
trabajo y seleccione la opción que mejor
corresponda entre las opciones que aparezcan.
Si no puede encontrar una que se aproxime al
trabajo {de usted/de {INITIALS/NAME}}, haga
clic en “Título del trabajo no está en la lista.”

“Job title not listed.”

“Título del trabajo no está en la lista.”

PROGRAMMER INSTRUCTIONS:
DISPLAY THE LIST OF JOB TITLES “SOCTITLE”
IN THE PRELOAD ASSOCIATED WITH EMQ125.
SAVE EACH JOB TITLE WITH THE SOCCODE6
CODE, BUT DO NOT DISPLAY THE CODE IN THE
SURVEY LIST.
ADD SPECIAL ANSWER TO DISPLAY “Job title not
listed” AS A RADIO BUTTON AT THE END OF THE
LIST OF JOB TITLES.

DISPLAY THE LIST OF JOB TITLES “SOCTITLE” IN
THE PRELOAD ASSOCIATED WITH EMQ125. SAVE
EACH JOB TITLE WITH THE SOCCODE2 CODE, BUT
DO NOT DISPLAY THE CODE IN THE SURVEY LIST.
ADD SPECIAL ANSWER TO DISPLAY “Título del
trabajo no está en la lista.” AS A RADIO BUTTON
AT THE END OF THE LIST OF JOB TITLES.

__________________________________________________________

Box 2

IF EMQ125 = "JOB TITLE NOT LISTED" OR
EMQ125 = SK GO TO EMQ126 (GENERAL
OCCUPATION). ELSE IF THE RESPONDENT'S
ANSWER IN EMQ125 MATCHES MORE THAN
ONE SOCCODE6 CODE, GO TO EMQ125b
(SPECIFIC OCCUPATION). ELSE IF THE
RESPONDENT'S ANSWER IN EMQ125 MATCHES
ONLY ONE SOCCODE6 CODE, GO TO EMQ129
(JOB DUTIES).
NOTE: IF THE RESPONDENT INDICATES THAT
THE JOB TITLE IS NOT LISTED IN EMQ125,
THE RESPONDENT IS DIRECTED TO GENERAL
(EMQ126), SPECIFIC (EMQ127), AND
DETAILED (EMQ128) CATEGORIES FOR
CODING. IF A JOB TITLE SELECTED IN
EMQ125 MATCHES MORE THAN ONE
SOCCODE6 NUMBER IN THE EMQ125
DROPDOWN LIST, ONE MORE DROPDOWN
LIST (USING SOCCODE6_LABEL) WILL BE
PROVIDED IN EMQ125b TO OBTAIN A JOB
TITLE. IF A JOB TITLE SELECTED IN EMQ125
MATCHES ONLY ONE SOCCODE6 NUMBER IN
THE EMQ125 DROPDOWN LIST, THE JOB TITLE
HAS BEEN OBTAINED AND THE RESPONDENT
IS SKIPPED TO EMQ129 (JOB DUTIES).

__________________________________________________________

EMQ125b
DISPLAY INSTRUCTIONS:
DISPLAY “Your” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY “Su puesto de trabajo” IF CURRENT CYCLE
OF LOOP 1 IS ASKING ABOUT THE RESPONDENT.
ELSE DISPLAY “El puesto de trabajo de
{INITIALS/NAME}”.

QUESTION TEXT:
Question “{Your/{INITIALS/NAME}’s} job title
could be classified into more than one
category.

“{Su puesto de trabajo/El puesto de trabajo de
{INITIALS/NAME}} se podría clasificar bajo más
de una categoría.

Please scroll down and select the specific
category that best describes
{your/{INITIALS/NAME}’s} job.

Por favor vaya hacía abajo y seleccione la
categoría específica que mejor describa su
trabajo.

Specific Area:”

La categoría específica:”

Watermark : "Select one"

Watermark: "Seleccione uno"

PROGRAMMER INSTRUCTIONS:
DISPLAY THE SOCCODE6_LABEL FOR THE
CODES FROM EMQ125 IN THE SPECIFIC AREA
DROPDOWN.

DISPLAY THE SOCCODE6_LABEL FOR THE CODES
FROM EMQ125 IN THE SPECIFIC AREA
DROPDOWN.

IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE. DON’T KNOW AND
RATHER NOT ANSWER IN THE PARENT SURVEY
PROBE SKIP TO EMQ129.

IF THIS QUESTION IS SK (SKIPPED), USE PARENT
SURVEY PROBE. DON’T KNOW AND RATHER NOT
ANSWER IN THE PARENT SURVEY PROBE SKIP TO
EMQ129.

__________________________________________________________

Box 3

GO TO EMQ129.

__________________________________________________________

EMQ126
DISPLAY INSTRUCTIONS:
DISPLAY EMQ126, EMQ127, AND EMQ128 ON THE
SAME SCREEN.
DISPLAY “you” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY “Usted” AND “su trabajo” IF CURRENT CYCLE
OF LOOP 1 IS ASKING ABOUT THE RESPONDENT.
ELSE DISPLAY “el trabajo de {INITIALS/NAME}.”
DISPLAY “actual” IF CURRENTLY EMPLOYED OR ON
LEAVE FROM A JOB (EMQ005 = 1 or 2). ELSE
DISPLAY “más reciente”.

DISPLAY “current” IF CURRENTLY EMPLOYED OR ON
LEAVE FROM A JOB (EMQ005 = 1 or 2). ELSE
DISPLAY “most recent”.

QUESTION TEXT:
Question “Please help us categorize
{your/{INITIALS/NAME}’s} {current/most
recent} job using the dropdown boxes
displayed. Scrolling each dropdown, click to
select the category that best describes your
occupation area and classification."
General Area:”
Watermark : "Select one"

PROGRAMMER INSTRUCTIONS:
DISPLAY THE GENERAL CATEGORY FROM THE
EMQ126 PRELOAD IN THE GENERAL AREA
DROPDOWN.
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE. DON’T KNOW AND
RATHER NOT ANSWER IN THE PARENT SURVEY
PROBE SKIP TO EMQ129.

"Por favor ayúdenos a categorizar {su trabajo/el
trabajo de {INITIALS/NAME}} {actual/más
reciente} utilizando los cuadros desplegables
que se muestran. Yendo hacia abajo en cada
lista desplegable, haga clic para seleccionar la
opción que mejor describe el área y la
clasificación de su ocupación."
Área general:”
Watermark: "Seleccione uno"

__________________________________________________________

EMQ127
DISPLAY INSTRUCTIONS:
DISPLAY EMQ126, EMQ127, AND EMQ128 ON THE
SAME SCREEN.
DISPLAY “Your” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY “Su puesto de trabajo” IF CURRENT CYCLE
OF LOOP 1 IS ASKING ABOUT THE RESPONDENT.
ELSE DISPLAY “El puesto de trabajo de
{INITIALS/NAME}”.

QUESTION TEXT:
Question “{Your/{INITIALS/NAME}’s} job title
could be classified into more than one
category.

“{Su puesto de trabajo/El puesto de trabajo de
{INITIALS/NAME}} se podría clasificar bajo más
de una categoría.

Please scroll down and select the specific
category that best describes
{your/{INITIALS/NAME}’s} job.

Por favor vaya hacía abajo y seleccione la
categoría específica que mejor describa su
trabajo.

Specific Area:”

La categoría específica:”

Watermark : "Select one"

Watermark: "Seleccione uno"

PROGRAMMER INSTRUCTIONS:
USING THE CODE SELECTED FOR THE GENERAL
OCCUPATION CATEGORY FROM THE EMQ126
PRELOAD (E.G., “Transportation and Material
Moving Occupations” FOR MAJOR GROUP CODE
53-000), DISPLAY THE SPECIFIC CATEGORY
FROM THE EMQ127 PRELOAD THAT MATCHES
THE FIRST TWO DIGITS OF THE CODE IN
EMQ127 (E.G., “Air Transportation Workers” FOR
SPECIFIC GROUP CODE 53-200).
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE. DON’T KNOW AND
RATHER NOT ANSWER IN THE PARENT SURVEY
PROBE SKIP TO EMQ129.

USING THE CODE SELECTED FOR THE GENERAL
OCCUPATION CATEGORY FROM THE EMQ126
PRELOAD (E.G., “Ocupaciones de transporte y
mudanzas” FOR MAJOR GROUP CODE 53-000),
DISPLAY THE SPECIFIC CATEGORY FROM THE
EMQ127 PRELOAD THAT MATCHES THE FIRST
TWO DIGITS OF THE CODE IN EMQ127 (E.G.,
“Trabajadores de transporte aéreo” FOR SPECIFIC
GROUP CODE 53-200).

__________________________________________________________

EMQ128
DISPLAY INSTRUCTIONS:
DISPLAY EMQ126, EMQ127, AND EMQ128 ON THE
SAME SCREEN.

QUESTION TEXT:
Question “Detailed Occupation Classification:”

“Clasificación detallada de ocupaciones:”

Watermark : "Select one"

Watermark: "Seleccione uno"

PROGRAMMER INSTRUCTIONS:
USING THE CODE SELECTED FOR THE SPECIFIC
CATEGORY FROM THE EMQ127 PRELOAD (E.G.,
“Air Transportation Workers” FOR SPECIFIC
GROUP CODE 53-200), DISPLAY THE DETAILED
CATEGORY FROM THE EMQ128 PRELOAD THAT
MATCHES THE FIRST FOUR DIGITS OF THE
CODE IN EMQ128, INCLUDING THE DASH AS A
DIGIT (E.G., “Commercial Pilots” FOR DETAILED
GROUP CODE 53-2012).

USING THE CODE SELECTED FOR THE SPECIFIC
CATEGORY FROM THE EMQ127 PRELOAD (E.G.,
“Air
Transportation Workers” FOR SPECIFIC GROUP
CODE 53-200), DISPLAY THE DETAILED
CATEGORY FROM THE EMQ128 PRELOAD THAT
MATCHES THE FIRST FOUR DIGITS OF THE CODE
IN EMQ128, INCLUDING THE DASH AS A DIGIT
(E.G., “Pilotos comerciales” FOR DETAILED GROUP
CODE 53-2012).

__________________________________________________________

EMQ129
DISPLAY INSTRUCTIONS:
DISPLAY “are” IF (CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A PARENT FIGURE WHO IS
CURRENTLY EMPLOYED OR ON LEAVE FROM A JOB
(EMQ005 = 1 or 2)). ELSE DISPLAY “were”.

DISPLAY “son” IF (CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT A PARENT FIGURE WHO IS
CURRENTLY EMPLOYED OR ON LEAVE FROM A JOB
(EMQ005 = 1 or 2)). ELSE DISPLAY “eran”.

DISPLAY "your" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.

DISPLAY “job duties” IN BOLD TEXT.

DISPLAY “responsabilidades de trabajo” IN BOLD
TEXT.

IF JOB TITLE IN EMQ125 IS NOT “JOB NOT LISTED”
OR SK, DISPLAY “as a/an {JOB TITLE FROM
EMQ125}”. ELSE USE A NULL DISPLAY.

IF JOB TITLE IN EMQ125 IS NOT “JOB NOT LISTED”
OR SK, DISPLAY “como {JOB TITLE FROM EMQ125}”.
ELSE USE A NULL DISPLAY.

QUESTION TEXT:
Question “What {are/were}
{your/{INITIALS/NAME}}’s job duties {as a/an
{JOB TITLE FROM EMQ125}} (for example,
instruct and evaluate students and create
lesson plans; assemble and install pipe
sections and review building plans for work
details)?”

ENTER TEXT

“¿Cuáles {son/eran} las responsabilidades de
trabajo de {usted/INITIALS/NAME} como {JOB
TITLE FROM EMQ125}} (por ejemplo, enseñar y
evaluar a los estudiantes y crear planes para las
lecciones; armar e instalar secciones de
tuberías y revisar planes de construcción para
ver detalles del trabajo)?”

__________________________________________________________

EMQ160
DISPLAY INSTRUCTIONS:
DISPLAY "you" IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

DISPLAY “usted” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
"{INITIALS/NAME}" (AND THAT PERSON'S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.

QUESTION TEXT:
Question “At any point since the start of the
pandemic, please indicate whether or not
{you/{INITIALS/NAME}} had to do any of the
following as a result of the coronavirus
pandemic. Please select all that apply.”
CODES

“Por favor indique si {usted/{INITIALS/NAME}}
tuvo que hacer alguna de las siguientes cosas
en algún momento desde el comienzo de la
pandemia. Por favor seleccione todo lo que
corresponda.”

Code All That Apply

Work more than desired

Trabajar más de lo que quería

Work less than desired

Trabajar menos de lo que quería

Take a job outside regular line of work

Take a less desirable job

Empezar un trabajo fuera de su ocupación
habitual
Empezar un trabajo menos deseable

Put off enrolling for additional education

Look for additional education or training

Postergar matricularse para seguir sus
estudios
Procurar más educación o entrenamiento

None of the above

Ninguno de los anteriores

PROGRAMMER INSTRUCTIONS:
IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 7, 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.”

IF MORE THAN ONE CODE IS SELECTED AND
ONE OF THEM IS CODE 7, DISPLAY HARD
ERROR CHECK MESSAGE, “Usted seleccionó
“Ninguno de los anteriores” pero también
seleccionó otra opción dela lista. Por favor revise
lo que contestó y corrija su respuesta. Luego
seleccione "Siguiente" para continuar.”

__________________________________________________________

EMQ210
DISPLAY INSTRUCTIONS:
DISPLAY “have you” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY “has
{INITIALS/NAME}” (AND THAT PERSON’S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.

DISPLAY “usted” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY
“{INITIALS/NAME}” (AND THAT PERSON’S
INITIALS/FIRST NAME) IF CURRENT CYCLE OF LOOP
IS ASKING ABOUT A PARENT FIGURE WHO IS NOT
THE RESPONDENT.

QUESTION TEXT:
Question “Since {CHILD} was born, {have
you/has/INITIALS{NAME}} served on active
duty in the U.S. Armed Forces, military
Reserves, or National Guard?”

“Desde que nació {CHILD},
¿{usted/INITIALS/NAME}} ha estado en el
servicio active en las Fuerzas Armadas de los
EE. UU., en la Reserva Militar o en la Guardia
Nacional?”

CODES
1

Yes

Sí
Box 5

PROGRAMMER INSTRUCTIONS:
HELP FOR STEM: Active duty does not include
training for the Reserves or National Guard, but
does include activation, for example, for wars or
help with national emergencies.
IN HELP TEXT, DISPLAY “does” IN UNDERLINED
TEXT IN THE LINE THAT INCLUDES "…but does
include activation…"
SK SKIPS TO BOX 5.

IN HELP TEXT, DISPLAY “incluye” IN UNDERLINED
TEXT IN THE LINE THAT INCLUDES "…pero incluye
activación…"
HELP FOR STEM: El servicio activo no incluye
entrenamiento para las Reservas o la Guardia
Nacional, pero incluye activación, por ejemplo,
para las guerras o para ayudar con emergencias
nacionales.

__________________________________________________________

EMQ215
DISPLAY INSTRUCTIONS:
DISPLAY “Are you” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY DISPLAY
“Is INITIALS/{NAME}” (AND THAT
INITIALS/PERSON’S FIRST NAME) IF CURRENT CYCLE
OF LOOP IS ASKING ABOUT A PARENT FIGURE WHO
IS NOT THE RESPONDENT.

DISPLAY “usted” IF CURRENT CYCLE OF LOOP 1 IS
ASKING ABOUT THE RESPONDENT. DISPLAY DISPLAY
“INITIALS/{NAME}” (AND THAT INITIALS/PERSON’S
FIRST NAME) IF CURRENT CYCLE OF LOOP IS ASKING
ABOUT A PARENT FIGURE WHO IS NOT THE
RESPONDENT.

QUESTION TEXT:
{Are you/Is {NAME}} currently on active duty
in the U.S. Armed Forces, military Reserves, or
National Guard?”

"{¿Está usted/¿Está {NAME}} actualmente en
servicio activo en las Fuerzas Armadas de los
EE. UU., las Reservas Militares o la Guardia
Nacional?”

CODES
1

Yes

Sí

__________________________________________________________

Box 5

END LOOP 1
ASK EMQ005 - EMQ215 FOR NEXT “KEY”
PARENT FIGURE.
IF NO NEXT “KEY” PARENT FIGURE, CONTINUE
WITH EMQ300.

__________________________________________________________

EMQ300
DISPLAY INSTRUCTIONS:
DISPLAY "your" IF THE RESPONDENT IS A PARENT
(INQ005g = 1, 2, 3, 4, OR 91). DISPLAY “his” IF THE
CHILD IS MALE (INQ050b = 1). DISPLAY “her” IF THE
CHILD IS FEMALE (INQ050b = 2). DISPLAY “their” IF
THE CHILD IS ANOTHER GENDER (INQ050b = 3).
ELSE DISPLAY THE CHILD’S NAME IF GENDER IS
MISSING (INQ050b = SK) AS SHOWN IN THE
GLOBAL SPECS.

DISPLAY "usted" IF THE RESPONDENT IS A PARENT
(INQ005g = 1, 2, 3, 4, OR 91). DISPLAY “él” IF THE
CHILD IS MALE (INQ050b = 1). DISPLAY “ella” IF THE
CHILD IS FEMALE (INQ050b = 2). ELSE DISPLAY THE
CHILD’S NAME IF THE CHILD IS ANOTHER GENDER
(INQ050b = 3) OR GENDER IS MISSING (INQ050b =
SK) AS SHOWN IN THE GLOBAL SPECS.

QUESTION TEXT:
Question “Since {CHILD} was born, was there
any time in which {his/her/their/your} family
had serious financial problems or was unable
to pay the monthly bills?”

“Desde que nació {CHILD}, ¿hubo algún
momento en que la familia de {él/ella/usted}
tuvo serios problemas económicos o no pudo
pagar las cuentas mensuales?"

SaVisible "True"

CODES
1

Yes

Box 6

DON'T KNOW

Box 6

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
SK SKIPS TO BOX 6.

Sí

__________________________________________________________

EMQ305a
DISPLAY INSTRUCTIONS:
DISPLAY EMQ305a AND EMQ305b TOGETHER ON ONE
SCREEN.
DISPLAY THE CHILD’S NAME IN “{CHILD}” IN THE
FIRST DISPLAY AND “your” IN THE SECOND DISPLAY
IF THE RESPONDENT IS THE CHILD'S female
parent/male parent/parent of another gender. ELSE,
DISPLAY “{CHILD}” IN THE FIRST DISPLAY AND THE
CHILD’S NAME IN “{CHILD}’s” IN THE SECOND
DISPLAY.

DISPLAY THE CHILD’S NAME IN “{CHILD}” IN THE
FIRST DISPLAY AND “su familia” IN THE SECOND
DISPLAY IF
THE RESPONDENT IS THE CHILD'S female
parent/male parent/parent of another gender. ELSE,
DISPLAY “{CHILD}” IN THE FIRST DISPLAY AND THE
CHILD’S NAME IN “{CHILD}’s” IN THE SECOND
DISPLAY.

QUESTION TEXT:
Question “During how many years or months
since {{CHILD}} was born has
{{CHILD}'s/your} family had serious financial
problems?”
Pre-unit “Years:”
Watermark: “Enter years”
“Don’t know”

“¿Por cuántos meses o años desde que nació
{{CHILD}}, {su familia/la familia de {CHILD}}
ha tenido serios problemas económicos?”
Pre-unit “Años:”
Watermark: “Ponga los años”
“No sé”

ENTER NUMBER
Range

0 to 10

Soft Range

1 to 8

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “No sé” AS
A RADIO BUTTON.

DON’T KNOW AND SK SKIP TO BOX 6.

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, "You have entered {DISPLAY
RESPONSE AT EMQ305a}. Please confirm. If this
is correct, select Next to continue."

IF A SOFT RANGE IS VIOLATED, DISPLAY ERROR
MESSAGE, “Usted ha puesto {DISPLAY RESPONSE
AT EMQ305a). Por favor confirme. Si es correcto,
seleccione Siguiente para continuar."

__________________________________________________________

EMQ305b
DISPLAY INSTRUCTIONS:
DISPLAY EMQ305a AND EMQ305b TOGETHER ON ONE
SCREEN.

QUESTION TEXT:
Question “and”

“y”

Pre-unit “Months:”

Pre-unit “Meses:”

Watermark: “Enter months”

Watermark: “Ponga los meses”

“Don’t know”

“No sé”

ENTER NUMBER
Range

0 to 12

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “Don’t
know” AS A RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “No sé” AS
A RADIO BUTTON.

__________________________________________________________

Box 6

GO TO SECTION WPQ (WELFARE AND OTHER
PUBLIC TRANSFERS).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

WPQ

Welfare and Other Public Transfers

__________________________________________________________

WPQ030
DISPLAY INSTRUCTIONS:
DISPLAY “you were” AND “you” IF (INQ005g = 1 AND
FSQ040 = 2) (THE RESPONDENT IS A BIOLOGICAL
FEMALE PARENT). OTHERWISE, DISPLAY “{CHILD}’s
mother was” AND “she”.

DISPLAY “usted” IF FSQ140 = 1 (THE RESPONDENT
IS THE BIOLOGICAL FEMALE PARENT). OTHERWISE,
DISPLAY “la madre de {CHILD}”.

QUESTION TEXT:
Question “When {you were/{CHILD}'s mother
was} pregnant with {CHILD}, did {you/she}
receive any benefits from the Special
Supplemental Food Program for Women,
Infants, and Children, or WIC?”

“Cuando {usted/la madre de {CHILD}} estaba
embarazada con {CHILD}, ¿recibió algún
beneficio del Programa Suplementario de
Comida para Mujeres, Infantes y Niños o WIC
(por sus siglas en inglés)?"

SaVisible "True"
CODES
1

Yes

Sí

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

BOLD “WIC” ON FIRST INSTANCE ONLY IN HELP
TEXT

HELP FOR STEM: WIC: Este programa proporciona
asistencia alimentaria y educación nutricional a
mujeres embarazadas y madres de bajos ingresos
en el postparto y a sus bebés, así como a niños de
hasta 5 años con bajos ingresos. WIC es la
abreviatura de Special Supplemental Food
Program for Women, Infants, and Children
(Programa especial de alimentación suplementaria
para mujeres, bebés y niños). Los beneficios de
WIC pueden incluir alimentos, cheques, vouchers
y/o una tarjeta de débito llamada EBT
(Transferencia Electrónica de Beneficios).

HELP FOR STEM: WIC: This program provides
food assistance and nutritional education to lowincome pregnant and postpartum women and
their infants, as well as to low-income children
up to age 5. WIC is short for the Special
Supplemental Food Program for Women, Infants,
and Children. WIC benefits can include food,
checks, vouchers, and/or a debit card called EBT
(Electronic Benefit Transfer).

__________________________________________________________

WPQ040

QUESTION TEXT:
Question “Did {CHILD} receive any WIC
benefits as an infant or child?”

“¿Recibió {CHILD} algún beneficio de WIC
cuando era bebé o niño(a)?”

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
BOLD “WIC” on first instance ONLY IN HELP
TEXT.
HELP FOR STEM: WIC: This program provides
food assistance and nutritional education to lowincome pregnant and postpartum women and
their infants, as well as to low-income children
up to age 5. WIC is short for the Special
Supplemental Food Program for Women, Infants,
and Children. WIC benefits can include food,
checks, vouchers, and/or a debit card called EBT
(Electronic Benefit Transfer).

BOLD “WIC” on first instance ONLY IN HELP TEXT.
HELP FOR STEM: WIC: Este programa proporciona
asistencia alimentaria y educación nutricional a
mujeres embarazadas y madres de bajos ingresos
en el postparto y a sus bebés, así como a niños de
hasta 5 años con bajos ingresos. WIC es la
abreviatura de Special Supplemental Food
Program for Women, Infants, and Children
(Programa especial de alimentación suplementaria
para mujeres, bebés y niños). Los beneficios de
WIC pueden incluir alimentos, cheques, vouchers
y/o una tarjeta de débito llamada EBT
(Transferencia Electrónica de Beneficios).

__________________________________________________________

WPQ070
DISPLAY INSTRUCTIONS:
FOR "or STATE TANF PROGRAM NAME"; DISPLAY
NAME FOR STATE TANF PROGRAM, IF ANY, FROM
PRELOAD. ELSE, IF MISSING, USE A NULL DISPLAY.

FOR "o STATE TANF PROGRAM NAME"; DISPLAY
NAME FOR STATE TANF PROGRAM, IF ANY, FROM
PRELOAD. ELSE, IF MISSING, USE A NULL DISPLAY.

QUESTION TEXT:
Question “Since {CHILD} was born, have you
or anyone in your household ever received
Temporary Assistance for Needy Families,
sometimes called TANF {or {STATE TANF
PROGRAM NAME}}?”

“Desde que {CHILD} nació, ¿usted o alguien
más en su hogar recibió alguna vez Ayuda
Temporal para Familias Necesitadas, a veces
llamada TANF {o {STATE TANF PROGRAM
NAME}}?”

CODES
1

Yes

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO WPQ109.

Sí
WPQ109

__________________________________________________________

WPQ100
DISPLAY INSTRUCTIONS:
FOR "or STATE TANF PROGRAM NAME"; DISPLAY
NAME FOR STATE TANF PROGRAM, IF ANY, FROM
PRELOAD. ELSE, USE A NULL DISPLAY.

FOR "o STATE TANF PROGRAM NAME"; DISPLAY
NAME FOR STATE TANF PROGRAM, IF ANY, FROM
PRELOAD. ELSE, USE A NULL DISPLAY.

QUESTION TEXT:
Question “In the past 12 months, have you or
anyone in your household received TANF {or
{STATE TANF PROGRAM NAME}}?”

“En los últimos 12 meses, ¿usted o alguien en
su hogar ha recibido TANF {o {STATE TANF
PROGRAM NAME}}?”

CODES
1

Yes

Sí
WPQ109

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO WPQ109.
BOLD “TANF” (FIRST INSTANCE ONLY) IN HELP
TEXT
HELP FOR STEM: TANF: Temporary Assistance
for Needy Families (TANF) or {STATE TANF
PROGRAM NAME} in {STATE} is a government
program that provides cash benefits to lowincome families with children. Many states
provide TANF money through an Electronic
Benefits Transfer (EBT) card that is like a debit
or ATM card. TANF was formerly known as Aid to
Families with Dependent Children, or AFDC. For
this question, consider whether or not TANF (or
AFDC) was received in the past 12 calendar
months, not the last calendar year.

BOLD “TANF” (FIRST INSTANCE ONLY) IN HELP
TEXT
HELP FOR STEM: TANF: La Ayuda Temporal para
Familias Necesitadas (TANF) o {STATE TANF
PROGRAM NAME} en {STATE} es un programa del
gobierno que proporciona beneficios en efectivo a
familias con bajos ingresos y con hijos. Muchos
estados proporcionan el dinero de TANF por medio
de una tarjeta de Transferencia Electrónica de
Beneficios (EBT) que es como una tarjeta de
débito o de cajero automático. El TANF se conocía
anteriormente como Ayuda a Familias con Hijos
Dependientes (Aid to Families with Dependent
Children, AFDC).
Para esta pregunta, tome en cuenta si se recibió o
no TANF (o AFDC) en los últimos 12 meses
naturales, y no el año pasado por el calendario.

__________________________________________________________

WPQ105
DISPLAY INSTRUCTIONS:
FOR "or STATE TANF PROGRAM NAME"; DISPLAY
NAME FOR STATE TANF PROGRAM, IF ANY, FROM
PRELOAD. ELSE, IF MISSING, DISPLAY “TANF”.

FOR "o de STATE TANF PROGRAM NAME"; DISPLAY
NAME FOR STATE TANF PROGRAM, IF ANY, FROM
PRELOAD. ELSE, IF MISSING, DISPLAY “TANF”.

QUESTION TEXT:
Question “During those 12 months, how many
months did your household receive TANF {or
{STATE TANF PROGRAM NAME}}?”

“Durante esos 12 meses, ¿cuántos meses
recibió su hogar los beneficios de TANF {o de
{STATE TANF PROGRAM NAME}}?

Pre-unit “Month(s)”

Pre-unit “Mes(es)”

Watermark “Enter months”

Watermark “Ponga los meses”

ENTER NUMBER
Range

1 to 12

__________________________________________________________

WPQ109

QUESTION TEXT:
Question “Since {CHILD} was born, have you
or anyone in your household ever received
food stamps, also called SNAP (the
Supplemental Nutrition Assistance Program),
or food benefits on EBT (Electronic Benefit
Transfer)?”

“Desde que {CHILD} nació, ¿alguna vez usted o
alguien en su hogar ha recibido estampillas de
comida o cupones de alimentos, también
llamados SNAP (Programa de Asistencia
Nutricional Suplementaria), o beneficios de
alimentos por EBT (Transferencia Electrónica de
Beneficios)?"

CODES
1

Yes

Sí
WPQ170

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO WPQ170.
BOLD IN HELP TEXT: “Food Stamps or SNAP
(Supplemental Nutrition Assistance Program)"
HELP FOR STEM: Food Stamps or SNAP
(Supplemental Nutrition Assistance Program): A
government program that provides plastic cards
that can be used to buy food. In the past, SNAP
was called the Food Stamp Program and gave
people benefits in paper coupons or food stamps.

BOLD IN HELP TEXT: “estampillas de comida o
cupones de alimentos o SNAP (Programa de
Asistencia Nutricional Suplementaria)"
HELP FOR STEM: Cupones de alimentos o SNAP
(Programa de Asistencia Nutricional
Suplementaria): Programa gubernamental que
proporciona tarjetas de plástico que pueden
utilizarse para comprar alimentos. En el pasado,
SNAP se llamaba Programa de Cupones para
Alimentos y daba a la gente beneficios en cupones
de papel o cupones para alimentos.

__________________________________________________________

WPQ110

QUESTION TEXT:
Question "In the past 12 months, have you or
anyone in your household received food
stamps, also called SNAP, or food benefits on
EBT?"

"En los últimos 12 meses, ¿usted o alguien en
su hogar ha recibido estampillas de comida o
cupones de alimentos, también llamados SNAP
(Programa de Asistencia Nutricional
Suplementaria), o beneficios de alimentos por
EBT (Transferencia Electrónica de Beneficios)?"

CODES
1

Yes

Sí
WPQ170

__________________________________________________________

WPQ120

QUESTION TEXT:
Question "During those 12 months, how many
months did your household receive food
stamps or food benefits on EBT (Electronic
Benefit Transfer) from SNAP?"
Pre-unit “Month(s)”
Watermark “Enter months”

"Durante esos 12 meses, ¿cuántos meses
recibió su hogar estampillas de comida o
cupones de alimentos o beneficios de alimentos
por EBT (Transferencia Electrónica de
Beneficios) de SNAP?
Pre-unit “Mes(es)”
Watermark “Ponga los meses”

ENTER NUMBER
Range

1 to 12

__________________________________________________________

WPQ122

QUESTION TEXT:
Question “Did you or anyone in your household
receive food stamps, also called SNAP, or food
benefits on EBT because of not having work
during the coronavirus pandemic?”

“¿Usted o alguien en su hogar recibió
estampillas de comida o cupones de alimentos o
beneficios de alimentos por EBT (Transferencia
Electrónica de Beneficios) de SNAP por no tener
trabajo durante la pandemia del coronavirus?"

CODES
1

Yes

Sí

PROGRAMMER INSTRUCTIONS:
BOLD IN HELP TEXT: “Food Stamps or SNAP
(Supplemental Nutrition Assistance Program)”
HELP FOR STEM: Food Stamps or SNAP
(Supplemental Nutrition Assistance Program): a
government program that provides plastic cards
that can be used to buy food. In the past, SNAP
was called the Food Stamp Program and gave
people benefits in paper coupons or food stamps.

__________________________________________________________

WPQ170
DISPLAY INSTRUCTIONS:
DISPLAY 'free' AND 'reduced price' IN UNDERLINED
TEXT.

DISPLAY ‘gratis’ AND ‘a precio reducido’ IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “Does {CHILD} receive complete
school lunches for free or reduced price at
school?”

“¿Recibe {CHILD} almuerzos completos gratis o
a precio reducido en la escuela?”

CODES
1

Yes

Sí
WPQ200

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO WPQ200.
HELP FOR STEM: By complete school lunch, we
mean a complete meal such as a salad, soup, a
sandwich, or a hot meal that is offered each day
at a fixed price, not just milk, snacks, or ice
cream. This does not include a lunch
{he/she/they} brought from home.

HELP FOR STEM: Al decir almuerzos completos,
nos referimos a una comida completa que consiste
en ensalada, sopa, un sandwich, o una comida
caliente, que se ofrece cada día a un precio fijo, y
que no sea sólo leche, snacks o helado. Esto no
incluye el almuerzo que traiga de su casa.

__________________________________________________________

WPQ180

QUESTION TEXT:
Question “Are these lunches free or reduced
price?”

“¿Son estos almuerzos o lonches gratis o son a
precio reducido?”

CODES
1

Free

Gratis

Reduced price

A precio reducido

__________________________________________________________

WPQ200

QUESTION TEXT:
Question “Does {CHILD}'s school offer
breakfast for its students?”

“¿Se ofrecen desayunos a los estudiantes en la
escuela de {CHILD}?”

CODES
1

Yes

Sí
Box 1

__________________________________________________________

WPQ210

QUESTION TEXT:
Question “Does {CHILD} usually receive a
breakfast provided by the school?”

“¿Recibe usualmente {CHILD} un desayuno
proporcionado por la escuela?”

CODES
1

Yes

Sí
Box 1

__________________________________________________________

WPQ215
DISPLAY INSTRUCTIONS:
DISPLAY “free” AND “reduced price” IN UNDERLINED
TEXT.

DISPLAY “gratis” AND “a precio reducido” IN
UNDERLINED TEXT.

QUESTION TEXT:
Question “Does {CHILD} receive free or
reduced price breakfasts at school?”

“¿Recibe {CHILD} desayunos gratis o a precio
reducido en la escuela?”

CODES
1

Yes

Sí
Box 1

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO BOX 1.
__________________________________________________________

WPQ216

QUESTION TEXT:
Question “Are these breakfasts free or reduced
price?”

“¿Son estos desayunos gratis o son a precio
reducido?”

CODES
1

Free

Gratis

Reduced price

A precio reducido

__________________________________________________________

WPQ220

QUESTION TEXT:
Question “During the last five days {CHILD}
was in school, how many school breakfasts did
{he/she/they} receive?”

“En los últimos cinco días en que {CHILD} fue a
la escuela, ¿cuántos desayunos escolares
recibió?

Pre-unit “Breakfasts:”

Pre-unit “Desayunos:”

Watermark “Number of breakfasts”

Watermark “Número de desayunos”

ENTER NUMBER
Range

0 to 5

__________________________________________________________

Box 1

GO TO SECTION PAQ (PARENT INCOME AND
ASSETS).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

PAQ

Parent Income and Assets

__________________________________________________________

PAQ110

QUESTION TEXT:
Question “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?”

"En estudios como éste, algunas veces se
agrupan los hogares de acuerdo a sus ingresos.
¿Cuánto fueron los ingresos totales de todas las
personas de su hogar durante el último año,
incluyendo los salarios u otros ingresos,
intereses, jubilación, y demás para todos los
miembros del hogar?"

CODES
1

$5,000 or less

$5,000 o menos

$5,001 to $10,000

Entre $5,001 y $10,000

$10,001 to $15,000

Entre $10,001 y $15,000

$15,001 to $20,000

Entre $15,001 y $20,000

$20,001 to $25,000

Entre $20,001 y $25,000

$25,001 to $30,000

Entre $25,001 y $30,000

$30,001 to $35,000

Entre $30,001 y $35,000

$35,001 to $40,000

Entre $35,001 y $40,000

$40,001 to $45,000

Entre $40,001 y $45,000

$45,001 to $50,000

Entre $45,001 y $50,000

$50,001 to $55,000

Entre $50,001 y $55,000

$55,001 to $60,000

Entre $55,001 y $60,000

$60,001 to $65,000

Entre $60,001 y $65,000

$65,001 to $70,000

Entre $65,001 y $70,000

$70,001 to $75,000

Entre $70,001 y $75,000

$75,001 to $100,000

Entre $75,001 y $100,000

$100,001 to $200,000

Entre $100,001 y $200,000

$200,001 to $300,000

Entre $200,001 y $300,000

$300,001 or more

$300,001 o más

PROGRAMMER INSTRUCTIONS:
IF THIS QUESTION IS SK (SKIPPED), USE
PARENT SURVEY PROBE.

__________________________________________________________

Box 1

IF PAQ110 = REF OR DK, GO TO Box 2.
ELSE, PAQ120 IS ASKED IF HOUSEHOLD IS AT
200% OF POVERTY (+8%) OR BELOW.
ASK PAQ120 IF
(NUMBER IN HH = 1 AND PAQ110 < 8) OR
(NUMBER IN HH = 2 AND PAQ110 < 10) OR
(NUMBER IN HH = 3 AND PAQ110 < 12) OR
(NUMBER IN HH = 4 AND PAQ110 < 14) OR
(NUMBER IN HH = 5 AND PAQ110 < 17) OR
(NUMBER IN HH = 6 AND PAQ110 < 17) OR
(NUMBER IN HH = 7 AND PAQ110 < 17) OR
(NUMBER IN HH = 8 AND PAQ110 < 18) OR
(NUMBER IN HH GREATER THAN OR EQUAL TO
9 AND PAQ110 < 18).
ELSE, GO TO Box 2.

__________________________________________________________

PAQ120

QUESTION TEXT:
Question “What was your total household
income last year, to the nearest thousand?”

"¿Cuál fue el total de los ingresos de su hogar
durante el año pasado, redondeando a miles?”

Pre-unit “Total income:”

Pre-unit “Ingresos Tolales”

Watermark “Enter number”

Watermark “Ponga el número”

ENTER NUMBER
Range

0 to

PROGRAMMER INSTRUCTIONS:
ALLOW UP TO 9 DIGITS. DISPLAY COMMAS IN
FRONT OF THE FOURTH AND SEVENTH DIGIT IF
APPLICABLE.
SOFT RANGE CHECK - TOTAL INCOME SHOULD
BE IN RANGE OF ANSWER TO PAQ110. IF
ANSWER IS NOT IN RANGE OF ANSWER TO
PAQ110, DISPLAY SOFT EDIT MESSAGE “You
have entered {DISPLAY RESPONSE AT PAQ120}.
Please confirm. If this is correct, select Next to
continue.”

SOFT RANGE CHECK - TOTAL INCOME SHOULD BE
IN RANGE OF ANSWER TO PAQ110. IF ANSWER IS
NOT IN RANGE OF ANSWER TO PAQ110, DISPLAY
SOFT EDIT MESSAGE “Usted puso {ANSWER TO
PAQ120}. Por favor confirme. Si es correcto,
seleccione Siguiente para continuar.”

__________________________________________________________

Box 2

GO TO SECTION CMQ (MOBILITY AND
TRACKING UPDATES).

__________________________________________________________

Early Childhood Longitudinal Study Parent
Survey Spring K - Form PSSK
Section

CMQ

Mobility and Tracking Updates

__________________________________________________________

Box 0

IF THE CHILD IS IN ONE OF THE DISTRICTS
NOTED IN THE PRELOAD THAT DISALLOWS
COLLECTION OF TRACING DATA, GO TO
CMQ500. ELSE GO TO CMQ100.

__________________________________________________________

CMQ100

QUESTION TEXT:
Question "Is there a relative or friend, who
does not live in this household, who will
always know where you are if you move? We
will only contact this person if we cannot
locate you for the next survey."

"¿Tiene algún pariente o amigo que no viva en
esta casa, que siempre sabrá dónde está si es
que usted se muda? Solamente contactaremos
a esta persona si no podemos ubicarle a usted
para la próxima encuesta."

CODES
1

Yes

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CMQ500.

Sí
CMQ500

__________________________________________________________

CMQ110a
DISPLAY INSTRUCTIONS:
FOR FIRST NAME, ALLOW 0 – 100 CHARACTERS TO
BE ENTERED.
DISPLAY CMQ110a-c3 TOGETHER.

QUESTION TEXT:
Question “What is the contact information for
that person?

“¿Cuál es la información de contacto de esa
persona?

First Name:”

Primer nombre: "

ENTER TEXT

__________________________________________________________

CMQ110b
DISPLAY INSTRUCTIONS:
FOR LAST NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ110a-c3 TOGETHER.

QUESTION TEXT:

Question “Last Name:”
ENTER TEXT

“Apellido:”

__________________________________________________________

CMQ110c1
DISPLAY INSTRUCTIONS:
FOR EMAIL, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ110a-c3 TOGETHER.

QUESTION TEXT:
Question "Email Address:"

"Dirección de correo electrónico (email):"

Watermark "name@domain.com"

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
PROGRAM SHOULD VALIDATE EMAIL ADDRESS.
IF THE EMAIL ADDRESS DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE FOLLOWING
MESSAGE "The email address should contain the
"@" sign and at least one period. Please check
and when the address is correct, select Next to
continue."

IF THE EMAIL ADDRESS DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE FOLLOWING
MESSAGE "La dirección electrónica debería tener
el símbolo "@" y por lo menos un punto. Por favor
confirme y cuando la dirección sea la correcta,
seleccione Siguiente para continuar."

__________________________________________________________

CMQ110c2
DISPLAY INSTRUCTIONS:
DISPLAY CMQ110a-c3 TOGETHER.

QUESTION TEXT:
Question "Mobile Number:”

"Teléfono celular:"

“This person doesn't have a mobile phone.”

"Esta persona no tiene un teléfono celular."

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn't have a mobile phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene un teléfono celular.” AS A RADIO
BUTTON.

FOR MOBILE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE MOBILE PHONE NUMBER SO
THAT IT IS IN THIS FORMAT (###)-###-####.

FOR MOBILE NUMBER, ALLOW 0-12 CHARACTERS
TO BE ENTERED. APPLY EDIT MASK TO VALIDATE
MOBILE PHONE NUMBER SO THAT IT IS IN THIS
FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “El número de teléfono debe tener 10
dígitos ((XXX)-XXX-XXXX). Por favor verifíquelo y
póngalo de nuevo.”

__________________________________________________________

CMQ110c3
DISPLAY INSTRUCTIONS:
DISPLAY CMQ110a-c3 TOGETHER.

QUESTION TEXT:
Question "Landline Number:"

"Teléfono de la casa:"

“This person doesn't have a landline phone.”

“Esta persona no tiene teléfono de la casa/línea
de tierra.”

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn't have a landline phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene teléfono de la casa/línea de
tierra.” AS A RADIO BUTTON.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE LANDLINE PHONE NUMBER
SO THAT IT IS IN THIS FORMAT (###)-#######.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT MASK
TO VALIDATE LANDLINE PHONE NUMBER SO THAT
IT IS IN THIS FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “El número de teléfono debe tener 10
dígitos ((XXX)-XXX-XXXX). Por favor verifíquelo y
póngalo de nuevo."

__________________________________________________________

CMQ110d1
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 1, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY CMQ110d1-h TOGETHER.

QUESTION TEXT:
Question "Please enter the mailing address:"

"Por favor ponga la dirección de correo postal:"

Address Line 1:"

Dirección – Línea 1:"

ENTER TEXT

__________________________________________________________

CMQ110d2
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 2, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY CMQ110d1-h TOGETHER.

QUESTION TEXT:
Question "Address Line 2:"

"Dirección – Línea 2:"

Watermark “Apartment number"

Watermark “Número de apartamento"

ENTER TEXT

__________________________________________________________

CMQ110e
DISPLAY INSTRUCTIONS:
FOR CITY, ALLOW 0 – 50 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ110d1-h TOGETHER.

QUESTION TEXT:
Question "City:"
ENTER TEXT

"Ciudad:"

__________________________________________________________

CMQ110f
DISPLAY INSTRUCTIONS:
FOR STATE/DISTRICT/TERRITORY HAVE DROP DOWN
BOX WITH STATE NAMES, THE DISTRICT OF
COLUMBIA, AND THE U.S. TERRITORIES.
DISPLAY CMQ110d1-h TOGETHER.

QUESTION TEXT:
Question "Please select a state, district, or
territory:"

"Por favor seleccione un estado, distrito o
territorio:”

Watermark “Select a state”

Watermark “Seleccione un estado”

ENTER TEXT

__________________________________________________________

CMQ110g
DISPLAY INSTRUCTIONS:
FOR ZIP CODE, ALLOW 0 – 5 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ110d1-h TOGETHER.

QUESTION TEXT:
Question "ZIP code:"

"Código postal:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

CMQ110h
DISPLAY INSTRUCTIONS:
DISPLAY CMQ110d1-h TOGETHER.

QUESTION TEXT:
Question "What is this person’s relationship to
you?"

"¿Qué relación o parentesco tiene esta persona
con usted?"

CODES
1

Relative

Pariente

Person at your job

Alguien de su trabajo

Neighbor

Vecino(a)

Friend

Amigo(a)

Other

Otro

__________________________________________________________

Box 3

IF A FIRST NAME FOR THE FIRST CONTACT
PERSON IS NOT EMPTY OR SK (CMQ110a HAS
DATA) OR THERE IS AN EMAIL ADDRESS THAT
IS NOT EMPTY OR SK (CMQ110c1 HAS DATA)
OR A MOBILE OR LANDLINE NUMBER THAT IS
NOT EMPTY OF SK (CMQ110C2 OR CMQ110C3
HAVE DATA) OR A MAILING ADDRESS THAT IS
NOT EMPTY OR SK (CMQ110d1, e, AND f HAVE
DATA), GO TO CMQ130 TO ASK FOR A
SECOND CONTACT PERSON. ELSE, GO TO
CMQ500.

__________________________________________________________

CMQ130
DISPLAY INSTRUCTIONS:
IF CMQ110a HAS DATA, DISPLAY THE FIRST NAME
FROM CMQ110a. ELSE DISPLAY “the person you just
gave contact information for”.

IF CMQ110a HAS DATA, DISPLAY THE FIRST NAME
FROM CMQ110a. ELSE DISPLAY “la persona cuya
información de contacto usted acaba de proporcionar”.

QUESTION TEXT:
Question “Besides {{FIRST NAME}/the person
you just gave contact information for}, is there
another relative or friend, who does not live in
this household, but who will always know
where you are if you move?”

“Además de {{FIRST NAME}/ la persona cuya
información de contacto usted acaba de
proporcionar}, ¿tiene algún otro pariente o
amigo que no vive en esta casa, y que siempre
sabra dónde está si usted se muda?”

CODES
1

Yes

Sí
CMQ500

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CMQ500.
HELP FOR STEM: We will only contact this
person if we cannot locate you for the next
survey.

HELP FOR STEM: Solo llamaríamos a esta persona
si no (lo/la) podemos localizar para la próxima
encuesta.

__________________________________________________________

CMQ140a
DISPLAY INSTRUCTIONS:
FOR FIRST NAME, ALLOW 0 – 100 CHARACTERS TO
BE ENTERED.
DISPLAY CMQ140a-c3 TOGETHER.

QUESTION TEXT:
Question “What is the contact information for
that person?

“¿Cuál es la información de contacto de esa
persona?

First Name: "

Primer nombre: "

ENTER TEXT

__________________________________________________________

CMQ140b
DISPLAY INSTRUCTIONS:
FOR LAST NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ140a-c3 TOGETHER.

QUESTION TEXT:
Question "Last Name:"

"Apellido:"

ENTER TEXT

__________________________________________________________

CMQ140c1
DISPLAY INSTRUCTIONS:
FOR EMAIL, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ140a-c3 TOGETHER.

QUESTION TEXT:
Question "Email Address:"

"Dirección de correo electrónico (email):"

Watermark "name@domain.com"

IF THE EMAIL ADDRESS DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE FOLLOWING
MESSAGE "La dirección electrónica debería tener
el símbolo "@" y por lo menos un punto. Por favor
confirme y cuando la dirección sea la correcta,
seleccione Siguiente para continuar."

__________________________________________________________

CMQ140c2
DISPLAY INSTRUCTIONS:
DISPLAY CMQ140a-c3 TOGETHER.

QUESTION TEXT:
Question "Mobile Number:”

”Teléfono celular”

“This person doesn't have a mobile phone.”

“Esta persona no tiene un teléfono celular.”

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn't have a mobile phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene un teléfono celular.” AS A RADIO
BUTTON.

FOR MOBILE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE MOBILE PHONE NUMBER SO
THAT IT IS IN THIS FORMAT (###)-###-####.

FOR MOBILE NUMBER, ALLOW 0-12 CHARACTERS
TO BE ENTERED. APPLY EDIT MASK TO VALIDATE
MOBILE PHONE NUMBER SO THAT IT IS IN THIS
FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE "El número de teléfono debe tener 10
dígitos ((XXX)-XXX-XXXX). Por favor verifíquelo y
póngalo de nuevo."

__________________________________________________________

CMQ140c3
DISPLAY INSTRUCTIONS:
DISPLAY CMQ140a-c3 TOGETHER.

QUESTION TEXT:
Question "Landline Number:"

"Teléfono de la casa:"

“This person doesn't have a landline phone.”

"Esta persona no tiene teléfono de la casa/línea
de tierra."

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn't have a landline phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene teléfono de la casa/línea de
tierra.” AS A RADIO BUTTON.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE LANDLINE PHONE NUMBER
SO THAT IT IS IN THIS FORMAT (###)-#######.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT MASK
TO VALIDATE LANDLINE PHONE NUMBER SO THAT
IT IS IN THIS FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “El número de teléfono debe tener 10
dígitos ((XXX)-XXX-XXXX). Por favor verifíquelo y
póngalo de nuevo.”

__________________________________________________________

CMQ140d1
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 1, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY CMQ140d1-h TOGETHER.

QUESTION TEXT:
Question "Please enter the mailing address:"

"Por favor ponga la dirección postal:"

Address Line 1:"

Dirección - Línea 1:"

ENTER TEXT

__________________________________________________________

CMQ140d2
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 2, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY CMQ140d1-h TOGETHER.

QUESTION TEXT:
Question "Address Line 2:"

"Dirección Línea 2:"

Watermark “Apartment number"

Watermark “Número de apartamento"

ENTER TEXT

__________________________________________________________

CMQ140e
DISPLAY INSTRUCTIONS:
FOR CITY, ALLOW 0 – 50 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ140d1-h TOGETHER.

QUESTION TEXT:
Question "City:"
ENTER TEXT

"Ciudad:"

__________________________________________________________

CMQ140f
DISPLAY INSTRUCTIONS:
FOR STATE/DISTRICT/TERRITORY HAVE DROP DOWN
BOX WITH STATE NAMES, THE DISTRICT OF
COLUMBIA,AND THE U.S. TERRITORIES.
DISPLAY CMQ140d1-h TOGETHER.

QUESTION TEXT:
Question "Please select a state, district, or
territory:"

"Por favor seleccione un estado, distrito o
territorio:”

Watermark “Select a state”

Watermark “Seleccione un estado”

ENTER TEXT

__________________________________________________________

CMQ140g
DISPLAY INSTRUCTIONS:
FOR ZIP CODE, ALLOW 0 – 5 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ140d1-h TOGETHER.

QUESTION TEXT:
Question "ZIP code:"

"Código postal:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

CMQ140h
DISPLAY INSTRUCTIONS:
DISPLAY CMQ140d1-h TOGETHER.

QUESTION TEXT:
Question "What is this person’s relationship to
you?"

"¿Qué relación o parentesco tiene esta persona
con usted?"

CODES
1

Relative

Pariente

Person at your job

Alguien de su trabajo

Neighbor

Vecino(a)

Friend

Amigo(a)

Other

Otro

__________________________________________________________

Box 4

IF FOCAL CHILD HAS ONE OR MORE
NONRESIDENT PARENTS WHO ARE LIVING
(HRQ030=1) AND WITH WHOM THE CHILD
HAS HAD CONTACT (NRQ040 = 1 OR 2), ASK
CMQ170a-h TO OBTAIN CONTACT
INFORMATION FOR ONE OF THESE PARENTS
(NOTE: IF THERE IS MORE THAN ONE
NONRESIDENT PARENT, THE RESPONDENT
WILL SELECT ONE FOR CONTACT
INFORMATION).
OTHERWISE, GO TO CMQ500.

__________________________________________________________

CMQ170a
DISPLAY INSTRUCTIONS:
DISPLAY CMQ170a-c3 TOGETHER.
IF THERE IS ONLY ONE NONRESIDENT PARENT WITH
NRQ040 = 1 OR 2, DO THE FOLLOWING: USE A NULL
DISPLAY FOR ALL DISPLAYS SHOWN FOR “or”.
DISPLAY 'biological female parent' IF NRQ040=1 OR 2
AND HRQ015=1 AND HRQ030=1 FOR A
NONRESIDENT BIOLOGICAL FEMALE PARENT. ELSE
USE A NULL DISPLAY.
DISPLAY 'biological male parent' IF NRQ040=1 OR 2
AND HRQ015=2 AND HRQ030=1 FOR A
NONRESIDENT BIOLOGICAL MALE PARENT. ELSE USE
A NULL DISPLAY.
DISPLAY CODE FOR 'Biological parent of another
gender' IF NRQ040=1 OR 2 AND HRQ015=3 AND
HRQ030=1 FOR A NONRESIDENT BIOLOGICAL
PARENT OF ANOTHER GENDER. ELSE USE A NULL
DISPLAY.

DISPLAY CODE FOR 'la madre biológica' IF NRQ040=1
OR 2 AND HRQ015=1 AND HRQ030=1 FOR A
NONRESIDENT BIOLOGICAL MOTHER. ELSE USE A
NULL DISPLAY.
DISPLAY CODE FOR 'el padre biológico' IF NRQ040=1
OR 2 AND HRQ015=2 AND HRQ030=1 FOR A
NONRESIDENT BIOLOGICAL MALE PARENT. ELSE USE
A NULL DISPLAY.
DISPLAY CODE FOR 'madre o padre biológico(a) de
otro género' IF NRQ040=1, OR 2 AND HRQ015=3
AND HRQ030=1 FOR A NONRESIDENT BIOLOGICAL
PARENT OF ANOTHER GENDER, ELSE USE NULL
DISPLAY.
DISPLAY CODE FOR 'la madre adoptiva' IF NRQ040=1
OR 2 AND HRQ015=4 AND HRQ030=1 FOR A
NONRESIDENT ADOPTIVE FEMALE PARENT. ELSE USE
A NULL DISPLAY.

DISPLAY 'adoptive female parent' IF NRQ040=1 OR 2
AND HRQ015=3 AND HRQ030=1 FOR A
NONRESIDENT ADOPTIVE FEMALE PARENT. ELSE USE
A NULL DISPLAY.

DISPLAY CODE FOR 'el padre adoptivo' IF NRQ040=1
OR 2 AND HRQ015=5 AND HRQ030=1 FOR A
NONRESIDENT ADOPTIVE MALE PARENT. ELSE USE A
NULL DISPLAY.

DISPLAY 'adoptive male parent' IF NRQ040=1 OR 2
AND HRQ015=4 AND HRQ030=1 FOR A
NONRESIDENT ADOPTIVE MALE PARENT, ELSE USE A
NULL DISPLAY.

DISPLAY CODE FOR '{madre o padre adoptivo(a) de
otro género}' IF NRQ040=1 OR 2 AND HRQ015=6
AND HRQ030=1 FOR A NONRESIDENT ADOPTIVE
PARENT OF ANOTHER GENDER. ELSE USE A NULL
DISPLAY.

DISPLAY CODE FOR 'Adoptive parent of another
gender' IF NRQ040=1 OR 2 AND HRQ015=6 AND
HRQ030=1 FOR A NONRESIDENT ADOPTIVE PARENT
OF ANOTHER GENDER. ELSE USE A NULL DISPLAY.
ELSE IF THERE ARE TWO NONRESIDENT PARENTS
WITH NRQ040 = 1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER , ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY “or” BETWEEN
THE TWO PARENT DISPLAYS.
ELSE IF THERE ARE THREE NONRESIDENT PARENTS
WITH NRQ040 = 1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY “or” BETWEEN
THE FIRST AND SECOND PARENT DISPLAYS AND THE

ELSE IF THERE ARE TWO NONRESIDENT PARENTS
WITH NRQ040 = 1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY “or” BETWEEN
THE TWO PARENT DISPLAYS.
ELSE IF THERE ARE THREE NONRESIDENT PARENTS
WITH NRQ040 = 1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY “or” BETWEEN
THE FIRST AND SECOND PARENT DISPLAYS AND THE
SECOND AND THIRD PARENT DISPLAYS.
ELSE IF THERE ARE FOUR NONRESIDENT PARENTS
WITH NRQ040 = 1 OR 2, USE THE DISPLAYS ABOVE

SECOND AND THIRD PARENT DISPLAYS.
ELSE IF THERE ARE FOUR NONRESIDENT PARENTS
WITH NRQ040 = 1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY “or” BETWEEN
THE FIRST AND SECOND PARENT DISPLAYS, THE
SECOND AND THIRD PARENT DISPLAYS, AND THE
THIRD AND FOURTH DISPLAYS.
ELSE IF THERE ARE FIVE NONRESIDENT PARENTS
WITH NRQ040=1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY "or" BETWEEN
THE FIRST AND SECOND PARENT DISPLAYS , THE
SECOND AND THIRD PARENT DISPLAYS, THE THIRD
AND FOURTH DISPLAYS, AND THE FOURTH AND
FIFTH DISPLAYS.
ELSE IF THERE ARE SIX NONRESIDENT PARENTS
WITH NRQ040=1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER
GENDER) AND DISPLAY "or" BETWEEN THE FIRST
AND SECOND PARENT DISPLAYS, THE SECOND AND
THIRD PARENT DISPLAYS, THE THIRD AND FOURTH
DISPLAYS, THE FOURTH AND FIFTH DISPLAYS, AND
THE FIFTH AND SIXTH DISPLAYS.

FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY “or” BETWEEN
THE FIRST AND SECOND PARENT DISPLAYS, THE
SECOND AND THIRD PARENT DISPLAYS, AND THE
THIRD AND FOURTH DISPLAYS.
ELSE IF THERE ARE FIVE NONRESIDENT PARENTS
WITH NRQ040=1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER GENDER) AND DISPLAY "or" BETWEEN
THE FIRST AND SECOND PARENT DISPLAYS, THE
SECOND AND THIRD PARENT DISPLAYS, THE THIRD
AND FOURTH DISPLAYS, AND THE FOURTH AND
FIFTH DISPLAYS.
ELSE IF THERE ARE SIX NONRESIDENT PARENTS
WITH NRQ040=1 OR 2, USE THE DISPLAYS ABOVE
FOR EACH TYPE OF PARENT (BIOLOGICAL FEMALE
PARENT, BIOLOGICAL MALE PARENT, BIOLOGICAL
PARENT OF ANOTHER GENDER, ADOPTIVE FEMALE
PARENT, ADOPTIVE MALE PARENT, ADOPTIVE PARENT
OF ANOTHER
GENDER) AND DISPLAY "or" BETWEEN THE FIRST
AND SECOND PARENT DISPLAYS, THE SECOND AND
THIRD PARENT DISPLAYS, THE THIRD AND FOURTH
DISPLAYS, THE FOURTH AND FIFTH DISPLAYS, AND
THE FIFTH AND SIXTH DISPLAYS.

FOR FIRST NAME, ALLOW 0 – 100 CHARACTERS TO
BE ENTERED.

QUESTION TEXT:
Question “What is the contact information for
{CHILD}'s {biological female parent/ {or}
biological male parent/{or} biological parent of
another gender/ {or} adoptive female parent /
{or} adoptive male parent/{or} adoptive
parent of another gender}?

“¿Cuál es la información de contacto de {la
madre biológica/ {o} el padre biológico / {o}
madre o padre biológico(a) de otro género/ {o}
la madre adoptiva/ {o} el padre adoptivo/ {o}
madre o padre adoptivo(a) de otro género} de
{CHILD}?

First Name:"

Primer nombre:"

"I already provided this contact information."

“Ya proporcioné esta información de contacto.”

"Don't know"

“No sé.”

"Rather not answer"

“Prefiero no contester”

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “I already
provided this contact information.”, “Don’t
know”, and “Rather not answer” AS RADIO
BUTTONS.

ADD A SPECIAL ANSWER TO DISPLAY “Ya
proporcioné esta información de contacto.”, “No
sé”, and ““Prefiero no contestar” AS RADIO
BUTTONS.

__________________________________________________________

CMQ170b
DISPLAY INSTRUCTIONS:
FOR LAST NAME, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ170a-c3 TOGETHER.

QUESTION TEXT:
Question "Last Name:"
ENTER TEXT

"Apellido:"

__________________________________________________________

CMQ170c1
DISPLAY INSTRUCTIONS:
FOR EMAIL, ALLOW 0 – 100 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ170a-c3 TOGETHER.

QUESTION TEXT:
Question "Email Address:"

"Dirección de correo electrónico (email):"

Watermark "name@domain.com"

IF THE EMAIL ADDRESS DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE FOLLOWING
MESSAGE "La dirección electrónica debería tener
el símbolo "@" y por lo menos un punto. Por favor
confirme y cuando la dirección sea la correcta,
seleccione Siguiente para continuar."

__________________________________________________________

CMQ170c2
DISPLAY INSTRUCTIONS:
DISPLAY CMQ170a-c3 TOGETHER.

QUESTION TEXT:
Question "Mobile Number:”

"Teléfono celular:”

“This person doesn't have a mobile phone.”

“Esta persona no tiene teléfono celular.”

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn't have a mobile phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene teléfono celular “AS A RADIO
BUTTON.

FOR MOBILE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE MOBILE PHONE NUMBER SO
THAT IT IS IN THIS FORMAT (###)-###-####.

FOR MOBILE NUMBER, ALLOW 0-12 CHARACTERS
TO BE ENTERED. APPLY EDIT MASK TO VALIDATE
MOBILE PHONE NUMBER SO THAT IT IS IN THIS
FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “El número de teléfono ((XXX)-XXXXXXX). Por favor verifíquelo y póngalo de nuevo.”

__________________________________________________________

CMQ170c3
DISPLAY INSTRUCTIONS:
DISPLAY CMQ170a-c3 TOGETHER.

QUESTION TEXT:
Question "Landline Number:"

"Teléfono de la casa:"

“This person doesn't have a landline phone.”

“Esta persona no tiene teléfono de la casa/línea
de tierra.”

PROGRAMMER INSTRUCTIONS:
ADD A SPECIAL ANSWER TO DISPLAY “This
person doesn't have a landline phone.” AS A
RADIO BUTTON.

ADD A SPECIAL ANSWER TO DISPLAY “Esta
persona no tiene teléfono de la casa/línea de
tierra.” AS A RADIO BUTTON.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT
MASK TO VALIDATE LANDLINE PHONE NUMBER
SO THAT IT IS IN THIS FORMAT (###)-#######.

FOR LANDLINE NUMBER, ALLOW 0-12
CHARACTERS TO BE ENTERED. APPLY EDIT MASK
TO VALIDATE LANDLINE PHONE NUMBER SO THAT
IT IS IN THIS FORMAT (###)-###-####.

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “The phone number must be 10
numbers ((XXX)-XXX-XXXX). Please check and
enter again.”

IF THE PHONE NUMBER DOES NOT PASS THE
VALIDATION CHECK, DISPLAY THE ERROR
MESSAGE “El número de teléfono ((XXX)-XXXXXXX). Por favor verifíquelo y póngalo de nuevo.”

__________________________________________________________

CMQ170d1
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 1, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY CMQ170d1-h TOGETHER.

QUESTION TEXT:
Question "Please enter the mailing address:"

"Por favor ponga la dirección de correo postal:"

Address Line 1:"

Dirección – Línea 1:"

ENTER TEXT

__________________________________________________________

CMQ170d2
DISPLAY INSTRUCTIONS:
FOR ADDRESS LINE 2, ALLOW 0 – 100 CHARACTERS
TO BE ENTERED.
DISPLAY CMQ170d1-h TOGETHER.

QUESTION TEXT:
Question "Address Line 2:"

"Dirección - Línea 2:"

Watermark “Apartment number"

Watermark “Número de apartamento"

ENTER TEXT

__________________________________________________________

CMQ170e
DISPLAY INSTRUCTIONS:
FOR CITY, ALLOW 0 – 50 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ170d1-h TOGETHER.

QUESTION TEXT:
Question "City:"
ENTER TEXT

"Ciudad:"

__________________________________________________________

CMQ170f
DISPLAY INSTRUCTIONS:
FOR STATE/DISTRICT/TERRITORY HAVE DROP DOWN
BOX WITH STATE NAMES, THE DISTRICT OF
COLUMBIA, AND THE U.S. TERRITORIES.
DISPLAY CMQ170d1-h TOGETHER.

QUESTION TEXT:
Question "Please select a state, district, or
territory:"

"Por favor seleccione un estado, distrito o
territorio:”

Watermark “Select a state”

Watermark “Seleccione un estado”

ENTER TEXT

__________________________________________________________

CMQ170g
DISPLAY INSTRUCTIONS:
FOR ZIP CODE, ALLOW 0 – 5 CHARACTERS TO BE
ENTERED.
DISPLAY CMQ170d1-h TOGETHER.

QUESTION TEXT:
Question "ZIP code:"

"Código postal:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

CMQ170h
DISPLAY INSTRUCTIONS:
DISPLAY CMQ170d1-h TOGETHER.
DISPLAY CODE FOR 'Biological female parent' IF
NRQ040=1 OR 2 AND HRQ015=1 AND HRQ030=1
FOR A NONRESIDENT BIOLOGICAL MOTHER. ELSE
USE A NULL DISPLAY.
DISPLAY CODE FOR 'Biological male parent' IF
NRQ040=1 OR 2 AND HRQ015=2 AND HRQ030=1
FOR A NONRESIDENT BIOLOGICAL MALE PARENT.
ELSE USE A NULL DISPLAY.
DISPLAY CODE FOR 'Biological parent of another
gender' IF NRQ040=1, OR 2 AND HRQ015=3 AND
HRQ030=1 FOR A NONRESIDENT BIOLOGICAL
PARENT OF ANOTHER GENDER, ELSE USE NULL
DISPLAY.
DISPLAY CODE FOR 'Adoptive female parent' IF
NRQ040=1 OR 2 AND HRQ015=4 AND HRQ030=1
FOR A NONRESIDENT ADOPTIVE FEMALE PARENT.
ELSE USE A NULL DISPLAY.
DISPLAY CODE FOR 'Adoptive male parent' IF
NRQ040=1 OR 2 AND HRQ015=5 AND HRQ030=1
FOR A NONRESIDENT ADOPTIVE MALE PARENT. ELSE
USE A NULL DISPLAY.
DISPLAY CODE FOR 'Adoptive parent of another
gender' IF NRQ040=1 OR 2 AND HRQ015=6 AND
HRQ030=1 FOR A NONRESIDENT ADOPTIVE PARENT
OF ANOTHER GENDER. ELSE USE A NULL DISPLAY.

DISPLAY CODE FOR 'Madre biológica' IF NRQ040=1
OR 2 AND HRQ015=1 AND HRQ030=1 FOR A
NONRESIDENT BIOLOGICAL MOTHER. ELSE USE A
NULL DISPLAY.
DISPLAY CODE FOR 'Padre biológico' IF NRQ040=1
OR 2 AND HRQ015=2 AND HRQ030=1 FOR A
NONRESIDENT BIOLOGICAL MALE PARENT. ELSE USE
A NULL DISPLAY.
DISPLAY CODE FOR 'Madre o padre biológico(a) de
otro género' IF NRQ040=1, OR 2 AND HRQ015=3
AND HRQ030=1 FOR A NONRESIDENT BIOLOGICAL
PARENT OF ANOTHER GENDER, ELSE USE NULL
DISPLAY.
DISPLAY CODE FOR 'Madre adoptiva' IF NRQ040=1
OR 2 AND HRQ015=4 AND HRQ030=1 FOR A
NONRESIDENT ADOPTIVE FEMALE PARENT. ELSE USE
A NULL DISPLAY.
DISPLAY CODE FOR 'Padre adoptivo' IF NRQ040=1 OR
2 AND HRQ015=5 AND HRQ030=1 FOR A
NONRESIDENT ADOPTIVE MALE PARENT. ELSE USE A
NULL DISPLAY.
DISPLAY CODE FOR '{Madre o padre adoptivo(a) de
otro género}' IF NRQ040=1 OR 2 AND HRQ015=6
AND HRQ030=1 FOR A NONRESIDENT ADOPTIVE
PARENT OF ANOTHER GENDER. ELSE USE A NULL
DISPLAY.

QUESTION TEXT:
Question "Please confirm this person’s
relationship to {CHILD} by selecting a choice
below."

"Por favor confirme la relación o parentesco de
esta persona con {CHILD}, seleccionando una
de las siguientes opciones."

CODES
1

{Biological female parent}

{Madre biológica}

{Biological male parent}

{Padre biológico}

{Biological parent of another gender}

{Madre o padre biológico(a) de otro género}

{Adoptive female parent}

{Madre adoptiva}

{Adoptive male parent}

{Padre adoptivo}

{Adoptive parent of another gender}

{Madre o padre adoptivo(a) de otro género}

Other

Otro

__________________________________________________________

CMQ500

QUESTION TEXT:
Question “Are you, or is someone else,
planning to move to a new home with
{CHILD} before fall 2024?"

“¿Usted o alguien más tiene planes de mudarse
a otro hogar con {CHILD} antes del otoño de
2024?"

CODES
1

Yes

CMQ505a1

Sí

CMQ510

PROGRAMMER INSTRUCTIONS:
SK SKIPS TO CMQ510.
__________________________________________________________

CMQ505a1
DISPLAY INSTRUCTIONS:
DISPLAY CMQ505a1-d TOGETHER.

QUESTION TEXT:
Question "Please enter what {CHILD}’s new
address will be in fall 2024.

"Por favor ponga cuál será la nueva dirección de
{CHILD} en la primavera de 2024.

Address Line 1: "

Dirección – Línea 1:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

__________________________________________________________

CMQ505a2
DISPLAY INSTRUCTIONS:
DISPLAY CMQ505a1-d TOGETHER.

QUESTION TEXT:
Question "Address Line 2:"

"Dirección – Línea 2:"

Watermark “Apartment number"

Watermark “Número de apartamento"

ENTER TEXT

__________________________________________________________

CMQ505b
DISPLAY INSTRUCTIONS:
DISPLAY CMQ505a1-d TOGETHER.

QUESTION TEXT:
Question "City:"

"Ciudad:"

ENTER TEXT

__________________________________________________________

CMQ505c
DISPLAY INSTRUCTIONS:
DISPLAY CMQ505a1-d TOGETHER.

QUESTION TEXT:
Question "Please select a state, district, or
territory:"

"Por favor seleccione un estado, distrito o
territorio:”

Watermark "Select a state"

Watermark “Seleccione un estado”

PROGRAMMER INSTRUCTIONS:
FOR STATE/DISTRICT/TERRITORY HAVE DROP
DOWN BOX WITH STATE NAMES, THE DISTRICT
OF COLUMBIA, AND THE U.S. TERRITORIES.

__________________________________________________________

CMQ505d
DISPLAY INSTRUCTIONS:
DISPLAY CMQ505a1-d TOGETHER.
FOR ZIP CODE, ALLOW 0 – 5 CHARACTERS TO BE
ENTERED.

QUESTION TEXT:
Question "ZIP code:"

"Código postal:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

CMQ510

QUESTION TEXT:
Question “In the fall of 2024, what school will
{CHILD} attend?”

“¿A qué escuela asistirá {CHILD} en el otoño de
2024?"

SaVisible “True”
CODES
1

The same school that {CHILD} attends now

CMQ805

A la misma escuela que {CHILD} asiste ahora

A new school

CMQ520

A una escuela nueva

{CHILD} will be homeschooled INSTEAD of
attending a school

CMQ805

{CHILD} recibirá su enseñanza escolar en
casa EN VEZ de asistir a una escuela
(homeschooling)
DON'T KNOW

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").

__________________________________________________________

CMQ520

QUESTION TEXT:
Question “Will {CHILD} go to a public or
private school in the fall of 2024?”

“¿Irá {CHILD} a una escuela pública o privada
en el otoño de 2024?”

SaVisible “True”
CODES
1

Public

Pública

Private

Privada

DON'T KNOW

PROGRAMMER INSTRUCTIONS:
DISPLAY DON'T KNOW OPTION (SaVisible
"True").
DON’T KNOW AND SK SKIP TO CMQ805.
__________________________________________________________

CMQ525

QUESTION TEXT:
Question "Please enter the full name of the
school that {CHILD} will attend in fall 2024."
ENTER TEXT

"Por favor ponga el nombre completo de la
escuela a donde asistirá {CHILD} en el otoño
de 2024."

__________________________________________________________

CMQ525b
DISPLAY INSTRUCTIONS:
DISPLAY CMQ525b-eOS TOGETHER.

QUESTION TEXT:
Question "Where is the school located?

"¿Dónde está ubicada la escuela?

City: "

"Ciudad:"

ENTER TEXT

__________________________________________________________

CMQ525c
DISPLAY INSTRUCTIONS:
DISPLAY CMQ525b-eOS TOGETHER.

QUESTION TEXT:
Question "Please select a state, district, or
territory:"

"Por favor Seleccione un estado, distrito o
territorio:”

Watermark "Select a state"

Watermark “Seleccione un estado”

PROGRAMMER INSTRUCTIONS:

ALLOW EMPTY AND ASSIGN AS VALUE SK. IF
ANSWER IS SK, GO TO NEXT QUESTION.
FOR STATE/DISTRICT/TERRITORY HAVE DROP
DOWN BOX WITH STATE NAMES, THE DISTRICT
OF COLUMBIA, AND THE U.S. TERRITORIES.

__________________________________________________________

CMQ525d
DISPLAY INSTRUCTIONS:
DISPLAY CMQ525b-eOS TOGETHER.
FOR ZIP CODE, ALLOW 0 – 5 CHARACTERS TO BE
ENTERED.

QUESTION TEXT:
Question "ZIP Code:"

"Código postal:"

ENTER TEXT
DON'T KNOW

DON'T KNOW

IF THE ZIP CODE IS LESS THAN 5 DIGITS,
DISPLAY THE ERROR MESSAGE, "El código postal
debe tener 5 dígitos. Por favor corrija su respuesta
y póngala nuevamente."

__________________________________________________________

CMQ525e
DISPLAY INSTRUCTIONS:
DISPLAY CMQ525b-eOS TOGETHER.

QUESTION TEXT:
Question "What is the county for the school?"

"¿En qué condado está la escuela?"

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.”

Comience a poner el nombre del condado,
empezando con la primera letra. Si aparece en
la lista el nombre que estaba poniendo,
selecciónelo en la lista. Si no aparece en la lista,
seleccione “No está en la lista”.

County: "
“Not on list.”
"Don't know"

Condado: "
"No está en la lista."
“No sé”

ENTER TEXT
PROGRAMMER INSTRUCTIONS:
PROVIDE THE LIST OF COUNTIES ASSOCIATED
WITH THE STATE OF THE SCHOOL ADDRESS IN
CMQ525c.

ADD SPECIAL ANSWERS TO DISPLAY “No está en
la lista” AND “No sé” AS RADIO BUTTONS AT THE
END OF THE LIST OF COUNTIES.

ADD SPECIAL ANSWERS TO DISPLAY “Not on
list” AND “Don’t know” AS RADIO BUTTONS AT
THE END OF THE LIST OF COUNTIES.
__________________________________________________________

Box 4b

IF A COUNTY IS SELECTED THAT IS NOT ON
THE LIST, GO TO CMQ525eOS. ELSE GO TO
CMQ805.

__________________________________________________________

CMQ525eOS
DISPLAY INSTRUCTIONS:
DISPLAY CMQ525b-eOS TOGETHER.

QUESTION TEXT:
Question “County"

“Condado"

Watermark “Enter county"

Watermark “Ponga el condado"

ENTER TEXT

__________________________________________________________

Box 5

GO TO CMQ805.

__________________________________________________________

CMQ800

QUESTION TEXT:
Question "Thank you very much for taking the
time to participate in the Early Childhood
Longitudinal Study. Please select "Finish" to
return to the MyECLS website. This will save
your responses and keep them secure.”

PROGRAMMER INSTRUCTIONS:
INCLUDE FINISH BUTTON THAT ROUTES BACK
TO MANAGEMENT SYSTEM.

"Muchas gracias por su cooperación y por
dedicarnos tiempo para participar en el Estudio
Longitudinal de la Temprana Infancia. Haga clic
en “Terminar” para volver a la página de
MyECLS. Así sus respuestas se guardarán y se
mantendrán protegidas.”

__________________________________________________________

Box 6

CASE WITH A CHANGE IN RESPONDENTS IS
FINISHED AND HAS ROUTED BACK TO
MANAGEMENT SYSTEM. NOTE: IN THE
MANAGEMENT SYSTEM, THIS CASE WILL HAVE
A TASK LEVEL STATUS OF 13 (RESET,
RESPONDENT CHANGED TO MOST
KNOWLEDGEABLE ADULT) AND ANOTHER
CASE WILL BE INITIATED USING THE ANSWER
TO INQ002 (INQ002 = 2 ANOTHER
RESPONDENT IN THE HOUSEHOLD KNOWS
MORE AND INQ003 = 3 THE CHILD DOES NOT
LIVE IN THE HOUSEHOLD) AND CONTACT
INFORMATION FOR THE NEW RESPONDENT
(INQ005a (FIRST NAME), INQ005b (LAST
NAME), INQ005c (EMAIL ADDRESS), INQ005d
(MOBILE NUMBER), INQ005e (LANDLINE
NUMBER), INQ005f1 (ADDRESS LINE 1),
INQ005f2 (ADDRESS LINE 2), INQ005f3
(CITY), INQ005f4 (STATE), AND INQ005f5
(ZIP)).
SAVE THIS CONTACT INFORMATION IN THE
MANAGEMENT SYSTEM FOR USE WHEN
CALLING BACK HOUSEHOLDS WITH A STATUS
CODE OF 13.

__________________________________________________________

CMQ805

QUESTION TEXT:
Question "Thank you very much for taking the
time to participate in the Early Childhood
Longitudinal Study. Please select "Finish" to
complete your survey and return to the
MyECLS website. This will save your responses
and keep them secure."
PROGRAMMER INSTRUCTIONS:
INCLUDE FINISH BUTTON THAT ROUTES BACK
TO MANAGEMENT SYSTEM.

File Type	application/pdf
Author	Nancy Vaden-Kiernan
File Modified	2024-02-01
File Created	2023-10-29