0 Appendix C

EHS 5TH GRADE FOLLOW-UP STUDY
MATERNAL INTERVIEW

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.1

SECTION 1
FAMILY DEMOGRAPHICS

FD1
ALL

Thank you for agreeing to participate in this study (once again).
Let me begin by confirming the name of the child we will be talking about
today.
The child’s first name is [FILL FOR FIRST NAME OF CHILD FROM FILE].
Is that correct?
INTERVIEWER: IF RESPONDENT GIVES DIFFERENT NAME, MAKE SURE YOU
ARE TALKING ABOUT THE RIGHT CHILD.
FIRST NAME OF
CHILD=CHILD

STRING
OF 15

FD2

FD2
ALL

And [CHILD]’s last name is [FILL FOR LAST NAME OF CHILD FROM
FILE], correct?
INTERVIEWER: IF RESPONDENT GIVES DIFFERENT NAME, MAKE SURE YOU
ARE TALKING ABOUT THE RIGHT CHILD.
LAST NAME OF
CHILD=CHILD

STRING
OF 15

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.2

FD3

FD3
ALL

Is [CHILD] male or female?
INTERVIEWER: CODE WITHOUT ASKING.

MALE
FEMALE
DK
R

1
2
D
R

FD4.1

FD4.1
ALL
What is [CHILD]’s birth date?

CHILD’S BIRTH DAY
DK
R

MM/DD/YYYY
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.3

FD4.2

FD4.2
ALL
INTERVIEWER: DETERMINE IF RESPONDENT IS REPORTING ON RIGHT CHILD.
FILE:
FIRST NAME CHILD
LAST NAME OF CHILD
BIRTH DAY OF CHILD

CORRECT CHILD
NOT CORRECT CHILD

REPORTED BY RESPONDENT:
FIRST NAME CHILD
LAST NAME OF CHILD
BIRTH DAY OF CHILD

1
2

FD4.4
FD4.3

FD4.3
IF FD4.2=2
I’m sorry, it appears there is a problem with our records. I need to contact
my supervisor and I will contact you again to reschedule an appointment.

INTERRUPT INTERVIEW AND CONSULT SUPERVISOR

FD4.4
ALL
I also would like to make sure that I have your name correctly. What is
your first name?
RESPONDENT’S FIRST NAME
DK
R

STRING
0F 15
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.4

FD4.5

FD4.5
ALL
What is your last name?
RESPONDENT’S LAST NAME

STRING
0F 15
D
R

DK
R

FD4.6

FD4.6
ALL
INTERVIEWER: CODE WITHOUT ASKING. IS RESPONDENT MALE OR FEMALE?

MALE
FEMALE

1
2

FD7

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.5

FD7
ALL
How are you related to [CHILD]?
INTERVIEWER: PROBE FOR TYPE OF PARENT
BIOLOGICAL/BIRTH
PARENT
STEP PARENT
ADOPTIVE PARENT
FOSTER PARENT
GRANDPARENT
GREAT GRANDPARENT
PARENT’S/ BOY OR
GIRLFRIEND
OTHER RELATIVE
(SPECIFY:___________)
OTHER NON-RELATIVE
(SPECIFY:___________)
DK
REF

1
2
3
4
5
6
7
8
9
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.6

FD9

FD9
ALL
Now I have some questions about the people [CHILD] lives with.
Do you currently live with [CHILD] …
All or almost all of the
time,
About half of the time,
Some of the time, or
None of the time?
DK
REF

1

FD10

2
3
4
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.7

FD10
ALL
you and IF FD9<4
Not including [you and] [CHILD], how many other people lived in the same
household during the past 30 days?
ENTER TOTAL
NUMBER
DK
REF

FF
d
r

IF = 0 FD17.
ELSE FD12
FD17

BEGIN LOOP FOR FD12
LOOP [ANSWER IN FD10] TIMES TO GET INFORMATION FOR ALL
PEOPLE IN HOUSEHOLD
LOOP=NUMBER IN THE LOOP
FD12.1
IF FD10 NE 0, D, OR R AND LOOP LE FD10
you and IF FD9<4
Oldest IF LOOP=1 AND FD10>1
second oldest, third oldest, etc IF LOOP>1.
(IF FD10>1 AND LOOP=1) Starting with the oldest person that lived with
[you and] [CHILD] during the past 30 days, is this person a male or a
female?
(IF FD10>1 AND IF LOOP>1) Now thinking about the [second, third, etc.
oldest] person, is this person a male or a female?
(IF FD10=1) Is this person a male or a female?
MALE
FEMALE

1
2

FD12.2

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.8

FD12.2
IF FD10 NE 0, D, OR R AND LOOP LE FD10
he IF FD12.1 =MALE; she IF FD12.1 =FEMALE
How old is [she/he]?
PROBE: Your best estimate is fine.
INTERVIEWER: IF LESS THAN 1 YEAR OLD ENTER ZERO

AGE
DK
REF

FF
D
R

FD12.3

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.9

FD12.3
IF FD10 NE 0, D, OR R AND LOOP LE FD10
he IF FD12.1 =MALE; she IF FD12.1 =FEMALE
Oldest IF LOOP=1
second oldest, third oldest, etc IF LOOP>1.
you and IF FD9<4
reduce the categories? Too many

And, how is [she/he] related to [CHILD]?
PROBE: This is the [oldest/second oldest etc] who lived with [you and]
[CHILD] in the past 30 days?
INTERVIEWER: PROBE FOR TYPE OF PARENT OR SIBLING
IF FD12.1=FEMALE
MOTHER
GRANDMOTHER
GREAT GRANDMOTHER
MOTHER’S
PARTNER/BOYFRIEND
SISTER
NIECE
COUSIN
AUNT
OTHER RELATIVE
(SPECIFY:___________)
OTHER NON-RELATIVE
(SPECIFY:___________)
OTHER (SPECIFY)
DK
REF

IF FD12.1=MALE
FATHER
GRANDFATHER
GREAT GRANDFATHER
FATHER’S
PARTNER/BOYFRIEND
BROTHER
NEPHEW
COUSIN
UNCLE
OTHER RELATIVE
(SPECIFY:___________)
OTHER NON-RELATIVE
(SPECIFY:___________)
OTHER (SPECIFY)
DK
REF

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.10

1
2
3

FD12.4.1
FD12.4

4
5
6
7
8

FD12.4.2
FD12.4
FD12.4

9
11
12
d
r

FD12.4

FD12.4.1
IF FD12.3=1
he IF FD12.1=MALE; she IF FD12.1=FEMALE
father IF FD12.1=MALE; mother IF FD12.1=FEMALE
Is [she/he] [CHILD]’s biological step, adoptive of foster [father/mother]?
BIOLOGICAL OR BIRTH
STEP
ADOPTIVE
FOSTER
DK
REF

1
2
3
4
D
R

FD12.5

FD12.4.2
IF FD12.3 =2
he IF FD12.1=MALE; she IF FD12.1=FEMALE
brother IF FD12.1=MALE;sister IF FD12.1=FEMALE
Is [she/he] [CHILD]’s full, half, step, adoptive, or foster [brother/sister]?
FULL
STEP
ADOPTIVE
FOSTER
DK
REF

1
2
3
4
D
R

FD12.5

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.11

FD12.4
IF FD12.2 <18
he IF FD12.1=MALE; she IF FD12.1=FEMALE
Has [she/he] ever attended a Early Head Start Program?
YES
NO
DK
REF

1
2
D
R

FD12.5

FD12.5
IF LOOP=FD10
you and IF FD9<4
Was there anybody else living with you and [CHILD] in the same household
in the past 30 days that you did not mention yet?
YES

1

NO
DK
REF

2
D
R

FD10=FD10+1 AND
CONTINUE LOOP
FD13

END LOOP FD12

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.12

FD13
ALL
Final version of question still pendin;may change order of this question and ask later

The next question is about your educational background. What is the
highest grade or year of school that you have completed or what are the
highest degrees, diplomas or certificates you have received?
IF RESPONDENT SAYS, “NONE”, ASK: Did you complete an elementary,

middle or junior high school program?
IF RESPONDENT SAYS, “ HIGH SCHOOL OR HIGH SCHOOL DIPLOMA”, ASK: Did

you receive a high school diploma or GED?
PROBE FOR OTHER DEGREES.
NONE

1

UP TO 8TH GRADE /ELEMENTARY, MIDDLE OR
JUNIOR HIGH SCHOOL DIPLOMA
11 AND 12TH GRADE
12TH GRADE BUT NO HIGH SCHOOL DIPLOMA
GED CERTIFICATE
HIGH SCHOOL DIPLOMA

2

VOC/TECH PROGRAM AFTER HIGH SCHOOL
BUT NO VOC/TECH DIPLOMA
VOC/TECH DIPLOMA
SOME COLLEGE BUT NO DEGREE
ASSOCIATE’S DEGREE
BACHELOR’S DEGREE
GRADUATE OR PROFESSIONAL
SCHOOL BUT NO DEGREE
MASTER’S DEGREE (MA, MS)
DOCTORATE DEGREE (PHD, EDD)
PROFESSIONAL DEGREE AFTER BACHELOR’S
DEGREE (MEDICINE/MD; DENTISTRY/DDS;
LAW/JD/LLB; ETC.
DK
REF

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.13

3
4
5
6
7
8
9
10
11
12
13
14
15

2
R

FD17

FD17
ALL
Are you currently attending school, participating in any training program or
taking any classes? Please include GED classes, vocational or trade
school, job skills training or programs, Job Corps and college courses?
YES
NO
DK
REF

1
2
d
r

FD18

FD18
ALL
Are you currently working at a job or business for pay? This includes
temporary jobs, working in your own business, being in the military, or any
other type of work you get paid for.
YES
NO
DK
REF

1
2
d
r

FD19
FD18.1

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.14

FD18.1
IF FD18<>YES
Are you currently…
Unemployed,
Looking for work, or
laid off
Disabled or retired,
Not working,
Or are you doing
something else?
(DESCRIBE)
IN PRISON/JAIL
DK
REF

1

FD24

2
3
4

6
d
r

FD19
IF FD18= 1
How many different jobs do you currently have?
ENTER TOTAL
NUMBER
DK
REF

FF

FD20

d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.15

FD20
IF FD18=1
adding up the hours from all your current jobs IF FD19>1
[Adding up the hours from all your current jobs], about how many hours
per week do you usually work for pay??
PROBE IF HOURS VARY: What are the average number of hours per week

you work?
.

ENTER TOTAL
HOURS
DK
REF

FF

FD21

d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.16

FD21
IF FD18=1
(IF MORE THAN 1 JOB FD19>1) Thinking about the job where you work
the most hours per week, do you regularly work….
(IF ONE JOB FD19=1) Do you regularly work…

a
b
c
d
e

Weekdays?
Evening (6PM TO 11 PM)?
Nights (11PM TO 7 AM)?
Weekends?
Different times each week?
DK
REF

YES
1
1
1
1
1
1
1

NO
2
2
2
2
2
2
2

DK
d
d
d
d
d
d
d

REF
r
r
r
r
r
r
r

FD22

FD22
IF FD18=1
any of IF FD19>1; [s] IF FD19>1
Are you eligible for any of the following benefits at [any of] your job[s]? By
eligible we mean the benefit is available to you now, even if you have
decided not to receive it or do not need it. What about…

a
b
c

Health insurance?
Sick leave?
Paid vacation?

YES
1
1
1

NO
2
2
2

DK
d
d
d

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.17

R
r
r
r

FD22.1

FD22.1
IF FD18=1
What are your earnings before taxes and other deductions? Please include
in the amount tips, commissions, and regular overtime pay from all the jobs
you currently have.
Probe: You can give me the amount per hour, per week, per two weeks,
per two times a month, per month, or per year.
INTERVIEWER: IF RESPONDENT CAN ONLY REPORT EARNINGS AFTER TAXES
ENTER THE AMOUNT OF EARNINGS AFTER TAXES AND CONTINUE.

AMOUNT
DK
REF

FFF,FFF.FF
d
r

FD23

FD23
IF FD18=1 and FD22.1 NE DK, REF
Is this amount …
INTERVIEWER: CODE WITHOUT ASKING IF KNOWN.

Per hour,
Per day,
Per week,
Per two weeks,
Per two times a
months
Per month, or
Per year?
DK
REF

1
2
3
4
5

FD23.3

6
7
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.18

FD23.3
IF FD23<>DK OR REF
Comment: spit question to maker reporting easier

Just to confirm, this amount is before taxes?
INTERVIEWER: CODE WITHOUT ASKING IF KNOWN.
INTERVIEWER: IF ‘NO’ CONFIRM IF AFTER TAXES

YES, BEFORE TAXES
NO, AFTER TAXES
DK
REF

1
2
D
R

FD24

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.19

FD24
ALL
Now I would like to ask you about types of income and support you or
members of your household may currently be receiving. Do you or any
other members of your household currently receive income or a check
from…

a
b
c
e
f
g
h
i
j

[STATE FOR TANF=TANF BOX] or
welfare
General Assistance, General Relief or
[LOCAL NAME]?
Security Retirement Disability, SSI,
SSDI, Survivor’s Benefits or SSA?
Unemployment insurance benefits?
Food stamps?
WIC?
Child support payments?
Medicaid,[state fill for CHIP] or any other
government medical assistance? or
Did you receive some other type of
assistance I did not mention?
(Specify:________)

YES NO
1
2

DK
d

R
r

1

2

d

r

1

2

d

r

1
1
1
1
1

2
2
2
2
2

d
d
d
d
d

r
r
r
r
r

1

2

d

r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.20

Alabama
Alaska
Arizona

Arkansas

TANF box
STATE WELFARE AGENCIES
Nebraska
FA (Family Assistance Program)
Nevada
ATAP (Alaska Temporary Assistance
Program)
New
EMPOWER (Employing and Moving
People Off Welfare and Encouraging
Hampshire
Responsibility)

New Jersey

FAP (Family Assistance Program),
financial aid for work exempt
families
NHEP (New Hampshire
Employment Program), financial aid
for work-mandated families
WFNJ (Work First New Jersey)

New Mexico

NM Works

FA (Family Assistance Program)
Work First

Colorado
Connecticut

TEA (Transitional Employment
Assistance)
CALWORKS (California Work
Opportunity and Responsibility for
Kids)
Colorado Works
JOBS FIRST

Delaware

ABC (A Better Chance)

New York
North
Carolina
North Dakota

District of
Columbia
Florida
Georgia

TANF

Ohio

Welfare Transition Program
TANF

Oklahoma
Oregon

Hawaii
Idaho

TANF
Temporary Assistance For Families in
Idaho
TANF

Pennsylvania
Rhode Island

California

Illinois
Indiana

Iowa
Kansas

Kentucky
Louisiana

Massachusetts

TANF, cash assistance, IMPACT
(Indiana Manpower Placement and
Comprehensive Training, TANF work
program
FIP (Family Investment Program)
Kansas Works

K-TAP (Kentucky Transitional
Assistance Program)
FITAP (Family Independence
Temporary Assistance Program) cash
assistance
STEP (Strategies to Empower People)
TAFDC (Transitional Aid to Families
with Dependent Children), cash
assistance
ESP (Employment Services Program),

Employment First
TANF

South
Carolina
South
Dakota

Tennessee
Texas

Utah

TEEM (Training, Employment,
Education Management)
OWF (Ohio Works First)
TANF
JOBS (Job Opportunities and Basic
Skills)
Pennsylvania TANF
FIP (Family Independence
Program)
Family Independence
TANF

Families First
Texas Works (Department of
Human Services), cash
assistance
Choices (Texas Workforce
Commission, TANF work program
FEP (Family Employment Program)

Vermont

ANFC (Aid to Families with Needy
Children), cash assistance
Reach Up, TANF work program

Virginia

VIEW (Virginia Initiative for
Employment, Not Welfare)

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.21

Michigan
Minnesota
Mississippi
Missouri
Montana

TANF work program
FIP (Family Independence Program)
MFIP (Minnesota Family Investment
Program)
TANF
Beyond Welfare

Washington
West Virginia

WorkFirst
West Virginia Works

Wisconsin
Wyoming

W-2 (Wisconsin Works)
POWER (Personal Opportunities
With Employment Responsibility)

FAIM (Families Achieving
Independence in Montana)

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.22

FD25
ALL
In the past 12 months, what was your household’s total income before
taxes and other deductions? Please include your own income and the
income of every person living in your household. Please also include the
money you may have told me about from jobs and public assistance
programs, child support payments as well as any other sources we haven’t
discussed such as income from rent, interest, and dividends. Was it…
PROBE: Your best estimate is fine.
$25,000 or less or
More than $25,000?
DK
REF

1
2
d
r

FD26
FD27
FD28
FD28

FD26
IF FD25=1
Was it…
INTERVIEWER: YOU CAN STOP READING RESPONSE CATEGORIES IF
RESPONDENT PROVIDES ANSWER.

$5000 or less,
More than $5,000 but
less than $10,000,
More than $10,00 but
less than $15,000
More than $15,000 but
less than $20,000, or
More than $20,00 but
less than or equal to
$25,000?
DK
REF

1
2
3
4
5

d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.23

FD28

FD27
IF FD25=2
Was it…
INTERVIEWER: YOU CAN STOP READING RESPONSE CATEGORIES IF
RESPONDENT PROVIDES ANSWER.

More than $25,000 but
less than $30,000,
More than $30,000 but
less than $35,000,
More than $35,000 but
less than $40,000,
More than $40,000 but
less than $50,000,
More than $50,000 but
less than $75,000,
More than $75,000 but
less than $100,000,
More than $100,000
but less than
$200,000, or
More than $200,000?
DK
REF

1

FD28

2
3
4
5
6
7

8
d
r

FD28
ALL
he If FD3 =MALE; she IF FD3=FEMALE
Since [CHILD] started first grade, in how many different places has [she/he]
lived for at least four months or longer? Please include the place where
[CHILD] is living now.
ENTER TOTAL
NUMBER
DK
REF

FF
(RANGE>0)

FD29

d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.24

FD29
ALL
he If FD3 =MALE; she IF FD3=FEMALE
Since [CHILD] started first grade, has [he/she] ever been homeless?
PROBE: Being homeless includes staying at a shelter, living on the streets,
or staying for a period of time with friends or family without having a place
of your own.
YES
NO
DK
REF

1
2
d
r

CH1

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.25

SECTION 2
CHILD’S HEALTH

CH1
ALL
Now, I have a few questions about [CHILD]’s health.
In the past year, did you or someone else take [CHILD] for a well-child care
visit or regular checkups?
YES
NO
DK
REF

1
2
d
r

CH3

CH3
ALL
he If FD3 =MALE; she IF FD3=FEMALE
What kind of place does [CHILD] usually go to when [he/she] is sick? Is
it….
A doctor’s office (including an HMO)
The emergency room at a hospital,
A clinic or hospital outpatient
department, or
Some other place (DESCRIBE)
CHILD DOES NOT GET SICK OR GO
TO DOCTOR
DK
REF

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.26

1
2
3
4
5
d
r

CH4
ALL
How are [CHILD]’s health care services primarily covered or paid for right
now? Are they…

Covered by Medicaid, [LOCAL
NAME FOR CHIP], or any other
government program that pays for
[CHILD]’s healthcare,
Covered by a private insurance
through an employer or directly
purchased by you or some one else,
Do you or someone else mostly pay
for these services out of your own
pocket,
Are these services provided free of
charge, or
Are these services covered or paid
for some other way (specify)?
CHILD NEVER GOES TO THE
DOCTOR
DK
REF

1

2

3

4
5
6
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.27

CH5

CH5
ALL
In the past year did you or someone else take [CHILD] to visit a dentist for a
routine check-up or cleaning?
YES
NO
DK
REF

1
2
d
r

CH6

CH6
ALL
he If FD3 =MALE; she IF FD3=FEMALE
Take out blindness and deafness; still make a decision if ever question and treatment since 1st grade

Since [CHILD] started first grade, has [he/she] been diagnosed by a health
professional or any other professional with any of the following conditions?
(IF YES) Did [CHILD]

receive treatment for
this?
a
b
c
d
e
f
g
h
i
j
k

ADD or ADHD?
Allergies?
Chronic sinusitis ?
Asthma?
Diabetes?
Emotional problem?
A hearing problem?
Lead poisoning?
Obesity or being
overweight?
A vision problem which
requires glasses?
Injuries or accidents
requiring medical care?

YES

NO

1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2

d
d
d
d
d
d
d
d
d

1

2

1

2

DK REF

YES

NO

DK

REF

r
r
r
r
r
r
r
r
r

1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2

d
d
d
d
d
d
d
d
d

r
r
r
r
r
r
r
r
r

d

r

1

2

d

r

d

r

1

2

d

r

CH7

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.28

CH7
ALL
him If FD3 =MALE; her IF FD3=FEMALE
comment: word change

Does [CHILD] regularly take any medications prescribed to [him/her] by a
doctor?
YES
NO
DK
REF

1
2
d
r

CH8
CH9
CH9

CH8
IF CH7= 1
comment: word change

What is the medication prescribed for?
CODE ALL THAT APPLY.

ASTHMA
ADD/ADHD
OTHER
DK
REF

1
2
3
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.29

CH9

CH9
ALL

Overall, would you say [CHILD]’s health is…
Excellent,
Very Good,
Good,
Fair, or
Poor?
DK
REF

1
2
3
4
5
d
r

CE1

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.30

SECTION 3
CHILD’S EDUCATION
CE1
ALL

Now I would like to talk with you about [CHILD]’s school experiences.
Is [CHILD] currently attending or enrolled in school?
INTERVIEWER: IF THE CHILD IS HOME SCHOOLED ANSWER NO.

YES
NO
DK
REF

1
2
d
r

CE3
CE2
CE3

CE2
IF CE1=NO

What is the main reason [CHILD] is currently not attending or enrolled in
school?
BEING HOME SCHOOLED
ILLNESS/INJURY
SUSPENSION
EXPULSION FROM
SCHOOL
SCHOOL
VACATION/BREAK
OTHER REASON
(SPECIFY)
DK
REF

1
2
3
4
5
6
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.31

CE11
CE2.1

CE2.1
IF CE1=NO
How long has [CHILD] been out of school for this reason?
INTERVIEWER: ENTER WEEKS HERE AND MONTHS ON NEXT SCREEN. IF LESS
THAN ONE MONTH ENTER ZERO.
INTERVIEWER: IF CHILD HAS NEVER BEEN IN SCHOOL, ENTER ‘99’

NUMBER OF WEEKS NOT IN
SCHOOL
DK
REF

FF

CE2.2

d
r

CE2.2
IF CE1=NO
INTERVIEWER: ENTER MONTHS HERE.
NUMBER OF YEARS NOT IN
SCHOOL
DK
REF

FF
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.32

CE3 OR
CE29

CE3
If CE1=1 OR (IF CE2<>1 AND CE2.1/CE2.2 < XX AMOUNT OF TIME TO BE
DETERMINED)

(IF CE1=1) What is the name of the school that [CHILD] is attending or
enrolled in now?
(IF CE2.1/CE2.21 AND CE2.1/CE2.2 < XX AMOUNT OF TIME TO BE
DETERMINED

What is the school’s address?
INTERVIEWER: PROBE FOR AS MUCH ADDRESS INFORMATION AS YOU CAN
(NUMBER AND STREET NAME).

ADDRESS SCHOOL
DK
REF

STRING OF 30
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.33

CE5

CE5
If CE1=1 OR IF CE2<>1 OR CE2.1/CE2.2 < XX AMOUNT OF TIME TO BE
DETERMINED

What city is that school in?
INTERVIEWER: CODE IF ALREADY KNOWN.

NAME OF CITY
DK
REF

STRING
OF 15
d
r

CE6

CE6
If CE1=1 OR IF CE2<>1 OR CE2.1/CE2.2 < XX AMOUNT OF TIME TO BE
DETERMINED
considering taking these questions and get info from unified school files

Is this a public or private school?
PUBLIC
PRIVATE
DK
REF

1
2
d
r

CE6.1
CE8
CE8.1

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.34

CE6.1
IF CE6=1
Did you or someone else choose this school for [CHILD] or was [CHILD]
assigned to this school?
INTERVIEWER: IF ASSIGNED SCHOOL IS ALSO CHOSEN SCHOOL CODE
‘ASSIGNED’.
SCHOOL CHOSEN
SCHOOL ASSIGNED
DK
REF

1
2
d
r

CD7

CE7
IF CE6=1
Is this public school….
A regular school,
A school with a magnet
program such as a
science, math or a
foreign language
immersion program,
A charter school,
A special education
school which primarily
serves children with
disabilities, or
Some other type of
public school (specify)?
DK
REF

1
2

3
4

5
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.35

CE9

CE8
IF CE6=2
Is this private school…
A Catholic school,
A school with another
religious background
or affiliation,
A non-religious school
without a religious
background or
affiliation, or
Some other private
school (specify)?
DK
REF

1
2

CE8.1

3

4
d
r

CE8.1
If CE6=2
Is this a special education school, which primarily serves children with
disabilities?
INTERVIEWER: DO NOT ASK IF ALREADY KNOWN.

YES
NO
DK
REF

1
2
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.36

CE9

CE9
IF CE6=1,2
What is the lowest grade taught at this school?
INTERVIEWER: IF RESPONDENT ANSWERS 1ST GRADE, PROBE IF SCHOOL HAS
A KINDERGARTEN OR NURSERY/PREKINDERGARTEN PROGRAM.
PRE KINDERGARTEN
(INCLUDE HEAD START)
KINDERGARTEN
1ST
2ND
3RD
4T
5TH
6TH
7TH
8T
9TH
10TH
11TH
12TH
SCHOOL DOES NOT HAVE
GRADES
DK

N

CE10

K
1
2
3
4
5
6
7
8
9
10
11
12
99

CE12

d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.37

CE10
IF CE9 <>99

What is the highest grade taught at this school?
KINDERGARTEN
1ST
2ND
3RD
4T
5TH
6TH
7TH
8T
9TH
10TH
11TH
12TH
DK
REF

K
1
2
3
4
5
6
7
8
9
10
11
12
d
r

CE11

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.38

CE11
(IF CE1=YES OR CE2=1 OR (CE2.1/2.299
(IF CE1=YES) What grade is [CHILD] currently enrolled in?
(IF CE1=N0) What grade was [CHILD] most recently enrolled in?
(IF CE2=1) At what grade level is [CHILD] currently taught?
KINDERGARTEN
1ST
2ND
3RD
4TH
5TH
6TH
7TH
8TH
9TH
10TH
11TH
NOT IN A GRADE
DK
REF

K
1
2
3
4
5
6
7
8
9
10
11
99
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.39

CE12
IF CE1=YES OR CE2.1/2.2REF
(IF CE12=1) What is the name of [CHILD]’s primary or main teacher?
(IF CE12=2,3, OR DK) What is the name of the teacher who teaches
[CHILD] reading or English?
Please give me the teacher’s first and last name if you can.
IF CHILD DOES NOT HAVE ENGLISH TEACHER PROBE: You can also give me

the name of the teacher who teaches [CHILD] math or social sciences.
INTERVIEWER: THE CHILD CAN BE CONSULTED IF RESPONDENT IS NOT SURE
OF THE TEACHER’S NAME

NAME OF TEACHER
DK
REF

STRING OF 30

CE12.2 OR CE 13

d
r

CE18

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.41

CE12.2

If CE12=2
What subject(s) does this teacher teach?
INTERVIEWER: CODE WITHOUT ASKING IF KNOWN

SUBJECT
DK
REF

STRING OF 30
d
r

CE13

CE13
IF CE12.1 <> REF
Is this teacher male or female?
INTERVIEWER: CODE WITHOUT ASKING IF KNOWN
MALE
FEMALE
DK
REF

1
2
d
r

CH17

CE17
IF CE12.1 <> REF
Including [CHILD] about how many students are in the class with this
teacher?
PROBE: Your best estimate is fine.
TOTAL NUMBER OF STUDENTS
DK
REF

FF
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.42

CE18

CE18
IF CE1=YES OR CE2.1/2.21
Now I would like to talk about other schools [CHILD] has attended since
starting first grade.
Since [CHILD] started first grade, how many different schools has [CHILD]
attended? Please include the [current/most recent] school that [CHILD] is
attending in your count.
INTERVIEWER: IF CHILD HAS BEEN HOMESCHOOLED COUNT THE
HOMESCHOOL AS A SEPARATE SCHOOL.
ENTER NUMBER OF DIFFERENT
SCHOOLS

DK
REF

FF
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.48

CE42.1
or
CE48.1

CE42.1
IF CE41>1

(CE1=1) Which school has [CHILD] attended the longest since first grade?
Is it the school [he/she] is currently attending or is it another school?
(IF CE2.1/2.21

(CE42.1=1) Including the grade the child is currently attending, how many
grades has [CHILD] attended at his/her current school since starting first
grade?
(CE42.1=2) How many grades did CHILD attend at this other school since
starting first grade?

INTERVIEWER: IF CHILD ATTENDED PART OF A GRADE IN THIS SCHOOL
INCLUDE THIS GRADE IN THE COUNT.

NUMBER OF GRADES
DK
REF

FF
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.50

CE47
If CE42.1=2
What is the lowest grade taught at this other school?
INTERVIEWER: IF RESPONDENT ANSWERS 1ST GRADE, PROBE IF SCHOOL HAS
A KINDERGARTEN OR NURSERY/PREKINDERGARTEN PROGRAM.
NURSERY/PRESCHOOL,
PREK, HEAD START
KINDERGARTEN
1ST
2ND
3RD
4T
5TH
6TH
7TH
8T
9TH
10TH
11TH
12TH
SCHOOL DOES NOT HAVE
GRADES
DK

N

CE48

K
1
2
3
4
5
6
7
8
9
10
11
12
99

CE48.1
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.51

CE48
If CE47<>99
What is the highest grade taught at this other school?
KINDERGARTEN
1ST
2ND
3RD
4T
5TH
6TH
7TH
8T
9TH
10TH
11TH
12TH
SCHOOL DOES NOT
HAVE GRADES
DK
REF

K
1
2
3
4
5
6
7
8
9
10
11
12
99

CE48.1

D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.52

CE48.1
ALL
Has [CHILD] ever been required to attend summer school?
YES
NO
DK
REF

1
0
d
r

CE49
CE49.1

CE49
IF CE48.1= 1
How many times did [he/she] attend summer school?
NUMBER OF
SUMMERS
DK
REF

FF

CE49.1

D
R

CE49.1
ALL ?
Has [CHILD] ever repeated any grades?
YES
NO
DK
REF

1
2
D
R

CE50
CE51

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.53

CE50
IF CE49=1

Which grades did [CHILD] repeat?
CODE ALL THAT APPLY

A
B
C
D
E
F
G

KINDERGARTEN
1ST
2ND
3RD
4TH
5TH
6TH

YES
1
1
1
1
1
1
1

NO
2
2
2
2
2
2
2

DK
D
D
D
D
D
D
D

REF
R
R
R
R
R
R
R

CE51

CE51
IF CE1=YES OR CE2.1/2.2’88’ OR ‘99’

Are you and [BIO OTHER] currently
Married,
Divorced,
Separated, or
Have you never been married to each
other?
MARRIAGE ANNULLED
WIDOWED
DIED
DK

1
2
3
4

FA4
FA4
FA4
FA7

5
6
7
d

FA4

REF

r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.83

FA3.1
FA7

FA3.1
IF FA3=7 OR FA1=’99’

Were you and [BIO OTHER] ever married?

YES
NO
DK
REF

1
2
D
R

FA4
FA7

FA4
IF FA3=1,2,3,5,6 OR FA3.1=YES

When did you and [BIO OTHER] get married?
INTERVIEWER: YOU WILL ENTER THE MONTH HERE AND YEAR ON THE
NEXT PAGES.
INTERVIEWER: IF NEVER MARRIED CODE ‘99’.

Year
DK

FF
d

REF

r

FA5

FA5
IF FA3=1,2,3,5,6 OR FA3.1=YES

INTERVIEWER: ENTER THE YEAR HERE

MONTH
DK
REF

FFFF
d

FA6

r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.84

FA6
(IF FA3=1,2,3,5,6 OR FA3.1=YES) OR IF FA4<>99

Did you and [BIO OTHER] get married before or after [CHILD] was
born?
INTERVIEWER: CODE WITHOUT ASKING IF ALREADY KNOWN

BEFORE
CHILD WAS
BORN
AFTER
CHILD WAS
BORN

1

FA9

2

FA7

FA7
(IF FA1<>’88’ OR FA6<>1) OR FA4=99

(If FD4.6=2) When [CHILD] was born, did [BIO OTHER] sign a birth
certificate or document that identifies him as the legal father of [CHILD]?
(If FD4.6=1) When [CHILD] was born, did you sign a birth certificate or
document that identifies you as the legal father of [CHILD]?

YES, SIGNED BIRTH
CERTIFICATE
NO
DK
REF

1

FA9

2
d
r

FA7.1

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.85

FA7.1
IF FA7=NO,DK

Has a court ever ruled that you are [CHILD]’s father?
INTERVIEWER: CODE WITHOUT ASKING IF ALREADY KNOWN

YES
NO
DK
REF

FA9

1
2
d
r

FA9
IF FA2<>’88’

(IF FD7 =1) Including [CHILD],
[H/h]ow many children do you have with [BIO OTHER]?
NUMBER OF
OTHER CHILDREN
DK
REF

FF

FA10

RANGE>0

D
R

FA10
IF FA2<>’88 ,‘99’ OR FA3<>.6,7 and FA9<>1
Already asked in FD10. If we ask we should use we should use same categories as in
FD9

Do you and [BIO OTHER] currently live together all or most of the time?
INTERVIEWER: CODE WITHOUT ASKING IF KNOWN

YES
NO
DK

1
2
d

REF

r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.86

FA10.1
FA10.2

FA10.1
If FA10=YES OR FA9=1
Added this question to make it easier to respond

Have you and [BIO OTHER] always lived together?
YES
NO
DK

1
2
d

REF

r

FA29
FA14

FA10.2
If FA10=NO
Added this question to make it easier to respond

Have you and [BIO OTHER] ever lived together?
YES
NO
DK

1
2
d

REF

r

FA14
FA16

FA14
IF FA10.1=NO OR FA10.2=YES
problematic to calculate for the respondent as well as for us to determine how many years of total year
since first grade father lived with child?

How many years since [CHILD] started first grade, have you, [BIO
OTHER], and [CHILD] lived together?
INTERVIEWER: IF LESS THAN 1 YEAR ENTER ZERO

NUMBER OF YEARS
DK
REF

FF
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.87

FA15
OR
FA16

FA15
If FA10.2=YES

How old was [CHILD] when you, [BIO OTHER], and [CHILD] last lived
together?
AGE OF CHILD
DK
REF

FF
D

FA16

R

FA16
IF FA10=NO

In the past three months, how often has [CHILD] stayed overnight with
[BIO OTHER]? Was it…
INTERVIEWER: INCLUDE NIGHTS [BIO OTHER] STAYED WITH RESPONDENT

Every night or almost every night
A few times a week
A few times a month
About once a month,
Less often than that, or
Never in the past three months?
DK

1
2
3
4
5
6
D

REF

R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.88

FA17

FA17
IF FA10=NO

In the past three months, how often has [CHILD] seen [BIO OTHER]? Was
it…
Every day or almost every day,
A few times a week,
A few times a month,
About once a month,
Less often than that, or,
Never in the past three months?
DK

1
2
3
4
5
6
D

FA19

REF

R

FA20

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.89

FA20

FA19
IF FA17=4,5,6,DK
REVISIT CATEGORIES

Why was [BIO OTHER] unable to see [CHILD] more often?
INTERVIEWER: PROBE FOR ADDITIONAL REASONS
CHECK ALL THAT APPLY

A
B
C
D
E
F
G
H
I

J
K

L

LIVES TOO FAR AWAY
IS SICK OR DISABLED
IS IN THE MILITARY
IS IN JAIL OR PRISON
DOESN’T HAVE ENOUGH
TIME.
I WON’T LET SEE (HIM/HER)
NOT INTERESTED IN SEEING
CHILD
THE HOURS HE/SHE HAS TO
WORK INTERFERE
HAS A COURT ORDER
PREVENTING [HIM/HER] TO
SEE OUR CHILD/DOMESTIC
VIOLENCE
MY HUSBAND/BOYFRIEND
DOESN’T LIKE [HIM/HER]
MY FAMILY DOESN’T LIKE
HIM/HER OR HIS/HER FAMILY
DISCOURAGES [HIM/HER] TO
SEE CHILD
SOME OTHER REASON?
(SPECIFY:
DK
ref

YES
YES
YES
YES
YES

NO
NO
NO
NO
NO

YES
YES

NO
NO

YES

NO

YES

NO

YES

NO

YES

NO

YES

NO

d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.90

FA19.1

FA19.1
FA10=NO

In the past three months, how often has [CHILD] talked on the telephone,
received a letter, or email from [BIO OTHER]? Was it…

Every day or almost every day,
A few times a week,
A few times a month,
About once a month,
Less often than that, or
Never?
DK

1
2
3
4
5
6
D

REF

R

FA19.2
OR
FA21.1

FA19.2
IF FA17=Never in the past three months
you IF RESP=BIO; MOTHER OF CHILD IF RESP=OTHER FEMALE

he If FD3 =MALE; she IF FD3=FEMALE
How old was [CHILD] when [he/she] last saw [BIO OTHER]?
CODE WITHOUT ASKING IF ALREADY KNOWN
IF ‘NEVER SEEN CHILD, ENTER ‘99’
IF ‘at birth’ ENTER ‘0’ AND ‘0’ ON THE NEXT SCREEN
ENTER YEARS HERE AND MONTHS ON NEXT SCREEN

MONTHS
DK
REF

FF
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.91

FA19.2

FA19.2
IF FA17<>Never in the past three months
ENTER MONTHS HERE
IF ‘at birth’ ‘ENTER ‘0’
IF AGE IS JUST PROVIDED IN YEARS, ENTER ‘0’

YEARS
DK
REF

FF
D

FA20

R

FA21.1
IF FA10=NO

Is [CHILD] currently covered by a court order or legal agreement that
determines who [CHILD] lives with?
YES
NO
DK

1
2
D

REF

R

FA21.2
FA22
FA22

FA21.2
IF FA21.1=YES

Is the agreement that [CHILD] …
Lives with you all of the time,
Lives with [BIO OTHER] all of the
time,
Partially lives with you and partially
lives with [BIO OTHER],
[CHILD] lives with other family
member, or
[CHILD] lives with someone else?
DK

1
2

REF

r

3
4
5
d

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.92

FA22

FA22
IF FA10=N0

Has [CHILD] ever been covered by a court order or legal agreement that
requires [BIO OTHER] to pay child support for [CHILD]?
YES
NO
DK
REF

1
2
D

FA23
FA24

R

FA23
FA22=YES

During the past year, were you supposed to receive any child support
payments for [CHILD]?
YES
NO
DK
REF

1
2
d
r

FA23.1
FA24

FA23.1
IF FA23=YES

During the past year, have you received these child support payments
regularly so that you could almost always count on getting them?
YES
NO
DK
REF

1
2
d
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.93

FA24

FA24
IF FA10=NO
extra IF FA23.1=YES

(IF FA23.1=YES) Not counting the child support you already told me about,
During the past year, did [BIO OTHER] give you [extra] money to help out
with the cost of raising [CHILD]?
YES
NO
DK

1
2
D

REF

R

FA27

FA27
IF FA10=NO

him If FD3 =MALE; her IF FD3=FEMALE
In the past year, how often has [BIO OTHER] bought clothes, toys, or
presents for [CHILD] or gave him/her money?
Did [BIO OTHER] do this…
Often
Sometimes, or
Never
DK
REF

1
2
3
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.94

FA27.1

FA27.1
IF FA10=NO

his If FD3 =MALE; her IF FD3=FEMALE
In the past year, how often has [BIO OTHER] paid [CHILD]’s medical
insurance, doctors bills, or for [his/her] medicines?
Did [BIO OTHER] do this…
Often
Sometimes, or
Never
DK
REF

1
2
3
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.95

FA29.1

FA29.1
FA3<>6,7 OR FA1=’’88’, ‘99’

The next question is about [BIO OTHER]’s educational background.
What is the highest grade or year of school that [BIO OTHER] has
completed or what is the highest degrees, diplomas or certificates [BIO
OTHER] has received or the highest grade or year of school that [BIO
OTHER] has completed?
PROBE: IF RESPONDENT SAYS, “NONE”, ASK: Did [BIO OTHER] complete an

elementary, middle or junior high school program?
PROBE: IF RESPONDENT SAYS, “HIGH SCHOOL OR HIGH SCHOOL DIPLOMA”,
ASK: Did [BIO OTHER] receive a high school diploma or a GED program?
PROBE FOR OTHER DEGREES.

NONE

1

UP TO 8TH GRADE /ELEMENTARY, MIDDLE OR
JUNIOR HIGH SCHOOL DIPLOMA
11 AND 12TH GRADE
12TH GRADE BUT NO HIGH SCHOOL DIPLOMA
GED CERTIFICATE
HIGH SCHOOL DIPLOMA

2

VOC/TECH PROGRAM AFTER HIGH SCHOOL
BUT NO VOC/TECH DIPLOMA
VOC/TECH DIPLOMA
SOME COLLEGE BUT NO DEGREE
ASSOCIATE’S DEGREE
BACHELOR’S DEGREE
GRADUATE OR PROFESSIONAL
SCHOOL BUT NO DEGREE
MASTER’S DEGREE (MA, MS)
DOCTORATE DEGREE (PHD, EDD)
PROFESSIONAL DEGREE AFTER BACHELOR’S
DEGREE (MEDICINE/MD; DENTISTRY/DDS;
LAW/JD/LLB; ETC.
DK
REF

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.96

3
4
5
6
7
8
9
10
11
12
13
14
15

2
R

FA29.2

FA29.2
FA3<>6,7 OR FA1=’’88’, ‘99’

Is [BIO OTHER] currently attending school, participating in any training
program or taking any classes? Please include GED classes, vocational or
trade school, job skills training or programs, Job Corps and college
courses?

YES
NO
DK
REF

1
2
d
r

FA29.3

FA29.3
FA3<>6,7 OR FA1=’’88’, ‘99’ OR FA19=4
he IF FD4.6=2;she IF FD4.6=1

Is [BIO OTHER] currently working at a job or business for pay? This
includes temporary jobs, working in his own business, being in the military,
or any other type of work [he/she] gets paid for.
YES
NO
DK
REF

1
2
d
r

FA30
FA29.4

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.97

FA29.4
IF FA29.3<>1
he IF FD4.6=2;she IF FD4.6=1

Is [BIO OTHER] currently…
Unemployed,
Looking for work, or
laid off,
Disabled or retired,
Not working,
Or is he/she doing
something else?
(DESCRIBE)
IN PRISON
DK
REF

1

FA30

2
3
4

5
d
r

FA30
IF FA10=YES

On a typical day, do you, [BIO OTHER] and [CHILD] get to eat
together?
YES
NO
DK

1
2
d

REF

r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.98

FA30.1
FA30.2

FA30.1
IF FA28=YES

Which meals do you, [BIO OTHER] and [CHILD] eat together on a
typical day?
YES

NO

DK

REF

Breakfast?

1

2

d

r

Lunch?
Dinner?

1
1

2
2

d
d

r
r

FA30.2

FA30.2
IF FA2<> ‘99’,’88’ OR FA3<>6,7

Which of the following statements best describes your relationship
with [BIO OTHER] right now?
We generally get along pretty well,
We don’t get along too well,
We fight a lot and do not get along
well,
We avoid seeing each other
We have no contact with each other,
or
I have no idea where he is.
DK

1
2
3

REF

r

4
5
6
d

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.99

FA31

Section on Father Figure
FA31
IF FA10=NO AND FD4.6=FEMALE
father IF RESP=FD4.6=2; mother IF FD4.6=1
him IF CHILD IS MALE;her IF CHILD IS FEMALE

The next questions are about a father or father figure who is no the
[CHILD]’s biological father. This person may or may not live with the
[CHILD] in the same household.
Is there someone (else) who is like a [father] to [CHILD]? This should be
someone who spends time with [CHILD], takes care of [CHILD] and, in
general does the kind of things a person who is close to a child might do
with him or her?
YES
NO
DK

1
2
D

REF

R

FA32
END

FA32
IF FA31=YES

Just so I can refer to him by name, what is his first name?
NAME OF FATHER
FIGURE=[FATHER FIGURE]
DK
REF

STRING
OF 20
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.100

FA34

FA34
IF FA31=YES

How is [FATHER FIGURE] related to [CHILD]?

STEP PARENT
MOTHER’S BOY FRIEND/PARTNER
MATERNAL GRANDPARENT
PATERNAL GRANDPARENT
OTHER RELATIVE (DESCRIBE)
NON RELATIVE (DESCRIBE)
DK
REF

1
2
3
4
5
6
d
r

FA34.1
FA38

FA34.1
IF FA34=1,2

Are [FATHER FIGURE] and you currently married?
YES
NO
DK

1
2
D

REF

R

FA36

FA36
IF FA34=1 OR 2

Do you have any children with [FATHER FIGURE]?
YES
NO
DK

1
2
D

REF

R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.101

FA37
FA38
FA38

FA37
IF FA36=YES

How many children do you have with [FATHER FIGURE]?
NUMBER OF
CHILDREN
DK
REF

FF

FA38

D
R

FA38
IF FA31=YES
For comment on these questions see BIO OTHER section

Do you, [CHILD], and [FATHER FIGURE] currently live together all or most
of the time?
YES
NO
DK
REF

1
2
D
R

FA38.1
FA38.2
FA45

FA38.1
IF FA38=YES
For comment on these questions see BIO OTHER section

Have you, [CHILD], and [FATHER FIGURE] always live together?
YES
NO
DK

1
2
D

REF

R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.102

FA40
FA39

FA38.2
IF FA38=NO
For comment on these questions see BIO OTHER section

Have you, [CHILD], and [FATHER FIGURE] ever live together?
YES
NO
DK

1
2
D

REF

R

FA39
FA40

FA39
IF FA38.1=NO OR FA38.2=YES
you IF RESP=BIO; MOTHER OF CHILD IF RESP=OTHER FEMALE
For comment on these questions see BIO OTHER section

Since [CHILD] started first grade, about how many years have you,
[CHILD] and [FATHER FIGURE] lived together?
NUMBER OF YEARS
NO
DK
REF

FF
2
D

FA40
OR
FA39

R

FA39
IF FA38.2=YES
For comment on these questions see BIO OTHER section

How old was [CHILD] when you, [CHILD] and [FATHER FIGURE] last lived
together?
AGE OF CHILD
DK
REF

FF
D
R

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.103

FA40

FA40
FA31=YES

The next question is about [FATHER FIGURE]’s educational background.
What is the highest grade or year of school that [FATHER FIGURE] has
completed or what is the highest degrees, diplomas or certificates
[FATHER FIGURE] has received or the highest grade or year of school that
[FATHER FIGURE] has completed?
PROBE: IF RESPONDENT SAYS, “NONE”, ASK: Did [FATHER FIGURE]

complete an elementary, middle or junior high school program?
PROBE: IF RESPONDENT SAYS, “HIGH SCHOOL OR HIGH SCHOOL DIPLOMA”,
ASK: Did [FATHER FIGURE] receive a high school diploma or a GED

program?
PROBE FOR OTHER DEGREES.
NONE

1

UP TO 8TH GRADE /ELEMENTARY, MIDDLE OR
JUNIOR HIGH SCHOOL DIPLOMA
11 AND 12TH GRADE
12TH GRADE BUT NO HIGH SCHOOL DIPLOMA
GED CERTIFICATE
HIGH SCHOOL DIPLOMA

2

VOC/TECH PROGRAM AFTER HIGH SCHOOL
BUT NO VOC/TECH DIPLOMA
VOC/TECH DIPLOMA
SOME COLLEGE BUT NO DEGREE
ASSOCIATE’S DEGREE
BACHELOR’S DEGREE
GRADUATE OR PROFESSIONAL
SCHOOL BUT NO DEGREE
MASTER’S DEGREE (MA, MS)
DOCTORATE DEGREE (PHD, EDD)
PROFESSIONAL DEGREE AFTER BACHELOR’S
DEGREE (MEDICINE/MD; DENTISTRY/DDS;
LAW/JD/LLB; ETC.
DK
REF

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.104

3
4
5
6
7
8
9
10
11
12
13
14
15

2
R

FD42

FA42
FA31=YES

Is [FATHER FIGURE ] currently attending school, participating in any
training program or taking any classes? Please include GED classes,
vocational or trade school, job skills training or programs, Job Corps and
college courses?
YES
NO
DK
REF

1
2
d
r

FA42.1

FA42.1
FA31=YES

Is [FATHER FIGURE] currently working at a job or business for pay? This
includes temporary jobs, working in his own business, being in the military,
or any other type of work he gets paid for.
YES
NO
DK
REF

1
2
d
r

FA43
FA42.2

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.105

FA42.2
IF FA42<>1
he IF FD32=2;she IF FD32=1

Is [FATHER FIGURE] currently…
Unemployed,
Looking for work, or
laid off,
Disabled or retired,
Not working,
Or is he doing
something else?
(DESCRIBE)
IN PRISON
DK
REF

1

FA30

2
3
4

5
d
r

FA43
IF FA38=YES

On a typical day, do you, [FATHER FIGURE] and [CHILD] get to eat
together?
YES
NO
DK
REF

1
2
d
r

FA44
IF FA43=YES

Which meals do you, [FATHER FIGURE] and [CHILD] eat together
on a typical day?
YES

NO

DK

REF

Breakfast?

1

2

d

r

Lunch?
Dinner?

1
1

2
2

d
d

r
r

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.106

FA45

FA45
IF FA31=YES

Which of the following statements best describes your relationship
with [FATHER FIGURE] right now?
We generally get along well,
We don’t get along too well,
We fight a lot and do not get along well,
We avoid seeing each other,
We have no contact with each other, or
I have no idea where he is.
DK

1
2
3
4
5
6
d

REF

r

FA46

FA46
ALL

I have no more questions. Thank you very much for participating

EHS 5th Grade Follow-Up Study, Appendix D, Maternal Interview, 8/31/2006, p.107