Spring Student Questionnaire

APPENDIX A
ECLS-K
Spring 2007 Grade 8 Student Questionnaire

Spring 2007
Grade 8
Student Questionnaire
Prepared for the U.S. Department of Education
National Center for Education Statistics by:
Westat
1650 Research Boulevard
Rockville, Maryland 20850

LABEL

Use a #2 pencil to complete this questionnaire.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless it displays a valid OMB control number. The valid OMB
control number for this information collection is 1850-0750. Approval expires 01/31/2009.
The time required to complete this information collection is estimated to average 20
minutes per response, including the time to review instruction, search existing data
resources, gather the data needed, and complete and review the information collected. If you
have any comments concerning the accuracy of the time estimate or suggestions for
improving the survey instrument, please write to: U.S. Department of Education,
Washington, D.C. 20202-4700. If you have comments or concerns regarding the status of
your individual response to this survey, write directly to: National Center for Education
Statistics, 1990 K Street, N.W., Washington, D.C. 20006-5650.

The collection of information in this survey is authorized by Public Law 107-279
Education Sciences Reform Act of 2002, Title I, Part C, Sec. 151(b) and Sec. 153(a).
Participation is voluntary. You may skip questions you do not wish to answer;
however, we hope that you will answer as many questions as you can. Your
responses are protected from disclosure by federal statute (PL 107-279, Title I, Part C,
Sec. 183). All responses that relate to or describe identifiable characteristics of
individuals may be used only for statistical purposes and may not be disclosed, or
used, in identifiable form for any other purpose, unless otherwise compelled by law.
Data will be combined to produce statistical reports. No individual data that links
your name, address, telephone number, or identification number with your responses
will be included in the statistical reports.

MARKING DIRECTIONS
PLEASE READ CAREFULLY AND USE A SOFT LEAD (#2) PENCIL TO COMPLETE THIS
QUESTIONNAIRE.
CHECKING BOXES
It is important that you check the box next to your answers and print clearly.
Shown below is the correct way to mark your answers, along with examples of incorrect ways.

Correct Mark:

Incorrect Marks:
Light and thin, outside the box, thick or scrawled.

PRINTING ANSWERS IN BOXES:
Print entire answer in box. Answers should be printed clearly and should not touch or cross any of
the box lines. Do not cross zeroes or sevens. That is, do not write a zero with a line through it like
this – 0, and do not write a seven with a line through it like this – 7.
Write digits like this:

1234567890
Write words like this:

Harry Potter

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GENERAL INSTRUCTIONS
PLEASE READ EACH QUESTION CAREFULLY. It is important that you follow the directions for
responding to each kind of question. Here are examples of the three types of items:

I. MARK ONE RESPONSE
1.

What is the color of your eyes?
MARK ONE RESPONSE.
Brown
If the color of your eyes is
green, you would mark the
circle beside green.

Blue
Green
Another color

II. MARK ALL THAT APPLY
2.

Last week, did you do any of the following?
MARK ALL THAT APPLY.
Saw a play
Went to a movie
Attended a sporting event
None of the above

If you went to a movie and
attended a sporting event last
week, but did not see a play,
you would mark the two circles
as shown.

III. MARK ONE RESPONSE ON EACH LINE.
3.

Do you plan to do any of the following next week?
MARK ONE RESPONSE ON EACH LINE.
Yes

a. Study at a friend’s
house
b. Go to a museum

No

Don’t
know

If you plan to study at a friend's
house, do not plan to go to a
museum, and do not plan to visit
a relative, you would mark one
box on each line as shown.

c. Visit a relative

THIS IS THE END OF THE EXAMPLES.

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THIS QUESTIONNAIRE IS NOT A TEST.

WE HOPE YOU WILL ANSWER EVERY QUESTION (OTHER THAN THE ONES YOU ARE
DIRECTED TO SKIP OVER), BUT YOU MAY SKIP ANY QUESTION YOU DO NOT WISH
TO ANSWER.

PLEASE GO TO THE NEXT PAGE
TO BEGIN THE QUESTIONNAIRE.

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YOUR SCHOOL EXPERIENCES

1.

This school year, how often did you …
MARK ONE RESPONSE ON EACH LINE.
Never

2.

a.

Feel like you fit in at your
school?

b.

Feel close to classmates at
your school?

c.

Feel close to teachers at
your school?

d.

Enjoy being at your school?

e.

Feel safe at your school?

Sometimes

Often

Always

How important are good grades…
MARK ONE RESPONSE ON EACH LINE.
Not
important

3.

a.

To you?

b.

To your parents?

Somewhat
important

Important

Very
Important

Overall, about how many hours do you spend on homework each week both in and
out of school combined?

hours per week

5

4.

In the past year, have you…
MARK ONE RESPONSE ON EACH LINE.
Yes

5.

a.

Had a tutor or mentor to help with your reading
skills?

b.

Had a tutor or mentor to help with your math
skills?

c.

Attended summer school for a class you did not do
well in during the school year?

d.

Attended summer school so that you could take an
advanced or enrichment course?

No

As things stand now, how far in school do you think you will get?
MARK ONE RESPONSE ONLY.
Less than high school graduation
High school graduation or GED only
Attend or complete a 2-year program in a community college or vocational
school
Attend college, but not complete a 4-year degree
Graduate from a 4-year college
Obtain a Master’s degree or equivalent
Obtain a Ph.D., M.D., or other advanced degree
Don’t know

6.

Among your close friends, how important is it to them that they…
MARK ONE RESPONSE ON EACH LINE.

Not
important

6

a.

Attend classes regularly?

b.

Get good grades?

c.

Continue their education
past high school?

Somewhat
important

Very
important

Not applicable,
I have no
close friends.

7.

How often are the following statements true?
MARK ONE RESPONSE ON EACH LINE.
Never

a.

My classmates think it is
important to be my friend.

b.

My classmates like me
the way I am.

c.

My classmates care about
my feelings.

d.

My classmates like me as
much as they like others.

e.

My classmates really care
about me.

Seldom

Sometimes

Often

Always

7

ACTIVITIES
1.

Have you participated in the following school-sponsored activities this school year?
MARK ONE RESPONSE ON EACH LINE.
Did not
participate

2.

a.

School sports

b.

Drama or music

c.

School clubs (e.g., school
yearbook, newspaper, hobby
club, photography)

In a typical week, how many total hours do you spend on all school-sponsored
extracurricular activities (sports, clubs, or other activities)?

hours per week

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Participated

Participated
as an officer,
leader, or captain

3.

How often do you spend time…
MARK ONE RESPONSE ON EACH LINE.
Rarely
or never

4.

a.

Having friends over to
your home?

b.

Hanging out at a friend’s
home?

c.

Out with friends (not at
someone’s home)?

d.

Talking with friends on
the telephone or
Internet?

e.

Working on hobbies, arts,
crafts, or playing a
musical instrument?

f.

Taking music, art,
foreign language, or
dance classes outside of
school?

g.

Playing non-school
sports?

h.

In an organized nonschool activity (such as,
scouts, 4-H, or youth
groups)?

i.

At home by yourself?

j.

Using a computer for
school work?

Less than
once a week

Once or
twice a week

Every day
or almost
every day

How many hours of reading do you do each week not counting schoolwork?
(Do not count any school-assigned reading.)

hours

9

5.

What are the titles of the last two books you have read? (Do not count any schoolassigned reading.)
ENTER NAME OF THE PUBLICATION.
st

a.

1 book

b.

2nd book
Did not read any books

6.

How many days in the past week did you …
WRITE A NUMBER ON EACH LINE.
Number of
days

7.

a.

Read national or local news in a newspaper or
from an online news service?

b.

Watch national or local news on TV?

How many hours a day do you usually watch TV, videotapes, or DVDs?
WRITE A NUMBER ON EACH LINE.
Hours
per day

8.

a.

On weekdays

b.

On weekends

Do you have a TV in your bedroom? (If you have more than one bedroom, please
tell us about the bedroom you spend the most time in.)
Yes
No

10

9.

How many hours a day do you play computer or videogames such as Nintendo, Play
Station, or Xbox? WRITE A NUMBER ON EACH LINE.
Hours
per day
a. On weekdays
b. On weekends

10.

How many hours a day do you spend on the Internet? WRITE A NUMBER ON
EACH LINE.
Hours
per day
a. On weekdays
b. On weekends

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ABOUT YOURSELF
1.

How true is each of these about you?
MARK ONE RESPONSE ON EACH LINE.
Not at
all true

a.

Math is one of my best subjects.

b.

I feel angry when I have trouble
learning.

c.

I like reading.

d.

I worry about taking tests.

e.

I get good grades in math.

f.

I often feel lonely.

g.

English is one of my best subjects.

h.

I feel sad a lot of the time.

i.

I like math.

j.

I worry about doing well in school.

k.

I enjoy doing work in reading.

l.

I worry about finishing my work.

m.

I enjoy doing work in math.

n.

I worry about having someone to hang
out with at school.

o.

I get good grades in English.

p.

I feel ashamed when I make mistakes at
school.

REFERENCES
1. Adapted with permission from Self-Description Questionnaire II (SDQII; Marsh, 1990).

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A little bit
true

Mostly
true

Very
true

2.

How do you feel about the following statements?
Strongly
MARK ONE RESPONSE ON EACH LINE.
disagree

3.

a.

I feel good about myself.

b.

I don't have enough control over the
direction my life is taking.

c.

In my life, good luck is more important
than hard work for success.

d.

I feel I am a person of worth, the equal
of other people.

e.

I am able to do things as well as most
other people.

f.

Every time I try to get ahead, something
or somebody stops me.

g.

My plans hardly ever work out, so
planning only makes me unhappy.

h.

On the whole, I am satisfied with
myself.

i.

I certainly feel useless at times.

j.

At times I think I am no good at all.

k.

When I make plans, I am almost certain
I can make them work.

l.

I feel I do not have much to be proud of.

m.

Chance and luck are very important for
what happens in my life.

Disagree

Agree

Strongly
agree

What adult do you to talk to when you need…
MARK ALL THAT APPLY IN EACH ROW.

Parent

a.

Someone to cheer you up?

b.

Help with school work?

c.

Advice about making
important decisions?

Adult
relative

Adult at
school

Other
adult

No one

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4.

What kid do you to talk to when you need…
MARK ALL THAT APPLY IN EACH ROW.
Brother
or sister

5.

a.

Someone to cheer you up?

b.

Help with school work?

c.

Advice about making
important decisions?

Friends
at school

Other
friends

No one

Is English your native language (the first language you learned to speak when you
were a child)?
Yes (GO TO NEXT SECTION ON PAGE 15)
No

6.

How often do you speak your native language with…
MARK ONE RESPONSE ON EACH LINE.
IF AN EXAMPLE DOES NOT APPLY TO YOU, MARK “Does not apply.”

Never

14

a.

your parents?

b.

your brothers and
sisters?

c.

friends in your
school?

d.

friends outside of
your school?

Sometimes

About half
of the time

Always
or most
of the time

Does not
apply

WEIGHT AND EXERCISE
1.

How would you describe your weight?
MARK ONE RESPONSE.
Very underweight
Slightly underweight
About the right weight
Slightly overweight
Very overweight

2.

Are you trying to do any of the following about your weight?
MARK ONE RESPONSE.
Lose weight
Gain weight
Stay the same weight
I am not trying to do anything about my weight

3.

4.

On how many of the past 7 days did you exercise or participate in physical activity
for at least 20 minutes that made you sweat and breathe hard, such as basketball,
soccer, running, swimming laps, fast bicycling, fast dancing, or similar aerobic
exercise?
MARK ONE RESPONSE.
0 days

3 days

6 days

1 days

4 days

7 days

2 days

5 days

In an average week when you are in school, on how many days do you go to
physical education (PE) classes?
MARK ONE RESPONSE.
0 days

3 days

1 days

4 days

2 days

5 days

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YOUR DIET
These questions are about buying food and drinks at your school. Please only think about
buying things at school; do not think about eating at school.
1.

In your school, can kids buy candy, ice cream, cookies, cakes, brownies or other
sweets in the school?
Yes
No (GO TO QUESTION 4)

2.

During the last week that you were in school, how many times did you buy candy,
ice cream, cookies, cakes, brownies or other sweets at school?
MARK ONE RESPONSE.
I did not buy any at school during the last week in school
(GO TO QUESTION 4)
1 or 2 times during the last week in school
3 or 4 times during the last week in school
1 time per day
2 times per day
3 times per day
4 or more times per day

3.

During the last week that you were in school, where in the school did you usually
buy candy, ice cream, cookies, cakes, brownies or other sweets?
MARK ONE RESPONSE.
Vending machine in school
School cafeteria
Somewhere else in school

4.

In your school, can kids buy potato chips, corn chips (Fritos, Doritos), Cheetos,
pretzels, popcorn, crackers or other salty snack foods at school?
Yes
No (GO TO QUESTION 7)

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5.

During the last week that you were in school, how many times did you buy salty
snack foods at school?
MARK ONE RESPONSE.
I did not buy any at school during the last week in school
(GO TO QUESTION 7)
1 or 2 times during the last week in school
3 or 4 times during the last week in school
1 time per day
2 times per day
3 times per day
4 or more times per day

6.

During the last week that you were in school, where in the school did you usually
buy salty snack foods?
MARK ONE RESPONSE.
Vending machine in school
School cafeteria
Somewhere else in school

7.

In your school, can kids buy soda pop (EXAMPLES Coke, Pepsi, Mountain Dew),
sports drinks (EXAMPLE Gatorade), or fruit drinks that are not 100% fruit juice
(EXAMPLES Kool-Aid, Hi-C, Fruitopia, Fruitworks) in the school?
Yes
No (GO TO QUESTION 10)

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8.

During the last week that you were in school, how many times did you buy soda
pop, sports drinks, or fruit drinks at school?
MARK ONE RESPONSE.
I did not buy any at school during the last week in school
(GO TO QUESTION 10)
1 or 2 times during the last week in school
3 or 4 times during the last week in school
1 time per day
2 times per day
3 times per day
4 or more times per day

9.

During the last week that you were in school, where in the school did you usually
buy soda pop, sports drinks, or fruit drinks?
MARK ONE RESPONSE.
Vending machine in school
School cafeteria
Somewhere else in school

The next questions ask about food you ate or drank during the past 7 days. Think about all
the meals and snacks you had from the time you got up until you went to bed. Be sure to
include food you ate at home, at school, at restaurants, or anywhere else.
10.

During the past 7 days, how many glasses of milk did you drink? (Include all types
of milk, including cow’s milk, soy milk or any other kind of milk; include the milk
you drank in a glass or cup, from a carton, or with cereal. Count the half pint of
milk served at school as equal to one glass.)
MARK ONE RESPONSE.
I did not drink milk during the past 7 days (GO TO QUESTION 12)
1 to 3 glasses during the past 7 days
4 to 6 glasses during the past 7 days
1 glass per day
2 glasses per day
3 glasses per day
4 or more glasses per day

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11.

What kind of milk did you drink during the past 7 days?
MARK ONE RESPONSE.
Regular milk from a cow (including whole milk, low fat milk, chocolate
milk, or any other kind of cow’s milk)
Soy milk
Both regular milk and soy milk
Some other kind of milk

12.

During the past 7 days, how many times did you drink 100% fruit juices such as
orange juice, apple juice, or grape juice? (Do not count punch, Kool-Aid, sports
drinks, or other fruit-flavored drinks.)
MARK ONE RESPONSE.
I did not drink 100% fruit juice during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

13.

During the past 7 days, how many times did you drink soda pop (EXAMPLES Coke,
Pepsi, Mountain Dew), sports drinks (EXAMPLE Gatorade), or fruit drinks that are
not 100% fruit juice (EXAMPLES Kool-Aid, Hi-C, Fruitopia, Fruitworks)?
MARK ONE RESPONSE.
I did not drink any during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

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14.

During the past 7 days, how many times did you eat green salad?
MARK ONE RESPONSE.
I did not eat any green salad during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

15.

During the past 7 days, how many times did you eat potatoes? (Do not count french
fries, fried potatoes, or potato chips.)
MARK ONE RESPONSE.
I did not eat potatoes during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

16.

During the past 7 days, how many times did you eat carrots?
MARK ONE RESPONSE.
I did not eat carrots during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

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17.

During the past 7 days, how many times did you eat other vegetables? (Do not
count green salad, potatoes, or carrots.)
MARK ONE RESPONSE.
I did not eat other vegetables during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

18.

During the past 7 days, how many times did you eat fruit, such as apples, bananas,
oranges, berries or other fruit? (Do not count fruit juice.)
MARK ONE RESPONSE.
I did not eat fruit during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

19.

During the past 7 days, about how many times did you eat a meal or snack from a
fast food restaurant such as McDonald’s, Pizza Hut, Burger King, KFC (Kentucky
Fried Chicken), Taco Bell, Wendy’s and so on?
MARK ONE RESPONSE.
I did not eat food from a fast food restaurant during the past 7 days
1 to 3 times during the past 7 days
4 to 6 times during the past 7 days
1 time per day
2 times per day
3 times per day
4 or more times per day

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20.

Date questionnaire completed:

MONTH

DAY

YEAR

THANK YOU FOR YOUR COOPERATION.

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