Spring Special Education Teacher Questionnaire

APPENDIX E.1
ECLS-K
Spring 2007 Special Education Teacher Questionnaire A

Special Education Teacher
Questionnaire A
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 5 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 107279 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.

INTRODUCTION
Dear Special Education Teacher/Related Services Provider,
The Early Childhood Longitudinal Study Kindergarten Class of 1998-1999 (ECLS-K) is
collecting information from the special education teachers/related service providers of
sampled students who have Individual Education Programs (IEPs) to investigate the
relationship between the students’ achievement and various school, classroom, and home
factors. This questionnaire collects information concerning your background and your
work with students with disabilities in this school.
Obviously, only you can provide this information. Therefore, although we realize you are
very busy, we urge you to complete this questionnaire as accurately as possible. The
information you provide is being collected for research purposes. 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.

THANK YOU VERY MUCH FOR YOUR HELP.

2

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

3

1.

What is your gender? MARK ONE.
Male
Female

2.

In what year were you born? WRITE IN YEAR BELOW.

19
ENTER YEAR

3.

Are you of Hispanic or Latino origin? MARK ONE.
Yes
No

4.

Which best describes your race? MARK ONE OR MORE.
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White

4

5.

What is the highest level of education you have completed? MARK ONE.
High school diploma or GED
Associate’s degree
Bachelor’s degree
At least one year of course work beyond a Bachelor’s but not a graduate degree
Master’s degree
Education specialist or professional diploma based on at least one year of
course work past a Master’s degree level
Doctorate

6.

What is the highest level of education completed by your own parents? MARK ONE
RESPONSE ONLY.
Did not complete high school
High school diploma or GED
Associate’s degree
Bachelor’s degree
At least one year of course work beyond a Bachelor’s degree but not a graduate
degree
Master’s degree
Completed a PhD, MD, or other advanced professional degree
Don’t know

7.

Counting this school year, how many years in total (including part-time) have you
worked in this school? WRITE IN THE YEARS BELOW.

YEARS

5

8.

Counting this school year, how many years (including part-time) have you been
working with students receiving special education or related services? WRITE IN
THE YEARS BELOW.

YEARS

9.

Counting this school year, how many years (including part-time) have you been
teaching? WRITE IN THE YEARS BELOW.

YEARS

10.

Which of the following credentials, licenses, or certificates do you have for working
with students with disabilities?
MARK ONE ON EACH LINE.
a. Emergency credential
b. Provisional or temporary credential
c. Disability-specific credential or endorsement
d. Special education credential or endorsement
(for more than one disability category)
e. General education credential
f. Speech/language state license or certification
g. Physical therapy license or certification
h. Occupational therapy license or certification
i. Certificate of Clinical Competence
j. Other professional license, credential, or endorsement
(PLEASE SPECIFY)
k. Don’t have special education or other professional
credential, endorsement or license

6

Yes

No

11.

Have you taken the following test?

MARK ONE RESPONSE ONLY.
Not taken

Taken and
passed

Taken and
have not
yet passed

Taken and
awaiting
test results

a. An exam for National Board for
Professional Teaching Standards
certification

12.

How many college courses have you completed in the following areas?
MARK ONE NUMBER ON EACH LINE.
a. Early childhood education

0

1

2

3

4

5

6+

b. Early childhood special education
c. Elementary education
d. Secondary education
e. English as a second language (ESL)
f. Bilingual education
g. General special education
h. Learning disabilities
i. Mental retardation
j. Orthopedic impairments
k. Serious emotional disturbance
l. Deafness and hearing
m. Blindness and vision
n. Communication disorders
o. Infants and toddlers with disabilities
p. Physical therapy
q. Occupational therapy
r. School psychology
s. Classroom management

7

13.

Which of the following best describes your current position in this school?
MARK ONE.
Special education teacher
Special education teacher consultant
General education teacher
Speech - language pathologist
Physical therapist
Physical therapy assistant or aide
Occupational therapist
Occupational therapy assistant or aide
School psychologist
Special education classroom aide
Other (PLEASE SPECIFY)

14.

How do you classify your main assignment at this school, that is, the activity at
which you spend most of your time during this school year? MARK ONE.
Regular full-time teacher/service provider
Regular part-time teacher/service provider
Itinerant teacher (i.e., your assignment requires you to provide
instruction/related services at more than one school)
Long-term substitute (i.e., your assignment requires that you fill the role of a
teacher on a long-term basis, but you are still considered a substitute)
Teacher aide
Other (PLEASE SPECIFY)

8

15.

During this school year, where did you work with students with IEPs?
MARK ONE ON EACH LINE.
a. In a general education classroom

Yes

No

b. In a special education classroom
c. In a non-classroom space (office, therapy room, small work space,
mobile van, etc.)
d. Other (PLEASE SPECIFY)
e. I do not work directly with students who have IEPs

16.

Please indicate the extent to which you agree with each of the following statements
on teaching.
MARK ONE ON EACH ROW.

Strongly
disagree

Disagree

Neither
disagree
nor agree

Agree

Strongly
agree

a. I really enjoy my present
assignment
b. I am certain I am making a
difference in the lives of the
students I work with.
c. If I could start over, I would
choose teaching again as my
career.
d. I am satisfied with my class size.
e. I worry about the security of my
job because of the performance of
the students in my class(es) on
state or local tests.

9

17.

During this school year, how many students with IEPs did you work with, on
average, each week? (Include students you work with directly, as well as students
for whom you consult with the general education teacher and/or another special
education teacher/service provider) MARK ONE.
1-10
11-20
21-40
More than 40
Don’t know

18.

Date questionnaire completed:

MONTH

DAY

YEAR

THANK YOU FOR YOUR COOPERATION.

10