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pdfAPPENDIX B
ECLS-K
Spring 2007 Parent Interview
ECLS-K Parent Interview --ROUND 8
June 5, 2006
Table of Contents
INQ
- Introduction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
2
PIQ
- Parent Involvement . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
7
FSQ
- Family Structure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
11
HEQ
- Home Environment, Activities, and Cognitive Stimulation . . . . . . . . . .
25
SCQ
- Schooling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
34
CFQ
- Critical Family Processes . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. . . .
37
DWQ
- Discipline, Warmth, and Emotional Supportiveness . . . . . . . . . . . . . . .
41
NRQ
- Non-Resident Parent Questions . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
43
PLQ
- Primary Language(s) Spoken . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
51
CHQ
- Child Health and Well Being . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
54
PPQ
- Parent’s Psychological Well Being and Health . . . . . . . . . . . . . . . . . . .
84
PEQ
- Parent Education . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
86
EMQ
- Parent Employment . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
89
WPQ
- Welfare and Other Public Transfers . . . . . . . . . . . . . . . . . . . . . . . . . . . .
94
FDQ
- Food Security . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . ..
98
PAQ
- Parent Income and Assets . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
102
CMQ
- Child Mobility and Plans to Move . . . . . . . . . . . . . . . . . . . . . . . . . . . .
106
ROUND 8 Parent – TOC-1
INTRODUCTION - INQ
BOX 1
IF (NumberOfChildren = 1) OR
IF (NumberOfChildren = 2 AND ChildNum = 1), CONTINUE WITH INQ.005.
IF (NumberOfChildren = 2 AND ChildNum = 2), GO TO BOX 1B.
INQ.005
We spoke with someone in your household before about an ongoing study that {{CHILD} {and TWIN}}
participated in a few years ago called the Early Childhood Longitudinal Study Kindergarten Class. The
U.S. Department of Education's National Center for Education Statistics sponsors the study. Now that
{{CHILD} {and TWIN}} {is/are} older, I have some more questions for you that ask about {{CHILD}'s {and
TWIN}'s} school and home experiences. The information I collect in this interview is extremely valuable
in understanding the development of young children and how their school experiences can be improved.
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.
PRESS ENTER TO CONTINUE.
CAPI INSTRUCTION: DISPLAY "and TWIN" IF THERE IS A TWIN.
DISPLAY “are" IF THERE IS A TWIN. OTHERWISE, DISPLAY “is.”
NOTE: THE DATE IN THIS QUESTION IN ROUND 8 INCORPORATES SPRING 2000, SPRING 2002, AND SPRING 2004.
INQ.010
During our last interview, we talked with {NAME OF RESPONDENT} who took part in the Early
Childhood Longitudinal Study Kindergarten Class in the {spring of 2000/spring of 2002/spring of 2004}. .
Am I talking to the same person?
CAPI INSTRUCTION: DISPLAY FIRST AND LAST NAME OF RESPONDENT FROM PRELOAD. USE THE
NAME OF PERSONTYPE=R.
CAPI INSTRUCTION: DISALLOW DK AND RF.
YES ...............................................................
NO .................................................................
INQ.010a
1
2
VERIFY NAME, RELATIONSHIP, AND AGE WITH RESPONDENT.
ENTER THE NUMBER NEXT TO THE PERSON ON THE HOUSEHOLD ROSTER WHO IS THE
CURRENT ROUND RESPONDENT. SELECT THIS PERSON’S NAME EVEN IF THE AGE LISTED IS
A YEAR OR TWO DIFFERENT FROM THE AGE OF THE RESPONDENT IF YOU HAVE CONFIRMED
IT IS THE SAME PERSON.
IF NAME NOT LISTED, ENTER 0.
CAPI INSTRUCTIONS:
1.
DISPLAY THE UPDATED HOUSEHOLD ROSTER WITH AGE, GENDER, AND RELATIONSHIP
FROM THE PRELOAD. AT THE TOP OF THE ROSTER, DISPLAY "0 NOT ON LIST." NEXT TO
AGE, DISPLAY THE WORD “APPROXIMATELY”.
2.
DISPLAY HOUSEHOLD MEMBERS 15 YEARS OR OLDER AS RESPONSE CATEGORIES. DO NOT
DISPLAY THE NAMES OF HOUSEHOLD MEMBERS CODED AS NO LONGER LIVING IN THE
HOUSEHOLD IN MOST RECENT ROUND.
3.
IF ZERO IS ENTERED, GO TO INQ.011. OTHERWISE, GO TO BOX 1B.
4.
DISALLOW DK AND RF.
5.
FLAG THE RESPONDENT.
ROUND 8 Parent – INQ-2
6.
SET A FLAG CALLED "FLAGS.SAMERESP" THAT EQUALS 1 IF THE RESPONDENT IN INQ.010
WHO SAID HE/SHE WAS THE SAME RESPONDENT AS IN THE MOST RECENT ROUND IS THE
SAME PERSON INDICATED AS THE RESPONDENT IN INQ.010a.
NOTE: INQ.010b IS NEW IN ROUND 8.
HELP AVAILABLE
HELP TEXT:
Why we ask for the middle name: We are asking for your middle name or initial because it will help identify you if we ask to
talk to you in future rounds of the study.
INQ.010b
May I have your middle name or middle initial, please?
ENTER MIDDLE NAME OR INITIAL.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
_________________________________________________________
MIDDLE NAME OR INITIAL
INQ.011
May I have your name, please?
ENTER FIRST NAME.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
_________________________________________________________
FIRST NAME
INQ.012
[May I have your name, please?]
ENTER LAST NAME.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
_________________________________________________________
LAST NAME
NOTE: INQ.013 IS NEW IN ROUND 8.
HELP AVAILABLE
HELP TEXT:
Why we ask for the middle name: We are asking for your middle name or initial because it will help identify you if we ask to
talk to you in future rounds of the study.
INQ.013
May I also have your middle name or middle initial, please?
ENTER MIDDLE NAME OR INITIAL.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
_________________________________________________________
MIDDLE NAME OR INITIAL
ROUND 8 Parent – INQ-3
BOX 1B
INQ.014
IF NumberOfChildren = 2, CONTINUE WITH INQ.014.
IF NumberOfChildren = 1, GO TO INQ.015.
{For this interview, I will first ask questions that collect information specifically about {CHILD} and general
questions about you and your household. Once those questions are finished, I will need to ask some
questions that collect information specifically about {TWIN}. There will not be as many questions for
{TWIN }, since I will not need to ask the questions about you or your household.
/As I mentioned earlier, now I need to ask some questions specifically about {CHILD}. These questions will
not take as long as the first round of questions, since I have already asked the general questions about you
and your household.}
PRESS ENTER TO CONTINUE.
CAPI INSTRUCTION: DISPLAY "For this interview . . . you or your household." IF CURRENTLY ASKING
ABOUT SAMPLED CHILD 1. FOR "CHILD," DISPLAY THE NAME OF SAMPLED CHILD 1. FOR "TWIN,"
DISPLAY THE NAME OF SAMPLED CHILD 2.
CAPI INSTRUCTION: DISPLAY "As I mentioned . . . you and your household." IF CURRENTLY ASKING
ABOUT SAMPLED CHILD 2. FOR "CHILD," DISPLAY THE NAME OF SAMPLED CHILD 2.
CAPI INSTRUCTION: DISPLAY "Specifically about {CHILD}," AND "not" IN UNDERLINED TEXT.
INQ.015
{Before we begin the interview, I would like to verify some information.} I have recorded {CHILD's
FIRST, MIDDLE, AND LAST NAME} as {CHILD}'s full name. Is this correct?
ALSO VERIFY SPELLING.
MAKE CORRECTIONS TO NAME BELOW OR PRESS ENTER TO ACCEPT FIRST/MIDDLE/LAST NAME.
IF NO MIDDLE NAME OR INITIAL, ENTER 'NMN'.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS. HOWEVER, DO NOT
ALLOW INTERVIEWER TO CHANGE 'REAL DATA' TO '7' (REFUSED) OR '9' (DON'T KNOW).
CAPI INSTRUCTION: DISPLAY "Before we begin . . . some information." IF ONLY ONE SAMPLED CHILD
OR IF ON INTERVIEW FOR CHILD 1.
CAPI INSTRUCTION: IF CURRENTLY ASKING ABOUT CHILD 2, FOR '{CHILD}', DISPLAY THE NAME OF
SAMPLED CHILD 2.
CAPI INSTRUCTION: FOR CHILD'S FIRST, MIDDLE, AND LAST NAME, DISPLAY CHILD'S CORRECTED
FULL NAME FROM PRELOAD.
CAPI INSTRUCTION: USE PRELOAD LENGTH FOR CHILD'S NAME.
Current Info:
[CHILD'S FIRST NAME]
[CHILD'S MIDDLE NAME]
[CHILD'S LAST NAME]
FIRST NAME:
[___________________]
MIDDLE NAME: [___________________]
LAST NAME:
[___________________]
ROUND 8 Parent – INQ-4
NOTE: INQ.016 IS NEW IN ROUND 8.
INQ.016
Does {CHILD} have a nickname?
YES ............................................................... 1 (INQ.017)
NO ................................................................. 2 (BOX 2)
REFUSED ..................................................... 7 (BOX 2)
DON'T KNOW................................................ 9 (BOX 2)
NOTE: INQ.017 IS NEW IN ROUND 8.
INQ.017
What is {CHILD}’s nickname?
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
CAPI INSTRUCTION: USE MAXIMUM NUMBER OF SPACES IN LINE FOR THE LENGTH OF CHILD'S
NICKNAME.
NICKNAME:
[___________________]
BOX 2
INQ.020
IF NumberOfChildren = 2 AND ChildNum = 2, GO TO BOX 3.
ELSE, GO TO INQ.020.
{In the last interview, we recorded that {CHILD}'s home address was:}/{What is {CHILD}'s home
address?}
STREET ADDRESS1:
STREET ADDRESS2:
CITY:
STATE:
ZIP CODE:
[___________________]
[___________________]
[___________________]
[___________________]
[___________________]
{Is this still correct?}
{TYPE ADDRESS AND ENTER 1 FOR "YES, CORRECT ADDRESS."}
CAPI INSTRUCTION: DISPLAY "In the last interview.." and "Is this still correct" IF DATA ARE AVAILABLE
FROM THE PRELOAD. IF DATA ARE NOT AVAILABLE, display "What is …" and "TYPE ADDRESS…"
CAPI INSTRUCTION: IF PREVIOUS DATA ARE NOT AVAILABLE FOR ADDRESS, ALLOW REFUSED AND
DON'T KNOW IN ALL FIELDS.
CAPI INSTRUCTION: IF PREVIOUS DATA ARE NOT AVAILABLE FOR ADDRESS, DISPLAY 'HELP
AVAILABLE' WHEN ON STATE ENTRY FIELD. USE STATE ABBREVIATIONS AS HELP TEXT.
YES, CORRECT ADDRESS .........................
YES, SAME ADDRESS – MINOR
CORRECTIONS ........................................
NO. NEW ADDRESS ....................................
ROUND 8 Parent – INQ-5
1 (INQ.040)
2
3
INQ.030
HELP AVAILABLE
MAKE CORRECTIONS TO ADDRESS BELOW.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION: DISPLAY 'HELP AVAILABLE' WHEN ON STATE ENTRY FIELD.
ABBREVIATIONS AS HELP TEXT.
USE STATE
CAPI INSTRUCTION: DISPLAY CURRENT ADDRESS INFO IN THE RESPONSE FIELD.
Current Info:
[STREET ADDRESS1]
[STREET ADDRESS2]
[CITY]
[STATE]
[ZIP CODE]
STREET ADDRESS1:
STREET ADDRESS2:
CITY:
STATE:
ZIP CODE:
INQ.040
[___________________]
[___________________]
[___________________]
[___________________]
[___________________]
{I have recorded that {PHONE NUMBER} is {CHILD}'s family's current home phone number. Is this
correct? /What is {CHILD}'s family's current phone number?}
IF NO TELEPHONE, ENTER '000'.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: DISPLAY "I have recorded … correct?: IF A PHONE NUMBER IS AVAILABLE,
DISPLAY CORRECTED PHONE NUMBER FROM PRELOAD. IF the PRELOAD PHONE NUMBER WAS
'000' RF, DK, OR MISSING, DISPLAY "What is….. phone number?"
CAPI INSTRUCTION: IF CURRENT INFO IS NOT AVAILABLE, ENTRY IS REQUIRED FOR TELEPHONE
NUMBER. (REFUSED AND DON'T KNOW ARE ALLOWED)
Current Info:
[TELEPHONE NUMBER]
|___|___|___| - |___|___|___| -|___|___|___|___|
ENTER TELEPHONE NUMBER
or
REFUSED .................................................... 7
DON'T KNOW ............................................... 9
BOX 3
GO TO PIQ (PARENT INVOLVEMENT).
ROUND 8 Parent – INQ-6
PARENT INVOLVEMENT - PIQ
BOX 1
PIQ.010
IF CHILDNUM=1 OR IF CHILDNUM=2, CONTINUE WITH PIQ.010.
During this school year, have you or another adult in your household taken it upon yourself to contact
{CHILD}'s teacher or school for any reason having to do with {CHILD}?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
1
2
7
9
BOX 2
IF (NumberOfChildren = 1) OR IF (NumberOfChildren = 2 AND ChildNum = 1),
CONTINUE WITH PIQ.020.
IF (NumberOfChildren = 2 AND ChildNum = 2), GO TO PIQ.065.
PIQ.020
Since the beginning of this school year have you or the other adults in your household….
a1.
a2.
b1.
b2.
c1.
c2.
d1.
d2.
e1.
e2.
f1.
f2.
Attended an open house or back-to-school night?
Who did this, was it {CHILD}'s mother, father, both of them, or neither of them?
Attended a meeting of a PTA, PTO, or Parent-Teacher Organization?
Who did this, was it {CHILD}'s mother, father, both of them, or neither of them?
Gone to a regularly scheduled parent-teacher conference with {CHILD}'s teacher
or meeting with {CHILD}'s teacher?
Who did this, was it {CHILD}'s mother, father, both of them, or neither of them?
Attended a school or class event, such as a play, sports event, or science fair?
Who did this, was it {CHILD}'s mother, father, both of them, or neither of them?
Volunteered at the school or served on a committee?
Who did this, was it {CHILD}'s mother, father, both of them, or neither of them?
Participated in fundraising for {CHILD}'s school?
Who did this, was it {CHILD}'s mother, father, both of them, or neither of them?
CAPI INSTRUCTION:
1.
DISPLAY A 7 X 3 MATRIX IN THE RESPONSE AREA. DISPLAY RESPONSE CODES AT
a1, b1, c1, d1, e1, f1, IN THE 'ATTENDED" COLUMN. DISPLAY RESPONSE CODES AT a2,
b2, c2, d2, e2, f2 IN THE 'WHO DID THIS COLUMN'
ATTENDED?
WHO DID THIS?
OPEN HOUSE
PTA
PARENT-TEACHER CONFERENCE
SCHOOL OR CLASS EVENT
VOLUNTEERING
FUNDRAISING
2.
WHEN ON b1. c1, d1, e1, f1, DISPLAY THE MAJOR STEM: "Since….household…." IN SQUARE
BRACKETS.
ROUND 8 Parent – PIQ-7
3.
CAPI INSTRUCTIONS:
IF
CONTINUE WITH
OTHERWISE, GO TO
A2
B2
C2
D2
E2
F2
B1
C1
D1
E1
F1
PIQ.045
A1 = 1
B1 = 1
C1 = 1
D1 = 1
E1 = 1
F1 = 1
4.
CAPI INSTRUCTIONS:
RESPONSE CODES:
FOR A1, B1, C1, D1, E1, F1, 1=YES, 2=NO, 7=REFUSED,9=DON'T KNOW
FOR A2, B2, C2, D2, E2, F2, 1=MOTHER, 2=FATHER, 3=BOTH, 4=NEITHER, 7=REFUSED,
9=DON'T KNOW
PIQ.045
In another interview, it was reported that {ENGLISH/NON-ENGLISH LANGUAGE/a language other
than English} is spoken in your home. When (CHILD)'s teacher sends home notes or newsletters, are
these in {ENGLISH/NON-ENGLISH LANGUAGE/a language that you speak}?
CAPI INSTRUCTION:
IF NO OTHER LANGUAGE REGULARLY SPOKEN AT HOME BESIDES
(ENGLISH) OR IF (ENGLISH SPOKEN AS PRIMARY LANGUAGE) ACCORDING TO THE PRELOAD
FILE DISPLAY 'ENGLISH.' OTHERWISE, DISPLAY THE LANGUAGE SPECIFIED IN THE PRELOAD
IF A LANGUAGE CATEGORY WAS CHOSEN. OTHERWISE, IF THE PRELOAD HAS AN OTHER
SPECIFY CATEGORY TEXT STRING FOR LANGUAGE, OR IF THE RESPONDENT DID NOT
CHOOSE A PRIMARY LANGUAGE, OR IF ANSWER WAS DK OR RF, DISPLAY "a language other
than English" IN THE DISPLAY IN THE FIRST SENTENCE AND "a language that you speak" IN THE
DISPLAY IN THE SECOND SENTENCE.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
PIQ.050
1
2
7
9
This year, have the following reasons made it harder for you to participate in activities at {CHILD}'s
school? How about…
CAPI INSTRUCTIONS: WHEN ON B-H, PUT THE MAJOR STEM: "This year, have the following
reasons made it harder for you to participate in activities at {CHILD}'s school?" IN SQUARE
BRACKETS. DISPLAY "How about …" BELOW THE STEM IN BRACKETS ON A SEPARATE LINE.
YES
a.
b.
c.
d.
e.
f.
Inconvenient meeting times? Has that made it harder for you to
participate in activities at {CHILD}'s school? ...................................
No child care keeps your family from going to school meetings
or events? Has that made it harder for you to participate in
activities at {CHILD}'s school? ........................................................
Family members can't get time off from work? Has that made it
harder for you to participate in activities at {CHILD}'s school? .......
Problems with safety going to the school? Has that made it harder
for you to participate in activities at {CHILD}'s school?....................
The school does not make your family feel welcome? Has that made
it harder for you to participate in activities at {CHILD}'s school?......
Problems with transportation to the school? Has that made it harder
for you to participate in activities at {CHILD}'s school?....................
Round 7 Parent – PIQ-8
NO
REF
DK
1
2
7
9
1
2
7
9
1
2
7
9
1
2
7
9
1
2
7
9
1
2
7
9
BOX 3
IF ACCORDING TO THE PRELOAD A LANGUAGE OTHER THAN ENGLISH IS
SPOKEN IN THE HOME, THEN GO TO PIQ.050G. ELSE, GO TO PIQ.050H.
g.
h.
Problems because you or members of your family speak a language
other than English and meetings are conducted only in English?
Has that made it harder for you to participate in activities at
{CHILD}'s school?............................................................................
You don't hear about things going on at school that you might
want to be involved in? Has that made it harder for you to participate
in activities at {CHILD}'s school? .....................................................
1
2
7
9
1
2
7
9
NOTE: THE WORDING OF PIQ.065 HAS CHANGED FROM “CLASS” TO “SCHOOL FRIENDS”
PIQ.065
About how many parents of {CHILD}'s school friends do you talk with regularly, either in person or on
the phone?
CAPI INSTRUCTIONS: HARD RANGE CHECK: 0-40 PARENTS.
|___|___|
NUMBER OF PARENTS
OR
REFUSED .....................................................
DON'T KNOW................................................
77
99
HELP AVAILABLE
PIQ.070
How far in school do you expect {CHILD} to go? Would you say you expect {him/her} …
CAPI INSTRUCTION: DISPLAY "expect" IN UNDERLINED TEXT.
HELP SCREEN
How far the respondent expects the child to go in school:
This question is about how far in school the respondent realistically expects the child to go, not how far
the respondent hopes the child will go. If it is difficult to answer the question because the answer
depends on many factors, ask for the best guess.
To receive less than a high school diploma, .
To graduate from high school, ......................
To attend two or more years of college, ........
To finish a four- or five-year college degree,
To earn a master's degree or equivalent, or .
To finish a Ph.D., MD or other advanced
degree? ....................................................
REFUSED ....................................................
DON'T KNOW ...............................................
1
2
3
4
5
6
7
9
NOTE: PIQ.110 IS NEW IN ROUND 8.
PIQ.110
How disappointed would you be if {CHILD} did not graduate from high school? Would you say you would be…
Extremely disappointed, ...............................
Very disappointed, ........................................
Somewhat disappointed, or, .........................
Not disappointed?..........................................
REFUSED ....................................................
DON'T KNOW ...............................................
Round 7 Parent – PIQ-9
1
2
3
4
7
9
NOTE: BOX 4 IS NEW IN ROUND 8.
BOX 4
If (PIQ.070 = 1 OR 2), GO TO PIQ.120.
ELSE GO TO PIQ.112.
NOTE: PIQ.112 IS NEW IN ROUND 8.
PIQ.112
How disappointed would you be if {CHILD} did not graduate from college? Would you say you would be...
Extremely disappointed, ...............................
Very disappointed, ........................................
Somewhat disappointed, or, .........................
Not disappointed?..........................................
REFUSED ....................................................
DON'T KNOW ...............................................
1
2
3
4
7
9
NOTE: PIQ.120 IS NEW IN ROUND 8.
PIQ.120
If {CHILD} could be only one of the following in high school, which would be most important to you?
A brilliant student, .........................................
A leader in school activities, .........................
An athletic star, or, ........................................
The most popular?.........................................
REFUSED ....................................................
DON'T KNOW ...............................................
BOX 5
GO TO SECTION FSQ (FAMILY STRUCTURE).
Round 7 Parent – PIQ-10
1
2
3
4
7
9
FAMILY STRUCTURE – FSQ
BOX 1
IF (NumberOfChildren = 1) OR
IF (NumberOfChildren > 1 and ChildNum =1). CONTINUE WITH FSQ.Intro.
IF (NumberOfChildren >1 and ChildNum=2), GO TO BOX 6.
FSQ.Intro
Now I have a few questions about your household. We have listed that (READ NAMES FROM MATRIX) lived in
this household at the time of our last interview.
As I read each person's name again, please tell me if he or she still lives in this household.
PRESS ENTER TO CONTINUE
NOTE: THE GENDER FOR THE CHILD IN ROUND 8 IS TAKEN FROM THE GENDER COMPOSITE VARIABLE R6GENDER
FSQ.010
Does {NAME} still live in this household?
CAPI MATRIX INSTRUCTIONS:
1.
DISPLAY 'STILL' IN UNDERLINED TEXT.
2.
DISPLAY THE COMPLETED HOUSEHOLD MATRIX FROM THE PRELOAD FILE. THIS INCLUDES
THE PERSON TYPE, FIRST NAME, LAST NAME, AGE, AND GENDER COLUMNS (NOTE THAT THE
GENDER FOR THE CHILD IN ROUND 8 IS TAKEN FROM THE GENDER COMPOSITE VARIABLE
R6GENDER). THESE COLUMNS SHOULD BE PROTECTED, THAT IS, INFORMATION CANNOT BE
CHANGED.
DISPLAY ONLY THOSE HOUSEHOLD MEMBERS WHO, AS INDICATED IN THE PRELOAD, ARE
STILL IN THE HOUSEHOLD (IF THERE IS A "1" IN THE SIXTH COLUMN OF THE PREVIOUS
ROUND MATRIX.)
3.
ADD AS THE 6TH COLUMN TO THE MATRIX, 'STILL HERE.’ DISPLAY '1' IF PERSON STILL LIVES
IN THE HOUSEHOLD AND '2' IF THE PERSON DOES NOT (BASED ON HOW FSQ.010 IS CODED).
4.
THE CURSOR SHOULD START AT THE ‘STILL HERE’ COLUMN FOR THE FIRST PERSON LISTED
IN THE MATRIX.
5.
ADD AS THE 7TH COLUMN TO THE MATRIX, ’REASON LEFT' (FSQ.015).
6.
IF THE ‘STILL HERE’ COLUMN IS CODED 'NO', THE CURSOR SHOULD MOVE RIGHT TO THE
’REASON LEFT' COLUMN. IF THE ‘STILL HERE’ IS CODED 'YES', THE CURSOR SHOULD MOVE
TO THE ‘STILL HERE’ COLUMN FOR THE NEXT PERSON ON THE MATRIX (THE ’REASON LEFT'
COLUMN DOES NOT NEED TO BE COMPLETED IN THIS INSTANCE).
7.
IF FLAGS.SAMERESP <= 1 (QUESTION IS ABOUT THE RESPONDENT) AND INQ10A NE 0
(RESPONDENT IS NOT A NEW HOUSEHOLD MEMBER) AND FSQ.010 = 2 (NOT IN HH), DISPLAY
ERROR MESSAGE: 'THIS PERSON CANNOT BE THE RESPONDENT AND NOT BE IN THE
HOUSEHOLD.'
8.
ADD AS THE 8TH COLUMN TO THE MATRIX, ’REASON LEFT OS' (FSQ.015OS).
Round 8 Parent-FSQ- 11
9.
ONCE THE MATRIX IS COMPLETE (AS APPLICABLE) MOVE TO THE NEXT ITEM FSQ.045.
YES ..............................................................
NO ................................................................
FSQ.015
1 (Ask about next HH member)
2 (FSQ.015)
Why is {NAME} no longer living in this household?
CAPI MATRIX INSTRUCTIONS:
1.
DISPLAY THIS QUESTION WHENEVER IN THE "REASON LEFT" COLUMN.
2.
ONCE THIS ITEM IS CODED, THE CURSOR SHOULD MOVE TO THE ‘STILL HERE’ COLUMN FOR
THE NEXT PERSON ON THE MATRIX.
3.
HOWEVER, IF SOME OTHER REASON IS CODED, THEN FSQ.015OS MUST FIRST BE
COMPLETED BEFORE MOVING TO THE NEXT PERSON ON THE MATRIX.
SEPARATION OR DIVORCE ...................... 1
ATTENDING COLLEGE OR
BOARDING SCHOOL ............................... 2
LIVING ELSEWHERE FOR
EMPLOYMENT-RELATED REASONS ..... 3
DECEASED ................................................. 4
MOVED ON .................................................. 5
ROSTER ERROR ......................................... 6
MOVED BACK WITH PARENTS .................. 7
SOME OTHER REASON (SPECIFY)______ 91 (FSQ.0150S)
REFUSED ..................................................... 77
DON’T KNOW .............................................. 99
FSQ.015OS
[Why is {NAME} no longer living in this household?]
ENTER OTHER REASON.
CAPI MATRIX INSTRUCTIONS.
1.
DISPLAY "REASON LEFT OS" AS THE 8TH COLUMN IN THE MATRIX.
2.
DISPLAY THIS QUESTION WHENEVER IN THE "REASON LEFT OS" COLUMN.
3.
THIS COLUMN ONLY NEEDS TO BE COMPLETED IF CODE 91 IS SELECTED AS A REASON IN
THE ’REASON LEFT' COLUMN.
__________________________________________________
ENTER OTHER REASON
FSQ.020
[Please tell me the names and ages of all the other people who normally live here. Please do not include anyone
staying here temporarily who usually lives somewhere else.]
PROBE: Anyone else (living in this household)?
ENTER FIRST NAME OF {NEW} HOUSEHOLD MEMBER OR PRESS ENTER IF MATRIX IS COMPLETE.
CAPI MATRIX INSTRUCTIONS:
1.
DISPLAY THE HOUSEHOLD MATRIX (PERSON TYPE, FIRST NAME, LAST NAME, AGE, AND
GENDER COLUMNS.)
ROUND 8 Parent –FSQ-12
2.
THE INTERVIEWER CAN ADD UP TO 25 ROW ENTRIES.
THE INTERVIEWER CAN MOVE ALL AROUND THE MATRIX USING THE ARROW KEYS (EXCEPT ON
PROTECTED FIELDS).
3.
4.
FOR EACH HOUSEHOLD:
a.
DISPLAY ALL HOUSEHOLD MEMBERS AND ASSOCIATED INFORMATION FROM THE
PRELOAD OR UPDATED IN INQ (FOR THE CHILD AND ROUND 6 RESPONDENT).
HOWEVER, DO NOT DISPLAY THE NAMES OF THOSE HH MEMBERS THAT WERE
CODED '2' AT FSQ.010 (NOT IN HH ANYMORE). LEAVE THAT PERSON'S ROW BLANK.
b.
ALL PREVIOUS HH MEMBER ROWS SHOULD BE PROTECTED. THE CURSOR SHOULD
APPEAR ON THE FIRST BLANK FIRST NAME COLUMN.
c.
WHEN ON THE FIRST BLANK FIRST NAME COLUMN DISPLAY "Please tell…somewhere
else.", "PROBE: … household", "ENTER FIRST …COMPLETE", AND THE "NEW" IN THAT
SCREEN INSTRUCTION.
d.
WHEN ON THE SECOND BLANK FIRST NAME COLUMN, DISPLAY THE "PLEASE
TELL…SOMEWHERE ELSE." IN BRACKETS [ ]. THE PROBE AND SCREEN INSTRUCTION
CITED ABOVE SHOULD ALSO CONTINUE TO BE DISPLAYED.
DISPLAY “C” IN THE FIRST COLUMN TO INDICATE THAT PERSON IS THE FOCAL CHILD.
DISPLAY THE AGE AND GENDER OF THE CHILD IN THE APPROPRIATE COLUMNS OF THE
SECOND ROW.
IF APPLICABLE, DISPLAY THE NAME OF THE FOCAL CHILD'S TWIN IN THE THIRD ROW
OF THE FIRST NAME COLUMN.
DISPLAY "T" IN THE FIRST COLUMN TO INDICATE THAT THE PERSON IS THE FOCAL
CHILD'S TWIN.
DISPLAY THE AGE AND GENDER OF THE TWIN IN THE APPROPRIATE COLUMNS OF
THE THIRD ROW.
5.
FSQ.025
IF FLAGS.SAMERESP = 1, THEN DISPLAY THE "R" NEXT TO THE NAME OF THE PREVIOUS
ROUND RESPONDENT. DISPLAY THE NAME OF RESPONDENT ON THE FIRST ROW.
ENTER LAST NAME OF {NAME}.
CAPI INSTRUCTION: DISPLAY THIS QUESTION WHEN THE CURSOR IS POSITIONED IN THE LAST NAME
COLUMN OF THE HOUSEHOLD MATRIX.
FSQ.030
How old {are you/is {NAME}}?
ENTER AGE OF {NAME}.
ENTER ZERO IF PERSON’S AGE IS LESS THAN ONE YEAR.
CAPI INSTRUCTION: ACCEPT DON'T KNOW OR REFUSED.
CAPI INSTRUCTION: DISPLAY THIS QUESTION WHEN THE CURSOR IS POSITIONED IN THE AGE
COLUMN OF THE HOUSEHOLD MATRIX.
CAPI INSTRUCTION: DISPLAY "ARE YOU" WHEN THE CURSOR IS POSITIONED IN THE AGE COLUMN
FOR THE RESPONDENT'S ROW AND "IS {NAME}" (DISPLAY THE APPROPRIATE FIRST NAME) WHEN THE
CURSOR IS POSITIONED IN THE AGE COLUMN FOR SOMEONE OTHER THAN THE RESPONDENT'S
ROW.
ROUND 8 Parent –FSQ-13
FSQ.040
CODE IF OBVIOUS. OTHERWISE, ASK: {Are you/Is {NAME}} male or female?
ENTER GENDER OF {NAME}.
DISPLAY THIS QUESTION WHEN THE CURSOR IS POSITIONED IN THE GENDER COLUMN.
DISPLAY "ARE YOU" WHEN THE CURSOR IS POSITIONED IN THE GENDER COLUMN FOR THE
RESPONDENT'S ROW AND "IS {NAME}" (DISPLAY THE APPROPRIATE FIRST NAME) WHEN THE CURSOR
IS POSITIONED IN THE GENDER COLUMN FOR SOMEONE OTHER THAN THE RESPONDENT'S ROW.
MALE ...........................................................
FEMALE .......................................................
REFUSED ....................................................
DON’T KNOW ..............................................
FSQ.045
1
2
7
9
IS THE MATRIX COMPLETE?
CAPI INSTRUCTION: CHECK HOUSEHOLD MATRIX. IF ANY BLANK FIELDS, RETURN THE CURSOR TO
THE BLANK FIELD ON THE MATRIX AND DISPLAY THE APPROPRIATE ERROR MESSAGE.
YES ...............................................................
NO ................................................................
FSQ.060
Have we missed anyone who usually lives here who is temporarily away from home or living in a dorm at school,
or any babies or small children?
YES ...............................................................
NO ................................................................
REFUSED ....................................................
DON’T KNOW ..............................................
FSQ.110
1
2
7
9
(FSQ.020)
(FSQ. 110)
(FSQ. 110)
(FSQ. 110)
1
2
7
9
(FSQ.120)
(BOX 2)
(BOX 2)
(BOX 2)
Do you have a spouse or partner who lives in this household?
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON’T KNOW ..............................................
FSQ.120
1 (FSQ.060)
2 (COMPLETE MATRIX)
Who in the household is your spouse or partner?
ENTER NUMBER NEXT TO NAME OF PERSON WHO IS {RESPONDENT}'S SPOUSE/PARTNER.
IF NAME NOT LISTED, BACK UP AND ADD PERSON (IF PART OF HOUSEHOLD).
CAPI INSTRUCTION: DISPLAY HOUSEHOLD MEMBERS 16 YEARS OR OLDER AS RESPONSE CATEGORY
CHOICES. DO NOT DISPLAY THE NAMES OF HOUSEHOLD MEMBERS CODED AS NO LONGER LIVING IN
THE HOUSEHOLD AT FSQ.010.
CAPI INSTRUCTION: DO NOT DISPLAY THE RESPONDENT’S NAME.
CAPI INSTRUCTION: FLAG PERSON SELECTED AT FSQ.120 AS “RESPONDENT’S SPOUSE/PARTNER”.
CAPI INSTRUCTION: DISPLAY THE RESPONDENT'S FIRST NAME FOR {RESPONDENT}.
{DISPLAY HH MEMBER NAME 1} ...............
{DISPLAY HH MEMBER NAME 2} ...............
{DISPLAY HH MEMBER NAME 3} ...............
{DISPLAY HH MEMBER NAME 4} ...............
{DISPLAY HH MEMBER NAME 5} ...............
{DISPLAY HH MEMBER NAME 6} ...............
ROUND 8 Parent –FSQ-14
1
2
3
4
5
6
{DISPLAY HH MEMBER NAME 7} ...............
{DISPLAY HH MEMBER NAME 8} ...............
7
8
BOX 2
IF FLAGS.SAMERESP = 1 AND THE RESPONDENT IS NOT A BIRTH OR
ADOPTIVE MOTHER/FATHER OR THE SPECIFIC RELATIONSHIP OF THIS
RESPONDENT TO THE CHILD IS NE -1, 7 OR 9, GO TO FSQ.100.
ELSE, GO TO BOX 2A.
FSQ.100
During our last interview, it was reported that you were {CHILD}'s {RELATIONSHIP}. Has there been a change in
your relationship to {CHILD}?
CAPI INSTRUCTIONS: USING CURRENT ROSTER, DISPLAY SPECIFIC RELATIONSHIP OF STEPMOTHER,
FOSTER MOTHER, STEPFATHER, OR FOSTER FATHER. ELSE, IF RESPONDENT IS NOT ONE OF THESE
RELATIONSHIPS, DISPLAY OTHER RELATIONSHIP INFORMATION FROM ROSTER (E.G., OTHER
RELATIVE, OTHER NON-RELATIVE).
YES ...............................................................
NO.................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
(BOX 2A)
(BOX 2A)
(BOX 2A)
(BOX 2A)
BOX 2A
IF FLAGS.SAMERESP = 1 AND SPOUSE OR PARTNER IS THE SAME AS IN MOST
RECENT INTERVIEW AND (IS NOT A BIRTH OR ADOPTIVE MOTHER/FATHER) OR
(THE SPECIFIC RELATIONSHIP INFORMATION IS NE -1, 7 OR 9,) GO TO FSQ.121.
ELSE, GO TO BOX 4.
FSQ.121
During our last interview, it was reported that {NAME OF SPOUSE/PARTNER} was {CHILD}'s {RELATIONSHIP}.
Has there been a change in the relationship of {NAME OF SPOUSE/PARTNER} to {CHILD}?
CAPI INSTRUCTIONS: USING CURRENT ROSTER, DISPLAY SPECIFIC RELATIONSHIP OF STEPMOTHER,
FOSTER MOTHER, STEPFATHER, OR FOSTER FATHER. ELSE, IF RESPONDENT IS NOT ONE OF THESE
RELATIONSHIPS, DISPLAY OTHER RELATIONSHIP INFORMATION FROM ROSTER (E.G., OTHER
RELATIVE, OTHER NON-RELATIVE).
YES ...............................................................
NO.................................................................
DIFFERENT SPOUSE/PARTNER ................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent –FSQ-15
1
2
3
7
9
BOX 4
IF FSQ.100=1, GO TO FSQ.130. ELSE, IF FSQ.121=1, GO TO FSQ.130. ELSE, GO
TO LOOP 1.
LOOP 1
ASK FSQ.130 - FSQ.181 FOR EACH NEW PERSON ENUMERATED ON THE
HOUSEHOLD MATRIX (AT FSQ.020) WHO IS NOT THE FOCAL CHILD. DO NOT
ASK ABOUT HOUSEHOLD MEMBERS ENUMERATED IN A PREVIOUS ROUND.
OTHERWISE, GO TO BOX 5.
HELP AVAILABLE
FSQ.130
What is {your/{NAME}'s} relationship to {CHILD}?
CODE RELATIONSHIP OF HOUSEHOLD MEMBER.
HELP TEXT:
Mother/Female Guardian: The female primarily responsible for the child. Includes birth or biological
mothers, adoptive, step, and foster mothers, as well as, legal female guardians.
Father/Male Guardian: The male primarily responsible for the child. Includes birth or biological fathers,
adoptive, step, and foster fathers, as well as, legal male guardians.
Sister: Include biological (full, half), adoptive, step, and foster sisters.
Brother: Include biological (full, half), adoptive, step, and foster brothers.
Girlfriend or Partner of CHILD's Parent/Guardian: The female who has a "partner-like" relationship
with one of the child's parents or guardians. "Living as married" is another way of describing the
relationship.
Boyfriend or Partner of CHILD's Parent/Guardian: The male who has a "partner-like" relationship
with one of the child's parents or guardians. "Living as married" is another way of describing the
relationship.
Grandmother: The female parent of the child's biological or adoptive mother or father.
Grandfather: The male parent of the child's biological or adoptive mother or father.
Aunt: The sister of the child's biological or adoptive mother or father or the wife of the child's uncle.
Uncle: The brother of the child's biological or adoptive mother or father or the husband of the child's
aunt.
Cousin: A child of the focal child's uncle, aunt, or cousin.
Other Relative: Refers to relationships that aren't specifically listed, such as great grandmother, niece,
or nephew.
Other Non-relative: Refers to the relationship between two people when there is no family relationship
through blood, marriage, adoption, or partnership (i.e., living together as married). It also refers to more
ambiguous relationships that exist where there are two people living together as married and they have
children. For example, the child's father and the father's girlfriend (who is not the child's mother) live
together as married and the girlfriend's daughter lives with them. The relationship of the girlfriend's
daughter to the child would be siblings if they were married, but since the father and the girlfriend are not
married, she is an "other non-relative." If the "other non-relative" is coded, you will receive a list of other
codes to use if they are more descriptive than "other non-relative."
CAPI INSTRUCTION: DISPLAY THE RELATIONSHIP MATRIX.
ROUND 8 Parent –FSQ-16
CAPI INSTRUCTION: DO NOT DISPLAY THE FOCAL CHILD'S ROW.
CAPI INSTRUCTION: DISPLAY FIRST NAME, LAST NAME, AND AGE OF THE PERSON, USING
INFORMATION FROM THE CURRENT ROUND HOUSEHOLD MATRIX.
CAPI MATRIX INSTRUCTIONS:
a.
DO NOT DISPLAY THE NAMES OF HH MEMBERS NOT LIVING IN THE HOUSEHOLD
(CODED '2' AT FSQ.010).
b.
THE NAMES AND RELATIONSHIPS OF HOUSEHOLD MEMBERS COLLECTED LAST
ROUND SHOULD BE PROTECTED.
c.
THE CURSOR SHOULD START IN THE FIELD FOR THE FIRST NEW PERSON ADDED AT
FSQ.020 THIS ROUND.
MOTHER/FEMALE GUARDIAN .............................................................
FATHER/MALE GUARDIAN ...................................................................
SISTER ...................................................................................................
BROTHER ..............................................................................................
GIRLFRIEND OR PARTNER OF {CHILD}'S PARENT/GUARDIAN ........
BOYFRIEND OR PARTNER OF {CHILD}'S PARENT/GUARDIAN ........
GRANDMOTHER ....................................................................................
GRANDFATHER .....................................................................................
AUNT ......................................................................................................
UNCLE ....................................................................................................
COUSIN ..................................................................................................
OTHER RELATIVE .................................................................................
OTHER NON-RELATIVE ........................................................................
1
2
3
4
5
6
7
8
9
10
11
12
13
(FSQ.140)
(FSQ.150)
(FSQ.160)
(FSQ.170)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(FSQ.180)
HELP AVAILABLE
FSQ.140
{Are you/Is {NAME}} {CHILD}'s…
HELP TEXT:
Birth Mother: Child's female biological parent.
Adoptive Mother: The female who has taken the child into her own family by legal process to raise as
her own child.
Step Mother: The female other than the child's mother who is married to the child's father.
Foster Mother: The female with whom the child is placed temporarily, usually through a social service
agency and/or a court.
Female Guardian: The female legally placed in charge of the affairs of the child.
Birth mother, .................................................
Adoptive mother, ..........................................
Step mother, or ............................................
Foster mother or female guardian? ..............
REFUSED ....................................................
DON’T KNOW ..............................................
ROUND 8 Parent –FSQ-17
1
2
3
4
7
9
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
HELP AVAILABLE
FSQ.150
{Are you/Is {NAME}} {CHILD}'s…
HELP TEXT:
Birth Father: Child's male biological parent.
Adoptive Father: The male who has taken the child into his own family by legal process to raise as his
own child.
Step Father: The male other than the child's father who is married to the child's mother.
Foster Father: The male with whom the child is placed temporarily, usually through a social service
agency and/or a court.
Male Guardian: The male legally placed in charge of the affairs of the child.
Birth father,....................................................
Adoptive father, ............................................
Step father, or ..............................................
Foster father or male guardian? ...................
REFUSED ....................................................
DON’T KNOW ..............................................
1
2
3
4
7
9
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
HELP AVAILABLE
FSQ.160
{Are you/Is {NAME}} {CHILD}'s…
HELP TEXT:
Full Sister: A female with whom the child shares the same biological parents.
Half Sister: A female with whom the child shares one biological parent.
Step Sister: A female to whom the child is unrelated except by the marriage of one biological parent.
Adoptive Sister: A female to whom the child is unrelated except that they are in the same family in
which she or the child has been legally adopted by the family.
Foster Sister: A female to whom the child is unrelated except that they are in the same family in which
she or the child have been taken into the home on a temporary basis and the parents have legal
responsibility for the child.
Full sister,......................................................
Half sister, .....................................................
Step sister, ...................................................
Adoptive sister, or .........................................
Foster sister? ...............................................
REFUSED ....................................................
DON’T KNOW ..............................................
ROUND 8 Parent –FSQ-18
1
2
3
4
5
7
9
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
HELP AVAILABLE
FSQ.170
{Are you/Is {NAME}} {CHILD}'s…
HELP TEXT:
Full Brother: A male with whom the child shares the same biological parents.
Half Brother: A male with whom the child shares one biological parent.
Step Brother: A male to whom the child is unrelated except by the marriage of one biological parent.
Adoptive Brother: A male to whom the child is unrelated except that they are in the same family in
which he or the child has been legally adopted by the family.
Foster Brother: A male to whom the child is unrelated except that they are in the same family in which
he or the child have been taken into the home on a temporary basis and the parents have legal
responsibility for the child.
Full brother, ...................................................
Half brother, ..................................................
Step brother, ................................................
Adoptive brother, or ......................................
Foster brother? .............................................
REFUSED ....................................................
DON’T KNOW ..............................................
1
2
3
4
5
7
9
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
HELP AVAILABLE
FSQ.180
CODE NON-RELATIVE RELATIONSHIP BELOW IF MORE DESCRIPTIVE.
HELP TEXT:
Girlfriend or Partner of CHILD's Parent/Guardian: The female who has a "partner-like" relationship
with one of the child's parents or guardians. "Living as married" is another way of describing the
relationship.
Boyfriend or Partner of CHILD's Parent/Guardian: The male who has a "partner-like" relationship
with one of the child's parents or guardians. "Living as married" is another way of describing the
relationship.
Female Guardian: The female legally placed in charge of the affairs of the child.
Male Guardian: The male legally placed in charge of the affairs of the child.
Daughter/son of CHILD's Parent's Partner: The child of the person who has a "partner-like"
relationship with one of the child's parents or guardians.
Other Relative of CHILD's Parent's Partner: Some other relative of the person who has a "partnerlike" relationship with one of the child's parents or guardians.
Other Non-relative: If one of the codes for non-relative above does not better describe the relationship
of the person to the child, and there is no family relationship through blood, marriage, adoption, or
partnership (i.e., living together as married), use this code.
ROUND 8 Parent –FSQ-19
GIRLFRIEND OR PARTNER OF {CHILD}'S PARENT/GUARDIAN ........ 1 (BOX 5)
BOYFRIEND OR PARTNER OF {CHILD}'S PARENT/GUARDIAN ......... 2 (BOX 5)
FEMALE GUARDIAN............................................................................... 3 (BOX 5)
MALE GUARDIAN ................................................................................... 4 (BOX 5)
DAUGHTER/SON OF {CHILD}'S PARENT'S PARTNER ........................ 5 (BOX 5)
OTHER RELATIVE OF {CHILD}'S PARENT'S PARTNER ...................... 6 (BOX 5)
OTHER NONRELATIVE .......................................................................... 7 (FSQ.181)
SPECIFY _____________________________________________
REFUSED ............................................................................................... 77 (BOX 5)
DON’T KNOW ......................................................................................... 99 (BOX 5)
FSQ.181
SPECIFY OTHER NON-RELATIVE.
_______________________________________
OTHER NON-RELATIVE
BOX 5
END LOOP 1.
ASK FSQ.130 - FSQ.181 FOR NEXT NEW PERSON ON THE HOUSEHOLD
ROSTER WHO IS NOT THE FOCAL CHILD.
IF NO NEXT PERSON, CONTINUE WITH BOX 5A.
BOX 5A
LOOP 2.
IF ANY RESPONDENT, MOTHER FIGURE, OR FATHER FIGURE, OR
RESPONDENT AND RESPONDENT'S SPOUSE (IF NO MOTHER OR FATHER
FIGURES) (NEW OR OLD HH MEMBERS) IS MISSING ETHNICITY OR RACE
DATA, CONTINUE WITH FSQ.190.
OTHERWISE, GO TO BOX 5B.
HELP AVAILABLE
FSQ.190
{Are you/Is {NAME}} of Hispanic origin?
HELP TEXT:
Hispanic or Latino Origin: A person of Cuban, Mexican, Puerto Rican, South or Central American, or
other Spanish cultures or origin (or descent), regardless of race.
CAPI MATRIX INSTRUCTIONS:
DISPLAY IN COLUMN 1 EACH PERSON ENUMERATED ON THE HOUSEHOLD ROSTER (AT
FSQ.020) WHO IS THE RESPONDENT, MOTHER FIGURE (CODE ‘1’ AT FSQ.130, OR CODE ‘3’ AT
FSQ.180), OR FATHER FIGURE (CODE ‘2’ AT FSQ.130, OR CODE ‘4’ AT FSQ.180).
IF NO MOTHER OR FATHER FIGURES IN THE HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH A
CODE ‘1’ OR ‘2’ AT FSQ.130), OR (A CODE ‘3’ OR ‘4’ AT FSQ.180), DISPLAY IN COLUMN 1 THE
RESPONDENT, AND THE RESPONDENT’S SPOUSE/PARTNER (HOUSEHOLD MEMBER
SELECTED AT FSQ.120, IF ANY).
NOTE: IF THE RESPONDENT IS A MOTHER OR FATHER FIGURE, ONLY DISPLAY HIS/HER NAME
ONCE.
NOTE: DO NOT DISPLAY HOUSEHOLD MEMBERS CODED AS NOT LIVING IN THE HOUSEHOLD
AT FSQ.010.
ROUND 8 Parent –FSQ-20
DISPLAY FIRST NAME, LAST NAME, AND AGE OF THE PERSON, USING INFORMATION FROM
THE CURRENT ROUND HOUSEHOLD MATRIX.
NOTE: ASK ABOUT HISPANIC ORIGIN AND RACE ONLY IF NEW HOUSEHOLD MEMBERS ARE
THE FOCAL CHILD'S PARENTS OR THE RESPONDENT OR IF THERE ARE NO PARENTS, THEN
ABOUT THE RESPONDENT AND RESPONDENT'S SPOUSE/PARTNER (IF THEY ARE NEW OR IF
MISSING FOR PREVIOUS HH MEMBERS.)
THE CURSOR SHOULD BE POSITIONED ON THE FIRST BLANK FIELD.
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON’T KNOW ..............................................
1
2
7
9
HELP AVAILABLE
FSQ.195
What is {your/{NAME}'s} race?
CODE ALL THAT APPLY.
HELP TEXT:
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.
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, and Vietnam.
Black or African American: A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of
Hawaii, Guam, Samoa, or other Pacific Islands.
White: A person having origins in any of the original peoples of Europe, the Middle East, or North
Africa.
CAPI MATRIX INSTRUCTIONS:
DISPLAY IN COLUMN 1 EACH PERSON ENUMERATED ON THE HOUSEHOLD ROSTER (AT
FSQ.020) WHO IS THE RESPONDENT, MOTHER FIGURE (CODE ‘1’ AT FSQ.130 OR CODE ‘3’ AT
FSQ.180), OR FATHER FIGURE (CODE ‘2’ AT FSQ.130 OR CODE ‘4’ AT FSQ.180).
IF NO MOTHER OR FATHER FIGURES IN THE HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH
[(A CODE ‘1’ OR ‘2’ AT FSQ.130) OR (A CODE ‘3’ OR ‘4’ AT FSQ.180), DISPLAY IN COLUMN 1 THE
RESPONDENT AND THE RESPONDENT’S SPOUSE/PARTNER (HOUSEHOLD MEMBER SELECTED
AT FSQ.120, IF ANY).
NOTE: IF THE RESPONDENT IS A MOTHER OR FATHER FIGURE, ONLY DISPLAY HIS/HER NAME
ONCE.
IF CODE '91' (ANOTHER RACE) IS CHOSEN, DISPLAY THE 'RACE OS' COLUMN (FSQ.198) FOR
COMPLETION.
DISPLAY FIRST NAME, LAST NAME, AND AGE OF THE PERSON, USING INFORMATION FROM
THE CURRENT ROUND HOUSEHOLD MATRIX.
NOTE: ASK ABOUT HISPANIC ORIGIN AND RACE ONLY IF NEW HOUSEHOLD MEMBERS ARE
THE FOCAL CHILD'S PARENTS OR THE RESPONDENT OR IF THERE ARE NO PARENTS, THEN
ABOUT THE RESPONDENT AND RESPONDENT'S SPOUSE/PARTNER (IF THEY ARE NEW OR IF
MISSING FOR PREVIOUS HH MEMBERS.)
ROUND 8 Parent –FSQ-21
NOTE: DO NOT DISPLAY HOUSEHOLD MEMBERS CODED AS NOT LIVING IN THE HOUSEHOLD
AT FSQ.010.
AMERICAN INDIAN OR ALASKA NATIVE .. 1
ASIAN .......................................................... 2
BLACK OR AFRICAN AMERICAN ............... 3
NATIVE HAWAIIAN OR OTHER
PACIFIC ISLANDER .................................. 4
WHITE .......................................................... 5
ANOTHER RACE (SPECIFY) ...................... 91 (FSQ.198)
REFUSED .................................................... 7
DON’T KNOW .............................................. 9
FSQ.198
[What is {your/{NAME}'s} race?]
ENTER OTHER-SPECIFY TEXT.
_______________________________________
OTHER RACE
BOX 5B
END LOOP 2.
ASK FSQ.190 – FSQ.198 FOR NEXT PERSON WHO IS THE MOTHER FIGURE,
FATHER FIGURE, OR RESPONDENT OR RESPONDENT'S SPOUSE (IF NO
MOTHER OR FATHER FIGURES) (NEW OR OLD HH MEMBERS) WHOSE
ETHNICITY OR RACE DATA ARE MISSING.
IF NO NEXT PERSON, CONTINUE WITH FSQ.300.
FSQ.300
{FILL 1} currently married, separated, divorced, widowed, or {FILL 2} never been married?
CAPI INSTRUCTION: SEE ATTACHED FOR FILL SPECIFICATIONS.
MARRIED .....................................................
SEPARATED ...............................................
DIVORCED ..................................................
WIDOWED ...................................................
NEVER MARRIED .......................................
REFUSED ....................................................
DON’T KNOW ..............................................
ROUND 8 Parent –FSQ-22
1
2
3
4
5
7
9
BOX 7
IDENTIFY THE 2 “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) IF A MOTHER (RELATION=1) IS IN THE HOUSEHOLD SHE SHOULD BE A
KEY PARENT FIGURE; IF A FATHER (RELATION =2) IS IN THE HOUSEHOLD
HE SHOULD BE A KEY PARENT FIGURE; IF THERE ARE TWO MOTHERS
(RELATION=1) PICK THE MOTHER WITH THE LOWER NUMBER
RELATIONSHIP IN THE FOLLOWING SYSTEM: BIRTH MOTHER =1,
ADOPTIVE MOTHER=2, STEPMOTHER=3, AND FOSTER MOTHER OR
FEMALE GUARDIAN =4. IF TWO MOTHERS HAVE SAME NUMBER
RELATIONSHIP, PICK ONE WITH LOWEST PERSON NUMBER. IF THERE
ARE TWO FATHERS (RELATION=2), PICK THE FATHER WITH THE LOWER
NUMBER RELATIONSHIP IN THE FOLLOWING SYSTEM: BIRTH FATHER =1,
ADOPTIVE FATHER=2, STEPFATHER=3, AND FOSTER FATHER OR MALE
GUARDIAN =4. IF TWO FATHERS HAVE SAME NUMBER RELATIONSHIP,
PICK ONE WITH LOWEST PERSON NUMBER;
•
3) IF THERE IS A MOTHER (RELATION =1) BUT NO FATHER (RELATION=2)
AND THE MOTHER HAS A SPOUSE/PARTNER, THE MOTHER SHOULD BE A
KEY PARENT FIGURE AND THE SPOUSE/PARTNER SHOULD BE A KEY
PARENT FIGURE;
•
4) IF THERE IS A FATHER (RELATION=2) AND THE FATHER HAS A
SPOUSE/PARTNER, THE FATHER SHOULD BE A KEY PARENT FIGURE AND
THE SPOUSE/PARTNER SHOULD BE A KEY PARENT FIGURE;
•
5) OTHERWISE, IF THERE ARE NOT PARENTS IN THE HOUSEHOLD
(RELATION NE 1 OR 2), THE RESPONDENT SHOULD BE A KEY PARENT
FIGURE AND THE RESPONDENT’S SPOUSE/PARTNER, IF ONE, SHOULD BE
A KEY PARENT FIGURE.
BOX 8
GO TO HEQ (HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE
STIMULATION).
ROUND 8 Parent –FSQ-23
FSQ.300 FILL SPECIFICATIONS
{FILL 1} currently married, separated, divorced, widowed, or {FILL 2} never been married?
{FILL 1}
{FILL 2}
ParentIsR
BioMoInHH
BioFaInHH
AdopMoInHH
AdopFaInHH
The current roster
shows the relationship
of birth mother for at
least one HH
member (not the R)
for YES
The current roster
shows the relationship
of birth father for at
least one HH
member (not the R)
for YES
The current roster
shows the relationship
of adoptive mother for
at
least one HH
member (not the R)
for YES
The current roster
shows the relationship
of adoptive father for
at
least one HH
member (not the R)
for YES
NO
NO
Are you
have you
The current roster
shows a relationship of
birth/adoptive mother or
birth/adoptive father for
the
person flagged as the
respondent for YES
YES
Are CHILD's
biological parents
Are CHILD's
biological parents
Is CHILD's
biological mother
Is CHILD's
biological father
Is CHILD's
adoptive mother
Is CHILD's
adoptive father
Are CHILD's
adoptive parents
have they
NO
YES
YES
have they
NO
NO
NO
has she
NO
YES
NO
has he
NO
NO
YES
has she
NO
NO
NO
YES
NO
has he
NO
NO
NO
NO
YES
have they
NO
NO
NO
YES
YES
Round 8 Parent-FSQ- 24
HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE STIMULATION -- HEQ
BOX 1
IF CHILDNUM=1 OR IF CHILDNUM=2, CONTINUE WITH HEQ.010.
NOTE: HEQ.010 IS NEW IN ROUND 8.
HEQ.010 During the past year, how frequently did you or another adult family member and {CHILD} participate in the following
activities together?
PROBE: Would you say you never, rarely, sometimes, or frequently?
CAPI INSTRUCTION: DISPLAY "PROBE:… frequently?" in SQUARE BRACKETS FOR B-M.
NEVER
Attending school activities
such as sports, plays, or concerts.
Would you say you never, rarely,
sometimes, or frequently?
b. Working on homework or school
projects
c. Attending concerts, plays, or movies
outside of school
d. Attending sporting events outside
of school
e. Attending religious services
f. Attending family social functions
such as a party or wedding
g. Taking day trips or vacations
h. Working on a hobby or playing sports
i. Going shopping
j. Going to restaurants/eating out
k. Spending time just talking together
l. Watching TV together
m. Doing something else fun together
RARELY
SOMETIMES FREQUENTLY
R
DK
a.
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
1
2
2
3
3
4
4
7
7
9
9
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
7
7
7
7
7
7
7
7
9
9
9
9
9
9
9
9
NOTE: BOX 1A IS NEW IN ROUND 8.
BOX 1a
IF (NumberofChildren=1) OR (Number of Children>1 AND ChildNum=1),
ASK HEQ.015. OTHERWISE, IF (NumberofChildren>1 and ChildNum=2),
GO TO HEQ.075.
NOTE: HEQ.015 IS NEW IN ROUND 8.
HEQ.015 Have you read a book in the last year?
YES ............................................................... 1 (HEQ.020)
NO................................................................. 2 (HEQ.075)
REFUSED ..................................................... 7 (HEQ.075)
DON'T KNOW ............................................... 9 (HEQ.075)
Round 8 Parent-HEQ- 25
NOTE: HEQ.020 IS NEW IN ROUND 8.
HEQ.020 What are the titles of the last two books you have read?
CAPI INSTRUCTION: ALLOW FOR 3 LINES TO ENTER TEXT
ENTER THE NAME OF THE FIRST BOOK.
OR
REFUSED ..................................................... 77 (HEQ.075)
DON'T KNOW ............................................... 99 (HEQ.075)
NOTE: HEQ.021 IS NEW IN ROUND 8.
HEQ.021 [What are the titles of the last two books you have read]?
CAPI INSTRUCTION: ALLOW FOR 3 LINES TO ENTER TEXT
ENTER THE NAME OF THE SECOND BOOK.
OR
DID NOT READ A SECOND BOOK.............. 66
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
NOTE: STEM OF QUESTION CHANGED. ALSO, ITEMS E – G OF HEQ.075 ARE NEW IN ROUND 8.
HEQ.075
Are there family rules for {CHILD} about any of the following…
a.
b.
c.
d.
e.
f.
g.
What programs {CHILD} can watch?...............................................
How early or late {he/she} may watch television?............................
How many hours {he/she} may watch television on weekdays?......
How many hours {he/she} may watch television each week? .........
Maintaining a certain grade point average?.....................................
Doing homework?............................................................................
How many hours {he/she} may spend on the computer or playing
video games each week? ................................................................
ROUND 8 Parent –HEQ-26
YES
1
1
1
1
1
1
NO
2
2
2
2
2
2
REF
7
7
7
7
7
7
DK
9
9
9
9
9
9
1
2
7
9
NOTE: HEQ.076 IS NEW IN ROUND 8.
HEQ.076 How often do you …
PROBE: Would you say never, rarely, sometimes, or always?
CAPI INSTRUCTION: DISPLAY "PROBE:…always?" in SQUARE BRACKETS FOR B-E.
NEVER
a.
b.
c.
d.
e.
Check that {CHILD}
has completed all homework?
Would you say never, rarely,
sometimes, or always?
Discuss {CHILD}'s report
card with {him/her}?
Know where {CHILD}
is when {he/she} is not at home or
in school?
Make and enforce curfews
for {CHILD}?
Require {CHILD}
to do work or chores?
RARELY SOMETIMES
ALWAYS
REF
DK
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
REF
DK
NOTE: HEQ.077 IS NEW IN ROUND 8.
HEQ.077 How often do you …
PROBE: Would you say never, rarely, sometimes, or always?
CAPI INSTRUCTION: DISPLAY "PROBE:…always?" in SQUARE BRACKETS FOR B.
NEVER
a. Meet the friends that {CHILD}
spends time with? Would
you say never, rarely,
sometimes, or always?
b. Approve of the friends
that {CHILD} spends time
with?
c. How often does {CHILD}
spend time with friends you
don’t approve of?
RARELY SOMETIMES
CHILD
HAS
NO
ALWAYS FRIENDS
1
2
3
4
5
7
9
1
2
3
4
5
7
9
1
2
3
4
5
7
9
ROUND 8 Parent –HEQ-27
NOTE: HEQ.080 IS NEW IN ROUND 8.
HEQ.080
How many days a week does {CHILD} spend most of the afternoon after school with adult supervision (for example, with
you or other relatives, coaches, or at work)?
HARD RANGE CHECK: 1 – 5 DAYS.
|___|___|
ENTER NUMBER OF DAYS
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
HEQ.090 Now I have some questions about {CHILD’s} homework. How often does {CHILD} do homework either at home or
somewhere else outside of school? Would you say…
PROBE: This refers to homework assigned by the school and not extra work provided by the parent.
Never, ...........................................................
Less than once a week, ................................
1 to 2 times a week, .....................................
3 to 4 times a week, or ..................................
5 or more times a week? ...............................
HOMEWORK ISN’T ASSIGNED ...................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
5
6
7
9
(HEQ.110)
(HEQ.091)
(HEQ.091)
(HEQ.091)
(HEQ.091)
(HEQ.110)
(HEQ.110)
(HEQ.110)
HEQ.091 Is there a place in your home that is set aside for {CHILD} to do homework?
YES ...............................................................
NO.................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
NOTE: HEQ.093 IS WORDED DIFFERENTLY IN ROUND 8.
HEQ.093 Does {CHILD) have someone who can help {him/her} with English homework?
YES ............................................................... 1 (HEQ.095)
NO................................................................. 2 (HEQ.096)
REFUSED ..................................................... 7 (HEQ.096)
DON'T KNOW ............................................... 9 (HEQ.096)
NOTE: HEQ.095 IS WORDED DIFFERENTLY IN ROUND 8.
HEQ.095 During this school year, how often did someone help {CHILD} with {his/her} English homework? Would you say…
Never, ........................................................... 1 (HEQ.096)
Less than once a week, ................................ 2 (HEQ.095b)
1 to 2 times a week, ..................................... 3 (HEQ.095b)
3 to 4 times a week, or .................................. 4 (HEQ.095b)
5 or more times a week? ............................... 5 (HEQ.095b)
REFUSED ..................................................... 7 (HEQ.095b)
DON'T KNOW ............................................... 9 (HEQ.095b)
NOTE: HEQ.095b IS WORDED DIFFERENTLY IN ROUND 8.
HEQ.095b Who usually helps {CHILD} with {his/her} English homework?
ROUND 8 Parent –HEQ-28
CODE ONLY ONE PERSON WHO HELPS THE MOST.
CAPI INSTRUCTION: DISPLAY “usually” IN UNDERLINED TEXT.
MOTHER ................................................................................................ 1
FATHER .................................................................................................. 2
SISTER OR BROTHER .......................................................................... 3
GRANDPARENT...................................................................................... 4
ANOTHER ADULT IN THE HOUSEHOLD .............................................. 5
SOMEONE AT AN AFTER SCHOOL PROGRAM ................................... 6
ADULTS WHO DON’T LIVE IN THE HOUSEHOLD ................................ 7
REFUSED ................................................................................................ 77
DON'T KNOW .......................................................................................... 99
HEQ.096 Does {CHILD) have someone who can help {him/her} with homework in math?
YES ...............................................................
NO.................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(HEQ.098)
(HEQ.100)
(HEQ.100)
(HEQ.100)
HEQ.098 During this school year, how often did someone help {CHILD} with {his/her} math homework? Would you say…
Never, ........................................................... 1 (HEQ.100)
Less than once a week, ................................ 2 (HEQ.099)
1 to 2 times a week, ..................................... 3 (HEQ.099)
3 to 4 times a week, or .................................. 4 (HEQ.099)
5 or more times a week? ............................... 5 (HEQ.099)
REFUSED ..................................................... 7 (HEQ.099)
DON'T KNOW ............................................... 9 (HEQ.099)
ROUND 8 Parent –HEQ-29
HEQ.099 Who usually helps {CHILD} with {his/her} math homework?
CODE ONLY ONE PERSON WHO HELPS THE MOST.
CAPI INSTRUCTION: DISPLAY “usually” IN UNDERLINED TEXT.
MOTHER ................................................................................................ 1
FATHER .................................................................................................. 2
SISTER OR BROTHER .......................................................................... 3
GRANDPARENT...................................................................................... 4
ANOTHER ADULT IN THE HOUSEHOLD .............................................. 5
SOMEONE AT AN AFTER SCHOOL PROGRAM ................................... 6
ADULTS WHO DON’T LIVE IN THE HOUSEHOLD ................................ 7
REFUSED ................................................................................................ 77
DON'T KNOW .......................................................................................... 99
NOTE: HEQ.100 IS NEW IN ROUND 8.
HEQ.100 Does {CHILD) have someone who can help {him/her} with homework in science?
YES ...............................................................
NO.................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(HEQ.101)
(BOX 2)
(BOX 2)
(BOX 2)
NOTE: HEQ.101 IS NEW IN ROUND 8.
HEQ.101 During this school year, how often did someone help {CHILD} with {his/her} science homework? Would you say…
Never, ........................................................... 1 (BOX 2)
Less than once a week, ................................ 2 (HEQ.102)
1 to 2 times a week, ..................................... 3 (HEQ.102)
3 to 4 times a week, or .................................. 4 (HEQ.102)
5 or more times a week? ............................... 5 (HEQ.102)
REFUSED ..................................................... 7 (HEQ.102)
DON'T KNOW ............................................... 9 (HEQ.102)
NOTE: HEQ.102 IS NEW IN ROUND 8.
HEQ.102 Who usually helps {CHILD} with {his/her} science homework?
CODE ONLY ONE PERSON WHO HELPS THE MOST.
CAPI INSTRUCTION: DISPLAY “usually” IN UNDERLINED TEXT.
MOTHER ................................................................................................ 1
FATHER .................................................................................................. 2
SISTER OR BROTHER .......................................................................... 3
GRANDPARENT...................................................................................... 4
ANOTHER ADULT IN THE HOUSEHOLD .............................................. 5
SOMEONE AT AN AFTER SCHOOL PROGRAM ................................... 6
ADULTS WHO DON’T LIVE IN THE HOUSEHOLD ................................ 7
REFUSED ................................................................................................ 77
DON'T KNOW .......................................................................................... 99
BOX 2
IF (NumberofChildren=1) OR (Number of Children>1 AND ChildNum=1),
ASK ALL OF HEQ.110. OTHERWISE, IF (NumberofChildren>1 and
ChildNum=2), ASK ONLY HEQ.110b.
ROUND 8 Parent –HEQ-30
HELP AVAILABLE
HEQ.110 {I'm going to read some statements about things that may occur in your family.} {Now I have some questions about
meals and other routines.} In a typical week, please tell me the number of days…
CAPI INSTRUCTION: DISPLAY “I’m…family” IF (Number of Children=1) OR IF (Number of Children>1 and
ChildNum=1.) OTHERWISE, IF (Number of Children >1 and ChildNum=2) DISPLAY “Now…routines.”
a.
b.
c.
d.
At least some of the family eats breakfast together.
{CHILD} has breakfast at a regular time.
Your family eats the evening meal together.
The evening meal is served at a regular time.
CAPI INSTRUCTIONS:
1.
DISPLAY "HELP AVAILABLE" WHEN ON B, C, AND D. DISPLAY THE FOLLOWING HELP TEXT FOR
B AND D: "Regular: Regular means generally around the same time." DISPLAY THE FOLLOWING
HELP TEXT FOR C: "Family: By family, we mean at least one adult and one child."
2.
WHEN ON B-D. DISPLAY "I'm going… days" IN SQUARE BRACKETS.
3.
DISPLAY "WEEK" IN UNDERLINED TEXT.
4.
HARD RANGE CHECK: 0-7 DAYS.
|___|
NUMBER OF DAYS
OR
REFUSED .................................................... 77
DON'T KNOW .............................................. 99
NOTE: BOX 2A IS NEW IN ROUND 8.
BOX 1a
IF (NumberofChildren=1) OR (Number of Children>1 AND ChildNum=1),
ASK HEQ.120. OTHERWISE, IF (NumberofChildren>1 and ChildNum=2),
GO TO HEQ.130.
NOTE: HEQ.120 IN ROUND 8 IS HEQ.400 FROM ROUND 6.
HEQ.120 Now, I have a question about your neighborhood. How safe is it for children to play outside during the day in your
neighborhood?
Would you say it's …
Not at all safe, ..............................................
Somewhat safe, or ........................................
Very safe? .....................................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent –HEQ-31
1
2
3
7
9
NOTE: HEQ.130A AND B IN ROUND 8 ARE FROM HEQ.420 IN ROUND 6.
HEQ.130 Now I would like to ask you about some things you might talk with {CHILD} about. In the past month, how often have
you talked with {CHILD} about...
PROBE:
Would you say not at all, a few times a month, a few times a week, or every day?
CAPI INSTRUCTION: DISPLAY “month” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY “Now…about…” and "PROBE:…day?" in SQUARE BRACKETS FOR B.
a.
b.
c.
d.
e.
{His/her} day at school?
Would you say not at all, a few times
a month, a few times a week, or
every day?
What {he/she} does with {his/her}
friends?
Talked about {his/her} school work
or grades?
Talked about things {he/she} is
doing at school?
Talked about (his/her) future.
NOT
AT
ALL
A
A FEW FEW
TIMES TIMES
A
A
EVERY
MONTH WEEK DAY REF
DK
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
1
2
2
3
3
4
4
7
7
9
9
NOTE: HEQ.140 IS HEQ.421 FROM ROUND 6.
HEQ.140 In the past year, how often have you talked with {CHILD} about...
PROBE: Would you say not at all, once, twice, or three or more times?
CAPI INSTRUCTION: DISPLAY “year” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "PROBE:…times?" in SQUARE BRACKETS FOR B-D.
a.
b.
The subjects of smoking
or tobacco use? Would you say
not at all, once, twice, or three
or more times?
The subject of drinking alcoholic
beverages, such as beer, wine,
or liquor?
ONCE
THREE
OR
MORE
TWICE TIMES REF
DK
1
2
3
4
7
9
1
2
3
4
7
9
NOT
AT
ALL
ROUND 8 Parent –HEQ-32
c.
d.
Topics related to sex, such as
sexual activity or sexually
transmitted diseases?
The subject of drug use, such as
marijuana, inhalants, or cocaine?
1
2
3
4
7
9
1
2
3
4
7
9
NOTE: HEQ.150 IS NEW IN ROUND 8.
HEQ.150 In the past year, how often have you {or {NAME OF SPOUSE/PARTNER}} discussed or shared information about the
following with {CHILD}?
PROBE: Would you say never, rarely, sometimes, or often?
CAPI INSTRUCTION: DISPLAY “year” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "PROBE:…often?" in SQUARE BRACKETS FOR B-D.
NEVER RARELY SOMETIMES OFTEN REF
a.
b.
c.
d.
Selecting courses or programs at
school? Would you say
never, rarely, sometimes, or
often?
Plans for after high school
Community, national, and world
events?
Things that are troubling {him/her}?
DK
1
1
2
2
3
3
4
4
7
7
9
9
1
1
2
2
3
3
4
4
7
7
9
9
NOTE: HEQ.160 IS NEW IN ROUND 8.
HEQ.160 How often would it be true for you to make each of the following statements about {CHILD}?
PROBE: Would you say never, sometimes, often, or always?
CAPI INSTRUCTION: DISPLAY "PROBE:…always?" in SQUARE BRACKETS FOR B-D.
NEVER SOMETIMES OFTEN ALWAYS REF DK
a.
b.
c.
d.
e.
You get along well with {him/her}.
Would you say
never, sometimes, often, or
always?
{CHILD} and you make decisions
about {his/her} life together?
You just do not understand {him/her}?
You feel you can really trust {him/her}?
{He/she} interferes with your activities
1
2
3
4
7
9
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
7
7
7
7
9
9
9
9
BOX 3
GO TO SCQ (SCHOOLING).
ROUND 8 Parent –HEQ-33
SCHOOLING -- SCQ
NOTE: SECTION SCQ IS NEW IN ROUND 8
BOX 1
IF CHILDNUM=1 OR IF CHILDNUM=2, CONTINUE WITH SCQ.005.
NOTE: SCQ.005 IS NEW IN ROUND 8.
SCQ.005 Now I would like to ask you about {CHILD}'s grades during this school year. Overall, across all subjects (he/she)
takes at school does (he/she) get...
Mostly A.s, ........................................................... 1
Mostly B.s, ........................................................... 2
Mostly C.s, ........................................................... 3
Mostly D.s, .......................................................... 4
Mostly F’s., or....................................................... 5
Does {CHILD}’s school not give these grades?.... 6
REFUSED , ......................................................... 7
DON’T KNOW ...................................................... 9
(SCQ.015)
(SCQ.015)
(SCQ.015)
(SCQ.015)
(SCQ.015)
(SCQ.010)
(SCQ.010)
(SCQ.010)
NOTE: SCQ.010 IS NEW IN ROUND 8.
SCQ.010 Would you describe (his/her) work at school as...
Excellent, ................................................ 1
Above average, ...................................... 2
Average, ................................................. 3
Below average, or................................... 4
Failing? ................................................... 5
REFUSED, .............................................. 7
DON'T KNOW, ........................................ 9
NOTE: SCQ.015 WAS PIQ.007 IN ROUND 6.
SCQ.015 Is {CHILD} in {his/her} regularly assigned school or a school that you {or {CHILD}’s parents} chose?
CAPI INSTRUCTIONS: IF THE RESPONDENT IS NOT A MOTHER/FATHER OR MALE/FEMALE GUARDIAN
(THIS INCLUDES BIRTH, ADOPTIVE, STEP, AND FOSTER PARENTS OR GUARDIANS) THEN DISPLAY "or
{CHILD}’s parents". OTHERWISE, USE A NULL DISPLAY.
ASSIGNED ...................................................
CHOSEN ......................................................
ASSIGNED SCHOOL IS SCHOOL OF
CHOICE......................................................
CHILD IS HOMESCHOOLED........................
REFUSED ....................................................
DON’T KNOW ...............................................
1 (SCQ.025)
2 (SCQ.020)
3
4
7
9
NOTE: SCQ.020 IS NEW IN ROUND 8.
SCQ.020 Is {his/her} school in your assigned school district?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
Round 8 Parent-SCQ- 34
1
2
7
9
(SCQ.025)
(BOX 2)
(SCQ.020)
(SCQ.020)
NOTE: SCQ.025 IS NEW IN ROUND 8.
SCQ.025. Has (CHILD) ever had an in- or out-of-school suspension?
YES ............................................................... 1 (SCQ.030)
NO ................................................................. 2 (SCQ.035)
REFUSED ..................................................... 7 (SCQ.035)
DON'T KNOW................................................ 9 (SCQ.035)
NOTE: SCQ.030 IS NEW IN ROUND 8.
SCQ.030 How many times was (CHILD) suspended?
HARD RANGE CHECK: 1 – 5 TIMES.
|___|
ENTER NUMBER OF TIMES
OR
REFUSED .....................................................
DON'T KNOW................................................
7
9
NOTE: SCQ.035 IS NEW IN ROUND 8.
SCQ.035 How much do you agree or disagree with each of the following statements about {CHILD}’s school?
PROBE: Would you say you strongly agree, agree, neither agree nor disagree, disagree, or strongly disagree?
CAPI INSTRUCTION: DISPLAY "PROBE:…strongly disagree?" in SQUARE BRACKETS FOR B-E.
STRONGLY
AGREE
AGREE
a.
b.
c.
d.
e.
{CHILD}’s school
places a high priority on
learning. Would you say you
strongly agree, agree, neither
agree nor disagree, disagree, or
strongly disagree?
{CHILD}’s school is
a safe place.
{CHILD}’s school is
a good school.
Violence is a problem
at (CHILD)’s school.
Drinking or drugs is
a problem at (CHILD)’s school.
NEITHER
AGREE
NOR
DISAGREE
STRONGLY
DISAGREE DISAGREE
R DK
1
2
3
4
5
7
9
1
2
3
4
5
7
9
1
2
3
4
5
7
9
1
2
3
4
5
7
9
1
2
3
4
5
7
9
ROUND 8 Parent – SCQ-35
NOTE: SCQ.040 IS NEW IN ROUND 8.
SCQ.040 How satisfied are you with the education {CHILD} has received in {his/her} current school?
Very satisfied, ................................................
Somewhat satisfied,.......................................
Somewhat dissatisfied, or..............................
Very dissatisfied?...........................................
REFUSED .....................................................
DON'T KNOW................................................
BOX 2
GO TO CFQ (CRITICAL FAMILY PROCESSES)
ROUND 8 Parent – SCQ-36
1
2
3
4
7
9
CRITICAL FAMILY PROCESSES – CFQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren> 1 AND ChildNum = 1),
CONTINUE WITH BOX 2. OTHERWISE, GO TO BOX 6.
BOX 2
IF FSQ.110=1 (Partner currently living in household), ASK QUESTION CFQ.100.
OTHERWISE, GO TO CFQ.110.
CFQ.100 Now, I'd like to ask a question about your relationship with {NAME OF CURRENT SPOUSE/PARTNER}.
Would you say that your relationship is…
CAPI INSTRUCTION: DISPLAY NAME OF SPOUSE/PARTNER FROM FSQ.120.
Very happy, ...................................................
Fairly happy, or .............................................
Not too happy? ..............................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
7
9
NOTE: CFQ.101 IS NEW IN ROUND 8.
CFQ.101 The following statements describe the way some people feel about their spouse or partner and their
relationship in general. Please tell me whether you strongly agree, agree, disagree, or strongly disagree with
the following statements.
PROBE: Would you say you strongly agree, agree, disagree, or strongly disagree?
CAPI INSTRUCTION: DISPLAY "PROBE:…strongly disagree?" in SQUARE BRACKETS FOR B-E.
CAPI INSTRUCTIONS: In “G” DISPLAY “{CHILD}” IF NumberOfChildren = 1. DISPLAY “our children” IF
NumberOfChildren > 1.
STRONGLY
AGREE
AGREE
a.
b.
c.
d.
e.
f.
g.
We enjoy doing even
ordinary, day-to-day things
together. Would you say
you strongly agree, agree,
disagree, or strongly
disagree?
I am satisfied with the way
we handle our problems
and disagreements.
I view our relationship as
lifelong
My partner listens to me
when I need someone
to talk to.
My partner expresses
love and affection to me.
I trust my partner to be
faithful to me.
We are BOTH committed
to being there for
{{CHILD}/our children}
DISAGREE
STRONGLY
DISAGREE
7
DK
1
2
3
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
2
3
ROUND 8 Parent –CFQ-37
4
7
9
1
4
REF
9
NOTE: CFQ.105 IS NEW IN ROUND 8.
CFQ.105 Couples deal with serious disagreements in different ways. When you have a serious disagreement with your
spouse or partner, how often do you…
PROBE: Would you say never, rarely, sometimes, or often?
CAPI INSTRUCTION: DISPLAY "PROBE:…often?" in SQUARE BRACKETS FOR B-G.
NEVER
a.
b.
c.
d.
e.
f.
g.
Stop speaking to each
other? Would you say
never, rarely, sometimes,
or often?
Discuss your disagreements
calmly?
Argue heatedly or shout at
each other?
End up pushing, hitting,
or throwing things
at each other?
Reach a compromise?
Criticize each other?
Argue in front of {CHILD}?
RARELY
SOMETIMES OFTEN
REF
DK
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
1
1
1
2
2
2
2
3
3
3
3
4
4
4
4
7
7
7
7
9
9
9
9
NOTE: CFQ.110 IS NEW IN ROUND 8.
CFQ.110 How often did you attend religious services in the past year? Would you say….
Never or almost never , .................................
Several times a year, ....................................
Several times a month, ..................................
Once a week, or ............................................
Several times a week?, .................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
5
7
9
NOTE: CFQ.120 IS NEW IN ROUND 8.
CFQ.120 {Regardless of whether you now attend any religious services} do you {or {NAME OF SPOUSE/PARTNER}}
ever think of {yourself/yourselves} as part of a particular religion?
{PROBE IF NECESSARY: If the answer is “yes” for either yourself or {NAME OF SPOUSE/PARTNER},
answer “yes” to this question.}
CAPI INSTRUCTION: DISPLAY “Regardless…services” IF CFQ.110=1, 7 OR 9.
DISPLAY “Do you” IF (CFQ.110 = 2, 3, 4, OR 5). DISPLAY “do you” IF (CFQ.110 = 1, 7, OR 9).
DISPLAY “{or {NAME OF SPOUSE/PARTNER}}” IF THERE IS A SPOUSE/PARTNER IN THE
HOUSEHOLD.
DISPLAY “{PROBE…question.}” IF THERE IS A SPOUSE/PARTNER IN THE HOUSEHOLD.
DISPLAY “yourselves” IF THERE IS A SPOUSE/PARTNER IN THE HOUSEHOLD. OTHERWISE,
DISPLAY “yourself.”
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent –CFQ-38
1
2
7
9
NOTE: CFQ.190 IS NEW IN ROUND 8.
CFQ.190 How important are your religious beliefs in influencing how you raise {{CHILD}/your children}? Would you say…
CAPI INSTRUCTIONS: DISPLAY “{CHILD}” IF NumberOfChildren = 1. DISPLAY “our children” IF
NumberOfChildren > 1.
Very important, ..............................................
Important, .....................................................
Somewhat important,.....................................
Not at all important, or ...................................
Do you have no religion or religious
belief system?,...............................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
5
7
9
NOTE: CFQ.200 IS NEW IN ROUND 8.
CFQ.200. In terms of your political views, would you consider yourself to be
A liberal, ........................................................
A conservative, .............................................
A moderate, or...............................................
Haven't you thought much about this?...........
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
7
9
BOX 3
IF CFQ.200 = 1, GO TO CFQ.210.
IF CFQ.200 = 2, GO TO CFQ.220.
IF CFQ.200 = 3, GO TO CFQ.230.
IF CFQ.200 = 4, GO TO CFQ.230.
ELSE GO TO BOX 4.
NOTE: CFQ.210 IS NEW IN ROUND 8.
CFQ.210. Do you consider yourself to be strongly liberal or just liberal?
STRONGLY LIBERAL ...................................
LIBERAL .......................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
BOX 4
GO TO BOX 6.
NOTE: CFQ.220 IS NEW IN ROUND 8.
CFQ.220. Do you consider yourself to be strongly conservative or just conservative?
STRONGLY CONSERVATIVE......................
CONSERVATIVE .........................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent –CFQ-39
1
2
7
9
BOX 5
GO TO BOX 6.
NOTE: CFQ.230 IS NEW IN ROUND 8.
CFQ.230. Do you think of yourself as more like liberals or conservatives?
CLOSER TO LIBERALS................................
CLOSER TO CONSERVATIVES .................
NEITHER ......................................................
REFUSED .....................................................
DON’T KNOW ...............................................
BOX 6
GO TO SECTION DWQ (DISCIPLINE, WARMTH, AND EMOTIONAL
SUPPORTIVENESS).
ROUND 8 Parent –CFQ-40
1
2
3
7
9
DISCIPLINE, WARMTH, AND EMOTIONAL SUPPORTIVENESS -- DWQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1), GO TO
DWQ.100. OTHERWISE, IF (NumberOfChildren > 1 AND ChildNum =2), GO TO
DWQ.200
NOTE: THE FIRST THREE CATEGORIES IN DWQ.100 ARE NEW IN ROUND 8.
DWQ.100 Most teenagers misbehave or get into trouble from time to time. When {CHILD} misbehaves, what do you {or
{NAME OF SPOUSE/PARTNER}} typically do?
PROBE IF NECESSARY: Anything else?
CODE ALL THAT APPLY.
Ground {him/her} or put {him/her}
on restriction, ................................................
Take away {his/her} allowance, ....................
Hit or slap {him/her}, .....................................
Talk to {him/her} about what {he/she}
did wrong, .....................................................
Ignore it, .......................................................
Make {him/her} do some work around
the house, .....................................................
Make fun of {him/her}, ..................................
Make {him/her} apologize, ............................
Take away a privilege, ..................................
Give a warning, ............................................
Yell at {CHILD} or threaten {him/her}, or........
Something else?............................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
5
6
7
8
9
10
11
12
77
99
NOTE: DWQ.200a-c ARE NEW IN ROUND 8.
DWQ.200
How many times in the past week have you ...
HARD RANGE CHECK: 0 – 21 TIMES.
a. Told (CHILD) that you love (him/her)?
|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED.................................................... 77
DON'T KNOW.............................................. 99
b. Praised {CHILD} for doing something worthwhile?
|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED.................................................... 77
DON'T KNOW.............................................. 99
ROUND 8 Parent – DWQ-41
c. Shown {CHILD} physical affection such as kiss, hug, or pat or rub (his/her) back?
|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
BOX 2
GO TO SECTION NRQ (NON-RESIDENT PARENT QUESTIONS).
ROUND 8 Parent – DWQ-42
NON-RESIDENT PARENT QUESTIONS -- NRQ
BOX 1
IF BOTH BIOLOGICAL PARENTS (ACCORDING TO THE ROSTER, AT LEAST
ONE HOUSEHOLD MEMBER IS A BIRTH MOTHER AND AT LEAST ONE
HOUSEHOLD MEMBER IS A BIRTH FATHER) ARE CURRENTLY LIVING
TOGETHER IN THE HOUSEHOLD, GO TO BOX 10.
OTHERWISE, CONTINUE WITH BOX 2.
BOX 2
LOOP 1
ASK BOX 3 - NRQ.050 ONE TIME FOR EACH BIOLOGICAL MOTHER,
ADOPTIVE MOTHER, BIOLOGICAL FATHER, AND ADOPTIVE FATHER
NOT LIVING IN THE HOUSEHOLD. DEFINE RELATIONSHIPS ACCORDING
TO THE CURRENT ROSTER.
DETERMINING LOOPING ELIGIBILITY:
1.
BIOLOGICAL MOTHER: NO HOUSEHOLD MEMBER WHO IS A BIRTH
MOTHER
2. ADOPTIVE MOTHER NOT IN HH: NO BIOLOGICAL OR ADOPTIVE
MOTHER IN HOUSEHOLD, BUT ADOPTIVE FATHER IS IN THE
HOUSEHOLD.
3. BIOLOGICAL FATHER: NO HOUSEHOLD MEMBER WHO IS A BIRTH
FATHER.
4. ADOPTIVE FATHER NOT IN HH: NO BIOLOGICAL OR ADOPTIVE
FATHER IN HOUSEHOLD, BUT ADOPTIVE MOTHER IS IN THE
HOUSEHOLD
5. IF NRQ.100 = 5 (PARENT DECEASED) IN ANY PREVIOUS ROUND
FOR ANY OF THE BIOLOGICAL NON-RESIDENT PARENTS, DO NOT
LOOP ON THIS PARENT. IF NRQ.100 = 5 (PARENT DECEASED) IN
ROUNDS 4, 5, OR 6 FOR ANY OF THE ADOPTIVE NON-RESIDENT
PARENTS, DO NOT LOOP ON THIS PARENT.
•
IF THERE ARE ANY ELIGIBLE CASES ACCORDING TO THE LOOPING RULES
ABOVE, GO TO BOX 3 FOR EACH ELIGIBLE CASE UNTIL ALL ELIGIBLES
HAVE BEEN ASKED ABOUT IN THE QUESTIONS. ELSE, GO TO BOX 10.
BOX 3
IF NumberOfChildren = 1 OR
IF NumberOfChildren >1 AND ChildNum = 1,
GO TO NRQ.100
OTHERWISE, CONTINUE WITH BOX 4.
BOX 4
IF NRQ.100 = 5 (PARENT DECEASED), 6 (NO CONTACT SINCE ADOPTION), 7
(NO ADOPTIVE PARENT), DK, OR REF FOR ChildNum = 1, GO TO BOX 8.
OTHERWISE, CONTINUE WITH NRQ.050.
ROUND 8 Parent – NRQ-43
NRQ.050
Did {CHILD 2} have the same amount of contact with {his/her} {biological/adoptive} {mother/father} as
{CHILD}?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
NRQ.100
1
2
7
9
(BOX 8)
(NRQ.100)
(BOX 8)
(BOX 8)
The next questions are about {CHILD}'s contact with {his/her} (biological/adoptive) (father/mother).
[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 {his/her} biological parents. Any
information you can provide will be helpful.]
How long has it been since {CHILD} last had a visit, a phone call, or received a card or letter from
{his/her} (biological/adoptive) (father/mother)? Would you say …
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
DISPLAY '[WE…HELPFUL]' IF THERE ARE NO BIRTH PARENTS IN THE HOUSEHOLD.
OTHERWISE, USE A NULL DISPLAY.
DISPLAY 'FOR ADOPTIVE PARENTS' IF THE RESPONDENT IS AN ADOPTIVE FATHER OR
MOTHER.
Less than one month, .................................... 1 (NRQ.110)
More than a month but less
than a year,................................................ 2 (BOX 5)
More than a year, or ...................................... 3 (BOX 5)
No contact since birth? .................................. 4 (BOX 8)
PARENT IS DECEASED ............................... 5 (BOX 8)
NO CONTACT SINCE ADOPTION ............... 6 (BOX 8)
NO ADOPTIVE (MOTHER/FATHER)............ 7 (BOX 8)
REFUSED ..................................................... 77 (BOX 8)
DON'T KNOW ............................................... 99 (BOX 8)
Round 7 Parent – NRQ-44
NRQ.110
How many days has {CHILD} seen {his/her} {biological/adoptive} {father/mother} in the past 4 weeks?
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
HARD RANGE CHECK: 0 – 28 DAYS.
|___|___|
ENTER NUMBER OF DAYS
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
NRQ.115
How many nights did {CHILD} and (his/her) (biological/adoptive) {father/mother} sleep in the same house
in the past 4 weeks?
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
HARD RANGE CHECK: 0 – 28 DAYS.
|___|___|
ENTER NUMBER OF DAYS
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
NRQ.116
Did {CHILD}’s (biological/adoptive) {father/mother} miss any scheduled visits with {CHILD} in the past 4
weeks?
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent – NRQ-45
1
2
7
9
NRQ.117
How many times have {CHILD} and (his/her) (biological/adoptive) {father/mother} talked on the
telephone to each other in the past 4 weeks?
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
HARD RANGE CHECK: 0 – 28 DAYS.
|___|___|
ENTER NUMBER OF DAYS
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
BOX 5
NRQ.120
IF NumberOfChildren = 1 OR IF NumberOfChildren >1 AND Childnum = 1,
CONTINUE WITH NRQ.120. OTHERWISE, GO TO BOX 7.
Since the beginning of this school year has {CHILD}'s {biological/adoptive} {mother/father}...
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
CAPI INSTRUCTIONS: DISPLAY "Since….father" in SQUARE BRACKETS WHEN ON B-D.
a.
b.
c.
d.
NO
REF
DK
YES
Attended an open house or a back-to-school night?........................ .......1 ........... 2 ........... 7.......... 9
Gone to a regularly-scheduled parent-teacher conference with
{CHILD}'s teacher or meeting with {CHILD}'s teacher? ................... .......1 ........... 2 ........... 7.......... 9
Attended a school or class event, such as a play or sport
event or science fair?....................................................................... .......1 ........... 2 ........... 7.......... 9
Volunteered at the school or served on a committee? ..................... .......1 ........... 2 ........... 7.......... 9
ROUND 8 Parent – NRQ-46
NRQ.250
How many minutes does {CHILD}'s {biological/adoptive} {mother/father} live from {him/her}?
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
10 MINUTES OR LESS.................................
11-30 MINUTES ............................................
31-59 MINUTES ............................................
1-2 HOURS ...................................................
MORE THAN 2 HOURS ................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
5
7
9
NOTE: NRQ.251 WAS NRQ.252 IN ROUND 6
NRQ.251
During the last year, how often has {CHILD}’s {biological/adoptive} {mother/father} paid for {CHILD}’s
medical insurance, doctor bills, or medicines, separate from child support?
Has {he/she} helped pay for these…..
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL MOTHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY BIOLOGICAL FATHER FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE MOTHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY ADOPTIVE FATHER FOR
THE PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH OR ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY "she" FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH OR ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY "he" FOR THE
PARTICULAR LOOP R IS ON.
Often, ............................................................
Sometimes, ...................................................
Hardly ever, or ..............................................
Never?...........................................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent – NRQ-47
1
2
3
4
7
9
NOTE: BOX 6 IS NEW IN ROUND 8.
BOX 6
IF NRQ.251 = 1, 2, OR 3, GO TO NRQ.252. OTHERWISE, GO TO NRQ.253.
NOTE: NRQ.252 IS NEW IN ROUND 8.
NRQ.252 How much of (CHILD)’s medical expenses does (biological/adoptive) (father/mother) pay for? Would you say…
CAPI INSTRUCTION: DISPLAY “or” IN RESPONSE CATEROGY 2 AND DISPLAY “?” IN RESPONSE
CATEGORY 3 IF NRQ.251 = 3.
CAPI INSTRUCTION: DISPLAY “,or” IN RESPONSE CATEGORY 3 AND “All” IN RESPONSE CATEGORY 4
IF NRQ.251 = 1 OR 2.
Less than half, ..............................................
About half, {or}, .............................................
More than half {?} {,or } .................................
{All?} ..............................................................
REFUSED .....................................................
DON’T KNOW ...............................................
NRQ.253
1
2
3
4
7
9
What about other bills or expenses for {CHILD}? In the last year, has {he/she} helped pay for these….
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH OR ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY "she" FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS A BIRTH OR ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY "he" FOR THE
PARTICULAR LOOP R IS ON.
Often, ............................................................
Sometimes, ...................................................
Hardly ever, or ..............................................
Never?...........................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
7
9
NOTE: BOX 6a IS NEW IN ROUND 8.
BOX 6a
IF NRQ.253 = 1, 2, OR 3, GO TO NRQ.254. OTHERWISE, GO TO BOX 7.
ROUND 8 Parent – NRQ-48
NOTE: NRQ.254 IS NEW IN ROUND 8.
NRQ.254 How much of these other bills or expenses for (CHILD)’s does {his/her} (biological/adoptive) (father/mother) pay
for? Would you say…
CAPI INSTRUCTION: DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her” IF THE CHILD IS FEMALE.
CAPI INSTRUCTION: DISPLAY “or” IN RESPONSE CATEGORY 2 AND DISPLAY “?” IN RESPONSE
CATEGORY 3 IF NRQ.253 = 3.
CAPI INSTRUCTION: DISPLAY “,or” IN RESPONSE CATEGORY 3 AND “All” IN RESPONSE CATEGORY 4
IF NRQ.253 = 1 OR 2.
Less than half, ..............................................
About half, {or}, .............................................
More than half {?} {,or } .................................
{All?} ..............................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
7
9
BOX 7
ASK NRQ.100 TO NRQ.254 FOR THE NEXT NON-RESIDENTIAL PARENT, IF
NO NEXT NON-RESIDENTIAL PARENT, GO TO BOX 9.
BOX 8
IF NRQ.100=5 (PARENT DECEASED), 6 (NO CONTACT SINCE ADOPTION), 7
(NO ADOPTIVE PARENT), DK, OR RF FOR ALL THE NON-RESIDENT
PARENTS OF THE FIRST CHILD (NUMBEROFCHILDREN=1 OR
(NUMBEROFCHILDREN>1 AND CHILDNUM=1)), GO TO BOX 10.
IF (NUMBEROFCHILDREN>1 AND CHILDNUM=2), GO TO BOX 10.
OTHERWISE, CONTINUE WITH NRQ.261.
NRQ.261 Next, I'd like to ask some questions about child support. Have child support payments for {CHILD} ever been
awarded by a court or a judge, agreed to in writing, agreed to informally, or do you not have an agreement of
any kind?
CODE ALL THAT APPLY. '5' CANNOT BE CODED WITH ANY OTHER RESPONSE OPTION.
YES, AWARDED BY A COURT .................... 1 (BOX 9)
YES, AGREED TO IN WRITING ................... 2 (BOX 9)
YES, AGREED TO INFORMALLY ................ 3 (BOX 9)
YES, AWARD PENDING............................... 4 (BOX 9)
NO AGREEMENT ......................................... 5 (BOX 10)
OTHER (SPECIFY)____________________ 91 (NRQ.261OS)
REFUSED ..................................................... 7 (BOX 10)
DON'T KNOW ............................................... 9 (BOX 10)
NRQ.261OS What kind of agreement do you have?
SPECIFY AGREEMENT.
CAPI INSTRUCTION: DK AND RF DISALLOWED.
ROUND 8 Parent – NRQ-49
BOX 9
NRQ.264
IF MORE THAN 1 NONRESIDENT PARENT CONTINUE WITH NRQ.264.
OTHERWISE, GO TO NRQ.265.
What parent do you have this agreement with?
PROBE: Any other parent?
CODE ALL THAT APPLY.
CAPI INSTRUCTION: DK AND RF DISALLOWED.
{CHILD}'S BIOLOGICAL FATHER ................
{CHILD}'S BIOLOGICAL MOTHER ...............
{CHILD}'S ADOPTIVE FATHER ....................
{CHILD}'S ADOPTIVE MOTHER...................
NRQ.265
In the past year were you supposed to receive any child support payments for {CHILD}?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
NRQ.266
1
2
3
4
1
2 (BOX 10)
7 (BOX 10)
9 (BOX 10)
During the last year, have you received this money regularly, so that you could almost always count on
getting the money?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
BOX 10
GO TO SECTION PLQ (PRIMARY LANGUAGE(S) SPOKEN).
ROUND 8 Parent – NRQ-50
1
2
7
9
PRIMARY LANGUAGE(S) SPOKEN -- PLQ
NOTE: THIS SECTION IS FROM ROUND 1 OF ECSL-K.
BOX 1
IF MORE THAN 1 SAMPLED CHILD TO BE ASKED ABOUT AND
CURRENTLY ASKING ABOUT CHILD 2 AND ONLY ENGLISH IS SPOKEN IN
THE HOME (PLQ.020 = 2, 7, OR 9 FOR CHILD 1), GO TO BOX 3.
IF MORE THAN 1 SAMPLED CHILD TO BE ASKED ABOUT AND
CURRENTLY ASKING ABOUT CHILD 2 AND ANOTHER LANGUAGE,
OTHER THAN ENGLISH, IS SPOKEN IN THE HOME (PLQ.020 = 1 FOR
CHILD 1), GO TO PLQ.080.
OTHERWISE, CONTINUE WITH PLQ.020.
NOTE: PLQ.020 IS FROM ROUND 1 OF ECSL-K.
PLQ.020
Is any language other than English regularly spoken in your home?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
NOTE: PLQ.030 IS FROM ROUND 1 OF ECSL-K.
PLQ.030
Is English also spoken in your home?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
NOTE: PLQ.040 IS FROM ROUND 1 OF ECSL-K.
PLQ.040
What languages other than English are spoken in your home?
CODE ALL THAT APPLY
ARABIC .......................................
CHINESE.....................................
FILIPINO LANGUAGE.................
FRENCH......................................
GERMAN.....................................
GREEK ........................................
ITALIAN .......................................
JAPANESE..................................
1
2
3
4
5
6
7
8
KOREAN ....................................... 9
POLISH ....................................... 10
PORTUGUESE ........................... 11
SPANISH .................................... 12
VIETNAMESE ............................. 13
SOME OTHER LANGUAGE
(SPECIFY) _________________ 14
REFUSED .................................... 77
DON’T KNOW .............................. 99
ROUND 8 Parent – PLQ-51
(PLQ.030)
(BOX 3)
(BOX 3)
(BOX 3)
BOX 2
IF ONLY ONE LANGUAGE SPOKEN IN THE HOME (PLQ.030 = 2, 7, OR 9
AND ONLY ONE LANGUAGE IS CODED AT PLQ.040 OR PLQ.040 = 77 OR
99), GO TO PLQ.070.
OTHERWISE, CONTINUE WITH PLQ.060.
NOTE: PLQ.060 IS FROM ROUND 1 OF ECSL-K.
PLQ.060
What is the primary language spoken in your home?
CODE ‘15’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
ENGLISH.....................................
ARABIC .......................................
CHINESE.....................................
FILIPINO LANGUAGE.................
FRENCH......................................
GERMAN.....................................
GREEK ........................................
ITALIAN .......................................
JAPANESE..................................
KOREAN ....................................... 9
POLISH ....................................... 10
PORTUGUESE ........................... 11
SPANISH .................................... 12
VIETNAMESE ............................. 13
SOME OTHER LANGUAGE
(SPECIFY) _________________ 14
REFUSED .................................... 77
DON’T KNOW .............................. 99
0
1
2
3
4
5
6
7
8
NOTE: PLQ.070 IS FROM ROUND 1 OF ECSL-K.
PLQ.070
How well do you . . .
PROBE: Would you say very well, pretty well, not very well, or not well at all?
CAPI INSTRUCTION: DISPLAY “PROBE…not well at all?” in SQUARE BRACKETS FOR B-D.
VERY
WELL
a. Speak English? Would you
say very well, pretty well, not
very well or not well at all?
b. Read English?
c. Write English?
d. Understand someone speaking
English?
NOT
PRETTY VERY
WELL
WELL
NOT WELL
AT ALL
REF
DK
1
1
1
2
2
2
3
3
3
4
4
4
7
7
7
9
9
9
1
2
3
4
7
9
ROUND 8 Parent – PLQ-52
NOTE:
PLQ.080
PLQ.080 IS FROM ROUND 1 OF ECSL-K BUT IS LIMITED TO FOCAL CHILDREN AND KEY PARENT
FIGURES IN ROUND 8. THE SPEC IS SIMILAR TO WHAT WAS USED IN ROUND 1 AND INCLUDES TWO
ITEMS, PLQ.083 AND PLQ.090.
How often {do/does} {{you/{NAME}}/{CHILD}} use {{NON-ENGLISH LANGUAGE}/a language other than
English} in speaking to {{CHILD}/{you/{NAME}}}? Would you say never, sometimes, often, or very often?
IF MORE THAN ONE NON-ENGLISH LANGUAGE SPOKEN, SAY: On average, how often {do/does}
{{you/{NAME}}/{CHILD}} use all languages, other than English, in speaking to {{CHILD}/{you/{NAME}}}?
PROBE: We just need to know in general.
First Name
PLQ.083 {NAME} speaking to
{CHILD}?
PLQ.090 {CHILD} speaking
to {NAME}?
{Display HH Member Name}
|___|
|___|
{Display HH Member Name}
|___|
|___|
CAPI ROSTER INSTRUCTION: DISPLAY IN COLUMN 1 PERSONS ENUMERATED ON THE
HOUSEHOLD ROSTER WHO ARE KEY PARENT FIGURES (UP TO TWO PERSONS).
CAPI MATRIX INSTRUCTIONS:
1. THE FIRST COLUMN OF THE MATRIX (FIRST NAME) IS READ ONLY (SEE CAPI ROSTER
INSTRUCTIONS ABOVE).
2. WHEN CURSOR IS POSITIONED IN THE SECOND COLUMN (PLQ.083), DISPLAY "HOW OFTEN
{DO/DOES} {YOU/{NAME}} USE {NON-ENGLISH LANGUAGE}/A LANGUAGE OTHER THAN
ENGLISH} IN SPEAKING TO {CHILD}? WOULD YOU SAY NEVER, SOMETIMES, OFTEN, OR VERY
OFTEN?" AND "IF MORE THAN ONE NON-ENGLISH LANGUAGE SPOKEN, SAY: ON AVERAGE,
HOW OFTEN {DO/DOES} {YOU/{NAME}} USE ALL LANGUAGES, OTHER THAN ENGLISH, IN
SPEAKING TO {CHILD}?"
3. WHEN CURSOR IS POSITIONED IN THE THIRD COLUMN {PLQ.090}, DISPLAY "HOW OFTEN DOES
{CHILD} USE {{NON-ENGLISH LANGUAGE}/A LANGUAGE OTHER THAN ENGLISH} IN SPEAKING
TO {YOU/{NAME}}? WOULD YOU SAY NEVER, SOMETIMES, OFTEN, OR VERY OFTEN?" AND "IF
MORE THAN ONE NON-ENGLISH LANGUAGE SPOKEN, SAY: ON AVERAGE, HOW OFTEN DOES
{CHILD} USE ALL LANGUAGES, OTHER THAN ENGLISH, IN SPEAKING TO {YOU/{NAME}}."
4. CURSOR WILL MOVE FROM PLQ.083 TO PLQ.090 FOR SAME PERSON AND THEN WILL MOVE TO
PLQ.083 FOR NEXT PERSON, ETC. THE CURSOR WILL MOVE IN THIS FASHION UNTIL ALL
FIELDS ARE COMPLETED.
5. INTERVIEWER CANNOT LEAVE THE MATRIX UNTIL ALL FILES ARE ACCOUNTED FOR.
Never, ...........................................................
Sometimes, ...................................................
Often, or .......................................................
Very often? ....................................................
REFUSED .....................................................
DON’T KNOW ...............................................
BOX 3
GO TO SECTION CHQ (CHILD HEALTH AND WELL BEING).
ROUND 8 Parent – PLQ-53
1
2
3
4
7
9
CHILD HEALTH AND WELL BEING -- CHQ
BOX 1
ASK SECTION CHQ ABOUT EACH SAMPLED CHILD.
CHQ.010
Now I have some questions about {CHILD}'s health and well-being. For the next set of questions, please
base your answers on how {CHILD} compares to other teenagers of the same age.
Would you say {CHILD} is independent and takes care of {himself/herself} ...
Better than other teenagers {his/her} age, ....
As well as other teenagers, ...........................
Slightly less well than other teenagers, or .....
Much less well than other teenagers? ...........
REFUSED ....................................................
DON'T KNOW ..............................................
CHQ.020
Does {CHILD} pay attention ....
Better than other teenagers {his/her} age, ....
As well as other teenagers, ...........................
Slightly less well than other teenagers, or .....
Much less well than other teenagers? ...........
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.030
1
2
3
4
7
9
1
2
3
4
7
9
Does {CHILD} learn, think, and solve problems ...
Better than other teenagers {his/her} age, ....
As well as other teenagers, ...........................
Slightly less well than other teenagers, or ....
Much less well than other teenagers? ..........
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
3
4
7
9
BOX 2
IF CHILD HAS PROBLEMS WITH PAYING ATTENTION (CHQ.020 = 3 or 4) OR
CHILD HAS PROBLEMS WITH LEARNING, THINKING AND SOLVING
PROBLEMS (CHQ.030 = 3 OR 4), CONTINUE WITH CHQ.040.
OTHERWISE, GO TO CHQ.080.
Round 7 Parent – CHQ-54
HELP AVAILABLE
CHQ.040
Has {CHILD} ever been evaluated by a professional in response to {his/her} ability to pay attention or
learn?
IF R INCLUDES EVALUATION OF OVERALL ACTIVITY LEVEL, SAY:
evaluation of {CHILD}'s attention span only.
Please answer for the
CAPI INSTRUCTION: DISPLAY "IF … SAY: " IN LIGHT BLUE AND DISPLAY "Please ….only" IN
BLACK.
HELP TEXT: Professional: 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.
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.050
1
2 (CHQ. 080)
7 (CHQ. 080)
9 (CHQ. 080)
Did you obtain a diagnosis of a problem from a professional?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ. 080)
7 (CHQ. 080)
9 (CHQ. 080)
HELP AVAILABLE
NOTE: THE ADDITION OF DYSCALCULIA TO CATEGORY 6 OF CHQ.060 IS NEW IN ROUND 8. IT IS NOT A NEW
CATEGORY BUT A NEW NAME OF A DISABILITY IN THE CATEGORY WITH DYSLEXIA.
CHQ.060
What was the diagnosis?
PROBE: What was the primary diagnosis?
HELP TEXT:
Learning disability: This is a disorder in one or more of the basic psychological processes involved in
understanding or in using language (spoken or written) which shows up as difficulty to listen, think,
speak, read, write, spell, or do mathematical calculations. In some cases the child can perform at grade
level, but only with special help. Some names of learning disabilities are dyslexia (CODE UNDER
DYSLEXIA), developmental aphasia, minimal brain dysfunction, and brain injury. The term does not
include learning problems that are primarily the result of problems with seeing, hearing, or walking,
mental retardation, emotional disturbance, or environmental, cultural, or economic disadvantage. A
commonly used acronym is "LD."
Attention Deficit Disorder (ADD): A childhood syndrome characterized by short attention span that is
inappropriate for his/her age group.
Attention Deficit Hyperactivity Disorder (ADHD): The child displays signs of inattention, impulsivity,
and hyperactivity that are inappropriate for his or her mental and chronological age. Adults in the child’s
environment, such as parents and teachers must report the signs. 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. Onset is typically before age seven and condition lasts at least six months.
ROUND 8 Parent – CHQ-55
Developmental delay: A condition in which a young child falls significantly behind his/her age-mates in
physical, mental, social/emotional, or speech development. It does not simply mean that the child talked
somewhat later than some children talked or was smaller than average. Not to be confused with autism
or pervasive developmental delay. If the child's social behavior and relationships with other people are
generally consistent with his or her delayed cognitive development, then the classification of the
condition as developmental delay is probably appropriate. If this is not the case, see the definitions of
autism and pervasive developmental disorder or delay.
Autism is a pervasive lack of responsiveness to other people that has its onset before 30 months of age.
Other defining characteristics are that the impaired social development and delayed or deviant language
development are not merely predictable from the child's cognitive retardation. Some autistic children are
actually advanced in their reading skills, memory skills, or musical abilities. There is also an insistence
on sameness, as shown by stereotyped play, abnormal preoccupations, or resistance to change.
Pervasive developmental disorder or delay is also characterized by gross and sustained impairment
in social relationships, but typically has an onset after 30 months of age. Other characteristics are
sudden excessive anxiety, inappropriate affect or emotions, resistance to change in the environment,
oddities of motor movement, abnormalities of speech, hypersensitivity to sensory stimuli, and selfmutilation. This condition generally does not involve delusions, hallucinations, incoherence, or bizarre
associations.
Dyslexia: A learning disability (see above definition) marked by impairment of the ability to recognize
and comprehend the written word.
Dyscalculia: A learning disability (see above definition) marked by impairment in the ability to perform
and remember calculations in mathematics.
Mental Retardation: The child's mental and/or social/emotional development is significantly and
noticeably behind what would ordinarily be expected for a child of his or her age. This is a more
significant delay than a developmental delay.
LEARNING DISABILITY................................ 1
ATTENTION DEFICIT DISORDER (ADD) .... 2
ATTENTION DEFICIT HYPERACTIVE
DISORDER (ADHD) ...................................... 3
DEVELOPMENTAL DELAY .......................... 4
AUTISM OR PERVASIVE DEVELOPMENTAL
DISORDER................................................. 5
DYSLEXIA, DYSCALCULIA .......................... 6
MENTAL RETARDATION ............................. 7
OTHER (SPECIFY)____________________ 91
___________________________________
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
BOX 3
IF CHQ.060 = 91, CONTINUE WITH CHQ.060OS. OTHERWISE, GO TO CHQ.075.
CHQ.060OS
[What was the diagnosis?]
SPECIFY DIAGNOSIS.
_________________________________________________________
ROUND 8 Parent – CHQ-56
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.075
In what year was the diagnosis made?
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.080)
ENTER YEAR................................................
(CHQ.080)
OR
REFUSED ..................................................... 7777 (CHQ.076)
DON'T KNOW ............................................... 9999 (CHQ.076)
NOTE: DATE IN CHQ.076 CHANGED FROM 2002 TO 2004.
CHQ.076
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.080
1
2
7
9
Thinking about {CHILD}'s overall activity level, would you say {he/she} is …
Less active than other teenagers of {his/her} age, .... 1
About as active, ......................................................... 2 (CHQ.150)
Slightly more active, or............................................... 3
A lot more active than other teenagers of {his/her} age?4
REFUSED ................................................................. 7 (CHQ150)
DON'T KNOW ........................................................... 9 (CHQ150)
CHQ.090
Do you have any concerns about {CHILD}'s overall activity level?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-57
1
2 (CHQ.150)
7 (CHQ.150)
9 (CHQ.150)
HELP AVAILABLE
CHQ.100
Has {CHILD} ever been evaluated by a professional in response to {his/her} overall activity level?
IF R INCLUDES EVALUATION OF ATTENTION SPAN, SAY: Please answer for the evaluation of
{CHILD}'s overall activity level only.
CAPI INSTRUCTION: DISPLAY "overall" IN UNDERLINED TEXT IN BOTH QUESTION TEXT AND
PROBE.
CAPI INSTRUCTION: DISPLAY "IF … SAY: " IN LIGHT BLUE AND DISPLAY "Please ….only" IN
BLACK.
HELP TEXT: Professional: 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.
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.110
1
2 (CHQ.150)
7 (CHQ.150)
9 (CHQ.150)
Did you obtain a diagnosis of a problem from a professional?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.150)
7 (CHQ.150)
9 (CHQ.150)
HELP AVAILABLE
CHQ.120
What was the diagnosis?
PROBE: What was the primary diagnosis?
HELP TEXT:
Learning disability: This is a disorder in one or more of the basic psychological processes involved in
understanding or in using language (spoken or written) which shows up as difficulty to listen, think,
speak, read, write, spell, or do mathematical calculations. In some cases the child can perform at grade
level, but only with special help. Some names of learning disabilities are dyslexia (CODE UNDER
DYSLEXIA), developmental aphasia, minimal brain dysfunction, and brain injury. The term does not
include learning problems that are primarily the result of problems with seeing, hearing, or walking,
mental retardation, emotional disturbance, or environmental, cultural, or economic disadvantage. A
commonly used acronym is "LD."
Attention Deficit Disorder (ADD): A childhood syndrome characterized by short attention span that is
inappropriate for his/her age group.
Attention Deficit Hyperactivity Disorder (ADHD): The child displays signs of inattention, impulsivity,
and hyperactivity that are inappropriate for his or her mental and chronological age. Adults in the child’s
environment, such as parents and teachers, must report the signs. 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. Onset is typically before age seven and condition lasts at least six months.
ROUND 8 Parent – CHQ-58
Hyperactivity: Having behavior characterized by constant overactivity.
Dyslexia: A learning disability (see above definition) marked by impairment of the ability to recognize
and comprehend the written word.
Mental Retardation: The child's mental and/or social/emotional development is significantly and
noticeably behind what would ordinarily be expected for a child of his or her age. This is a more
significant delay than a developmental delay.
LEARNING DISABILITY................................ 1
ATTENTION DEFICIT DISORDER (ADD) .... 2
ATTENTION DEFICIT HYPERACTIVE
DISORDER (ADHD) ................................... 3
HYPERACTIVITY .......................................... 4
DYSLEXIA ..................................................... 5
MENTAL RETARDATION ............................. 6
OTHER (SPECIFY)____________________ 91
___________________________________
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9
BOX 4
IF CHQ.120 = 91, CONTINUE WITH CHQ.120OS. OTHERWISE, GO TO CHQ.135.
CHQ.120OS
[What was the diagnosis?]
SPECIFY DIAGNOSIS.
_________________________________________________________
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.135
In what year was the diagnosis made?'
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.150)
ENTER YEAR................................................
(CHQ.150)
OR
REFUSED ..................................................... 7777
DON'T KNOW ............................................... 9999
(CHQ.136)
(CHQ.136)
ROUND 8 Parent – CHQ-59
NOTE: DATE IN CHQ.136 CHANGED FROM 2002 TO 2004.
CHQ.136
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.150
1
2
7
9
Does {CHILD} pronounce words, communicate with and understand others ...
IF RESPONDENT INDICATES CHILD DIFFERS ON ANY OF THE AREAS (E.G., CAN UNDERSTAND
BUT NOT PRONOUNCE), SAY: Answer for the area in which the child has the most difficulty.
CAPI INSTRUCTION: DISPLAY "IF … SAY: IN LIGHT BLUE "AND DISPLAY "Answer ….difficulty" IN
BLACK.
Better than other teenagers {his/her} age, ....
As well as other teenagers, ..........................
Slightly less well than other teenagers, or .....
Much less well than other teenagers? ...........
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
7
9
(CHQ.270)
(CHQ.270)
(CHQ.160)
(CHQ.160)
(CHQ.270)
(CHQ.270)
HELP AVAILABLE
CHQ.160
Has {CHILD} ever been evaluated by a professional in response to {his/her} ability to communicate?
HELP TEXT: Professional: 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.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.170
1
2 (CHQ.190)
7 (CHQ.190)
9 (CHQ.190)
Did you obtain a diagnosis of a problem from a professional?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.190)
7 (CHQ.190)
9 (CHQ.190)
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.185
In what year was the diagnosis made?
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.190)
ENTER YEAR................................................
OR
REFUSED ..................................................... 7777
DON'T KNOW ............................................... 9999
ROUND 8 Parent – CHQ-60
(CHQ.190)
(CHQ.186)
(CHQ.186)
NOTE: DATE IN CHQ.186 CHANGED FROM 2002 TO 2004.
CHQ.186
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.190
1
2
7
9
Does {CHILD} have difficulty hearing and understanding speech in a normal conversation?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(CHQ.200)
(CHQ.270)
(CHQ.270)
(CHQ.270)
HELP AVAILABLE
CHQ.200
Has {CHILD} 's hearing ever been evaluated by a professional?
HELP TEXT: Professional: 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 vision and hearing questions, having been evaluated at the school by a health professional
does count as being evaluated by a professional.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.210
1
2
7
9
(CHQ.210)
(CHQ.270)
(CHQ.270)
(CHQ.270)
Did you obtain a diagnosis of a problem from a professional?
YES ..............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-61
1
2 (CHQ.270)
7 (CHQ.270)
9 (CHQ.270)
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.225
In what year was the diagnosis made?'
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.230)
ENTER YEAR................................................
(CHQ.230)
OR
REFUSED ..................................................... 7777 (CHQ.226)
DON'T KNOW ............................................... 9999 (CHQ.226)
NOTE: DATE IN CHQ.226 CHANGED FROM 2002 TO 2004.
CHQ.226
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.230
1
2
7
9
Which of the following best describes {CHILD}'s hearing loss? Is {he/she} …
Deaf in both ears, ...................................................................
Deaf in one ear and hard of hearing in the other, ...................
Deaf in one ear and normally hearing in the other,.................
Hard of hearing in both ears, or ..............................................
Hard of hearing in one ear and normally hearing in the other?
REFUSED .............................................................................
DON'T KNOW .......................................................................
1
2
3
4
5
7
9
HELP AVAILABLE
CHQ.240
Does {CHILD} usually wear a hearing aid(s)?
HELP TEXT: Hearing Aid: A small electronic sound amplifier worn in or behind the ear that
compensates for impaired hearing.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.250
1
2
7
9
Does {CHILD} have a cochlear implant(s)?
HELP AVAILABLE
HELP TEXT: 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.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-62
1
2
7
9
(CHQ.251)
(BOX 5)
(BOX 5)
(BOX 5)
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.251
In what year (was it/were they) implanted?
CAPI INSTRUCTION: RANGE CHECK: 1990-2007.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.254)
ENTER YEAR................................................
(CHQ.254)
OR
REFUSED ..................................................... 7777 (CHQ.252)
DON'T KNOW ............................................... 9999 (CHQ.252)
CHQ.252
Was it before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.254
1
2
7
9
Does (CHILD) use the cochlear implant(s) in school?
All the time,....................................................
Some of the time, or .....................................
Not at all? ......................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
7
9
BOX 5
IF CHILD DOES NOT WEAR HEARING AID (CHQ.240=2,7, OR 9) AND DOES
NOT HAVE OR DOES NOT USE COCHLEAR IMPLANTS (CHQ.250=2,7, OR 9),
GO TO CHQ.270
OTHERWISE, CONTINUE WITH CHQ.260.
CHQ.260
What is the effect of the device on {CHILD}'s ability to hear and understand speech in normal
conversations? Does it ...
Greatly improves {his/her} ability to
understand speech, ......................................
Somewhat improves {his/her} ability to
understand speech, .......................................
Minimally improves {his/her} ability to
understand speech, or...................................
Does not improve {his/her} ability to
understand speech? ......................................
REFUSED ....................................................
DON'T KNOW ..............................................
ROUND 8 Parent – CHQ-63
1
2
3
4
7
9
CHQ.270
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 or letters on paper?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(CHQ.290)
(CHQ.325)
(CHQ.325)
(CHQ.325)
HELP AVAILABLE
CHQ.290
Has {CHILD}’s vision ever been evaluated by a professional?
HELP TEXT: Professional: 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 vision and hearing questions, having been evaluated at the school by a health professional
does count as being evaluated by a professional.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
BOX 6
CHQ.300
IF CHILD HAS DIFFICULTY SEEING (CHQ.270=1) AND
CHILD HAS NOT HAD VISION EVALUATED (CHQ.290=2, 7, OR 9),
GO TO CHQ.325.
OTHERWISE, CONTINUE WITH CHQ.300.
Did you obtain a diagnosis of a vision-related problem from a professional?
CAPI INSTRUCTION: DISPLAY "vision-related" IN UNDERLINED TEXT.
YES ..............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.325)
7 (CHQ.325)
9 (CHQ.325)
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.313
In what year was the diagnosis made?'
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.316)
ENTER YEAR................................................
(CHQ.316)
OR
REFUSED ..................................................... 7777 (CHQ.314)
DON'T KNOW ............................................... 9999 (CHQ.314)
ROUND 8 Parent – CHQ-64
NOTE: DATE IN CHQ.076 CHANGED FROM 2002 TO 2004.
CHQ.314
CHQ.316
CHQ.320
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
Correctable with glasses, ..............................
Improvable with glasses, or ...........................
Not correctable with glasses?........................
REFUSED ....................................................
DON'T KNOW ..............................................
1 (CHQ.325)
2
3
7
9
Is {CHILD}'s eyesight ...
Please tell me which of the following {CHILD}'s best eyesight allows {him/her} to see?
CAPI INSTRUCTION: DISPLAY "best" IN UNDERLINED TEXT.
Large print in books,..........................................................
Form and/or color of objects, but not detail, ......................
Shadows, ..........................................................................
Lights, or ...........................................................................
Does {CHILD} see no light or have no light perception? ...
REFUSED ........................................................................
DON'T KNOW ..................................................................
CHQ.325
Would you say {CHILD} behaves and relates to other teenagers and adults ...
Better than other teenagers {his/her} age, ....
As well as other teenagers, ...........................
Slightly less well than other teenagers, or .....
Much less well than other teenagers? ...........
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.327
1
2
3
4
5
7
9
1
2
3
4
7
9
(CHQ.350)
(CHQ.350)
(CHQ.350)
(CHQ.350)
Do you have any concerns about {CHILD}'s overall behavior and relations to other teenagers and
adults?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-65
1
2 (CHQ.350)
7 (CHQ.350)
9 (CHQ.350)
HELP AVAILABLE
CHQ.330
Has {CHILD} ever been evaluated by a professional in response to {his/her} overall behavior and
relations to other teenagers and adults?
IF R INCLUDES EVALUATION OF ATTENTION SPAN, SAY: Please answer for the evaluation of
{CHILD}'s overall behavior only.
CAPI INSTRUCTION: DISPLAY "IF … SAY: " IN LIGHT BLUE AND DISPLAY "Please ….only" IN
BLACK.
CAPI INSTRUCTION: DISPLAY "overall" IN UNDERLINED TEXT.
HELP TEXT: Professional: 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.
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.335
1
2 (CHQ.350)
7 (CHQ.350)
9 (CHQ.350)
Did you obtain a diagnosis of a problem from a professional?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.350)
7 (CHQ.350)
9 (CHQ.350)
HELP AVAILABLE
CHQ.337
What was the diagnosis?
PROBE: What was the primary diagnosis?
HELP TEXT:
Learning disability: This is a disorder in one or more of the basic psychological processes involved in
understanding or in using language (spoken or written) which shows up as difficulty to listen, think,
speak, read, write, spell, or do mathematical calculations. In some cases the child can perform at grade
level, but only with special help. Some names of learning disabilities are dyslexia, developmental
aphasia, minimal brain dysfunction, and brain injury. The term does not include learning problems that
are primarily the result of problems with seeing, hearing, or walking, mental retardation, emotional
disturbance, or environmental, cultural, or economic disadvantage. A commonly used acronym is "LD."
Attention Deficit Disorder (ADD): A childhood syndrome characterized by short attention span that is
inappropriate for his/her age group.
Attention Deficit Hyperactivity Disorder (ADHD): The child displays signs of inattention, impulsivity,
and hyperactivity that are inappropriate for his or her mental and chronological age. Adults in the child’s
environment, such as parents and teachers must report the signs. 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. Onset is typically before age seven and condition lasts at least six months.
Hyperactivity: Having behavior characterized by constant overactivity.
ROUND 8 Parent – CHQ-66
Mental Retardation: The child's mental and/or social/emotional development is significantly and
noticeably behind what would ordinarily be expected for a child of his or her age. This is a more
significant delay than a developmental delay.
Serious Emotional Disturbance or SED- A condition that has 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 with peers and teachers; (c) inappropriate behavior or feelings;
(d) a general mood of unhappiness or depression; or (e) a tendency to develop physical symptoms or
fears associated with personal or school problems. The term includes schizophrenia but does not apply
to children who are socially maladjusted, unless it is determined that they have a serious emotional
disturbance.
LEARNING DISABILITY................................ 1
ATTENTION DEFICIT DISORDER (ADD) .... 2
ATTENTION DEFICIT HYPERACTIVE
DISORDER (ADHD) ................................... 3
HYPERACTIVITY .......................................... 4
MENTAL RETARDATION ............................. 5
SERIOUS EMOTIONAL DISTURBANCE(SED) 6
OTHER (SPECIFY)____________________ 91
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9
BOX 7
IF CHQ.337 = 91, CONTINUE WITH CHQ.337OS. OTHERWISE, GO TO CHQ.345.
CHQ.337OS
[What was the diagnosis?]
SPECIFY DIAGNOSIS.
_________________________________________________________
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.345
In what year was the diagnosis made?
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.350)
ENTER YEAR................................................
(CHQ.350)
OR
REFUSED ..................................................... 7777 (CHQ.346)
DON'T KNOW ............................................... 9999 (CHQ.346)
NOTE: DATE IN CHQ.346 CHANGED FROM 2002 TO 2004.
CHQ.346
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-67
1
2
7
9
CHQ.350
Do you have any concerns about {CHILD}'s overall emotional behavior, such as anxiety or depression?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.400)
7 (CHQ.400)
9 (CHQ.400)
HELP AVAILABLE
CHQ.355
Has {CHILD} ever been evaluated by a professional in response to {his/her} overall emotional behavior?
IF R INCLUDES EVALUATION OF ATTENTION SPAN, SAY: Please answer for the evaluation of
{CHILD}'s overall emotional behavior only.
CAPI INSTRUCTION: DISPLAY "IF … SAY: IN LIGHT BLUE "AND DISPLAY "Please ….only" IN
BLACK.
HELP TEXT: Professional: 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.
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.360
1
2 (CHQ.400)
7 (CHQ.400)
9 (CHQ.400)
Did you obtain a diagnosis of a problem from a professional?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.400)
7 (CHQ.400)
9 (CHQ.400)
HELP AVAILABLE
NOTE: IN ROUND 8, CODING CATEGORIES 8 AND 9 ARE NEW IN CHQ.365. ALSO, ROUND 6 CATEGORY 8 FOR
“OTHER DEPRESSIVE DISORDER” IS CATEGORY 10 IN ROUND 8.
CHQ.365
What was the diagnosis?
PROBE: What was the primary diagnosis?
HELP TEXT:
Panic Disorder: A disorder in which there is the sudden onset of several different physical signs, such
as rapid heartrate, shaking, sweating, nausea, dizziness, and difficulty breathing. A panic disorder may
make a child think that something horrible is about to happen.
Separation Anxiety Disorder: This is the fear a child has of being separated from his/her parents which
is far more than would be expected for the child’s developmental stage.
Agoraphobia: This is anxiety about being in places or situations from which escape might be difficult or
embarrassing or in which help might not be available in the event of having an unexpected panic attack.
Children usually avoid the situations or else they are endured with distress or anxiety about having a
panic attack. This disorder is not due to any social phobia such as obsessive-compulsive disorder, or
separation anxiety.
ROUND 8 Parent – CHQ-68
Social Phobia: A marked and persistent fear of social or performance situations in which the child is
exposed to unfamiliar people or possible scrutiny. These situations provoke anxiety, which can take the
form of panic, crying, and tantrums, freezing or shrinking from the situation. The avoidance or anxious
anticipation and distress caused by these situations interfere significantly with the child’s routine,
academic functioning or social activities.
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.
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. [CODE AS OTHER ANXIETY DISORDER]
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 concentration, frequent complaints of physical illnesses, and thoughts of suicide or
destructive behavior.
Dysthymia: Dysthymia is a milder form of depression than clinical depression. Symptoms of dysthymia
are similar to those for depression and include problems with school work, withdrawal from other
children, shyness, irritability, problems with relationships, and sleep difficulties.
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, severe
worthlessness, hallucinations or strange beliefs about the past.
PANIC DISORDER........................................
SEPARATION ANXIETY DISORDER ...........
AGORAPHOBIA ............................................
SOCIAL PHOBIA...........................................
OBSESSIVE COMPULSIVE DISORDER......
OTHER ANXIETY DISORDER......................
BIPOLAR DISORDER ...................................
DEPRESSION ...............................................
DYSTHYMIA (MILD DEPRESSION) .............
OTHER DEPRESSIVE DISORDER ..............
OTHER (SPECIFY)____________________
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
5
6
7
8
9
10
91
77
99
BOX 8
IF CHQ.365 = 91, CONTINUE WITH CHQ.365OS. OTHERWISE, GO TO BOX 8a.
CHQ.365OS
[What was the diagnosis?]
SPECIFY DIAGNOSIS.
_________________________________________________________
ROUND 8 Parent – CHQ-69
NOTE: BOX 8a IS NEW IN ROUND 8.
BOX 8a
IF CHQ.365 = 8, 9, OR 10, CONTINUE WITH CHQ.370. OTHERWISE, GO TO
CHQ.375.
NOTE: CHQ.370 IS NEW IN ROUND 8.
CHQ.370 You said that (CHILD) has (depression/dysthymia /a depressive disorder). Is (CHILD) now taking any
prescription medicine for the condition related to {his/her] depression or depressive disorder?
CAPI INSTRUCTION: DISPLAY “depression” IF CHQ.365 = 8. DISPLAY “dysthymia” IF CHQ.365 = 9.
DISPLAY “a depressive disorder” IF CHQ.365 = 10.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
NOTE: SKIP FOR REFUSED ANSWERS IS SAME AS FOR DON’T KNOW ANSWERS FOR THIS ITEM IN ROUND 8.
CHQ.375
In what year was the diagnosis made?'
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTION: RANGE CHECK: 1990-2007 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.400)
ENTER YEAR................................................
(CHQ.400)
OR
REFUSED ..................................................... 7777 (CHQ.376)
DON'T KNOW ............................................... 9999 (CHQ.376)
NOTE: DATE IN CHQ.376 CHANGED FROM 2002 TO 2004.
CHQ.376
Was the diagnosis made before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
NOTE: CHQ.400 IS NEW IN ROUND 8.
CHQ.400
Do you have any concerns about {CHILD}'s weight or an eating disorder?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-70
1
2 (CHQ.500)
7 (CHQ.500)
9 (CHQ.500)
NOTE: CHQ.410 IS NEW IN ROUND 8.
CHQ.410
What is that concern?
CODE ALL THAT APPLY
HELP TEXT:
Overweight/Obese: If a child is overweight or obese, his or her weight is greater than what is
considered healthy for his or her height. A child who is overweight is defined as having a “body mass
index” or BMI that is equal to or above the 95th percentile. The 95th percentile means that compared to
children of the same gender and age, 95 percent have a lower BMI.
Underweight: If a child is underweight, his or her weight is less than what is considered healthy for his
or her height. A child who is underweight is defined as having a “body mass index” or BMI that is less
than the 5th percentile. The 5th percentile means that compared to children of the same gender and age,
5 percent have a lower BMI.
Anorexia: A person with anorexia, or anorexia nervosa, has an eating disorder characterized by not
eating enough food, having a distorted image of his or her body, refusing to maintain a normal body
weight, and being afraid to gain weight even though he or she is very underweight.
Bulemia: A person with bulimia, or bulimia nervosa, has an eating disorder often characterized by
eating a large amount of food in a short time and then purging it by vomiting, exercising too much, or
using medications such as laxatives or diuretics. Persons with bulimia may be of average weight, but
often obsess about their body shape and size.
OVERWEIGHT/OBESE................................. 1
UNDERWEIGHT ........................................... 2
ANOREXIA .................................................... 3
BULEMIA....................................................... 4
OTHER (SPECIFY)____________________ 91
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
BOX 8b
IF CHQ.410 = 91, CONTINUE WITH CHQ.410OS. OTHERWISE, GO TO CHQ.415.
CHQ.410OS
[What was the diagnosis?]
SPECIFY DIAGNOSIS.
_________________________________________________________
CHQ.415. How old was {CHILD} when this first became a concern?
CAPI INSTRUCTION: RANGE CHECK: 0 – 16 YEARS OLD. UNLESS AGE IN HOUSEHOLD ROSTER = DK
OR RF, AGE ENTERED AT THIS ITEM CANNOT EXCEED THIS PERSON'S AGE IN THE HOUSEHOLD
ROSTER. OTHERWISE, DISPLAY ERROR MESSAGE: "This age cannot be greater than person's age."
|___|___|
AGE
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
ROUND 8 Parent – CHQ-71
CHQ.420
Has {CHILD} seen a medical professional about this concern?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.500
Would you say {CHILD}'s health is ...
Excellent, .......................................................
Very good, .....................................................
Good,.............................................................
Fair, or ...........................................................
Poor?.............................................................
REFUSED ....................................................
DON'T KNOW ..............................................
CHQ.510
1
2
7
9
1
2
3
4
5
7
9
Does {CHILD} currently use special equipment for children with special needs, such as a wheelchair,
communication board, electronic Braille device, or other assistive device, etc.?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
BOX 9
IF CHILD HAS ANY DISABILITIES OR HIS OR HER HEALTH IS FAIR OR POOR,
THAT IS:
CHQ.010=3, 4 (INDEPENDENCE)
OR
CHQ.020=3, 4 (ATTENTION)
OR
CHQ.030=3, 4 (THINK/LEARN/SOLVE)
OR
CHQ.080=4 (HYPERACTIVE)
OR
CHQ.150=3, 4 (COMMUNICATION)
OR
CHQ.190=1 (HEARING)
OR
CHQ.270=1 (VISION)
OR
CHQ.325=3, 4 (BEHAVIOR)
OR
CHQ.350=1 (EMOTIONS)
OR
CHQ.500=4, 5 (HEALTH),
GO TO CHQ.520.
OTHERWISE, GO TO CHQ.550.
ROUND 8 Parent – CHQ-72
CHQ.520
Children with disabilities include children with developmental delays, communication impairments, or
special health care needs. During this school year, did {CHILD} ever receive therapy services or take
part in a program for children with disabilities?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.525
Is {CHILD} still receiving any of these services?
YES ...............................................................
NO .................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
CHQ.535
1
2 (BOX 9a)
7 (BOX 9a)
9 (BOX 9a)
1 (CHQ.540)
2
7
9
In what year was the last of these services received?
CAPI INSTRUCTION: RANGE CHECK: 1990-2007 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S
BIRTHDATE AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.540)
ENTER YEAR................................................
(CHQ.540)
OR
REFUSED ..................................................... 7777 (CHQ.540)
DON'T KNOW ............................................... 9999 (CHQ.536)
CHQ.536
Were the last of the services received before 2004?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.537
(CHQ.537)
(CHQ.540)
(CHQ.537)
(CHQ.537)
Were the last of the services received before (CHILD) entered elementary school?
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.540
1
2
7
9
1
2
7
9
Overall, how helpful were the special services your child and/or family received?
Very helpful,...................................................
Helpful, ..........................................................
Not helpful, or ................................................
Not at all helpful?...........................................
REFUSED ....................................................
DON'T KNOW ..............................................
ROUND 8 Parent – CHQ-73
1
2
3
4
7
9
CHQ.545
During this school year did (CHILD) receive any services for children with special needs such as speech
therapy or did (he/she) participate in a special education program?
CAPI INSTRUCTIONS: DISPLAY 'this school year' IN UNDERLINED TEXT
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
(CHQ.550)
(BOX 9a)
(BOX 9a)
(BOX 9a)
NOTE: BOX 9a IN ROUND 8 INCLUDES REFERENCES TO PAST ROUNDS INCLUDING ROUND 6.
BOX 9a
• IF CHQ.546 WAS ASKED IN THE LAST ROUND, ROUND 6, BASED ON PAST
INFORMATION ABOUT SPECIAL SERVICES OR SPECIAL EDUCATION [(P6SVNEED NE -1)
OR (P6SVELGB NE -1) OR (P6SVREF NE -1) OR (P6SVNSCH NE -1) OR (P6SVSOME NE -1)],
THEN GO TO CHQ.550.
• ELSE, IF P2SPECND (CHQ.160 IN ROUND 2) = 1 OR P5SPECND (CHQ.545 IN ROUND 5) =
1 OR P6SPECND (CHQ.545 IN ROUND 6) = 1 (CHILD HAD SERVICES FOR SPECIAL NEEDS
OR WAS IN SPECIAL EDUCATION PROGRAM IN ROUNDS 2, 5, OR 6), GO TO CHQ.546.
• OTHERWISE, GO TO CHQ.550.
CHQ.546
In an earlier year of the study, it was reported by your household that {CHILD} received services for
children with special needs or was in a special education program. Is {CHILD} no longer participating in
these services or special education because {he/she}…
YES NO REF DK
a.
b.
c.
d.
e.
No longer needs services? ..............................
1
Is no longer eligible for services?.....................
1
Services were refused by {his/her} parent
or guardian?....................................................
1
{CHILD} moved and is not receiving these services
in the new school?...........................................
1
Something else? (SPECIFY) ...........................
1
(SPECIFY) _________________________________
2
2
7
7
9
9
2
7
9
2
2
7
7
9
9
BOX 9b
CHQ.547OS
IF CHQ. 546e=1, GO TO CHQ.547OS. ELSE, GO TO CHQ 550.
[Is {CHILD} no longer participating in these services or special education because {he/she}…of some
other reason?]
SPECIFY REASON
_______________________________________________________
ROUND 8 Parent – CHQ-74
CHQ.550
How long has it been since {CHILD}'s last visit to a dentist or dental hygienist for dental care?
NEVER ..........................................................
LESS THAN 6 MONTHS ...............................
6 MONTHS TO YEAR ...................................
1 TO 2 YEARS ..............................................
MORE THAN 2 YEARS .................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.555
1
2
3
4
5
7
9
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?
PROBE: Routine health care may include check-ups, or immunization appointments.
NEVER ..........................................................
LESS THAN 6 MONTHS ...............................
6 MONTHS TO YEAR ...................................
1 TO 2 YEARS ..............................................
MORE THAN 2 YEARS .................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.560
Now I have some questions about common health conditions. Has a doctor, nurse, or other medical
professional ever told you that {CHILD} has chronic sinusitis?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
CHQ.565
(CHQ.565)
(CHQ.570)
(CHQ.570)
(CHQ.570)
1
2
7
9
Has a doctor, nurse, or other medical professional ever told you that {CHILD} has asthma?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
CHQ.575
1
2
7
9
Does {he/she} receive treatment for this condition?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
CHQ.570
1
2
3
4
5
7
9
1
2
7
9
Does {he/she} receive treatment for this condition?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent – CHQ-75
1
2
7
9
(CHQ.575)
(CHQ.580)
(CHQ.580)
(CHQ.580)
CHQ.580
Has a doctor, nurse, or other medical professional ever told you that {CHILD} has hay fever or allergic
rhinitis without asthma?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
CHQ.585
1
2
7
9
(CHQ.585)
(CHQ.590)
(CHQ.590)
(CHQ.590)
Does {he/she} receive treatment for this condition?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
NOTE: CHQ.590 IS NEW IN ROUND 8.
CHQ.590
Has a doctor, nurse, or other medical professional ever told you that {CHILD} has diabetes?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
(CHQ.600)
(CHQ.690)
(CHQ.690)
(CHQ.690)
NOTE: CHQ.600 IS NEW IN ROUND 8.
CHQ.600
Does {he/she} receive treatment for this condition?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
NOTE: THE DATE IN THIS QUESTION IN ROUND 8 INCORPORATES SPRING 2000, 2002, AND 2004.
CHQ.690
Now I have some questions about childhood injuries. How many times since our last interview in {spring
of 2000/spring of 2002/spring of 2004} has {CHILD} seen a doctor or other medical professional or
visited a clinic or emergency room for an injury?
SOFT RANGE CHECK:
HARD RANGE CHECK:
0 – 28 TIMES
0 - 99 TIMES
|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED ..................................................... 777
DON'T KNOW ............................................... 999
BOX 10
IF CHQ.690 equals 0 or REFUSED or DON’T KNOW then go to CHQ.695.
OTHERWISE, GO TO CHQ.693.
ROUND 8 Parent – CHQ-76
CHQ.693
How many times has {CHILD} been hospitalized at least one night for injuries?
SOFT RANGE CHECK:
HARD RANGE CHECK:
0 – 28 TIMES
0 - 99 TIMES
|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED ..................................................... 777
DON'T KNOW ............................................... 999
CHQ.695
What kinds of health insurance or health care coverage does {CHILD} have? By health insurance I mean
any kind of coverage that pays for health care expenses. Please do not include private plans that only
provide extra cash while hospitalized. Does {he/she} have…
CAPI INSTRUCTIONS:
IN CHQ.695b, DISPLAY NAME FOR STATE MEDICAID PROGRAM, IF
ANY, FOR "or STATE MEDICAID PROGRAM NAME"; ELSE, USE NULL DISPLAY.
IN CHQ.695c, DISPLAY NAME FOR STATE CHIP PROGRAM, IF ANY, FOR "or STATE CHIP
PROGRAM NAME"; ELSE, USE NULL DISPLAY.
IN CHQ.695e, DISPLAY NAME FOR OTHER STATE SPONSORED HEALTH PLAN, IF ANY, FOR
"STATE SPONSORED HEALTH PLAN NAME"; ELSE, USE NULL DISPLAY.
a.
b.
c.
d.
e.
A private health insurance plan from an employer, workplace,
or purchased directly or through a state or local
government program or community program?.................................
Medicaid {or STATE MEDICAID PROGRAM NAME}? ....................
CHIP (Children's Health Insurance Program){or NAME
OF STATE CHIP PROGRAM NAME}? ...........................................
Military health care, or VA, or CHAMPUS, or TRICARE, or
CHAMP-VA? ...................................................................................
Another government program (Indian Health Service,
Medicare {,STATE SPONSORED HEALTH PLAN NAME})? .........
YES
NO
REF
DK
1
1
2
2
7
7
9
9
1
2
7
9
1
2
7
9
1
2
7
9
7
9
BOX 10b
IF ANY CHQ.695a, b, c, d, or e EQUALS 1, AUTOCODE CHQ.695f = 2 AND GO TO
BOX 11C.
OTHERWISE, ASK CHQ.695f.
f.
No health insurance? ......................................................................
ROUND 8 Parent – CHQ-77
1
2
NOTE: IN ROUND 8, BOX 11c BELOW INCLUDES PAST INFORMATION FROM ROUND 6, IN ADDITION TO
INFORMATION FROM ROUNDS 1, 4, AND 5. THE SKIP ALSO INCLUDES CURRENT INFORMATION IN ROUND 8.
BOX 11c
•
CHQ.740
IF CHILD HAD ADD, ADHD, OR HYPERACTIVITY IN CURRENT OR PREVIOUS
ROUND [(P1WHATD1 (CHQ.125 IN ROUND 1) = 2 OR 7) OR (P1WHATD3 (CHQ.160
IN ROUND 1) = 2, 3, OR 7) OR (P4DGNATT (CHQ.060 IN ROUND 4) = 2 OR 3) OR
(P4DGNACT (CHQ.120 IN ROUND 4) = 2, 3, OR 4) OR (P5DGNATT (CHQ.060 IN
ROUND 5) = 2 OR 3) OR (P5DGNACT (CHQ.120 IN ROUND 5) = 2, 3, OR 4) OR
(P5DGNBEH (CHQ.337 IN ROUND 5) = 2, 3, OR 4) OR (P6DGNATT (CHQ.060 IN
ROUND 6) = 2 OR 3) OR (P6DGNACT (CHQ.120 IN ROUND 6) = 2, 3, OR 4) OR
(P6DGNBEH (CHQ.337 IN ROUND 6) = 2, 3, OR 4)] OR (P8DGNATT (CHQ.060 IN
ROUND 8) = 2 OR 3) OR (P8DGNACT (CHQ.120 IN ROUND 8) = 2, 3, OR 4) OR
(P8DGNBEH (CHQ.337 IN ROUND 8) = 2, 3, OR 4)] THEN ASK CHQ.740.
OTHERWISE, GO TO CHQ.900.
{In an earlier year of the study, someone in your household told us that {CHILD} has attention deficit
disorder, ADHD, or hyperactivity.} Is {CHILD} now taking any prescription medicine for the condition
related to {his/her] ADD, ADHD, or hyperactivity?
CAPI INSTRUCTION: DISPLAY “In an ….hyperactivity” IF CHILD WAS NOT REPORTED TO HAVE
ADD, ADHD, OR HYPERACTIVITY IN THIS ROUND (P6DGNATT NE 2 OR 3) AND (P6DGNACT NE 2,
3, OR 4) AND (P6DGNBEH NE 2, 3, OR 4).
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.760
1
2 (CHQ.763)
7 (CHQ.763)
9 (CHQ.763)
How long has {CHILD} taken such prescription medicine for this condition, in total?
Less than one month, ....................................
Less than a year, ..........................................
1 to 2 years,...................................................
3 to 4 years, or...............................................
More than 5 years?........................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-78
1
2
3
4
5
7
9
NOTE: CHQ.763 IS NEW IN ROUND 8.
CHQ.763
Individual therapy refers to a therapy/counseling situation where the focus of the treatment is on the
individual. Therapy is likely to be provided by a mental health professional. Since spring 2004, has
{CHILD} received any individual therapy?
HELP TEXT:
Individual therapy: this includes therapy or counseling from any of the following: psychiatrist,
psychologist, licensed clinical social worker, or counselor.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (CHQ.770)
7 (CHQ.770)
9 (CHQ.770)
NOTE: CHQ.764 IS NEW IN ROUND 8.
CHQ.764
Was the main reason for receiving therapy due to {CHILD}’s…
ADHD (ATTENTION DEFICIT/HYPERACTIVE DISORDER), ....... 1
Learning problems, ...................................................................... 2
Other behavioral/emotional difficulties, or...................................... 3
Something else (SPECIFY)? ........................................................ 91
SPECIFY__________________________
REFUSED
...................................................................... 7
DON'T KNOW
...................................................................... 9
NOTE: BOX 11g AND CHQ.764OS ARE NEW IN ROUND 8.
BOX 11g
CHQ.764OS
IF CHQ. 764 = 91, GO TO CHQ.764OS. ELSE, GO TO CHQ.765.
[Was the main reason for receiving therapy due to {CHILD}’s…]
SPECIFY MAIN REASON
_______________________________________________________
ROUND 8 Parent – CHQ-79
NOTE: CHQ.765 IS NEW IN ROUND 8.
CHQ.765
Did {CHILD} see…..
COUNT EACH PERSON ONLY ONCE. IF SOMEONE HAS MORE THAN ONE DEGREE (E.G., A
PSYCHOLOGIST AND A COUNSELOR), PICK THE CATEGORY WITH THE LOWEST NUMBER ON
THIS LIST (E.G., 1. PSYCHIATRIST; 2. PSYCHOLOGIST; 3. SOCIAL WORKER; 4. COUNSELOR).
YES NO REF DK
a.
b.
c.
d.
e.
A psychiatrist? ...................................................
1
Psychologist? ....................................................
1
Social worker?...................................................
1
Counselor?........................................................
1
Someone else (SPECIFY)?...............................
1
(SPECIFY) _________________________________
2
2
2
2
2
7
7
7
7
7
9
9
9
9
9
NOTE: BOX 11h AND CHQ.765 ARE NEW IN ROUND 8.
BOX 11h
CHQ.765OS
IF CHQ. 765e = 1, GO TO CHQ.791OS. ELSE, GO TO CHQ.766.
[Did {CHILD} see…..]
SPECIFY OTHER PERSON CHILD SAW
_______________________________________________________
NOTE: CHQ.766 IS NEW IN ROUND 8.
CHQ.766
Was this at school, out of school, or both?
AT SCHOOL..................................................
OUT OF SCHOOL.........................................
BOTH ............................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-80
1
2
3
7
9
NOTE: CHQ.767 IS NEW IN ROUND 8.
CHQ.767
About how many times since spring 2004 has {CHILD} received this help?
Five times or less,..........................................
Between 6 and 20 times, ...............................
Between 21 and 50 times, or .........................
More than 50 times?......................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
7
9
HELP AVAILABLE
CHQ.770
Family therapy refers to a therapy/counseling situation where the focus of the treatment is on a family.
Family therapy is likely to be provided by a mental health professional. Since spring 2004, has your
family received any family therapy?
HELP TEXT:
Family therapy: this includes therapy or counseling from any of the following: psychiatrist, psychologist,
licensed clinical social worker, or counselor.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.780
1
2 (CHQ.900)
7 (CHQ.900)
9 (CHQ.900)
Was the main reason for receiving family therapy due to {CHILD}’s…
ADHD (ATTENTION DEFICIT/HYPERACTIVE DISORDER), ....... 1
Learning problems, ...................................................................... 2
Other behavioral/emotional difficulties, or...................................... 3
Something else (SPECIFY)? ........................................................ 91
SPECIFY__________________________
REFUSED
...................................................................... 7
DON'T KNOW
...................................................................... 9
BOX 11i
CHQ.781OS
IF CHQ. 780 = 91, GO TO CHQ.781OS. ELSE, GO TO CHQ.790.
[Was the main reason for receiving family therapy due to {CHILD}’s…]
SPECIFY MAIN REASON
_______________________________________________________
ROUND 8 Parent – CHQ-81
CHQ.790
Did the family see…..
COUNT EACH PERSON ONLY ONCE. IF SOMEONE HAS MORE THAN ONE DEGREE (E.G., A
PSYCHOLOGIST AND A COUNSELOR), PICK THE CATEGORY WITH THE LOWEST NUMBER ON
THIS LIST (E.G., 1. PSYCHIATRIST; 2. PSYCHOLOGIST; 3. SOCIAL WORKER; 4. COUNSELOR).
YES NO REF DK
b. A psychiatrist? ...................................................
1
2
7
9
b. Psychologist? ....................................................
1
2
7
9
c. Social worker?...................................................
1
2
7
9
d. Counselor?........................................................
1
2
7
9
e. Someone else (SPECIFY)?...............................
1
2
7
9
(SPECIFY) _________________________________
BOX 11j
CHQ.791OS
IF CHQ. 790e = 1, GO TO CHQ.791OS. ELSE, GO TO CHQ.800.
[Did the family see…..]
SPECIFY OTHER PERSON FAMILY SAW
_______________________________________________________
NOTE: IN CHQ.800, THE DATE HAS CHANGED TO SPRING 2004.
CHQ.800
About how many times since spring 2004 has the family received this help?
Five times or less,..........................................
Between 6 and 20 times, ...............................
Between 21 and 50 times, or .........................
More than 50 times?......................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – CHQ-82
1
2
3
4
7
9
NOTE: CHQ.900 IS NEW IN ROUND 8.
CHQ.900. I am going to read a list of items that sometimes describe teenagers. For each of the following
characteristics please tell me extent to which they are not true, somewhat, or certainly true for
(CHILD) over the last six months or this school year.
PROBE: Would you say not true, somewhat true, or certainly true?
CAPI INSTRUCTION: DISPLAY "PROBE:…certainly true?" in SQUARE BRACKETS FOR B-Y.
NOT
TRUE
{He/She} is considerate of other
people’s feelings.
Would you say not
true, somewhat true,
or certainly true?
b. {He/She} is restless, overactive,
cannot stay still for long
c. {He/She} often complains of
headaches, stomach-aches or
sickness
d. {He/She} shares readily with other youth,
for example books, games, food
e. {He/She} often loses {his/her} temper
f. {He/She} would rather be alone than with
other youth
g. {He/She} is generally well behaved, usually
does what adults request
h. {He/She} has many worries or often seems
worried
i. {He/She} is helpful if someone is hurt, upset,
or feeling ill
j. {He/She} is constantly fidgeting or
squirming
k. {He/She} has at least one good friend
l. {He/She} often fights with other youth or
bullies them
m. {He/She} is often unhappy, depressed or
tearful
n. {He/She} is generally liked by other youth
o. {He/She} is easily distracted, concentration
wanders
p. {He/She} is nervous in new situations, easily
loses confidence
q. {He/She} is kind to younger children
r. {He/She} often lies or cheats
s. {He/She} is picked on or bullied by other youth
t. {He/She} often offers to help others (parents,
teachers, children)
u. {He/She} thinks things out before acting
v. {He/She} steals from home, school or
elsewhere
w. {He/She} gets along better with adults than
with other youth
x. {He/She} has many fears, easily scared
y. {He/She} has a good attention span, sees work
through to the end
SOMEWHAT
TRUE
CERTAINLY
TRUE
REF
DK
a.
1
2
3
7
9
1
2
3
7
9
1
2
3
7
9
1
1
2
2
3
3
7
7
9
9
1
2
3
7
9
1
2
3
7
9
1
2
3
7
9
1
2
3
7
9
1
1
2
2
3
3
7
7
9
9
1
2
3
7
9
1
1
2
2
3
3
7
7
9
9
1
2
3
7
9
1
1
1
1
2
2
2
2
3
3
3
3
7
7
7
7
9
9
9
9
1
1
2
2
3
3
7
7
9
9
1
2
3
7
9
1
1
2
2
3
3
7
7
9
9
1
2
3
7
9
BOX 12
GO TO PPQ (PARENT’S PSYCHOLOGICAL WELL-BEING AND HEALTH).
ROUND 8 Parent – CHQ-83
PARENT’S PSYCHOLOGICAL WELL-BEING AND HEALTH -- PPQ
BOX 1
IF (NumberOfChildren = 1) OR (NumberOfChildren > 1 AND ChildNum = 1),
CONTINUE WITH INSTRUCTIONS IN BOX 1. ELSE, IF (NumberofChildren > 1 AND
ChildNum = 2), GO TO BOX 2.
IF PERSON FLAGGED AS THE RESPONDENT IS A "PARENT FIGURE" MEANING
THE MOTHER OR FATHER OR MALE OR FEMALE GUARDIAN (THIS INCLUDES
BIRTH, ADOPTIVE, STEP, AND FOSTER PARENTS OR GUARDIANS)
OR
IF NO HOUSEHOLD MEMBER IS A "PARENT FIGURE" AS DEFINED ABOVE
CONTINUE WITH PPQ.100.
OTHERWISE, GO TO BOX 2 .
NOTE: PPQ.100 IS NEW TO ROUND 8 AND THE SAME AS PPQ.100-PPQ.210 IN ROUND 2
PPQ.100 I'm going to read some statements that may relate to how you have felt about yourself and your life during the past
week. For each statement I read, please indicate how often in the past week you felt or behaved this way. There are
no right or wrong answers.
PROBE:
Would you say never, some of the time, a moderate amount of time, or most of the time?
CAPI INSTRUCTION: DISPLAY “past week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY “Would…time" in SQUARE BRACKETS FOR B-I.
SOME
OF
THE
NEVER TIME
a.
b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
Felt that you were bothered by things that
don’t usually bother you? Would you say never,
some of the time, a moderate amount of time, or
most of the time?
Felt that you did not feel like eating, that your
appetite was poor?
Felt that you could not shake off the blues
even with help from your family and friends?
Felt that you had trouble keeping your mind on
what you were doing?
Felt depressed?
Felt that everything you did was an effort?
Felt fearful?
Felt that your sleep was restless?
Felt that you talked less than usual?
Felt lonely?
Felt sad?
Felt that you could not get going?
A
MODERATE
AMOUNT
OF
TIME
MOST
OF
THE
TIME
REF
DK
1
2
3
4
7
9
1
2
3
4
7
9
1
2
3
4
7
9
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
4
7
7
7
7
7
7
7
7
7
9
9
9
9
9
9
9
9
9
ROUND 8 Parent – PPQ-84
PPQ.220
Now, I would like to ask you about your health. In general, would you say that your health is…
Excellent, ......................................................
Very good, ....................................................
Good, ...........................................................
Fair, or...........................................................
Poor? ............................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
5
7
9
NOTE: PPQ.230 IS NEW IN ROUND 8.
PPQ.230 This is a list of things that sometimes happen. In the past year, which, if any, have happened to you?
a.
b.
c.
d.
e.
f.
g.
h.
Have you been robbed, mugged, or
attacked in the past year?
Has your electricity or phone been
cut off because the bills weren’t paid?
Have you lost a job for any reason?
Have you moved residence?
Have you had a big change in family
income?
Have you been seriously ill or
hospitalized?
Have you had a change in your
marital status?
Have you experienced a death in
the family?
YES
NO
REF
DK
1
2
7
9
1
1
1
2
2
2
7
7
7
9
9
9
1
2
7
9
1
2
7
9
1
2
7
9
1
2
7
9
BOX 2
GO TO SECTION PEQ (PARENT EDUCATION).
ROUND 8 Parent – PPQ-85
PARENT EDUCATION - PEQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1,
CONTINUE WITH BOX 2.
OTHERWISE, GO TO BOX 4.
BOX 2
PEQ.010
•
ASK PEQ.010-PEQ.060 FOR 2 "KEY" PARENT FIGURES IN THE HOUSEHOLD.
THIS PERSON OR PERSONS SHOULD BE CHOSEN AS DEFINED IN FSQ.
•
AFTER DETERMINING FOR WHOM THE EDUCATION QUESTIONS WILL BE
ASKED, CHECK PRELOAD TO DETERMINE IF EACH PERSON HAD NONMISSING
ROUND 6 COMPOSITE VARIABLE DATA THAT HAS NOT BEEN FLAGGED (DUE
TO DATA INCONSISTENCIES WITH A PREVIOUS ROUND). IF SO, GO TO PEQ.010
FOR THAT PERSON.
•
OTHERWISE, GO TO PEQ.020 FOR EACH APPROPRIATE PERSON.
{Now I have a few questions about education and job training.} Since our last interview in spring 2004,
{have/has} {you/{NAME}} completed any additional grades of school or received any diplomas or degrees?
CAPI INSTRUCTION: DISPLAY "Now…training." IF ON FIRST CYCLE OF LOOP1. OTHERWISE, USE A
NULL DISPLAY.
YES ...............................................................
NO.................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
(PEQ.020)
(BOX 3)
(BOX 3)
(BOX 3)
HELP AVAILABLE
PEQ.020
{What grade, diploma, or degree was that?}/{Now I have a few questions about education and job training.}
{What is the highest grade or year of school that {you/{NAME}} {have/has} completed?
CAPI INSTRUCTIONS:
1.
IF A CASE HAD ROUND 6 EDUCATION INFORMATION, DISPLAY "What grade….was that?"
2.
OTHERWISE: IF ON FIRST CYCLE OF LOOP 1, DISPLAY "Now I have…..training." AND "What
is…..completed?" OTHERWISE, DISPLAY "What is…..completed?" ONLY.
HELP TEXT:
Highest Grade or Year of School Completed: For grades 1-11, enter the exact grade level. If the person
you are asking about completed elementary school, find out the last grade completed. If the respondent says
the person finished 12th grade, ask whether the person received a diploma or got the equivalent of a high
school diploma.
Completing a given grade in school should be counted as the number of years it normally takes to complete
that grade level of education, regardless of how many years it actually took the person to finish. This means
that for persons who skipped or repeated grades in elementary school, you will enter the highest grade
completed regardless of the number of years they were in school. This rule is true for elementary school
through high school and is especially relevant to college.
12th grade but no diploma: The person completed the 12th grade, but did not earn a high school diploma or
GED.
ROUND 8 Parent – PEQ-86
High school diploma/equivalent: A certificate that verifies that a person has successfully completed the
required courses of a high school curriculum. Includes either actually graduating from high school or having a
GED. The GED is an exam certified equivalent of a high school diploma received when the person has not
actually received a degree from attending high school, but has acquired his/her GED (high school equivalency
based on passing the GED exam).
Vocational/technical program after high school but no voc/tech diploma: The person attended this type
of program, but did not earn a degree/diploma/certificate of successful completion of the program.
Vocational/trade school after high school refers to work or trade-related education received after completing
high school, but does 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.
Vocational/technical program after high school: The person attended this type of program, but DID earn a
degree/diploma/certificate of successful completion of the program. Vocational/trade school after high school
refers to work or trade-related education received after completing high school, but does 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.
Some college but no degree: The person does not have a 4-year college (bachelor's) degree but has
completed a class for credit at a college, university, or vocational/technical school.
Associate's degree: A 2-year college degree typically earned at a community college (rather than a trade
school).
Bachelor's degree: A 4-year college degree earned at a university or 4-year college. It is sometimes called
an "undergraduate degree."
Graduate or professional school but no degree: The person attended a graduate or professional school
that advanced him/her 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.
Master's (MA, MS): Studies beyond a bachelor's degree, but not a Ph.D. or Ed.D.
Doctorate Degree (Ph.D., Ed.D.): Studies beyond a Master's degree that result in a doctorate degree.
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.
NEVER WENT TO SCHOOL ...................................................................
1ST GRADE.............................................................................................
2ND GRADE ...........................................................................................
3RD GRADE ..........................................................................................
4TH GRADE ............................................................................................
5TH GRADE ............................................................................................
6TH GRADE ............................................................................................
7TH GRADE ............................................................................................
8TH GRADE ............................................................................................
9TH GRADE ............................................................................................
10TH GRADE ..........................................................................................
11TH GRADE ..........................................................................................
12TH GRADE BUT NO DIPLOMA ..........................................................
HIGH SCHOOL DIPLOMA/EQUIVALENT OR VOC/TECH PROGRAM
AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA .....................
VOC/TECH PROGRAM AFTER HIGH SCHOOL ....................................
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.) ....................
REFUSED ................................................................................................
DON'T KNOW ..........................................................................................
ROUND 8 Parent – PEQ-87
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
(BOX 3)
(BOX 3)
(BOX 3)
(BOX 3)
21 (BOX 3)
77
99
PEQ.021
{Do/Does} {you/{NAME}} have a high school diploma or its equivalent, such as a GED?
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
BOX 3
LOOP 2.
ASK PEQ.010 - PEQ.021 ABOUT NEXT MOTHER OR FATHER FIGURE IN THE
HOUSEHOLD OR RESPONDENT AND RESPONDENT'S PARTNER IF NO MOTHER
AND FATHER FIGURES.
IF NO NEXT MOTHER OR FATHER FIGURE, GO TO BOX 4.
BOX 4
GO TO SECTION EMQ (PARENT EMPLOYMENT).
ROUND 8 Parent – PEQ-88
PARENT EMPLOYMENT - EMQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1),
CONTINUE WITH BOX 2.
OTHERWISE, GO TO BOX 5.
BOX 2
LOOP 1
THE EMPLOYMENT SECTION WILL BE ASKED FOR 2 "KEY" PARENT FIGURES IN
THE HOUSEHOLD AS DEFINED IN FSQ.
•
AFTER DETERMINING FOR WHOM THE EMPLOYMENT SECTION WILL BE
ASKED, CHECK PRELOAD TO DETERMINE IF EACH PERSON WAS EMPLOYED
OR ON LEAVE FROM A JOB IN ROUND 6. IF SO, WE WILL ONLY VERIFY
EMPLOYMENT STATUS FROM ROUND 6 FOR THIS PERSON AND GO TO
EMQ.010.
•
OTHERWISE, ASK EMQ.020 - EMQ.150 FOR EACH APPROPRIATE PERSON.
NOTE: THE DATE CHANGED TO SPRING 2004 IN ROUND 8.
EMQ.010
Since our last interview in spring 2004, has {your/{NAME’s}} job title, place of or type of employment
changed?
PROBE: During the last interview, we recorded that {you/NAME} worked for {EMPLOYER NAME} as a {JOB
TITLE}.
CAPI INSTRUCTION: FROM ROUND 6, DISPLAY EMPLOYER NAME FROM EMQ.120 AND JOB TITLE
FROM EMQ.140.
YES ...............................................................
NO.................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
EMQ.020
During the past week did {you/{NAME}} work at a job for pay?
1
2
7
9
(EMQ.020)
(EMQ.040)
(EMQ.020)
(EMQ.020)
HELP AVAILABLE
HELP TEXT:
Job for pay: Paid work for wages, salary, commission, or pay 'in kind.' Examples of 'pay in kind' include
meals, living quarters, or supplies provided in place of wages. This definition of employment includes work in
the person's own business, professional practice, or farm, paid leave of absence (including vacations and
illnesses), and work without pay in a family business or farm run by a relative. This definition excludes
unpaid volunteer work (such as for a church or charity), unpaid leaves of absence, temporary layoffs (such as
a strike), and work around the house.
IF SELF-EMPLOYED, CODE AS YES.
CAPI INSTRUCTION:
DISPLAY "you" IF PERSON CURRENTLY BEING LOOPED ON IS THE
RESPONDENT. OTHERWISE, DISPLAY "{NAME}".
CAPI INSTRUCTION:
BEING LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY
YES ...............................................................
NO.................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
ROUND 8 Parent – EMQ-89
1 (EMQ.040)
2
7
9
EMQ.030
{Were you/Was {NAME}} on leave or vacation from a job?
YES ...............................................................
NO.................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
EMQ.040
1
2 (EMQ.060)
7 (EMQ.060)
9 (EMQ.060)
How many jobs {do you/does {NAME}} have now?
CAPI INSTRUCTION: RANGE CHECK 1-6.
|___|
ENTER # OF JOBS
OR
REFUSED ....................................................
DON'T KNOW ..............................................
EMQ.050
7
9
About how many total hours per week {do you/does {NAME}} usually work for pay, counting all (# of jobs from
EMQ.040, IF MORE THAN ONE) jobs?
IF HOURS VARY, PROBE FOR AVERAGE HOURS PER WEEK.
CAPI INSTRUCTION: IF NUMBER OF JOBS IS GREATER THAN ONE IN EMQ.040, DISPLAY NUMBER
OF JOBS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: RANGE CHECK 1-80.
|___|___|
ENTER # OF WEEKLY HOURS
(BOX 2A)
OR
REFUSED ..................................................... 7777 (BOX 2A)
DON'T KNOW ............................................... 9999 (BOX 2A)
BOX 2A
IF EMQ.010=2, GO TO BOX 4A.
OTHERWISE, GO TO BOX 4.
HELP AVAILABLE
NOTE: EMQ.060 HAS A NEW CAPI INSTRUCTION TO DISPLAY "in the past 4 weeks" IN UNDERLINED TEXT
EMQ.060
{Have you/Has {NAME}} been actively looking for work in the past 4 weeks?
CAPI INSTRUCTION: DISPLAY "in the past 4 weeks" IN UNDERLINED TEXT
HELP TEXT:
Actively looking for work: The person has done at least one of the following activities in the past 4 weeks:
1.
Checked with public employment agency;
2.
Checked with private employment agency;
3.
Checked with employer directly/sent resume;
4.
Checked with friends or relatives; or
5.
Placed or answered ads/sent resume.
YES ...............................................................
NO.................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
ROUND 8 Parent – EMQ-90
1
2 (BOX 3)
7 (BOX 3)
9 (BOX 3)
EMQ.070
What {have you/has {NAME}} been doing in the past 4 weeks to find work?
CODE ALL THAT APPLY.
CAPI INSTRUCTION: DISPLAY "in the past 4 weeks" IN UNDERLINED TEXT
CHECKED WITH PUBLIC EMPLOYMENT AGENCY ............................. 1
CHECKED WITH PRIVATE EMPLOYMENT AGENCY .......................... 2
CHECKED WITH EMPLOYER DIRECTLY/SENT RESUME .................. 3
CHECKED WITH FRIENDS OR RELATIVES ......................................... 4
PLACED OR ANSWERED ADS/SENT RESUME ................................... 5
READ WANT-ADS .................................................................................. 6
SOMETHING ELSE (SPECIFY) _______________________________ 91
_________________________________________________________
REFUSED ............................................................................................... 77
DON'T KNOW ......................................................................................... 99
NOTE: THE SKIPS IN BOX 2B CHANGED BECAUSE EMQ.080 WAS DELETED.
BOX 2B
IF ANY CATEGORY IN EMQ.070 BETWEEN "1" AND "5" IS ENTERED BUT
NEITHER "6" NOR "91" HAS BEEN ENTERED, GO TO EMQ.100. ELSE, IF "91" IS
ENTERED IN EMQ.070, CONTINUE WITH EMQ.070OS. OTHERWISE, GO TO
BOX 3.
EMQ.070OS
[What {have you/has {NAME}} been doing in the past 4 weeks to find work?]
SPECIFY ACTIVITIES.
CAPI INSTRUCTION: DISPLAY "in the past 4 weeks" in UNDERLINED TEXT
BOX 3
EMQ.100
IF DOING SOMETHING ELSE IN THE PAST 4 WEEKS (EMQ.070 = 91),
CONTINUE WITH EMQ.100.
OTHERWISE, IF EMQ.060 = 2, REF, OR DK GO TO BOX 4A.
OTHERWISE, IF EMQ.070 = 6 (and not 6 combined with an answer of 1-5), 77REF, or
99DK, GO TO BOX 4.
Could {you/{NAME}} have taken a job last week if one had been offered?
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
ROUND 8 Parent – EMQ-91
1
2
7
9
BOX 4
EMQ.120
IF (WORKED AT A JOB FOR PAY (EMQ.020=1) OR (WAS ON LEAVE OR
VACATION (EMQ.030=1)) OR (WAS ACTIVELY LOOKING FOR WORK
(EMQ.060=1)), CONTINUE WITH EMQ.120.
OTHERWISE, GO TO BOX 4A.
For whom {do/does/did} {you/{NAME}} work {when {you/{he/she}} last worked}?
PROBE FOR: NAME OF THE COMPANY, BUSINESS, ORGANIZATION, OR OTHER EMPLOYER. IF
MORE THAN ONE CURRENT JOB, ASK ABOUT THE ONE AT WHICH THE PERSON SPENDS THE MOST
TIME.
CAPI INSTRUCTION: DISPLAY "do" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING
LOOPED ON IS THE RESPONDENT. DISPLAY "does" IF EMQ.020 =1 OR EMQ.030 = 1 AND PERSON
CURRENTLY BEING LOOPED ON IS NOT THE RESPONDENT.
DISPLAY "did" IF
EMQ.060 = 1.
CAPI INSTRUCTION: DISPLAY "when {you/{he/she}} last worked" IF EMQ.060 = 1. OTHERWISE, USE A
NULL DISPLAY.
CAPI INSTRUCTION:
DISPLAY "YOU" IF PERSON CURRENTLY BEING LOOPED ON IS THE
RESPONDENT. OTHERWISE, DISPLAY "{HE/SHE}".
_________________________________________________________
ENTER EMPLOYER NAME
REFUSED ...............................................................................................
DON'T KNOW .........................................................................................
EMQ.130
7
9
What kind of business or industry {is/was} this?
PROBE: What do they make or do?
PROBE: For example, TV and radio manufacturing, retail shoe store, state labor department, farming.
CAPI INSTRUCTION: DISPLAY "is" IF EMQ.020 = 1 OR EMQ.030 = 1. OTHERWISE, DISPLAY "was".
_________________________________________________________
ENTER INDUSTRY DESCRIPTION
REFUSED ................................................................................................
DON'T KNOW ..........................................................................................
EMQ.140
7
9
What kind of work {are/is/were/was} {you/{NAME}} doing?
PROBE: What {is/was} {your/{NAME}'s} job called?
PROBE: For example, electrical engineer, stock clerk, typist, farmer.
CAPI INSTRUCTION: DISPLAY "are" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY
BEING LOOPED ON IS THE RESPONDENT. DISPLAY "is" IF EMQ.020 =1 OR EMQ.030 = 1 AND PERSON
CURRENTLY BEING LOOPED ON IS NOT THE RESPONDENT. DISPLAY "were" IF EMQ.060 = 1 AND
PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT. DISPLAY "was" IF EMQ.060 =1 AND
PERSON CURRENTLY BEING LOOPED ON IS NOT THE RESPONDENT.
_________________________________________________________
ENTER JOB TITLE
REFUSED ................................................................................................
DON'T KNOW ..........................................................................................
ROUND 8 Parent – EMQ-92
7
9
EMQ.150
What {are/were} {your/{NAME}'s} most important activities or duties on this job?
{you/{NAME}} actually do at this job?
What {do/does/did}
CAPI INSTRUCTION: DISPLAY "are" IF EMQ.020 = 1 OR EMQ.030 = 1. DISPLAY "were" IF EMQ.060 = 1.
DISPLAY "do" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING LOOPED ON IS
RESPONDENT. DISPLAY "did" IF EMQ.060 = 1. DISPLAY "does" IF EMQ.020 = 1 OR EMQ.030 = 1 AND
PERSON CURRENTLY BEING LOOPED ON IS NOT THE RESPONDENT.
PROBE: For example, typing, keeping account books, filing, selling cars, operating a printing press, finishing
concrete.
_________________________________________________________
ENTER JOB DUTIES
REFUSED ...............................................................................................
DON'T KNOW .........................................................................................
7
9
BOX 4A
ASK EMQ.010 – EMQ.150 ABOUT NEXT MOTHER OR FATHER FIGURE IN THE
HOUSEHOLD OR RESPONDENT AND RESPONDENT'S SPOUSE IF NO
MOTHER AND FATHER FIGURES.
IF NO NEXT MOTHER OR FATHER FIGURES, GO TO BOX 5.
BOX 5
GO TO WPQ (WELFARE AND OTHER PUBLIC TRANSFERS).
ROUND 8 Parent – EMQ-93
WELFARE AND OTHER PUBLIC TRANSFERS – WPQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1),
CONTINUE WITH WPQ.100. OTHERWISE, GO TO BOX 3.
HELP AVAILABLE
WPQ.100
In the past 12 months, have you or anyone in your household received Temporary Assistance for Needy
Families, sometimes called TANF {or{STATE TANF PROGRAM NAME}}?
PROBE: TANF was formally known as Aid to Families with Dependent Children, or AFDC.
HELP TEXT: TANF: is a government program that provides cash benefits to low-income families with
children. This program is also known by {STATE TANF PROGRAM NAME} in {STATE}.
CAPI INSTRUCTIONS:
1. DISPLAY STATE TANF PROGRAM NAME.
YES .................................................................. 1
NO ..................................................................... 2 (WPQ.110)
REFUSED ......................................................... 7 (WPQ.110)
DON'T KNOW ................................................... 9 (WPC.110)
WPQ.102
During those 12 months, how many months did your household receive TANF {or {STATE TANF
PROGRAM NAME}}?
ENTER NUMBER OF MONTHS.
HARD RANGE: 1-12 MONTHS.
CAPI INSTRUCTIONS:
1. DISPLAY STATE TANF PROGRAM NAME.
|___|___|
ENTER NUMBER OF MONTHS.
OR
REFUSED .................................................... 77
DON'T KNOW ............................................... 99
WPQ.105
Are you or anyone in your family required to work, attend school or anything else in order to receive
these benefits?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.106
1
2
7
9
What are you or anyone in your family required to do?
PROBE: Anything else?
CODE ALL THAT APPLY
Look for a job,................................................ 1
Work in a paid job,......................................... 2
Work in an unpaid job,................................... 3
Attend school or training, or........................... 4
Something else? (SPECIFY) ......................... 91
REFUSED ..................................................... 7
DON’T KNOW ............................................... 9
ROUND 8 Parent – WPQ-94
(WPQ.106)
(WPQ.110)
(WPQ.110)
(WPQ.110)
BOX 2A
IF WPQ.106=91, CONTINUE WITH WPQ.106OS. OTHERWISE, GO TO WPQ.110.
WPQ.106OS
[What are you or anyone in your family required to do?]
SPECIFY OTHER
_____________________________
HELP AVAILABLE
WPQ.110
In the past 12 months, have you or anyone in your household received food stamps?
HELP TEXT: Food Stamps: A government program that provides coupon books, checks, or plastic
cards that can be used to buy food.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.120
1
2
7
9
(WPQ.120)
(WPQ.150)
(WPQ.150)
(WPQ.150)
During those 12 months, how many months did your household receive food stamps?
ENTER NUMBER OF MONTHS.
HARD RANGE: 1-12 MONTHS.
|___|___|
ENTER NUMBER OF MONTHS.
OR
REFUSED .................................................... 77
DON'T KNOW .............................................. 99
WPQ.125
Are you or anyone in your family required to work, attend school or anything else in order to receive
these benefits?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.130
1
2
7
9
(WPQ.130)
(WPQ.150)
(WPQ.150)
(WPQ.150)
What are you or anyone in your family required to do?
PROBE: Anything else?
CODE ALL THAT APPLY
Look for a job,................................................ 1
Work in a paid job,......................................... 2
Work in an unpaid job,................................... 3
Attend school or training, or........................... 4
Something else? (SPECIFY) ......................... 91
REFUSED ..................................................... 7
DON’T KNOW ............................................... 9
BOX 2B
IF WPQ.130=91, CONTINUE WITH WPQ.130OS. OTHERWISE, GO TO WPQ.150.
ROUND 8 Parent – WPQ-95
WPQ.130OS
[What are you or anyone in your family required to do?]
SPECIFY OTHER
_____________________________
WPQ.150
Does {CHILD}'s school offer lunch for its students?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.160
(WPQ.160)
(WPQ.200)
(WPQ.200)
(WPQ.200)
Does {CHILD} usually receive a complete lunch offered at school? By complete school lunch, I 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, ice cream, or a lunch {he/she} brought from home.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.170
1
2
7
9
1
2
7
9
(WPQ.170)
(WPQ.200)
(WPQ.200)
(WPQ.200)
Does {CHILD} receive free or reduced price lunches at school?
CAPI INSTRUCTION: DISPLAY "free" AND "reduced price" IN UNDERLINED TEXT
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.180
1
2
7
9
(WPQ.180)
(WPQ.200)
(WPQ.200)
(WPQ.200)
Are these lunches free or reduced price?
FREE............................................................. 1 (WPQ.190)
REDUCED PRICE......................................... 2 (WPQ.190)
REFUSED ..................................................... 7 (WPQ.200)
DON'T KNOW ............................................... 9 (WPQ.200)
WPQ.190
During the last five days {CHILD} was in school, how many complete school lunches did {he/she}
receive?
HARD RANGE CHECK: 0-5 LUNCHES.
|___|
ENTER NUMBER OF SCHOOL LUNCHES
OR
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.200
7
9
Does {CHILD}'s school offer breakfast for its students?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – WPQ-96
1
2
7
9
(WPQ.210)
(BOX 3)
(BOX 3)
(BOX 3)
WPQ.210
Does {CHILD} usually receive a breakfast provided by the school?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.215
1
2
7
9
(WPQ.215)
(BOX 3)
(BOX 3)
(BOX 3)
Does {CHILD} receive free or reduced price breakfasts at school?
CAPI INSTRUCTION: DISPLAY "free" AND "reduced price" IN UNDERLINED TEXT
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.216
(WPQ.216)
(BOX 3)
(BOX 3)
(BOX 3)
1
2
7
9
(WPQ.220)
(WPQ.220)
(BOX 3
(BOX 3)
Are these breakfasts free or reduced price?
FREE.............................................................
REDUCED PRICE.........................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.220
1
2
7
9
During the last five days {CHILD} was in school, how many school breakfasts did {he/she} receive?
CAPI INSTRUCTION: HARD RANGE CHECK: 0-5 BREAKFASTS.
|___|
ENTER NUMBER OF SCHOOL BREAKFASTS
OR
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9
BOX 3
GO TO FDQ (FOOD SECURITY).
ROUND 8 Parent – WPQ-97
FOOD SECURITY - FDQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1),
CONTINUE WITH FDQ.130.
IF (NumberOfChildren > 1 and CHILDNUM=2), GO TO BOX 4.
FDQ.130
These next questions are about whether your family is able to afford the food that you need. I am going
to read you several statements that people have made about their food situation. For these statements,
please tell me whether 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}, 2006.
PROBE: Was that often true, sometimes true, or never true for {you/your household} in the last 12
months?
CAPI INSTRUCTIONS: DISPLAY CURRENT MONTH.
CAPI INSTRUCTIONS: DISPLAY "OFTEN," "SOMETIMES," AND "NEVER" IN THE MAIN QUESTION
TEXT AND PROBE AS UNDERLINED.
CAPI INSTRUCTIONS: USE "you," ,"I," “I was,” AND "my" 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 “your household,” “we,”
“we were,” AND “our.”
CAPI INSTRUCTIONS: DISPLAY “the children” AND “The children were” IF (NumberOfChildren > 1) OR
(THERE ARE CHILDREN IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL
CHILD/TWIN). OTHERWISE, DISPLAY “{CHILD}” AND “{CHILD} was.”
CAPI INSTRUCTIONS: DISPLAY "PROBE:…months" IN SQUARE BRACKETS FOR B - F.
OFTEN
TRUE
a.
b.
c.
d.
e.
{I/We} worried whether {my/our} food would
run out before {I/we} got money to buy
more. .........................................................
The food that {I/we} bought just didn’t last, and
{I/we} didn’t have money to get more..........
We couldn't afford to eat balanced meals. ..
{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 ......................................................
{I/We} couldn't feed {{CHILD}/the children} a
balanced meal because {I/we} couldn't afford
that..............................................................
SOMETIMES NEVER
TRUE
TRUE
REF
DK
1
2
3
7
9
1
1
2
2
3
3
7
7
9
9
1
2
3
7
9
1
2
3
7
9
3
7
9
BOX 2
IF ANY OF FDQ.130A TO FDQ.130E = 1 OR 2, CONTINUE WITH FDQ.130F.
OTHERWISE GO TO BOX 4.
f.
{{CHILD} was/The children were} not eating
enough because {I/we} just couldn't afford
enough food................................................
1
ROUND 8 Parent – FDQ-98
2
FDQ.140
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?
CAPI INSTRUCTIONS: DISPLAY "you" 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 REF. OTHERWISE, DISPLAY “you or other adults in your household.”
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.150
1
2
7
9
In the last 12 months, were you ever hungry but didn't eat because you couldn't afford enough food?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.180
1
2
3
7
9
In the last 12 months, did you ever eat less than you felt you should because there wasn't enough
money to buy food?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.170
(FDQ.150)
(FDQ.160)
(FDQ.160)
(FDQ.160)
How often did this happen? Would you say…
Almost every month.......................................
Some months, but not every month, or..........
In only 1 or 2 months? ...................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.160
1
2
7
9
1
2
7
9
In the last 12 months, did you lose weight because you didn't have enough money for food?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
7
9
BOX 3
IF (FDQ.130F=1 or 2) OR (FDQ.140=1) OR (ANY OF FDQ.160 TO FDQ.180=1), ASK
FDQ.190.
OTHERWISE GO TO BOX 4.
ROUND 8 Parent – FDQ-99
FDQ.190
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?
CAPI INSTRUCTIONS: DISPLAY "you" 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 REF. OTHERWISE, DISPLAY “you or other adults in your household.”
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.200
(FDQ.200)
(FDQ.210)
(FDQ.210)
(FDQ.210)
How often did this happen? Would you say…
Almost every month.......................................
Some months, but not every month, or..........
In only 1 or 2 months? ...................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.210
1
2
7
9
1
2
3
7
9
The next questions are about children living in the household who are under 18 years old.
In the last 12 months, since {CURRENT MONTH OF LAST YEAR}, 2006 did you ever cut the size of
{{CHILD}'s/any of the children's} meals because there wasn't enough money for food?
CAPI INSTRUCTIONS: DISPLAY “any of the children’s” IF (NumberOfChildren > 1) OR (THERE ARE
CHILDREN IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD/TWIN).
OTHERWISE, DISPLAY “{CHILD}’s.”
CAPI INSTRUCTIONS: DISPLAY THE CURRENT MONTH IN {CURRENT MONTH OF LAST YEAR}
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.220
1
2
7
9
In the last 12 months, did {{CHILD}/any of the children} ever skip a meal because there wasn't enough
money for food?
CAPI INSTRUCTIONS: DISPLAY “any of the children” IF (NumberOfChildren > 1) OR (THERE ARE
CHILDREN IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD/TWIN).
OTHERWISE, DISPLAY “{CHILD}.”
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
ROUND 8 Parent – FDQ-100
1
2
7
9
(FDQ.230)
(FDQ.240)
(FDQ.240)
(FDQ.240)
FDQ.230
How often did this happen? Would you say…
Almost every month.......................................
Some months, but not every month, or..........
In only 1 or 2 months? ...................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.240
1
2
3
7
9
In the last 12 months, {was {CHILD}/were any of the children} ever hungry but you just couldn't afford
more food?
CAPI INSTRUCTIONS: DISPLAY “were any of the children” IF (NumberOfChildren > 1) OR (THERE
ARE CHILDREN IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL
CHILD/TWIN). OTHERWISE, DISPLAY “was {CHILD}.”
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
FDQ.250
1
2
7
9
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?
CAPI INSTRUCTIONS: DISPLAY “any of the children” IF (NumberOfChildren > 1) OR (THERE ARE
CHILDREN IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD/TWIN).
OTHERWISE, DISPLAY “{CHILD}.”
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
BOX 4
GO TO SECTION PAQ (PARENT INCOME AND ASSETS).
ROUND 8 Parent – FDQ-101
1
2
7
9
PARENT INCOME AND ASSETS -- PAQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1,
CONTINUE WITH PAQ.100. OTHERWISE, GO TO BOX 5.
PAQ.100
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?
Was it …
$25,000 or less, or ...................................................................................
More than $25,000? .................................................................................
REFUSED ..................................................................................................
DON’T KNOW ............................................................................................
PAQ.110
1
2
7 (PAQ.135)
9 (PAQ.135)
Was it …
CAPI INSTRUCTION: IF PAQ.100=1, DISPLAY SET 1. IF PAQ.100=2, DISPLAY SET 2.
[SET 1}
$5,000 or less,.......................................................................................... 1
$5,001 to $10,000, ................................................................................... 2
$10,001 to $15,000, ................................................................................. 3
$15,001 to $20,000, or ............................................................................. 4
$20,001 to $25,000? ................................................................................ 5
REFUSED ................................................................................................ 77
DON’T KNOW .......................................................................................... 99
[SET 2]
$25,001 to $30,000 ..................................................................................
$30,001 to $35,000, .................................................................................
$35,001 to $40,000, .................................................................................
$40,001 to $50,000 ..................................................................................
$50,001 to $75,000, ................................................................................
$75,001 to $100,000, ...............................................................................
$100,001 to $200,000, or ........................................................................
$200,001 or more? ..................................................................................
REFUSED ................................................................................................
DON’T KNOW ..........................................................................................
BOX 3
ASK PAQ.120 IF
(NUMBER IN HH = 1 AND PAQ.110 < 3) OR
(NUMBER IN HH = 2 AND PAQ.110 < 4) OR
(NUMBER IN HH = 3 AND PAQ.110 < 5) OR
(NUMBER IN HH = 4 AND PAQ.110 < 5) OR
(NUMBER IN HH = 5 AND PAQ.110 < 6) OR
(NUMBER IN HH = 6 AND PAQ.110 < 7) OR
(NUMBER IN HH = 7 OR 8 AND PAQ.110 < 8) OR
(NUMBER IN HH g.e. 9 AND PAQ.110 < 10).
ELSE, GO TO PAQ.135.
ROUND 8 Parent – PAQ-102
6
7
8
9
10
11
12
13
77
99
PAQ.120
What was your total household income last year, to the nearest thousand?
CAPI INSTRUCTION: RANGE CHECK-TOTAL INCOME SHOULD BE IN RANGE OF ANSWER TO
PAQ. 110.
|___|___|___|,|___|___|___|,|___|___|___|.
ENTER TOTAL INCOME
OR
REFUSED ..................................................... 7777777777
DON’T KNOW ............................................... 9999999999
PAQ.135
Is tuition paid for {CHILD}'s education?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(PAQ.137)
(PAQ.140)
(PAQ.140)
(PAQ.140)
NOTE: THE RANGE CHECK HAS BEEN MODIFIED IN ROUND 8.
PAQ.137
Approximately, how much does {CHILD}'s family pay in tuition per year?
CAPI INSTRUCTION: RANGE CHECK = 1-33,000 DOLLARS.
$ |___|___| , |___|___|___|
ENTER AMOUNT OF TUITION
OR
REFUSED ..................................................... 777777
DON'T KNOW ............................................... 999999
NOTE: PAQ.140 IS NEW IN ROUND 8.
PAQ.140
Do you {or anyone else in your family living there} own the home or apartment, pay rent, or do something
else?
OWN.............................................................. 1 (PAQ.150)
RENT............................................................. 2 (PAQ.240)
DO SOMETHING ELSE ................................ 3 (PAQ.240)
REFUSED ..................................................... 7 (PAQ.240)
DON'T KNOW ............................................... 9 (PAQ.240)
NOTE: PAQ.150 IS NEW IN ROUND 8.
HELP AVAILABLE
HELP TEXT:
Present value of your house or apartment. We are asking about the fair market value or likely selling
price, not the profit or amount left over after paying off the mortgage. Your best guess is fine.
PAQ.150
Could you tell me what the present value of your (house/apartment) is--I mean about how much would it
bring if you sold it today?
PROBE: Your best guess is fine.
|___|___|,|___|___|___|,|___|___|___|.
ENTER TOTAL AMOUNT
OR
REFUSED ..................................................... 77777777 (PAQ.160)
DON’T KNOW ............................................... 99999999 (PAQ.160)
ROUND 8 Parent – PAQ-103
NOTE: PAQ.160 IS NEW IN ROUND 8.
PAQ.160
Would it amount to $100,000 or more?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(PAQ.170)
(PAQ.180)
(PAQ.190)
(PAQ.190)
1
2
7
9
(PAQ.190)
(PAQ.190)
(PAQ.190)
(PAQ.190)
1
2
7
9
(PAQ.190)
(PAQ.190)
(PAQ.190)
(PAQ.190)
1
2
7
9
(PAQ.200)
(PAQ.240)
(PAQ.210)
(PAQ.210)
NOTE: PAQ.170 IS NEW IN ROUND 8.
PAQ.170
Would it amount to $250,000 or more?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
NOTE: PAQ.180 IS NEW IN ROUND 8.
PAQ.180
Would it amount to $10,000 or more?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
NOTE: PAQ.190 IS NEW IN ROUND 8.
PAQ.190
Do you have a mortgage on this property?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
NOTE: PAQ.200 IS NEW IN ROUND 8.
PAQ.200
About how much is the remaining principal on this mortgage?
PROBE: Remaining principal is the amount still owed on the mortgage.
|___|___|___|,|___|___|___|,|___|___|___|.
ENTER TOTAL AMOUNT ............................ (PAQ.240)
OR
REFUSED ..................................................... 777777777 (PAQ.210)
DON’T KNOW ............................................... 999999999 (PAQ.210)
NOTE: PAQ.210 IS NEW IN ROUND 8.
PAQ.210
Would it amount to $100,000 or more?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
ROUND 8 Parent – PAQ-104
1
2
7
9
(PAQ.220)
(PAQ.230)
(PAQ.240)
(PAQ.240)
NOTE: PAQ.220 IS NEW IN ROUND 8.
PAQ.220
Would it amount to $250,000 or more?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
7
9
(PAQ.240)
(PAQ.240)
(PAQ.240)
(PAQ.240)
1
2
7
9
(PAQ.240)
(PAQ.240)
(PAQ.240)
(PAQ.240)
NOTE: PAQ.230 IS NEW IN ROUND 8.
PAQ.230
Would it amount to $10,000 or more?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
NOTE: PAQ.240 IS NEW IN ROUND 8.
PAQ.240 Have you {or {NAME OF SPOUSE/PARTNER}} done anything specific in order to have some money for
{CHILD}‘s education after high school?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
BOX 5
GO TO SECTION CMQ (CHILD MOBILITY AND PLANS TO MOVE).
ROUND 8 Parent – PAQ-105
1
2
7
9
(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)
CHILD MOBILITY AND PLANS TO MOVE – CMQ
BOX 1
IF (NumberOfChildren = 1) OR IF (NumberOfChildren > 1 AND ChildNum = 1,
CONTINUE WITH CMQ.010. OTHERWISE, GO TO CMQ.600.
CMQ.010
Since the spring of 2004, how many different places has {CHILD} lived for four months or more?
PROBE: IF RESPONDENT SAYS ZERO, ASK: By saying zero places, do you mean that {CHILD} did not
live anywhere since spring 2004 for four months or more?
CAPI INSTRUCTION: RANGE CHECK: 0 – 10 PLACES.
|___|___|
ENTER NUMBER OF PLACES
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99
BOX 2
IF CMQ.010=1, RF, OR DK, GO TO BOX 3. OTHERWISE, CONTINUE WITH
CMQ.020.
CMQ.020
Why did you move?
PROBE: Any other reason?
CODE ALL THAT APPLY.
SO CHILD COULD GO TO A BETTER SCHOOL.................................... 1
BOUGHT A HOUSE................................................................................. 2
MOVED TO BE NEARER JOB; JOB-RELATED REASONS ................... 3
MOVED TO NICER APARTMENT/HOUSE ............................................. 4
MOVED TO SAFER AREA, CRIME-RELATED REASONS..................... 5
MOVED TO LESS EXPENSIVE LIVING QUARTER ............................... 6
WAS EVICTED, COULD NOT PAY RENT IN PREVIOUS RESIDENCE. 7
OLD HOUSE/APARTMENT WAS DAMAGED......................................... 8
MOVED BECAUSE OF MARITAL SEPARATION, DIVORCE, DEATH
IN FAMILY ............................................................................................. 9
REFUSED ................................................................................................ 77
DON'T KNOW .......................................................................................... 99
BOX 3
IF HAVE SECOND TELEPHONE NUMBER FROM PRELOAD AND THE
RESPONDENT IN ROUND 8 IS THE SAME AS THE RESPONDENT IN ROUND 6 GO
TO CMQ.100. OTHERWISE, CONTINUE WITH CMQ.060.
ROUND 8 Parent – CMQ-106
CMQ.060
Thank you very much for your answers. The participation in the study of persons like yourself has provided a
wealth of information that researchers and policymakers use to learn about the factors that affect children’s
education. It has been so valuable that the U.S. Department of Education plans to continue the study in 2009.
We would like to be able to reach you so I’d like to ask some questions about how to find you.
Is there a second phone number, such as a work number, a friend or relative's number, or a beeper or cell
phone number, where you can sometimes be reached?
YES ...............................................................
NO.................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
CMQ.100
1
2
7
9
(CMQ.140)
(BOX 4)
(BOX 4)
(BOX 4)
Thank you very much for your answers. The participation in the study of persons like yourself has provided a
wealth of information that researchers and policymakers use to learn about the factors that affect children’s
education. It has been so valuable that the U.S. Department of Education plans to continue the study in 2009.
We would like to be able to reach you so I’d like to ask some questions about how to find you.
I have recorded {PHONE NUMBER} as a second phone number where you can sometimes be reached. Is
this the right number?
CAPI INSTRUCTION: IF HAVE SECOND TELEPHONE NUMBER FROM PRELOAD, DISPLAY THIS
SECOND PHONE NUMBER.
CAPI INSTRUCTION: IF ENTRY WAS MADE IN ROUND 6 CMQ.140, DISPLAY THIS AS THE SECOND
PHONE NUMBER.
YES ..............................................................
NO.................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
CMQ.140
1
2
7
9
(BOX 4)
(CMQ.140)
(BOX 4)
(BOX 4)
What is that telephone number?
IF NO TELEPHONE, ENTER ‘000’.
ENTER {NEW} SECOND PHONE NUMBER, INCLUDING AREA CODE.
CAPI INSTRUCTION: DISPLAY 'NEW' IF CMQ.100=2. OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE
NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
ROUND 8 Parent – CMQ-107
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
|__|__|__| – |__|__|__| –|__|__|__|__|
SECOND TELEPHONE NUMBER
CMQ.150
_______________
EXTENSION
Where is that telephone located?
OFFICE/PLACE OF BUSINESS .................. 1 (BOX 4)
RELATIVE (SPECIFY) _________________ 2 (CMQ.155)
NEIGHBOR (SPECIFY) ________________ 3 (CMQ.155)
FRIEND (SPECIFY) ___________________ 4 (CMQ.155)
BEEPER NUMBER ...................................... 5 (BOX 4)
CELL PHONE .............................................. 6 (BOX 4)
OTHER (SPECIFY) ___________________ 91 (CMQ.155)
REFUSED .................................................... 77 (BOX 4)
DON'T KNOW .............................................. 99 (BOX 4)
CMQ.155
[Where is that telephone located?]
SPECIFY {RELATIVE / NEIGHBOR / FRIEND / OTHER}.
CAPI INSTRUCTIONS:
1.
DISPLAY 'RELATIVE' IF CMQ.150=2.
2.
DISPLAY 'NEIGHBOR' IF CMQ.150=3.
3.
DISPLAY 'FRIEND' IF CMQ.150=4.
4.
DISPLAY 'OTHER' IF CMQ.150 = 91.
BOX 4
IF THE RESPONDENT IN ROUND 8 IS THE SAME AS THE RESPONDENT IN
ROUND 6 AND PRELOAD HAS FIRST CONTACT NAME, PHONE NUMBER, AND
ADDRESS, GO TO CMQ.200.
ELSE, GO TO CMQ.205.
CMQ.200
I have recorded that {NAME OF RELATIVE/FRIEND} at {PHONE NUMBER} on
{STREET ADDRESS, LINE 1}
{STREET ADDRESS, LINE 2}
{CITY}, {STATE} {ZIP CODE}
will always know where you are if you move. Is this still true?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
CAPI INSTRUCTION: DISPLAY FIRST CONTACT NAME, PHONE NUMBER, AND ADDRESS FROM
PRELOAD.
YES, NO CORRECTION NEEDED ..............
YES, MINOR CORRECTIONS NEEDED .....
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
3
7
9
ROUND 8 Parent – CMQ-108
(BOX 5)
(CMQ.210)
(CMQ.205)
(BOX 5)
(BOX 5)
NOTE: IN ROUND 8, CMQ.205 REFERS ONLY TO A RELATIVE.
CMQ.205
Is there a relative, who does not live in this household, who will always know where you are if you move?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
(CMQ.210)
(CMQ.206)
(CMQ.206)
(CMQ.206)
NOTE: CMQ.206 IS NEW IN ROUND 8 AND REFERS ONLY TO A FRIEND.
CMQ.206
Is there a friend, who does not live in this household, who will always know where you are if you move?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
(CMQ.210)
(BOX 7)
(BOX 7)
(BOX 7)
HELP AVAILABLE
CMQ.210
What is the name, address, and telephone number of that person?
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP OF PERSON TO RESPONDENT.
CAPI INSTRUCTIONS: IF CMQ.200=2, DISPLAY FIRST CONTACT NAME, PHONE NUMBER, AND
ADDRESS FROM PRELOAD IN THE RESPONSE FIELDS.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS EXCEPT FIRST AND
LAST NAME FIELD.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON STATE FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
ROUND 8 Parent – CMQ-109
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE
NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CAPI INSTRUCTION: WHEN ON THE RELATIONSHIP FIELD, DISPLAY "PROBE: What is this
person's relationship to you?"
BOX 5
IF THE RESPONDENT IN ROUND 8 IS THE SAME AS THE RESPONDENT IN
ROUND 6 AND HAVE SECOND CONTACT NAME, PHONE NUMBER, AND
ADDRESS FROM PRELOAD, GO TO CMQ.300.
ELSE, GO TO CMQ.305.
CMQ.300
I have also recorded that {NAME OF RELATIVE/FRIEND} at {PHONE NUMBER} on
{STREET ADDRESS, LINE 1}
{STREET ADDRESS, LINE 2}
{CITY}, {STATE} {ZIP CODE}
will always know how where you are if you move. Is this still true?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
CAPI INSTRUCTION: DISPLAY SECOND CONTACT NAME, PHONE NUMBER, AND ADDRESS FROM
PRELOAD.
YES, NO CORRECTION NEEDED ..............
YES, MINOR CORRECTIONS NEEDED .....
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
CMQ.305
1
2
3
7
9
(BOX 7)
(CMQ.310)
(CMQ.305)
(CMQ.305)
(CMQ.305)
Besides {PERSON AT CMQ.210}, is there another relative or friend, who does not live in this household, who
will always know where you are if you move?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
ROUND 8 Parent – CMQ-110
(CMQ.310)
(BOX 7)
(BOX 7)
(BOX 7)
HELP AVAILABLE
CMQ.310
What is the name, address, and telephone number of that person?
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP OF PERSON TO RESPONDENT.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY SECOND CONTACT NAME, PHONE NUMBER, AND
ADDRESS FROM PRELOAD IN THE RESPONSE FIELDS.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS EXCEPT FIRST AND
LAST NAME FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON STATE FIELD.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS,
SHOW EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE
NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CAPI INSTRUCTION: WHEN ON RELATIONSHIP FIELD, DISPLAY "PROBE: What is this person's
relationship to you?"
ROUND 8 Parent – CMQ-111
BOX 7
IF [(THE FIRST PRELOADED CONTACT WAS CORRECT OR NEEDED MINOR
CORRECTIONS (CMQ.200= 1 OR 2)) AND (THE FIRST CONTACT NAME IN
CMQ.210 IS A RELATIVE)) OR (IF THE SECOND CONTACT NAME IN CMQ.310 IS A
RELATIVE)], GO TO BOX 7A. OTHERWISE, ASK CMQ.311.
NOTE: CMQ.311 IS NEW IN ROUND 8.
CMQ.311
Is there a relative, who does not live in this household, who will always know where you are if you move?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
(CMQ.312)
(BOX 7A)
(BOX 7A)
(BOX 7A)
NOTE: CMQ.312 IS NEW IN ROUND 8.
HELP AVAILABLE
CMQ.312
What is the name, address, and telephone number of that person?
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP OF PERSON TO RESPONDENT.
CAPI INSTRUCTIONS: IF ROUND 6 CMQ.200=2, DISPLAY FIRST CONTACT NAME, PHONE NUMBER,
AND ADDRESS FROM PRELOAD IN THE RESPONSE FIELDS.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS EXCEPT FIRST AND
LAST NAME FIELD.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON STATE FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE
NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
ROUND 8 Parent – CMQ-112
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CAPI INSTRUCTION: WHEN ON THE RELATIONSHIP FIELD, DISPLAY "PROBE: What is this
person's relationship to you?"
BOX 7A
IF THE FOCAL CHILD HAS AT LEAST ONE NON-RESIDENTIAL PARENT WHOM
THE CHILD HAS HAD CONTACT WITH (NRQ.100 = 1 OR 2 FOR AT LEAST ONE
NON-RESIDENTIAL PARENT) AND THE RESPONDENT IN ROUND 8 IS THE SAME
AS THE RESPONDENT IN ROUND 6 AND PRELOAD HAS COMPLETED NONRESIDENT PARENT INFORMATION (SEE DEFINITION BELOW), CONTINUE WITH
CMQ.395.
OTHERWISE, GO TO BOX 8.
DEFINITION OF "COMPLETED" NON-RESIDENT PARENT INFORMATION: EITHER
(NAME + PHONE NUMBER) OR (NAME + CITY + STATE) ARE IN PRELOAD.
IF THE NON-RESIDENT PARENT ADDRESS IN PRELOAD DOES NOT MEET THE
DEFINITION OF "COMPLETE," THEN GO TO BOX 8.
CMQ.395
I have recorded {NAME OF NONRESIDENTIAL PARENT} at {ADDRESS, PHONE NUMBER} is {CHILD}'s
{RELATIONSHIP}. Is this information still correct?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
CAPI INSTRUCTIONS: DISPLAY THE NAME, ADDRESS, PHONE NUMBER AND RELATIONSHIP OF
NON-RESIDENTIAL PARENT FROM PRELOAD.
DISPLAY CITY, STATE, AND ZIP ON 1 LINE.
YES – NO CORRECTIONS NEEDED ..........
YES – MINOR CORRECTIONS NEEDED....
NO.................................................................
INFORMATION ALREADY PROVIDED
IN PREVIOUS ITEMS ...............................
REFUSED .....................................................
DON'T KNOW ...............................................
1 (CMQ.500)
2 (CMQ.400)
3 (BOX 8)
4 (CMQ.500)
7 (CMQ.500)
9 (CMQ.500)
BOX 8
IF FOCAL CHILD HAS AT LEAST ONE NON-RESIDENTIAL PARENT WHO THE
CHILD HAS HAD CONTACT WITH (NRQ.100=1 OR 2 FOR AT LEAST ONE NONRESIDENTIAL PARENT), CONTINUE WITH CMQ.400.
OTHERWISE, GO TO CMQ.500.
IF CMQ.395 WAS NOT ASKED AND IF FOCAL CHILD HAS AT LEAST ONE NONRESIDENT PARENT WHO THE CHILD HAS HAD CONTACT WITH (NRQ.100 = 1 OR
2 FOR AT LEAST ONE NON-RESIDENT PARENT), CONTINUE WITH CMQ.400.
IF CMQ.395 = 3 (NO) AND THE FOCAL CHILD HAS AT LEAST TWO NONRESIDENT PARENTS WHO THE CHILD HAS HAD CONTACT WITH (NRQ.100 = 1
OR 2 FOR TWO-NON-RESIDENT PARENTS), ALSO CONTINUE WITH CMQ.400.
OTHERWISE, GO TO CMQ.500.
ROUND 8 Parent – CMQ-113
HELP AVAILABLE
CMQ.400
What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or}
adoptive mother / {or} adoptive father}?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR
THERE IS NO ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER '000'.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP.
CAPI INSTRUCTIONS:
IF CMQ395 = 2, DISPLAY NAME, PHONE NUMBER, ADDRESS, AND
RELATIONSHIP OF NON-RESIDENTIAL PARENT FROM PRELOAD
CAPI INSTRUCTIONS: DISPLAY 'BIOLOGICAL MOTHER' IF NRQ100=1 OR 2 FOR A NON-RESIDENT
BIOLOGICAL MOTHER.
CAPI INSTRUCTIONS: DISPLAY '{OR} BIOLOGICAL FATHER] IF NRQ100=1 OR 2 FOR A NONRESIDENT BIOLOGICAL FATHER.
DISPLAY THE 'OR' IF NRQ100=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL MOTHER ALSO.
CAPI INSTRUCTION: DISPLAY '{OR} ADOPTIVE MOTHER' IFNRQ100=1 OR 2 FOR A NON-RESIDENT
ADOPTIVE MOTHER.
DISPLAY THE 'OR' IF NRQ100=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL MOTHER OR NONRESIDENT BIOLOGICAL FATHER ALSO.
CAPI INSTRUCTION: DISPLAY '{OR} ADOPTIVE FATHER' IF NRQ100=1 OR 2 FOR A NON-RESIDENT
ADOPTIVE FATHER.
DISPLAY THE 'OR' IF NRQ100=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL MOTHER OR NONRESIDENT BIOLOGICAL FATHER ALSO.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON THE STATE FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE
NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
ROUND 8 Parent – CMQ-114
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO
THE EXTENSION FIELD
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CMQ.500
Are you, or is someone else, planning to move to a new home with {CHILD} before in the near future?
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
CMQ.510
1
2
7
9
(CMQ.510)
(CMQ.571)
(CMQ.571)
(CMQ.571)
What is address and telephone number where {CHILD} will move?
ENTER STREET ADDRESS, LINE 1.
CMQ.520
[What is address and telephone number where {CHILD} will move?]
ENTER STREET ADDRESS, LINE 2.
CMQ.530
[What is address and telephone number where {CHILD} will move?]
ENTER CITY.
HELP AVAILABLE
CMQ.540
[What is address and telephone number where {CHILD} will move?]
ENTER STATE.
CAPI INSTRUCTION: DISPLAY STATE ABBREVIATIONS IN F1 HELP TEXT.
CMQ.550
[What is address and telephone number where {CHILD} will move?]
ENTER ZIP CODE.
CMQ.560
[What is address and telephone number where {CHILD} will move?]
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE NUMBER.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
ROUND 8 Parent – CMQ-115
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE
NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO
THE EXTENSION FIELD
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CMQ.570
CODE IF OBVIOUS. OTHERWISE, ASK: Will {CHILD} move . . .
To a new state, .............................................
To a new city or town in the same state, or ...
To a new home in the same city or town? .....
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
3
7
9
HELP AVAILABLE
NOTE: CMQ.571 IS NEW IN ROUND 8.
CMQ.571
Now I’d like to ask a few more questions about you {and {NAME OF SPOUSE/PARTNER}} to make sure that
we can locate you for the next interview {in case you move/after you move}. What is your date of birth?
HELP TEXT:
Why we ask for date of birth. A lot of people have the same last name and, if you should move, having your
date of birth helps us make sure we have the right person when we call people with your last name.
CAPI INSTRUCTION:
DISPLAY “{and
SPOUSE/PARTNER IN THE HOUSEHOLD.
{NAME
OF
SPOUSE/PARTNER}}”
CAPI INSTRUCTION: DISPLAY “after you move” if CMQ.500 = 1.
CMQ.500 = 2. OTHERWISE, USE A NULL DISPLAY.
IF
THERE
IS
A
DISPLAY “in case you move” IF
CAPI INSTRUCTION: HARD RANGE FOR MONTH IS 1-12.
|___|___|
ENTER MONTH ............................................
(CMQ.572)
OR
REFUSED ..................................................... 7777 (BOX 8a)
DON'T KNOW ............................................... 9999 (BOX 8a)
HELP AVAILABLE
NOTE: CMQ.572 IS NEW IN ROUND 8.
CMQ.572
[Now I’d like to ask a few more questions about you {and {NAME OF SPOUSE/PARTNER}} to make sure that
we can locate you for the next interview {in case you move/after you move}. What is your date of birth?]
HELP TEXT:
Why we ask for date of birth. A lot of people have the same last name and, if you should move, having your
date of birth helps us make sure we have the right person when we call people with your last name.
CAPI INSTRUCTION:
DISPLAY “{and
SPOUSE/PARTNER IN THE HOUSEHOLD.
{NAME
OF
SPOUSE/PARTNER}}”
ROUND 8 Parent – CMQ-116
IF
THERE
IS
A
CAPI INSTRUCTION: DISPLAY “after you move” if CMQ.500 = 1.
CMQ.500 = 2. OTHERWISE, USE A NULL DISPLAY.
DISPLAY “in case you move” IF
CAPI INSTRUCTION: HARD RANGE FOR DAY IS 1-31.
|___|___|
ENTER DAY..................................................
(CMQ.573)
OR
REFUSED ..................................................... 7777 (BOX 8a)
DON'T KNOW ............................................... 9999 (BOX 8a)
HELP AVAILABLE
NOTE: CMQ.573 IS NEW IN ROUND 8.
CMQ.573
[Now I’d like to ask a few more questions about you {and {NAME OF SPOUSE/PARTNER}} to make sure that
we can locate you for the next interview {in case you move/after you move}. What is your date of birth?]
HELP TEXT:
Why we ask for date of birth. A lot of people have the same last name and, if you should move, having your
date of birth helps us make sure we have the right person when we call people with your last name.
CAPI INSTRUCTION:
DISPLAY “{and
SPOUSE/PARTNER IN THE HOUSEHOLD.
{NAME
OF
SPOUSE/PARTNER}}”
CAPI INSTRUCTION: DISPLAY “after you move” if CMQ.500 = 1.
CMQ.500 = 2. OTHERWISE, USE A NULL DISPLAY.
IF
THERE
(BOX 8a)
OR
REFUSED ..................................................... 7777 (BOX 8a)
DON'T KNOW ............................................... 9999 (BOX 8a)
BOX 8a
IF THERE IS A SPOUSE/PARTNER, CONTINUE WITH CMQ.574. OTHERWISE, GO
TO BOX 8b.
HELP AVAILABLE
ROUND 8 Parent – CMQ-117
A
DISPLAY “in case you move” IF
CAPI INSTRUCTION: HARD RANGE FOR YEAR = 1947-1987.
|___|___|___|___|
ENTER YEAR ...............................................
IS
NOTE: CMQ.574 IS NEW IN ROUND 8.
CMQ.574
What is {NAME OF SPOUSE/PARTNER}}’s date of birth?
HELP TEXT:
Why we ask for date of birth. A lot of people have the same last name and, if you should move, having the
date of birth helps us make sure we have the right person when we call people with your last name.
CAPI INSTRUCTION: HARD RANGE FOR MONTH IS 1-12.
|___|___|
ENTER MONTH ............................................
(CMQ.575)
OR
REFUSED ..................................................... 7777 (CMQ.577)
DON'T KNOW ............................................... 9999 (CMQ.577)
HELP AVAILABLE
NOTE: CMQ.575 IS NEW IN ROUND 8.
CMQ.575
[What is {NAME OF SPOUSE/PARTNER}}’s date of birth?]
HELP TEXT:
Why we ask for date of birth. A lot of people have the same last name and, if you should move, having the
date of birth helps us make sure we have the right person when we call people with your last name.
CAPI INSTRUCTION: HARD RANGE FOR DAY IS 1-31.
|___|___|
ENTER DAY..................................................
(CMQ.576)
OR
REFUSED ..................................................... 7777 (CMQ.577)
DON'T KNOW ............................................... 9999 (CMQ.577)
HELP AVAILABLE
NOTE: CMQ.576 IS NEW IN ROUND 8.
CMQ.576
[What is {NAME OF SPOUSE/PARTNER}}’s date of birth?]
HELP TEXT:
Why we ask for date of birth. A lot of people have the same last name and, if you should move, having the
date of birth helps us make sure we have the right person when we call people with your last name.
CAPI INSTRUCTION: HARD RANGE FOR YEAR = 1947-1987.
|___|___|___|___|
ENTER YEAR ...............................................
(CMQ.577)
OR
REFUSED ..................................................... 7777 (CMQ.577)
DON'T KNOW ............................................... 9999 (CMQ.577)
ROUND 8 Parent – CMQ-118
NOTE: CMQ.577 IS NEW IN ROUND 8.
CMQ.577
What is {NAME OF SPOUSE/PARTNER}’s full name?
VERIFY SPELLING.
IF NO MIDDLE NAME OR INITIAL, ENTER 'NMN'.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION: ALLOW MAXIMUM NUMBER OF SPACES PER LINE FOR NAMES.
FIRST NAME:
[___________________]
MIDDLE NAME: [___________________]
LAST NAME:
[___________________]
BOX 8b
IF THERE IS A KEY FEMALE PARENT FIGURE IN THE HOUSEHOLD, CONTINUE
WITH CMQ.578. OTHERWISE, GO TO CMQ.579.
NOTE: CMQ.578 IS NEW IN ROUND 8.
CMQ.578
What is {your/NAME OF SPOUSE/PARTNER}’s maiden name?
VERIFY SPELLING.
CAPI INSTRUCTION: DISPLAY “your” IF THE RESPONDENT IS THE KEY FEMALE PARENT FIGURE.
OTHERWISE, DISPLAY THE NAME OF THE KEY FEMALE SPOUSE/PARTNER OF THE RESPONDENT.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
CAPI INSTRUCTION: ALLOW MAXIMUM NUMBER OF SPACES PER LINE FOR NAME.
MAIDEN NAME: [___________________]
NOTE: CMQ.579 IS NEW IN ROUND 8.
CMQ.579
In what name is your telephone listed?
VERIFY SPELLING.
IF NO MIDDLE NAME OR INITIAL USED IN TELEPHONE LISTING, ENTER 'NMN'.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION: ALLOW MAXIMUM NUMBER OF SPACES PER LINE FOR NAMES.
FIRST NAME:
[___________________]
MIDDLE NAME: [___________________]
LAST NAME:
[___________________]
BOX 9
ASK CMQ.600 FOR EACH SAMPLED CHILD.
ROUND 8 Parent – CMQ-119
CMQ.600
Now I have a question about {CHILD}’s school. Will { CHILD} still be attending the same school {he/she}
attends now in spring 2009?
YES ..............................................................
NO ................................................................
REFUSED ....................................................
DON'T KNOW ..............................................
1
2
7
9
BOX 10
IF (NumberOfChildren = 1) OR IF (NumberOfChildren = 2 AND ChildNum = 1): IF
CMQ.600 = 2, GO TO CMQ.610. OTHERWISE, GO TO CMQ.675.
IF (NumberOfChildren = 2 AND ChildNum = 2): IF CMQ.600 = 1, DK, RF for
ChildNum = 2, GO TO CMQ.675. ELSE, IF CMQ.600 = 2 for ChildNum = 2 AND
(CMQ.600 = 2 FOR ChildNum = 1), GO TO CMQ.605. ELSE,
IF CMQ.600 = 2 for ChildNum = 2 AND (CMQ.600 = 1, DK, RF FOR ChildNum = 1),
GO TO CMQ.610.
CMQ.605
Will {CHILD 2} attend the same new school as {CHILD 1} in spring 2009?
YES ...............................................................
NO.................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CMQ.610
1
2
7
9
(CMQ.675)
(CMQ.610)
(CMQ.675)
(CMQ.675)
What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?
ENTER SCHOOL NAME.
CMQ.620
[What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?]
ENTER STREET ADDRESS, LINE 1.
CMQ.630
[What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?]
ENTER STREET ADDRESS, LINE 2.
CMQ.640
[What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?]
ENTER CITY.
HELP AVAILABLE
CMQ.650
[What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?]
ENTER STATE.
CAPI INSTRUCTION: DISPLAY STATE ABBREVIATIONS IN F1 HELP TEXT.
ROUND 8 Parent – CMQ-120
CMQ.660
[What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?]
ENTER ZIP CODE.
CMQ.670
[What is the name, address, and telephone number of the school {CHILD} will attend in spring 2009?]
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
CAPI INSTRUCTION: DISPLAY EDIT MESSAGE IF PHONE NUMBER FIELD ENTRY = ‘000’: “Does the
school not have a telephone number or do they have one, but you don’t know what it is?
IF SCHOOL HAS NO TELEPHONE NUMBER, LEAVE ANSWER AS ‘000’. IF SCHOOL HAS TELEPHONE
NUMBER, BUT IT IS NOT KNOWN OR REFUSED, REPLACE ‘000’ WITH F5 FOR "DON’T KNOW" OR F6
FOR "REFUSED."
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW
EDIT: "Phone number has wrong format. Please correct. The phone number must be formatted as 10
numbers (xxx-xxx-xxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR (‘000’ AND
ANSWER WAS CONFIRMED AS CORRECT WITH EDIT MESSAGE), THE CURSOR SHOULD SKIP THE
EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE NUMBER FIELD HAS
ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CMQ.671
Is it a public or private school?
PUBLIC ........................................................
PRIVATE ......................................................
REFUSED ....................................................
DON’T KNOW ..............................................
CMQ.672
1
2
7
9
What is the name of the district this school is located in?
SPECIFY SCHOOL DISTRICT.
BOX 11
GO TO CMQ.675.
ROUND 8 Parent – CMQ-121
(CMQ.672)
(CMQ.673)
(CMQ.675)
(CMQ.675)
CMQ.673
What type of private school is it?
PROBE: Is it Catholic, another type of religious affiliation, or is it non-religious?
CATHOLIC ...................................................
ANOTHER TYPE OF RELIGIOUS
AFFILIATION ........................................
NON-RELIGIOUS .........................................
REFUSED ....................................................
DON’T KNOW ..............................................
CMQ.674
1 (CMQ.674)
2
3
7
9
(CMQ.675)
(CMQ.675)
(CMQ.675)
(CMQ.675)
What is the name of the diocese?
SPECIFY DIOCESE.
CMQ.675
Since spring 2004, how many times has {CHILD} changed from one school to another?
CAPI INSTRUCTION: SOFT RANGE CHECK: 0-3 TIMES. HARD RANGE CHECK: 0-5 TIMES.
|___|
ENTER NUMBER OF TIMES
OR
REFUSED .....................................................
DON'T KNOW ...............................................
7
9
BOX 12
END LOOP 1:
CMQ.680
IF NO NEXT SAMPLED CHILD, CONTINUE WITH CMQ.680.
OTHERWISE, GO TO BOX 1 IN INQ FOR THE NEXT SAMPLED CHILD (TWIN)
THAT IS PART OF THIS HOUSEHOLD.
WAS THIS INTERVIEW CONDUCTED BY TELEPHONE OR IN-PERSON?
TELEPHONE ...............................................
IN-PERSON .................................................
CMQ.690
1
2
WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?
ENGLISH ..................................................... 1 (BOX 13)
SPANISH ..................................................... 2 (BOX 13)
ANOTHER LANGUAGE (SPECIFY) ............. 91 (CMQ.690OS)
__________________________________ )
CMQ.690OS
[WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?]
SPECIFY LANGUAGE.
_______________________________________
OTHER LANGUAGE
CAPI INSTRUCTION: DK AND RF DISALLOWED.
ROUND 8 Parent – CMQ-122
BOX 13
SET FINAL DISPOSITION CODE:
IF CMQ.680 = 1 (TELEPHONE) AND CMQ.690 = 1 (ENGLISH), SET DISPOSITION CODE TO 60.
IF CMQ.680 = 1 (TELEPHONE) AND CMQ.690 = 2 (SPANISH), SET DISPOSITION CODE TO 61.
IF CMQ.680 = 1 (TELEPHONE) AND CMQ.690 = 91 (ANOTHER LANGUAGE), SET DISPOSITION
CODE TO 62.
IF CMQ.680 = 2 (IN-PERSON) AND CMQ.690 = 1 (ENGLISH), SET DISPOSITION CODE TO 63.
IF CMQ.680 = 2 (IN-PERSON) AND CMQ.690 = 2 (SPANISH), SET DISPOSITION CODE TO 64.
IF CMQ.680 = 2 (IN-PERSON) AND CMQ.690 = 91 (ANOTHER LANGUAGE), SET DISPOSITION
CODE TO 65.
CMQ.695
WHERE WAS THIS INTERVIEW CONDUCTED?
CHILD'S HOME ............................................
CHILD'S SCHOOL ........................................
SOMEWHERE ELSE ...................................
CMQ.700
1
2
3
Thank you for your cooperation and for taking the time to participate in the Early Childhood Longitudinal
Study.
ENTER 1 TO FINISH THE INTERVIEW.
ROUND 8 Parent – CMQ-123
| File Type | application/pdf |
| File Title | ECLS-K 8th Grade Student Questionnaire |
| Author | peter.tice |
| File Modified | 2006-07-20 |
| File Created | 2006-07-19 |