Teacher Survey

An Impact Evaluation of a School-Based Violence Prevention Program

Att_Appendix B Teacher Survey

Teacher Survey

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Attachment B
Teacher Survey

Teacher Survey
WHO IS CONDUCTING THIS SURVEY?
The U.S. Department of Education requests your participation in this survey. RTI International
is conducting this survey for the Department of Education.

WHAT IS THE PURPOSE OF THIS SURVEY?
The purpose of this survey is to gather information about teachers’ experiences concerning the
learning environment in the classroom and school. The survey also asks about your
perceptions of safety in and around the school and experiences with student misconduct. Your
answers on this survey will help describe the school environment and climate. Please do not
put your name on this survey.

WHO SHOULD COMPLETE THIS SURVEY?
This survey should be completed by teachers in grades 6 to 8.

TO WHOM SHOULD YOU GIVE YOUR COMPLETED SURVEY?
The school contact will collect the completed surveys during the week of your school’s student
survey administration. Please put your completed survey in the accompanying envelope.
Thank you for completing this survey.

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless such collection displays a valid OMB control number. The valid OMB control number for this information
collection is xxxx-xxxx. The time required to complete this information collection is estimated to average XX minutes
per response, including the time to review instructions, search existing data resources, gather the data needed, and
complete and review the information collection. If you have any comments concerning the accuracy of the time
estimate(s) or suggestions for improving this form, please write to: U.S. Department of Education, Washington, D.C.
20202-4651. If you have comments or concerns regarding the status of your individual submission of this form, write
directly to: Institute of Education Sciences, National Center for Educational Evaluation, U.S. Department of
Education, 555 New Jersey Avenue, Room 500-i, Washington, D.C. 20208.

During the PAST 30 DAYS at the school where you work, how often did YOU FEEL
UNSAFE in any of the following areas?
Never
–

Almost
never
–

Sometimes
–

Often
–

1.

The entrance into the school........................................

1 ............

2 ..............

3 .................

4

2.

Any hallways or stairs in the school .............................

1 ............

2 ..............

3 .................

4

3.

Any part of the school cafeteria ...................................

1 ............

2 ..............

3 .................

4

4.

Any school restroom ....................................................

1 ............

2 ..............

3 .................

4

5.

In any classroom .........................................................

1 ............

2 ..............

3 .................

4

6.

School parking lot, athletic fields, or other places
outside school buildings...............................................

1 ............

2 ..............

3 .................

4

During the PAST 30 DAYS, how often did YOU WITNESS the following events at your
school?
Never
–

7.

Almost
never
–

Sometimes
–

Often
–

A student threaten to hit, push, slap, or shove
another student ............................................................

1 ............

2 ..............

3 .................

4

A student actually hit, slap, shove, or push
another student ............................................................

1 ............

2 ..............

3 .................

4

A student threaten (but not actually injure) another
student with a weapon such as a knife, gun, or club ...

1 ............

2 ..............

3 .................

4

A student actually injure another student with
a weapon such as a knife, gun, or club........................

1 ............

2 ..............

3 .................

4

11.

A student get angry and yell at another student ..........

1 ............

2 ..............

3 .................

4

12.

A student throw something at another student
to hurt him or her..........................................................

1 ............

2 ..............

3 .................

4

13.

A student pick a fight with another student ..................

1 ............

2 ..............

3 .................

4

14.

A student take, damage, or destroy on purpose
something that belonged to another student................

1 ............

2 ..............

3 .................

4

A student try to force another student to do
something he or she didn’t want to do .........................

1 ............

2 ..............

3 .................

4

A student leave out another student on purpose
from a group or activity ................................................

1 ............

2 ..............

3 .................

4

A student tell lies, spread rumors, or say mean things
about someone to other students ................................

1 ............

2 ..............

3 .................

4

8.
9.
10.

15.
16.
17.

Page 1 of 5

Never
–

18.

Almost
never
–

Sometimes
–

Often
–

A student call another student an insulting name
or word .........................................................................

1 ............

2 ..............

3 .................

4

A student make fun of another student in front
of him or her just to be mean .......................................

1 ............

2 ..............

3 .................

4

20.

A student sexually harass another student ..................

1 ............

2 ..............

3 .................

4

21.

A student disrupt my class due to misbehavior............

1 ............

2 ..............

3 .................

4

19.

How often in the PAST SIX MONTHS have YOU been…?
Never
–

2 to 5
times
–

Once
–

More than
5 times
–

22.

Verbally abused by a student from your school ...........

1 ............

2 ..............

3 .................

4

23.

Threatened with physical harm by a student
from your school ..........................................................

1 ............

2 ..............

3 .................

4

Physically attacked or injured by a student
from your school ..........................................................

1 ............

2 ..............

3 .................

4

24.

Think about what happened in your school during the PAST 30 DAYS, when you answer
these questions.
In the PAST 30 DAYS, how often did you SEE OR HEAR A
STUDENT:

Never
–

Almost
never
–

Sometimes
–

Often
–

25.

Say or do something nice to another student .............

1 ..........

2 ..................

3 .................

4

26.

Say “thanks” or “you’re welcome”
to another student ........................................................

1 ..........

2 ..................

3 .................

4

Say or do something that made another student
feel good .....................................................................

1 ..........

2 ..................

3 .................

4

Invite another student to participate in a game,
group conversation, or a class activity .........................

1 ..........

2 ..................

3 .................

4

Say a compliment (praise, kind word)
to another student ........................................................

1 ..........

2 ..................

3 .................

4

30.

Offer to help another student .......................................

1 ..........

2 ..................

3 .................

4

31.

Share something with another student .......................

1 ..........

2 ..................

3 .................

4

27.
28.
29.

Page 2 of 5

Almost
never
–

Never
–

Sometimes
–

Often
–

32.

Act friendly with another student..................................

1 ..........

2 ..................

3 .................

4

33.

Show interest in another student’s ideas
or activities ...................................................................

1 ..........

2 ..................

3 .................

4

34.

Stop someone from getting in a fight ...........................

1 ..........

2 ..................

3 .................

4

35.

Protect someone from a “bully” ...................................

1 ..........

2 ..................

3 .................

4

The following questions are intended to indicate how often you use certain techniques
and resources with aggressors (students who display aggressive behaviors) and victims
or targets (students who are the recipients of that aggressive behavior). Please complete
every item by choosing the response that most closely reflects YOUR USE of the
intervention or approach.
Never
–

Almost
never
–

Sometimes
–

Often
–

36.

Model strategies for solving conflicts ............................

1 ...........

2 .................

3 ...............

4

37.

Create an “open door” policy for students who
are the target of aggression ..........................................

1 ...........

2 .................

3 ...............

4

Include victimized or isolated children
in group projects ...........................................................

1 ...........

2 .................

3 ...............

4

Use classroom routines that reduce the opportunity
for acting out behaviors.................................................

1 ...........

2 .................

3 ...............

4

Reward small improvements toward desired
behavior ........................................................................

1 ...........

2 .................

3 ...............

4

Use a behavior plan that provides students
choices and consequences for their choices ................

1 ...........

2 .................

3 ...............

4

Provide opportunities for students to confidentially
report aggressive acts...................................................

1 ...........

2 .................

3 ...............

4

Assist students victimized by aggressive peers
in identifying skills and behaviors they may
want to learn .................................................................

1 ...........

2 .................

3 ...............

4

Address aggressive situations in the classroom
immediately...................................................................

1 ...........

2 .................

3 ...............

4

Maintain calmness when faced with an aggressive
or disruptive student......................................................

1 ...........

2 .................

3 ...............

4

Confront students who make inappropriate
comments .....................................................................

1 ...........

2 .................

3 ...............

4

38.
39.
40.
41.
42.
43.

44.
45.
46.

Page 3 of 5

Never
–

Almost
never
–

Sometimes
–

Often
–

47.

Consult with school administrators for support .............

1 ...........

2 .................

3 ...............

4

48.

Use self-calming techniques during the school day ......

1 ...........

2 .................

3 ...............

4

49.

Model dignity and respect at school..............................

1 ...........

2 .................

3 ...............

4

50.

Provide positive reinforcement for prosocial
behavior ........................................................................

1 ...........

2 .................

3 ...............

4

The following is a list of statements that could describe a school. Think about your
school when responding to the following statements.
Strongly
agree
–

51.

Agree
–

Disagree
–

Strongly
disagree
–

The school rules for student behavior
are clearly defined..............................................................

1 ..........

2............

3 ..............

4

The school makes sure that students know the rules
for student behavior ...........................................................

1 ..........

2............

3 ..............

4

The school rules emphasize reinforcing
desired behavior ................................................................

1 ..........

2............

3 ..............

4

The school rules emphasize consequences for
undesired behavior ............................................................

1 ..........

2............

3 ..............

4

When a school rule is broken, it is clear
to the school staff what consequences should follow ........

1 ..........

2............

3 ..............

4

56.

The rules are consistently enforced at my school ..............

1 ..........

2............

3 ..............

4

57.

Teachers at my school punish students the same way
for breaking the same rule no matter who they are ...........

1 ..........

2............

3 ..............

4

Teachers compliment or reward students
when they follow the rules..................................................

1 ..........

2............

3 ..............

4

Teachers at my school reward the students the same
way for following the same rule no matter who they are ....

1 ..........

2............

3 ..............

4

Teachers or other adults at the school try to prevent
or stop bullying...................................................................

1 ..........

2............

3 ..............

4

61.

Teachers treat students with respect .................................

1 ..........

2............

3 ..............

4

62.

Teachers at my school know the procedure
for reporting bullying and violence .....................................

1 ..........

2............

3 ..............

4

52.
53.
54.
55.

58.
59.
60.

Page 4 of 5

Strongly
agree
–

63.
64.
65.
66.

Agree
–

Disagree
–

Strongly
disagree
–

My school periodically reviews school rules
to determine if they need modification ...............................

1 ..........

2............

3 ..............

4

Administrators at my school are supportive
of teachers in creating a safe school .................................

1 ..........

2............

3 ..............

4

Teachers at my school receive adequate training
in classroom management/discipline strategies ................

1 ..........

2............

3 ..............

4

Overall, my school is a positive environment
for students and staff .........................................................

1 ..........

2............

3 ..............

4

This last set of questions asks about your background.
67.

Are you:
a. Male
b. Female

68.

How long have you been teaching (at this school or any other school)?
a. less than 5 years
b. 5 to 10 years
c. 11 to 20 years
d. more than 20 years

69.

What is the highest level of education you completed?
a. High school graduate
b. Some college, no degree
c. Associates or 2–year degree
d. Bachelor’s or 4–year degree
e. Master’s degree
f.

Doctoral degree

Page 5 of 5


File Typeapplication/pdf
File TitleStudent Survey
AuthorInformation Technology Services
File Modified2009-03-24
File Created2006-02-15

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