Spring and Fall Parent Interviews

Appendix A.3
1998-99 Fall First, Spring First, Third, Fifth, or
Eighth Grade Parent Interview

*The following items were fielded as part of the ECLS-K: 1998-99 Fall First, Spring First Third, Fifth or
Eighth Grade Parent Interview.

A-157

Section FSQ
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}?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

FSQ.121

(BOX 2A)
(BOX 2A)
(BOX 2A)
(BOX 2A)

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}?

YES................................................................
NO .................................................................
DIFFERENT SPOUSE/PARTNER .................
REFUSED......................................................
DON’T KNOW................................................

FSQ.240

1
2
7
9

1
2
3
7
9

Now I have a few questions about {your/{NAME}'s} country of birth. In what country {were/was}
{you/{NAME}} born?

SPECIFY COUNTRY.
_________________________________________________________

FSQ.250

How old {was/were} {you/{NAME}} when {you/{he/she}} first moved to the United States?
|___|___|
AGE
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

FSQ.260

{Are/is} {you/{NAME}} a United States Citizen?
YES................................................................
NO .................................................................
DON’T KNOW................................................
REFUSED......................................................

A-158

1
2
7
9

FSQ.270

Did {you/{NAME}} attend school outside the United States?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

FSQ.280

1
2
7
9

(FSQ.280)
(BOX 7)
(BOX 7)
(BOX 7)

How many years of school {have/has} {you/{CHILD}'s mother} completed outside of the United States?
|___|___|
ENTER NUMBER OF YEARS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

FSQ.210

Now I have a few questions about {CHILD}'s ethnicity and race. Is {CHILD} a member of the
Spanish/Hispanic/Latino group?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

FSQ.215

(FSQ.215)
(FSQ.220)
(FSQ.220)
(FSQ.220)

Which of the following Spanish/Hispanic/Latino groups best describes {CHILD}'s origin? Is {he/she}… You
may name more than one.
Mexican, Mexican American or Chicano, ......
Puerto Rican, .................................................
Cuban, or .......................................................
Other Spanish/Hispanic/Latino? ....................
REFUSED......................................................
DON'T KNOW ................................................

FSQ.220

1
2
7
9

1
2
3
4
7
9

Is {CHILD} a member of an Asian group?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

1
2
7
9

(FSQ.225)
(FSQ.230)
(FSQ.230)
(FSQ.230)

FSQ.225

Which of the following Asian groups best describes {CHILD}'s origin? Is {he/she}… You may name more
than one.
Asian Indian, .................................................. 1
Chinese,......................................................... 2
Filipino, .......................................................... 3
Japanese, ...................................................... 4
Korean, .......................................................... 5
Vietnamese, .................................................. 6
Hmong, or ...................................................... 7
Other Asian? .................................................. 8
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

FSQ.230

Is {CHILD} a member of a Pacific Islander group?
YES................................................................
NO .................................................................

A-159

1 (FSQ.235)
2 (BOX 5)

REFUSED......................................................
DON'T KNOW ................................................

FSQ.235

Which of the following Pacific Islander group best describes {CHILD}'s origin? Is {he/she}… You may name
more than one.
Native Hawaiian, ............................................
Guamanian or Chamorro, ..............................
Samoan, or ....................................................
Other Pacific Islander?...................................
REFUSED......................................................
DON'T KNOW ................................................

FSQ.310

7 (FSQ.240)
9 (FSQ.240)

1
2
3
4
7
9

Many things happen in families that may affect young people. In the last 2 years, have any of the following
happened to your family?
YES
a.
b.
c.
d.
e.
f.

One of {CHILD}’s parents got divorced or separated .......................
One of {CHILD}’s parents got married or remarried .........................
A parent of {CHILD}’s died ...............................................................
A close relative of {CHILD}’s died ....................................................
{CHILD}’s family was homeless for a period of time.........................
A close friend of {CHILD}’s family died.............................................

A-160

1
1
1
1
1
1

NO

REF

DK

2
2
2
2
2
2

7
7
7
7
7
7

9
9
9
9
9
9

Section COQ

COQ.005

Earlier we asked about where people in your household were born. Now, we’d like to ask about {CHILD}’s
biological mother. In what country was {his/her} biological mother born?

COQ.005OS

[In what country was {his/her} biological mother born?]

SPECIFY COUNTRY.
_________________________________________________________

COQ.010

How old was {CHILD’}’s biological mother when she first moved to the United States?

|___|___|
AGE
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

COQ.015

Is she a United States citizen?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

COQ.020

1
2
7
9

{Earlier we asked about where people in your household were born.} Now, we’d like to ask about {CHILD}’s
biological father. In what country was {his/her} biological father born?

SPECIFY COUNTRY.
_________________________________________________________

COQ.025

How old was {CHILD’}’s biological father when he first moved to the United States?
|___|___|
AGE
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

COQ.030

Is he a United States citizen?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

A-161

1
2
7
9

A-162

Section PIQ

PIQ.026

Did you or another family member attend the orientation meeting or back-to-school night?
YES................................................................ 1
NO ................................................................. 2
REFUSED...................................................... 7
DON'T KNOW ................................................ 9

PIQ.030

{Now, I'd like to ask you about {CHILD}’s school.} What is your best guess about how well {CHILD} will do in
learning to use letters and reading this year? Do you think it will be…
Excellent, .....................................................................
Good, ...........................................................................
Satisfactory, or .............................................................
Unsatisfactory? ............................................................
REFUSED ...................................................................
DON'T KNOW .............................................................

PIQ.035

What is your best guess about how well {CHILD} will do in learning about numbers, logic, and math this
year? Do you think it will be…
Excellent, .....................................................................
Good, ...........................................................................
Satisfactory, or .............................................................
Unsatisfactory? ............................................................
REFUSED ...................................................................
DON'T KNOW .............................................................

PIQ.006

1
2
3
4
7
9

Now I’d like to ask you about {CHILD}'s school. Did you {or {CHILD}’s parents} choose where to live so that
{CHILD} could attend {his/her} current school?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

PIQ.020

1
2
3
4
7
9

1
2
7
9

Now, I'd like to ask you about {CHILD}'s school. Did you ever receive information about any of the following
from {CHILD}'s school?

YES
a.
b.
c.
d.

How to prepare {CHILD} for first grade? ............................
Summer book lists or reading assignments? ....................
Other suggested summer activities? .................................
Information about orientation meetings or back-to-school
nights for parents of incoming first graders? .....................

A-163

NO REFUSED

DON'T
KNOW

1
1
1

2
2
2

7
7
7

9
9
9

1

2

7

9

PIQ.080

How many times was {CHILD} late for school during the past four weeks?
|___|___|
NUMBER OF TIMES
or
REFUSED......................................................
DON'T KNOW ................................................

PIQ.090

77
99

Compared to other children in {CHILD}’s class, how well do you think {he/she} is doing in school this spring
in reading/ language arts?
Do you think {he/she} is doing....

Much worse, ..................................................
A little worse, .................................................
About the same, .............................................
A little better, or ..............................................
Much better? ..................................................
REFUSED......................................................
DON'T KNOW ................................................

PIQ.100

1
2
3
4
5
7
9

Compared to other children in {CHILD}’s class, how well do you think {he/she} is doing in school this spring
in math?
Do you think {he/she} is doing…

Much worse, ..................................................
A little worse, .................................................
About the same, .............................................
A little better, or ..............................................
Much better? ..................................................
REFUSED......................................................
DON'T KNOW ................................................

A-164

1
2
3
4
5
7
9

PIQ.120

Now I‘d like to ask you some questions about what the school is like. For each of the following, please tell
me how much you agree or disagree with the statements about {CHILD}’s school.
SD
a.

b.
c.
d.
e.
f.
g.
h.

PIQ.065

Parents are actively involved in this school’s
programs. Would you say you strongly disagree,
disagree, neither agree nor disagree,
agree or strongly agree? ..................................
Teacher absenteeism is a problem at this
school...............................................................
Child absenteeism is a problem at this school .
The community served by this school is
supportive of its goals and activities .................
There is a consensus among administrators
and teachers on goals and expectations. .........
Order and discipline are maintained satisfactorily
in the building(s) ..............................................
Overcrowding is a problem at this school .........
Parents of children in this school are welcome
to observe classes any time they are in session

D

NAD

A

SA

RF

DK

1

2

3

4

5

7

9

1
1

2
2

3
3

4
4

5
5

7
7

9
9

1

2

3

4

5

7

9

1

2

3

4

5

7

9

1
1

2
2

3
3

4
4

5
5

7
7

9
9

1

2

3

4

5

7

9

About how many parents of {CHILD}'s school friends do you talk with regularly, either in person or on the
phone?
|___|___|
ENTER NUMBER OF PARENTS
OR
REFUSED......................................................
DON'T KNOW ................................................

PIQ.110

77
99

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 ...............................................

A-165

1
2
3
4
7
9

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 ...............................................

PIQ.120

1
2
3
4
7
9

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 ...............................................

1
2
3
4
7
9

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…
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 ................................................

PIQ.110

1
2
3
4
5
6
7
9

(HEQ.110)
(HEQ.091)
(HEQ.091)
(HEQ.091)
(HEQ.091)
(HEQ.110)
(HEQ.110)
(HEQ.110)

How often does {CHILD} do homework at home? Would you say…
PROBE: This refers to homework assigned by the school and not extra work provided by the parent.
Never .............................................................
Less that once a week ...................................
1 to 2 times a week ........................................
3 to 4 times a week, or ...................................
5 or more times a week?................................
REFUSED......................................................
DON'T KNOW ................................................

A-166

1
2
3
4
5
7
9

(BOX 10)
(PIQ.120)
(PIQ.120)
(PIQ.120)
(PIQ.120)
(BOX 10)
(BOX 10)

PIQ.120

During this school year, how often did you help {him/her} with {his/her} homework? Would you say…
Never .............................................................
Less that once a week ...................................
1 to 2 times a week ........................................
3 to 4 times a week, or ...................................
5 or more times a week?................................
REFUSED......................................................
DON'T KNOW ................................................

1
2
3
4
5
7
9

Section HEQ

HEQ.091 Is there a place in your home that is set aside for {CHILD} to do homework?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
HEQ.092

1
2
7
9

Approximately, how much time is set aside every day for {CHILD} to do homework?
|___|___|___|
ENTER MINUTES
or
REFUSED...................................................... 777
DON'T KNOW ................................................ 999

HEQ.092b. [Approximately, how much time is set aside every day for {CHILD} to do homework?]
|___|
ENTER HOURS
or
REFUSED...................................................... 777
DON'T KNOW ................................................ 999
HEQ.093

Does {CHILD) have someone who can help {him/her} with homework in reading, language arts, or spelling?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.095

1
2
7
9

(HEQ.095)
(HEQ.096)
(HEQ.096)
(HEQ.096)

During this school year, how often did someone help {CHILD} with {his/her} reading, language arts or
spelling 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)

A-167

HEQ.095b

Who usually helps {CHILD} with {his/her} reading, language arts, or spelling homework?

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.093 Does {CHILD) have someone who can help {him/her} with homework for English or Language Arts class in areas
such as literature, grammar, and writing?

YES................................................................ 1 (HEQ.095)
NO ................................................................. 2 (HEQ.096)
REFUSED...................................................... 7 (HEQ.096)
DON'T KNOW ................................................ 9 (HEQ.096)

HEQ.095 During this school year, how often did someone help {CHILD} with {his/her} homework for English or Language
Arts class in areas such as literature, grammar, and writing? 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)

HEQ.095b Who usually helps {CHILD} with {his/her} homework for English or Language Arts class in areas such as literature,
grammar, and writing?

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 ................................................

A-168

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)
HEQ.099 Who usually helps {CHILD} with {his/her} math homework?
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.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)

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)

A-169

HEQ.102 Who usually helps {CHILD} with {his/her} science homework?
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.100

Is {CHILD} tutored on a regular basis, by someone other than you or a family member, in a specific subject,
such as reading, math, science, or a foreign language?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.106

1
2
7
9

(HEQ.106)
(BOX 14B)
(BOX 14B)
(BOX 14B)

What is {CHILD} tutored in?
READING ...................................................... 1 (BOX 14B)
MATH............................................................. 2 (BOX 14B)
SCIENCE ....................................................... 3 (BOX 14B)
FOREIGN LANGUAGE.................................. 4 (BOX 14B)
SPEECH ........................................................ 5 (BOX 14B)
WRITING AND SPELLING ............................ 6 (BOX 14B)
OTHER (SPECIFY) ....................................... 91 (HEQ.107OS)
REFUSED...................................................... 7 (BOX 14B)
DON'T KNOW ................................................ 9 (BOX 14B)

HEQ.107OS

[What is {CHILD} tutored in?]

A-170

HEQ.010 During the past year, how frequently did you or another adult family member and {CHILD} participate in the
following activities together?
NEVER
a.

b.
c.
d.
e.
f.
g.
h.
i.
j.
k.
l.
m.

Attending school activities
such as sports, plays, or concerts.
Would you say never, rarely,
sometimes, or frequently?
Working on homework or school
projects
Attending concerts, plays, or movies
outside of school
Attending sporting events outside
of school
Attending religious services
Attending family social functions
such as a party or wedding
Taking day trips or vacations
Working on a hobby or playing sports
Going shopping
Going to restaurants/eating out
Spending time just talking together
Watching TV together
Doing something else fun together

RARELY

SOMETIMES FREQUENTLY

R

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

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

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)

HEQ.020 In the last year, did you read one book or more than one book?

ONE BOOK.................................................... 1 (HEQ.025)
MORE THAN ONE BOOK ............................. 2 (HEQ.025)
REFUSED...................................................... 7 (HEQ.075)
DON'T KNOW ................................................ 9 (HEQ.075)

A-171

HEQ.025 What is the title of {the book/one of the books} you read?

REFUSED...................................................... 77 (HEQ.075)
DON'T KNOW ................................................ 99 (HEQ.075)

HEQ.040 What is the title of another book that you read in the last year?

REFUSED...................................................... 77
DON'T KNOW ................................................ 99
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? .................................................................

A-172

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

HEQ.076 How often do you …

a.

b.
c.
d.
e.

NEVER RARELY
Check that {CHILD} has completed
all homework? Would you say never,
rarely, sometimes, or always? .. 1
2
Discuss {CHILD}'s report
card with {him/her}? .................. 1
2
Know where {CHILD} is when {he/she}
is not at home or in school? ...... 1
2
Make and enforce curfews for
{CHILD}? .................................. 1
2
Require {CHILD} to do work or
chores? ..................................... 1
2

SOMETIMES

ALWAYS

REF

DK

3

4

7

9

3

4

7

9

3

4

7

9

3

4

7

9

3

4

7

9

REF

DK

HEQ.077 How often do you …

a.

b.
c.

NEVER RARELY
Meet the friends that {CHILD} spends
time with? Would you say never, rarely,
sometimes, or always? .................................... 1
2
Approve of the friends that {CHILD}
spends time with? ............................................ 1
2
How often does {CHILD} spend time with
friends you don’t approve of? ........................... 1
2

SOME
TIMES

CHILD
HAS NO
ALWAYS FRIENDS

3

4

5

7

9

3

4

5

7

9

3

4

5

7

9

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)?
|___|___|
ENTER NUMBER OF DAYS
OR
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

A-173

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...

NOT
AT ALL
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 ..........................................

1
1
1
1
1

A FEW
A FEW
TIMES
TIMES
A MONTH A WEEK

2
2
2
2
2

3
3
3
3
3

EVERY
DAY

REF

DK

4
4
4
4
4

7
7
7
7
7

9
9
9
9
9

REF

DK

HEQ.140 In the past year, how often have you talked with {CHILD} about...
NOT
AT ALL
a.

b.
c.
d.

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? ....................................................
Topics related to sex, such as sexual activity or
sexually transmitted diseases? ......................................
The subject of drug use, such as marijuana,
inhalants, or cocaine? ....................................................

ONCE

THREE OR
MORE
TWICE
TIMES

1

2

3

4

7

9

1

2

3

4

7

9

1

2

3

4

7

9

1

2

3

4

7

9

HEQ.150 In the past year, how often have you {or {NAME OF SPOUSE/PARTNER}} discussed or shared information about
the following with {CHILD}?

NEVER
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}? ...............................

A-174

1
1
1
1

RARELY

SOMETIMES

ALWAYS

REF

DK

2
2
2
2

3
3
3
3

4
4
4
4

7
7
7
7

9
9
9
9

HEQ.160 How often would it be true for you to make each of the following statements about {CHILD}?

RARELY

SOMETIMES

ALWAYS

REF

DK

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

NEVER
a.
b.
c.
d.
e.

HEQ.024

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? .........................

Does {CHILD} have {his/her} own library card?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.026

In the past month, that is, since {MONTH} {DAY}, has anyone in your family visited a library with {CHILD}?

YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.028

1
2
7
9

1
2
7
9

(HEQ.040)
(HEQ.028)
(HEQ.028)
(HEQ.028)

How about in the past year? Has anyone in your family visited a library with {CHILD}?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

A-175

1
2
7
9

HEQ.045

Do you have access to the Internet at home?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.050

(HEQ.046)
(HEQ.050)
(HEQ.050)
(HEQ.050)

In an average week how often does {CHILD} use the computer for educational purposes and homework
such as to improve reading or math skills? Would you say…
Never .............................................................
Once or twice a week.....................................
Three to six times a week, or .........................
Every day? .....................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.021

1
2
7
9

1
2
3
4
7
9

Which of the following items does your family have in your home?
YES NO
a.
b.
c.
d.

HEQ.030

A newspaper received on a regular basis? .................................... 1
A magazine received on a regular basis? ...................................... 1
A dictionary or an encyclopedia? ................................................... 1
A pocket calculator? ....................................................................... 1

2
2
2
2

REF
7
7
7
7

9
9
9
9

Now I’d like to talk with you about what you read at home. How often do you read the following items at
home?
LESS THAN A FEW EVERY
NEVER 1 A WEEK TIMES WK DAY
a.

b.
c.
d.

HEQ.115

DK

Newspapers or magazines? Would you say,
never, less than once a week a few times a
week, or everyday? ......................................
Books? .........................................................
Letters, notes, and e-mails? .........................
Internet or web pages? ...............................

1
1
1
1

2
2
2
2

3
3
3
3

4
4
4
4

REF DK

7
7
7
7

9
9
9
9

During the last five days {CHILD} was in school, how many breakfasts did (he/she) eat that were NOT
school breakfasts. By breakfast we mean breakfasts eaten at home, at childcare, or at school, but not part of
a school breakfast program. Please count only one breakfast per day.

|___|
NUMBER OF BREAKFASTS
OR
REFUSED ..................................................... 77
DON’T KNOW................................................ 99

A-176

HEQ.116

Where did {CHILD} eat these breakfasts?
YES
a. At home? ............................................................................................ 1
b. At a relative’s or friend’s home? ......................................................... 1
c. At a child care location? ..................................................................... 1
d. At school, but not part of school breakfast? ....................................... 1
e. At a restaurant, including food taken out from fast food
restaurants? .......................................................................................... 1
f. Somewhere else? (SPECIFY) .............................................................. 1

HEQ.118

NO

REF

DK

2
2
2
2

7
7
7
7

9
9
9
9

2
2

7
7

9
9

During the last five days {CHILD} was in school, how many breakfasts did you eat? Please count only one
breakfast per day.
|___|
NUMBER OF BREAKFASTS
OR
REFUSED ..................................................... 77
DON’T KNOW................................................ 99

(BUS TO SCHOOL)
HEQ.126
How long does this take? Would you say…
Less than 15 minutes, ...................................
15-30 minutes, or ...........................................
More then 30 minutes? .................................
REFUSED......................................................
DON’T KNOW................................................

HEQ.127

On school days, how much time does {CHILD} have between arriving at school and classes starting? Would
you say…
Less than 10 minutes, ...................................
10-20 minutes, or ..........................................
More then 20 minutes? ..................................
REFUSED......................................................
DON’T KNOW................................................

HEQ.140

1
2
3
7
9

1
2
3
7
9

On weeknights during the school year, does {CHILD} usually go to bed at about the same time each night,
or does {his/her} bedtime vary a lot from night to night?
HAS USUAL BEDTIME..................................
BEDTIME VARIES .........................................
REFUSED......................................................
DON'T KNOW ................................................

A-177

1
2
7
9

(HEQ.145)
(BOX 17)
(BOX 17)
(BOX 17)

HEQ.145

About what time does {CHILD} usually go to bed?

|___|___| - |___|___|
HOUR MINUTE
or
REFUSED...................................................... 77 (BOX 7)
DON'T KNOW ................................................ 99 (BOX 7)

HEQ.150

[About what time does {CHILD} usually go to bed?]
A.M. ...............................................................
P.M. ...............................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.010

1
2
7
9

Now I'd like to talk with you about {CHILD}'s activities with family members during a week of the summer. {Since
{CHILD} was not with you for a lot of the summer, please just answer questions about activities that you happen
to know about.} Thinking about the week right after July 4th, how often did you or any other family member …

NEVER

ONCE OR
TWICE

3-6
TIMES

EVERY
DAY

REFUSED

DON'T
KNOW

a. Do math activities with {CHILD},
such as learning numbers,
adding, subtracting, or measuring.
Would you say never, once or
twice, 3-6 times, or every day?

1

2

3

4

7

9

b. Do writing activities with
{him/her}?

1

2

3

4

7

9

c. Read books to {him/her}?

1

2

3

4

7

9

A-178

HEQ.020

Thinking about this week following July 4th, when you or another family member read to {CHILD}, how long
was {he/she} generally read to each time? Would you say ...
15 minutes or less, ......................................... 1
16 to 29 minutes, ........................................... 2
30 to 45 minutes, or ....................................... 3
45 minutes or more? ...................................... 4
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9

HEQ.030

During this week, how often did {CHILD} look at or read books on {his/her} own? Would you say ...
Never, ............................................................
Once or twice, ................................................
3 to 6 times, or ...............................................
Every day? .....................................................
REFUSED .....................................................
DON'T KNOW ...............................................

HEQ.035

1
2
3
4
7
9

Again, thinking about the week right after July 4th, I'd like to now ask you about different kinds of activities
{CHILD} did, either alone or with other people. In this week, how often did {CHILD}…

a. Help with family chores?
b. Play outside actively (for example,
running, jumping, or swinging)?
c. Do pretend play (for example,
play with dolls, dressed up, or
pretended to be someone else)?
d. Play board or card games?
e. Do arts or crafts?
f. Use the computer for games like
Nintendo or Sega?
g. Use the computer for educational
purposes?

NEVER
1

ONCE OR
TWICE
2

3-6
TIMES
3

EVERY
DAY
4

REFUSED
7

DON'T
KNOW
9

1

2

3

4

7

9

1
1
1

2
2
2

3
3
3

4
4
4

7
7
7

9
9
9

1

2

3

4

7

9

1

2

3

4

7

9

A-179

HEQ.037

During this week, did {CHILD} watch…
DON'T
YES

a.

Children's programs such as those on Nickelodeon or the
Disney Channel, or programs such as Sesame Street,
Reading Rainbow, or Magic School Bus? ............................. 1

NO

REFUSED KNOW

2

7

9

1
1

2
2

7
7

9
9

1
1

2
2

7
7

9
9

1
1
1
1

2
2
2
2

7
7
7
7

9
9
9
9

CODE '3' IF NO TV.

b.
c.
d.

e.
f.
g.
h.
i.

HEQ.038

A.
B.
C.

HEQ.038a

A.
B.

Cartoons? ............................................................................
Children's videos or movies? ................................................
Educational programs designed for a general audience,
such as those on the Discovery or Learning Channel or
programs such as National Geographic or NOVA? ...............
Sports? .................................................................................
Situation comedies or sit-coms that come on
in the evening, including re-runs? .........................................
Soap Operas? ......................................................................
Talk shows? .........................................................................
News shows or news channels? ...........................................

During the week after the 4th of July, on average about how many hours of television or video tapes did
{CHILD} watch at home each weekday, that is, Monday through Friday? How about…
Before breakfast?
Between breakfast and dinner time?
After dinner time?

How about on Saturday and Sunday? Thinking about the entire day, how many hours did {CHILD} watch
television or video tapes at home on…
Saturday?
Sunday?

HOURS
Saturday
Sunday

A-180

MINUTES

HEQ.039

Now, I'd like you to think about some things {CHILD} may have done at some time during the entire
summer. Thinking now about the entire summer, were there family rules for {CHILD} about any of the
following television-related activities?

DON'T

a.
b.
c.
d.

HEQ.040

What programs {CHILD} can watch? ....................................
How early or late {he/she} may watch television? .................
How many hours {he/she} may watch television overall? ......
How many hours {he/she} may watch television on
weekdays? ............................................................................

YES

NO

1
1
1

2
2
2

7
7
7

9
9
9

1

2

7

9

During the summer, how often did your family watch TV together? Would you say…
Often, .............................................................
Sometimes, ....................................................
Hardly ever, or ...............................................
Never? ...........................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.045

1
2
3
4 (HEQ.050)
7 (HEQ.050)
9 (HEQ.050)

When your family watched TV together during the summer, how often did you or another family member
discuss TV programs with {CHILD}? Would you say…
Often, .............................................................
Sometimes, ....................................................
Hardly ever, or ...............................................
Never? ...........................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.050

1
2
3
4
7
9

About how many times during the summer did {CHILD} go to the library?
|___|___|
ENTER # OF TIMES
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.060

REFUSED KNOW

Did {he/she} participate in any story hours at the library?
YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

A-181

1
2
7
9

HEQ.070

About how many times during the summer did {CHILD} go to a bookstore?
|___|___|
ENTER # OF TIMES
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.080

Did {he/she} participate in any story hours at the bookstore?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.100

Did {CHILD} take any vacations, including short trips, with your family, or any of {his/her} other relatives, this
summer?
YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

HEQ.130

1
2
7
9

1
2
7
9

About how many days did {CHILD} spend on vacations?
|___|___|___|
ENTER # DAYS
or
ENTIRE SUMMER ......................................... 0
REFUSED...................................................... 777
DON'T KNOW ................................................ 999

HEQ.150

During the summer, did you or another family member take {CHILD} to any of the following places?
DON'T

a.
b.
c.
d.
e.
f.
g.
h.

Art, science, or discovery museums? .................................
Historical sites? ..................................................................
Zoos or aquariums? ...........................................................
Amusement parks? .............................................................
Beaches, lakes, or rivers? ...................................................
Plays or concerts?...............................................................
State or national parks? ......................................................
A large city (other than where {CHILD} lives)? ....................

A-182

YES

NO

1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2

REFUSED KNOW

7
7
7
7
7
7
7
7

9
9
9
9
9
9
9
9

HEQ.220

Summer school includes programs that schools suggest or require a child to attend, and also school
enrichment programs that are optional. Did {CHILD} attend summer school this summer? Please don't
include summer camp.
YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

HEQ.230A

1
2
7
9

When did the program start? ENTER MONTH.
|___|___|
ENTER MONTH

HEQ.230B

[When did the program start?] ENTER DAY.
|___|___|
ENTER DAY

HEQ.240A

When did the program end? ENTER MONTH.
|___|___|
ENTER MONTH

HEQ.240B

[When did the program end?] ENTER DAY.
|___|___|
ENTER DAY

HEQ.250

How many days a week did {CHILD} attend summer school or the school enrichment program?
|___|___|
ENTER DAYS
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.260

How many hours a day did {CHILD} attend this program?
|___|___|
ENTER HOURS
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

A-183

HEQ.270

Did this program include...
DON'T

a.
b.
c.
d.
e.
f.
g.
h.
i.
j.

HEQ.280

Reading? ................................................................................
Math? .....................................................................................
Social Studies? ......................................................................
Science? .................................................................................
Foreign language? .................................................................
Art? ........................................................................................
Dance? ....................................................................................
Music? ....................................................................................
Computers? ...........................................................................
Sports? ...................................................................................

YES

NO

1
1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2
2

HEQ.298

9
9
9
9
9
9
9
9
9
9

1
2
3
7
9

Some children receive services such as speech or physical therapy during the school year. Did {CHILD}
receive such services during the last school year?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

HEQ.295

7
7
7
7
7
7
7
7
7
7

Was the summer school a program …
Required by the school, ..............................................
Suggested by the school, or ........................................
A program you decided to send {him/her} to? .............
REFUSED ....................................................................
DON'T KNOW ..............................................................

HEQ.290

REFUSED KNOW

Did {CHILD} continue to receive that service during the summer?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

1
2 (HEQ.300)
7 (HEQ.300)
9 (HEQ.300)

1
2
7
9

Did {CHILD} receive…

a.
b.
c.
d.

Speech or language therapy? ..........................................................
Physical or occupational therapy?....................................................
Psychological or psychiatric therapy? ..............................................
Any other kind of therapy? ...............................................................

A-184

YES

NO

RF

DK

1
1
1
1

2
2
2
2

7
7
7
7

9
9
9
9

HEQ.298OS

[Did {CHILD} receive any other kind of therapy?]
SPECIFY SERVICE.
_______________________________________
SERVICE

HEQ.300

Did {CHILD} attend any day or overnight camps over the summer? Please do not include regular child care
in this question, but only programs that are referred to as camp.

YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

HEQ.305

1
2 (BOX 6)
7 (BOX 6)
9 (BOX 6)

How many camps did {CHILD} go to?
|___|
ENTER NUMBER
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.320

Did {CHILD2} go to {any of} the same {camp/camps} as {CHILD1} this summer?
YES................................................................ 1 (HEQ.430)
NO ................................................................. 2
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9

HEQ.330

{Please answer for the camp where {CHILD} spent the most time during the summer.} How many days a
week did {CHILD} attend the camp?
|___|
ENTER DAYS
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.340

How many hours a day did {CHILD} attend the camp?

|___|___|
ENTER HOURS
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

A-185

HEQ.350

About how many weeks did {CHILD} attend the camp?
|___|___|
ENTER # OF WEEKS
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.360

Did the camp include...
DON'T

a.
b.
c.
d.
e.
f.
g.
h.
i.

Sports? ...................................................................................
Arts and crafts? ......................................................................
Field trips? .............................................................................
Games? .................................................................................
Nature lessons or science? ....................................................
Other academic lessons? .......................................................
Music? ....................................................................................
Performing arts or drama? ......................................................
Computers? ...........................................................................

YES

NO

1
1
1
1
1
1
1
1
1

2
2
2
2
2
2
2
2
2

REFUSED KNOW

7
7
7
7
7
7
7
7
7

9
9
9
9
9
9
9
9
9

HEQ.430

Was {CHILD} tutored over the summer on a regular basis, by someone other than you or a family member,
in a specific subject, such as reading, math, science, or a foreign language?
YES................................................................ 1
NO ................................................................. 2
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9

HEQ.440

What was {CHILD} tutored in? CODE ALL THAT APPLY.
READING ...................................................... 1
MATH............................................................. 2
SCIENCE ....................................................... 3
FOREIGN LANGUAGE.................................. 4
OTHER (SPECIFY) ___________________
____________________________________ 91
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9

HEQ.450

How many days a week was {CHILD} tutored?
|___|
ENTER DAYS
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

A-186

HEQ.460

How many hours a day was {CHILD} tutored?
|___|___|
ENTER HOURS
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.470
About how many weeks was {CHILD} tutored?
Round: fall-first grade, if conducted
|___|___|
ENTER # OF WEEKS
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

HEQ.480

Did {CHILD} participate in any of the following activities during the summer that were not school sponsored,
not part of camp or child care, or not provided by a family member?
DON'T

a.
b.
c.
d.
e.
f.

Music lessons? .......................................................................
Dance lessons? ......................................................................
Swimming lessons or swim team? ..........................................
Team sports or lessons? .........................................................
Individual sports lessons? .......................................................
Scout groups? .........................................................................

A-187

YES

NO

1
1
1
1
1
1

2
2
2
2
2
2

REFUSED KNOW

7
7
7
7
7
7

9
9
9
9
9
9

Section FRQ

FRQ.050

Now I am going to read some statements. Please tell me whether each statement is never true for you,
sometimes true for you, often true for you, or very often true for you.

NEVER
a.

b.

c.
d.
e.
f.

Even if I am really busy, I make time to
listen to {CHILD}. Would you say it's
never true, sometimes true, often true,
or very often true? ......................................
I discourage {CHILD} from talking about
{his/her} worries because it upsets
{him/her}. … ...............................................
I encourage {CHILD} to talk about {his/her}
troubles. .....................................................
I encourage {CHILD} to tell me about
{his/her} friends and activities. ...................
I encourage {CHILD} to express {his/her}
opinions. ....................................................
When I lose my patience with {CHILD}’s
questions and demands, I just don’t listen
to {CHILD} anymore. ..................................

A-188

SOMETIMES OFTEN

VERY
OFTEN 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

1

2

3

4

7

9

Section CFQ
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.
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

REF

DK

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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…
NEVER
a.

b.
c.
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?
Reach a compromise?
Criticize each other?
Argue in front of {CHILD}?

RARELY

SOMETIMES OFTEN

REF

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3
3

4
4
4
4

7
7
7
7

9
9
9
9

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................................................

A-189

1
2
3
4
5
7
9

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?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

1
2
7
9

CFQ.190 How important are your religious beliefs in influencing how you raise {{CHILD}/your children}? Would you say…
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

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

CFQ.210 Do you consider yourself to be strongly liberal or just liberal?
STRONGLY LIBERAL ...................................
LIBERAL .......................................................
REFUSED......................................................
DON’T KNOW................................................

1
2
7
9

CFQ.220 Do you consider yourself to be strongly conservative or just conservative?
STRONGLY CONSERVATIVE ......................
CONSERVATIVE ..........................................
REFUSED......................................................
DON’T KNOW................................................

1
2
7
9

CFQ.230 Do you think of yourself as more like liberals or conservatives?
CLOSER TO LIBERALS ................................
CLOSER TO CONSERVATIVES ..................
NEITHER ......................................................
REFUSED......................................................
DON’T KNOW................................................

A-190

1
2
3
7
9

CFQ.015

How about {NAME OF SPOUSE/PARTNER}? How often did {he/she} 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 ................................................
CFQ.020

1
2
3
4
5
7
9

Now I’m going to read some statements. Please tell me whether each statement is never true for you,
sometimes true for you, or always true for you.

a.

b.
c.
d.

e.
f.

If I need to do an errand, I can easily find
someone to watch {CHILD}. Would you say it
is never true for you, sometimes true for you,
or always true for you? ....................................
If I need a ride to get {CHILD} to the doctor,
friends or family will help me ..........................
If {CHILD} is sick, friends or family will call or
come by to check on how things are going ....
If {CHILD} is having problems at school, there
is a friend, relative, or neighbor I can talk it
over with .........................................................
If I have an emergency and need cash, family
or friends will loan it to me ..............................
If I have troubles or need advice, I have
someone I can talk to .....................................

A-191

NEVER
TRUE

SOMETIMES
TRUE

ALWAYS
TRUE

REF

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9

Section DWQ

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?
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................................................
DWQ.200

1
2
3
4
5
6
7
8
9
10
11
12
77
99

How many times in the past week have you ...
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
c. Shown {CHILD} physical affection such as kiss, hug, or pat or rub (his/her) back?
|___|___|
ENTER NUMBER OF TIMES.
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

A-192

Section SCQ
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, ..........................................................
Mostly B’s, .........................................................
Mostly C’s, .........................................................
Mostly D’s, ..........................................................
Mostly F’s, or ......................................................
Does {CHILD}’s school not give these grades? ..
REFUSED,..........................................................
DON’T KNOW.....................................................

1
2
3
4
5
6
7
9

(SCQ.015)
(SCQ.015)
(SCQ.015)
(SCQ.015)
(SCQ.015)
(SCQ.010)
(SCQ.010)
(SCQ.010)

SCQ.010 Would you describe (his/her) work at school as...
Excellent, ............................................................
Above average, ...................................................
Average, .............................................................
Below average, or ...............................................
Failing? ..............................................................
REFUSED, .........................................................
DON'T KNOW, ...................................................

1
2
3
4
5
7
9

SCQ.020 Is {his/her} school in your assigned school district?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

1
2
7
9

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)

SCQ.030 How many times was {CHILD} suspended?

|___|
ENTER NUMBER OF TIMES
OR
REFUSED......................................................
DON'T KNOW ................................................

A-193

7
9

SCQ.035 How much do you agree or disagree with each of the following statements about {CHILD}’s school?

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

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7

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SCQ.040 How satisfied are you with the education {CHILD} has received in {his/her} current school? Would you say you
are…

Very satisfied, ................................................
Somewhat satisfied, .......................................
Somewhat dissatisfied, or ..............................
Very dissatisfied? ...........................................
REFUSED......................................................
DON'T KNOW ................................................

A-194

1
2
3
4
7
9

Section PPQ
PPQ.230 This is a list of things that sometimes happen. In the past year, which, if any, have happened to you?

a.
c.
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

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2
2

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2

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9

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2

7

9

A-195

Section PEQ

PEQ.010

{Now I have a few questions about education and job training.} Since our last interview in spring 2011/2012,
{have/has} {you/{NAME}} completed any additional grades of school or received any diplomas or degrees?

YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

PEQ.020

1
2
7
9

(PEQ.020)
(BOX 3)
(BOX 3)
(BOX 3)

{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?
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 OR DOCTORATE (MA, MS) ..................................................
DOCTORATE DEGREE (PHD, EDD) .......................................................
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE
(MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.) .......................
REFUSED ................................................................................................
DON'T KNOW...........................................................................................

A-196

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 ............................................................... 1
NO ................................................................ 2
REFUSED ..................................................... 7
DON'T KNOW ............................................... 9

A-197

Section EMQ

EMQ.010

Since our last interview in spring {YEAR}, has {your/{NAME’s}} job title, place of or type of employment
changed?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

A-198

1
2
7
9

(EMQ.020)
(EMQ.040)
(EMQ.020)
(EMQ.020)

Section CCQ

CCQ.010

Now I'd like to talk to you about child care {CHILD} received during the summer on a regular basis from
someone other than {you/{his/her} {parents/guardians}}. This does not include occasional baby-sitting or
backup care providers. It also does not include summer camp.

CCQ.020

Did {CHILD} receive care from a relative on a regular basis during the summer? This may include
grandparents, brothers and sisters, or any relatives other than {you/{CHILD}'s {parents/guardians}}.

YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.030

How many different regular care arrangements did you have with relatives for {CHILD}'s care during the
summer?
ONE ...............................................................
TWO ..............................................................
THREE...........................................................
FOUR.............................................................
FIVE OR MORE .............................................
REFUSED......................................................
DON’T KNOW................................................

CCQ.040

1
2 (CCQ.120)
7 (CCQ.120)
9 (CCQ.120)

1
2
3
4
5
7
9

{Let's talk about the relative who provided the most care for {CHILD} during the summer.} Who is the relative
who cared for {CHILD}?
GRANDPARENT ...........................................
AUNT .............................................................
UNCLE...........................................................
BROTHER .....................................................
SISTER ..........................................................
ANOTHER RELATIVE ...................................
REFUSED......................................................
DON'T KNOW ................................................

A-199

1
2
3
4
5
6
7
9

CCQ.050

Was the care provided by {{CHILD}'s {RELATIVE}/that relative} in your home or another home?
OWN HOME/CHILD'S HOME ........................
OTHER HOME ..............................................
BOTH/VARIES ...............................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.055

Was the care that {CHILD} received from {his/her} {RELATIVE}/that relative} regularly scheduled at least
once each week during the summer?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.060

1
2
3
7
9

1
2 (BOX 2)
7 (BOX 2)
9 (BOX 2)

How many days each week did {CHILD} receive care from {{his/her} {RELATIVE}/that relative}?
|___|___|
ENTER # OF DAYS
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.070

How many hours each week did {CHILD} receive care from {{his/her} {RELATIVE}/that relative}?
|___|___|
ENTER # OF HOURS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.075

How many weeks during the summer did {CHILD} receive care from this relative?
|___|___|
ENTER # OF WEEKS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

A-200

CCQ.110

You said that {CHILD} was cared for by {NUMBER} other relatives on a regular basis. How many hours
each week does {CHILD} receive care from these other relatives?
|___|___|
ENTER # OF HOURS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.120

Now I'd like to ask you about any care {CHILD} received during the summer from nonrelatives in a private
home, not including child care centers or summer camp. Did {CHILD} receive care in a private home on a
regular basis during the summer from someone who is not related to {him/her}? This includes home child
care providers, regular sitters or neighbors.
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.130

How many different regular care arrangements did you have with nonrelatives for {CHILD}'s care during
the summer?
ONE ...............................................................
TWO ..............................................................
THREE...........................................................
FOUR.............................................................
FIVE OR MORE .............................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.140

1
2
3
4
5
7
9

{Let's talk about the nonrelative who provided the most care for {CHILD} during the summer.} Was that care
provided in your home or another home?
OWN HOME/CHILD'S HOME ........................
OTHER HOME ..............................................
BOTH/VARIES ...............................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.150.

1
2 (CCQ.220)
7 (CCQ.220)
9 (CCQ.220)

1
2
3
7
9

Was the care that {CHILD} received from that person regularly scheduled at least once each week during
the summer?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

A-201

1
2 (BOX 3)
7 (BOX 3)
9 (BOX 3)

CCQ.160

How many days each week did {CHILD} receive care from that person?
|___|
ENTER # OF DAYS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.170

How many hours each week did {CHILD} receive care from that person?
|___|___|
ENTER # OF HOURS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.175

How many weeks did {CHILD} receive care from that person?
|___|___|
ENTER # OF WEEKS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.210

You said that {CHILD} was cared for by {NUMBER} other nonrelatives on a regular basis. How many hours
each week did {CHILD} receive care from these nonrelatives?
|___|___|
ENTER # OF HOURS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.220

Did {CHILD} attend a day care center, including an extended day program,
not include any programs that are called summer camp.
YES................................................................ 1
NO ................................................................. 2
REFUSED...................................................... 7
DON'T KNOW ................................................ 9

CCQ.225

during the summer? Please do

(BOX 5)
(BOX 5)
(BOX 5)

How many different day care centers did {CHILD} attend on a regular basis during the summer?
ONE ...............................................................
TWO ..............................................................
THREE...........................................................
FOUR.............................................................
REFUSED......................................................
DON'T KNOW ................................................

A-202

1
2
3
4
7
9

CCQ.230

{Let's talk about the day care center that {CHILD} spent the most time during the summer.} During the
summer, did {CHILD} go to that program on a regularly scheduled basis at least once each week?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CCQ.240

1
2 (BOX 5)
7 (BOX 5)
9 (BOX 5)

How many days each week did {CHILD} go to that program during the summer?
|___|
ENTER # OF DAYS
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.250

How many hours each week did {CHILD} go to that program during the summer?
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.255

How many weeks did {CHILD} receive care from that program?
|___|___|
ENTER # OF WEEKS
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CCQ.290

You said that {CHILD} attended {NUMBER} other day care centers on a regular basis. How may hours each
week did {CHILD} receive care from these programs?
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

A-203

RELATIVE CARE:
CCQ.115

CCQ.120

Is there any charge or fee for the care, paid either by you or someone else?
YES................................................................ 1
NO ................................................................. 2
REFUSED...................................................... 7
DON’T KNOW................................................ 9

Do any of the following people or organizations help to pay for {CHILD’S}'s care? How about…

a.
b.
c.

CCQ.125

YES

NO

REF

1
1
1

2
2
2

7
7
7

A relative of {CHILD} outside your household who provides
money specifically for that care? ......................................................
A social service or welfare agency? .................................................
An employer? ...................................................................................

How much does your household pay {(his/her) {RELATIVE}/that relative} to care for {CHILD}?
$ |__|__|__|__|
ENTER AMOUNT OF PAYMENT ..................
OR
REFUSED.......................................... 777777
DON'T KNOW .................................... 999999

CCQ.128

(CCQ.120)
(BOX 4A)
(BOX 4A)
(BOX 4A)

(CCQ.128)
(CCQ.130)
(CCQ.130)

[How much does your household pay {(his/her) {RELATIVE} to care for {CHILD}?]
PER HOUR .................................................... 1
PER DAY ....................................................... 2
PER WEEK .................................................... 3
BIWEEKLY .................................................... 4
PER MONTH ................................................. 5
PER YEAR..................................................... 6
OTHER (SPECIFY) ....................................... 91
REFUSED...................................................... 7
DON'T KNOW ................................................ 9

CCQ.130

Is this amount for {CHILD} only, or does it include other children in your household?
CHILD ONLY ................................................. 1(BOX 4A)
CHILD AND OTHERS.................................... 2(CCQ.135)
REFUSED...................................................... 7(BOX 4A)
DON’T’ KNOW ............................................... 9(BOX 4A))

CCQ.135

How many children is this amount for, including {CHILD}?
|__|__|
ENTER NUMBER OF CHILDREN.
OR
REFUSED...................................................... 77
DON’T KNOW................................................ 99

A-204

DK
9
9
9

NON-RELATIVE CARE
CCQ.210

Is there any charge or fee for the care, paid either by you or someone else?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

CCQ.215

1
2
7
9

(CCQ.215)
(BOX 7)
(BOX 7)
(BOX 7)

Do any of the following people or organizations help to pay for {CHILD’S}'s care? How about…
NO REF

DK

1

2

7

9

A social service or welfare agency? .................................................

1

2

7

9

An employer? ...................................................................................

1

2

7

9

YES
a.

CCQ.220

A relative of {CHILD} outside your household who provides
money specifically for that care? ......................................................

b.
c.

How much does your household pay this nonrelative to care for {CHILD}?

$ |__|__|__|__|
ENTER AMOUNT ..........................................
OR
REFUSED............................................ 77777
DON'T KNOW ...................................... 99999

CCQ.225

(CCQ.225)
(CCQ.230)
(CCQ.230)

[How much does your household pay this nonrelative to care for {CHILD?}
PER HOUR .................................................... 1
PER DAY ....................................................... 2
PER WEEK .................................................... 3
BIWEEKLY .................................................... 4
PER MONTH ................................................. 5
PER YEAR..................................................... 6
OTHER (SPECIFY) ____________________ 91
REFUSED...................................................... 7
DON'T KNOW ................................................ 9

CCQ.230

Is this amount for {CHILD} only, or does it include other children in your household?
CHILD ONLY .................................................
CHILD AND OTHERS....................................
REFUSED......................................................
DON’T’ KNOW ...............................................

A-205

1
2
7
9

(BOX 7)
(CCQ.240)
(BOX 7)
(BOX 7)

CCQ.240

How many children is this amount for, including {CHILD}?
|__|__|
ENTER NUMBER OF CHILDREN
OR
REFUSED...................................................... 77
DON’T KNOW................................................ 99

DAY CARE CENTER
CCQ.380

Is there any charge or fee for the program, paid either by you or someone else?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

CCQ.385

(CCQ.385)
(BOX 8B)
(BOX 8B)
(BOX 8B)

Do any of the following people or organizations help to pay for {CHILD’S}'s care? How about…

a.
b.
c.

CCQ.390

1
2
7
9

A relative of {CHILD} outside your household who provides
money specifically for that care? ......................................................
A social service or welfare agency? .................................................
An employer? ...................................................................................

YES

NO

REF

DK

1
1
1

2
2
2

7
7
7

9
9
9

How much does your household pay the day care center to care for {CHILD}?
$ |__|__|__|__|
ENTER AMOUNT OF PAYMENT ..................
OR
REFUSED.......................................... 777777
DON’T KNOW .................................... 999999

(CCQ.393)
(CCQ.395)
(CCQ.395)

CCQ.393

[How much does your household pay the day care center to care for {CHILD}?]
PER HOUR .................................................... 1
PER DAY ....................................................... 2
PER WEEK .................................................... 3
BIWEEKLY .................................................... 4
PER MONTH ................................................. 5
PER YEAR..................................................... 6
OTHER (SPECIFY) ____________________ 91
REFUSED...................................................... 7
DON'T KNOW ................................................ 9

CCQ.395

Is this amount for {CHILD} only, or does it include other children in your household?
CHILD ONLY ................................................. 1 (BOX 8B)
CHILD AND OTHERS.................................... 2 (CCQ.400)
REFUSED...................................................... 7 (BOX 8B)
DON’T KNOW................................................ 9 (BOX 8B)

A-206

CCQ.400

How many children is this amount for, including {CHILD}?
|_|_|
ENTER NUMBER OF CHILDREN
OR
REFUSED...................................................... 77
DON’T KNOW................................................ 99

CCQ.330

{Let's talk about the program where {CHILD} spends the most time now.} Is that program located in the
school where {CHILD} attends {first/second/third/fourth/fifth} grade (or the grade {he/she} attends now)?
YES................................................................

1

NO ........................................................... 2
REFUSED .....................................................
DON'T KNOW ...............................................
CCQ.410

Sometimes children spend time caring for themselves, either at home or somewhere else, without an adult
or older child responsible for them. Does {CHILD} spend time caring for {himself/herself} on a regular basis
before or after school?
YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ................................................

CCQ.420

7
9

1
2
7
9

How many hours per week does {CHILD} take care of (himself/herself)?
|___|
ENTER # HOURS
OR
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

A-207

(CCQ.420)
(BOX 9)
(BOX 9)
(BOX 9)

Section CHQ

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

(CHQ.270)
(CHQ.270)
(CHQ.160)
(CHQ.160)
(CHQ.270)
(CHQ.270)

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
7
9

Does {CHILD} pronounce words, communicate with and understand others ...

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.325

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 ...............................................

CHQ.150

1
2
3
4
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 ................................................

A-208

1
2 (CHQ.350)
7 (CHQ.350)
9 (CHQ.350)

CHQ.330

Has {CHILD} ever been evaluated by a professional in response to {his/her} overall behavior and relations to
other teenagers and adults?

YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CHQ.337

1
2 (CHQ.350)
7 (CHQ.350)
9 (CHQ.350)

What was the diagnosis?

LEARNING DISABILITY ................................ 1
ATTENTION DEFICIT DISORDER (ADD) ..... 2
ATTENTION DEFICIT HYPERACTIVE
DISORDER (ADHD) ..................................... 3
HYPERACTIVITY .......................................... 4
MENTAL RETARDATION.............................. 5
DYSLEXIA ..................................................... 7
OTHER (SPECIFY) ____________________ 91
REFUSED...................................................... 7
DON'T KNOW ................................................ 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 ................................................

CHQ.355

1
2 (CHQ.400)
7 (CHQ.400)
9 (CHQ.400)

Has {CHILD} ever been evaluated by a professional in response to {his/her} overall emotional behavior?

YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

A-209

1
2 (CHQ.400)
7 (CHQ.400)
9 (CHQ.400)

CHQ.365

What was the diagnosis?

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

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?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.400

Do you have any concerns about {CHILD}'s weight or an eating disorder?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.410

1
2
7
9

1
2 (CHQ.500)
7 (CHQ.500)
9 (CHQ.500)

What is that concern?

OVERWEIGHT/OBESE ................................. 1
UNDERWEIGHT ............................................ 2
ANOREXIA .................................................... 3
BULIMIA ........................................................ 4
OTHER (SPECIFY) ____________________ 91
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

CHQ.415 How old was {CHILD} when this first became a concern?
|___|___|
AGE
or
REFUSED...................................................... 77
DON'T KNOW ................................................ 99

A-210

CHQ.420

Has {CHILD} seen a medical professional about this concern?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.040

Since spring {YEAR OF LAST INTERVIEW} has {CHILD} been evaluated by a professional in response to
{his/her} ability to pay attention or learn?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.100

1
2
7
9

(CHQ.210)
(CHQ.270)
(CHQ.270)
(CHQ.270)

Since spring {YEAR OF LAST INTERVIEW} has {CHILD}’s vision been evaluated by a professional?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.075

1
2 (CHQ.150)
7 (CHQ.150)
9 (CHQ.150)

Since spring {YEAR OF LAST INTERVIEW} has {CHILD} 's hearing been evaluated by a professional?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.290

1
2 (CHQ. 080)
7 (CHQ. 080)
9 (CHQ. 080)

Since spring {YEAR OF LAST INTERVIEW} has {CHILD} been evaluated by a professional in response to
{his/her} overall activity level?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.200

1
2
7
9

1
2
7
9

In what year was the diagnosis made?
|___|___|___|___| (CHQ.080)
ENTER YEAR ................................................

(CHQ.080)

OR
REFUSED...................................................... 7777 (CHQ.076)
DON'T KNOW ................................................ 9999 (CHQ.076)
CHQ.076

Was the diagnosis made before {YEAR}?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

A-211

1
2
7
9

CHQ.077

Was the diagnosis made before (CHILD) entered elementary school?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

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

1
2 (BOX 9a)
7 (BOX 9a)
9 (BOX 9a)

Is {CHILD} still receiving any of these services?
YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

CHQ.535

1
2
7
9

1 (CHQ.540)
2
7
9

In what year was the last of these services received?

|___|___|___|___| (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 {YEAR}?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.537

1
2
7
9

(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 ................................................

A-212

1
2
7
9

CHQ.540

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 ...............................................

CHQ.546

1
2
3
4
7
9

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
d.
No longer needs services?...............................
1
b.
Is no longer eligible for services? .....................
1
c.
Services were refused by {his/her} parent
or guardian? .............................................................
1
d. {CHILD} moved and is not receiving these services
in the new school? .................................................
1
e.
Something else? (SPECIFY) ............................
1
(SPECIFY) _________________________________

CHQ.547OS

2
2

7
7

9
9

2

7

9

2
2

7
7

9
9

[Is {CHILD} no longer participating in these services or special education because of some other reason?]
SPECIFY REASON
_______________________________________________________

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................................................

1
2
7
9

(CHQ.565)
(CHQ.570)
(CHQ.570)
(CHQ.570)

CHQ.565

Does {he/she} receive treatment for this condition?

CHQ.570

YES................................................................ 1
NO ................................................................. 2
REFUSED...................................................... 7
DON’T KNOW................................................ 9
Has a doctor, nurse, or other medical professional ever told you that {CHILD} has asthma?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

CHQ.575

Does {he/she} receive treatment for this condition?

A-213

1
2
7
9

(CHQ.575)
(CHQ.580)
(CHQ.580)
(CHQ.580)

YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................
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

1
2
7
9

(CHQ.600)
(CHQ.690)
(CHQ.690)
(CHQ.690)

Does {he/she} receive treatment for this condition?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

CHQ.690

(CHQ.585)
(CHQ.590)
(CHQ.590)
(CHQ.590)

Has a doctor, nurse, or other medical professional ever told you that {CHILD} has diabetes?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

CHQ.600

1
2
7
9

Does {he/she} receive treatment for this condition?
YES................................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW................................................

CHQ.590

1
2
7
9

1
2
7
9

Now I have some questions about childhood injuries. How many times since our last interview in {spring of
{YEAR}} has {CHILD} seen a doctor or other medical professional or visited a clinic or emergency room for
an injury?

|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED...................................................... 777
DON'T KNOW ................................................ 999

CHQ.693

How many times has {CHILD} been hospitalized at least one night for injuries?
|___|___|
ENTER NUMBER OF TIMES
OR
REFUSED...................................................... 777
DON'T KNOW ................................................ 999

A-214

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…

a.

b.
c.
d.
e.
f.

CHQ.763

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})? ..........
No health insurance? ......................................................................

YES

NO

REF

DK

1
1

2
2

7
7

9
9

1

2

7

9

1

2

7

9

1
1

2
2

7
7

9
9

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 {YEAR}, has {CHILD} received any
individual therapy?

YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CHQ.764

1
2 (CHQ.770)
7 (CHQ.770)
9 (CHQ.770)

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

A-215

CHQ.765

Did {CHILD} see…..
COUNT EACH PERSON IN CHQ.765A-E 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.

CHQ.766

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

Was this at school, out of school, or both?

AT SCHOOL ..................................................
OUT OF SCHOOL .........................................
BOTH .............................................................
REFUSED......................................................
DON'T KNOW ................................................

CHQ.767

1
2
3
7
9

About how many times since spring {YEAR} 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 ................................................

CHQ.770

9
9
9
9
9

1
2
3
4
7
9

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?

YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

A-216

1
2 (CHQ.900)
7 (CHQ.900)
9 (CHQ.900)

CHQ.780

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

CHQ.790

Did the family see…..
COUNT EACH PERSON IN CHQ.790A–E 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. 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) _________________________________

CHQ.800

About how many times since spring {YEAR} 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 ................................................

A-217

1
2
3
4
7
9

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.
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

A-218

Section TUQ

TUQ.010

Now, I'd like to get an idea of how {CHILD} spent {his/her} time over the summer. First, I'd like to find out
how much time {CHILD} had for summer vacation after the school year ended. On about what date did
{CHILD}’s school let out for the summer?
|___|___|
ENTER MONTH
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

TUQ.015

[Now, I'd like to get an idea of how {CHILD} spent {his/her} time over the summer. First, I'd like to find out
how much time {CHILD} had for summer vacation after the school year ended. On about what date did
{CHILD}’s school let out for the summer?]

.
|___|___|
ENTER DAY
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

TUQ.020

On what date did school start again?
|___|___|
ENTER MONTH
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

A-219

TUQ.025

[On what date did school start again?]
|___|___|
ENTER DAY
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

TUQ.035

Was {CHILD}'s vacation 2 weeks or longer?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

TUQ.040

1
2 (GO TO BOX 4)
7 (GO TO BOX 4)
9 (GO TO BOX 4)

Some children go away during the summer for short periods of time to stay with relatives, to go to camp, or
to go to other places. Please tell me, during the time that {CHILD} was out of regular school, how many
weeks was {he/she} not staying with you, either at home or at another place?
|___|___|
ENTER WEEKS
or
REFUSED ..................................................... 77
DON'T KNOW ............................................... 99

TUQ.060

Where was {CHILD} when {he/she} was not with you?
WITH A PARENT ........................................... 1
WITH ANOTHER RELATIVE ......................... 2
AT CAMP ....................................................... 3
SOME OTHER PLACE
(SPECIFY) ___________________ .............. 91
REFUSED...................................................... 7

A-220

Section NEQ

NEQ.020

Now, I have a few questions about your neighborhood. Please tell me if you have the following groups or
places in your neighborhood or a nearby area which you consider convenient to your home. Please tell us
whether you have these things, regardless of whether you use them or not. First, do you have….
DON'T

a.
b.
c.
d.
e.
f.

A recreation center or organized activities such as
Little League or soccer? ..........................................................
A community or neighborhood association? ..........................
A community pool?..................................................................
A community park or playground area? ..................................
A library or bookmobile? .........................................................
A boys' or girls' club? ..............................................................

A-221

YES

NO

1
1
1
1
1
1

2
2
2
2
2
2

REFUSED KNOW

7
7
7
7
7
7

9
9
9
9
9
9

Section NRQ

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…..

Often, ............................................................
Sometimes, ...................................................
Hardly ever, or ..............................................
Never? ...........................................................
REFUSED......................................................
DON’T KNOW................................................
NRQ.252

How much of {CHILD}’s medical expenses does {his/her} (biological/adoptive) (father/mother) pay for?
Would you say…
Less than half, ..............................................
About half, {or}, .............................................
More than half {?} {,or } .................................
{All?} ..............................................................
REFUSED......................................................
DON’T KNOW................................................

NRQ.253

1
2
3
4
7
9

1
2
3
4
7
9

What about other bills or expenses for {CHILD}? In the last year, such as clothes, haircuts, activity fees,
tuition, toys, etc.? In the past year, has {he/she} helped pay for these….
Often, ............................................................
Sometimes, ...................................................
Hardly ever, or ..............................................
Never? ...........................................................
REFUSED......................................................
DON’T KNOW................................................

1
2
3
4
7
9

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…
Less than half, ..............................................
About half, {or}, .............................................
More than half {?} {,or } .................................
{All?} ..............................................................
REFUSED......................................................
DON’T KNOW................................................

A-222

1
2
3
4
7
9

Section PEQ

PEQ.010

{Now I have a few questions about education and job training.} Since our last interview in spring {YEAR},
{have/has} {you/{NAME}} completed any additional grades of school or received any diplomas or degrees?

YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

PEQ.020

1
2
7
9

(PEQ.020)
(BOX 3)
(BOX 3)
(BOX 3)

{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?

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...........................................................................................

A-223

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.030

Are you/Is {NAME}} currently attending or enrolled in any courses from a school, college, or university?
YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

PEQ.040

{Are you/Is {NAME}} currently taking courses full-time or part-time?

FULL-TIME ...................................................
PART-TIME ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PEQ.050

1
2
7
9

During the past 12 months {have you/has {NAME}} participated in a job-training or on-the-job-training
program?

YES................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................

PEQ.060

1
2 (PEQ.050)
7 (PEQ.050)
9 (PEQ.050)

1
2 (BOX 3)
7 (BOX 3)
9 (BOX 3)

How many total hours in the past 12 months {have you/has NAME} spent in that program? Please include
hours spent on homework for the training program.
|___|___|___|
ENTER HOURS PER LAST 12 MONTHS
OR
REFUSED ..................................................... 777
DON'T KNOW ............................................... 999

A-224

Section WPQ

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

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

A-225

(WPQ.130)
(WPQ.150)
(WPQ.150)
(WPQ.150)

Section PAQ

PAQ.140

Do you {or anyone else in your family living there} own the home or apartment, pay rent, or do something
else?

PROBE:

Doing “something else” could include exchanging services for housing, not paying for housing, living in a
shelter to temporary housing, or having some other type of arrangement.

OWN .............................................................. 1 (PAQ.150)
RENT ............................................................. 2 (PAQ.240)
DO SOMETHING ELSE................................. 3 (PAQ.240)
REFUSED...................................................... 7 (PAQ.240)
DON'T KNOW ................................................ 9 (PAQ.240)

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?

|___|___|,|___|___|___|,|___|___|___| (PAQ.190)
ENTER TOTAL AMOUNT
OR
REFUSED...................................................... 77777777 (PAQ.160)
DON’T KNOW................................................ 99999999 (PAQ.160)

PAQ.160

Would it amount to $100,000 or more?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.170

1
2
7
9

(PAQ.190)
(PAQ.190)
(PAQ.190)
(PAQ.190)

1
2
7
9

(PAQ.190)
(PAQ.190)
(PAQ.190)
(PAQ.190)

Would it amount to $10,000 or more?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.190

(PAQ.170)
(PAQ.180)
(PAQ.190)
(PAQ.190)

Would it amount to $250,000 or more?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.180

1
2
7
9

Do you have a mortgage on this property?
YES................................................................
NO .................................................................

A-226

1 (PAQ.200)
2 (PAQ.240)

REFUSED......................................................
DON'T KNOW ................................................

A-227

7 (PAQ.240)
9 (PAQ.240)

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)

PAQ.210

Would it amount to $100,000 or more?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.220

(PAQ.220)
(PAQ.230)
(PAQ.240)
(PAQ.240)

1
2
7
9

(PAQ.240)
(PAQ.240)
(PAQ.240)
(PAQ.240)

1
2
7
9

(PAQ.240)
(PAQ.240)
(PAQ.240)
(PAQ.240)

Would it amount to $250,000 or more?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.230

1
2
7
9

Would it amount to $10,000 or more?
YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.240 Have you or anyone else in your family done anything specific in order to have some money for {CHILD}‘s
education after high school such as have a savings account, a 529 plan, a Coverdell Education Savings
Account or Education IRA, or a prepaid tuition account?

YES................................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................

PAQ.140

1
2
7
9

What is your current housing situation? Do you…
Own your own house or condominium, ....................................................
Rent your house or apartment, ................................................................
Exchange services for housing, ...............................................................
Not pay for housing, .................................................................................
Live in temporary housing or a shelter, or.................................................
Have another type of arrangement (SPECIFY)? .....................................
REFUSED ................................................................................................
DON’T KNOW ..........................................................................................

A-228

1
2
3
4
5
6
7
9

(BOX 5)
(BOX 5)
(BOX 5)
(BOX 5)

Possible New K:11 Items for the Parent Interview
PLQ.065

What is the primary language that you speak in your home?
CAPI INSTRUCTION: DISPLAY 'PRIMARY' IN UNDERLINED TEXT.
CODE ‘15’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
ENGLISH .....................................
ARABIC .......................................
CHINESE .....................................
FILIPINO LANGUAGE .................
FRENCH ......................................
GERMAN .....................................
GREEK ........................................
ITALIAN .......................................
JAPANESE ..................................

0
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

Did the diagnosis of dyslexia take into account that {CHILD} may be learning English?
YES................................................................
NO .................................................................
CHILD IS FLUENT IN ENGLISH ...................
REFUSED......................................................
DON'T KNOW ................................................

1
2
3
7
9

When you watch television, do you mostly watch programs in English or another language?
ENGLISH .......................................................
ANOTHER LANGUAGE ................................

1
2

When {CHILD} watches television, does {he/she} mostly watch programs in English or another language
ENGLISH .......................................................
ANOTHER LANGUAGE ................................

1
2

During this school year, how many times (have/has) (you/any adult in your household) gone to meetings or
participated in activities at (child)'s school?

TIMES .........................................................[ ]

{CHILD}’s teachers care about {him/her}.
YES................................................................
NO .................................................................

A-229

1
2