TIMSS Student Questionnaire - Grade 4

Trends in International Mathematics and Science Study (TIMSS:11) and Progress in International Reading Literacy Study (PIRLS:11)

TIMSS_2011_Draft_FT_Student_Quest_Grade_4

TIMSS Student Questionnaire - Grade 4

OMB: 1850-0645

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Identification Label

DRAFT

Student ID:
Student Name:
OMB # to go here

TIMSS 2011
Field Test Version

Student
Questionnaire
Grade 4
National Center for Education Statistics
U.S. Department of Education
1990 K St., NW
Washington, DC 20006

xyz

NCES is authorized to collect information from this
questionnaire under the Education Sciences Reform Act
of 2002 (Public Law 107-279, Section 153). You do not
have to provide the information requested. However,
the information you provide will help the U.S. Departstudent achievement in the United States. There are no
penalties should you choose not to participate in this
study. Your answers may be used only for statistical
able form for any other purpose (Public Law 107-279,
Section 183 and Title V, subtitle A of the E-Government
Act of 2002 (P.L. 107-347)). Your responses will be
combined with those from other participants to
produce summary statistics and reports.
This survey is estimated to take an average of 30
minutes, including time for reviewing instructions, and
completing and reviewing the collection of information.
An agency may not conduct or sponsor, and a person is
not required to respond to, a collection of information
unless it displays a currently valid OMB control number.
Send comments regarding this burden estimate or any
other aspect of this collection of information, including
suggestions for reducing this burden, to: Stephen
Provasnik, National Center for Education Statistics, U.S.
Department of Education, 1990 K Street NW, Room
9034, Washington, DC 20006-5650. Do not return the
completed form to this address.

D

irections

question, you should choose the answer you think is best.
Let us take a few minutes to practice the kinds of questions you will answer in this
booklet.

Example 1
Do you go to school?
Fill one circle only.

Yes --

O

No --

O

Example 2
How often do you do these things?
Fill one circle for each line.
Every day
or almost
every day

1
2

Once or
twice a
week

Once or
twice a
month

Never or
almost
never

a) I listen to music --------------------------

O

O

O

O

b) I talk with my friends ------------------

O

O

O

O

c) I play sports -------------------------------

O

O

O

O

Grade
Grade44Student
Student Questionnaire
Questionnaire

DRAFT

Example 3
What do you think? Tell how much you agree with these
statements.
Fill one circle for each line.
Agree
a lot

Agree
a little

Disagree
a little

Disagree
a lot

a) Watching movies is fun ----------------

O

O

O

O

b) I like eating ice cream -----------------

O

O

O

O

c) I do not like waking up early --------

O

O

O

O

d) I enjoy doing chores --------------------

O

O

O

O

• Read each question carefully, and pick the answer you think is best.
• Fill in the circle next to or under your answer.
•
like this:

O.

• Ask for help if you do not understand something or are not sure how to answer.

DRAFT

Grade 4 4>
Student
StudentQuestionnaire
Questionnaire

1998 -1999 -2000 -2001 -2002 -2003 -2004 -Other --

O
O
O
O
O
O
O
O
O

DRAFT

3
How often do you speak English at home?
Fill one circle only.

I always or almost always
speak English at home --

O

I sometimes speak English
and sometimes speak
another language at home --

O

I never speak English
at home

DRAFT

--

O

Grade 4 4>

Student
Student
Questionnaire
Questionnaire

DRAFT

5
Do you have any of these things at your home?
Fill one circle for each line.
Yes

No

a) Computer ----------------------------------

O

O

b) Study desk/table for your use -------

O

O

c) Books of your very own (do not
count your school books) --------------

O

O

d) Your own room ---------------------------

O

O

e) Internet c onnection ---------------------

O

O

Encyclopedia (as book or CD) --------

O

O

PlayStation, Game Cube, XBox,
or other TV/Video Game --------------

O

O

VCR or DVD Player ---------------------

O

O

Three or more cars, small trucks or
sport utility vehicles --------------------

O

O

DRAFT


4 Student Questionnaire

6
5

6
A. Do you ever use a computer?
Fill one circle only.

Yes --

O

No --

O
(If No, go to question 7)

B. How often do you use a computer in each of these places?
Fill one circle for each line.
Every day
or almost
every day

Once or
twice a
week

Once or
twice a
month

Never or
almost
never

a) At home ------------------------------------

O

O

O

O

b) At school -----------------------------------

O

O

O

O

c) Some other place -------------------------

O

O

O

O

C. How often do you use a computer to do these things?
Fill one circle for each line.
Every day
or almost
every day

Once or
twice a
month

Never or
almost
never

a) Look up information for school -----

O

O

O

O

b) Look up information on a topic
you like (e.g., your favorite athlete,
animals you like, or places
you have traveled to) -------------------

O

O

O

O

O

O

O

c) Exchange information about schoolwork
online (e.g., homework, discussion
boards, asking for help) --------------- O

7
6

Once or
twice a
week


4 Student
Student Questionnaire

DRAFT

7
How often do the following things happen at home?
Fill one circle for each line.
Every day
or almost
every day

Once or
twice a
week

Once or
twice a
month

Never or
almost
never

a) I talk about my schoolwork with
my parents --------------------------------

O

O

O

O

b) My parents help me with my
schoolwork --------------------------------

O

O

O

O

c) My parents make sure that I set
aside time for my homework ---------

O

O

O

O

d) My parents ask me what I learned
in school ------------------------------------

O

O

O

O

e) My parents check if I do my
homework ---------------------------------

O

O

O

O

My parents help me practice
to improve my reading -----------------

O

O

O

O

g) My parents help me practice
to improve my math skills ------------

O

O

O

O

h) I talk with my parents about
what I am reading ----------------------

O

O

O

O

O

O

O

O

f)

i)

DRAFT

My parents like to know where
I am after school -------------------------

Grade 4 4>

Student
Student
Questionnaire
Questionnaire

O

DRAFT

M

athematics in school

1
How much do you agree with these statements about
learning mathematics?
Fill one circle for each line.
Agree
a lot

Agree
a little

Disagree
a little

Disagree
a lot

a) I enjoy learning mathematics -------

O

O

O

O

b) I wish I did not have to study
mathematics ------------- -----------------

O

O

O

O

c) Mathematics is boring -----------------

O

O

O

O

d) I learn many interesting
things in mathematics -----------------

O

O

O

O

e) I like mathematics ----------------------

O

O

O

O

Learning mathematics takes
hard work ----------------------------------

O

O

O

O

g) It is important to do well
in mathematics --------------------------

O

O

O

O

f)

DRAFT

Grade

Student
Student
Questionnaire
Questionnaire

10
1

2
How much do you agree with these statements about your
mathematics lessons?
Fill one circle for each line.
Agree
a lot

Disagree
a little

Disagree
a lot

a) I know what my teacher expects
me to do ------------------------------------

O

O

O

O

---

O

O

O

O

c) I think of things not related to
the lesson ----------------------------------

O

O

O

O

d) My teacher is easy to understand --

O

O

O

O

e) I am interested in what my
teacher says -------------------------------

O

O

O

O

O

O

O

O

f)

11
2

Agree
a little

My teacher gives me interesting
things to do --------------------------------

Grade 4 4>

4 Student
StudentQuestionnaire
Questionnaire

12
3

S

cience in school

4
How much do you agree with these statements about
learning science?
Fill one circle for each line.
Agree
a lot

13
4

Agree
a little

Disagree
a little

Disagree
a lot

a) I enjoy learning science ---------------

O

O

O

O

b) I wish I did not have to
study science ------------------------------

O

O

O

O

c) I read about science in my
spare time ---------------------------------

O

O

O

O

d) Science is boring -------------------------

O

O

O

O

e) I learn many interesting
things in science -------------------------

O

O

O

O

f)

I like science ------------------------------

O

O

O

O

g) Learning science takes
hard work ----------------------------------

O

O

O

O

h) It is important to do well
in science ----------------------------------

O

O

O

O

Grade 4 4>

4 Student
StudentQuestionnaire
Questionnaire

14
5

6
How much do you agree with these statements about
science?
Fill one circle for each line.
Agree
a lot

Disagree
a little

Disagree
a lot

a) I usually do well in science -----------

O

O

O

O

b) Science is harder for me
than for many of my classmates ----

O

O

O

O

c) I am just not good at science ---------

O

O

O

O

d) I learn things quickly
in science ----------------------------------

O

O

O

O

e) My teacher tells me I am good
at science ----------------------------------

O

O

O

O

O

O

O

O

O

O

O

O

f)

Science is harder for me
than any other subject -----------------

g) I keep working on science

15
6

Agree
a little

Grade 4 4>
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