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Early Childhood Longitudinal Study, Kindergarten Class of 2010–11 (ECLS-K:2011)
Fall-Kindergarten
1
INTRODUCTION – INQ
INQ.002
(As I mentioned earlier,) You and {CHILD} have been selected to take part in the Early Childhood Longitudinal Study,
Kindergarten Class of 2010-2011, which is sponsored by the U.S. Department of Education, National Center for Education
Statistics. I have some questions for you that ask about {CHILD}'s school and home experiences. The information I collect in
this interview will be extremely valuable in understanding the development of young children and how their early school
experiences can be improved.
All responses that relate to or describe identifiable characteristics of individuals may be used only for statistical purposes
and may not be disclosed, or used, in identifiable form for any other purpose, unless otherwise compelled by law.
Parts of this call will be recorded for quality control purposes.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
CONTINUE WITH RECORDING ................. 1
CONTINUE WITHOUT RECORDING .......... 2
BOX 0
IF INQ.002 HAS BEEN ASKED TWICE, GO TO INQ.010. ELSE, GO TO INQ.003.
INQ.003
Are you the parent or guardian in this household who knows the most about {CHILD}'s care, education, and health?
NOTE: TO ANSWER “1” FOR “YES, THE PARENT OR GUARDIAN SHOULD LIVE IN THE SAME HOUSEHOLD AS
THE CHILD FOR THE MAJORITY OF THE YEAR, HAVE JOINT CUSTODY OF THE CHILD, OR BE THE ADULT
WHO SPENDS THE MOST TIME WITH THE CHILD WHEN THE CHILD IS NOT IN A GROUP HOME. IF YOU ARE
NOT SPEAKING TO THIS PERSON NOW, CODE “2” FOR “NO.” IF THE CHILD DOES NOT LIVE THERE NOW,
CODE “3” FOR “CHILD LIVES ELSEWHERE.”
YES ...............................................................
NO .................................................................
CHILD LIVES ELSEWHERE .........................
REFUSED .....................................................
DON'T KNOW ...............................................
2
1
2
3
8
9
(INQ.010)
(INQ.004)
(CMQ.701)
(INQ.004)
(INQ.004)
INQ.004
May I please speak with the parent or guardian in the household who knows the most about {CHILD}'s care,
education, and health?
NOTE: THE PARENT OR GUARDIAN SHOULD LIVE IN THE SAME HOUSEHOLD AS THE CHILD FOR THE
MAJORITY OF THE YEAR, HAVE JOINT CUSTODY OF THE CHILD, OR BE THE ADULT WHO SPENDS THE
MOST TIME WITH THE CHILD WHEN THE CHILD IS NOT IN A GROUP HOME. IF THIS PERSON IS AVAILABLE
AND YOU CAN SPEAK TO HIM/HER NOW, CODE “1”. IF YOU NEED TO CALL BACK AND THE PARENT OR
GUARDIAN WILL BE AVAILABLE IN THE FIELD PERIOD, CODE “2”. IF THE PARENT OR GUARDIAN IS NOT
AVAILABLE IN THE FIELD PERIOD, CODE “3” TO ASK FOR SOMEONE ELSE. IF THERE IS NOT A PARENT OR
GUARDIAN IN THE HOUSEHOLD WHO KNOWS THE MOST ABOUT THE CHILD’S CARE, EDUCATION, AND
HEALTH, CODE “4”. IF THE CHILD DOES NOT LIVE THERE NOW, CODE “5” FOR “CHILD LIVES ELSEWHERE.”
AVAILABLE........................................................................... 1 (INQ.002)
NOT AVAILABLE BUT WILL BE BEFORE END
OF FIELD PERIOD (CALLBACK APPT.)............................. 2 (CMQ.702)
NOT AVAILABLE IN FIELD PERIOD....................................3 (INQ.005)
NO PARENT OR GUARDIAN IN HH KNOWS ABOUT CHILD....4 (INQ.005)
CHILD LIVES ELSEWHERE ................................................ 5 (CMQ.701)
REFUSED ........................................................................... 8 (INQ.005)
DON'T KNOW .................................................................... 9 (INQ.005)
INQ.005
May I please speak with a household member who is 18 or older and knows about {CHILD}'s care, education, and
health?
NOTE: THE RESPONDENT SHOULD LIVE IN THE SAME HOUSEHOLD AS THE CHILD FOR THE MAJORITY OF
THE YEAR, HAVE JOINT CUSTODY OF THE CHILD, OR BE THE ADULT WHO SPENDS THE MOST TIME WITH
THE CHILD WHEN THE CHILD IS NOT IN A GROUP HOME. IF THIS PERSON IS ON THE PHONE, CODE “1”. IF
YOU NEED TO CALL BACK AND THIS PERSON WILL BE AVAILABLE IN THE FIELD PERIOD, CODE “2”. IF THIS
PERSON IS NOT AVAILABLE IN THE FIELD PERIOD, CODE “3”. IF THERE IS NOT AN ADULT IN THE
HOUSEHOLD WHO KNOWS ABOUT THE CHILD’S CARE, EDUCATION, AND HEALTH, CODE “4”. IF THE CHILD
DOES NOT LIVE THERE NOW, CODE “5” FOR “CHILD LIVES ELSEWHERE.”
PERSON ON PHONE............................................................1 (INQ.002)
NOT AVAILABLE BUT WILL BE BEFORE END
OF FIELD PERIOD (CALLBACK APPT).............................. 2 (CMQ.702)
NOT AVAILABLE IN FIELD PERIOD....................................3 (CMQ.703)
NO ADULT IN THE HH KNOWS ABOUT THE CHILD........4 (CMQ.703)
CHILD LIVES ELSEWHERE................................................ 5 (CMQ.701)
REFUSED ........................................................................... 8 (CMQ.703)
DON'T KNOW .................................................................... 9 (CMQ.703)
3
INQ.010
May I have your name, please?
ENTER THE RESPONDENT'S FIRST NAME.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
________________________________________________________
FIRST NAME
INQ.012
[May I have your name, please?]
ENTER RESPONDENT’S LAST NAME.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
________________________________________________________
LAST NAME
INQ.015
{Now, I would like to get}/I see that you or someone in your household has already given us} permission for {CHILD} to
participate in the study. {We would like for you to say that you have given us this permission.} For our records, please
state your name, your relationship to {CHILD}, {CHILD}’s name, and that you give us permission for {CHILD} to
participate in the ECLS-K 2011 study.
CAPI INSTRUCTIONS: IF THE PRELOAD SHOWS THAT PARENT ALREADY GAVE CONSENT FOR THE CHILD
TO PARTICIPATE IN THE STUDY, DISPLAY “I see…us” AND “We…permission.” ELSE, DISPLAY “Now, …get” AND
USE A NULL DISPLAY FOR “We…permission.”
CAPI INSTRUCTION: REFUSED AND DON’T KNOW ARE NOT ALLOWED.
DID PARENT/GUARDIAN GIVE PERMISSION?
YES ...............................................................
NO .................................................................
4
1
2
INQ.020
Before we begin the interview, I would like to verify some information.
I have recorded {CHILD's FIRST, MIDDLE, AND LAST NAME} as {CHILD}'s full name. Is this correct?
ALSO VERIFY SPELLING.
MAKE CORRECTIONS TO NAME BELOW OR PRESS ENTER TO ACCEPT FIRST/MIDDLE/LAST NAME.
IF NO MIDDLE NAME OR INITIAL, ENTER 'NMN'.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION: FOR CHILD'S FIRST, MIDDLE, AND LAST NAME, DISPLAY CHILD'S CORRECTED FULL
NAME FROM PRELOAD.
CAPI INSTRUCTION: USE PRELOAD LENGTH FOR CHILD'S NAME.
Current Info:
[CHILD'S FIRST NAME]
[CHILD'S MIDDLE NAME]
[CHILD'S LAST NAME]
FIRST NAME : [___________________]
MIDDLE NAME : [___________________]
LAST NAME : [___________________]
INQ.030
Are there any other names {CHILD} goes by?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
INQ.040
What are those names?
________________________________________________________
ENTER FIRST OTHER NAME
________________________________________________________
ENTER SECOND OTHER NAME
________________________________________________________
ENTER THIRD OTHER NAME
5
1
2 (INQ.050)
8 (INQ.050)
9 (INQ.050)
INQ.050
ASK IF NOT OBVIOUS: {I have {CHILD} recorded as {male/female}. Is that correct?}{/{Is {CHILD} male or female?}
MAKE CORRECTIONS TO GENDER BELOW.
CAPI INSTRUCTION: IF GENDER IS NONMISSING IN THE PRELOAD, DISPLAY “I have…{male/female}. Is that
correct?”, DISPLAY “male” IF THE PRELOAD SHOWS THAT THE CHILD IS MALE, DISPLAY “female” IF THE
PRELOAD SHOWS THAT THE CHILD IS FEMALE, AND NEXT TO “CURRENT INFO” BELOW, DISPLAY “MALE” IF
THE CHILD IS MALE ACCORDING TO THE PRELOAD AND DISPLAY “FEMALE” IF THE CHILD IS FEMALE.
ELSE, IF GENDER IS MISSING IN THE PRELOAD, DISPLAY “Is {CHILD}…female?” AND USE A NULL DISPLAY
FOR “MALE/FEMALE” NEXT TO “CURRENT INFO”.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
CURRENT INFO: [MALE/FEMALE]
MALE ............................................................
FEMALE .......................................................
REFUSED .....................................................
DON'T KNOW ...............................................
INQ.060
1
2
8
9
{I have recorded that {CHILD} was born on {DATE OF BIRTH}. Is that correct?/What is {CHILD}'s date of birth?}
{MAKE CORRECTIONS TO DATE OF BIRTH BELOW OR PRESS ENTER TO ACCEPT CURRENT
DATE OF BIRTH.}
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
CAPI INSTRUCTION: IF CURRENT INFO IS NOT AVAILABLE, ENTRY FOR DATE OF BIRTH IS REQUIRED.
(REFUSED AND DON'T KNOW ARE ALLOWED.)
CAPI INSTRUCTION: DISPLAY "I have recorded the {child} was born on {date of birth}. Is that correct?" AND "MAKE
CORRECTIONS TO DATE OF BIRTH BELOW OR PRESS ENTER TO ACCEPT CURRENT DATE OF BIRTH.}." IF A
DATE OF BIRTH IS AVAILABLE FOR THE FOCAL CHILD FROM THE PRELOAD. OTHERWISE, DISPLAY "What is
{child}'s date of birth?"
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH, 1-31 FOR DAY, 2003-2006 FOR YEAR.
Current Info: [DATE OF BIRTH]
|___|___| / |___|___| / |___|___||___|___|
ENTER DATE OF BIRTH (MONTH/DAY/YEAR)
REFUSED ..................................................... 88
DON'T KNOW ............................................... 99
BOX 1
n
n
IF ANY FIELD IN DATE OF BIRTH INQ.060=DK OR REF, GO TO INQ.090.
OTHERWISE, CONTINUE WITH INQ.080.
6
INQ.080
So {CHILD} is {AGE CALCULATED FROM DATE OF BIRTH AT INQ.060} years old. Is that correct?
CAPI INSTRUCTION: IF CODED '2' (NO), DISPLAY ERROR MESSAGE: 'IF AGE INCORRECT, CORRECT DATE
OF BIRTH."
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
INQ.090
1 (INQ.100)
2
8 (INQ.100)
9 (INQ.100)
How old is {CHILD}?
CAPI INSTRUCTION: RANGE CHECK 4-7.
CAPI INSTRUCTION: IF DK OR RF ENTERED, DISPLAY THIS MESSAGE, "YOU MUST ENTER AN AGE FOR THE
CHILD IF DATE OF BIRTH IS MISSING. IF THE RESPONDENT DOESN'T KNOW THE AGE, ASK FOR HIS/HER
BEST GUESS. IF THE RESPONDENT REFUSES TO PROVIDE AN AGE, ENTER YOUR BEST GUESS OR A '5' IF
YOU CAN'T GUESS THE CHILD'S AGE."
|___|
ENTER AGE
INQ.100
I have recorded that {CHILD}'s home address is:
CAPI INSTRUCTION: DISPLAY CURRENT ADDRESS INFO IN THE RESPONSE FIELD.
{STREET ADDRESS1..}
{STREET ADDRESS2..}
{CITY..} {ST} {ZIP CODE..}
Is this correct?
CORRECT ADDRESS ...................................
SAME ADDRESS - MINOR
CORRECTIONS .........................................
NEW ADDRESS ...........................................
7
1 (INQ.130)
2
3
INQ.110
MAKE CORRECTIONS TO ADDRESS BELOW.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION:
DISPLAY 'HELP AVAILABLE' WHEN ON STATE ENTRY FIELD.
ABBREVIATIONS AS HELP TEXT.
USE STATE
CAPI INSTRUCTION: DISPLAY CURRENT ADDRESS INFO IN THE RESPONSE FIELD.
Current Info:
STREET ADDRESS1 :
STREET ADDRESS2 :
CITY :
STATE :
ZIP CODE :
INQ.130
[STREET ADDRESS1]
[STREET ADDRESS2]
[CITY]
[STATE]
[ZIP CODE]
[___________________]
[___________________]
[___________________]
[___________________]
[___________________]
{I have recorded that {PHONE NUMBER} is {CHILD}'s family's current home phone number. Is this
correct?} /{What is {CHILD}'s family's current phone number?}
{MAKE CORRECTIONS TO PHONE NUMBER BELOW OR PRESS ENTER TO ACCEPT CURRENT
PHONE NUMBER.}
IF NO TELEPHONE, ENTER '000'.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW EDIT:
"Phone number has wrong format. Please correct. The phone number must be formatted as 10 numbers (xxx-xxxxxxx)."
CAPI INSTRUCTION: DISPLAY "I have recorded … correct?” AND “MAKE CORRECTIONS…NUMBER” IF A
PHONE NUMBER IS AVAILABLE, DISPLAY CORRECTED PHONE NUMBER FROM PRELOAD. IF the
PRELOAD PHONE NUMBER WAS '000' RF, DK, OR MISSING, DISPLAY "What is….. phone number?"
CAPI INSTRUCTION: IF CURRENT INFO IS NOT AVAILABLE, ENTRY IS REQUIRED FOR TELEPHONE
NUMBER. (REFUSED AND DON'T KNOW ARE ALLOWED)
Current Info:
[TELEPHONE NUMBER]
|___|___|___| - |___|___|___| -|___|___|___|___|
ENTER TELEPHONE NUMBER
REFUSED .....................................................
DON'T KNOW ...............................................
n
8
9
BOX 2
GO TO SECTION PIQ (PARENT'S INVOLVEMENT WITH CHILD'S SCHOOL).
8
PARENT'S INVOLVEMENT WITH THE CHILD'S SCHOOL - PIQ
PIQ.020
Now I'd like to ask you about {CHILD}'s school. Did {CHILD}'s school or teacher send home information about any of
the following when {CHILD} started kindergarten?
RESPONSES: YES = 1, NO = 2, REFUSED = 8, DON'T KNOW = 9
a.
b.
c.
d.
PIQ.030
How to prepare {CHILD} for kindergarten? ........................................ ____
Topics or skills that are part of the kindergarten program? ................ ____
What to do if {CHILD} will be late or absent from school? ................. ____
How to get in touch with a teacher or school staff to discuss
any concerns or questions about {CHILD}?....................................... ____
Have you met {CHILD}'s teacher yet?
YES ..............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PIQ.050
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.060
1
2
8
9
1
2
8
9
Is {CHILD} attending {his/her} regularly assigned school or a school that you [or {CHILD}’s parents] chose?
ASSIGNED .................................................... 1 (PIQ.070)
CHOSEN ....................................................... 2 (PIQ.070)
ASSIGNED SCHOOL IS SCHOOL OF
CHOICE ...................................................... 3 (PIQ.070)
CHILD IS HOMESCHOOLED ........................ 4 (PIQ.065)
REFUSED ..................................................... 8 (PIQ.070)
DON'T KNOW ............................................... 9 (PIQ.070)
9
PIQ.065
Does {CHILD} attend a school?
YES ............................................................... 1
NO ................................................................. 2 (CMQ.701)
REFUSED ..................................................... 8
DON'T KNOW ............................................... 9
PIQ.066
How many hours each week does {CHILD} usually go to a school for instruction? Please do not include time spent in
extracurricular activities.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-30. HARD RANGE CHECK 0-40.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
PIQ.070
Most schools have guidelines about when a child can start school based on his or her birth date.
Did you [or {CHILD}'s parents] enroll {CHILD} in kindergarten when {he/she} was old enough based on {his/her} birth
date, or did you [or {CHILD}'s parents] wait until {he/she} was older?
WHEN OLD ENOUGH ..................................
WAITED ........................................................
ENTERED EARLY ........................................
REFUSED......................................................
DON'T KNOW ................................................
PIQ.080
1
2
3
8
9
Is this {CHILD}'s first or second year of kindergarten?
FIRST ...........................................................
SECOND ......................................................
THIRD OR MORE .........................................
REFUSED......................................................
DON'T KNOW ................................................
10
1
2
3
8
9
PIQ.090
Children sometimes have problems adjusting to kindergarten. On the average, during the first two months of this
school year …
PROBE: IF THE CHILD HAS NOT YET BEEN IN SCHOOL FOR TWO MONTHS, ASK ABOUT PROBLEMS “SINCE
THE BEGINNING OF THE SCHOOL YEAR.”
RESPONSES: 1 = MORE THAN ONCE A WEEK, 2 = ONCE A WEEK OR LESS, 3 = NOT AT ALL, 8 = REFUSED, 9 =
DON'T KNOW
a.
b.
c.
d.
e.
f.
PIQ.110
Did {CHILD} complain about school more than once a week,
once a week or less, or not at all? ..................................................... ____
Was {CHILD} upset or reluctant to go to school? .............................. ____
Did {he/she} pretend to be sick to stay home from school? ............... ____
Did {he/she} say good things about school? ...................................... ____
Did {CHILD} say {he/she} liked {his/her} teacher? ............................. ____
Did {he/she} look forward to going to school? ................................... ____
Now I'm going to ask you how important you think it is for children to know or do certain things to be ready
for kindergarten.
IN “f” DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her” IF THE CHILD IS FEMALE. DISPLAY “his/her” IF
GENDER IS MISSING.
How important do you think it is that a child ...
RESPONSES: 1 = ESSENTIAL, 2 = VERY IMPORTANT, 3 = SOMEWHAT IMPORTANT, 4 = NOT VERY
IMPORTANT, 5 = NOT IMPORTANT, 8 = REFUSED, 9 = DON'T KNOW
a.
b.
c.
d.
e.
f.
Can count to 20 or more? Would you say it is essential,
very important, somewhat important, not very important,
or not important? ............................................................................... ____
Takes turns and shares? .................................................................. ____
Is able to use pencils and paint brushes? ......................................... ____
Sits still and pays attention? .............................................................. ____
Knows most of the letters of the alphabet?........................................ ____
Communicates needs, wants, and thoughts verbally in {his/her} primary
language?.......................................................................................... ____
11
HELP AVAILABLE
PIQ.120
How far in school do you expect {CHILD} to go? Would you say you expect {him/her} …
CAPI INSTRUCTION: DISPLAY "expect" IN UNDERLINED TEXT.
HELP TEXT
How far the respondent expects the child to go in school:
This question is about how far in school the respondent realistically expects the child to go, not how far the respondent
hopes the child will go. If it is difficult to answer the question because the answer depends on many factors, ask for the
best guess.
To receive less than a high school diploma, ............... 1
To graduate from high school, .................................... 2
To attend a vocational or technical school after
high school,............................................................ 3
To attend two or more years of college, ...................... 4
To finish a four- or five-year college degree, ............... 5
To earn a master's degree or equivalent, or ............... 6
To finish a Ph.D., MD, or other advanced degree? ..... 7
REFUSED ................................................................... 88
DON'T KNOW ............................................................. 99
BOX 1
n
GO TO SECTION FSQ (CURRENT FAMILY STRUCTURE).
12
FAMILY STRUCTURE - FSQ
FSQ.020
{Now I have a few questions about your household. We have noted that you and {CHILD} currently live in this
household. Please tell me the names and ages of all the other people who normally live here. Please do not include
anyone staying here temporarily who usually lives somewhere else.}
{How old {are you/is {NAME}}?}
{CODE IF OBVIOUS. OTHERWISE, ASK: {Are you/Is {NAME}} male or female?}
PROBE: Anyone else (living in this household)?
ENTER AGE AND GENDER OF RESPONDENT.
ENTER FIRST NAME, LAST NAME, AGE, AND GENDER OF EACH HOUSEHOLD MEMBER NAMED.
FIRST NAME
LAST NAME
AGE
GENDER
R
{Display Respondent First Name}
{Display
Respondent
Last Name}
[Enter Age - 3]
[Enter Gender - M/F]
C
{Display Child First Name}
{Display Child
Last Name}
{Display Age}
{Display Gender}
[Enter First Name - 20]
[Enter Last
Name - 20]
[Enter Age - 3]
[Enter Gender - M/F]
[Enter First Name - 20]
[Enter Last
Name - 20]
[Enter Age - 3]
[Enter Gender - M/F]
CAPI MATRIX INSTRUCTIONS:
1. DISPLAY THE RESPONDENT’S FIRST NAME (FROM INQ.010) IN THE FIRST ROW OF THE FIRST NAME
COLUMN. DISPLAY THE RESPONDENT’S LAST NAME (FROM INQ.012) IN THE FIRST ROW OF THE LAST
NAME COLUMN. DISPLAY “R” IN THE FIRST COLUMN TO INDICATE THAT PERSON IS THE RESPONDENT.
2. DISPLAY THE FIRST NAME (FROM INQ.020) OF THE FOCAL CHILD IN THE SECOND ROW OF THE FIRST
NAME COLUMN. DISPLAY THE LAST NAME (FROM INQ.020) OF THE FOCAL CHILD IN THE SECOND ROW
OF THE LAST NAME COLUMN. DISPLAY “C” IN THE FIRST COLUMN TO INDICATE THAT PERSON IS THE
FOCAL CHILD. DISPLAY THE AGE (IF INQ.080 = 1, CALCULATE AGE FROM INQ.060 BIRTHDATE; ELSE,
GET AGE FROM INQ.090) AND GENDER (INQ.050) OF THE CHILD IN THE APPROPRIATE COLUMNS OF
THE SECOND ROW.
3. DISPLAY THE FIRST PARAGRAPH "Now… somewhere else." WHEN YOU FIRST ARRIVE AT FSQ.020.
4. DISPLAY "How old {are you/is {NAME}}?" WHEN THE CURSOR IS POSITIONED IN THE AGE COLUMN.
DISPLAY "ARE YOU" WHEN THE CURSOR IS POSITIONED IN THE AGE COLUMN FOR THE RESPONDENT'S
ROW AND "IS {NAME}" (DISPLAY THE APPROPRIATE FIRST NAME) WHEN THE CURSOR IS POSITIONED IN
THE AGE COLUMN FOR SOMEONE OTHER THAN THE RESPONDENT'S ROW.
5. DISPLAY "CODE IF OBVIOUS. OTHERWISE, ASK: {Are you/is {NAME}} male or female?" WHEN THE
CURSOR IS POSITIONED IN THE GENDER COLUMN. DISPLAY "Are you" WHEN THE CURSOR IS
POSITIONED IN THE GENDER COLUMN FOR THE RESPONDENT'S ROW AND "Is {NAME}" (DISPLAY THE
APPROPRIATE FIRST NAME) WHEN THE CURSOR IS POSITIONED IN THE GENDER COLUMN FOR
SOMEONE OTHER THAN THE RESPONDENT'S ROW.
6. THE INTERVIEWER CAN ADD UP TO 25 ROW ENTRIES.
7. THE INTERVIEWER CAN MOVE ALL AROUND THE MATRIX USING THE ARROW KEYS.
8. REFUSED AND DON’T KNOW ARE ALLOWED ON THE AGE AND GENDER FIELDS.
9. ONCE THE MATRIX IS COMPLETE (AS APPLICABLE), MOVE TO THE NEXT ITEM FSQ.045.
13
FSQ.045
IS THE MATRIX COMPLETE?
CAPI INSTRUCTION: CHECK HOUSEHOLD MATRIX. IF ANY BLANK FIELDS, RETURN THE CURSOR TO THE
BLANK FIELD ON THE MATRIX AND DISPLAY THE APPROPRIATE ERROR MESSAGE.
YES ...............................................................
NO ................................................................
FSQ.060
Have we missed anyone who usually lives here who is temporarily away from home or living in a dorm at school, or any
babies or small children?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
FSQ.110
1 (FSQ.020)
2
8
9
Do you have a spouse or partner who lives in this household?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
FSQ.120
1 (FSQ.060)
2 (COMPLETE MATRIX)
1
2 (BOX 1)
8 (BOX 1)
9 (BOX 1)
Who in the household is your spouse or partner?
SELECT NAME FROM ROSTER.
ENTER NUMBER NEXT TO NAME OF PERSON WHO IS {RESPONDENT}'S SPOUSE/PARTNER.
{DISPLAY HH MEMBER NAME 1}
{DISPLAY HH MEMBER NAME 2}
{DISPLAY HH MEMBER NAME 3}
{DISPLAY HH MEMBER NAME 4}
{DISPLAY HH MEMBER NAME 5}
{DISPLAY HH MEMBER NAME 6}
{DISPLAY HH MEMBER NAME 7}
{DISPLAY HH MEMBER NAME 8}
...............
...............
...............
...............
...............
...............
...............
...............
1
2
3
4
5
6
7
8
IF NAME NOT LISTED, BACK UP AND ADD PERSON (IF PART OF HOUSEHOLD).
CAPI ROSTER INSTRUCTIONS:
1. ONLY DISPLAY HOUSEHOLD MEMBERS WHO ARE 16 YEARS OF AGE OR OLDER.
2. DO NOT DISPLAY THE RESPONDENT’S NAME.
3. DO NOT DISPLAY THE FOCAL CHILD’S NAME.
4. FLAG PERSON SELECTED AT FSQ.120 AS “RESPONDENT’S SPOUSE/PARTNER”.
5. DISPLAY THE RESPONDENT'S FIRST NAME FOR {RESPONDENT}.
BOX 1
LOOP 1
n
ASK FSQ.130 - FSQ.180 FOR EACH PERSON ENUMERATED ON THE HOUSEHOLD
ROSTER (AT FSQ.020) WHO IS NOT THE FOCAL CHILD.
14
HELP AVAILABLE
FSQ.130
What {is your/is {NAME}'s} relationship to {CHILD}?
CODE RELATIONSHIP OF HOUSEHOLD MEMBER.
CAPI INSTRUCTION: REFUSED AND DON’T KNOW ARE DISALLOWED FOR FSQ.130.
CAPI INSTRUCTION: DISPLAY “is your” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “is {NAME}”
USING THE NAME OF THE HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
HELP TEXT:
Mother/Female Guardian: The female primarily responsible for the child. Includes birth or biological
mothers, adoptive, step, foster, and other mothers, as well as, legal female guardians.
Father/Male Guardian: The male primarily responsible for the child. Includes birth or biological fathers,
adoptive, step, foster, and other fathers, as well as, legal male guardians.
Sister: Include biological (full, half), adoptive, step, and foster sisters.
Brother: Include biological (full, half), adoptive, step, and foster brothers.
Girlfriend or Partner of CHILD's Parent/Guardian: The female who has a "partner-like" relationship with
one of the child's parents or guardians. "Living as married" is another way of describing the relationship.
Boyfriend or Partner of CHILD's Parent/Guardian: The male who has a "partner-like" relationship with
one of the child's parents or guardians. "Living as married" is another way of describing the relationship.
Grandmother: The female parent of the child's biological or adoptive mother or father.
Grandfather: The male parent of the child's biological or adoptive mother or father.
Aunt: The sister of the child's biological or adoptive mother or father or the wife of the child's uncle.
Uncle: The brother of the child's biological or adoptive mother or father or the husband of the child's aunt.
Cousin: A child of the focal child's uncle, aunt, or cousin.
Other Relative: Refers to relationships that aren't specifically listed, such as great grandmother, niece, or
nephew.
Other Non-relative: Refers to the relationship between two people when there is no family relationship
through blood, marriage, adoption, or partnership (i.e., living together as married). It also refers to more
ambiguous relationships that exist where there are two people living together as married and they have
children. For example, the child's father and the father's girlfriend (who is not the child's mother) live
together as married and the girlfriend's daughter lives with them. The relationship of the girlfriend's
daughter to the child would be siblings if they were married, but since the father and the girlfriend are not
married, she is an "other non-relative." If the "other non-relative" is coded, you will receive a list of other
codes to use if they are more descriptive than "other non-relative."
CAPI INSTRUCTION: DISPLAY THE RELATIONSHIP MATRIX.
CAPI INSTRUCTION: DO NOT DISPLAY THE FOCAL CHILD'S ROW.
CAPI INSTRUCTION: DISPLAY FIRST NAME, LAST NAME, AND AGE OF THE PERSON, USING INFORMATION
FROM THE CURRENT ROUND HOUSEHOLD MATRIX.
15
MOTHER/FEMALE GUARDIAN .................... 1
FATHER/MALE GUARDIAN .......................... 2 (FSQ.150)
SISTER .......................................................... 3 (FSQ.160)
BROTHER ..................................................... 4 (FSQ.170)
GIRLFRIEND OR FEMALE PARTNER OF {CHILD}'S
PARENT/GUARDIAN .................................. 5 (BOX 2)
BOYFRIEND OR MALE PARTNER OF {CHILD}'S
PARENT/GUARDIAN .................................. 6 (BOX 2)
GRANDMOTHER .......................................... 7 (BOX 2)
GRANDFATHER ........................................... 8 (BOX 2)
AUNT ............................................................. 9 (BOX 2)
UNCLE .......................................................... 10 (BOX 2)
COUSIN ......................................................... 11 (BOX 2)
OTHER RELATIVE ........................................ 12 (BOX 2)
OTHER NONRELATIVE ................................ 13 (FSQ.180)
HELP AVAILABLE
FSQ.140
{Are you/Is {NAME}} {CHILD}’s ...
CAPI INSTRUCTION: DISPLAY “Are you” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “Is
{NAME}” USING THE NAME OF THE HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
HELP TEXT:
Biological or Birth Mother: Child's female biological parent. This may be the birth mother, but could also apply to a
mother who used a surrogate mother to have her biological child.
Adoptive Mother: The female who has taken the child into her own family by legal process to raise as her own child.
Step Mother: The female other than the child's mother who is married to the child's father.
Foster Mother: The female with whom the child is placed temporarily, usually through a social service agency and/or a
court.
Female Guardian: The female legally placed in charge of the affairs of the child.
Other Female Parent or Guardian: This person acts as the mother to the child, but does not fit into one of the other
categories. For example, in a household with two mothers, one of the mothers may not classify herself as biologically
related and she may not be legally in charge of the affairs of the child even though she is another parent to the child.
This category may also be used if a mother has a child through a surrogate mother, or with a donated egg, and does not
classify the child as biologically related or adopted through a legal process.
Biological or birth mother, ..............................
Adoptive mother,............................................
Step mother, .................................................
Foster mother or female guardian, or ............
Other female parent or guardian ....................
REFUSED......................................................
DON’T KNOW ................................................
16
1
2
3
4
5
8
9
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
HELP AVAILABLE
FSQ.150
{Are you/Is {NAME}} {CHILD}’s ...
CAPI INSTRUCTION: DISPLAY “Are you” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “Is
{NAME}” USING THE NAME OF THE HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
HELP TEXT:
Biological or Birth Father: Child's male biological parent. This could also apply to a father who used a
surrogate mother to have his biological child.
Adoptive Father: The male who has taken the child into his own family by legal process to raise as his
own child.
Step Father: The male other than the child's father who is married to the child's mother.
Foster Father: The male with whom the child is placed temporarily, usually through a social service
agency and/or a court.
Male Guardian: The male legally placed in charge of the affairs of the child.
Other Male Parent or Guardian: This person acts as the father to the child, but does not fit into one of the
other categories. For example, in a household with two fathers, one of the fathers may not classify himself
as biologically related and he may not be legally in charge of the affairs of the child even though he is
another parent to the child. This category may also be used if a father has a child through a surrogate
mother, or with donated sperm, and does not classify the child as biologically related or adopted through a
legal process.
Biological or birth father, ................................
Adoptive father,..............................................
Step father, or ................................................
Foster father or male guardian?.....................
Other male parent or guardian .......................
REFUSED......................................................
DON’T KNOW ................................................
17
1
2
3
4
5
8
9
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
HELP AVAILABLE
FSQ.160
{Are you/Is {NAME}} {CHILD}’s ...
CAPI INSTRUCTION: DISPLAY “Are you” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “Is
{NAME}” USING THE NAME OF THE HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
HELP TEXT:
Full Sister: A female with whom the child shares the same biological parents.
Half Sister: A female with whom the child shares one biological parent.
Step Sister: A female to whom the child is unrelated except by the marriage of one biological parent.
Adoptive Sister: A female to whom the child is unrelated except that they are in the same family in which
she or the child has been legally adopted by the family.
Foster Sister: A female to whom the child is unrelated except that they are in the same family in which
she or the child have been taken into the home on a temporary basis and the parents have legal
responsibility for the child.
Full sister, ......................................................
Half sister, ......................................................
Step sister, .....................................................
Adoptive sister, or ..........................................
Foster sister? .................................................
REFUSED......................................................
DON’T KNOW ................................................
18
1
2
3
4
5
8
9
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
HELP AVAILABLE
FSQ.170
{Are you/Is {NAME}} {CHILD}’s ...
CAPI INSTRUCTION: DISPLAY “Are you” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “Is
{NAME}” USING THE NAME OF THE HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
HELP TEXT:
Full Brother: A male with whom the child shares the same biological parents.
Half Brother: A male with whom the child shares one biological parent.
Step Brother: A male to whom the child is unrelated except by the marriage of one biological parent.
Adoptive Brother: A male to whom the child is unrelated except that they are in the same family in which
he or the child has been legally adopted by the family.
Foster Brother: A male to whom the child is unrelated except that they are in the same family in which he
or the child have been taken into the home on a temporary basis and the parents have legal responsibility
for the child.
Full brother,....................................................
Half brother, ...................................................
Step brother, ..................................................
Adoptive brother, or .......................................
Foster brother? ..............................................
REFUSED......................................................
DON’T KNOW ................................................
19
1
2
3
4
5
8
9
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
(BOX2)
(BOX 2)
(BOX 2)
HELP AVAILABLE
FSQ.180
CODE NON-RELATIVE RELATIONSHIP BELOW IF MORE DESCRIPTIVE.
HELP TEXT:
Girlfriend or Female Partner of CHILD's Parent/Guardian: The female who has a "partner-like"
relationship with one of the child's parents or guardians. "Living as married" is another way of describing
the relationship.
Boyfriend or Male Partner of CHILD's Parent/Guardian: The male who has a "partner-like" relationship
with one of the child's parents or guardians. "Living as married" is another way of describing the
relationship.
Female Guardian: The female legally placed in charge of the affairs of the child.
Male Guardian: The male legally placed in charge of the affairs of the child.
Daughter/son of CHILD's Parent's Partner: The child of the person who has a "partner-like" relationship
with one of the child's parents or guardians.
Other Relative of CHILD's Parent's Partner: Some other relative of the person who has a "partner-like"
relationship with one of the child's parents or guardians.
Other Non-relative: If one of the codes for non-relative above does not better describe the relationship of
the person to the child, and there is no family relationship through blood, marriage, adoption, or partnership
(i.e., living together as married), use this code.
CAPI INSTRUCTION: IF FSQ.180 IS CODED 1 (GIRLFRIEND), FLAG RESPONSE TO FSQ.130 AS CODE 5.
CAPI INSTRUCTION: IF FSQ.180 IS CODED 2 (BOYFRIEND), FLAG RESPONSE TO FSQ.130 AS CODE 6.
CAPI INSTRUCTION: IF FSQ.180 IS CODED 3 (FEMALE GUARDIAN), FLAG RESPONSE TO FSQ.130 AS CODE 1
AND RESPONSE TO FSQ.140 AS CODE 4.
CAPI INSTRUCTION: IF FSQ.180 IS CODED 4 (MALE GUARDIAN), FLAG RESPONSE TO FSQ.130 AS CODE 2
AND RESPONSE TO FSQ.150 AS CODE 4.
GIRLFRIEND OR FEMALE PARTNER OF {CHILD}'S
PARENT/GUARDIAN .................................. 1
BOYFRIEND OR MALE PARTNER OF {CHILD}'S
PARENT/GUARDIAN .................................. 2
FEMALE GUARDIAN .................................... 3
MALE GUARDIAN ......................................... 4
DAUGHTER/SON OF {CHILD}'S PARENT’S
PARTNER.................................................... 5
OTHER RELATIVE OF {CHILD}'S PARENT’S
PARTNER.................................................... 6
OTHER NON-RELATIVE (SPECIFY) _____ 91
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
20
FSQ.180OS SPECIFY OTHER NON-RELATIVE.
_______________________________________
OTHER NON-RELATIVE
BOX 2
END LOOP 1
n
ASK FSQ.130 - FSQ.180 FOR NEXT PERSON ON THE HOUSEHOLD ROSTER WHO IS
NOT THE FOCAL CHILD.
n
IF NO NEXT PERSON, CONTINUE WITH FSQ.190.
21
HELP AVAILABLE
FSQ.190
{Are you/Is {NAME}} Hispanic or Latino?}
HELP TEXT:
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin regardless of race.
FIRST NAME
HISPANIC/LATINO
{Display HH Member Name}
|___|
{Display HH Member Name}
|___|
{Display HH Member Name}
|___|
RESPONSES: YES = 1, NO = 2, REFUSED = 8, DON'T KNOW = 9
CAPI ROSTER INSTRUCTIONS: DISPLAY IN COLUMN 1 EACH PERSON ENUMERATED ON THE HOUSEHOLD
ROSTER (FSQ.020) WHO IS THE FOCAL CHILD, RESPONDENT, MOTHER FIGURE (CODE ‘1’ AT FSQ.130), OR
FATHER FIGURE (CODE ‘2’ AT FSQ.130).
IF NO MOTHER OR FATHER FIGURES IN THE HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH A CODE ‘1’ OR
‘2’ AT FSQ.130), DISPLAY IN COLUMN 1 THE FOCAL CHILD, THE RESPONDENT, AND THE RESPONDENT’S
SPOUSE/PARTNER (HOUSEHOLD MEMBER SELECTED AT FSQ.120, IF ANY).
NOTE: IF THE RESPONDENT IS A MOTHER OR FATHER FIGURE, ONLY DISPLAY HIS/HER NAME ONCE.
CAPI MATRIX INSTRUCTIONS:
1. DISPLAY FIRST NAME, LAST NAME, AND AGE OF THE PERSON, USING INFORMATION FROM THE
CURRENT ROUND HOUSEHOLD MATRIX.
2. THE CURSOR SHOULD BE POSITIONED ON THE FIRST BLANK FIELD.
3. THE FIRST COLUMN OF THE MATRIX (FIRST NAME) IS READ ONLY (SEE ROSTER INSTRUCTIONS
ABOVE).
4 DISPLAY “Are you” IF THE SUBJECT OF THE QUESTION IS THE RESPONDENT. ELSE, DISPLAY “Is {NAME}”
USING THE NAME OF THE HOUSEHOLD MEMBER THAT IS THE SUBJECT OF THE QUESTION.
5. DISPLAY "{Are you/Is {NAME}} HISPANIC OR LATINO?" AND "1 = YES 2 = NO" WHEN CURSOR IS
POSITIONED IN THE HISPANIC COLUMN OF THE MATRIX.
6. REFUSED AND DON'T KNOW ARE ALLOWED FOR HISPANIC/LATINO.
7. CURSOR WILL MOVE FROM HISPANIC/LATINO COLUMN TO RACE COLUMN IN FSQ.195 FOR SAME
PERSON AND THEN WILL MOVE TO HISPANIC/LATINO COLUMN IN FSQ.190 FOR NEXT PERSON, ETC.
THE CURSOR WILL MOVE IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED.
8. INTERVIEWER CANNOT LEAVE THE MATRIX UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
22
1
2
8
9
HELP AVAILABLE
FSQ.195
{What is {your/{NAME} 's } race? You may name one or more races to indicate what {you/NAME}
{consider/considers} {yourself/himself/herself} to be.
CODE ALL THAT APPLY}
HELP TEXT:
American Indian or Alaska Native: A person having origins in any of the original peoples of North and
South America (including Central America), and who maintains tribal affiliation or community attachment.
Asian: A person having origins in any of the original peoples of the Far East, Southeast Asia, or the Indian
subcontinent including, for example, Cambodia, China, India, Japan, Korea, Malaysia, Pakistan, the
Philippine Islands, Thailand, and Vietnam.
Black or African American: A person having origins in any of the black racial groups of Africa.
Native Hawaiian or Other Pacific Islander: A person having origins in any of the original peoples of
Hawaii, Guam, Samoa, or other Pacific Islands.
White: A person having origins in any of the original peoples of Europe, the Middle East, or North Africa.
RESPONSES:
AMERICAN INDIAN OR ALASKA NATIVE = 1, ASIAN = 2, BLACK OR AFRICAN AMERICAN = 3,
NATIVE HAWAIIAN OR OTHER PACIFIC ISLANDER = 4, WHITE = 5, REFUSED = 8, DON'T KNOW
=9
FIRST NAME
RACE
{Display HH Member Name}
|___|
{Display HH Member Name}
|___|
{Display HH Member Name}
|___|
CAPI INSTRUCTIONS: DISPLAY “your” “you” “consider” AND “yourself” IF THE SUBJECT OF THE QUESTIONS IS
THE RESPONDENT. ELSE, DISPLAY THE NAME OF THE SUBJECT OF THE QUESTIONS, “considers” AND
“himself” IF THE SUBJECT OF THE QUESTIONS IS MALE. ELSE, DISPLAY THE NAME OF THE SUBJECT OF THE
QUESTIONS, “considers” AND “herself” IF THE SUBJECT OF THE QUESTIONS IS FEMALE.
CAPI ROSTER INSTRUCTIONS: DISPLAY IN COLUMN 1 EACH PERSON ENUMERATED ON THE HOUSEHOLD
ROSTER (FSQ.020) WHO IS THE FOCAL CHILD, RESPONDENT, MOTHER FIGURE (CODE ‘1’ AT FSQ.130), OR
FATHER FIGURE (CODE ‘2’ AT FSQ.130).
IF NO MOTHER OR FATHER FIGURES IN THE HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH A CODE ‘1’ OR
‘2’ AT FSQ.130), DISPLAY IN COLUMN 1 THE FOCAL CHILD, THE RESPONDENT, AND THE RESPONDENT’S
SPOUSE/PARTNER (HOUSEHOLD MEMBER SELECTED AT FSQ.120, IF ANY).
NOTE: IF THE RESPONDENT IS A MOTHER OR FATHER FIGURE, ONLY DISPLAY HIS/HER NAME ONCE.
CAPI MATRIX INSTRUCTIONS:
2. DISPLAY FIRST NAME, LAST NAME, AND AGE OF THE PERSON, USING INFORMATION FROM THE
CURRENT ROUND HOUSEHOLD MATRIX.
2. THE CURSOR SHOULD BE POSITIONED ON THE FIRST BLANK FIELD.
3. THE FIRST COLUMN OF THE MATRIX (FIRST NAME) IS READ ONLY (SEE ROSTER INSTRUCTIONS
ABOVE).
5. DISPLAY "What is {your/{NAME}'s} race?", "CODE ALL THAT APPLY", AND ANSWER CATEGORIES WHEN
CURSOR IS POSITIONED IN THE RACE COLUMN OF THE MATRIX.
6. REFUSED AND DON'T KNOW ARE ALLOWED FOR RACE.
23
7.
8.
CURSOR WILL MOVE FROM THE RACE COLUMN (FSQ.195) BACK TO THE HISPANIC/LATINO COLUMN
(FSQ.190) FOR THE NEXT PERSON IN THE MATRIX, IF THERE IS ANOTHER HOUSEHOLD MEMBER TO BE
ASKED ABOUT. THE CURSOR WILL MOVE IN THIS FASHION UNTIL ALL FIELDS ARE COMPLETED.
INTERVIEWER CANNOT LEAVE THE MATRIX UNTIL ALL ANSWER FIELDS ARE ACCOUNTED FOR.
FSQ.200
{FILL 1}
{FILL 2}
ParentIsR
BioMoInHH
BioFaInHH
AdopMoInHH
AdopFaInHH
OtherinHH
THE CURRENT
ROSTER SHOWS A
RELATIONSHIP OF
BIOLOGICAL/
ADOPTIVE
MOTHER OR
BIOLOGICAL/
ADOPTIVE FATHER
FOR THE PERSON
FLAGGED AS THE
RESPONDENT FOR
YES
THE CURRENT
ROSTER SHOWS
THE
RELATIONSHIP OF
BIOLOGICAL
MOTHER FOR AT
LEAST ONE HH
MEMBER (NOT
THE R)
FOR YES
THE CURRENT
ROSTER SHOWS
THE
RELATIONSHIP OF
BIOLOGICAL
FATHER FOR AT
LEAST ONE HH
MEMBER (NOT
THE R)
FOR YES
THE CURRENT
ROSTER SHOWS
THE
RELATIONSHIP OF
ADOPTIVE
MOTHER FOR AT
LEAST ONE HH
MEMBER (NOT
THE R)
FOR YES
THE CURRENT
THE
CURRENT
ROSTER
SHOWS
THERE IS NO
BIOLOGICAL/
ADOPTIVE
MOTHER/FAT
HER IN THE
HOUSEHOLD
FOR YES
ROSTER
SHOWS THE
RELATIONSHIP
OF ADOPTIVE
FATHER FOR AT
LEAST ONE HH
MEMBER (NOT
THE R)
FOR YES
Are you
have you
YES
Are you
have you
Are CHILD's
biological parents
Are CHILD's
biological parents
Is CHILD's
biological mother
Is CHILD's
biological father
Is CHILD's
adoptive mother
Is CHILD's
adoptive father
Are CHILD's
adoptive parents
have they
NO
YES
YES
have they
NO
NO
NO
has she
NO
YES
NO
NO
has he
NO
NO
YES
NO
has she
NO
NO
NO
YES
NO
NO
has he
NO
NO
NO
NO
YES
NO
have they
NO
NO
NO
YES
YES
NO
YES
NO
NO
NO
{FILL 1} currently married, separated, divorced, widowed, or {FILL 2} never been married?
MARRIED……………………………………………..1
SEPARATED…………………………………………2
DIVORCED…………………………………………...3
WIDOWED……………………………………………4
NEVER MARRIED .............................................. 5
CIVIL UNIONS/DOMESTIC PARTNERSHIP……...6
REFUSED……………………………………………..8
DON’T KNOW…………………………………………9
24
NO
BOX 3
IDENTIFY THE 2 “KEY” PARENT FIGURES IN THE HOUSEHOLD. THIS PERSON OR PERSONS SHOULD BE
CHOSEN AS FOLLOWS:
·
1) THE KEY PARENT FIGURES SHOULD BE CHOSEN ONLY FROM AMONG CURRENT MEMBERS OF THE
HOUSEHOLD;
·
2) IF A MOTHER (RELATION=1) IS IN THE HOUSEHOLD SHE SHOULD BE A KEY PARENT FIGURE; IF A
FATHER (RELATION =2) IS IN THE HOUSEHOLD HE SHOULD BE A KEY PARENT FIGURE; IF THERE ARE
TWO MOTHERS (RELATION=1) PICK THE MOTHER WITH THE LOWER NUMBER RELATIONSHIP IN THE
FOLLOWING SYSTEM: BIRTH MOTHER =1, ADOPTIVE MOTHER=2, STEPMOTHER=3, FOSTER MOTHER
OR FEMALE GUARDIAN =4. OTHER TYPE OF MOTHER = 5. IF TWO MOTHERS HAVE SAME NUMBER
RELATIONSHIP, PICK ONE WITH LOWEST PERSON NUMBER. IF THERE ARE TWO FATHERS
(RELATION=2), PICK THE FATHER WITH THE LOWER NUMBER RELATIONSHIP IN THE FOLLOWING
SYSTEM: BIRTH FATHER =1, ADOPTIVE FATHER=2, STEPFATHER=3, FOSTER FATHER OR MALE
GUARDIAN =4, AND OTHER TYPE OF FATHER = 5. IF TWO FATHERS HAVE SAME NUMBER
RELATIONSHIP, PICK ONE WITH LOWEST PERSON NUMBER;
·
3) IF THERE IS A MOTHER (RELATION =1) BUT NO FATHER (RELATION=2) AND THE MOTHER HAS A
SPOUSE/PARTNER, THE MOTHER SHOULD BE A KEY PARENT FIGURE AND THE SPOUSE/PARTNER
SHOULD BE A KEY PARENT FIGURE;
·
4) IF THERE IS A FATHER (RELATION=2) BUT NO MOTHER (RELATION=1) AND THE FATHER HAS A
SPOUSE/PARTNER, THE FATHER SHOULD BE A KEY PARENT FIGURE AND THE SPOUSE/PARTNER
SHOULD BE A KEY PARENT FIGURE;
·
5) OTHERWISE, IF THERE ARE NOT PARENTS IN THE HOUSEHOLD (RELATION NE 1 OR 2), THE
RESPONDENT SHOULD BE A KEY PARENT FIGURE AND THE RESPONDENT’S SPOUSE/PARTNER, IF
ONE, SHOULD BE A KEY PARENT FIGURE.
BOX 4
IF BOTH (A BIOLOGICAL OR BIRTH MOTHER) AND (A BIOLOGICAL OR BIRTH FATHER)
ARE IN THE HOUSEHOLD (FSQ.140 = 1 AND FSQ.150 = 1), GO TO BOX 5. ELSE, GO TO
FSQ.205.
FSQ.205
How long has {CHILD} lived with you?
ENTER “88” IF THE CHILD HAS LIVED WITH THE RESPONDENT HIS/HER WHOLE LIFE.
CAPI INSTRUCTION: RANGE CHECK: 4-7 FOR YEARS, 0-12 FOR MONTHS.
|___|___|
ENTER YEARS
AND
|___|___|
ENTER MONTHS
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
n
BOX 5
GO TO SECTION PLQ (PRIMARY LANGUAGE SPOKEN)
25
PRIMARY LANGUAGE(S) SPOKEN - PLQ
HELP AVAILABLE
PLQ.020
Is any language other than English regularly spoken in your home?
HELP TEXT:
Regularly: A language, other than English, that is spoken on a regular basis (that is, occurring at least weekly) by at
least one household member.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
PLQ.030
Is English also spoken in your home?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
PLQ.040
1
2 (BOX 8)
8 (BOX 8)
9 (BOX 8)
1
2
8
9
What languages other than English are spoken in your home?
CODE ALL THAT APPLY
ARABIC .......................................
CHINESE LANGUAGE/DIALECT
FILIPINO LANGUAGE .................
FRENCH ......................................
GERMAN .....................................
GREEK ........................................
ITALIAN .......................................
JAPANESE ..................................
1
2
3
4
5
6
7
8
KOREAN ....................................... 9
POLISH ....................................... 10
PORTUGUESE ........................... 11
SPANISH ..................................... 12
VIETNAMESE ............................. 13
FARSI .......................................... 14
HMONG ....................................... 15
SOME OTHER LANGUAGE
(SPECIFY) _________________ 91
REFUSED .................................... 88
DON’T KNOW .............................. 99
BOX 1
IF PLQ.040 = 91, GO TO PLQ.040OS. ELSE, GO TO BOX 2.
26
PLQ.040OS
[What languages other than English are spoken in your home?]
SPECIFY LANGUAGE.
___________________________________________________________
BOX 2
n
n
IF ONLY ONE LANGUAGE SPOKEN IN THE HOME (PLQ.030 = 2, 8, OR 9 AND ONLY
ONE LANGUAGE IS CODED AT PLQ.040 OR PLQ.040 = 88 OR 99), GO TO PLQ.050.
OTHERWISE, GO TO BOX 3.
BOX 3
ASK PLQ.041, PLQ.041OS, AND PLQ.050 AS A LOOP FOR UP TO 2 “KEY” PARENT FIGURES
AS DEFINED IN BOX 3 OF FSQ.
HELP AVAILABLE
PLQ.041
What is the primary language that {you/NAME} {speak/speaks} in your home?
HELP TEXT:
Primary language: The language spoken most of the time.
CAPI INSTRUCTIONS: DISPLAY "you" AND “speak” IF CURRENT CYCLE OF LOOP IS ASKING ABOUT THE
RESPONDENT. DISPLAY "{NAME}" (AND THAT PERSON'S FIRST NAME) AND “speaks” IF ASKING ABOUT A
HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT.
CAPI INSTRUCTION: DISPLAY 'you' AND “NAME” IN UNDERLINED TEXT.
CODE ‘16’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
ENGLISH .....................................
ARABIC .......................................
CHINESE LANGUAGE/DIALECT
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
FARSI .......................................... 14
HMONG ....................................... 15
RESPONDENT CANNOT
CHOOSE A PRIMARY
LANGUAGE.................................. 16
SOME OTHER LANGUAGE
(SPECIFY) _________________ 91
REFUSED .................................... 88
DON’T KNOW .............................. 99
27
BOX 4
IF PLQ.041 = 91, GO TO PLQ.041OS. ELSE, GO TO PLQ.050.
PLQ.041OS
[What is the primary language that {you/NAME} {speak/speaks} in your home?]
CAPI INSTRUCTIONS: DISPLAY "you" AND “speak” IF CURRENT CYCLE OF LOOP IS ASKING ABOUT THE
RESPONDENT. DISPLAY "{NAME}" (AND THAT PERSON'S FIRST NAME) AND “speaks” IF ASKING ABOUT A
HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT.
CAPI INSTRUCTION: DISPLAY 'you' AND “NAME” IN UNDERLINED TEXT.
SPECIFY LANGUAGE.
___________________________________________________________
PLQ.050
How well do/does {you/NAME} . . .
CAPI INSTRUCTIONS: DISPLAY “do” AND "you" IF CURRENT CYCLE OF LOOP IS ASKING ABOUT THE
RESPONDENT. DISPLAY “done” AND "{NAME}" (AND THAT PERSON'S FIRST NAME) IF ASKING ABOUT A
HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT.
RESPONSES: VERY WELL = 1, PRETTY WELL = 2, NOT VERY WELL = 3, NOT WELL AT ALL = 4, REFUSED = 8,
DON'T KNOW = 9
a.
b.
c.
d.
Speak English? Would you say very
well, pretty well, not very well, or not
well at all? ............................................... ___
Read English? ....................................... ___
Write English? ....................................... ___
Understand someone speaking
English? ................................................. ___
BOX 5
ASK PLQ.041, PLQ.041OS, AND PLQ.050 AS A LOOP FOR SECOND “KEY” PARENT FIGURE
(IF APPLICABLE). ELSE, GO TO BOX 6.
BOX 6
IF (THERE ARE 2 KEY PARENT FIGURES IN THE HOUSEHOLD AND PLQ.041 FOR ONE KEY
PARENT FIGURE IS NOT EQUAL TO PLQ.041 FOR THE OTHER KEY PARENT FIGURE) OR
(THERE IS ONLY 1 KEY PARENT FIGURE BUT THERE ARE OTHER HOUSEHOLD MEMBERS
WHO ARE 18 YEARS OLD OR OLDER), ASK PLQ.060. ELSE, GO TO PLQ.083.
28
HELP AVAILABLE
PLQ.060
What is the primary language spoken in your home?
HELP TEXT:
Primary language: The language spoken the most of the time by most of the household members.
CAPI INSTRUCTION: DISPLAY 'primary' IN UNDERLINED TEXT.
CODE ‘16’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
CODE ‘17’ IF TWO LANGUAGES ARE USED EQUALLY.
ENGLISH .....................................
ARABIC .......................................
CHINESE LANGUAGE/DIALECT
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
FARSI .......................................... 14
HMONG ....................................... 15
SOME OTHER LANGUAGE
(SPECIFY) _________________ 91
RESPONDENT CANNOT
CHOOSE A PRIMARY
LANGUAGE.................................. 16
TWO LANGUAGES ARE USED
EQUALLY ..................................... 17
REFUSED .................................... 88
DON’T KNOW .............................. 99
BOX 7
IF PLQ.060 = 91, GO TO PLQ.060OS. ELSE, GO TO PLQ.083.
PLQ.060OS
[What is the primary language spoken in your home?]
CAPI INSTRUCTION: DISPLAY 'primary' IN UNDERLINED TEXT.
SPECIFY LANGUAGE.
___________________________________________________________
29
PLQ.083
How often {do/does} {{you/{NAME} use {{NON-ENGLISH LANGUAGE}/a language other than English} when speaking
to {{CHILD}? Would you say never, sometimes, often, or very often?
{PROBE: IF MORE THAN ONE NON-ENGLISH LANGUAGE SPOKEN, SAY: On average, how often {do/does}
{{you/{NAME}}/{CHILD}} use all languages, other than English, in speaking to {{CHILD}/{you/{NAME}}}?}
PROBE: We just need to know in general.
First Name
PLQ.083 VARIABLE NAME
How often {do/does}
{{you/{NAME}} use
{{NON-ENGLISH LANGUAGE}/a
language other than English} in
speaking to {CHILD}? Would you
say never, sometimes, often, or
very often?
{Display HH Member Name}
|___|
{Display HH Member Name}
|___|
CAPI ROSTER INSTRUCTION: DISPLAY IN COLUMN 1 PERSONS ENUMERATED ON THE HOUSEHOLD
ROSTER WHO ARE KEY PARENT FIGURES (UP TO TWO PERSONS).
CAPI MATRIX INSTRUCTIONS:
1. THE FIRST COLUMN OF THE MATRIX (FIRST NAME) IS READ ONLY (SEE CAPI ROSTER INSTRUCTIONS
ABOVE).
2. WHEN CURSOR IS POSITIONED IN THE SECOND COLUMN (PLQ.083), DISPLAY THE VARIABLE NAME FOR
PLQ.083 AT THE TOP OF THE COLUMN AND THE FOLLOWING QUESTION TEXT AT THE TOP OF THE SCREEN:
"How often {do/does} {{you/{NAME}} use {{NON-ENGLISH LANGUAGE}/a language other than English} in speaking to
{CHILD}? Would you say never, sometimes, often, or very often?” DISPLAY “you” IF THE KEY PARENT FIGURE IS
THE RESPONDENT. OTHERWISE, DISPLAY THE NAME OF THE KEY PARENT FIGURE. IF PLQ.040 SHOWS ONE
LANGUAGE SELECTED THAT HAS A CODE FROM 1 TO 15, DISPLAY THE NAME OF THE LANGUAGE IN "{NONENGLISH LANGUAGE}". ELSE IF PLQ.040 = 91, 88, OR 99, OR IF THERE ARE TWO OR MORE LANGUAGES IN
PLQ.040, DISPLAY "a language other than English" AND “{PROBE: IF MORE THAN ONE NON-ENGLISH
LANGUAGE SPOKEN, SAY: On average, how often {do/does} {{you/{NAME}} use all languages, other than English, in
speaking to {CHILD}?”
3. ANOTHER COLUMN OF THE MATRIX IS USED TO ASK PLQ.090 (BELOW) THE CURSOR WILL MOVE FROM
PLQ.083 TO PLQ.090 FOR THE SAME PERSON AND THEN WILL MOVE BACK TO PLQ.083 AND THEN PLQ.090
FOR THE SECOND PERSON.
4. INTERVIEWER CANNOT LEAVE THE MATRIX UNTIL ALL FIELDS ARE ACCOUNTED FOR.
NEVER, ........................................................
SOMETIMES, ...............................................
OFTEN, OR ..................................................
VERY OFTEN? ..............................................
REFUSED......................................................
DON’T KNOW ................................................
30
1
2
3
4
8
9
PLQ.090
How often does {CHILD}} use {{NON-ENGLISH LANGUAGE}/a language other than English} when speaking to
{you/{NAME}}? Would you say never, sometimes, often, or very often?
{PROBE: IF MORE THAN ONE NON-ENGLISH LANGUAGE SPOKEN, SAY: On average, how often {do/does}
{{you/{NAME}}/{CHILD}} use all languages, other than English, in speaking to {{CHILD}/{you/{NAME}}}?}
PROBE: We just need to know in general.
First Name
PLQ.090 VARIABLE NAME:
How often does {CHILD} use
{{NON-ENGLISH
LANGUAGE}/a language
other than English} in
speaking to {you/{NAME}}?
Would you say never,
sometimes, often, or very
often?"
{Display HH Member Name}
|___|
{Display HH Member Name}
|___|
CAPI ROSTER INSTRUCTION: DISPLAY IN COLUMN 1 PERSONS ENUMERATED ON THE HOUSEHOLD
ROSTER WHO ARE KEY PARENT FIGURES (UP TO TWO PERSONS).
CAPI MATRIX INSTRUCTIONS:
1. THE FIRST COLUMN OF THE MATRIX (FIRST NAME) IS READ ONLY (SEE CAPI ROSTER INSTRUCTIONS
ABOVE).
2. WHEN CURSOR IS POSITIONED IN THE NEXT COLUMN {PLQ.090}, DISPLAY THE VARIABLE NAME FOR
PLQ.090 AT THE TOP OF THE COLUMN AND THE FOLLOWING QUESTION TEXT AT THE TOP OF THE SCREEN:
"How often does {CHILD} use {{NON-ENGLISH LANGUAGE}/a language other than English} in speaking to
{you/{NAME}}? Would you say never, sometimes, often, or very often?" DISPLAY “you” IF THE KEY PARENT FIGURE
IS THE RESPONDENT. OTHERWISE, DISPLAY THE NAME OF THE KEY PARENT FIGURE. IF PLQ.040 SHOWS
ONE LANGUAGE SELECTED THAT HAS A CODE FROM 1 TO 15, DISPLAY THE NAME OF THE LANGUAGE IN
"{NON-ENGLISH LANGUAGE}". ELSE IF PLQ.040 = 91, 88, OR 99, OR IF THERE ARE TWO OR MORE
LANGUAGES IN PLQ.040, DISPLAY "a language other than English" AND “{PROBE: IF MORE THAN ONE NONENGLISH LANGUAGE SPOKEN, SAY: On average, how often does {CHILD} use all languages, other than English, in
speaking to {you/{NAME}}."
4. AFTER PLQ.090 IS COMPLETED FOR THE FIRST PERSON, THE CURSOR WILL MOVE BACK TO PLQ.083
FOR THE SECOND PERSON AND THEN TO PLQ.090 FOR THAT PERSON.,
5. INTERVIEWER CANNOT LEAVE THE MATRIX UNTIL ALL FIELDS ARE ACCOUNTED FOR.
NEVER, ........................................................
SOMETIMES, ...............................................
OFTEN, OR ..................................................
VERY OFTEN? ..............................................
REFUSED......................................................
DON’T KNOW ................................................
31
1
2
3
4
8
9
BOX 8
GO TO SECTION
STIMULATION).
HEQ
(HOME
ENVIRONMENT,
32
ACTIVITIES,
AND
COGNITIVE
HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE STIMULATION - HEQ
HELP AVAILABLE
HEQ.010
Now I'd like to talk with you about {CHILD}'s activities with family members. In a typical week, how often do you or any
other family members do the following things with {CHILD}?
PROBE: Would you say not at all, once or twice a week, 3-6 times a week, or every day?
HELP TEXT:
FAMILY MEMBER: A family member refers to any person who lives in the child's household and any relative of the
child living outside the child's household.
Tell stories: Story-telling is different from reading. Stories include fairy tales, family stories, or any type of story that is
not read.
Sing Songs with child: Include times that a family member sings to or with the child. This may include teaching the
child songs, singing along with tapes or to the radio, or singing while playing musical instruments.
Help child with arts and crafts: Arts and crafts may include making seasonal decorations, making cutouts or drawing
pictures, painting or finger-painting, whittling wood, etc. It also includes helping the child with arts and crafts projects
assigned by school, but done at home.
Involve child in household chores: Chores not mentioned can also satisfy this item.
Play games or do puzzles: Includes indoor "quiet" games like board games or puzzles, or more active indoor games
like Ping-Pong.
Talk about nature or do science projects: Talking about nature could include answering any questions the child may
have about trees, weather, etc. or watching a television program or video about nature together and then discussing it.
Science projects include any type of project designed to show the child how the world works, such as understanding
how plants grow, studying rocks, using flashlights to create shadows, or mixing paints to create different colors.
Build something or play with construction toys: This would include activities that the child does with family
members, such as making a tent, constructing a toy car, building a doghouse, and using Lincoln logs, Brio, or other
construction toys or tools.
Play a sport or exercise together: This includes calisthenics (e.g., jumping jacks, sit- ups), riding bicycles,
rollerblading, individual or team sports, games like hide-and-go-seek, or other outdoor activities where activity or
exercise is involved. Do not include times when the child does the sport or activity by him or herself.
Practice reading, writing, or working with numbers: This includes time family members spend on homework,
reading a calendar, practicing in an exercise or workbook.
CAPI INSTRUCTION:
1. WHEN ON B-I. DISPLAY "PROBE……every day?" IN SQUARE BRACKETS.
2. DISPLAY "Now …… {CHILD}?" IN SQUARE BRACKETS WHEN ON B-K.
3. DISPLAY “week” in UNDERLINED TEXT.
NOT
ONCE
3-6
AT ALL OR TWICE TIMES
a.
b.
c.
d.
e.
f.
g.
h.
i.
Tell stories to {CHILD}? Would you say
not at all, once or twice a week, 3-6 times a
week, or every day?
Sing songs with {CHILD}? ............................
Help {CHILD} to do arts and crafts? .............
Involve {CHILD} in household chores,
like cooking, cleaning, setting the table, or
caring for pets? ...........................................
Play games or do puzzles with {CHILD}? ....
Talk about nature or do science projects
with {CHILD}? .............................................
Build something or play with construction
toys with {CHILD}? ......................................
Play a sport or exercise together? ..............
Practice reading, writing or working with
numbers? ....................................................
EVERY
DAY
REF DK
1
1
1
2
2
2
3
3
3
4
4
4
8
8
8
9
9
9
1
1
2
2
3
3
4
4
8
8
9
9
1
2
3
4
8
9
1
1
2
2
3
3
4
4
8
8
9
9
1
2
3
4
8
9
33
BOX 1
IF (PLQ.020 = 1) CONTINUE WITH HEQ.020. ELSE, GO TO HEQ.030.
HEQ.020
How often do you or other family members use {PRIMARY LANGUAGE/a language other than English} when doing any
of the activities we just talked about?”
CAPI INSTRUCTIONS. IF PLQ.040 SHOWS ONE LANGUAGE SELECTED THAT HAS A CODE FROM 1 TO 15,
DISPLAY THE NAME OF THE LANGUAGE IN "{PRIMARY LANGUAGE}". ELSE IF PLQ.040 = 91, 88, OR 99, OR IF
THERE ARE TWO OR MORE LANGUAGES IN PLQ.040, DISPLAY "a language other than English".
Always, ..........................................................
Most of the time, ............................................
Sometimes, or................................................
Never? ...........................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
8
9
HELP AVAILABLE
HEQ.030
In a typical week, how often do you or any other family members read books to {CHILD}? Would you say…
HELP TEXT:
Read books: Include only times family members have read books to the child. Do not include times when the child
reads or looks at books by him or herself.
Not at all, .......................................................
Once or twice a week, ...................................
3-6 times a week, or ......................................
Every day? .....................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
8
9
BOX 2
IF HEQ.030 =1, 8, OR 9 GO TO HEQ.040. ELSE, IF (PLQ.020 = 1) CONTINUE WITH
HEQ.035. ELSE, GO TO HEQ.036.
HEQ.035
Do you or family members read books to {CHILD} in {PRIMARY LANGUAGE/a language other than English}...
CAPI INSTRUCTIONS. IF PLQ.040 SHOWS ONE LANGUAGE SELECTED THAT HAS A CODE FROM 1 TO 15,
DISPLAY THE NAME OF THE LANGUAGE IN "{PRIMARY LANGUAGE}". ELSE IF PLQ.040 = 91, 88, OR 99, OR IF
THERE ARE TWO OR MORE LANGUAGES IN PLQ.040, DISPLAY "a language other than English".
Not at all, .......................................................
Once or twice, ................................................
3-6 times, or ...................................................
Every day? .....................................................
REFUSED .....................................................
DON'T KNOW ...............................................
34
1
2
3
4
8
9
HEQ.036 ............................ Generally, how long is {CHILD} read to at each of these times?
CAPI INSTRUCTION: HARD RANGE CHECK: 1-60 MINUTES.
|___|___|
ENTER MINUTES
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
HELP AVAILABLE
HEQ.040
About how many children's books does {CHILD} have in your home now, including library books? Please only include
books that are for children.
HELP TEXT:
Number of children's books: This item asks about the books that belong to the child, not all books in the home (e.g.,
not parents' books). Books shared by siblings may be counted. For example, if the children share 50 books, count all
50.
CAPI INSTRUCTION:
HARD RANGE CHECK: 0-5000 BOOKS.
|___|___|___|___|
ENTER # OF BOOKS
REFUSED ..................................................... 888
DON'T KNOW ............................................... 999
BOX 3
IF (PLQ.020 = 1) AND (HEQ.040 IS GREATER THAN OR EQUAL TO 1), GO TO
HEQ.045. ELSE, GO TO HEQ.060.
35
HEQ.045
{Is this book/Are these books} {mainly} in English{,} {or} {PRIMARY LANGUAGE/a language other than
English},{?} {,or is one in English and the other in {PRIMARY LANGUAGE/,or a language other than
English}/,or are there about the same number of books in English as in another language}?
CAPI INSTRUCTIONS: IF HEQ.040 = 1, DISPLAY “Is this book”, USE A NULL DISPLAY FOR “mainly”, USE A NULL
DISPLAY FOR “,”, AND DISPLAY {or} AND “?”. USE A NULL DISPLAY FOR THE REST OF THE SENTENCE AND
DISPLAY RESPONSE CATEGORIES 1 AND 2. ELSE, IF HEQ.040 = 2, DISPLAY “Are these books”, USE A NULL
DISPLAY FOR “mainly”, DISPLAY “{PRIMARY LANGUAGE/a language other than English}” ACCORDING TO THE
INSTRUCTIONS BELOW, AND DISPLAY “,or is one in English and the other in {PRIMARY LANGUAGE/,or a language
other than English}” AND DISPLAY RESPONSE CATEGORIES 1-3. ELSE, DISPLAY “Are these books”, “mainly”,
DISPLAY “{PRIMARY LANGUAGE/a language other than English}” ACCORDING TO THE INSTRUCTIONS BELOW,
DISPLAY “,or are there about the same number of books in English as in another language” AND DISPLAY
RESPONSE CATEGORIES 1-3.
CAPI INSTRUCTIONS. IF PLQ.040 SHOWS ONE LANGUAGE SELECTED THAT HAS A CODE FROM 1 TO 15,
FOR ALL LANGUAGE DISPLAYS IN THIS ITEM, DISPLAY THE NAME OF THE LANGUAGE IN "{PRIMARY
LANGUAGE}". ELSE IF PLQ.040 = 91, 88, OR 99, OR IF THERE ARE TWO OR MORE LANGUAGES IN PLQ.040,
DISPLAY "a language other than English".
ENGLISH, .......................................................................................
{PRIMARY LANGUAGE/A LANGUAGE
OTHER THAN ENGLISH} ................................................................
SAME NUMBER IN ENGLISH AND {PRIMARY LANGUAGE/
A LANGUAGE OTHER THAN ENGLISH} .......................................
REFUSED ......................................................................................
DON'T KNOW .................................................................................
HEQ.060
2
3
8
9
Now, please think about the past week. How often did {CHILD} look at picture books outside of school in the past
week? Would you say ...
Never, ............................................................
Once or twice a week, ...................................
3 to 6 times a week, or...................................
Every day? .....................................................
REFUSED .....................................................
DON'T KNOW ...............................................
HEQ.070
1
1
2
3
4
8
9
In the past week, how often did {CHILD} read to or pretend to read to {himself/herself} or to others outside of school?
Would you say ...
CAPI INSTRUCTION: DISPLAY "week" IN UNDERLINED TEXT.
Never, ............................................................
Once or twice a week, ...................................
3 to 6 times a week, or...................................
Every day? .....................................................
REFUSED .....................................................
DON'T KNOW ...............................................
BOX 4
n
GO TO SECTION CCQ (CHILD CARE).
36
1
2
3
4
8
9
CHILD CARE - CCQ
CCQ.005
Next, I'd like to talk with you about the child care arrangements you have for {CHILD}, both for this year and last year.
First, I'd like to talk to you about all child care {CHILD} now receives on a regular basis from someone other than
{you/{his/her} {parents/guardians}}. This does not include occasional baby-sitting or backup care providers.
PRESS ENTER TO CONTINUE.
CAPI INSTRUCTION: FOR ALL DISPLAYS DEFINE "PARENT FIGURE" AS THE MOTHER OR FATHER OR MALE
OR FEMALE GUARDIAN (THIS INCLUDES BIRTH, ADOPTIVE, STEP, FOSTER, AND OTHER PARENTS OR
GUARDIANS).
IF RESPONDENT IS A PARENT FIGURE, OR THERE IS NO PARENT IN THE HOUSEHOLD, DISPLAY "you",
OTHERWISE DISPLAY "{his/her} {parents/guardians}".
CAPI INSTRUCTION: DISPLAY “regular basis” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "parents" IF AT LEAST ONE HH MEMBER, NOT THE RESPONDENT, IS A PARENT
FIGURE OR THE RELATIONSHIP IS DK OR RF, OTHERWISE DISPLAY "guardians".
37
HELP AVAILABLE
Relative Care
CCQ.010
Is {CHILD} now receiving care from a relative on a regular basis (including care provided before or after school)? This
may include grandparents, brothers and sisters, or any relatives other than {you/{CHILD}'s {parents/guardians}}.
CAPI INSTRUCTION: DISPLAY “now” AND "regular basis" IN UNDERLINED TEXT.
FOR ALL DISPLAYS DEFINE "PARENT FIGURE" AS THE MOTHER OR FATHER OR MALE OR FEMALE
GUARDIAN (THIS INCLUDES BIRTH, ADOPTIVE, STEP, AND FOSTER PARENTS OR GUARDIANS).
IF RESPONDENT IS A PARENT FIGURE, OR THERE IS NO PARENT IN THE HOUSEHOLD, DISPLAY "you",
OTHERWISE DISPLAY "{his/her} {parents/guardians}".
CAPI INSTRUCTION: DISPLAY "parents" IF AT LEAST ONE HH MEMBER, NOT THE RESPONDENT, IS A
PARENT FIGURE OR THE RELATIONSHIP IS DK OR RF, OTHERWISE DISPLAY "guardians".
HELP TEXT:
Care from a relative: Record care or programs provided by a relative other than the child’s parents in a private home.
The private home may be the child’s home, the caregiver’s home, or another home. In all cases, do not include care
provided by a parent, even if they do not live in the household. (Do not include visitation with a separated or divorced
parent who does not have custody.)
If there is at least one parent in the household, any relative living in the household is eligible to be counted as a care
arrangement, if the care is provided on a regularly scheduled basis. Relatives outside the household may also be
regular care providers.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
similar to parents).
Relative care arrangements may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
38
1 (CCQ.020)
2
8
9
HELP AVAILABLE
CCQ.015
Has {CHILD} ever received care from a relative on a regular basis?
CAPI INSTRUCTION: DISPLAY "ever” AND “regular basis” IN UNDERLINED TEXT.
HELP TEXT:
Care from a relative: Record care or programs provided by a relative other than the child’s parents in a private home.
The private home may be the child’s home, the caregiver’s home, or another home. In all cases, do not include care
provided by a parent, even if they do not live in the household. (Do not include visitation with a separated or divorced
parent who does not have custody.)
If there is at least one parent in the household, any relative living in the household is eligible to be counted as a care
arrangement, if the care is provided on a regularly scheduled basis. Relatives outside the household may also be
regular care providers.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
similar to parents).
Relative care arrangements may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
39
1
2 (CCQ.115)
8 (CCQ.115)
9 (CCQ.115)
HELP AVAILABLE
CCQ.020
How old was {CHILD} in years and months when {he/she} first received care from any relative on a regular basis?
CAPI INSTRUCTION: DISPLAY "first”, “any” AND “regular basis” IN UNDERLINED TEXT.
CAPI INSTRUCTION: RANGE CHECK 0-7 FOR YEARS, 0-12 FOR MONTHS.
HELP TEXT:
Care from a relative: Record care or programs provided by a relative other than the child’s parents in a private home.
The private home may be the child’s home, the caregiver’s home, or another home. In all cases, do not include care
provided by a parent, even if they do not live in the household. (Do not include visitation with a separated or divorced
parent who does not have custody.)
If there is at least one parent in the household, any relative living in the household is eligible to be counted as a care
arrangement, if the care is provided on a regularly scheduled basis. Relatives outside the household may also be
regular care providers.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
similar to parents).
Relative care arrangements may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
|___|___|
ENTER YEAR
AND
|___|___|
ENTER MONTH
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
40
HELP AVAILABLE
CCQ.025
Did {CHILD} receive care from a relative on a regular basis the year before {he/she} started kindergarten?
THIS MEANS ANYTIME IN THE YEAR BEFORE CHILD ENTERED KINDERGARTEN.
CAPI INSTRUCTION: DISPLAY “regular basis the year before” IN UNDERLINED TEXT.
HELP TEXT:
Care from a relative: Record care or programs provided by a relative other than the child’s parents in a private home.
The private home may be the child’s home, the caregiver’s home, or another home. In all cases, do not include care
provided by a parent, even if they do not live in the household. (Do not include visitation with a separated or divorced
parent who does not have custody.)
If there is at least one parent in the household, any relative living in the household is eligible to be counted as a care
arrangement, if the care is provided on a regularly scheduled basis. Relatives outside the household may also be
regular care providers.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
similar to parents).
Relative care arrangements may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ............................................................... 1
NO ................................................................. 2 (BOX 2)
REFUSED...................................................... 8 (BOX 2)
DON'T KNOW ................................................ 9 (BOX 2)
41
HELP AVAILABLE
CCQ.030
How many different regular care arrangements did you have with relatives for {CHILD}'s care in the year before {he/she}
started kindergarten?
CAPI INSTRUCTION: DISPLAY “regular” AND “the year before” IN UNDERLINED TEXT.
HELP TEXT:
Regular Care Arrangements: Arrangements or programs occurring on a routine schedule (i.e., occurring at least
weekly or on some other schedule). Do not include occasional babysitting or "back up" arrangements that are just used
once in a while.
ONE ..............................................................
TWO .............................................................
THREE .........................................................
FOUR ...........................................................
FIVE OR MORE.............................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
5
8
9
HELP AVAILABLE
CCQ.031
Head Start is a federally sponsored preschool program primarily for children from low-income families. {Was the regular
care arrangement that {CHILD} had with a relative/Were any of the regular care arrangements that {CHILD} had with
relatives} in the year before kindergarten Head Start?
CAPI INSTRUCTION: DISPLAY “the year before” IN UNDERLINED TEXT.
HELP TEXT:
Head Start: Head Start is a federally funded early childhood education program designed to improve the schoolreadiness of disadvantaged children (i.e., children from low-income families). Children who participate are usually 3 to 5
years old. Head Start may be offered in a variety of locations. For this question, we are interested in Head Start
services in a family child care program in a private home where the child is cared for by someone who is related to the
child but is not his or her parent.
Rarely, you may find a case in which a respondent reports that the child is in "home Head Start," that is, he/she
participates in Head Start in his/her own home. Generally, this involves the parent acting as the child's teacher,
supplemented by occasional home visits by a Head Start teacher and perhaps some occasional group activities at a
central location. Do not include child care by a parent in this question.
CAPI INSTRUCTIONS: DISPLAY “Was…relative” IF CCQ.030 = 1. ELSE, DISPLAY “Were…relatives”.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
42
1
2
8
9
CCQ.035
For the next few questions please think about the relative who provided the most care for {CHILD} the year before
{he/she} started kindergarten. Was that care provided in your home or in another home?
CAPI INSTRUCTION: DISPLAY “the year before” IN UNDERLINED TEXT.
OWN HOME ..................................................
OTHER HOME ..............................................
BOTH/VARIES...............................................
REFUSED .....................................................
DON'T KNOW ...............................................
CCQ.040
1
2
3
8
9
How many days each week did {CHILD} receive care from {his/her} relative the year before {he/she} started
kindergarten?
IF RESPONDENT SAYS SCHEDULE CHANGED, ANSWER FOR THE SCHEDULE CHILD HAD AT THE END OF
LAST YEAR.
CAPI INSTRUCTION: DISPLAY “days” AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-5. RANGE CHECK 1-7.
|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
CCQ.045
How many hours each week did {CHILD} receive care from {his/her} relative the year before {he/she} started
kindergarten?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
IF RESPONDENT SAYS SCHEDULE CHANGED, ANSWER FOR THE SCHEDULE CHILD HAD AT THE END OF
LAST YEAR.
CAPI INSTRUCTION: DISPLAY “hours” AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 0-70.
|___|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
43
CCQ.050
For how long did {CHILD} receive care from {his/her} relative the year before {he/she} started kindergarten? Would you
say …
CAPI INSTRUCTION: DISPLAY "the year before" IN UNDERLINED TEXT.
One to two months, .......................................
Three to five months, ....................................
Six to eight months, or ..................................
Nine to twelve months? .................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.050b
1
2
3
4
8
9
What language did {CHILD}’s relative speak most when caring for
{CHILD}?
CODE ‘16’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
ENGLISH .....................................
ARABIC .......................................
CHINESE LANGUAGE/DIALECT
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
FARSI .......................................... 14
HMONG ....................................... 15
RESPONDENT CANNOT
CHOOSE A PRIMARY
LANGUAGE…………………..……16
SOME OTHER LANGUAGE
(SPECIFY) _________________ 91
REFUSED .................................... 88
DON’T KNOW .............................. 99
BOX 1
IF CCQ.050b = 91, GO TO CCQ.050bOS. ELSE, GO TO CCQ.050c.
CCQ.050bOS [What language did {CHILD}’s relative speak most when caring for {CHILD}?]
SPECIFY LANGUAGE.
___________________________________________________________
CCQ.050c
Was this relative 18 years of age or older at the time he or she cared for {CHILD}?
YES, ............................................................. 1
NO ................................................................. 2
REFUSED...................................................... 8
DON’T KNOW ................................................ 9
44
BOX 2
IF CHILD IS CURRENTLY RECEIVING CARE FROM A RELATIVE (CCQ.010= 1), CONTINUE
WITH CCQ.060.
OTHERWISE, GO TO CCQ.115.
HELP AVAILABLE
CCQ.060
{Let's talk about your current care arrangements with relatives.} How many different regular care arrangements do you
currently have with relatives?
HELP TEXT:
Care from a relative: Record care or programs provided by a relative other than the child’s parents in a private home.
The private home may be the child’s home, the caregiver’s home, or another home. In all cases, do not include care
provided by a parent, even if they do not live in the household. (Do not include visitation with a separated or divorced
parent who does not have custody.)
If there is at least one parent in the household, any relative living in the household is eligible to be counted as a care
arrangement, if the care is provided on a regularly scheduled basis. Relatives outside the household may also be
regular care providers.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
similar to parents).
Relative care arrangements may or may not have a charge or fee.
Regular Care Arrangements: Arrangements or programs occurring on a routine schedule (i.e., occurring at least
weekly or on some other schedule). Do not include occasional babysitting or "back up" arrangements that are just used
once in a while.
CAPI INSTRUCTION: IF CCQ.025 = 1, DISPLAY THE SENTENCE "Let's talk about … with
relatives." OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY “regular” AND "currently" IN UNDERLINED TEXT.
ONE ..............................................................
TWO ..............................................................
THREE ..........................................................
FOUR ............................................................
FIVE OR MORE.............................................
REFUSED......................................................
DON'T KNOW ................................................
45
1
2
3
4
5
8
9
CCQ.065
{Let's talk about the relative who provides the most care for {CHILD} now.} Who is the relative who cares for {CHILD}?
PROBE FOR RELATIONSHIP TO CHILD.
CAPI INSTRUCTION: DISPLAY "{Let's talk about the relative who provides the most care for {CHILD} now.}" IF
CCQ.060 = 2, 3, 4, 5, 8, OR 9. OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY “now" IN UNDERLINED TEXT.
GRANDPARENT ...........................................
AUNT .............................................................
UNCLE ..........................................................
BROTHER .....................................................
SISTER ..........................................................
ANOTHER RELATIVE ...................................
REFUSED......................................................
DON'T KNOW ................................................
1 (CCQ.070)
2
3
4
5
6
8
9
BOX 2B
IF CCQ.065 = 1, AUTOCODE CCQ.066 = 1 AND GO TO CCQ.070
OTHERWISE, GO TO CCQ.066.
CCQ.066
Is {{CHILD}'s {RELATIVE}/ that relative} 18 years of age or older?
CAPI INSTRUCTION: DISPLAY "{CHILD}'S {RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERWISE, DISPLAY
"that relative".
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "aunt" IF CCQ.065
DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
YES, .............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
CCQ.070
= 2; DISPLAY "uncle" IF CCQ.065 = 3;
1
2
8
9
Is the care provided by {{CHILD}'s {RELATIVE}/ that relative} in your home or another home?
CAPI INSTRUCTION: DISPLAY "{CHILD}'S {RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERW ISE, DISPLAY
"that relative".
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent” IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 = 2;
DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
OWN HOME ..................................................
OTHER HOME ..............................................
BOTH/VARIES...............................................
REFUSED......................................................
DON'T KNOW ................................................
46
1
2
3
8
9
CCQ.075
Does {CHILD} receive that care before school, after school, or on weekends?
CODE ALL THAT APPLY
BEFORE SCHOOL ........................................
AFTER SCHOOL ...........................................
WEEKENDS ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
8
9
HELP AVAILABLE
CCQ.080
Is the care that {CHILD} receives from {{his/her} {RELATIVE}/that relative} regularly scheduled at least once each
week?
HELP TEXT:
Regularly Scheduled: Regularly scheduled at least once each week could mean every Wednesday, every Monday
and Friday, everyday, or some other schedule, as long as it is at least once each week.
CAPI INSTRUCTION: DISPLAY "{his/her} {RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERWISE, DISPLAY "that
relative".
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent” IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 = 2;
DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
CAPI INSTRUCTION: DISPLAY "regularly scheduled" AND “each” IN UNDERLINED TEXT.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.085
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
How many days each week does {CHILD} receive care from {{his/her} {RELATIVE}/that relative}?
CAPI INSTRUCTION: SOFT RANGE CHECK 1-5. HARD RANGE CHECK 1-7.
CAPI INSTRUCTION: DISPLAY "{his/her} {RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERWISE, DISPLAY "that
relative".
CAPI INSTRUCTION: DISPLAY "days" AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent” IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 = 2;
DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
47
CCQ.090
How many hours each week does {CHILD} receive care from {{his/her} {RELATIVE}/that relative}?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "{his/her} {RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERWISE, DISPLAY
"that relative."
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 =
2; DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
CCQ.092
Is there any charge or fee for the care {CHILD} receives from {{his/her} {RELATIVE}/that relative}, paid either by you or
someone else?
IF NECESSARY SAY, Please only think about the relative who provides the most care for {CHILD}.
CAPI INSTRUCTION: DISPLAY "{his/her} {RELATIVE}" IF CCQ.065 = 1, 2, 3,4, OR 5. OTHERWISE, DISPLAY "that
relative."
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 = 2;
DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
YES ..............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
48
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
CCQ.093
Do any of the following people or organizations help to pay for {{his/her} {RELATIVE}/that relative} to care for {CHILD}?
How about…
CAPI INSTRUCTION: FOR ITEMS B – D DISPLAY THE FIRST PARAGRAPH (Do any …
{CHILD}) IN BRACKETS.
CAPI INSTRUCTION: DISPLAY "{his/her} {RELATIVE}" IF CCQ.065 = 1, 2, 3,4, OR 5. OTHERWISE, DISPLAY "that
relative."
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 = 2;
DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
a.
b.
c.
d.
e.
A relative of {CHILD} outside your household who provides
money specifically for that care? ......................................................
Temporary Assistance for Needy
Families, or TANF?........................
Another social service or welfare agency? .......................................
An employer? ..................................................................................
Someone else? (SPECIFY) .............................................................
YES
NO
R
DK
1
2
8
9
1
1
1
2
2
2
8
8
8
9
9
9
BOX 3
IF CCQ.093E = 1, GO TO CCQ.093OS. ELSE, GO TO CCQ.094.
CCQ.093OS
[Who was that?]
SPECIFY PERSON.
________________________________________________________
CCQ.094
How much does your household pay for {CHILD}’s {RELATIVE}/that relative} to care for {him/her}, not counting any
money that you may receive from others to help pay for care?
CAPI INSTRUCTION: DISPLAY "{RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERWISE, DISPLAY "that
relative."
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065 =
2; DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
CAPI INSTRUCTION: HARD RANGE CHECK: $1 – 9999.
$|___|___|___|___|.|___|___|
ENTER AMOUNT OF PAYMENT .................. (CCQ.095)
REFUSED.................................................... 8 (BOX 4)
DON'T KNOW .............................................. 9 (BOX 4)
49
CCQ.095
[How much does your household pay for {CHILD}’s {RELATIVE}/that relative} to care for {him/her}, not counting any
money that you may receive from others to help pay for care?]
ENTER UNIT
CAPI INSTRUCTION: DISPLAY "{RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5. OTHERWISE, DISPLAY "that
relative."
CAPI INSTRUCTION: FOR "{RELATIVE}", DISPLAY "grandparent IF CCQ.065 = 1; DISPLAY "aunt" IF CCQ.065
= 2; DISPLAY "uncle" IF CCQ.065 = 3; DISPLAY "brother" IF CCQ.065 = 4; DISPLAY "sister" IF CCQ.065 = 5.
PER HOUR.................................................. 1 (BOX 3B)
PER DAY..................................................... 2 (BOX 3B)
PER WEEK.................................................. 3 (BOX 3B)
PER MONTH............................................... 4 (BOX 3B)
PER YEAR .................................................. 5 (BOX 3B)
EVERY TWO WEEKS..................................6 (BOX 3B)
OTHER (SPECIFY)...................................... 91 (CCQ.095OS)
REFUSED .................................................. 8 (BOX 4)
DON'T KNOW ............................................. 9 (BOX 4)
CCQ.095OS [How much does your household pay for {CHILD}’s {RELATIVE}/that relative} to care for {him/her}, not counting any
money that you may receive from others to help pay for care?]
SPECIFY UNIT.
___________________________________________________________
BOX 3B
n
CCQ.096
IF THE NUMBER OF CHILDREN IN THE HOUSEHOLD WHO ARE LESS THAN OR
EQUAL TO 15 YEARS OLD (INCLUDING THE CHILD) = 1, GO TO BOX 4. ELSE, GO
TO CCQ.096.
How many children is this amount for, including {CHILD}?
{CHILD} ONLY .......................................................................................... 1
{CHILD} + 1 MORE (2 TOTAL) ................................................................. 2
{CHILD} + 2 MORE (3 TOTAL) ................................................................. 3
{CHILD} + 3 OR MORE (4 OR MORE TOTAL) ........................................ 4
REFUSED................................................................................................. 8
DON’T KNOW ........................................................................................... 9
BOX 4
n
n
IF ONLY ONE CURRENT REGULAR RELATIVE CARE ARRANGEMENT FOR CHILD
(CCQ.060 = 1 OR 8 OR 9), GO TO CCQ.115.
OTHERWISE, CONTINUE WITH CCQ.110.
50
CCQ.110
You said that {CHILD} was cared for by {NUMBER} other {relatives/relative} on a regular basis. How many hours each
week does {CHILD} receive care from {these/this} other {relatives/relative}?
CAPI INSTRUCTION: FOR "{NUMBER}", DISPLAY "1" IF CCQ.060 = 2; "2" IF CCQ.060 = 3; DISPLAY "3" IF CCQ.060
= 4. IF CCQ.060 = 5, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CCQ.060 = 2, DISPLAY "relative," "this” and “relative." OTHERWISE, DISPLAY "relatives",
"these,” and “relatives."
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
Non-Relative Care
HELP AVAILABLE
CCQ.115
{Now I'd like to ask you about any care {CHILD} receives from nonrelatives in a private home, not including child care
centers.} Is {CHILD} now receiving care in a private home on a regular basis from someone who is not related to
{him/her} (including care provided before or after school)? This includes home child care providers, regular sitters or
neighbors. {It does not include child care centers.}
PROBE: This refers to care received from nonrelatives in a private home, including home child care providers, regular
sitters, or neighbors. However, this does not include child care centers.
CAPI INSTRUCTION: DISPLAY "now" AND "regular basis before or after school" IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "Now . . . centers" IF CCQ.010 = 1. OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY “It does not include child care centers.” IF CCQ.010 NE 1. OTHERWISE, USE A
NULL DISPLAY.
HELP TEXT:
Care from a non-relative: Non-relative care is provided by someone not related to the child and is located in a private
home. The private home may be the child’s home, the caregiver’s home, or another home.
If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a
care arrangement, IF the care is given on a regularly scheduled basis.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
treated the same as parents).
Non-relative care arrangements or programs may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
51
1 (CCQ.125)
2
8
9
HELP AVAILABLE
CCQ.120
Has {CHILD} ever received care in a private home from a nonrelative on a regular basis?
CAPI INSTRUCTION: DISPLAY "ever" AND “regular basis” IN UNDERLINED TEXT.
HELP TEXT:
Care from a non-relative: Non-relative care is provided by someone not related to the child and is located in a private
home. The private home may be the child’s home, the caregiver’s home, or another home.
If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a
care arrangement, IF the care is given on a regularly scheduled basis.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
treated the same as parents).
Non-relative care arrangements or programs may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
1
2 (CCQ.260)
8 (CCQ.260)
9 (CCQ.260)
HELP AVAILABLE
CCQ.125
How old was {CHILD} in years and months when {he/she} first received regular care in a private home from any
nonrelative?
CAPI INSTRUCTION: DISPLAY "first", “regular”, AND “any” IN UNDERLINED TEXT.
CAPI INSTRUCTION: RANGE CHECK 0-7 FOR YEARS, 0-12 FOR MONTHS.
HELP TEXT:
Care from a non-relative: Non-relative care is provided by someone not related to the child and is located in a private
home. The private home may be the child’s home, the caregiver’s home, or another home.
If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a
care arrangement, IF the care is given on a regularly scheduled basis.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
treated the same as parents).
Non-relative care arrangements or programs may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
|___|___|
ENTER YEAR
AND
|___|___|
ENTER MONTH
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
52
HELP AVAILABLE
CCQ.130
Did {CHILD} receive care from a nonrelative on a regular basis the year before {he/she} started kindergarten?
THIS MEANS ANYTIME IN THE YEAR BEFORE CHILD ENTERED KINDERGARTEN.
CAPI INSTRUCTION: DISPLAY “regular basis the year before” IN UNDERLINED TEXT.
PROBE: This refers to care received from nonrelatives in a private home, including home child care providers, regular
sitters, or neighbors. However, this does not include child care centers.
HELP TEXT:
Care from a non-relative: Non-relative care is provided by someone not related to the child and is located in a private
home. The private home may be the child’s home, the caregiver’s home, or another home.
If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a
care arrangement, IF the care is given on a regularly scheduled basis.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
treated the same as parents).
Non-relative care arrangements or programs may or may not have a charge or fee.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
1
2 (BOX 5)
8 (BOX 5)
9 (BOX 5)
HELP AVAILABLE
CCQ.135
How many different regular care arrangements did you have with nonrelatives for {CHILD}'s care the year before
{he/she} started kindergarten?
CAPI INSTRUCTION: DISPLAY "regular" AND “the year before” IN UNDERLINED TEXT.
HELP TEXT: Regular Care Arrangements: Arrangements or programs occurring on a routine schedule (i.e., occurring
at least weekly or on some other schedule). Do not include occasional babysitting or "back up" arrangements that are
just used once in a while.
ONE ..............................................................
TWO .............................................................
THREE .........................................................
FOUR ...........................................................
FIVE OR MORE.............................................
REFUSED .....................................................
DON'T KNOW ...............................................
53
1
2
3
4
5
8
9
HELP AVAILABLE
CCQ.136
{Head Start is a federally sponsored preschool program primarily for children from low-income families.} {Was the
regular care arrangement that {CHILD} had with a nonrelative /Were any of the regular care arrangements that {CHILD}
had with nonrelatives} in the year before kindergarten Head Start?
CAPI INSTRUCTION: DISPLAY “the year before” IN UNDERLINED TEXT.
HELP TEXT:
Head Start: Head Start is a federally funded early childhood education program designed to improve the schoolreadiness of disadvantaged children (i.e., children from low-income families). Children who participate are usually 3 to 5
years old. Head Start may be offered in a variety of locations. For this question, we are interested in Head Start
services in a family child care program in a private home where the child is cared for by someone who is not his or her
parent and is not related to the child.
CAPI INSTRUCTIONS:
DISPLAY.
DISPLAY “Head Start…families” IF CCQ.031 WAS NOT ASKED.
ELSE, USE A NULL
CAPI INSTRUCTIONS: DISPLAY “Was..nonrelative” IF CCQ.135 = 1. ELSE, DISPLAY “Were…nonrelatives”.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.140
1
2
8
9
For the next few questions please think about the nonrelative who provided the most care for {CHILD} the year before
{he/she} started kindergarten. Was that care provided in your home or in another home?
CAPI INSTRUCTION: DISPLAY “the year before” IN UNDERLINED TEXT.
OWN HOME ..................................................
OTHER HOME ..............................................
BOTH/VARIES...............................................
REFUSED .....................................................
DON'T KNOW ...............................................
CCQ.145
1
2
3
8
9
How many days each week did {CHILD} receive care from a nonrelative the year before {he/she} started kindergarten?
IF RESPONDENT SAYS SCHEDULE CHANGED, ANSWER FOR THE SCHEDULE CHILD HAD AT THE END OF
LAST YEAR.
CAPI INSTRUCTION: DISPLAY "days" AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-5. HARD RANGE CHECK 1-7.
|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
54
CCQ.150
How many hours each week did {CHILD} receive care from a nonrelative the year before {he/she} started kindergarten?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
IF RESPONDENT SAYS SCHEDULE CHANGED, ANSWER FOR THE SCHEDULE CHILD HAD AT THE END OF
LAST YEAR.
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
CCQ.155
For how long did {CHILD} receive care from the nonrelative the year before {he/she} started kindergarten? Would you
say …
CAPI INSTRUCTION: DISPLAY "the year before" IN UNDERLINED TEXT.
One to two months, .......................................
Three to five months, ....................................
Six to eight months, or ..................................
Nine to twelve months? .................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.155b
1
2
3
4
8
9
What language did {CHILD}’s nonrelative speak most when caring for
{CHILD}?
CODE ‘16’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
ENGLISH .....................................
ARABIC .......................................
CHINESE LANGUAGE/DIALECT
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
FARSI .......................................... 14
HMONG ....................................... 15
RESPONDENT CANNOT
CHOOSE A PRIMARY
LANGUAGE…………………..……16
SOME OTHER LANGUAGE
(SPECIFY) _________________ 91
REFUSED .................................... 88
DON’T KNOW .............................. 99
55
BOX 5
IF CCQ.155b = 91, GO TO CCQ.155bOS. ELSE, GO TO CCQ.155c.
CCQ.155bOS [What language did {CHILD}’s nonrelative speak most when caring for
{CHILD}?]
SPECIFY LANGUAGE.
___________________________________________________________
CCQ.155c
Was this nonrelative 18 years of age or older at the time he or she cared for {CHILD}?
YES ..............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
1
2
8
9
BOX 6
n
n
IF CHILD IS NOT CURRENTLY RECEIVING CARE FROM A NON-RELATIVE (CCQ.115
= 2 OR 8 OR 9), GO TO CCQ.260.
OTHERWISE, CONTINUE WITH CCQ.165.
56
HELP AVAILABLE
CCQ.165
{Let's talk about your current care arrangements with nonrelatives.} How many different regular care arrangements do
you currently have with nonrelatives?
CAPI INSTRUCTION: IF CCQ.130 = 1, DISPLAY THE SENTENCE "Let's talk about … with
nonrelatives." OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY "regular" AND "currently" IN UNDERLINED TEXT.
HELP TEXT:
Care from a non-relative: Non-relative care is provided by someone not related to the child and is located in a private
home. The private home may be the child’s home, the caregiver’s home, or another home.
If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a
care arrangement, IF the care is given on a regularly scheduled basis.
If neither parent lives in the household, do not include care provided by guardians who live with the child (they are
treated the same as parents).
Non-relative care arrangements or programs may or may not have a charge or fee.
Regular Care Arrangements: Arrangements or programs occurring on a routine schedule (i.e., occurring at least
weekly or on some other schedule). Do not include occasional babysitting or "back up" arrangements that are just used
once in a while.
ONE ..............................................................
TWO ..............................................................
THREE ..........................................................
FOUR ............................................................
FIVE OR MORE.............................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.166
1
2
3
4
5
8
9
{Let's talk about the nonrelative who provides the most care for {CHILD} now.} Is this person 18 years of age or older?
CAPI INSTRUCTION: DISPLAY "Let's talk about the nonrelative who provides the most care for {CHILD} now.} IF
CCQ.165 = 2, 3, 4, 5, 8, OR 9. OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY “now" IN UNDERLINED TEXT.
YES, .............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
CCQ.170
1
2
8
9
Is that care provided in your home or another home?
OWN HOME ..................................................
OTHER HOME ..............................................
BOTH/VARIES...............................................
REFUSED......................................................
DON'T KNOW ................................................
57
1
2
3
8
9
CCQ.175
Does {CHILD} receive that care before school, after school, or on weekends?
CODE ALL THAT APPLY
BEFORE SCHOOL ........................................
AFTER SCHOOL ...........................................
WEEKENDS ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
8
9
HELP AVAILABLE
CCQ.180
Is the care that {CHILD} receives from that person regularly scheduled at least once each week?
HELP TEXT:
Regularly Scheduled: Regularly scheduled at least once each week could mean every Wednesday, every Monday
and Friday, everyday, or some other schedule, as long as it is at least once each week.
CAPI INSTRUCTION: DISPLAY "regularly scheduled" AND “each” IN UNDERLINED TEXT.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.185
1
2 (BOX 8)
8 (BOX 8)
9 (BOX 8)
How many days each week does {CHILD} receive care from that person?
CAPI INSTRUCTION: DISPLAY "days" AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-5. HARD RANGE CHECK 1-7.
|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
CCQ.190
How many hours each week does {CHILD} receive care from that person?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
58
CCQ.192
Is there any charge or fee for the care {CHILD} receives from this nonrelative, paid either by you or someone else?
IF NECESSARY SAY, Please only think about the nonrelative who provides the most care for {CHILD}.
CAPI INSTRUCTION: DISPLAY “most” IN UNDERLINED TEXT.
YES ..............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
CCQ.193
1
2 (BOX 8)
8 (BOX 8)
9 (BOX 8)
Do any of the following people or organizations help to pay for this nonrelative to care for {CHILD}?
How about…
CAPI INSTRUCTION: FOR ITEMS B – D DISPLAY THE FIRST PARAGRAPH (Do any …
{CHILD}) IN BRACKETS.
a.
b.
c.
d.
e.
A relative of {CHILD} outside your household who provides
money specifically for that care? ......................................................
Temporary Assistance for Needy
Families, or TANF?........................
Another social service or welfare agency? .......................................
An employer? ..................................................................................
Someone else? (SPECIFY) .............................................................
YES
NO
R
DK
1
2
8
9
1
1
1
2
2
2
8
8
8
9
9
9
BOX 7
IF CCQ.193e = 1, GO TO CCQ.193OS. ELSE, GO TO CCQ.194.
CCQ.193OS
[Who was that?]
SPECIFY PERSON.
___________________________________________________________
CCQ.194
How much does your household pay this person to care for {CHILD}, not counting any money that you may
receive from others to help pay for care?
CAPI INSTRUCTION: HARD RANGE CHECK: $1 – 9999.
$|___|___|___|___|.|___|___|
ENTER AMOUNT OF PAYMENT .................. (CCQ.195)
REFUSED.................................................... 8 (BOX 8)
DON'T KNOW .............................................. 9 (BOX 8)
59
CCQ.195
[How much does your household pay this person to care for {CHILD}, not counting any money that you may
receive from others to help pay for care?
ENTER UNIT
PER HOUR.................................................. 1 (BOX 7B)
PER DAY..................................................... 2 (BOX 7B)
PER WEEK.................................................. 3 (BOX 7B)
PER MONTH............................................... 4 (BOX 7B)
PER YEAR .................................................. 5 (BOX 7B)
EVERY TWO WEEKS..................................6 (BOX 7B)
OTHER (SPECIFY)...................................... 91 (CCQ.195OS)
REFUSED .................................................. 8 (BOX 8)
DON'T KNOW ............................................. 9 (BOX 8)
CCQ.195OS [How much does your household pay this person to care for {CHILD}, not counting any money that you may
receive from others to help pay for care?]
SPECIFY UNIT.
___________________________________________________________
BOX 7B
n
CCQ.196
IF THE NUMBER OF CHILDREN IN THE HOUSEHOLD WHO ARE LESS THAN OR
EQUAL TO 15 YEARS OLD (INCLUDING THE CHILD) = 1, GO TO BOX 8. ELSE, GO
TO CCQ.196.
How many children is this amount for, including {CHILD}?
{CHILD} ONLY .......................................................................................... 1
{CHILD} + 1 MORE (2 TOTAL) ................................................................. 2
{CHILD} + 2 MORE (3 TOTAL) ................................................................. 3
{CHILD} + 3 OR MORE (4 OR MORE TOTAL) ........................................ 4
REFUSED................................................................................................. 8
DON’T KNOW ........................................................................................... 9
BOX 8
n
n
IF ONLY ONE CURRENT REGULAR NON-RELATIVE CARE ARRANGEMENT FOR
CHILD (CCQ.165 = 1 OR 8 OR 9), GO TO CCQ.260.
OTHERWISE, CONTINUE WITH CCQ.205.
60
CCQ.205
You said that {CHILD} was cared for by {NUMBER} other {nonrelative/nonrelatives} on a regular basis. How many
hours each week does {CHILD} receive care from {this nonrelative/these nonrelatives}?
CAPI INSTRUCTION: FOR "{NUMBER}", DISPLAY "1" IF CCQ.165 = 2; DISPLAY "2" IF CCQ.165 = 3; DISPLAY "3"
IF CCQ.165 = 4.
CAPI INSTRUCTION: IF CCQ.165 = 2, DISPLAY "nonrelative" AND "this nonrelative."
"nonrelatives" AND "these nonrelatives."
OTHERWISE, DISPLAY
CAPI INSTRUCTION: DISPLAY “hours” AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
Day Care Center/Before- or After-School Program
HELP AVAILABLE
CCQ.260
{Now I'd like to ask you about any care {CHILD} receives from day care centers or before- or after-school programs.} Is
{CHILD} now attending a day care center or a before- or after-school program at a school or in a center on a regular
basis?
CAPI INSTRUCTION: DISPLAY "Now . . . programs" IF CCQ.115 = 1. OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY "now" and "regular basis" in UNDERLINED TEXT.
HELP TEXT:
Day Care Center or Before- or After-School Program: Includes any type of formal program that provides care and
supervision. It may be in a child's school or in another location, such as a church or a free-standing building. Head Start
programs, nursery schools, preschools, and prekindergarten programs that include children who are now in
kindergarten (some of which may be sponsored by the state) are also included.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
61
1 (CCQ.275)
2
8
9
HELP AVAILABLE
CCQ.265
Has {CHILD} ever attended a day care center, nursery school, preschool, prekindergarten, or before- or after-school
program at a school or in a center on a regular basis?
CAPI INSTRUCTION: DISPLAY "ever" and "regular basis" in UNDERLINED TEXT.
HELP TEXT:
Day Care Center: Includes any type of formal program that provides care and supervision. It may be in a child's
school or in another location, such as a church or a free-standing building. Head Start programs, nursery schools,
preschools, and prekindergarten programs (some of which may be sponsored by the state) are also included.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
1
2 (BOX 12)
8 (BOX 12)
9 (BOX 12)
HELP AVAILABLE
CCQ.275
How old was {CHILD} in years and months when {he/she} first attended any day care center, nursery school, preschool,
prekindergarten, or before- or after-school program on a regular basis?
CAPI INSTRUCTION: RANGE CHECK 0-7 FOR YEARS, 0-12 FOR MONTHS.
CAPI INSTRUCTION: DISPLAY "first", “any” AND "regular basis" IN UNDERLINED TEXT.
HELP TEXT:
Day Care Center: Includes any type of formal program that provides care and supervision. It may be in a child's
school or in another location, such as a church or a free-standing building. Head Start programs, nursery schools,
preschools, and prekindergarten programs (some of which may be sponsored by the state) are also included.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
|___|___|
ENTER YEAR
AND
|___|___|
ENTER MONTH
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
62
HELP AVAILABLE
CCQ.280
Did {CHILD} attend a day care center, nursery school, preschool, or prekindergarten program on a regular basis the
year before {he/she} started kindergarten?
THIS MEANS ANYTIME IN THE YEAR BEFORE CHILD ENTERED KINDERGARTEN.
CAPI INSTRUCTION: DISPLAY "regular basis the year before" IN UNDERLINED TEXT.
HELP TEXT:
Day Care Center: Includes any type of formal program that provides care and supervision. It may be in a child's
school or in another location, such as a church or a free-standing building. Head Start programs, nursery schools,
preschools, and prekindergarten programs (some of which may be sponsored by the state) are also included.
Regular Basis: An arrangement or program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule). Do not include occasional babysitting or "back up" arrangements that are just used once in a while.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CCQ.285
1
2 (BOX 12)
8 (BOX 12)
9 (BOX 12)
How many different day care centers, nursery schools, preschools, or prekindergarten programs did {CHILD} attend on
a regular basis the year before {he/she} started kindergarten?
CAPI INSTRUCTION: DISPLAY "regular basis the year before" in UNDERLINED TEXT.
ONE ..............................................................
TWO .............................................................
THREE .........................................................
FOUR ...........................................................
FIVE OR MORE.............................................
REFUSED .....................................................
DON'T KNOW ...............................................
63
1
2
3
4
5
8
9
CCQ.286
{Head Start is a federally sponsored preschool program primarily for children from low-income families.} {Was/Were any
of} {CHILD}’s care arrangement{s} in a day care center, nursery school, preschool, or prekindergarten program in the
year before kindergarten Head Start?
CAPI INSTRUCTION: DISPLAY “the year before” IN UNDERLINED TEXT.
HELP TEXT:
Head Start: Head Start is a federally funded early childhood education program designed to improve the schoolreadiness of disadvantaged children (i.e., children from low-income families). Children who participate are usually 3 to 5
years old. Head Start may be offered in a variety of locations. For this question, we are interested in Head Start
services in a center setting.
CAPI INSTRUCTIONS: DISPLAY “Head Start…families” IF CCQ.031 AND CCQ.136 WERE NOT ASKED. ELSE, USE
A NULL DISPLAY.
CAPI INSTRUCTIONS: DISPLAY “Was” and “arrangement” IF CCQ.285 = 1. ELSE, DISPLAY “Were any of” AND
“arrangements”.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
BOX 9
n
n
CCQ.287
IF ONLY ONE CURRENT REGULAR CENTER CARE ARRANGEMENT FOR CHILD
(CCQ.285 = 1) AND IT WAS HEAD START (CCQ.286 = 1), GO TO CCQ.301.
OTHERWISE, CONTINUE WITH CCQ.287.
{Was the day care center, nursery school, preschool, or prekindergarten program/Were any of the day care centers,
nursery schools, preschools, or prekindergarten programs} a state-sponsored preschool or state-sponsored
prekindergarten program?
CAPI INSTRUCTIONS: DISPLAY “Was…program” IF CCQ.285 = 1. ELSE, DISPLAY “Were…programs”.
HELP TEXT:
State-sponsored preschool or state-sponsored prekindergarten program:
State-sponsored preschool or
prekindergarten programs are child care programs that are paid for by the state. In some states, the programs are for all
children, while in others they are only for some children such as those whose families have low incomes. Statesponsored programs can be in a public or private setting, and can be part-day or full-day. Many state pre-kindergarten
programs are delivered through child care programs.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
64
1
2
8
9
BOX 10
n
n
IF THERE IS MORE THAN ONE CENTER BASED CARE ARRANGEMENT (CCQ.285 =
2, 3, 4, 5, 8, OR 9), GO TO CCQ.300.
ELSE, GO TO CCQ.301.
CCQ.300
For the next few questions please think about the program that {CHILD} attended most the year before {he/she} started
kindergarten.
THIS MEANS ANYTIME IN THE YEAR BEFORE CHILD ENTERED KINDERGARTEN.
CAPI INSTRUCTION: DISPLAY “the year before” IN UNDERLINED TEXT.
CCQ.301
Where was the program that {CHILD} attended {most} located? For example, was it in its own building, a school, in a
church or synagogue, or some other place?
IF R SAYS “SCHOOL”, PROBE: Was that a public school or a private school?
IF R SAYS “SOME OTHER PLACE”, PROBE: Was it in a community center, a public library, more than one place, or
some other place?
CAPI INSTRUCTION: DISPLAY "most” IF CCQ.285 = 2, 3, 4, 5, 8, OR 9. OTHERWISE, USE A NULL DISPLAY.
ITS OWN BUILDING ................................................................................
A PUBLIC ELEMENTARY, JUNIOR HIGH, OR HIGH SCHOOL .............
A PRIVATE ELEMENTARY, JUNIOR HIGH, OR HIGH SCHOOL ...........
A COLLEGE OR UNIVERSITY ................................................................
A CHURCH, SYNAGOGUE, OR OTHER PLACE OF WORSHIP ............
RESPONDENT'S HOME ..........................................................................
ANOTHER HOME ....................................................................................
A COMMUNITY CENTER ........................................................................
A PUBLIC LIBRARY .................................................................................
AN OFFICE BUILDING OR STOREFRONT BUILDING THAT SHARES
WALLS WITH OTHER BUSINESSES ......................................................
MORE THAN ONE PLACE .......................................................................
SOME OTHER PLACE .............................................................................
REFUSED ................................................................................................
DON'T KNOW...........................................................................................
CCQ.303
1
2
3
4
5
6
7
8
9
(CCQ.305)
(CCQ.305)
(CCQ.305)
(CCQ.305)
10
11
12
88
99
Was that program located in the school where {CHILD} now attends kindergarten?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
65
1
2
8
9
CCQ.305
How many days each week did {CHILD} go to the program?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
IF RESPONDENT SAYS SCHEDULE CHANGED, ANSWER FOR THE SCHEDULE CHILD HAD AT THE END OF
LAST YEAR.
CAPI INSTRUCTION: DISPLAY "days" AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-5. HARD RANGE CHECK 1-7.
|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
CCQ.310
How many hours each week did {CHILD} go to the program?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
IF RESPONDENT SAYS SCHEDULE CHANGED, ANSWER FOR THE SCHEDULE CHILD HAD AT THE END OF
LAST YEAR.
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
CCQ.315
For how long did {CHILD} receive care at that program the year before {he/she} started kindergarten?
Would you say …
One to two months, .......................................
Three to five months, ....................................
Six to eight months, or ..................................
Nine to twelve months? ................................
REFUSED......................................................
DON'T KNOW ................................................
66
1
2
3
4
8
9
CCQ.320
What language did {CHILD}’s main care provider or teacher at that program speak most when caring for {CHILD}?
CODE ‘16’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
ENGLISH .....................................
ARABIC .......................................
CHINESE LANGUAGE/DIALECT
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
FARSI .......................................... 14
HMONG ....................................... 15
RESPONDENT CANNOT
CHOOSE A PRIMARY
LANGUAGE.................................. 16
SOME OTHER LANGUAGE
(SPECIFY) _________________ 91
REFUSED .................................... 88
DON’T KNOW .............................. 99
BOX 11
IF CCQ.320 = 91, GO TO CCQ.320OS. ELSE, GO TO BOX 12.
CCQ.320OS [What language did {CHILD}’s main care provider or teacher at that program speak most when caring for
{CHILD}?]
SPECIFY LANGUAGE.
___________________________________________________________
BOX 12
n
n
IF CHILD IS NOT CURRENTLY IN CENTER OR PROGRAM CARE
(CCQ.260 = 2 OR 8 OR 9), GO TO CCQ.376.
OTHERWISE, CONTINUE WITH CCQ.325.
67
CCQ.325
{Let's talk about your current care arrangements with day care centers or before or after school programs.} How many
different day care centers or before- or after-school care programs does {CHILD} currently go to on a regular basis?
CAPI INSTRUCTION: DISPLAY "currently"AND “regular” IN UNDERLINED TEXT.
CAPI INSTRUCTION: IF CCQ.280 = 1, DISPLAY THE SENTENCE "Let’s …programs." OTHERWISE, USE A NULL
DISPLAY.
HELP TEXT:
Day Care Center or Before- or After-School Program: Includes any type of formal program that provides care and
supervision. It may be in a child's school or in another location, such as a church or a free-standing building. Head Start
programs, nursery schools, preschools, and prekindergarten programs that include children who are now in
kindergarten (some of which may be sponsored by the state) are also included.
ONE ...............................................................
TWO ..............................................................
THREE ..........................................................
FOUR ............................................................
FIVE OR MORE.............................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.330
1
2
3
4
5
8
9
{Let's talk about the program where {CHILD} spends the most time now.} Is that program located in the school where
{CHILD} attends kindergarten?
CAPI INSTRUCTION: DISPLAY "now" IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY {Let's talk about the program where {CHILD} spends the most time now.} IF CCQ.325
= 2, 3, 4, 5, 8, OR 9. OTHERWISE, USE A NULL DISPLAY.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CCQ.335
1
2
8
9
Does {CHILD} go to that program before school, after school, or on weekends?
CODE ALL THAT APPLY
BEFORE SCHOOL ........................................
AFTER SCHOOL ...........................................
WEEKENDS ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
68
1
2
3
8
9
HELP AVAILABLE
CCQ.340
Does {CHILD} go to that program on a regularly scheduled basis at least once each week?
HELP TEXT:
Regularly Scheduled: Regularly scheduled at least once each week could mean every Wednesday, every Monday
and Friday, everyday, or some other schedule, as long as it is at least once each week.
CAPI INSTRUCTION: DISPLAY "regularly scheduled" and "each" IN UNDERLINED TEXT.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CCQ.350
1
2 (BOX 14)
8 (BOX 14)
9 (BOX 14)
How many days each week does {CHILD} go to that program?
CAPI INSTRUCTION: DISPLAY "days" AND “week” IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-5. HARD RANGE CHECK 1-7.
|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON'T KNOW ................................................ 99
CCQ.355
Other than regular school hours, how many hours each week does {CHILD} go to that program?
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
69
CCQ.365
Is there any charge or fee for the program, paid either by you or someone else?
IF NECESSARY SAY, Please only think about the program that provides the most care for {CHILD}.
CAPI INSTRUCTIONS: DISPLAY “most” IN UNDERLINED TEXT.
YES, .............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
CCQ.370
1
2 (BOX 14)
8 (BOX 14)
9 (BOX 14)
Do any of the following people or organizations help to pay for {CHILD} to go to that program?
How about…
CAPI INSTRUCTION: FOR ITEMS B – E DISPLAY THE FIRST PART OF THE QUESTION “Do any …
program?” IN BRACKETS.
a.
b.
c.
d.
e.
A relative of {CHILD} outside your household who provides
money specifically for that care? ......................................................
Temporary Assistance for Needy
Families, or TANF?........................ ..................................................
Another social service or welfare agency? .......................................
An employer? ..................................................................................
Someone else? (SPECIFY) .............................................................
YES
NO
R
DK
1
2
8
9
1
1
1
2
2
2
8
8
8
9
9
9
BOX 13
IF CCQ.370e = 1, GO TO CCQ370OS. ELSE, GO TO CCQ.371.
CCQ.370OSOS [Who was that?]
SPECIFY PERSON.
___________________________________________________________
CCQ.371
How much does your household pay for {CHILD} to go to that program, not counting any money that you may receive
from others to help pay for care?
CAPI INSTRUCTION: HARD RANGE CHECK: $1 – 9999.
$|___|___|___|___|.|___|___|
ENTER AMOUNT OF PAYMENT .................. (CCQ.372)
REFUSED.................................................... 8 (BOX 14)
DON'T KNOW .............................................. 9 (BOX 14)
70
CCQ.372
[How much does your household pay this person to care for {CHILD}, not counting any money that you may receive
from others to help pay for care?
ENTER UNIT
PER HOUR.................................................. 1 (BOX 13B)
PER DAY..................................................... 2 (BOX 13B)
PER WEEK.................................................. 3 (BOX 13B)
PER MONTH............................................... 4 (BOX 13B)
PER YEAR .................................................. 5 (BOX 13B)
EVERY TWO WEEKS..................................6 (BOX 13B)
OTHER (SPECIFY)...................................... 91 (CCQ.372OS)
REFUSED .................................................. 8 (BOX 14)
DON'T KNOW ............................................. 9 (BOX 14)
CCQ.372OS [How much does your household pay this person to care for {CHILD}, not counting any money that you may receive
from others to help pay for care?]
SPECIFY UNIT.
___________________________________________________________
BOX 13B
n
CCQ.373
IF THE NUMBER OF CHILDREN IN THE HOUSEHOLD WHO ARE LESS THAN OR
EQUAL TO 15 YEARS OLD (INCLUDING THE CHILD) = 1, GO TO BOX 14. ELSE, GO
TO CCQ.373.
How many children is this amount for, including {CHILD}?
{CHILD} ONLY .......................................................................................... 1
{CHILD} + 1 MORE (2 TOTAL) ................................................................. 2
{CHILD} + 2 MORE (3 TOTAL) ................................................................. 3
{CHILD} + 3 OR MORE (4 OR MORE TOTAL) ........................................ 4
REFUSED................................................................................................. 8
DON’T KNOW ........................................................................................... 9
BOX 14
n
n
IF ONLY ONE CURRENT REGULAR CENTER OR PROGRAM CARE ARRANGEMENT
FOR CHILD (CCQ.325 = 1 OR 88 OR 99), GO TO CCQ.376.
OTHERWISE, CONTINUE WITH CCQ.375.
71
CCQ.375
You said that {CHILD} attended {NUMBER} other day care {center/centers} or before- or after-school
{program/programs} on a regular basis. How many hours each week does {CHILD} attend {this program/these
programs}?
CAPI INSTRUCTION: FOR "{NUMBER}", DISPLAY "1" IF CCQ.325 = 2; DISPLAY "2" IF CCQ.325 = 3; DISPLAY "3"
IF CCQ.325 = 4. IF CCQ.325 = 5, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CCQ.325 = 2, DISPLAY "center," "program" AND "this program." OTHERWISE, DISPLAY
"centers," "programs" AND "these programs."
CAPI INSTRUCTION: DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1-50. HARD RANGE CHECK 1-70.
|___|___|
ENTER # OF HOURS
REFUSED...................................................... 888
DON'T KNOW ................................................ 999
CCQ.376
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?
CAPI INSTRUCTION: DISPLAY “regular basis” IN UNDERLINED TEXT.
YES, .............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
CCQ.377
1
2 (BOX 15)
8 (BOX 15)
9 (BOX 15)
How many hours per week does {CHILD} take care of {himself/herself}?
CAPI INSTRUCTIONS:
1. DISPLAY "hours" AND "week" IN UNDERLINED TEXT.
2. SOFT RANGE CHECK : 0 – 25. HARD RANGE CHECK: 0-70 HOURS.
|___|
ENTER # HOURS
REFUSED ..................................................... 88
DON'T KNOW ............................................... 99
72
BOX 15
IF CHILD IS IN CURRENT CARE FOR 5 OR MORE HOURS PER WEEK AND AT LEAST ONE
CARE TYPE USED 5 OR MORE HOURS A WEEK IS USED BEFORE OR AFTER SCHOOL
(CCQ.090 GE 5 AND ONE OF THE CODES IN CCQ.075 IS 1 AND/OR 2) OR (CCQ.190 GE 5
AND ONE OF THE CODES IN CCQ.175 IS 1 AND/OR 2) OR (CCQ.355 GE 5 AND ONE OF THE
CODES IN CCQ.335 IS 1 OR 2), GO TO CCQ.380.
(NOTE: CCQ.075, CCQ.175, AND CCQ.335 ARE “CODE ALL THAT APPLY” AND MAY ALSO
HAVE CODES OF 3 FOR WEEKEND CARE, BUT THEY NEED TO HAVE A CODE OF 1
AND/OR 2 FOR “BEFORE” OR “AFTER SCHOOL” CARE TO GO TO CCQ.380.)
ELSE, GO TO BOX 19.
CCQ.380
As part of this study, we will be interviewing the early care and education provider of children in the study. That is, we
would like to interview the person who most often regularly supervises your child before or after school. Thus, we would
like to talk to {CHILD}’s {relative caregiver/non-relative caregiver/center director and teacher}.
We would like your permission to contact {CHILD}’s {relative caregiver/non-relative caregiver/center director and
teacher}. Is that OK?
CAPI INSTRUCTIONS: AMONG CHILD CARE TYPES THAT ARE USED 5 OR MORE HOURS A WEEK AND USED
AT LEAST SOME OF THE TIME BEFORE OR AFTER SCHOOL, CALCULATE WHERE THE CHILD SPENDS THE
MOST HOURS OF CHILD CARE (COMPARE HOURS OF CARE BY A RELATIVE FOR WHICH CCQ.090 GE 5 AND
CCQ.075 HAS A CODE OF 1 AND/OR 2) TO (HOURS OF CARE BY A NONRELATIVE FOR WHICH CCQ.190 GE 5
AND CCQ.175 HAS A CODE OF 1 AND/OR 2) TO HOURS OF CARE AT A CENTER FOR WHICH CCQ.355 GE 5
AND CCQ.335 HAS A CODE OF 1 AND/OR 2), IF ANY INFORMATION IS MISSING, COUNT IT AS ZERO. IF THE
MOST HOURS OF CARE ARE WITH A RELATIVE-, DISPLAY “relative caregiver”. ELSE, IF THE MOST HOURS OF
CARE ARE WITH A NON-RELATIVE, DISPLAY “non-relative caregiver”. ELSE, IF THE MOST HOURS OF CARE
ARE WITH A CENTER, DISPLAY “center director and teacher.”
ELSE, IF (THERE ARE THREE TYPES OF CARE (RELATIVE CARE, NON-RELATIVE CARE, AND CENTER CARE))
AND (ALL ARE USED 5 OR MORE HOURS A WEEK AND AT LEAST SOME OF THE TIME BEFORE OR AFTER
SCHOOL) AND (THE NUMBER OF HOURS ARE EQUAL AMONG THREE TYPES OF CARE), SELECT ONE OF
THEM RANDOMLY AND USE THE APPROPRIATE DISPLAY FOR “relative caregiver,” “non-relative caregiver,” OR
“center director and teacher.”
ELSE, IF THERE ARE THREE TYPES OF CARE AND (ALL ARE USED 5 OR MORE HOURS A WEEK AND AT
LEAST SOME OF THE TIME BEFORE OR AFTER SCHOOL) AND (TWO OF THEM HAVE HOURS THAT ARE
EQUAL TO EACH OTHER AND GREATER THAN THE HOURS OF THE THIRD TYPE), SELECT ONE OF THE TWO
RANDOMLY AND USE THE APPROPRIATE DISPLAY FOR “relative caregiver,” “non-relative caregiver,” OR “center
director and teacher.”
ELSE, IF THERE ARE ONLY TWO TYPES OF CARE AND (BOTH ARE USED 5 OR MORE HOURS A WEEK AND AT
LEAST SOME OF THE TIME BEFORE OR AFTER SCHOOL) AND (BOTH TYPES OF CARE HAVE AN EQUAL
NUMBER OF HOURS), SELECT ONE OF THEM RANDOMLY AND USE THE APPROPRIATE DISPLAY FOR “relative
caregiver,” “non-relative caregiver,” OR “center director and teacher.”
CAPI INSTRUCTIONS: REFUSED AND DON’T KNOW DISALLOWED.
YES ...............................................................
NO .................................................................
73
1
2 (GO TO BOX 19)
CCQ.390
What is the name of {CHILD}’s {relative caregiver/nonrelative caregiver/center director}?
VERIFY SPELLING.
ENTER FIRST NAME.
CAPI INSTRUCTIONS: USE DISPLAY INSTRUCTIONS IN CCQ.380.
REFUSED......................................................
DON’T KNOW ................................................
CCQ.395
8
9
[What is the name of {CHILD}’s {relative caregiver/non-relative caregiver/center director}?]
VERIFY SPELLING.
ENTER LAST NAME.
CAPI INSTRUCTIONS: USE DISPLAY INSTRUCTIONS IN CCQ.380.
REFUSED......................................................
DON’T KNOW ................................................
8
9
BOX 16
IF THE CHILD HAS THE MOST HOURS OF CARE IN A CENTER, GO TO CCQ.415.
ELSE, GO TO CCQ.450.
CCQ.415
What is the name of {CHILD}’s child care center?
VERIFY SPELLING.
ENTER NAME.
____________________________________________________
REFUSED......................................................
DON’T KNOW ................................................
74
8
9
CCQ.420
Is {CHILD}’s center director the same person as {his/her} primary {before- or after-school teacher or care
provider/caregiver}?
IF NEEDED, EXPLAIN: Sometimes there is a person in charge of a child care center who is different from the teacher or
care provider who mainly cares for your child. In smaller centers, though, the person in charge of the child care center
and the main teacher or care provider might be the same person. We would like to know if the center director is the
same person as your child’s main teacher or care provider.
CAPI INSTRUCTIONS: IF MOST HOURS OF CHILD CARE ARE IN CENTER BASED CARE AND THE CHILD IS IN
A SCHOOL (CCQ.330 = 1), DISPLAY “before- or after-school teacher or care provider”. ELSE, DISPLAY “caregiver”.
YES ............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CCQ.430
1 (CCQ.450)
2
8
9
What is the name of {CHILD}’s primary {before- or after-school teacher or care provider/caregiver} at {CENTER
NAME/the child care center}?
CAPI INSTRUCTIONS:
FIRST DISPLAY: IF CHILD HAS CHILD CARE IN A SCHOOL (CCQ.330 = 1), DISPLAY “teacher or care provider”.
ELSE, IF CHILD DOES NOT HAVE CHILD CARE IN A SCHOOL (CCQ.330 = 2, 8, 9), DISPLAY “caregiver”.
SECOND DISPLAY: DISPLAY NAME GIVEN FOR CENTER IN CCQ.415 FOR “CENTER NAME”.
ELSE, IF CENTER NAME IS MISSING DISPLAY “the child care center”.
VERIFY SPELLING.
ENTER FIRST NAME.
________________________________________________________
FIRST NAME
REFUSED......................................................
DON'T KNOW ................................................
CCQ.435
8
9
[What is the name of {CHILD}’s primary {before- or after-school teacher or care provider/caregiver} at {CENTER
NAME/the child care center}?]
CAPI INSTRUCTIONS: FIRST DISPLAY: IF CHILD HAS CHILD CARE IN A SCHOOL (CCQ.330 = 1), DISPLAY
“teacher or care provider”. ELSE, IF CHILD DOES NOT HAVE CHILD CARE IN A SCHOOL (CCQ.330 = 2, 8, 9),
DISPLAY “caregiver”.
SECOND DISPLAY: DISPLAY NAME GIVEN FOR CHILD IN CCQ.415 FOR “CENTER NAME”. ELSE, IF CENTER
NAME IS MISSING, DISPLAY “the child care center”.
VERIFY SPELLING.
ENTER LAST NAME.
________________________________________________________
LAST NAME
REFUSED......................................................
DON'T KNOW ................................................
75
8
9
BOX 17
IF THE CHILD HAS MOST HOURS OF CARE WITH A RELATIVE, AUTOCODE CCQ.450
ACCORDING TO ANSWER IN CCQ.066 AND GO TO BOX 18. ELSE, IF THE CHILD HAS THE
MOST HOURS OF CARE WITH A NON-RELATIVE, AUTOCODE CCQ.450 ACCORDING TO
THE ANSWER IN CCQ.166 AND GO TO BOX 18.
ELSE, GO TO CCQ.450.
CCQ.450
Is {PROVNAME} 18 years of age or older?
DISPLAY INSTRUCTIONS: IF MOST CHILD CARE IS IN A CENTER AND THE CENTER DIRECTOR IS NOT THE
BEFORE OR AFTER SCHOOL TEACHER OR CARE PROVIDER, DISPLAY NAME ENTERED AT CCQ.430/CCQ.435
FOR {PROVNAME}. ELSE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR {PROVNAME}.
YES ...............................................................
NO ...................................................................
REFUSED......................................................
DON’T KNOW ................................................
1
2
8
9
BOX 18
IF CCQ.450 NE 1 (CAREGIVER IS YOUNGER THAN 18 OR REF/DK), GO TO BOX 19 (WE WILL NOT CONDUCT
THE INTERVIEW WITH THE CAREGIVER).
ELSE, GO TO CCQ.451.
76
CCQ.451
What is {{RELATIVE/CAREGIVER’S NAME}/{CENTER NAME})/{{CHILD}’s caregiver}/{CENTER NAME}/{the child care
center}}’s telephone number?
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
{Does the school not have a telephone number or do they have one, but you don’t know what it is?”
{IF SCHOOL HAS NO TELEPHONE NUMBER, LEAVE ANSWER AS ‘000’. IF SCHOOL HAS TELEPHONE NUMBER,
BUT IT IS NOT KNOWN OR REFUSED, REPLACE ‘000’ WITH F5 FOR "DON’T KNOW" OR F6 FOR "REFUSED."}
CAPI INSTRUCTIONS: IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS RELATIVE OR NONRELATIVE CARE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR “{RELATIVE/CAREGIVER’S NAME}.” IF
FIRST OR LAST NAME IS MISSING, BUT ONE NAME IS THERE, USE THE NON-MISSING NAME. IF BOTH
NAMES ARE MISSING, USE “{CHILD}’s caregiver”.
ELSE, IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS CENTER-BASED CARE, DISPLAY NAME
ENTERED AT CCQ.415 FOR “{CENTER NAME}.” IF NAME FOR CENTER IS MISSING, DISPLAY “the child care
center.”
CAPI INSTRUCTION: IF CENTER IS IN A SCHOOL (CCQ.330 = 1), DISPLAY EDIT MESSAGE IF PHONE NUMBER
FIELD ENTRY = ‘000’: “Does the school not have a telephone number or do they have one, but you don’t know what it
is? “ AND “IF…”REFUSED.”
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW EDIT:
"Phone number has wrong format. Please correct. The phone number must be formatted as 10 numbers (xxx-xxxxxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR (‘000’ AND ANSWER WAS
CONFIRMED AS CORRECT WITH EDIT MESSAGE), THE CURSOR SHOULD SKIP THE EXTENSION FIELD AND
MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE NUMBER FIELD HAS ENTRIES, THE CURSOR
SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
77
CCQ.455
What is the mailing address of {{RELATIVE/CAREGIVER’S NAME)/{{CHILD}’s caregiver}/{CENTER NAME}/{the child
care center}}?
IF DON’T KNOW, SAY: Do you know the street it is on?
ENTER STREET ADDRESS, LINE 1.
VERIFY SPELLING.
________________________________________________________
STREET ADDRESS LINE 1
CAPI INSTRUCTIONS: IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS RELATIVE OR NONRELATIVE CARE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR “{RELATIVE/CAREGIVER’S NAME}.” IF
FIRST OR LAST NAME IS MISSING, BUT ONE NAME IS THERE, USE THE NON-MISSING NAME. IF BOTH
NAMES ARE MISSING, USE “{CHILD}’s caregiver”.
ELSE, IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS CENTER-BASED CARE, DISPLAY NAME
ENTERED AT CCQ.415 FOR “{CENTER NAME}.” IF NAME FOR CENTER IS MISSING, DISPLAY “the child care
center.”
CAPI INSTRUCTIONS: REFUSED AND DON’T KNOW ARE ALLOWED.
CCQ.460
[What is the mailing address of {{RELATIVE/CAREGIVER’S NAME)/{{CHILD}’s caregiver}/{CENTER NAME}/{child care
center}}?]
ENTER STREET ADDRESS, LINE 2.
VERIFY SPELLING.
________________________________________________________
STREET ADDRESS LINE 2
CAPI INSTRUCTIONS: IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS RELATIVE OR NONRELATIVE CARE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR “{RELATIVE/CAREGIVER’S NAME}.” IF
FIRST OR LAST NAME IS MISSING, BUT ONE NAME IS THERE, USE THE NON-MISSING NAME. IF BOTH
NAMES ARE MISSING, USE “{CHILD}’s caregiver”.
ELSE, IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS CENTER-BASED CARE, DISPLAY NAME
ENTERED AT CCQ.415 FOR “{CENTER NAME}.” IF NAME FOR CENTER IS MISSING, DISPLAY “the child care
center.”
CAPI INSTRUCTIONS: REFUSED AND DON’T KNOW ARE ALLOWED.
78
CCQ.465
[What is the mailing address of {{RELATIVE/CAREGIVER’S NAME)/{{CHILD}’s caregiver}/{CENTER NAME}/{the child
care center}}?]
ENTER CITY.
VERIFY SPELLING.
________________________________________________________
CITY
CAPI INSTRUCTIONS: IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS RELATIVE OR NONRELATIVE CARE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR “{RELATIVE/CAREGIVER’S NAME}.” IF
FIRST OR LAST NAME IS MISSING, BUT ONE NAME IS THERE, USE THE NON-MISSING NAME. IF BOTH
NAMES ARE MISSING, USE “{CHILD}’s caregiver”.
ELSE, IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS CENTER-BASED CARE, DISPLAY NAME
ENTERED AT CCQ.415 FOR “{CENTER NAME}.” IF NAME FOR CENTER IS MISSING, DISPLAY “the child care
center.”
CAPI INSTRUCTIONS: REFUSED AND DON’T KNOW ARE ALLOWED.
HELP AVAILABLE
CCQ.470
[What is the mailing address of {{RELATIVE/CAREGIVER’S NAME)/{{CHILD}’s caregiver}/{CENTER NAME}/{the child
care center}}?]
ENTER STATE.
________________________________________________________
STATE
CAPI INSTRUCTION: DISPLAY STATE ABBREVIATIONS IN F1 HELP TEXT.
CAPI INSTRUCTIONS: IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS RELATIVE OR NONRELATIVE CARE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR “{RELATIVE/CAREGIVER’S NAME}.” IF
FIRST OR LAST NAME IS MISSING, BUT ONE NAME IS THERE, USE THE NON-MISSING NAME. IF BOTH
NAMES ARE MISSING, USE “{CHILD}’s caregiver”.
ELSE, IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS CENTER-BASED CARE, DISPLAY NAME
ENTERED AT CCQ.415 FOR “{CENTER NAME}.” IF NAME FOR CENTER IS MISSING, DISPLAY “the child care
center.”
CAPI INSTRUCTIONS: REFUSED AND DON’T KNOW ARE ALLOWED.
79
CCQ.475
[What is the mailing address of {{RELATIVE/CAREGIVER’S NAME)/{{CHILD}’s caregiver}/{CENTER NAME}/{the child
care center}}?]
ENTER ZIP CODE.
________________________________________________________
ZIP CODE
CAPI INSTRUCTIONS: IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS RELATIVE OR NONRELATIVE CARE, DISPLAY NAME ENTERED AT CCQ.390/CCQ.395 FOR “{RELATIVE/CAREGIVER’S NAME}.” IF
FIRST OR LAST NAME IS MISSING, BUT ONE NAME IS THERE, USE THE NON-MISSING NAME. IF BOTH
NAMES ARE MISSING, USE “{CHILD}’s caregiver”.
ELSE, IF CHILD CARE PROVIDER WHERE MOST HOURS OF CARE IS CENTER-BASED CARE, DISPLAY NAME
ENTERED AT CCQ.415 FOR “{CENTER NAME}.” IF NAME FOR CENTER IS MISSING, DISPLAY “the child care
center.”
CAPI INSTRUCTIONS: REFUSED AND DON’T KNOW ARE ALLOWED.
CCQ.490
Please tell me anything special that I should know about contacting your {relative caregiver/non-relative caregiver/center
director and teacher}.
CHECKLIST OF QUESTIONS TO ASK RESPONDENT:
1.
HOURS OF OPERATION?
2.
BEST TIME TO CALL YOUR CHILD CARE PROVIDER ABOUT THE INTERVIEW?
3.
DOES THE CENTER DIRECTOR OR CAREGIVER SPEAK ENGLISH WELL ENOUGH TO ANSWER
QUESTIONS IN ENGLISH, OR SHOULD WE HAVE A BILINGUAL INTERVIEWER CALL?
(4. IF A BILINGUAL INTERVIEWER IS NEEDED, DOES THE CENTER DIRECTOR/CAREGIVER SPEAK
SPANISH?)
ENTER INFORMATION HERE.
CAPI INSTRUCTIONS: USE DISPLAY INSTRUCTIONS IN CCQ.380.
BOX 19
n
GO TO SECTION CHQ (CHILD'S HEALTH AND WELL-BEING).
80
CHILD'S HEALTH AND WELL-BEING - CHQ
CHQ.005
Now I have some questions about {CHILD}'s health. How much did {CHILD} weigh when {he/she} was born?
ENTER UNIT
POUNDS (WITH OR WITHOUT OUNCES) ..
GRAMS ........................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.006
1
2
8
9
(CCQ.006)
(CCQ.007)
(CHQ.010)
(CHQ.010)
[Now I have some questions about {CHILD}'s health. How much did {CHILD} weigh when {he/she} was born?]
IF ANSWER GIVEN IN POUNDS AND NOT OUNCES, PROBE TO ALSO GET OUNCES.
ENTER POUNDS AND OUNCES.
CAPI INSTRUCTION: RANGE CHECK: 1-13 FOR POUNDS, 0-15 FOR OUNCES.
|___|___|
POUNDS
AND
|___|___|
OUNCES
REFUSED .....................................................
DON'T KNOW ...............................................
8
9
BOX 1
IF BOTH POUNDS AND OUNCES ARE ENTERED IN CHQ.006 AND NEITHER ANSWER IS
REFUSED OR DON’T KNOW, GO TO CHQ.025.
ELSE, IF (CHQ.006 IS REFUSED OR DON’T KNOW FOR THE NUMBER OF POUNDS) OR (THE
NUMBER OF POUNDS IN CHQ.006 IS 5 AND REFUSED OR DON’T KNOW FOR THE NUMBER
OF OUNCES, GO TO CHQ.010. ELSE, IF THE NUMBER OF POUNDS IN CHQ.006 IS 3 AND
REFUSED OR DON’T KNOW FOR THE NUMBER OF OUNCES, GO TO CHQ.015. ELSE, IF THE
NUMBER OF POUNDS IN CHQ.006 IS 10 AND REFUSED OR DON’T KNOW FOR THE NUMBER
OF OUNCES, GO TO CHQ.016.
CHQ.007
[Now I have some questions about {CHILD}'s health. How much did {CHILD} weigh when {he/she} was born?]
CAPI INSTRUCTION: RANGE CHECK: 454 –6,322 GRAMS.
|___|___|___|___|
ENTER GRAMS
REFUSED .....................................................
DON'T KNOW ...............................................
81
8
9
BOX 2
IF GRAMS ARE ENTERED IN CHQ.007, GO TO CHQ.025.
ELSE, IF CHQ.007 IS REFUSED OR DON’T KNOW, GO TO CHQ.010.
CHQ.010
HELP AVAILABLE
When {he/she} was born, did {CHILD} weigh more than 5 1/2 pounds?
HELP TEXT:
5 ½ pounds = 5 pounds, 8 ounces = 2,495 grams
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ................................................
1 ( CHQ.016)
2
8
9
BOX 3
IF THE NUMBER OF POUNDS IN CHQ.006 WAS 5 AND REFUSED OR DON’T KNOW FOR THE
NUMBER OF OUNCES, GO TO CHQ.025. ELSE, GO TO CHQ.015.
HELP AVAILABLE
CHQ.015
Did {he/she} weigh more than 3 pounds?
HELP TEXT:
3 pounds = 1,361 grams
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ................................................
1
2
8
9
BOX 4
IF (CHQ.015 = 1 OR 2) OR (CHQ.010 = 2 AND CHQ.015 = REF OR DK), GO TO CHQ.025. ELSE,
GO TO CHQ.016.
82
HELP AVAILABLE
CHQ.016
Did {he/she} weigh more than 10 pounds?
HELP TEXT: 10 pounds = 4,536 grams
YES ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ................................................
CHQ.025
Was {CHILD} born more than two weeks before {he/she} was due?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ...............................................
CHQ.030
1
2
8
9
1
2 (CHQ.031)
8 (CHQ.031)
9 (CHQ.031)
How many days or weeks early was {he/she}?
CAPI INSTRUCTION: RANGE CHECK: 1-31 IF DAYS IS THE UNIT; 1-20 IF WEEKS IS THE UNIT.
|___|___|
ENTER NUMBER
REFUSED .....................................................
DON'T KNOW ...............................................
8
9
ENTER UNIT
WEEKS..........................................................
DAYS .............................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.031
Was {CHILD} ever breastfed or fed breast milk?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ...............................................
83
1
2
8
9
1
2 (CHQ.035)
8 (CHQ.035)
9 (CHQ.035)
CHQ.032
How old was {CHILD} when {he/she} completely stopped breastfeeding or being fed breast milk?
ENTER “96” IF CHILD IS STILL BREASTFEEDING.
CAPI INSTRUCTIONS: RANGE CHECK: 0-36 IF MONTHS IS THE UNIT; 0-7 IF YEARS IS THE UNIT.”
CAPI INSTRUCTIONS: DISPLAY “he” IF THE CHILD IS MALE. DISPLAY “she” IF THE CHILD IS FEMALE.
|___|___|
ENTER AGE
REFUSED ..................................................... 88
DON'T KNOW ............................................... 99
ENTER UNIT
MONTHS ......................................................
YEARS .........................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
BOX 5
IF (AN AGE IS ENTERED FOR CHQ.032 AND UNIT IS 1 OR 2) OR (CHILD IS STILL BEING
BREASTFED (CHQ.032 = 96)), GO TO CHQ.035.ELSE, GO TO CHQ.033.
CHQ.033
[How old was {CHILD} when {he/she} completely stopped breastfeeding or being fed
breast milk?]
Was {he/she}…
0 to 3 months, ................................................ 1
4 to 6 months, ................................................ 2
7 to 9 months, ................................................ 3
10 to 12 months, ............................................ 4
13 to 15 months, ............................................ 5
16 to 18 months, or ........................................ 6
Over 18 months? ........................................... 7
CHQ.035
Was {CHILD} a twin, triplet, or other child born as part of a multiple birth?
IF HIGHER-ORDER MULTIPLE BIRTH, CODE NUMBER OF CHILDREN BORN TOGETHER, EVEN IF ONE OR
MORE WAS STILLBORN OR DIED SHORTLY AFTER BIRTH.
NO .................................................................
YES, A TWIN .................................................
YES, A TRIPLET ...........................................
YES, MULTIPLE BIRTH (4 OR MORE) .........
REFUSED......................................................
DON'T KNOW ................................................
84
1 (CHQ.085)
2
3
4
8 (CHQ.085)
9 (CHQ.085)
CHQ.070
{Were {CHILD} and {his/her} twin identical twins or fraternal (non-identical) twins?}/{Was {CHILD} identical to any of the
other children born with {CHILD}?}
CAPI INSTRUCTIONS: DISPLAY "Were {CHILD} and….twins?" IF CHQ.035 = 2. ELSE, DISPLAY “Was…{CHILD}?”
IDENTICAL. ...................................................
FRATERNAL .................................................
MULTIPLE BIRTH CONTAINING AN
IDENTICAL TWIN PAIR OF WHICH
{CHILD} IS ONE ..........................................
MULTIPLE BIRTH WITH NO IDENTICAL
TWIN PAIR, OR {CHILD} IS NOT ONE
OF THE IDENTICAL TWINS .......................
REFUSED......................................................
DON'T KNOW ................................................
CHQ.085
3
4
8
9
Were there any complications in {CHILD}'s birth or delivery?
YES. ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.090
1
2
1
2 (CHQ.091)
8 (CHQ.091)
9 (CHQ.091)
What were the complications?
CODE ALL THAT APPLY
FEBRILE (MORE THAN 100 DEGREES F. OR 38 DEGREES C.) ............ 1
MECONIUM (BABY’S FECAL MATTER), MODERATE/HEAVY ................. 2
PREMATURE RUPTURE OF MEMBRANE (MORE THAN 12 HOURS)..... 3
ABRUPTIO PLACENTA (THE PLACENTA LINING SEPARATED FROM
UTERUS) ................................................................................................... 4
PLACENTA PREVIA (THE PLACENTA COVERED ALL OR
PART OF THE OPENING TO THE CERVIX) .............................................. 5
OTHER EXCESSIVE BLEEDING ................................................................ 6
SEIZURES DURING LABOR ...................................................................... 7
PRECIPITOUS LABOR (FAST LABOR, LESS THAN 3 HOURS) ............... 8
PROLONGED LABOR (MORE THAN 20 HOURS) ..................................... 9
DYSFUNCTIONAL LABOR (DID NOT GO FORWARD IN
A NORMAL PATTERN OF LABOR) ............................................................ 10
BREECH/MALPRESENTATION (BABY’S FEET CAME OUT FIRST) ........ 11
CEPHALOPELVIC DISPROPORTION (THE BABY’S
HEAD OR BODY IS TOO LARGE FOR THE MOTHER’S PELVIS) ............ 12
CORD PROLAPSE (UMBILICAL CORD DROPPED THROUGH CERVIX
AHEAD OF THE BABY) .............................................................................. 13
ANESTHETIC COMPLICATIONS ............................................................... 14
FETAL DISTRESS .................................................................................... 15
OTHER COMPLICATION OF LABOR AND/OR DELIVERY ....................... 16
REFUSED .................................................................................................. 88
DON'T KNOW ............................................................................................. 99
85
CHQ.091
Did {CHILD} receive any newborn care in an intensive care unit, premature nursery, or any other type of special care
facility?
YES .................................................................. 1
NO ................................................................. 2
REFUSED ..................................................... 8
DON'T KNOW ............................................... 9
CHQ.092
Before {CHILD} turned 3, did {he/she} ever receive services from a program called Early
Intervention Services or have an Individualized Family Service Plan, or IFSP?
YES. ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.095
Has {CHILD} ever had an ear infection?
YES. ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.096
1
2
8
9
(CHQ.100)
(CHQ.096)
(CHQ.096)
(CHQ.096)
Has {CHILD} ever had an ear ache?
YES. ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.100
1
2
8
9
1
2 (CHQ.330)
8 (CHQ.330)
9 (CHQ.330)
How old was {CHILD} when {he/she} had {his/her} first {ear infection/ear ache}?
PROBE: IF ANSWER GIVEN IN ONLY YEARS AND NO MONTHS, PROBE FOR NUMBER OF MONTHS AS WELL
PLEASE RECORD ANSWER IN YEARS AND/OR MONTHS. ENTER “0” FOR YEARS IF ANSWER IS ONLY GIVEN
IN MONTHS. ENTER “0” FOR MONTHS IF, AFTER PROBING, THERE ARE NO ADDITIONAL MONTHS.
CAPI INSTRUCTION: DISPLAY “ear infection” IF CHQ.095 = 1. ELSE, DISPLAY “ear ache”.
CAPI INSTRUCTION: RANGE CHECK: 0-7 IF YEARS IS THE UNIT; 0-36 IF MONTHS IS THE UNIT.
|___|
YEARS
AND
|___|___|
MONTHS
REFUSED ..................................................... 8 (CHQ.101)
DON'T KNOW ............................................... 9 (CHQ.101)
86
CHQ.101
Was {CHILD} less than 2 years old when {he/she} had {his/her} first {ear infection/ear ache}?
CAPI INSTRUCTION: DISPLAY “ear infection” IF CHQ.095 = 1. ELSE, DISPLAY “ear ache”.
YES. ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8 (CHQ.330)
9 (CHQ.330)
BOX 6
IF CHQ.096 = 1 (EAR ACHE) AND [(CHQ.100 IS (LESS THAN 2 YEARS AND 0 MONTHS) OR
(LESS THAN 0 YEARS AND 24 MONTHS)) OR (CHQ.101 = 1)], GO TO CHQ.110. ELSE, IF
CHQ.096 = 1 (EAR ACHE) AND [(CHQ.100 IS (MORE THAN OR EQUAL TO 2 YEARS AND 0
MONTHS) OR (MORE THAN OR EQUAL TO 0 YEARS AND 24 MONTHS)) OR (CHQ.101 = 2), GO
TO CHQ.140.
ELSE, IF CHQ.095 = 1 (EAR INFECTION) AND CHQ.100 IS [((LESS THAN 2 YEARS AND 0
MONTHS) OR (LESS THAN 0 YEARS AND 24 MONTHS)) OR (CHQ.101 = 1)], GO TO CHQ.105.
ELSE, IF CHQ.095 = 1 (EAR INFECTION) AND CHQ.100 IS [((MORE THAN OR EQUAL TO 2
YEARS AND 0 MONTHS) OR (MORE OR EQUAL TO THAN 0 YEARS AND 24 MONTHS)) OR
(CHQ.101 = 2)], GO TO CHQ.135.
CHQ.105
Before 2 years, or 24 months, of age, how many times did a doctor, nurse, or other medical professional tell you that
{CHILD} had an ear infection?
RECORD NUMBER OF TIMES
CAPI INSTRUCTIONS: RANGE: 0 – 15.
|___|
NUMBER OF TIMES
REFUSED .....................................................
DON'T KNOW ...............................................
BOX 6B
IF CHQ.105 GE 1, GO TO CHQ.110. ELSE, GO TO CHQ.125.
87
8
9
CHQ.110
Before 2 years, or 24 months, of age, how were {CHILD}’s {ear infections/ear aches} treated by your doctor, nurse, or
other medical professional?
CODE ALL THAT APPLY FOR 1-6.
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
NO TREATMENT/WATCH AND WAIT ...................................................... 1
DECONGESTANTS ................................................................................... 2
ANTIBIOTICS............................................................................................. 3
WITH EAR TUBES ..................................................................................... 4
ANALGESICS (E.G., FEVER REDUCER OR PAIN RELIEVER) ............... 5
EAR DROPS .............................................................................................. 6
DID NOT GO TO DOCTOR, NURSE, OR MEDICAL PROFESSIONAL .... 7 (CHQ.125)
OTHER (SPECIFY) .................................................................................... 91
REFUSED .................................................................................................. 8
DON’T KNOW ............................................................................................ 9
BOX 7
IF ONE OF THE CODES IN CHQ.110 = 91, GO TO CHQ.110OS. ELSE, GO TO BOX 8.
CHQ.110OS {Before 2 years, or 24 months, of age, how were {CHILD}’s {ear infections/ear aches} treated by your doctor, nurse, or
other medical professional?]
CAPI INSTRUCTION: DISPLAY “ear infection” IF CHQ.095 = 1. ELSE, DISPLAY “ear ache”.
SPECIFY TREATMENT.
___________________________________________________________
BOX 8
IF ONE OF THE CODES IN CHQ.110 = 4, GO TO CHQ.115. ELSE, GO TO CHQ.125.
88
CHQ.115
How old was your child when {he/she} first had surgery to place ear tubes in {his /her} ears to treat ear infections?
ENTER YEAR AND/OR MONTHS.
PROBE: IF ANSWER GIVEN AS ONE YEAR AND NO MONTHS, PROBE FOR NUMBER OF MONTHS AS WELL
PLEASE RECORD ANSWER IN YEAR AND/OR MONTHS. ENTER “0” FOR YEAR IF ANSWER IS ONLY GIVEN IN
MONTHS. ENTER “0” FOR MONTHS IF, AFTER PROBING, THERE ARE NO ADDITIONAL MONTHS.
CAPI INSTRUCTION: RANGE CHECK: 0-1 IF YEAR IS THE UNIT; 0-23 IF MONTHS IS THE UNIT.
|___|
YEAR
|___|___|
MONTHS
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.120
8
9
Have ear tubes been placed in the right ear, left ear, or both ears when your child has had surgery to place tubes in
{his/her} ears?
IF NEEDED: PLEASE CONSIDER ALL SURGERIES IF {CHILD} HAD MORE THAN ONE TO PLACE EAR TUBES
BEFORE HE/SHE TURNED 2.
RIGHT EAR. ..................................................
LEFT EAR......................................................
BOTH EARS ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.125
1
2
3
8
9
Before 2 years, or 24 months, of age, how many {other} times do you think {CHILD} had an {ear infection/ earache}
for which you did not seek medical treatment?
CAPI INSTRUCTION: DISPLAY “other” IF [(CHQ.105 NE 0, REF, OR DK) OR (CHQ.110 NE 7)].
CAPI INSTRUCTION: DISPLAY “ear infection” IF CHQ.095 = 1. ELSE, DISPLAY “ear ache”.
Never,. ...........................................................
Once, .............................................................
Twice, ............................................................
3 to 5 times, or ...............................................
6 or more times? ............................................
REFUSED .....................................................
DON'T KNOW ...............................................
89
1
2
3
4
5
8
9
CHQ.130
Before 2 years, or 24 months, of age, did {CHILD} ever have 3 or more {ear infections/ear aches} in a 12 month time
period?
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
YES. ..............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
BOX 8B
IF CHQ.095 = 1, GO TO CHQ.135. ELSE, GO TO CHQ.140.
CHQ.135
After your child’s second birthday (24 months or older) but before the start of this school year, how many times did a
doctor, nurse, or other medical professional tell you that {CHILD} had an ear infection?
RECORD NUMBER OF TIMES
CAPI INSTRUCTIONS: RANGE: 0 – 15.
|___|
NUMBER OF TIMES
REFUSED .....................................................
DON'T KNOW ...............................................
8
9
BOX 9
IF CHQ.135 GE 1, GO TO CHQ.140. ELSE, GO TO CHQ.155.
CHQ.140
After your child’s second birthday (24 months or older), how were {CHILD}’s {ear infections/ear aches} treated by
your doctor, nurse, or other medical professional?
CODE ALL THAT APPLY FOR 1-6.
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
NO TREATMENT/WATCH AND WAIT ...................................................... 1
DECONGESTANTS ................................................................................... 2
ANTIBIOTICS............................................................................................. 3
WITH EAR TUBES ..................................................................................... 4
ANALGESICS (E.G., FEVER REDUCER OR PAIN RELIEVER) ............... 5
EAR DROPS .............................................................................................. 6
DID NOT GO TO DOCTOR, NURSE, OR MEDICAL PROFESSIONAL .... 7 (CHQ.155)
OTHER (SPECIFY) .................................................................................... 91
REFUSED .................................................................................................. 8
DON’T KNOW ............................................................................................ 9
90
BOX 10
IF ONE OF THE CODES IN CHQ.140 = 91, GO TO CHQ.140OS. ELSE, GO TO BOX 11.
CHQ.140OS
After your child’s second birthday (24 months or older), how were {CHILD}’s {ear infections/ear aches} treated by
your doctor, nurse, or other medical professional?
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
SPECIFY TREATMENT.
___________________________________________________________
BOX 11
IF (ONE OF THE CODES IN CHQ.110 = 4) AND (ONE OF THE CODES IN CHQ.140 = 4), GO TO
CHQ.150. ELSE, IF ONE OF THE CODES IN CHQ.140 = 4, GO TO CHQ.145. ELSE, GO TO
CHQ.155.
CHQ.145
How old was your child when he/she first had surgery to place ear tubes in {his/her} ears to treat {ear infections/ear
aches}?
ENTER NUMBER OF YEARS AND/OR MONTHS.
PROBE: IF ANSWER GIVEN IN YEARS AND NOT MONTHS, PROBE FOR NUMBER OF MONTHS AS WELL
PLEASE RECORD ANSWER IN YEARS AND/OR MONTHS. ENTER “0” FOR YEARS IF ANSWER IS ONLY GIVEN
IN MONTHS. ENTER “0” FOR MONTHS IF, AFTER PROBING, THERE ARE NO ADDITIONAL MONTHS.
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
CAPI INSTRUCTION: RANGE CHECK: 0-7 IF YEARS IS THE UNIT; 0-36 IF MONTHS IS THE UNIT.
|___|
YEARS
|___|___|
MONTHS
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.150
8
9
Have ear tubes been placed in the right ear, left ear, or both ears when your child has had surgery to place ear tubes in
{his/her} ears {after {his/her} second birthday, but before the start of this school year}?
CAPI INSTRUCTIONS: DISPLAY “after {his/her} second birthday?” IF ONE OF THE CODES IN CHQ.110 = 4. ELSE,
USE A NULL DISPLAY.
RIGHT EAR. ..................................................
LEFT EAR......................................................
BOTH EARS ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
91
1
2
3
8
9
CHQ.155
After your child’s second birthday (24 months or older) but before the start of this school year, how many {other}
times do you think {CHILD} has had an {ear infection/earache} for which you did not seek medical treatment?
CAPI INSTRUCTION: DISPLAY “other” IF [(CHQ.135 NE 0, REF, OR DK) OR (CHQ.140 = 7)].
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
Never,. ...........................................................
Once, .............................................................
Twice, ............................................................
3 to 5 times, or ...............................................
6 or more times? ............................................
REFUSED .....................................................
DON'T KNOW ...............................................
CHQ.326
1
2
3
4
5
8
9
After your child’s second birthday (24 months or older) but before the start of this school year, did {CHILD} ever have 3
or more {ear infections/ear aches} in a 12 month time period?
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.095 = 1. ELSE, DISPLAY “ear aches”.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CHQ.330
1
2
8
9
Would you say {CHILD}'s health is ...
Excellent, .......................................................
Very good, .....................................................
Good, .............................................................
Fair, or ...........................................................
Poor? .............................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
4
5
8
9
BOX 12
n
GO TO SECTION SSQ (SOCIAL SKILLS, PROBLEM BEHAVIORS, AND APPROACHES
TOWARD LEARNING).
92
SOCIAL SKILLS, PROBLEM BEHAVIORS, AND APPROACHES TOWARD LEARNING - SSQ
SSQ.010
I am going to read you a list of statements describing things that children sometimes do. For each statement, I want
you to tell me how often {CHILD} acts in this way.
Rounds: 1, 2, 3, 4
Source: K1.SSQ.010
How often does {CHILD}:
PROBE: Would you say never, sometimes, often or very often?
RESPONSES: 1 = NEVER, 2 = SOMETIMES, 3 = OFTEN, 4 = VERY OFTEN, 8 = REFUSED,
9 = DON'T KNOW
CAPI INSTRUCTIONS: DISPLAY “I…way.” and “How often does {CHILD}:” IN BRACKETS FOR B-U. DISPLAY
“I…way.” and “How…{CHILD}:” AND “How often is {CHILD}:” IN BRACKETS FOR W AND X.
a.
Easily join others in play? Would you say never, sometimes,
often, or very often? .......................................................................... ___
b. Respond appropriately to teasing? ................................................... ___
c. Make and keep friends? ................................................................... ___
d. Comfort or help others? .................................................................... ___
e. Worry about things? ......................................................................... ___
f. Listen carefully to others? ................................................................. ___
g. Act sad? ........................................................................................... ___
h. Control {his/her} temper? .................................................................. ___
i. Cooperate with family members? ..................................................... ___
j. Keep working at something until {he/she} is finished? ...................... ___
k. Argue with others? ............................................................................ ___
l. Fight with others? ............................................................................. ___
m. Show interest in a variety of things? ................................................. ___
n. Have a tantrum when {he/she} does not get {his/her} way? ............. ___
o. Concentrate on a task and ignore distractions? ............................... ___
p. Easily become angry? ...................................................................... ___
q. Appear to be lonely? ......................................................................... ___
r. Help with chores? ............................................................................. ___
s. Have a problem being accepted and liked by others? ..................... ___
t. Act impulsively? ................................................................................ ___
u. Show low self-esteem? ..................................................................... ___
How often is {CHILD}:
v.
w.
x.
Eager to learn new things? ............................................................... ___
Hyperactive? .................................................................................... ___
Creative in work or in play? .............................................................. ___
BOX 1
n
GO TO SECTION MHQ (PARENT MARITAL HISTORY).
93
PARENT MARITAL HISTORY - MHQ
MHQ.010
Next are a few questions about {your/{CHILD}'s parents'} marital history.
CAPI INSTRUCTION: DISPLAY "your" IF A MOTHER OR FATHER FIGURE IS THE RESPONDENT (FSQ.130 = 1 OR
2 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). OTHERWISE, DISPLAY "{CHILD}'S
parents".
BOX 1
1.
IF [(RESPONDENT IS BIOLOGICAL PARENT (FSQ.140 = 1 OR FSQ.150 =1 FOR THE HOUSEHOLD
MEMBER FLAGGED AS THE RESPONDENT)) AND
((NO OTHER PARENT IS IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE ‘1’ OR ‘2’ AT
FSQ.130 - OTHER THAN THE RESPONDENT) OR
(SECOND PARENT IS NONBIOLOGICAL PARENT (FSQ.130 = 1 OR 2 BUT FSQ.140 IS NOT CODED ‘1’
AND FSQ.150 IS NOT CODED ‘1’ OR FSQ.130 = 5 OR 6 FOR A HOUSEHOLD MEMBER WHO IS NOT
THE RESPONDENT))] AND [THE BIOLOGICAL PARENT RESPONDENT IS NOT MARRIED (FSQ.200 NE
1)], AUTOCODE THAT BIOLOGICAL PARENT IS NOT MARRIED TO A NON-BIOLOGICAL PARENT
(MHQ.040 = 2) AND GO TO MHQ.045 (TO ASK ABOUT COHABITATION).
2.
ELSE, IF [(RESPONDENT IS BIOLOGICAL PARENT (FSQ.140 = 1 OR FSQ.150 =1 FOR THE
HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT)) AND
((NO OTHER PARENT IS IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE ‘1’ OR ‘2’ AT
FSQ.130 - OTHER THAN THE RESPONDENT) OR
(SECOND PARENT IS NONBIOLOGICAL PARENT (FSQ.130 = 1 OR 2 BUT FSQ.140 IS NOT CODED ‘1’
AND FSQ.150 IS NOT CODED ‘1’ OR FSQ.130 = 5 OR 6 FOR A HOUSEHOLD MEMBER WHO IS NOT
THE RESPONDENT))] AND [THE BIOLOGICAL PARENT RESPONDENT IS MARRIED (FSQ.200 EQ 1)],
GO TO MHQ.040 (TO ASK IF BIOLOGICAL PARENT IS MARRIED TO A NON-BIOLOGIAL PARENT).
3.
ELSE, IF [(RESPONDENT IS NOT A BIOLOGICAL PARENT, BUT ONE BIOLOGICAL PARENT IS IN
HOUSEHOLD (FSQ.140 = 1 OR FSQ.150 = 1 FOR A HOUSEHOLD MEMBER WHO IS NOT FLAGGED AS
THE RESPONDENT)) AND (RESPONDENT IS NOT SOMEONE WHO COULD BE A PARTNER TO
HIM/HER (FSQ.130 IS NOT CODED ‘1’, ‘2’, ‘5’, OR ‘6’ FOR A HOUSEHOLD MEMBER WHO IS NOT THE
RESPONDENT))] AND [THE BIOLOGICAL PARENT IS NOT MARRIED (FSQ.200 NE 1)], AUTOCODE
THAT BIOLOGICAL PARENTS ARE NOT MARRIED (MHQ.060 = 2), AND GO TO MHQ.070 (TO ASK
ABOUT COHABITATION).
4.
ELSE, IF [(RESPONDENT IS NOT A BIOLOGICAL PARENT, BUT ONE BIOLOGICAL PARENT IS IN
HOUSEHOLD (FSQ.140 = 1 OR FSQ.150 = 1 FOR A HOUSEHOLD MEMBER WHO IS NOT FLAGGED AS
THE RESPONDENT)) AND (RESPONDENT IS NOT SOMEONE WHO COULD BE A PARTNER TO
HIM/HER (FSQ.130 IS NOT CODED ‘1’, ‘2’, ‘5’, OR ‘6’ FOR A HOUSEHOLD MEMBER WHO IS NOT THE
RESPONDENT))] AND [THE BIOLOGICAL PARENT IS MARRIED (FSQ.200 NE 1)], GO TO MHQ.060 (TO
ASK IF THE BIOLOGICAL PARENTS ARE MARRIED TO EACH OTHER).
94
5.
ELSE, IF [(RESPONDENT IS NOT A BIOLOGICAL PARENT, BUT ONE BIOLOGICAL PARENT IS IN HOUSEHOLD
(FSQ.140 = 1 OR FSQ.150 = 1 FOR A HOUSEHOLD MEMBER WHO IS NOT FLAGGED AS THE RESPONDENT))
AND (RESPONDENT IS A NONBIOLOGICAL PARENT OR SPOUSE/PARTNER OF RESIDENT BIOLOGICAL
PARENT (FSQ.130 = 1 OR 2 BUT FSQ.140 IS NOT CODED ‘1’ AND FSQ.150 IS NOT CODED ‘1’ OR FSQ.130 = 5
OR 6 FOR THE HOUSEHOLD MEMBER WHO IS FLAGGED AS THE RESPONDENT))] AND THE RESPONDENT IS
NOT MARRIED (FSQ.200 NE 1), AUTOCODE THAT THE RESPONDENT AND THE BIOLOGICAL PARENT ARE
NOT MARRIED (MHQ.080 = 2) AND GO TO MHQ.090 (TO ASK ABOUT COHABITATION).
6.
ELSE, IF [(RESPONDENT IS NOT A BIOLOGICAL PARENT, BUT ONE BIOLOGICAL PARENT IS IN HOUSEHOLD
(FSQ.140 = 1 OR FSQ.150 = 1 FOR A HOUSEHOLD MEMBER WHO IS NOT FLAGGED AS THE RESPONDENT))
AND (RESPONDENT IS A NONBIOLOGICAL PARENT OR SPOUSE/PARTNER OF RESIDENT BIOLOGICAL
PARENT (FSQ.130 = 1 OR 2 BUT FSQ.140 IS NOT CODED ‘1’ AND FSQ.150 IS NOT CODED ‘1’ OR FSQ.130 = 5
OR 6 FOR THE HOUSEHOLD MEMBER WHO IS FLAGGED AS THE RESPONDENT))] AND THE RESPONDENT IS
MARRIED (FSQ.200 EQ 1), GO TO MHQ.080 (TO ASK IF THE RESPONDENT IS MARRIED TO THE BIOLOGICAL
PARENT).
7.
ELSE, IF NO BIOLOGICAL PARENTS ARE IN HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH A CODE ‘1’ AT
FSQ.140 OR WITH A CODE ‘1’ AT FSQ.150), GO TO MHQ.100 (TO ASK IF THE RESPONDENT IS MARRIED).
8.
ELSE, IF [THERE ARE TWO BIOLOGICAL PARENTS IN THE HOUSEHOLD AND THE RESPONDENT IS ONE OF
THEM (FSQ.140 = 1 OR FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT AND
ANOTHER HOUSEHOLD MEMBER)] AND [THEY ARE NOT MARRIED (FSQ.200 NE 1)], AUTOCODE THAT THE
BIOLOGICAL PARENT RESPONDENT IS NOT MARRIED TO THE OTHER BIOLOGICAL PARENT (MHQ.020 = 2)
AND GO TO MHQ. 030 (TO ASK ABOUT COHABITATION).
9.
ELSE, IF [THERE ARE TWO BIOLOGICAL PARENTS IN THE HOUSEHOLD AND THE RESPONDENT IS ONE OF
THEM (FSQ.140 = 1 OR FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT AND
ANOTHER HOUSEHOLD MEMBER)] AND [THEY ARE MARRIED (FSQ.200 EQ 1)], CONTINUE WITH MHQ.020
(TO ASK IF THE BIOLOGICAL PARENT RESPONDENT IS MARRIED TO THE OTHER BIOLOGICAL PARENT).
MHQ.020
Are you legally married to {CHILD}'s biological {father/mother}?
CAPI INSTRUCTION: DISPLAY "father" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). DISPLAY "mother" IF THE BIOLOGICAL FATHER
IS THE RESPONDENT (FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
YES ...............................................................
NO .................................................................
NO, MARRIED TO SAME SEX PARTNER....
NO, LIVING WITH SAME SEX PARTNER ....
REFUSED......................................................
DON’T KNOW ................................................
MHQ.025
1
2
3
4
8
9
(MHQ.030)
(MHQ.096)
(MHQ.098)
(MHQ.030)
(MHQ.030)
When did you get married?
THIS REFERS TO RESPONDENT'S CURRENT MARRIAGE.
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.165)
REFUSED...................................................... 888 (MHQ.165)
DON’T KNOW ................................................ 999 (MHQ.165)
95
MHQ.030
Are you and {CHILD}'s biological {father/mother} currently living together in a marriage-like relationship?
CAPI INSTRUCTION: DISPLAY "father" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). DISPLAY "mother" IF THE BIOLOGICAL FATHER
IS THE RESPONDENT (FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.035
1
2 (MHQ.040)
8 (MHQ.040)
9 (MHQ.040)
When did you and {CHILD}'s biological {father/mother} begin living together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
CAPI INSTRUCTION: DISPLAY "father" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). DISPLAY "mother" IF THE BIOLOGICAL FATHER
IS THE RESPONDENT (FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.165)
REFUSED...................................................... 888 (MHQ.165)
DON’T KNOW ................................................ 999 (MHQ.165)
MHQ.040
Are you legally married to someone who is not {CHILD}'s biological {father/mother} at the present time?
CAPI INSTRUCTION: DISPLAY “not” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "father" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). DISPLAY "mother" IF THE BIOLOGICAL FATHER
IS THE RESPONDENT (FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.045
1 (MHQ.050)
2
8
9
Are you currently living in a marriage-like relationship with someone who is not {CHILD}'s biological {father/mother}?
CAPI INSTRUCTION: DISPLAY “not” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY "father" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). DISPLAY "mother" IF THE BIOLOGICAL FATHER
IS THE RESPONDENT (FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
96
1
2
8
9
(MHQ.055)
(MHQ.125)
(MHQ.125)
(MHQ.125)
MHQ.050
When did your current marriage begin?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.125)
REFUSED...................................................... 888 (MHQ.125)
DON’T KNOW ................................................ 999 (MHQ.125)
MHQ.055
When did you and this person begin living together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.125)
REFUSED...................................................... 888 (MHQ.125)
DON’T KNOW ................................................ 999 (MHQ.125)
MHQ.060
Are {CHILD}'s biological parents legally married?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.065
1
2 (MHQ.070)
8 (MHQ.070)
9 (MHQ.070)
When did their marriage begin?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.165)
REFUSED...................................................... 888 (MHQ.165)
DON’T KNOW ................................................ 999 (MHQ.165)
MHQ.070
Are {CHILD}'s biological parents currently living together in a marriage-like relationship?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
97
1
2 (MHQ.125)
8 (MHQ.125)
9 (MHQ.125)
MHQ.075
When did {CHILD}'s biological parents begin living together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.165)
REFUSED...................................................... 888 (MHQ.165)
DON’T KNOW ................................................ 999 (MHQ.165)
MHQ.080
Are you and {CHILD}'s biological parent legally married?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.085
1
2 (MHQ.090)
8 (MHQ.090)
9 (MHQ.090)
When did you get married?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.125)
REFUSED...................................................... 888 (MHQ.125)
DON’T KNOW ................................................ 999 (MHQ.125)
MHQ.090
Are you and {CHILD}'s biological parent living together in a marriage-like relationship?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.095
1
2 (MHQ.125)
8 (MHQ.125)
9 (MHQ.125)
When did you first start living together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.125)
REFUSED...................................................... 888 (MHQ.125)
DON’T KNOW ................................................ 999 (MHQ.125)
MHQ.096
Are you legally married?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
98
1
2 (MHQ.098)
8 (MHQ.098)
9 (MHQ.098)
MHQ.097
When did you get married?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.125)
REFUSED...................................................... 888 (MHQ.125)
DON’T KNOW ................................................ 999 (MHQ.125)
MHQ.098
Are you living with someone in a marriage-like relationship?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.099
1
2 (MHQ.125)
8 (MHQ.125)
9 (MHQ.125)
When did you begin living together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED...................................................... 888 (MHQ.125)
DON’T KNOW ................................................ 999 (MHQ.125)
MHQ.100
Are you legally married?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.105
1
2 (MHQ.110)
8 (MHQ.110)
9 (MHQ.110)
When did you get married?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.120)
REFUSED...................................................... 888 (MHQ.120)
DON’T KNOW ................................................ 999 (MHQ.120)
MHQ.110
Are you living with someone in a marriage-like relationship?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
99
1
2 (MHQ.120)
8 (MHQ.120)
9 (MHQ.120)
MHQ.115
When did you begin living together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
MHQ.120
{[Next are a few question about {CHILD}'s biological parents. We understand that some of these questions may be
difficult {for adoptive parents} to answer, however, these are standard questions we ask when a child does not live with
{his/her} biological parents. Any information you can provide will be helpful.]} To the best of your knowledge, are
{CHILD}'s biological parents currently legally married to each other?
CAPI INSTRUCTION: DISPLAY "[Next are …. be helpful.]" IF THERE ARE NO BIOLOGICAL
PARENTS IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140 OR
FSQ.150. OTHERWISE, USE A NULL DISPLAY.
YES ...............................................................
NO .................................................................
BIOLOGICAL PARENTS UNKNOWN ...........
REFUSED......................................................
DON’T KNOW ................................................
MHQ.125
1 (MHQ.130)
2
3 (BOX 6)
8
9
[To the best of your knowledge] {Have you/Has {CHILD}'s biological {mother/father}} EVER been married
to {CHILD}'s biological {father/mother}?
CAPI INSTRUCTION: DISPLAY "Have you" AND “father” IN THE LAST FILL IF THE RESPONDENT IS A
BIOLOGICAL MOTHER (FSQ.140 =1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
DISPLAY "Have you" AND “mother” IN THE LAST FILL IF THE RESPONDENT IS A BIOLOGICAL FATHER (FSQ.150
= 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
OTHERWISE, DISPLAY "Has {CHILD}'s biological {mother/father}".
DISPLAY "mother" (SECOND FILL) and "father" (NEXT FILL) IF THE RESPONDENT IS A FATHER
FIGURE/PARTNER (FSQ.130 = 2 OR 6 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE
RESPONDENT) OR IF THERE ARE NOT BIOLOGICAL PARENTS IN THE HOUSEHOLD (FSQ.140 AND
FSQ.150 DO NOT EQUAL 1 FOR ANY HOUSEHOLD MEMBER). OTHERWISE, DISPLAY "father" (SECOND FILL) and
"mother" (NEXT FILL).
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
100
1
2 (MHQ.150)
8 (MHQ.150)
9 (MHQ.150)
MHQ.130
[To the best of your knowledge] When did that marriage begin?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
BOX 2
n
n
MHQ.135
IF BIOLOGICAL PARENTS CURRENTLY MARRIED (MHQ.120 = 1), GO TO BOX 4.
OTHERWISE, CONTINUE WITH MHQ.135.
[To the best of your knowledge] Did that marriage end in…
Legal separation, ...........................................
Divorce, ........................................................
Annulment, or ................................................
Death ? ......................................................... .
REFUSED......................................................
DON’T KNOW ................................................
1
2
3
4
8
9
BOX 3
n
MHQ.136
IF THE MARRIAGE ENDED IN DEATH (MHQ.135 = 3), GO TO BOX 4. ELSE, GO TO
MHQ.136.
In what month and year did the marriage legally end?
CAPI INSTRUCTION: DISPLAY “father” IF THE RESPONDENT IS A BIOLOGICAL MOTHER (FSQ.140 =1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT) OR IF THERE ARE NOT BIOLOGICAL
PARENTS IN THE HOUSEHOLD (FSQ.140 AND FSQ.150 DO NOT EQUAL 1 FOR ANY HOUSEHOLD MEMBER).
DISPLAY “mother” IF THE RESPONDENT IS A BIOLOGICAL FATHER (FSQ.150 = 1 FOR THE HOUSEHOLD
MEMBER FLAGGED AS THE RESPONDENT).
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
101
BOX 4
n
n
MHQ.145
IF RESPONDENT IS THE BIOLOGICAL MOTHER OR FATHER, OR THE BIOLOGICAL
MOTHER OR FATHER IS IN THE HOUSEHOLD, GO TO MHQ.160.
OTHERWISE, CONTINUE WITH MHQ.145.
[To the best of your knowledge] When did {CHILD} stop living in a household with at least one biological parent?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 2003-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
(MHQ.165)
REFUSED...................................................... 888 (MHQ.165)
DON’T KNOW ................................................ 999 (MHQ.165)
MHQ.150
[To the best of your knowledge] Since {CHILD} was born, have {you/{CHILD}'s biological {mother/father}} and
{CHILD}'s biological {father/mother} ever lived together in a marriage-like relationship?
CAPI INSTRUCTION: DISPLAY "you" IF THE RESPONDENT IS A BIOLOGICAL MOTHER OR BIOLOGICAL
FATHER (FSQ.140 =1 OR FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
OTHERWISE, DISPLAY "{CHILD}'S BIOLOGICAL {mother/father}". DISPLAY "mother" and "father" (NEXT FILL) IF
THE RESPONDENT IS A FATHER FIGURE/PARTNER (FSQ.130 = 2 OR 6 FOR THE HOUSEHOLD MEMBER
FLAGGED AS THE RESPONDENT) OR IF THERE ARE NOT BIOLOGICAL PARENTS IN THE HOUSEHOLD
(FSQ.140 AND FSQ.150 DO NOT EQUAL 1 FOR ANY HOUSEHOLD MEMBER). OTHERWISE, DISPLAY "father"
and "mother".
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.155
1
2 (MHQ.165)
8 (MHQ.165)
9 (MHQ.165)
[To the best of your knowledge] When did {you/{CHILD}'s biological {mother/father}} and {CHILD}'s biological
{father/mother} first live together in the same household?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
CAPI INSTRUCTION: DISPLAY "you" IF THE RESPONDENT IS A BIOLOGICAL MOTHER OR BIOLOGICAL
FATHER (FSQ.140 =1 OR FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
OTHERWISE, DISPLAY "{CHILD}'S BIOLOGICAL {mother/father}". DISPLAY "mother" and "father" (NEXT FILL) IF
THE RESPONDENT IS A FATHER FIGURE/PARTNER (FSQ.130 = 2 OR 6 FOR THE HOUSEHOLD MEMBER
FLAGGED AS THE RESPONDENT) OR IF THERE ARE NOT BIOLOGICAL PARENTS IN THE HOUSEHOLD
(FSQ.140 AND FSQ.150 DO NOT EQUAL 1 FOR ANY HOUSEHOLD MEMBER). OTHERWISE, DISPLAY "father"
and "mother".
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
102
MHQ.160
[To the best of your knowledge] When did {you/{CHILD}'s biological {mother/father}} and {CHILD}'s biological
{father/mother} last live together?
CAPI INSTRUCTION: RANGE CHECK: 1-12 FOR MONTH; 1975-2010 FOR YEAR.
CAPI INSTRUCTION: DATE RECORDED AT MHQ.160 MUST BE AFTER DATE RECORDED AT MHQ.155 OR
MHQ.130.
CAPI INSTRUCTION: DISPLAY "you" IF THE RESPONDENT IS A BIOLOGICAL MOTHER OR BIOLOGICAL
FATHER (FSQ.140 =1 OR FSQ.150 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT).
OTHERWISE, DISPLAY "{CHILD}'S BIOLOGICAL {mother/father}". DISPLAY "mother" and "father" (NEXT FILL) IF
THE RESPONDENT IS A FATHER FIGURE/PARTNER (FSQ.130 = 2 OR 6 FOR THE HOUSEHOLD MEMBER
FLAGGED AS THE RESPONDENT) OR IF THERE ARE NOT BIOLOGICAL PARENTS IN THE HOUSEHOLD
(FSQ.140 AND FSQ.150 DO NOT EQUAL 1 FOR ANY HOUSEHOLD MEMBER). OTHERWISE, DISPLAY "father"
and "mother".
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
MHQ.165
How old {were you/was {CHILD}'s biological mother} when {you/she} had a child for the first time?
CAPI INSTRUCTION: RANGE CHECK: 12-55 FOR AGE IN YEARS.
CAPI INSTRUCTION: DISPLAY "were you" AND "you" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT
(FSQ.140 = 1 FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). OTHERWISE, DISPLAY "was
{CHILD}'S biological mother" AND "she".
|___|___|
ENTER AGE IN YEARS
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
103
BOX 4
n
IF BIOLOGICAL MOTHER WAS MARRIED OR LIVING AS MARRIED WHEN CHILD WAS
BORN (THE DATE OF MARRIAGE/LIVING AS MARRIED ENTERED AT MHQ.025,
MHQ.035, MHQ.050, MHQ.055, MHQ.065, MHQ.075, MHQ.085, MHQ.095, MHQ.130, OR
MHQ.155 IS BEFORE THE FOCAL CHILD'S DATE OF BIRTH), GO TO BOX 6.
NOTE: THE RESPONDENT MUST BE THE BIOLOGICAL MOTHER (FSQ.140 = 1 FOR
THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT) IN ORDER FOR THE
DATE AT MHQ.050 AND MHQ.055 TO QUALIFY FOR THIS CHECK.
NOTE: THE BIOLOGICAL MOTHER MUST BE IN THE HOUSEHOLD (FSQ.140 = 1 FOR
A HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT) IN ORDER FOR THE
DATE AT MHQ.085 AND MHQ.095 TO QUALIFY FOR THIS CHECK.
NOTE: AS LONG AS THE YEAR IN THESE QUESTIONS IS BEFORE THE YEAR OF
CHILD'S BIRTH, THE MONTH CAN BE DON'T KNOW/REFUSED. IF THE YEAR IN
THESE QUESTIONS AND THE YEAR OF THE FOCAL CHILD'S BIRTH ARE THE SAME,
COMPARE THE MONTHS (THE MONTH MUST BE BEFORE THE MONTH OF THE
CHILD'S BIRTH).
n
MHQ.175
OTHERWISE, CONTINUE WITH MHQ.175.
I just wanted to double check: {Were you/Was {CHILD}'s biological mother} married to anyone when {CHILD} was
born?
CAPI INSTRUCTION: DISPLAY "Were you" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1
FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). OTHERWISE, DISPLAY "Was {CHILD}'S
biological mother".
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
MHQ.180
1 (BOX 6)
2
8
9
{Were you/Was {CHILD}'s biological mother} living in a marriage-like relationship with anyone when {CHILD} was born?
CAPI INSTRUCTION: DISPLAY "Were you" IF THE BIOLOGICAL MOTHER IS THE RESPONDENT (FSQ.140 = 1
FOR THE HOUSEHOLD MEMBER FLAGGED AS THE RESPONDENT). OTHERWISE, DISPLAY "Was {CHILD}'S
biological mother".
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
BOX 6
n
GO TO SECTION HRQ (HISTORICAL ROSTER).
104
1
2
8
9
HISTORICAL ROSTER - HRQ
BOX 1
n
n
IF THERE IS NO BIOLOGICAL MOTHER (NO HOUSEHOLD MEMBER WITH A CODE ‘1’
AT FSQ.140) OR NO BIOLOGICAL FATHER (NO HOUSEHOLD MEMBER WITH A
CODE ‘1’ AT FSQ.150) CURRENTLY LIVING IN THE HOUSEHOLD, CONTINUE WITH
BOX 2.
OTHERWISE, GO TO BOX 5.
BOX 2
LOOP 1
n
ASK HRQ.030-HRQ.120 ONE TIME FOR EACH BIOLOGICAL MOTHER (NO
HOUSEHOLD MEMBER WITH A CODE ‘1’ AT FSQ.140) AND/OR BIOLOGICAL FATHER
(NO HOUSEHOLD MEMBER WITH A CODE ‘1’ AT FSQ.150) WHO IS NOT CURRENTLY
LIVING IN THE HOUSEHOLD.
HRQ.030
I'd like to ask you a few questions about {CHILD}'s biological {mother/father}. Is {CHILD}'s biological {mother/father}
currently living?
CODE ‘3’ IF RESPONDENT VOLUNTEERS DON’T KNOW WHO BIOLOGICAL {MOTHER/FATHER} IS.
CAPI INSTRUCTION: DISPLAY "mother" IF LOOPING ON BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN
THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140). DISPLAY "father" IF LOOPING ON
BIOLOGICAL FATHER NOT CURRENTLY LIVING IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A
CODE '1' AT FSQ.150).
YES ...............................................................
NO .................................................................
DON’T KNOW WHO BIOLOGICAL
{MOTHER/FATHER} IS ...............................
REFUSED......................................................
DON’T KNOW ................................................
105
1
2
3 (BOX 5)
8
9
HRQ.040
What {was/is/} {CHILD}'s biological {mother’s/father’s} date of birth?
ONLY MONTH AND YEAR IS NECESSARY.
CAPI INSTRUCTION: DISPLAY “was” if HRQ.030 = 2. ELSE, DISPLAY “is”.
CAPI INSTRUCTION: DISPLAY "mother" IF LOOPING ON BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN
THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140). DISPLAY "father" IF LOOPING ON
BIOLOGICAL FATHER NOT CURRENTLY LIVING IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A
CODE '1' AT FSQ.150).
CAPI INSTRUCTION: RANGE CHECK 1-12 FOR MONTH, 1920-1994 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___||___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
BOX 3
n
n
n
HRQ.060
IF A YEAR IS ENTERED AT HRQ.040 AND BIOLOGICAL PARENT IS DECEASED
(HRQ.030=2), GO TO HRQ.060.
IF (A YEAR IS ENTERED OR YEAR IS REF/DK AT HRQ.040 (HRQ.040 HAS THE YEAR
OR WAS ANSWERED 888 OR 999)) AND (BIOLOGICAL PARENT IS NOT DECEASED
OR ANSWER TO WHETHER LIVING WAS REF/DK (HRQ.030=1, 8, 9)), GO TO
HRQ.090.
OTHERWISE, CONTINUE WITH HRQ.060.
How old {is/was} {CHILD}'s biological {mother/father} {when {he/she} died}?
CAPI INSTRUCTION: DISPLAY "mother" IF LOOPING ON BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN
THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140). DISPLAY "father" IF LOOPING ON
BIOLOGICAL FATHER NOT CURRENTLY LIVING IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A
CODE '1' AT FSQ.150).
CAPI INSTRUCTION: DISPLAY "is" IF BIOLOGICAL PARENT (CURRENTLY BEING ASKED ABOUT) IS NOT
DECEASED (HRQ.030=1, 8, 9). OTHERWISE, DISPLAY "was".
CAPI INSTRUCTION: DISPLAY "when {he/she} died" IF BIOLOGICAL PARENT (CURRENTLY BEING ASKED)
ABOUT IS DECEASED (HRQ.030=2). DISPLAY “he” IF LOOPING ON THE FATHER. ELSE, DISPLAY “she” IF
LOOPING ON THE MOTHER.
CAPI INSTRUCTION: RANGE CHECK 12-90.
|___|___|
ENTER AGE IN YEARS
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
106
BOX 4
n
n
HRQ.080
IF BIOLOGICAL PARENT IS DECEASED (HRQ.030=2), CONTINUE WITH HRQ.080.
OTHERWISE, GO TO HRQ.090.
What is {CHILD}'s biological {mother’s/father’s} date of death?
ONLY MONTH AND YEAR IS NECESSARY.
CAPI INSTRUCTION: DISPLAY "mother" IF LOOPING ON BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN
THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140). DISPLAY "father" IF LOOPING ON
BIOLOGICAL FATHER NOT CURRENTLY LIVING IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A
CODE '1' AT FSQ.150).
CAPI INSTRUCTION: RANGE CHECK 1-12 FOR MONTH, 2002-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___||___|___|
ENTER YEAR
REFUSED...................................................... 888
DON’T KNOW ................................................ 999
HRQ.090
{Is/Was} {he/she} Hispanic or Latino?
CAPI INSTRUCTION: DISPLAY "Is" IF BIOLOGICAL PARENT (CURRENTLY BEING ASKED ABOUT) IS NOT
DECEASED (HRQ.030=1, 8, 9). OTHERWISE, DISPLAY "Was".
CAPI INSTRUCTION: DISPLAY "he" IF LOOPING ON BIOLOGICAL FATHER NOT CURRENTLY LIVING IN THE
HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140). DISPLAY "she" IF LOOPING ON
BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A
CODE '1' AT FSQ.150).
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
107
1
2
8
9
HRQ.100
What {is/was} {his/her} race? You may name one or more races to indicate what {he/she} considers {himself/herself} to
be.
CAPI INSTRUCTION: DISPLAY "is" IF BIOLOGICAL PARENT (CURRENTLY BEING ASKED ABOUT) IS NOT
DECEASED (HRQ.030=1, 8, 9). OTHERWISE, DISPLAY "was".
CAPI INSTRUCTION:
DISPLAY “his”, "he", AND “himself” IF LOOPING ON BIOLOGICAL FATHER NOT
CURRENTLY LIVING IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140). DISPLAY
“her”, "she", AND “herself” IF LOOPING ON BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN THE HOUSEHOLD
(NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.150).
CODE ALL THAT APPLY
AMERICAN INDIAN OR ALASKA NATIVE ...
ASIAN ............................................................
BLACK OR AFRICAN AMERICAN ................
NATIVE HAWAIIAN OR OTHER
PACIFIC ISLANDER ...................................
WHITE ...........................................................
REFUSED......................................................
DON’T KNOW ................................................
HRQ.110
1
2
3
4
5
8
9
To the best of your knowledge, {has/did} {CHILD} ever {lived/live} with {his/her} biological {mother/father}?
{CODE ‘3’ IF RESPONDENT VOLUNTEERS FATHER WAS DECEASED BEFORE CHILD WAS BORN.}
{CODE ‘4’ IF RESPONDENT VOLUNTEERS MOTHER WAS DECEASED BEFORE/WHEN CHILD WAS BORN.}
CAPI INSTRUCTION: DISPLAY "has" AND "lived" IF BIOLOGICAL PARENT CURRENTLY BEING ASKED ABOUT IS
NOT DECEASED (HRQ.030=1, 8, 9). OTHERWISE, DISPLAY "did" AND "live".
CAPI INSTRUCTION: DISPLAY “his” IF THE CHILD IS MALE. ELSE, DISPLAY “her” IF THE CHILD IS FEMALE.
CAPI INSTRUCTION: DISPLAY "CODE '3' IF … WAS BORN" AND "FATHER DECEASED … 3 (BOX 5)" IF
CURRENTLY ASKING ABOUT THE BIOLOGICAL FATHER NOT CURRENTLY LIVING IN THE HOUSEHOLD.
CAPI INSTRUCTION: DISPLAY "CODE '4' IF … WAS BORN" AND "MOTHER DECEASED … 4 (BOX 5)" IF
CURRENTLY ASKING ABOUT THE BIOLOGICAL MOTHER NOT CURRENTLY LIVING IN THE HOUSEHOLD.
YES ...............................................................
NO .................................................................
{FATHER DECEASED BEFORE
CHILD BORN...............................................
{MOTHER DECEASED BEFORE/WHEN
CHILD BORN
REFUSED......................................................
DON’T KNOW ................................................
108
1
2 (BOX 5)
3 (BOX 5)}
4 (BOX 5)
8 (BOX 5)
9 (BOX 5)
HRQ.120
When did {CHILD}'s {mother/father} last live in the same household as {CHILD}?
CAPI INSTRUCTION: RANGE CHECK 1-12 FOR MONTH, 2003-2010 FOR YEAR.
|___|___|
ENTER MONTH
AND
|___|___||___|___|
ENTER YEAR
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
BOX 5
n
GO TO SECTION NRQ (NON-RESIDENT PARENT QUESTIONS).
109
NON-RESIDENT PARENT QUESTIONS - NRQ
BOX 1
n
n
IF BOTH BIOLOGICAL PARENTS (CODED ‘1’ AT FSQ.140 FOR AT LEAST ONE
HOUSEHOLD MEMBER AND CODED ‘1’ AT FSQ.150 FOR AT LEAST ONE
HOUSEHOLD MEMBER) ARE CURRENTLY LIVING TOGETHER IN THE HOUSEHOLD,
GO TO BOX 5.
OTHERWISE, CONTINUE WITH BOX 2.
BOX 2
LOOP 1
n
ASK BOX 3 – BOX 4 ONE TIME FOR EACH BIOLOGICAL MOTHER, ADOPTIVE
MOTHER, BIOLOGICAL FATHER, AND ADOPTIVE FATHER NOT LIVING IN THE
HOUSEHOLD.
DETERMINING LOOPING ELIGIBILITY:
1.
BIOLOGICAL MOTHER: NO HOUSEHOLD MEMBER WITH A CODE ‘1’
AT FSQ.140.
2. ADOPTIVE MOTHER NOT IN HH: NO BIOLOGICAL OR ADOPTIVE
MOTHER IN HOUSEHOLD, BUT ADOPTIVE FATHER IS IN THE
HOUSEHOLD.
3. BIOLOGICAL FATHER: NO HOUSEHOLD MEMBER WITH A CODE ‘1’
AT FSQ.150.
4. ADOPTIVE FATHER NOT IN HH: NO BIOLOGICAL OR ADOPTIVE
FATHER IN HOUSEHOLD, BUT ADOPTIVE MOTHER IS IN THE
HOUSEHOLD.
110
BOX 3
n
n
n
n
n
n
IF ASKING ABOUT BIOLOGICAL MOTHER NOT IN HOUSEHOLD AND BIOLOGICAL
MOTHER IS NOT LIVING OR RESPONDENT DOES NOT KNOW WHO THE
BIOLOGICAL MOTHER IS (HRQ.030=2, 3, 8, OR 9), GO TO
BOX 4.
IF ASKING ABOUT BIOLOGICAL MOTHER NOT IN HOUSEHOLD AND BIOLOGICAL
MOTHER IS STILL LIVING (HRQ.030=1), GO TO NRQ.040 FOR THE BIOLOGICAL
MOTHER.
IF ASKING ABOUT BIOLOGICAL FATHER NOT IN HOUSEHOLD AND BIOLOGICAL
FATHER IS NOT LIVING OR RESPONDENT DOES NOT KNOW WHO THE
BIOLOGICAL FATHER IS (HRQ.030=2, 3, 8, OR 9), GO TO
BOX 4.
IF ASKING ABOUT BIOLOGICAL FATHER NOT IN HOUSEHOLD AND BIOLOGICAL
FATHER IS STILL LIVING (HRQ.030=1), GO TO NRQ.040 FOR THE BIOLOGICAL
FATHER.
IF THERE ARE NO BIOLOGICAL PARENTS IN THE HOUSEHOLD (NO HOUSEHOLD
MEMBERS CODE ‘1’ AT FSQ.140 OR FSQ.150) AND THERE IS AT LEAST ONE
ADOPTIVE PARENT IN THE HOUSEHOLD (AT LEAST ONE HOUSEHOLD MEMBER
WITH A CODE OF ‘2’ AT FSQ.140 OR FSQ.150), CONTINUE WITH NRQ.030.
ELSE, GO TO BOX 4.
NOTE: AFTER BOX 3 IS CONSIDERED, BOX 3 – BOX4 LOOPS WILL DO THE
FOLLOWING:
FOR TWO ADOPTIVE PARENTS WILL ASK ABOUT THE CHILD’S BIOLOGICAL MOTHER
AND FATHER WHO ARE NOT IN THE HOUSEHOLD.
FOR ONE BIOLOGICAL PARENT AND ONE ADOPTIVE PARENT, WE WILL ASK ABOUT
THE OTHER BIOLOGICAL PARENT WHO IS NOT IN THE HOUSEHOLD.
FOR ONE BIOLOGICAL PARENT IN THE HOUSEHOLD, WE WILL ASK ABOUT THE
OTHER BIOLOGICAL PARENT WHO IS NOT IN THE HOUSEHOLD.
FOR ONE ADOPTIVE PARENT, IF THERE ARE NO BIOLOGICAL PARENTS IN THE
HOUSEHOLD, WE WILL ASK ABOUT WHETHER THERE IS ANOTHER ADOPTIVE
PARENT AND IF SO WE WILL ASK ABOUT THAT PARENT, IN ADDITION TO THE
BIOLOGICAL MOTHER AND FATHER NOT IN THE HOUSEHOLD.
IF THERE ARE NO BIOLOGICAL OR ADOPTIVE PARENTS IN THE HOUSEHOLD, WE
WILLASK ABOUT THE BIOLOGICAL MOTHER AND FATHER WHO ARE NOT IN THE
HOUSEHOLD.
111
NRQ.030
You said before that {you/{NAME}} {are/is} {CHILD}'s adoptive {mother/father}.
{father/mother}?
Does {CHILD} have an adoptive
CAPI INSTRUCTION: DISPLAY "you" AND "are" IF FSQ.140 = 2 (IF ASKING ABOUT NON-RESIDENT ADOPTIVE
FATHER) OR FSQ.150 = 2 (IF ASKING ABOUT NON-RESIDENT ADOPTIVE MOTHER) FOR THE PERSON
FLAGGED AS THE RESPONDENT. DISPLAY "{NAME}" AND "Is" IF FSQ.140 = 2 (IF ASKING ABOUT NONRESIDENT ADOPTIVE FATHER) OR FSQ.150 = 2 (IF ASKING ABOUT NON-RESIDENT ADOPTIVE MOTHER) FOR
A HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT.
CAPI INSTRUCTION: DISPLAY "mother" AND "father" IF ASKING ABOUT A NON-RESIDENT ADOPTIVE FATHER.
DISPLAY "father" AND "mother" IF ASKING ABOUT A NON-RESIDENT ADOPTIVE MOTHER.
YES ...............................................................
NO ................................................................
REFUSED......................................................
DON'T KNOW ................................................
NRQ.040
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
The next questions are about {CHILD}'s contact with {his/her} {biological/adoptive} {father/mother}.
[We understand that some of these questions may be difficult {for adoptive parents} to answer, however, these are
standard questions we ask when a child does not live with {his/her} biological parents. Any information you can provide
will be helpful.]
How long has it been since {CHILD} last had a visit, a phone call, or received a card or letter from {his/her}
{biological/adoptive} {father/mother}? Would you say ...
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY “biological” AND “mother” FOR THE PARTICULAR
LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY “biological” AND “father” FOR THE PARTICULAR
LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY “adoptive” AND “mother” FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY “adoptive” AND “father” FOR THE
PARTICULAR LOOP R IS ON.
DISPLAY '[We…helpful]' IF THERE ARE NO BIRTH PARENTS IN THE HOUSEHOLD. OTHERWISE, USE A NULL
DISPLAY.
DISPLAY 'for adoptive parents' IF THE RESPONDENT IS AN ADOPTIVE FATHER OR MOTHER.
Less than one month ....................................
More than a month but less than a year, .......
More than a year, or ......................................
No contact since birth ....................................
PARENT IS DECEASED ...............................
NO CONTACT SINCE ADOPTION ...............
NO ADOPTIVE (MOTHER/FATHER) ............
PARENT UNKNOWN/WAS ONLY A DONOR
REFUSED......................................................
DON’T KNOW ................................................
112
1
2
3
4
5
6
7
8
88
99
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
NRQ.050
How many days has {CHILD} seen {his/her} {biological/adoptive} {father/mother} in the past 4 weeks?
CAPI INSTRUCTIONS:
IF THERE IS A BIRTH FATHER IN THE HOUSEHOLD, DISPLAY “biological” AND “mother” FOR THE PARTICULAR
LOOP R IS ON.
IF THERE IS A BIRTH MOTHER IN THE HOUSEHOLD, DISPLAY “biological” AND “father” FOR THE PARTICULAR
LOOP R IS ON.
IF THERE IS AN ADOPTIVE FATHER IN THE HOUSEHOLD, DISPLAY “adoptive” AND “mother” FOR THE
PARTICULAR LOOP R IS ON.
IF THERE IS AN ADOPTIVE MOTHER IN THE HOUSEHOLD, DISPLAY “adoptive” AND “father” FOR THE
PARTICULAR LOOP R IS ON.
CAPI INSTRUCTION: RANGE CHECK 0-28.
|___|___|
ENTER # OF DAYS
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
BOX 4
END LOOP 1
n
ASK BOX 3 – BOX 4 FOR NEXT NON-RESIDENTIAL PARENT.
n
IF NO NEXT NON-RESIDENTIAL PARENT, CONTINUE WITH BOX 5.
BOX 5
n
GO TO SECTION CFQ (CRITICAL FAMILY PROCESSES).
113
CRITICAL FAMILY PROCESSES - CFQ
BOX 1
IF FSQ.130 = 1 (MOTHER OR FEMALE GUARDIAN) FOR ANY HOUSEHOLD MEMBER) OR
NRQ.040 = 1 FOR THE NON-RESIDENT ADOPTIVE/BIOLOGICAL MOTHER (THE NONRESIDENT ADOPTIVE OR BIOLOGICAL MOTHER HAS CONTACTED THE CHILD LESS THAN
A MONTH AGO), GO TO BOX 2. ELSE, GO TO CFQ.010.
CFQ.010
Now I have some questions about relationships {CHILD} may have with other people. Is there any person who is like a
mother to {CHILD}?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CFQ.020
1
2 (BOX 2)
8 (BOX 2)
9 (BOX 2)
Who is this person?
CODE ALL THAT APPLY
GRANDMOTHER ........................................................
BIOLOGICAL MOTHER ...............................................
STEPMOTHER ...........................................................
ADOPTIVE MOTHER .................................................
FOSTER MOTHER .....................................................
RESPONDENT'S GIRLFRIEND/PARTNER ................
TEACHER/COACH ......................................................
CLERGY ......................................................................
AUNT ...........................................................................
CHILD'S SIBLING ........................................................
FRIEND OF FAMILY ....................................................
BABYSITTER/NANNY/CAREGIVER ...........................
OTHER RELATIVE ......................................................
OTHER NON-RELATIVE .............................................
REFUSED ...................................................................
DON'T KNOW .............................................................
1
2
3
4
5
6
7
8
9
10
11
12
13
14
88
99
BOX 2
IF FSQ.130 = 2 (FATHER OR MALE GUARDIAN) FOR ANY HOUSEHOLD MEMBER) OR
NRQ.040 = 1 FOR THE NON-RESIDENT ADOPTIVE/BIOLOGICAL FATHER (THE NONRESIDENT ADOPTIVE OR BIOLOGICAL FATHER HAS CONTACTED THE CHILD LESS THAN
A MONTH AGO), GO TO CFQ.060. ELSE, GO TO CFQ.030.
114
CFQ.030
{Now I have some questions about relationships {CHILD} may have with other people.} Is there any person who is like
a father to {CHILD}?
CAPI INSTRUCTION: DISPLAY “Now…people” IF CFQ.010 WAS NOT ASKED. ELSE, USE A NULL DISPLAY.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
CFQ.040
1
2 (CFQ.060)
8 (CFQ.060)
9 (CFQ.060)
Who is this person?
CODE ALL THAT APPLY
GRANDFATHER ..........................................................
BIOLOGICAL FATHER ................................................
STEPFATHER .............................................................
ADOPTIVE FATHER....................................................
FOSTER FATHER .......................................................
RESPONDENT'S BOYFRIEND/PARTNER .................
TEACHER/COACH ......................................................
CLERGY ......................................................................
UNCLE .........................................................................
CHILD'S SIBLING ........................................................
FRIEND OF FAMILY ....................................................
BABYSITTER/NANNY/CAREGIVER ...........................
OTHER RELATIVE ......................................................
OTHER NON-RELATIVE .............................................
REFUSED ...................................................................
DON'T KNOW .............................................................
CFQ.060
1
2
3
4
5
6
7
8
9
10
11
12
13
14
88
99
Now I’d like to ask about {CHILD}’s grandparents. How many of {CHILD}'s grandparents are still living?
NONE ............................................................
ONE ...............................................................
TWO ..............................................................
THREE ..........................................................
FOUR ............................................................
MORE THAN FOUR ......................................
REFUSED .....................................................
DON'T KNOW ...............................................
115
0 (BOX 3)
1
2
3
4
5
8 (BOX 3)
9 (BOX 3)
CFQ.070
How many grandparents would you say {CHILD} has a close relationship with?
NONE ............................................................
ONE ...............................................................
TWO ..............................................................
THREE ..........................................................
FOUR ............................................................
MORE THAN FOUR ......................................
REFUSED .....................................................
DON'T KNOW ...............................................
0
1
2
3
4
5
8
9
BOX 3
n
GO TO SECTION PEQ (PARENT EDUCATION AND HUMAN CAPITAL).
116
PARENT EDUCATION AND HUMAN CAPITAL - PEQ
BOX 1
LOOP 1
n
ASK PEQ.020 - PEQ.080 FOR 2 “KEY” PARENT FIGURES AS DEFINED IN BOX 3 OF
FSQ AND UP TO 3 NON-RESIDENTIAL BIOLOGICAL/ADOPTIVE PARENTS (EVEN IF
DECEASED).
n
ALWAYS ASK ABOUT THE NON-RESIDENTIAL PARENT LAST. DEFINE NONRESIDENT PARENTS AS FOLLOWS:
1. NON-RESIDENT BIOLOGICAL MOTHER (IF HRQ.030=1 OR 2 FOR A BIOLOGICAL
MOTHER)
2. NON-RESIDENT BIOLOGICAL FATHER (IF HRQ.030=1 OR 2 FOR A BIOLOGICAL
FATHER)
3. NON-RESIDENT ADOPTIVE MOTHER OR FATHER (IF NRQ.030=1 FOR A NONRESIDENT ADOPTIVE PARENT).
NOTE: FOR RESIDENT PARENTS/RESPONDENT, LOOP 1 WILL BE ASKED A MINIMUM OF 1
TIME AND A MAXIMUM OF 2 TIMES. FOR NON-RESIDENT PARENTS, LOOP 1 WILL BE
ASKED A MINIMUM OF 0 TIMES AND A MAXIMUM OF 3 TIMES.
HELP AVAILABLE
PEQ.020
{Now I have a few questions about education and job training.} What {is/was} the highest grade or year of school that
{you/{NAME}/{CHILD}'s {biological/adoptive} {mother/father}} {have/has/had} completed?
{[IF NECESSARY, SAY: Again, any information you can provide will be helpful.]}
CAPI INSTRUCTION: DISPLAY "Now … training." IF FIRST CYCLE OF LOOP 1. OTHERWISE, USE A NULL
DISPLAY.
CAPI INSTRUCTION: DISPLAY "was" AND “had” IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NONRESIDENT BIOLOGICAL PARENT AND HRQ.030 = 2 FOR THAT PARENT. OTHERWISE, DISPLAY "is".
CAPI INSTRUCTIONS: DISPLAY "you" IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT THE RESPONDENT.
DISPLAY "{NAME}" (AND THAT PERSON'S FIRST NAME) IF CURRENT CYCLE OF LOOP IS ASKING ABOUT A
HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT. DISPLAY "{CHILD}'S {mother/father}" IF CURRENT
CYCLE OF LOOP IS ASKING ABOUT THE NONRESIDENTIAL MOTHER/FATHER. DISPLAY “mother” IF THE
NONRESIDENTIAL MOTHER IS BEING ASKED ABOUT. DISPLAY “father” IF THE NON-RESIDENTIAL FATHER IS
BEING ASKED ABOUT.
CAPI INSTRUCTION: DISPLAY "biological" IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NON-RESIDENT BIOLOGICAL PARENT. OTHERWISE, DISPLAY "adoptive".
CAPI INSTRUCTION: DISPLAY "have" IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT THE
RESPONDENT. DISPLAY "had" IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A NONRESIDENT
BIOLOGICAL PARENT AND HRQ.030 = 2 FOR THAT PARENT. OTHERWISE, DISPLAY "has".
CAPI INSTRUCTION: DISPLAY "[IF NECESSARY … be helpful.]" IF THERE ARE NO BIOLOGICAL
PARENTS IN THE HOUSEHOLD (NO HOUSEHOLD MEMBER WITH A CODE '1' AT FSQ.140 OR
FSQ.150). OTHERWISE, USE A NULL DISPLAY.
HELP TEXT:
117
Highest Grade or Year of School Completed: For grades 1-11, enter the exact grade level. If the person you are
asking about completed elementary school, find out the last grade completed. If the respondent says the person
finished 12th grade, ask whether the person received a diploma or got the equivalent of a high school diploma.
Completing a given grade in school should be counted as the number of years it normally takes to complete that grade
level of education, regardless of how many years it actually took the person to finish. This means that for persons who
skipped or repeated grades in elementary school, you will enter the highest grade completed regardless of the number
of years they were in school. This rule is true for elementary school through high school and is especially relevant to
college.
12th grade but no diploma: The person completed the 12th grade, but did not earn a high school diploma or GED.
High school equivalent: This means that the person has a GED. The GED is an exam certified equivalent of a high
school diploma received when the person has not actually received a degree from attending high school, but has
acquired his/her GED (high school equivalency based on passing the GED exam).
High school diploma: A certificate that verifies that a person has successfully completed the required courses of a
high school curriculum and has actually graduated from high school rather than having a GED.
Vocational/technical program after high school but no voc/tech diploma: The person attended this type of
program, but did not earn a degree/diploma/certificate of successful completion of the program. Vocational/trade school
after high school refers to work or trade-related education received after completing high school, but does not include
college. Examples include secretarial school, mechanical or computer training school, etc. Some community colleges
offer vocational training, but this would be considered "1-2 years of college" or "associate's degree" and not vocational
or trade school.
Vocational/technical program after high school: The person attended this type of program and DID earn a
degree/diploma/certificate of successful completion of the program. Vocational/trade school after high school refers to
work or trade-related education received after completing high school, but does not include college. Examples include
secretarial school, mechanical or computer training school, etc. Some community colleges offer vocational training, but
this would be considered "1-2 years of college" or "associate's degree" and not vocational or trade school.
Some college but no degree: The person does not have a 4-year college (bachelor's) degree but has completed a
class for credit at a college or university.
Associate's degree: A 2-year college degree typically earned at a community college (rather than a trade school).
Bachelor's degree: A 4-year college degree earned at a university or 4-year college. It is sometimes called an
"undergraduate degree."
Graduate or professional school but no degree: The person attended a graduate or professional school that
advanced him/her toward a degree beyond a Bachelor's degree (for example, a Master's, Doctorate, or other
professional degree). However, the person did not complete the program or earn the degree.
Master's (MA, MS): Studies beyond a bachelor's degree, but not a Ph.D. or Ed.D.
Doctorate Degree (Ph.D., EDD): Studies beyond a Master's degree that result in a doctorate degree.
Professional degree after bachelor's degree (Medicine/MD; Dentistry/DDS, Law/JD/LLB): Any other graduate
degrees earned with academic studies beyond the bachelor's.
1ST GRADE ............................................................................................. 1
2ND GRADE ............................................................................................ 2
3RD GRADE ........................................................................................... 3
4TH GRADE ............................................................................................ 4
5TH GRADE ............................................................................................ 5
6TH GRADE ............................................................................................ 6
7TH GRADE ............................................................................................ 7
8TH GRADE ............................................................................................ 8
9TH GRADE ............................................................................................ 9
10TH GRADE .......................................................................................... 10
11TH GRADE .......................................................................................... 11
118
12TH GRADE BUT NO DIPLOMA ..........................................................
HIGH SCHOOL EQUIVALENT/GED ........................................................
HIGH SCHOOL DIPLOMA .......................................................................
VOC/TECH PROGRAM
AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA ......................
VOC/TECH PROGRAM AFTER HIGH SCHOOL, DIPLOMA ............... 16
SOME COLLEGE BUT NO DEGREE ......................................................
ASSOCIATE'S DEGREE ..........................................................................
BACHELOR'S DEGREE ...........................................................................
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE ............
MASTER'S (MA, MS) ...............................................................................
DOCTORATE DEGREE (PHD, EDD) ......................................................
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE
(MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.) .....................
REFUSED ................................................................................................
DON'T KNOW...........................................................................................
PEQ.030
12
13 (BOX 2)
14 (BOX 2)
15
17
18
19
20
21
22
(BOX 2)
(BOX 2)
(BOX 2)
(BOX 2)
23 (BOX 2)
88
99
{Do/Does/Did} {you/{NAME}/{CHILD}'s {biological/adoptive} {mother/father}} have a high school diploma, or its
equivalent, such as a GED, or neither?
CAPI INSTRUCTIONS: DISPLAY “Do” AND "you" IF CURRENT CYCLE OF LOOP IS ASKING ABOUT THE
RESPONDENT. DISPLAY “Does” AND "{NAME}" (AND THAT PERSON'S FIRST NAME) IF CURRENT CYCLE OF
LOOP IS ASKING ABOUT A HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT. DISPLAY "Did" IF
CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A NONRESIDENT BIOLOGICAL PARENT AND HRQ.030=2 FOR
THAT PARENT. DISPLAY "{CHILD}'S {MOTHER/FATHER}" IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT
THE NON-RESIDENTIAL MOTHER/FATHER.
CAPI INSTRUCTION: DISPLAY "biological" IF CURRENT CYCLE OF LOOP 1 IS ASKING ABOUT A
NON-RESIDENT BIOLOGICAL PARENT. OTHERWISE, DISPLAY "adoptive".
HIGH SCHOOL DIPLOMA ............................
HIGH SCHOOL EQUIVALENT (GED) ...........
NO HIGH SCHOOL DIPLOMA/EQUIVALENT
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
8
9
BOX 2
n
n
PEQ.050
IF ASKING ABOUT A NONRESIDENTIAL BIOLOGICAL/ADOPTIVE PARENT, GO TO
BOX 3.
OTHERWISE, CONTINUE WITH PEQ.050.
{Are you/Is {NAME}} currently attending or enrolled in any courses from a school, college, or university?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
119
1
2 (PEQ.070)
8 (PEQ.070)
9 (PEQ.070)
PEQ.060
{Are you/Is {NAME}} currently taking courses full-time or part-time?
FULL-TIME ...................................................
PART-TIME ..................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PEQ.070
1
2
8
9
{Are you/Is {NAME}} currently participating in a job-training or on-the-job-training program?
HELP TEXT:
Job-training/On-the-job-training program: Job training includes activities that qualify someone to work in a particular
occupation, such as a carpenter, a cook, or an electrician. Do not include 2-year colleges (A.A. degree), 4-year college
degree (B.A.) or high school equivalency degrees (GED). On-the-job training includes activities at the work site to help
the learner develop job-related skills while doing work at the same time. This also includes apprenticeships.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PEQ.080
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
About how many hours a week {do/does} {you/NAME}} spend in that program? Please include hours spent on
homework for the training program.
CAPI INSTRUCTION: RANGE CHECK 0-80.
|___|___|
ENTER HOURS PER WEEK
REFUSED ..................................................... 88
DON'T KNOW ............................................... 99
BOX 3
END LOOP 1
n
ASK PEQ.020 - PEQ.080 FOR NEXT PERSON.
n
IF NO NEXT PERSON, CONTINUE WITH BOX 4.
BOX 4
n
GO TO SECTION EMQ (PARENT EMPLOYMENT).
120
PARENT EMPLOYMENT - EMQ
BOX 1
LOOP 1
n
ASK EMQ.020 - EMQ.150 FOR 2 “KEY” PARENT FIGURES IN THE HOUSEHOLD AS
DEFINED IN BOX 3 OF FSQ.
HELP AVAILABLE
EMQ.020
During the past week, did {you/{NAME}} work at a job for pay?
HELP TEXT:
Job for pay: Paid work for wages, salary, commission, or pay 'in kind.' Examples of 'pay in kind' include meals, living
quarters, or supplies provided in place of wages. This definition of employment includes work in the person's own
business, professional practice, or farm, paid leave of absence (including vacations and illnesses), and work without pay
in a family business or farm run by a relative. This definition excludes unpaid volunteer work (such as for a church or
charity), unpaid leaves of absence, temporary layoffs (such as a strike), and work around the house.
IF SELF-EMPLOYED, CODE AS YES.
IF RESPONDENT OR SPOUSE/PARTNER IS SELF-EMPLOYED, CODE AS YES.
CAPI INSTRUCTION: DISPLAY "you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "{NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
EMQ.030
1 (EMQ.040)
2
8
9
{Were you/Was {NAME}} on leave or vacation from a job?
CAPI INSTRUCTION: DISPLAY "Were you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "Was {NAME}".
CAPI INSTRUCTION: FOR "Was {NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
LOOPED ON.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
121
1
2 (EMQ.060)
8 (EMQ.060)
9 (EMQ.060)
EMQ.040
How many jobs {do you/does {NAME}} have now?
CAPI INSTRUCTION: RANGE CHECK 1-6.
CAPI INSTRUCTION: DISPLAY "do you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "does {NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
|___|
ENTER # OF JOBS
REFUSED .....................................................
DON'T KNOW ...............................................
EMQ.050
8
9
About how many total hours per week {do you/does {NAME}} usually work for pay{, counting {all/both} {# of jobs from
EMQ.040, IF MORE THAN ONE} jobs}?
IF HOURS VARY, PROBE FOR AVERAGE HOURS PER WEEK.
CAPI INSTRUCTION: DISPLAY "do you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "does {NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
CAPI INSTRUCTION: IF NUMBER OF JOBS IS GREATER THAN ONE IN EMQ.040, DISPLAY “counting…jobs”.
ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF NUMBER OF JOBS = 2 IN EMQ.040, DISPLAY “both” AND USE A NULL DISPLAY FOR “#
of jobs…ONE”. ELSE, DISPLAY “all” AND THE NUMBER OF JOBS IN EMQ.040.
CAPI INSTRUCTION: RANGE CHECK 0-80.
|___|___|
ENTER # OF WEEKLY HOURS
(EMQ.055)
REFUSED...................................................... 888 (EMQ.055)
DON'T KNOW ................................................ 999 (EMQ.055)
122
EMQ.055
(Do you/Does [he/she}) work a regular day shift, that is, one with most of the hours between 6 a.m. and 6 p.m.?
CAPI INSTRUCTION: DISPLAY "Do you" IF PERSON CURRENTLY BEING LOOPED ON IS THE
RESPONDENT. OTHERWISE, DISPLAY "Does {he/she}".
CAPI INSTRUCTION: FOR "{he/she}", DISPLAY “he” IF THE PERSON WHO IS CURRENTLY BEING
LOOPED ON IS MALE. DISPLAY “she” IF THE PERSON CURRENTLY BEING LOOPED ON IS FEMALE.
YES ................................................................1 (BOX 4)
NO ..................................................................2 (EMQ.056)
REFUSED...................................................... 8 (BOX 4)
DON'T KNOW ................................................ 9 (BOX 4)
EMQ.056
(Do you/Does {he/she)) work…
CAPI INSTRUCTION: DISPLAY "Do you" IF PERSON CURRENTLY BEING LOOPED ON IS THE
RESPONDENT. OTHERWISE, DISPLAY "Does {he/she}".
CAPI INSTRUCTION: FOR "{he/she}", DISPLAY “he” IF THE PERSON WHO IS CURRENTLY BEING
LOOPED ON IS MALE. DISPLAY “she” IF THE PERSON CURRENTLY BEING LOOPED ON IS FEMALE.
A regular evening shift - any time between 2 P.M. and Midnight, ................ 1 (BOX 4)
A regular night shift - any time between 9 P.M. and 8 A.M,.......................... 2 (BOX 4)
A variable shift—one that changes from days to evenings
or nights, where (you/he/she) choose(s) (your/his/her) own hours, or ........ 3 (BOX 4)
A variable shift, with hours set by (your/his/her) employer? ......................... 4 (BOX 4)
WORKS WHEN WORK IS AVAILABLE ...................................................... 5 (BOX 4)
REFUSED .................................................................................................... 8 (BOX 4)
DON’T KNOW .............................................................................................. 9 (BOX 4)
123
HELP AVAILABLE
EMQ.060
{Have you/Has {NAME}} been actively looking for work in the past 4 weeks?
CAPI INSTRUCTION: DISPLAY "Have you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "Has {NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
CAPI INSTRUCTION: DISPLAY "in the past 4 weeks" IN UNDERLINED TEXT
HELP TEXT:
Actively looking for work: The person has done at least one of the following activities in the past 4 weeks:
1. Checked with public employment agency;
2. Checked with private employment agency;
3. Checked with employer directly/sent resume;
4. Checked with friends or relatives; or
5. Placed or answered ads/sent resume.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
EMQ.070
1
2 (EMQ.080)
8 (EMQ.080)
9 (EMQ.080)
What {have you/has {NAME}} been doing in the past 4 weeks to find work?
CAPI INSTRUCTION: DISPLAY "have you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "has {NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
CAPI INSTRUCTION: DISPLAY "in the past 4 weeks" IN UNDERLINED TEXT
CODE ALL THAT APPLY
CHECKED WITH PUBLIC EMPLOYMENT AGENCY .............................. 1
CHECKED WITH PRIVATE EMPLOYMENT AGENCY .......................... 2
CHECKED WITH EMPLOYER DIRECTLY/SENT RESUME ................... 3
CHECKED WITH FRIENDS OR RELATIVES ......................................... 4
PLACED OR ANSWERED ADS/SENT RESUME ................................... 5
READ WANT-ADS .................................................................................. 6
SOMETHING ELSE (SPECIFY) _______________________________ 91
________________________________________________________
REFUSED ............................................................................................... 88
DON'T KNOW .......................................................................................... 99
124
BOX 2
IF ANY CATEGORY IN EMQ.070 BETWEEN "1" AND "5" IS ENTERED BUT
NEITHER "6" NOR "91" HAS BEEN ENTERED, GO TO EMQ.100. ELSE, IF "6" IS
ENTERED IN EMQ.070 BUT "91" IS NOT, GO TO EMQ.080. ELSE, IF "91" IS
ENTERED IN EMQ.070, CONTINUE WITH EMQ.070OS. OTHERWISE, GO TO
EMQ.080.
EMQ.070OS [What {have you/has {NAME}} been doing in the past 4 weeks to find work?]
SPECIFY ACTIVITIES.
CAPI INSTRUCTION: DISPLAY "have you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "has {NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
CAPI INSTRUCTION: DISPLAY "in the past 4 weeks" IN UNDERLINED TEXT
EMQ.080
What {were you/was {NAME}} doing most of last week? Would you say …
CAPI INSTRUCTION: DISPLAY "last week" in UNDERLINED TEXT
Keeping house or caring for children, ........... 1 (BOX 3)
Going to school, ............................................ 2 (BOX 3)
Retired, ......................................................... 3 (BOX 3)
Unable to work, or ......................................... 4 (BOX 3)
Something else? What was that?
(SPECIFY) _________________________ 91
REFUSED ..................................................... 8 (BOX 3)
DON'T KNOW ............................................... 9 (BOX 3)
EMQ.080OS [What {were you/was {NAME}} doing most of last week? Would you say …]
SPECIFY ACTIVITY.
CAPI INSTRUCTION: DISPLAY "last week" in UNDERLINED TEXT
BOX 3
n
n
IF DOING SOMETHING ELSE IN THE PAST 4 WEEKS (EMQ.070 = 91),
CONTINUE WITH EMQ.100.
OTHERWISE, GO TO BOX 4.
125
EMQ.100
Could {you/{NAME}} have taken a job last week if one had been offered?
CAPI INSTRUCTION: DISPLAY "you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "{NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
YES ..............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
BOX 4
n
n
EMQ.120
IF WORKED AT A JOB FOR PAY (EMQ.020=1)
OR
WAS ON LEAVE OR VACATION (EMQ.030=1)
OR
WAS ACTIVELY LOOKING FOR WORK (EMQ.060=1),
CONTINUE WITH EMQ.120.
OTHERWISE, GO TO BOX 5.
For whom {do/does/did} {you/{NAME}} work {when {you/{he/she}} last worked}?
PROBE FOR: NAME OF THE COMPANY, BUSINESS, ORGANIZATION, OR OTHER EMPLOYER. IF MORE THAN
ONE CURRENT JOB, ASK ABOUT THE ONE AT WHICH THE PERSON SPENDS THE MOST TIME.
CAPI INSTRUCTION: DISPLAY "do" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING LOOPED
ON IS THE RESPONDENT. DISPLAY "DOES" IF EMQ.020 =1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING
LOOPED
ON
IS
NOT
THE
RESPONDENT.
DISPLAY
"did"
IF
EMQ.060 = 1.
CAPI INSTRUCTION: DISPLAY "you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "{NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
CAPI INSTRUCTION: DISPLAY "WHEN {you/{he/she}} LAST WORKED" IF EMQ.060 = 1. OTHERWISE, USE A
NULL DISPLAY.
CAPI INSTRUCTION: DISPLAY "you" IF PERSON CURRENTLY BEING LOPPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "{he/she}".
________________________________________________________
ENTER EMPLOYER NAME
REFUSED ...............................................................................................
DON'T KNOW ..........................................................................................
126
8
9
EMQ.130
What kind of business or industry {is/was} this?
PROBE: What do they make or do?
PROBE: For example, TV and radio manufacturing, retail shoe store, state labor department, farming.
CAPI INSTRUCTION: DISPLAY "is" IF EMQ.020 = 1 OR EMQ.030 = 1. OTHERWISE, DISPLAY "was".
________________________________________________________
ENTER INDUSTRY DESCRIPTION
REFUSED ................................................................................................
DON'T KNOW...........................................................................................
EMQ.140
8
9
What kind of work {are/is/were/was} {you/{NAME}} doing?
PROBE: What {is/was/} {your/{NAME}'s} job called?
PROBE: For example, electrical engineer, stock clerk, administrative assistant, or farmer.
CAPI INSTRUCTION: DISPLAY "are" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING
LOOPED ON IS THE RESPONDENT. DISPLAY "is" IF EMQ.020 =1 OR EMQ.030 = 1 AND PERSON CURRENTLY
BEING LOOPED ON IS NOT THE RESPONDENT. DISPLAY "were" IF EMQ.060 = 1 AND PERSON CURRENTLY
BEING LOOPED ON IS THE RESPONDENT. DISPLAY "was" IF EMQ.060 =1 AND PERSON CURRENTLY BEING
LOOPED ON IS NOT THE RESPONDENT.
CAPI INSTRUCTION: DISPLAY "you" IF PERSON CURRENTLY BEING LOOPED ON IS THE RESPONDENT.
OTHERWISE, DISPLAY "{NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
________________________________________________________
ENTER JOB TITLE
REFUSED ................................................................................................
DON'T KNOW...........................................................................................
127
8
9
EMQ.150
What {are/is/were/was} {your/{NAME}'s} most important activities or duties on this job?
{you/{NAME}} actually do at this job?
What {do/does/did}
CAPI INSTRUCTION: DISPLAY "are" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING
LOOPED ON IS THE RESPONDENT. DISPLAY "is" IF EMQ.020 =1 OR EMQ.030 = 1 AND PERSON CURRENTLY
BEING LOOPED ON IS NOT THE RESPONDENT. DISPLAY "were" IF EMQ.060 = 1 AND PERSON CURRENTLY
BEING LOOPED ON IS THE RESPONDENT. DISPLAY "was" IF EMQ.060 =1 AND PERSON CURRENTLY BEING
LOOPED ON IS NOT THE RESPONDENT.
CAPI INSTRUCTION: IN FIRST SENTENCE, DISPLAY "your" IF PERSON CURRENTLY BEING LOOPED ON IS THE
RESPONDENT. OTHERWISE, DISPLAY "{NAME}’s". IN SECOND SENTENCE, DISPLAY "you" IF PERSON
CURRENTLY BEING LOOPED ON IS THE RESPONDENT. OTHERWISE, DISPLAY "{NAME}".
CAPI INSTRUCTION:
LOOPED ON.
FOR "{NAME}", DISPLAY THE PERSON'S FIRST NAME WHO IS CURRENTLY BEING
CAPI INSTRUCTION: DISPLAY "do" IF EMQ.020 = 1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING LOOPED
ON IS THE RESPONDENT. DISPLAY "does" IF EMQ.020 =1 OR EMQ.030 = 1 AND PERSON CURRENTLY BEING
LOOPED ON IS NOT THE RESPONDENT. DISPLAY "did" IF EMQ.060 = 1.
PROBE: For example, word processing, keeping account books, filing, selling cars, operating a printing press, finishing
concrete.
________________________________________________________
ENTER JOB DUTIES
REFUSED ...............................................................................................
DON'T KNOW ..........................................................................................
8
9
BOX 5
END LOOP 1
n
ASK EMQ.020 - EMQ.150 FOR NEXT PERSON.
n
IF NO NEXT PERSON, CONTINUE WITH EMQ.180.
EMQ.180
Since {CHILD} was born, was there any time in which {his/her/your} family had serious financial problems or was unable
to pay the monthly bills?
CAPI INSTRUCTIONS: IF THE RESPONDENT IS THE CHILD'S MOTHER OR FATHER (BIOLOGICAL, ADOPTIVE,
STEP, FOSTER, GUARDIAN), DISPLAY “your”. ELSE, IF THE CHILD IS MALE, DISPLAY “his”. ELSE, IF THE CHILD
IS FEMALE, DISPLAY “her”. ELSE, IF GENDER IS MISSING DISPLAY “his/her”.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
128
1
2 (BOX 6)
8 (BOX 6)
9 (BOX 6)
EMQ.190
During how many years or months since {he/she} was born has {{CHILD}'s/your} family had serious financial problems?
CAPI INSTRUCTIONS: IF THE RESPONDENT IS THE CHILD'S MOTHER OR FATHER (BIOLOGICAL, ADOPTIVE,
STEP, FOSTER, GUARDIAN), DISPLAY “your”. ELSE, DISPLAY THE CHILD’S NAME IN “{CHILD}’s”.
CAPI INSTRUCTION: RANGE CHECK: 1-11 IF UNIT IS MONTHS; 1-7 IF UNIT IS YEARS.
|___|___|
ENTER NUMBER
REFUSED ..................................................... 88
DON'T KNOW ............................................... 99
ENTER UNIT
MONTH ........................................................
YEAR ............................................................
REFUSED .....................................................
DON'T KNOW ...............................................
n
1
2
8
9
BOX 6
GO TO SECTION WPQ (WELFARE AND OTHER PUBLIC TRANSFERS).
129
WELFARE AND OTHER PUBLIC TRANSFERS - WPQ
WPQ.030
HELP AVAILABLE
When {you were/{CHILD}'s mother was} pregnant with {CHILD}, did {you/she} receive any benefits from the Special
Supplemental Food Program for Women, Infants, and Children, or WIC?
HELP TEXT:
WIC: This program provides food assistance and nutritional education to low-income pregnant and postpartum women
and their infants, as well as to low-income children up to age 5. WIC is short for the Special Supplemental Food
Program for Women, Infants, and Children. WIC benefits can include food, checks, vouchers, and/or a debit card called
EBT (Electronic Benefit Transfer).
CAPI INSTRUCTION: DISPLAY "you were" AND "you" IF FSQ.140 = 1 FOR THE PERSON FLAGGED AS THE
RESPONDENT. OTHERWISE DISPLAY "{CHILD}'S mother was" AND "she".
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
1
2
8
9
HELP AVAILABLE
WPQ.040
Did {CHILD} receive any WIC benefits as an infant or child?
HELP TEXT:
WIC: This program provides food assistance and nutritional education to low-income pregnant and postpartum women
and their infants, as well as to low-income children up to age 5. WIC is short for the Special Supplemental Food
Program for Women, Infants, and Children. WIC benefits can include food, checks, vouchers, and/or a debit card called
EBT (Electronic Benefit Transfer).
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON'T KNOW ................................................
130
1
2
8
9
WPQ.050
HELP AVAILABLE
In the past 12 months, have you or anyone in your household received Temporary Assistance for Needy Families,
sometimes called TANF {or {STATE TANF PROGRAM NAME}}?
PROBE: TANF was formally known as Aid to Families with Dependent Children, or AFDC.
HELP TEXT:
TANF:
Temporary Assistance for Needy Families (TANF) or {STATE TANF PROGRAM NAME} in {STATE} is a
government program that provides cash benefits to low-income families with children. Many states provide TANF
money through an Electronic Benefits Transfer (EBT) card that is like a debit or ATM card.
Past 12 Months: For this question, consider whether or not TANF (or AFDC) was received in the past 12 calendar
months, not the last calendar year.
CAPI INSTRUCTIONS:
1. DISPLAY STATE TANF PROGRAM NAME.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.060
1
2 (WPQ.070)
8 (WPQ.070)
9 (WPQ.070)
During those 12 months, how many months did your household receive TANF {or {STATE TANF PROGRAM NAME}}?
ENTER NUMBER OF MONTHS.
HARD RANGE: 1-12 MONTHS.
CAPI INSTRUCTIONS:
1. DISPLAY STATE TANF PROGRAM NAME.
|___|___|
ENTER NUMBER OF MONTHS (WPQ.080)
REFUSED ..................................................... 88 (WPQ.080)
DON'T KNOW ................................................ 99 (WPQ.080)
WPQ.070
Since {CHILD} was born, have you or anyone in your household ever received TANF {or {STATE TANF PROGRAM
NAME}}?
CAPI INSTRUCTIONS:
1. DISPLAY STATE TANF PROGRAM NAME.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
131
1
2
8
9
HELP AVAILABLE
WPQ.080
In the past 12 months, have you or anyone in your household received food stamps, also called SNAP (the
Supplemental Nutrition Assistance Program), or food benefits on EBT (Electronic Benefit Transfer)?
HELP TEXT: Food Stamps or SNAP (Supplemental Nutrition Assistance Program). A government program that
provides plastic cards that can be used to buy food. In the past, SNAP was called the Food Stamp Program and gave
people benefits in paper coupons or food stamps.
YES ..............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
WPQ.090
1
2 (WPQ.100)
8 (WPQ.100)
9 (WPQ.100)
During those 12 months, how many months did your household receive food stamps or food benefits on EBT (Electronic
Benefit Transfer) from SNAP?
ENTER NUMBER OF MONTHS.
HARD RANGE: 1-12 MONTHS.
|___|___|
ENTER NUMBER OF MONTHS (BOX 1)
REFUSED ..................................................... 88 (BOX 1)
DON'T KNOW ............................................... 99 (BOX 1)
WPQ.100
Since {CHILD} was born, have you or anyone in your household ever received food stamps or food benefits on EBT
(Electronic Benefit Transfer) from SNAP?
YES ..............................................................
NO ................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
BOX 1
n
GO TO SECTION CMQ (CHILD MOBILITY AND CONTACT INFORMATION).
132
CHILD MOBILITY AND CONTACT INFORMATION - CMQ
CMQ.010
Since {CHILD} was born, how many different places has {he/she} lived for four months or more?
PROBE: IF RESPONDENT SAYS ZERO, ASK: By saying zero places, do you mean that {CHILD} did not live
anywhere for four months or more?
CAPI INSTRUCTION: RANGE CHECK: 0 – 10 PLACES.
|___|___|
ENTER # OF PLACES
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
BOX 1
n
n
CMQ.030
IF CHILD ONLY LIVED AT ONE PLACE (CMQ.010=1, 88, 99), GO TO CMQ.050.
OTHERWISE, CONTINUE WITH CMQ.030.
How long has {CHILD} lived in {his/her} current residence?
CAPI INSTRUCTION: RANGE CHECK 0-7 FOR YEARS, 0-12 FOR MONTHS.
|___|___|
AND
|___|___|
ENTER YEARS
ENTER MONTHS
REFUSED...................................................... 88
DON’T KNOW ................................................ 99
CMQ.050
Thank you very much for your cooperation and for taking the time to participate in this important study. Just to make
sure I can reach you for the next interview, which will take place in the spring, I’d like to ask a few questions about how
to find you.
CMQ.070
Is there a second phone number, such as a work number, a friend or relative’s number, or a beeper or cell phone
number, where you can sometimes be reached?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
133
1
2 (CMQ.091)
8 (CMQ.091)
9 (CMQ.091)
CMQ.080
What is that telephone number?
IF NO TELEPHONE, ENTER ‘000’.
ENTER SECOND PHONE NUMBER, INCLUDING AREA CODE.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW EDIT:
"Phone number has wrong format. Please correct. The phone number must be formatted as 10 numbers (xxx-xxxxxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE NUMBER
FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION:
WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
|__|__|__| – |__|__|__| –|__|__|__|__|
SECOND TELEPHONE NUMBER
REFUSED......................................................
DON’T KNOW ................................................
CMQ.090
_______________
EXTENSION
8 (CMQ.091)
9 (CMQ.091)
Where is that telephone located?
OFFICE/PLACE OF BUSINESS .................... 1 (CMQ.091)
RELATIVE (SPECIFY) _________________ 2
NEIGHBOR (SPECIFY) ________________ 3
FRIEND (SPECIFY) ___________________ 4
BEEPER NUMBER ........................................ 5 (CMQ.091)
CELL PHONE ................................................ 6 (CMQ.091)
OTHER (SPECIFY) ___________________ 7
REFUSED...................................................... 88 (CMQ.091)
DON’T KNOW ................................................ 99 (CMQ.091)
134
CMQ.090OS [Where is that telephone located?]
SPECIFY {RELATIVE / NEIGHBOR / FRIEND / OTHER}.
CAPI INSTRUCTIONS:
CMQ.091
CMQ.092
1.
DISPLAY 'RELATIVE' IF CMQ.090=2.
2.
DISPLAY 'NEIGHBOR' IF CMQ.090=3.
3.
DISPLAY 'FRIEND' IF CMQ.090=4.
4.
DISPLAY 'OTHER' IF CMQ.090 = 91.
Is there an e-mail address where we could reach you?
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
1
2 (CMQ.100)
8 (CMQ.100)
9 (CMQ.100)
What is your e-mail address?
IF EMAIL ADDRESS WILL NOT FIT THE SPACE PROVIDED, ENTER IT IN COMMENTS.
CAPI INSTRUCTIONS: ALLOW 33 TOTAL CHARACTERS FOR THE E-MAIL ADDRESS.
CAPI INSTRUCTIONS: ALLOW FOR REFUSED AND DON’T KNOW ANSWERS.
______________________________________________________________________
ENTER E-MAIL ADDRESS
CMQ.100
Is there a relative or friend, who does not live in this household, who will always know where you are if you move?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
135
1
2 (CMQ.680)
8 (CMQ.680)
9 (CMQ.680)
CMQ.110
What is the name, address, and telephone number of that person?
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP OF PERSON TO RESPONDENT.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS EXCEPT FIRST AND LAST NAME
FIELD.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON STATE FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW EDIT:
"Phone number has wrong format. Please correct. The phone number must be formatted as 10 numbers (xxx-xxxxxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE NUMBER
FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CAPI INSTRUCTION: WHEN ON THE RELATIONSHIP FIELD, DISPLAY "PROBE: What is this person's relationship
to you?"
PROBE: What is this person’s relationship to you?
First Name: ________________
Last Name: ____________________
Street Address: ____________________________________________________
____________________________________________________
City: ____________________
State: ___________
Zip: ____________
Phone: (_____)__________________
Relationship:
____________________________________________________
136
CMQ.130
Besides {PERSON AT CMQ.110}, is there another relative or friend, who does not live in this household, who will
always know where you are if you move?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
CAPI INSTRUCTIONS: DISPLAY FIRST AND LAST NAME OF PERSON AT CMQ.110.
YES ...............................................................
NO .................................................................
REFUSED......................................................
DON’T KNOW ................................................
137
1
2 (CMQ.680)
8 (CMQ.680)
9 (CMQ.680)
CMQ.140
What is the name, address, and telephone number of that person?
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER ‘000’.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP OF PERSON TO RESPONDENT.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS EXCEPT FIRST AND LAST NAME
FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON STATE FIELD.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW EDIT:
"Phone number has wrong format. Please correct. The phone number must be formatted as 10 numbers (xxx-xxxxxxx)."
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE NUMBER
FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
CAPI INSTRUCTION: WHEN ON RELATIONSHIP FIELD, DISPLAY "PROBE: What is this person's relationship to
you?"
PROBE: What is this person’s relationship to you?
First Name: ______________________
Last Name: ____________________
Street Address: ____________________________________________________
____________________________________________________
City: ____________________
State: ___________
Zip: ____________
Phone: (_____)________________________
Relationship:
____________________________________________________
138
BOX 2
n
n
CMQ.170
IF FOCAL CHILD HAS A NON-RESIDENT PARENT WHO IS LIVING (HRQ.030=1) AND
WITH WHOM THE CHILD HAS HAD CONTACT (NRQ.040 = 1 OR 2 FOR THE
NONRESIDENT PARENT WHO IS LIVING), CONTINUE WITH CMQ.170.
OTHERWISE, GO TO CMQ.680.
What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “6.”
ENTER FIRST AND LAST NAME.
ENTER STREET ADDRESS, LINE 1.
ENTER STREET ADDRESS, LINE 2.
ENTER CITY.
ENTER STATE.
ENTER ZIP CODE.
IF NO TELEPHONE, ENTER '000'.
ENTER PHONE NUMBER, INCLUDING AREA CODE/EXTENSION.
ENTER RELATIONSHIP.
CAPI INSTRUCTIONS:
BIOLOGICAL MOTHER.
DISPLAY 'BIOLOGICAL MOTHER' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT
CAPI INSTRUCTIONS: DISPLAY '{OR} BIOLOGICAL FATHER] IF NRQ.040=1 OR 2 FOR A NON-RESIDENT
BIOLOGICAL FATHER. DISPLAY THE 'OR' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL MOTHER
ALSO.
CAPI INSTRUCTION: DISPLAY '{or} ADOPTIVE MOTHER' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT ADOPTIVE
MOTHER. DISPLAY THE 'or' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL MOTHER OR NONRESIDENT BIOLOGICAL FATHER ALSO.
CAPI INSTRUCTION: DISPLAY '{or} ADOPTIVE FATHER' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT ADOPTIVE
FATHER. DISPLAY THE 'or' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL MOTHER OR NONRESIDENT BIOLOGICAL FATHER ALSO.
DISPLAY STATE ABBREVIATIONS AS HELP TEXT WHEN ON THE STATE FIELD.
WHEN NOT ON THE NAME FIELD, DISPLAY ITEM TEXT IN SQUARE BRACKETS.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD IS NOT ‘000’ AND IS NOT 10 NUMBERS, SHOW EDIT:
"Phone number has wrong format. Please correct. The phone number must be formatted as 10 numbers (xxx-xxxxxxx)."
139
CAPI INSTRUCTION: ADD A SEPARATE RESPONSE FIELD FOR ENTERING TELEPHONE EXTENSION.
CAPI INSTRUCTION: IF THE PHONE NUMBER FIELD HAS ENTRIES OF DK, RF, OR ‘000’, THE CURSOR
SHOULD SKIP THE EXTENSION FIELD AND MOVE TO THE NEXT ITEM. OTHERWISE, IF THE PHONE NUMBER
FIELD HAS ENTRIES, THE CURSOR SHOULD MOVE TO THE EXTENSION FIELD.
CAPI INSTRUCTION: ALLOW 10 SPACES FOR THE EXTENSION FIELD.
CAPI INSTRUCTION: EMPTY IS ALLOWED AT THE EXTENSION FIELD.
CAPI INSTRUCTION: WHEN THE CURSOR IS AT THE EXTENSION FIELD, DISPLAY THE INTERVIEWER
INSTRUCTION: 'ENTER EXTENSION.'
First Name: ______________________
Last Name: ____________________
Street Address: ____________________________________________________
____________________________________________________
City: ____________________
State: ___________
Zip: ____________
Phone: (_____)________________________
Relationship:
____________________________________________________
CMQ.680
WAS THIS INTERVIEW CONDUCTED BY TELEPHONE OR IN-PERSON?
TELEPHONE………………….1
IN-PERSON……………………2
CMQ.690
WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?
ENGLISH ..................................................................... 1 (CMQ.695)
SPANISH ..................................................................... 2 (CMQ.695)
ANOTHER LANGUAGE............................................... 91 (CMQ.690OS)
CMQ.690OS SPECIFY OTHER LANGUAGE.
[WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?]
CMQ.695
WHERE WAS THIS INTERVIEW CONDUCTED?
CHILD’S HOME ...........................................................
CHILD’S SCHOOL .......................................................
SOMEWHERE ELSE ...................................................
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1
2
3
BOX 3
SET FINAL DISPOSITION CODE:
IF CMQ.680=1 (TELEPHONE) AND CMQ.690=1 (ENGLISH), SET DISPOSITION CODE TO 60.
IF CMQ.680=1 (TELEPHONE) AND CMQ.690=2 (SPANISH), SET DISPOSITION CODE TO 61.
IF CMQ.680=1 (TELEPHONE) AND CMQ.690=3 (ANOTHER LANGUAGE), SET DISPOSITION CODE TO 62.
IF CMQ.680=2 (IN-PERSON) AND CMQ.690=1 (ENGLISH), SET DISPOSITION CODE TO 63.
IF CMQ.680=2 (IN-PERSON) AND CMQ.690=2 (SPANISH), SET DISPOSITION CODE TO 64.
IF CMQ.680=2 (IN-PERSON) AND CMQ.690=3 (ANOTHER LANGUAGE), SET DISPOSITION CODE TO 65.
CMQ.700
Thank you very much for your cooperation and for taking the time to participate in the Early Childhood Longitudinal Study.
PRESS ENTER TO CONTINUE.
BOX 4
GO TO CMQ.720.
CMQ.701
We would like to call the parent or guardian for {CHILD} at the household where {he/she} lives. Please give me the name and
telephone number for the home that I should call. AFTER EXITING ON THE NEXT SCREEN, ENTER CONTACT INFORMATION
FOR CHILD’S RESIDENCE INTO THE ELECTRONIC RECORD OF CALLS.
BOX 5
GO TO CMQ.720.
CMQ.702
We would like to call back when {CHILD}’s parent or guardian is available. Please tell me when we should call back. AFTER
EXITING ON THE NEXT SCREEN, ENTER CALL BACK TIME INTO THE ELECTRONIC RECORD OF CALLS.
BOX 6
GO TO CMQ.720.
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CMQ.703
Thank you. AFTER EXITING ON THE NEXT SCREEN, ENTER INTO THE ELECTRONIC RECORD OF CALLS WHETHER YOU
SPOKE TO THE CONTACT PERSON AND ANY INFORMATION YOU HAVE ABOUT WHY AN APPROPRIATE RESPONDENT
WAS NOT AVAILABLE, NOT IN THE HOUSEHOLD, OR THE INFORMATION WAS REFUSED/DON’T KNOW.
BOX 7
GO TO CMQ.720.
CMQ.704
Thank you very much for your cooperation and for taking the time to participate in the Early Childhood Longitudinal Study.
AFTER EXITING ON THE NEXT SCREEN, ENTER INTO THE ELECTRONIC RECORD OF CALLS THAT THE CHILD IS
HOMESCHOOLED. WE DO NOT NEED TO CALL BACK.
CMQ.720
PRESS 1 AND ENTER TO SAVE AND EXIT THIS CASE.
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| File Type | application/pdf |
| File Modified | 0000-00-00 |
| File Created | 2010-01-29 |