54 Socio-demographic form

Attachment 54

Sociodemographic Form - Parent

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Expiration Date: XX/XX/XXXX

Sociodemographic Form - Parent1
Estimated burden time: 2 minutes
Item
Context

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Responses

Responses2

The first set of questions that follow
ask about the family of the child you
brought in. Please answer to the
best of your ability.
Which parents and/or legal guardians,
including yourself, live in the child’s
home? (Guardians include step or
foster parents; girlfriend, boyfriend or
partner of parent; or another
relative.)

1=Biologic mother and father
2=Biological mother and guardian
3=Biological father and guardian
4=Biological mother only
5=Biological father only
6=Adoptive mother and father
7=Adoptive mother and guardian
8=Adoptive father and guardian
9=Two guardians (no biological
parents)
10=One guardian (no biological
parents)

Questions for
person who
brought child
for testing

What is your relationship to the child
participating in this study?

1=Biological mother
2=Adoptive mother
3=Stepmother
4=Foster mother
5=Biological father
6=Adoptive father
7=Stepfather
8=Foster father
9=Sister (including step, adoptive and
foster)
10=Brother (including step, adoptive
and foster)
11=Grandmother
12=Grandfather
13=Other relative
14=Other non-relative
15=Girlfriend or partner of child's
parent/guardian
16=Boyfriend or partner of child's
parent/guardian

Questions for
person who
brought child
for testing

How old was the child when you began
living with him/her? (If from birth,
enter zero years.)

Questions for
person who
brought child
for testing

What is your month and year of birth?

Public reporting burden for this collection of information is estimated to average 2 1/2 hours per response, including
the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and
completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not
required to respond to, a collection of information unless it displays a currently valid OMB control number. Send
comments regarding this burden estimate or any other aspect of this collection of information, including suggestions
for reducing this burden to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD
20892-7974, ATTN: PRA (0925-xxxx*) EXP: (xx/xxxx). Do not return the completed form to this address.

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Expiration Date: XX/XX/XXXX
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Context

Item Stem

Responses

Questions for
person who
brought child
for testing

What is your gender?

1 = Male
2 = Female

Questions for
person who
brought child
for testing

Are you of Spanish, Hispanic or Latino
origin or descent?

1=Yes
2=No

Questions for
person who
brought child
for testing

What is your race? (Mark one or more

1=American Indian or Alaska Native
2=Asian
4=Black or African American
8=Native Hawaiian or Other Pacific
Islander
16=White

Questions for
person who
brought child
for testing

In what country were you born?

1=United States
2=Other Country

Questions for
person who
brought child
for testing

In what year did you move to the
United States to stay?

Questions for
person who
brought child
for testing

What is your birth country?

Questions for
person who
brought child
for testing

What language do you mainly speak at
home?

Questions for
person who
brought child
for testing

Please specify the language you
mainly speak at home.

Questions for
person who
brought child
for testing

At ANY TIME IN THE LAST 3 months
have you attended high school or
college?

1=No, I have not attended in the last
3 months
2=Yes, I am a full-time student
3=Yes, I am a part-time student

Questions for
person who
brought child
for testing

What is the highest grade or level of
school you have completed or the
highest degree you received? If
currently enrolled, mark the previous
grade or highest degree received.

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13 =High School Diploma, GED, or
alternative credential
14 =Some college credit but less than
1 year of college credit

Responses2

1 = English
2 = Spanish
3 = English and Spanish equally
4 = Some other language

15 =1 or more years of
college, no degree
16 =Associates degree (for
example, AA, AS)
17 =Bachelor’s degree (for
example: BA, AB, BS)
18 =Master’s degree (for
example: MA, MS, MEng,
MEd, MSW, MBA)
19 =Professional degree
beyond a Bachelor’s
degree (for example: MD,
DDS, DVM, LLB, JD)
20= Doctorate degree (for
example: PhD, EdD)

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Context

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Responses

Questions for
person who
brought child
for testing

Associate’s degrees (AA’s) can have an
occupational, technical, or vocational
focus or an academic focus.
Occupational, technical, or vocational
AA’s are awarded in fields such as
nursing and consumer services and
typically provide training for specific
jobs. Academic AA’s are primarily
awarded in liberal arts and the
sciences and are typically sought by
students who intend to transfer into a
bachelor’s degree program. Would you
say your AA degree was…?

0=Occupational, technical or
vocational
1=Academic

Questions for
person who
brought child
for testing

Not including the credits earned for
your associate’s degree, how many
additional years of college credits
have you completed toward a
bachelor’s degree?

0=No additional credits or less than
one year of additional credits
completed toward a bachelor's degree
1=1 year of credits completed toward
a bachelor's degree
2=2 years of credits completed
toward a bachelor's degree
3=3 or more years of credits
completed toward a bachelor's degree

Questions for
person who
brought child
for testing

Which do you have, a high school
diploma, a GED, or an alternative
credential?

0=High School Diploma
1=GED
2=Alternative credential

Questions for
person who
brought child
for testing

Please specify alternative credential.
If unknown, enter unknown:

Questions for
person who
brought child
for testing

What was the highest grade in school
that you successfully passed?

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma

Questions for
person who
brought child
for testing

Which best describes the amount of
college credit that you have
successfully completed toward a
bachelor’s degree?

1=1 year of credits earned toward a
bachelor’s degree
2=2 years of credits earned toward a
bachelor’s degree
3=3 or more years of credits earned
toward a bachelor’s degree

Questions for
person who
brought child
for testing

Which best describes the number of
graduate credits that you have
completed in a master’s degree
program, professional degree program
(for example: MD, DDS, DVM, LLB, JD),
or doctoral degree program (for
example: PhD, EdD)?

0=No credits or less than one year of
credits completed toward a graduate
degree
1=1 year of credits completed toward
a graduate degree
2=2 years of credits completed
toward a graduate degree
3=3 or more years of credits
completed toward a graduate degree

Responses2

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Responses

Questions for
person who
brought child
for testing

Were these graduate credits earned
in…?

1=A master’s degree program
2=A professional degree program (for
example: MD, DDS, DVM, LLB, JD) or a
doctoral program (for example: PhD,
EdD)

Questions for
person who
brought child
for testing

Which best describes the number of
graduate credits that you completed
beyond your master’s degree in a
master’s degree program, professional
degree program (for example: MD,
DDS, DVM, LLB, JD), or doctoral
degree program (for example: PhD,
EdD)?

0=No graduate credits or less than
one year of graduate credits
completed beyond a master’s degree
1=One or more years of graduate
credits completed beyond a master’s
degree

Questions for
person who
brought child
for testing

Were these graduate credits beyond
your master’s degree earned in …?

1=Another master’s degree program
2=A professional degree program
3=A doctoral degree program
0=No graduate credits earned beyond
a master’s degree

Questions for
person who
brought child
for testing

Are you currently…?

0=A Homemaker
1=Unemployed
2=Retired
3=On Disability
4=On Leave of Absence
5=Full-Time Employed
6=Part-Time Employed
7=Full-Time Student

Questions for
person who
brought child
for testing

Are you now…?

Questions for
person who
brought child
for testing

In general, would you say your health
is…?

0=Married
1=Widowed
2=Divorced
3=Separated
4=Never Married
5=Living with Partner
1=Excellent
2=Very good
3=Good
4=Fair
5=Poor

Responses2

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Responses

Questions
about other
parent or
guardian
living in the
household
with the
child

You indicated that another adult
responsible for the child also lives in
the home. Now we have a few
questions about this person.

Questions
about other
parent or
guardian
living in the
household
with the
child

What is this person’s relationship to
the child participating in this study?

Questions
about other
parent or
guardian
living in the
household
with the
child

How old was the child when this
person began living with him/her? (If
from birth, enter zero years.)

Questions
about other
parent or
guardian
living in the
household
with the
child
Questions
about other
parent or
guardian
living in the
household
with the
child

What is this person’s month and year
of birth? (If unknown, please enter
zeros.)

What is this person’s gender?

1 = Male
2 = Female

Questions
about other
parent or
guardian
living in the
household
with the
child

Is this person of Spanish, Hispanic or
Latino origin or descent?

1=Yes
2=No
3=Don't know

1=Biological mother
2=Adoptive mother
3=Stepmother
4=Foster mother
5=Biological father
6=Adoptive father
7=Stepfather
8=Foster father
9=Sister (including step, adoptive and
foster)
10=Brother (including step, adoptive
and foster)
11=Grandmother
12=Grandfather
13=Other relative
14=Other non-relative
15=Girlfriend or partner of child's
parent/guardian
16=Boyfriend or partner of child's
parent/guardian

Responses2

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Responses

Questions
about other
parent or
guardian
living in the
household
with the
child

What is this person’s race? (Mark one
or more.)

1=American Indian or Alaska Native
2=Asian
4=Black or African American
8=Native Hawaiian or Other Pacific
Islander
16=White
32=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

In what country was this person born?

1=United States
2=Other Country
3=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

In what year did this person move to
the United States to stay?

Questions
about other
parent or
guardian
living in the
household
with the
child

What is this person's birth country?

Questions
about other
parent or
guardian
living in the
household
with the
child

What language does this person mainly
speak at home?

Questions
about other
parent or
guardian
living in the
household
with the
child

Please specify the language this
person mainly speaks at home.

Questions
about other
parent or
guardian
living in the
household
with the
child

At ANY TIME IN THE LAST 3 months has
this person attended high school or
college?

1 = English
2 = Spanish
3 = Spanish and English equally
4 = Some other language
5= Don't know

1=No, this person has not attended in
the last 3 months
2=Yes, this person is a full-time
student
3=Yes, this person is a part-time
student
4=Don't know

Responses2

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Responses

Responses2

Questions
about other
parent or
guardian
living in the
household
with the
child

What is the highest grade or level of
school this person has completed or
the highest degree received? If
currently enrolled, mark the previous
grade or highest degree received.

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13 =High School Diploma, GED, or
alternative credential
14 =Some college credit but less than
1 year of college credit

15 =1 or more years of
college, no degree
16 =Associates degree (for
example, AA, AS)
17 =Bachelor’s degree (for
example: BA, AB, BS)
18 =Master’s degree (for
example: MA, MS, MEng,
Med, MSW, MBA)
19 =Professional degree
beyond a Bachelor’s
degree (for example: MD,
DDS, DVM, LLB, JD)
20= Doctorate degree (for
example: PhD, EdD)
21=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Associate’s degrees (AA’s) can have an
occupational, technical, or vocational
focus or an academic focus.
Occupational, technical, or vocational
AA’s are awarded in fields such as
nursing and consumer services and
typically provide training for specific
jobs. Academic AA’s are primarily
awarded in liberal arts and the
sciences and are typically sought by
students who intend to transfer into a
bachelor’s degree program. Would you
say this person's AA degree was…?

0=Occupational, technical or
vocational
1=Academic
2=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Not including the credits earned for an
associate’s degree, how many
additional years of college credits has
this person completed toward a
bachelor’s degree?

0=No additional credits or less than
one year of additional credits
completed toward a bachelor's degree
1=1year of credits completed toward
a bachelor's degree
2=2 years of credits completed
toward a bachelor's degree
3=3 or more years of credits
completed toward a bachelor's degree
4=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Which does this person have, a high
school diploma, a GED, or an
alternative credential?

0=High School Diploma
1=GED
2=Alternative credential
3=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Please specify alternative credential.
If unknown, enter unknown:

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Context

Item Stem

Responses

Questions
about other
parent or
guardian
living in the
household
with the
child

What was the highest grade in school
that this person successfully passed?

Questions
about other
parent or
guardian
living in the
household
with the
child

Which best describes the amount of
college credit that this person has
successfully completed toward a
bachelor’s degree?

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13=Don't know
1=1 year of credits earned toward a
bachelor’s degree
2=2 years of credits earned toward a
bachelor’s degree
3=3 or more years of credits earned
toward a bachelor’s degree
4=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Which best describes the number of
graduate credits that this person has
completed in a master’s degree
program, professional degree program
(for example: MD, DDS, DVM, LLB, JD),
or doctoral degree program (for
example: PhD, EdD)?

0=No credits or less than one year of
credits completed toward a graduate
degree
1=1 year of credits completed toward
a graduate degree
2=2 years of credits completed
toward a graduate degree
3=3 or more years of credits
completed toward a graduate degree
4=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Were these graduate credits earned
in…?

1=A master’s degree program
2=A professional degree program (for
example: MD, DDS, DVM, LLB, JD) or a
doctoral program (for example: PhD,
EdD)
3=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Which best describes the number of
graduate credits that this person
completed beyond his/her master’s
degree in a master’s degree program,
professional degree program (for
example: MD, DDS, DVM, LLB, JD), or
doctoral degree program (for
example: PhD, EdD)?

0=No graduate credits or less than
one year of graduate credits
completed beyond a master’s degree
1=One or more years of graduate
credits completed beyond a master’s
degree
2=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

Were these graduate credits beyond
his/her master’s degree earned in …?

1=Another master’s degree program
2=A professional degree program
3=A doctoral degree program
0=No graduate credits earned beyond
a master’s degree
4=Don't know

Responses2

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Context

Item Stem

Responses

Questions
about other
parent or
guardian
living in the
household
with the
child

Is this person currently…?

0=A Homemaker
1=Unemployed
2=Retired
3=On Disability
4=On Leave of Absence
5=Full-Time Employed
6=Part-Time Employed
7=Full-Time Student
8=Don't know

Questions
about other
parent or
guardian
living in the
household
with the
child

In general, would you say this person's
health is…?

1=Excellent
2=Very good
3=Good
4=Fair
5=Poor
6=Don't know

Now we have some questions about
the child’s biological mother.
Questions
about
biological
mother not
living with
the child

What is her month and year of birth?
(If unknown, enter zeros.)

Questions
about
biological
mother not
living with
the child

Is she of Spanish, Hispanic or Latino
origin or descent?

1=Yes
2=No
3=Don't know

Questions
about
biological
mother not
living with
the child

What is her race? (Mark one or more.)

1=American Indian or Alaska Native
2=Asian
4=Black or African American
8=Native Hawaiian or Other Pacific
Islander
16=White
32=Don't know

Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child

On how many days in the past year has
she seen the child? (If you don't
know, enter 'don't know.')

In what country was she born?

In what year did she move to the
United States to stay? (if unknown,
enter zeros.)

1=United States
2=Other Country
3=Don't know

Responses2

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Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child

What is her birth country?

What language does she mainly speak
at home?

Responses

Responses2

1 = English
2 = Spanish
3 = Spanish and English equally
4 = Some other language
5 = Don't know

Please specify the language she mainly
speaks at home:

At ANY TIME IN THE LAST 3 months has
she attended high school or college?

1=No, she has not attended in the last
3 months
2=Yes, she is a full-time student
3=Yes, she is a part-time student
4=Don't know

What is the highest grade or level of
school she has completed or the
highest degree received? If currently
enrolled, mark the previous grade or
highest degree received.

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13 =High School Diploma, GED, or
alternative credential
14 =Some college credit but less than
1 year of college credit

Questions
about
biological
mother not
living with
the child

Associate’s degrees (AA’s) can have an
occupational, technical, or vocational
focus or an academic focus.
Occupational, technical, or vocational
AA’s are awarded in fields such as
nursing and consumer services and
typically provide training for specific
jobs. Academic AA’s are primarily
awarded in liberal arts and the
sciences and are typically sought by
students who intend to transfer into a
bachelor’s degree program. Would you
say her AA degree was…?

0=Occupational, technical or
vocational
1=Academic
2=Don't know

Questions
about
biological
mother not
living with
the child

Not including the credits earned for an
associate’s degree, how many
additional years of college credits has
she completed toward a bachelor’s
degree?

0=No additional credits or less than
one year of additional credits
completed toward a bachelor's degree
1=1year of credits completed toward
a bachelor's degree
2=2 years of credits completed
toward a bachelor's degree
3=3 or more years of credits
completed toward a bachelor's degree
4=Don't know

15 =1 or more years of
college, no degree
16 =Associates degree (for
example, AA, AS)
17 =Bachelor’s degree (for
example: BA, AB, BS)
18 =Master’s degree (for
example: MA, MS, MEng,
Med, MSW, MBA)
19 =Professional degree
beyond a Bachelor’s
degree (for example: MD,
DDS, DVM, LLB, JD)
20= Doctorate degree (for
example: PhD, EdD)
21=Don't know

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Context

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Responses

Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child
Questions
about
biological
mother not
living with
the child

Which does she have, a high school
diploma, a GED, or an alternative
credential?

0=High School Diploma
1=GED
2=Alternative credential
3=Don't know

Questions
about
biological
mother not
living with
the child

Which best describes the amount of
college credit that she has successfully
completed toward a bachelor’s
degree?

Questions
about
biological
mother not
living with
the child

Which best describes the number of
graduate credits that she has
completed in a master’s degree
program, professional degree program
(for example: MD, DDS, DVM, LLB, JD),
or doctoral degree program (for
example: PhD, EdD)?

0=No credits or less than one year of
credits completed toward a graduate
degree
1=1 year of credits completed toward
a graduate degree
2=2 years of credits completed
toward a graduate degree
3=3 or more years of credits
completed toward a graduate degree
4=Don't know

Questions
about
biological
mother not
living with
the child

Were these graduate credits earned
in…?

1=A master’s degree program
2=A professional degree program (for
example: MD, DDS, DVM, LLB, JD) or a
doctoral program (for example: PhD,
EdD)
3=Don't know

Questions
about
biological
mother not
living with
the child

Which best describes the number of
graduate credits that she completed
beyond her master’s degree in a
master’s degree program, professional
degree program (for example: MD,
DDS, DVM, LLB, JD), or doctoral
degree program (for example: PhD,
EdD)?

0=No graduate credits or less than
one year of graduate credits
completed beyond a master’s degree
1=One or more years of graduate
credits completed beyond a master’s
degree
2=Don't know

Please specify alternative credential.
If unknown, enter unknown:

What was the highest grade in school
that she successfully passed?

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13=Don't know
1=1 year of credits earned toward a
bachelor’s degree
2=2 years of credits earned toward a
bachelor’s degree
3=3 or more years of credits earned
toward a bachelor’s degree
4=Don't know

Responses2

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Context

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Responses

Questions
about
biological
mother not
living with
the child

Were these graduate credits beyond
her master’s degree earned in …?

1=Another master’s degree program
2=A professional degree program
3=A doctoral degree program
0=No graduate credits earned beyond
a master’s degree
4=Don't know

Questions
about
biological
mother not
living with
the child

Is she currently…?

0=A Homemaker
1=Unemployed
2=Retired
3=On Disability
4=On Leave of Absence
5=Full-Time Employed
6=Part-Time Employed
7=Full-Time Student
8=Don't know

Questions
about
biological
mother not
living with
the child

In general, would you say her health
is…?

1=Excellent
2=Very good
3=Good
4=Fair
5=Poor
6=Don't know

Now we have some questions about
the child’s biological father.
Questions
about
biological
father not
living with
the child

What is his month and year of birth?
(If unknown, enter zeros.)

Questions
about
biological
father not
living with
the child

Is he of Spanish, Hispanic or Latino
origin or descent?

1=Yes
2=No
3=Don't know

Questions
about
biological
father not
living with
the child

What is his race? (Mark one or more.)

1=American Indian or Alaska Native
2=Asian
4=Black or African American
8=Native Hawaiian or Other Pacific
Islander
16=White
32=Don't know

Questions
about
biological
father not
living with
the child

On how many days in the past year has
he seen the child? (If you don't know,
enter 'don't know.')

Questions
about
biological
father not
living with
the child

In what country was he born?

1=United States
2=Other Country
3=Don't know

Responses2

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Questions
about
biological
father not
living with
the child

In what year did he move to the
United States to stay? (if unknown,
enter zeros.)

Questions
about
biological
father not
living with
the child
Questions
about
biological
father not
living with
the child

What is his birth country?

Questions
about
biological
father not
living with
the child
Questions
about
biological
father not
living with
the child
Questions
about
biological
father not
living with
the child

Please specify the language he mainly
speaks at home:

Questions
about
biological
father not
living with
the child

Associate’s degrees (AA’s) can have an
occupational, technical, or vocational
focus or an academic focus.
Occupational, technical, or vocational
AA’s are awarded in fields such as
nursing and consumer services and
typically provide training for specific
jobs. Academic AA’s are primarily
awarded in liberal arts and the
sciences and are typically sought by
students who intend to transfer into a
bachelor’s degree program. Would you
say his AA degree was…?

What language does he mainly speak
at home?

Responses

Responses2

1 = English
2 = Spanish
3 = Spanish and English equally
4 = Some other language
5 = Don't know

At ANY TIME IN THE LAST 3 months has
he attended high school or college?

1=No, he has not attended in the last
3 months
2=Yes, he is a full-time student
3=Yes, he is a part-time student
4=Don't know

What is the highest grade or level of
school he has completed or the
highest degree received? If currently
enrolled, mark the previous grade or
highest degree received.

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13 =High School Diploma, GED, or
alternative credential
14 =Some college credit but less than
1 year of college credit
0=Occupational, technical or
vocational
1=Academic
2=Don't know

15 =1 or more years of
college, no degree
16 =Associates degree (for
example, AA, AS)
17 =Bachelor’s degree (for
example: BA, AB, BS)
18 =Master’s degree (for
example: MA, MS, MEng,
Med, MSW, MBA)
19 =Professional degree
beyond a Bachelor’s
degree (for example: MD,
DDS, DVM, LLB, JD)
20= Doctorate degree (for
example: PhD, EdD)
21=Don't know

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Responses

Questions
about
biological
father not
living with
the child

Not including the credits earned for an
associate’s degree, how many
additional years of college credits has
he completed toward a bachelor’s
degree?

0=No additional credits or less than
one year of additional credits
completed toward a bachelor's degree
1=1year of credits completed toward
a bachelor's degree
2=2 years of credits completed
toward a bachelor's degree
3=3 or more years of credits
completed toward a bachelor's degree
4=Don't know

Questions
about
biological
father not
living with
the child

Which does he have, a high school
diploma, a GED, or an alternative
credential?

0=High School Diploma
1=GED
2=Alternative credential
3=Don't know

Questions
about
biological
father not
living with
the child

Please specify alternative credential.
If unknown, enter unknown:

Questions
about
biological
father not
living with
the child

What was the highest grade in school
that he successfully passed?

00=No formal schooling
01 =1st grade
02 =2nd grade
03 =3rd grade
04 =4th grade
05 =5th grade
06 =6th grade
07 =7th grade
08 =8th grade
09 =9th grade
10 =10th grade
11 =11th grade
12 =12th grade - No diploma
13=Don't know

Questions
about
biological
father not
living with
the child

Which best describes the amount of
college credit that he has successfully
completed toward a bachelor’s
degree?

Questions
about
biological
father not
living with
the child

Which best describes the number of
graduate credits that he has
completed in a master’s degree
program, professional degree program
(for example: MD, DDS, DVM, LLB, JD),
or doctoral degree program (for
example: PhD, EdD)?

1=1 year of credits earned toward a
bachelor’s degree
2=2 years of credits earned toward a
bachelor’s degree
3=3 or more years of credits earned
toward a bachelor’s degree
4=Don't know
0=No credits or less than one year of
credits completed toward a graduate
degree
1=1 year of credits completed toward
a graduate degree
2=2 years of credits completed
toward a graduate degree
3=3 or more years of credits
completed toward a graduate degree
4=Don't know

Questions
about
biological
father not
living with
the child

Were these graduate credits earned
in…?

1=A master’s degree program
2=A professional degree program (for
example: MD, DDS, DVM, LLB, JD) or a
doctoral program (for example: PhD,
EdD)
3=Don't know

Responses2

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Responses

Questions
about
biological
father not
living with
the child

Which best describes the number of
graduate credits that he completed
beyond his master’s degree in a
master’s degree program, professional
degree program (for example: MD,
DDS, DVM, LLB, JD), or doctoral
degree program (for example: PhD,
EdD)?

0=No graduate credits or less than
one year of graduate credits
completed beyond a master’s degree
1=One or more years of graduate
credits completed beyond a master’s
degree
2=Don't know

Questions
about
biological
father not
living with
the child

Were these graduate credits beyond
his master’s degree earned in …?

1=Another master’s degree program
2=A professional degree program
3=A doctoral degree program
0=No graduate credits earned beyond
a master’s degree
4=Don't know

Questions
about
biological
father not
living with
the child

Is he currently…?

0=A Homemaker
1=Unemployed
2=Retired
3=On Disability
4=On Leave of Absence
5=Full-Time Employed
6=Part-Time Employed
7=Full-Time Student
8=Don't know

Questions
about
biological
father not
living with
the child

In general, would you say his health
is…?

1=Excellent
2=Very good
3=Good
4=Fair
5=Poor
6=Don't know

Responses2