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pdfAPPENDIX B
PARENT INTERVIEWS
Early Childhood Longitudinal Study, Kindergarten Class of 2010-11
(ECLS-K:2011)
Spring First-Grade and Fall Second-Grade National Data Collections
OMB Clearance Package
# 1850-0750 v.10
Spring First-Grade Parent Interview
INTRODUCTION (SPRING FIRST GRADE) - INQ
BOX 1
IF THE CASE HAS A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN, OR
FALL-FIRST GRADE INTERVIEW, GO TO INQ.005. ELSE, GO TO INQ.040.
INQ.005
{In the fall of 2010/Last fall/Last spring}, we spoke with {NAME OF RESPONDENT} who took part in the Early
Childhood Longitudinal Study, Kindergarten Class of 2010-2011 on {DATE OF LAST INTERVIEW}. Am I
talking to the same person?
VERIFY NAME, AGE AND RELATIONSHIP WITH RESPONDENT:
NAME: {FIRST NAME} {LAST NAME}.
AGE: {APPROXIMATELY {UPDATED AGE FROM PRELOAD} YEARS OLD/UNKNOWN}
RELATIONSHIP TO CHILD: {RELATIONSHIP TO CHILD/UNKNOWN}.
ENTER “1” FOR YES EVEN IF THE AGE LISTED IS A YEAR OR TWO DIFFERENT FROM THE AGE OF
THE RESPONDENT IF YOU HAVE CONFIRMED IT IS THE SAME PERSON.
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, DISPLAY “In the fall of 2010” IF THE MOST
RECENTLY COMPLETED OR PARTIALLY COMPLETED PARENT INTERVIEW WAS IN THE FALL OF
KINDERGARTEN. DISPLAY “Last fall” IF THE MOST RECENTLY COMPLETED OR PARTIALLY
COMPLETED PARENT INTERVIEW WAS IN THE FALL OF FIRST GRADE. DISPLAY “Last spring” IF THE
MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW WAS IN THE SPRING OF
KINDERGARTEN.
CAPI INSTRUCTION: FOR “NAME OF RESPONDENT” DISPLAY FIRST AND LAST NAME OF
RESPONDENT FROM MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW FROM
PRELOAD. USE THE NAME OF PERSONTYPE=R.
CAPI INSTRUCTION: FOR “FIRST NAME” AND “LAST NAME” DISPLAY MOST RECENTLY COMPLETED
OR PARTIALLY COMPLETED ROUND RESPONDENT’S FIRST AND LAST NAME FROM THE PRELOAD.
IF AGE IS NOT ONE OF THESE MISSING VALUES (MISSING, REFUSED, OR DON'T KNOW), DISPLAY
"APPROXIMATELY…OLD". FOR “UPDATED AGE FROM PRELOAD” DISPLAY AGE OF MOST RECENT
ROUND RESPONDENT FROM PRELOAD. IF AGE IS MISSING, REFUSED, OR DON'T KNOW, DISPLAY
"UNKNOWN."
FOR “RELATIONSHIP TO CHILD” DISPLAY RELATIONSHIP OF RESPONDENT TO CHILD FROM
PRELOAD. IF RELATIONSHIP IS MISSING, REFUSED, OR DON’T KNOW, DISPLAY “UNKNOWN”.
CAPI INSTRUCTION: FLAG THE RESPONDENT IN THE HOUSEHOLD ROSTER AND SET A FLAG
CALLED "FLAGS.SAMERESP" THAT EQUALS 1 IF INQ.005 = 1.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
YES ............................................................... 1 (INQ.090)
NO ................................................................. 2 (INQ.010)
YES, SAME PERSON, BUT
CHILD LIVES ELSEWHERE NOW................ 3 (CMQ.701)
INQ.010
May I please speak with {NAME OF PREVIOUS ROUND RESPONDENT}?
NOTE: IF THE PERSON ASKED FOR IN THIS QUESTION IS AVAILABLE AND YOU CAN SPEAK TO
HIM/HER NOW, 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 BECAUSE
HE/SHE IS AWAY OR DOES NOT CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, CODE “3”
TO ASK FOR SOMEONE ELSE. IF THE CHILD DOES NOT LIVE THERE NOW, CODE “4” FOR “CHILD
LIVES ELSEWHERE.”
CAPI INSTRUCTION: DISPLAY FIRST AND LAST NAME OF RESPONDENT FROM MOST RECENTLY
COMPLETED OR PARTIALLY COMPLETED INTERVIEW FROM PRELOAD.
CAPI INSTRUCTION: IF INQ.010 = 1, HARD ERROR CHECK SHOULD READ:
PLEASE GO BACK TO THE PREVIOUS QUESTION (INQ.005) TO VERIFY THE RESPONDENT.
PRESS G TO GO BACK NOW.
PRESS C TO CANCEL.
AVAILABLE........................................................................... 1 (INQ.005)
NOT AVAILABLE BUT WILL BE BEFORE END
OF FIELD PERIOD (CALLBACK APPT.)........................ ...... 2 (CMQ.702)
NOT AVAILABLE IN FIELD PERIOD........................... ......... 3 (INQ.015)
CHILD LIVES ELSEWHERE ................................................. 4 (CMQ.701)
REFUSED ............................................................................ 8 (INQ.015)
DON'T KNOW ..................................................................... 9 (INQ.015)
INQ.015
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 ...............................................
1
2
3
8
9
(INQ.030)
(INQ.020)
(CMQ.701)
(INQ.020)
(INQ.020)
INQ.020
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 BECAUSE HE/SHE IS AWAY
OR DOES NOT CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, 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.030)
NOT AVAILABLE BUT WILL BE BEFORE END
OF FIELD PERIOD (CALLBACK APPT.) ................................................ 2 (CMQ.702)
NOT AVAILABLE IN FIELD PERIOD ......................................................3 (INQ.025)
NO PARENT OR GUARDIAN IN HH KNOWS ABOUT CHILD ............... 4 (INQ.025)
CHILD LIVES ELSEWHERE ................................................................... 5 (CMQ.701)
REFUSED ..............................................................................................8 (INQ.025)
DON'T KNOW ....................................................................................... 9 (INQ.025)
INQ.025
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 BECAUSE
HE/SHE IS AWAY OR DOES NOT CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, 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.030)
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 HH KNOWS ABOUT CHILD..........................4 (CMQ.703)
CHILD LIVES ELSEWHERE............. ...................................5 (CMQ.701)
REFUSED ........................................................................... 8 (CMQ.703)
DON'T KNOW .................................................................... 9 (CMQ.703)
INQ.030
May I have your name please?
SELECT NAME FROM LIST BELOW.
IF THE NAME IS ON THE LIST OF HOUSEHOLD MEMBERS, ENTER THE NUMBER NEXT TO THE
PERSON ON THE HOUSEHOLD ROSTER WHO WILL BE THE CURRENT ROUND RESPONDENT.
SELECT THIS PERSON’S NAME EVEN IF THE AGE LISTED IS A YEAR OR TWO DIFFERENT FROM
THE AGE OF THE RESPONDENT.
VERIFY NAME, RELATIONSHIP, AND AGE WITH RESPONDENT.
IF NAME NOT LISTED, ENTER 0.
CAPI INSTRUCTIONS:
1.
DISPLAY NAME, RELATIONSHIP, AND AGE OF HOUSEHOLD MEMBERS FROM
THE MOST RECENT UPDATED HOUSEHOLD ROSTER FROM THE PRELOAD. AT
THE TOP OF THE ROSTER, DISPLAY "0 NOT ON LIST. IF RELATIONSHIP OR AGE
IS MISSING, REFUSED, OR DON'T KNOW, DISPLAY "UNKNOWN". IF AGE IS NOT
MISSING, REFUSED, OR DON'T KNOW, NEXT TO AGE DISPLAY THE WORD
“APPROXIMATELY”. IF THERE IS NOT A HOUSEHOLD ROSTER BECAUSE THERE
IS ONLY FALL-FIRST GRADE DATA, SEE INSTRUCTION 2.
2.
DISPLAY HOUSEHOLD MEMBERS 15 YEARS OR OLDER AS RESPONSE
CATEGORIES (IN CASE OF RESPONDENT/INTERVIEWER ERROR EARLY IN THE
INTERVIEW, INCLUDE THE RESPONDENT FROM THE MOST RECENTLY
COMPLETED OR PARTIALLY COMPLETED INTERVIEW IN THIS DISPLAY EVEN
THOUGH HE/SHE SHOULD HAVE BEEN SELECTED AT INQ.005). IN
HOUSEHOLDS THAT ONLY HAVE FALL-FIRST GRADE DATA AND NOT FALL-K OR
SPRING-K DATA, THE ONLY PERSON DISPLAYED WILL BE THE FALL-FIRST
GRADE RESPONDENT BECAUSE HOUSEHOLD MATRIX QUESTIONS WERE NOT
ASKED IN FALL-FIRST GRADE.
IF THE RESPONDENT FROM THE MOST RECENTLY COMPLTED OR PARTIALLY
3.
COMPLETED INTERVIEW IS SELECTED AT THIS SCREEN (EVEN THOUGH
HE/SHE SHOULD HAVE BEEN SELECTED AT INQ.005), SET "FLAGS.SAMERESP"
=1 AND GO TO INQ.090.
4.
IF ZERO IS ENTERED, GO TO INQ.060. ELSE, IF IT IS A CASE WITH A COMPLETE
OR PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN
INTERVIEW BUT A NEW RESPONDENT WHO WAS ALREADY IN THE
HOUSEHOLD MATRIX, GO TO INQ.080.
5.
DISALLOW DK AND RF.
6.
FLAG THE RESPONDENT.
INQ.040
(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, except as required by
law.
This call will be recorded for quality control purposes.
CONTINUE WITH RECORDING ............... 1 (BOX 2)
CONTINUE WITHOUT RECORDING ........ 2 (INQ.040b)
INQ.040b THIS INTERVIEW IS NOT BEING RECORDED.
IF NEEDED: That’s fine. This interview will not be recorded.
PRESS 1 AND ENTER TO CONTINUE.
BOX 2
IF INQ.040 HAS BEEN ASKED TWICE, GO TO INQ.060. ELSE, GO TO INQ.041.
INQ.041
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 ...............................................
INQ.042
1
2
3
8
9
(INQ.060)
(INQ.042)
(CMQ.701)
(INQ.042)
(INQ.042)
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
THIS PERSON IS NOT AVAILABLE IN THE FIELD PERIOD BECAUSE HE/SHE IS AWAY OR DOES NOT
CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, 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.040)
NOT AVAILABLE BUT WILL BE BEFORE END
OF FIELD PERIOD (CALLBACK APPT.) ................................................ 2 (CMQ.702)
NOT AVAILABLE IN FIELD PERIOD ......................................................3 (INQ.043)
NO PARENT OR GUARDIAN IN HH KNOWS
ABOUT CHILD ...................................................................... ................ 4 (INQ.043)
CHILD LIVES ELSEWHERE .................................................. .......... ..... 5 (CMQ.701)
REFUSED ............................................................................. .......... ..... 8 (INQ.043)
DON'T KNOW ...................................................................... .......... ..... 9 (INQ.043)
INQ.043
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 BECAUSE
HE/SHE IS AWAY OR DOES NOT CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, 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.060)
NOT AVAILABLE BUT WILL BE BEFORE END
OF FIELD PERIOD (CALLBACK APPT) ................................................. 2 (CMQ.702)
NOT AVAILABLE IN FIELD PERIOD ...................................................... .3 (CMQ.703)
NO PARENT OR GUARDIAN IN HH KNOWS
ABOUT CHILD. ...................................................................... ................ 4 (CMQ.703)
CHILD LIVES ELSEWHERE .................................................. ................ 5 (CMQ.701)
REFUSED ............................................................................. ................8 (CMQ.703)
DON'T KNOW ...................................................................... ................ 9 (CMQ.703)
INQ.060
{[}May I have your name, please?{]}
ENTER THE RESPONDENT’S FIRST NAME.
VERIFY SPELLING.
CAPI INSTRUCTION: DISPLAY “[“ AND ”]” IF INQ.030 WAS ASKED. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
_________________________________________________________
FIRST NAME
INQ.070
[May I have your name, please?]
ENTER LAST NAME.
VERIFY SPELLING.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
_________________________________________________________
LAST NAME
BOX 3
FOR CASES WITHOUT A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN,
OR FALL-FIRST GRADE INTERVIEW, GO TO INQ.130 AND ASK INQ130 THROUGH BOX 8. ELSE, GO TO INQ.080.
INQ.080
(As I mentioned earlier), you and {CHILD} were 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, except as
required by law.
This call will be recorded for quality control purposes.
CONTINUE WITH RECORDING……….1 (BOX 4)
CONTINUE WITHOUT RECORDING….2 (INQ.080b)
INQ.080b
THIS INTERVIEW IS NOT BEING RECORDED.
IF NEEDED: That’s fine. This interview will not be recorded.
PRESS 1 AND ENTER TO CONTINUE.
BOX 4
FOR NEW SPRING FIRST GRADE RESPONDENTS IN HOUSEHOLDS THAT HAD INQ DATA FROM A COMPLETE OR
PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN, OR FALL-FIRST GRADE INTERVIEW, GO
TO INQ130.
INQ.090
{In the fall of 2010/Last fall/Last spring}, you and {CHILD} took 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 since our last interview. 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, except as
required by law.
This call will be recorded for quality control purposes.
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, DISPLAY “In the fall of 2010” IF THE MOST
RECENTLY COMPLETED OR PARTIALLY COMPLETED PARENT INTERVIEW WAS IN THE FALL OF
KINDERGARTEN. DISPLAY “Last fall” IF THE MOST RECENTLY COMPLETED OR PARTIALLY
COMPLETED PARENT INTERVIEW WAS IN THE FALL OF FIRST GRADE. DISPLAY “Last spring” IF THE
MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW WAS IN THE SPRING OF
KINDERGARTEN.
CONTINUE WITH RECORDING……….1 (INQ.110)
CONTINUE WITHOUT RECORDING….2 (INQ.090b)
INQ.090b
THIS INTERVIEW IS NOT BEING RECORDED.
IF NEEDED: That’s fine. This interview will not be recorded.
PRESS 1 AND ENTER TO CONTINUE.
INQ.110
I would like to verify the spelling of your name for our records. Is your first name spelled {FIRST
NAME OF PREVIOUS ROUND RESPONDENT}?
CAPI INSTRUCTION: FROM THE PRELOAD, DISPLAY FIRST NAME OF RESPONDENT FROM THE
MOST RECENTLY COMPLETED OR PARITIALLY COMPLETED INTERVIEW.
YES…………………………………………….. 1
NO……………………………………………… 2
INQ.112
(INQ.115)
(INQ.112)
How do you spell your first name?
VERIFY SPELLING.
INQ.115
[I would like to verify the spelling of your name for our records. Is your last name spelled] {LAST NAME
OF PREVIOUS ROUND RESPONDENT}?
CAPI INSTRUCTION: FROM THE PRELOAD, DISPLAY LAST NAME OF RESPONDENT FROM THE
MOST RECENTLY COMPLETED OR PARITIALLY COMPLETED INTERVIEW.
YES…………………………………………….. 1
NO……………………………………………… 2
INQ.116
How do you spell your last name?
VERIFY SPELLING.
(INQ.130)
(INQ.116)
INQ.130
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. HOWEVER, DO NOT
ALLOW INTERVIEWER TO CHANGE 'REAL DATA' TO '8' (REFUSED) OR '9' (DON'T KNOW).
CAPI INSTRUCTION: FOR CHILD'S FIRST, MIDDLE, AND LAST NAME, DISPLAY CHILD'S 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: [___________________]
BOX 5
IF (THIS CASE DOES NOT HAVE A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRINGKINDERGARTEN, OR FALL-FIRST GRADE INTERVIEW) OR (THE CASE HAS A COMPLETE OR PARTIALLY
COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN, OR FALL-FIRST GRADE INTERVIEW AND THE
CHILD’S SEX IS MISSING), GO TO INQ.160. ELSE, GO TO BOX 6.
INQ.160
ASK IF NOT OBVIOUS: {I have {CHILD} recorded as {male/female}. Is that correct?}{Is {CHILD} male or
female?}
{MAKE CORRECTIONS TO GENDER BELOW OR PRESS ENTER TO ACCEPT CURRENT GENDER.}
{Current Info: [MALE/FEMALE]}
DISPLAY CORRECTED INFORMATION ABOUT CHILD'S GENDER FROM PRELOAD. IF GENDER IS
NONMISSING IN THE PRELOAD, DISPLAY “I have…{male/female}. Is that correct?” AND “MAKE
CORRECTIONS TO GENDER BELOW OR PRESS ENTER TO ACCEPT CURRENT GENDER. 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” AND DO NOT DISPLAY “CURRENT INFO”. REFUSED AND DON'T
KNOW ALLOWED.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED.
MALE ................................................................... 1
FEMALE .............................................................. 2
REFUSED .......................................................... 8
DON’T KNOW ..................................................... 9
BOX 6
IF (THIS CASE DOES NOT HAVE A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRINGKINDERGARTEN, OR FALL-FIRST GRADE INTERVIEW) OR (THE CASE HAS A COMPLETE OR PARTIALLY
COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN, OR FALL-FIRST GRADE INTERVIEW AND THE
CHILD’S DATE OF BIRTH IS MISSING), GO TO INQ.170. ELSE, GO TO BOX 8.
INQ.170
{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: DISPLAY INFORMATION ABOUT CHILD'S DATE OF BIRTH FROM PRELOAD.
DISPLAY THE NAME OF THE MONTH, NOT THE NUMBER OF THE MONTH, FOLLOWED BY THE DAY
WITH THE APPROPRIATE LETTERS AT THE END TO GO WITH THE DATE, AND THEN THE YEAR
(E.G., August 12th, 2005). IF DATE OF BIRTH IS NOT AVAILABLE IN THE PRELOAD, ENTRY FOR DATE
OF BIRTH IS REQUIRED. REFUSED AND DON'T KNOW ALLOWED IF THERE ARE NO PRELOADED
DATA. IF THERE ARE PRELOADED DATA DO NOT ALLOW THEM TO BE OVERWRITTEN BY
REFUSED/DON’T KNOW. IF A DATE OF BIRTH IS AVAILABLE FOR THE FOCAL CHILD FROM THE
PRELOAD, DISPLAY "I have recorded that {CHILD} was born on {DATE OF BIRTH}. Is that correct?" AND
"MAKE CORRECTIONS … BIRTH.”‘ ALSO, IF DATE OF BIRTH IS AVAILABLE IN THE PRELOAD,
DISPLAY IT NEXT TO “CURRENT INFO” BELOW. OTHERWISE, IF DATE OF BIRTH IS NOT AVAILABLE
IN THE PRELOAD, DISPLAY "What is {child}'s date of birth?" AND USE A NULL DISPLAY FOR DATE OF
BIRTH AND DO NOT DISPLAY “CURRENT INFO”. RANGE CHECK: 1-12 FOR MONTH, 1-31 FOR DAY,
2003-2007 FOR YEAR. IF MONTH IS OUT OF RANGE, DISPLAY ERROR MESSAGE ”THE BIRTHDAY
MONTH SHOULD BE BETWEEN 1 AND 12.” IF DAY IS OUT OF RANGE, DISPLAY ERROR MESSAGE
“THE BIRTHDAY DAY SHOULD BE BETWEEN 1 AND 31.” IF YEAR IS OUT OF RANGE, DISPLAY ERROR
MESSAGE “THE BIRTHDAY YEAR SHOULD BE IN THE RANGE OF 2003 – 2007. CONFIRM THE
YEAR THE CHILD WAS BORN AND, IF STILL NOT IN RANGE, ENTER “DON’T KNOW” AND A
COMMENT.”
{CURRENT INFO: [DATE OF BIRTH]}
|___|___| / |___|___| / |___|___||___|___|}
ENTER DATE OF BIRTH (MONTH/DAY/YEAR)
BOX 7
IF ANY FIELD IN DATE OF BIRTH VARIABLE INQ.170 = REFUSED OR DK, GO TO INQ.176.
ELSE, CONTINUE WITH INQ.175.
INQ.175
So {CHILD} is {AGE CALCULATED FROM DATE OF BIRTH AT INQ.170} years old. Is that correct?
IF AGE IS INCORRECT, GO BACK TO INQ170 AND CORRECT DATE OF BIRTH.
IF AGE IS STILL INCORRECT, ANSWER “NO” TO THIS QUESTION (INQ175).
CAP INSTRUCTIONS: USE ERROR MESSAGE THAT SAYS: IF AGE INCORRECT, CORRECT DATE OF
BIRTH.
1. PRESS G or ENTER TO REENTER DATE OF BIRTH.
2. PRESS C OR ESCAPE TO CANCEL.
“S” FOR SUPPRESS SHOULD ALSO BE AN OPTION ON THIS SCREEN, IN ADDITION TO G FOR “GO
TO” AND “C” FOR CLOSE.
YES .....................................................................1 (BOX 8)
NO ....................................................................... 2 (ERROR MESSAGE)
REFUSED ..........................................................8 (INQ.176)
DON’T KNOW ..................................................... 9 (INQ.176)
INQ.176
How old is {CHILD}?
CAPI INSTRUCTION: RANGE CHECK 4-9.
IF DK OR RF, DISPLAY "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 '6' IF YOU CAN'T
GUESS AT THE CHILD'S AGE."
REFUSED ………………………………………….. 8
DON’T KNOW ……………………………………… 9
BOX 8
IF PREVIOUS ADDRESS IS IN THE PRELOAD, GO TO INQ.180. ELSE, IF PREVIOUS ADDRESS IS NOT IN THE
PRELOAD, GO TO INQ.190.
INQ.180 I have recorded that {CHILD}'s home address is:
STREET ADDRESS1: [___________________]
STREET ADDRESS2: [___________________]
CITY:
[___________________]
STATE:
[___________________]
ZIP CODE:
[___________________]
Is this still correct?
CAPI INSTRUCTION: IN THE RESPONSE FIELD, DISPLAY CURRENT ADDRESS INFO FROM THE
PRELOAD.
CAPI INSTRUCTION: IF REFUSED OR DON’T KNOW, GO TO BOX 9.
YES, CORRECT ADDRESS .................................. ..... 1 (INQ.200)
YES, SAME ADDRESS – MINOR
CORRECTIONS ................................................. ..... 2 (INQ.190)
NO, NEW ADDRESS.................................................... 3 (INQ.190)
INQ.190
{What is {CHILD}’s home address?}
{MAKE CORRECTIONS TO ADDRESS BELOW.}
{ENTER STATE ABBREVIATION BY USING LOOKUP FILE. TO ACTIVATE LOOKUP, BEGIN TO
TYPE STATE NAME. USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.}
CAPI INSTRUCTION: IF THE HOME ADDRESS WAS NOT IN THE PRELOAD, DISPLAY “What
is…address?” ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF INQ.180 = 2 OR 3, DISPLAY “MAKE CORRECTIONS…BELOW.” ELSE, USE
A NULL DISPLAY.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION:
DISPLAY ”ENTER STATE ABBREVIATION BY USING LOOKUP FILE.
ACTIVATE LOOKUP, BEGIN TO TYPE STATE NAME.
TO
USE THE ARROW KEYS TO HELP YOU
LOCATE A MATCH.” WHEN ON STATE ENTRY FIELD.
CAPI INSTRUCTION: DISPLAY CURRENT ADDRESS INFO IN THE RESPONSE FIELD IF PREVIOUS
ADDRESS INFORMATION WAS IN PRELOAD.
CAPI INSTRUCTION: FOR THIS ITEM ONLY, DO NOT DISPLAY PUERTO RICO IN THE STATE
LOOKUP FILE.
[STREET ADDRESS1]
[STREET ADDRESS2]
[CITY]
[STATE]
[ZIP CODE]
STREET ADDRESS1: [___________________]
STREET ADDRESS2: [___________________]
CITY: [___________________]
STATE: [___________________]
ZIP CODE: [___________________]
BOX 9
IF TELEPHONE NUMBER IS IN THE PRELOAD, GO TO INQ.200. ELSE, IF TELEPHONE NUMBER IS NOT IN THE
PRELOAD, GO TO INQ.205.
INQ.200
I have recorded that {PHONE NUMBER} is {CHILD}'s family's current home phone number. Is this correct?
CAPI INSTRUCTION: DISPLAY CURRENT PHONE NUMBER FROM PRELOAD.
CAPI INSTRUCTION: REFUSED AND DON’T KNOW GO TO BOX 10.
YES, CORRECT TELEPHONE NUMBER...... …….….. 1(BOX 10)
YES, SAME TELEPHONE NUMBER – MINOR
CORRECTIONS …………………………………………2 (INQ.205)
NO, NEW TELEPHONE NUMBER …………………….. 3 (INQ.205)
INQ.205
{What is {CHILD}'s family's current home phone number?}
{MAKE CORRECTIONS TO TELEPHONE NUMBER BELOW.}
IF NO TELEPHONE, ENTER '000'.
CAPI INSTRUCTION:
IF TELEPHONE NUMBER WAS MISSING IN PRELOAD, DISPLAY “What
is…number?”. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION:
IF INQ.200 = 2 OR 3, DISPLAY “MAKE…BELOW.” ELSE, USE A NULL
DISPLAY.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
CAPI INSTRUCTION: DISPLAY CURRENT TELEPHONE NUMBER IN THE RESPONSE FIELD.
[CURRENT TELEPHONE NUMBER]
TELEPHONE NUMBER: [___________________]
REFUSED ...................................................................
8
DON'T KNOW .............................................................
9
BOX 10
IF THE PRELOAD SHOWS THAT THE CASE IS PART OF THE FALL-FIRST GRADE SUBSAMPLE, GO TO INQ.210.
ELSE, GO TO BOX 11.
INQ.210
USE CONSENT SCRIPT BEFORE READING THE TEXT BELOW.
As part of the study, we are testing children's hearing. We would like to get your permission to do this with
{CHILD}. For our records, please state your name, your relationship to {CHILD}, {CHILD}’s name, and that
you give us permission to test {CHILD}'s hearing.
DID PARENT GIVE PERMISSION?
CAPI INSTRUCTION: REFUSED AND DON’T KNOW ARE NOT ALLOWED.
YES………………………………….1
NO…………………………………...2
BOX 11
IF THE PRELOAD SHOWS THAT INQ.300 WAS ASKED IN THE SPRING OF KINDERGARTEN, GO TO BOX 14. ELSE,
GO TO INQ.300.
INQ.300
Next, I have a few questions about {CHILD}'s background. Was {CHILD} born in this country, that is, in
any of the fifty states or the District of Columbia?
YES …………………………………………….. 1 (BOX 14)
NO …………………………………………….... 2 (INQ.310)
REFUSED ……………………………………… 8 (BOX 14)
DON’T KNOW …………………………………. 9 (BOX 14)
INQ.310
In what country or territory was {CHILD} born?
TO ACTIVATE LOOKUP, BEGIN TO TYPE COUNTRY OR TERRITORY. IF COUNTRY IS NOT ON THE
LIST, HIGHLIGHT ***NOT ON LIST*** IN THE LOOKUP FILE AND PRESS ENTER.
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
CAPI INSTRUCTION: DISPLAY COUNTRY LOOKUP FILE.
FIELD FOR ENTERING RESPONSE CODES.
ALLOW 3 SPACES IN THE RESPONSE
REFUSED ................................................... . 8
DON’T KNOW ............................................. . 9
BOX 12
IF INQ.310 = 0 (NOT ON LIST), CONTINUE WITH INQ.312OS. OTHERWISE, GO TO INQ.320.
INQ.312OS
What is {CHILD}'s country of birth?
SPECIFY COUNTRY
INQ.320
In what year did {CHILD} come to the United States to stay?
CAPI INSTRUCTION: RANGE CHECK: THE YEAR CHILD CAME TO U.S. CANNOT BE EARLIER THAN
CHILD'S YEAR OF BIRTH OR LATER THAN THE CURRENT YEAR.
REFUSED ................................................... . 8
DON’T KNOW ............................................. . 9
BOX 13
IF INQ.310 = 90, 139, 179, 203, 235 (GUAM, MARIANA ISLAND, PUERTO RICO, SOLOMON ISLANDS, US VIRGIN
ISLANDS), GO TO BOX 14.
OTHERWISE, CONTINUE WITH INQ.330.
INQ.330
Is {CHILD} a U.S. citizen?
YES ……………………………………………...1
NO …………………………………………….....2
REFUSED …………………………...………….8
DON’T KNOW …………………………………..9
BOX 14
GO TO SECTION PIQ (PARENT'S INVOLVEMENT WITH CHILD'S SCHOOL).
PARENT’S INVOLVEMENT WITH CHILD’S SCHOOL - PIQ
PIQ.051
Now, I'd like to ask you about {CHILD}'s school. To what extent did you or someone else in your household
choose where to live so that {CHILD} could attend {his/her} current school? Would you say that {CHILD}
being able to go to {his/her} current school was …
PROBE: “Choosing where to live” means moving to a particular neighborhood so that the child can go to the
school that is assigned to that neighborhood.
A primary factor in choosing where you live, .
One of several factors, or ..............................
Not a factor in choosing where you live? .......
REFUSED ....................................................
DON'T KNOW ...............................................
PIQ.060
1
2
3
8
9
Is {CHILD} attending {his/her} regularly assigned school or a school that you or someone else in your
household chose?
ASSIGNED .................................................... 1 (PIQ.130)
CHOSEN ....................................................... 2 (PIQ.130)
ASSIGNED SCHOOL IS SCHOOL OF
CHOICE...................................................... 3 (PIQ.130)
CHILD IS HOMESCHOOLED ........................ 4 (PIQ.065)
REFUSED .................................................... 8 (PIQ.130)
DON'T KNOW ............................................... 9 (PIQ.130)
HELP AVAILABLE
PIQ.065
Does {CHILD} attend a school?
HELP TEXT: We are asking about attending a school because some children who are schooled at home also
attend school for some classes.
YES ............................................................... 1
NO ................................................................ 2 (BOX 1)
REFUSED .................................................... 8 (BOX 1)
DON'T KNOW ............................................... 9 (BOX 1)
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.130
Since the beginning of this school year, have you or the other adults in your household attended an open
house or a back-to-school night?
NOTE: IF THE CHILD TRANSFERRED TO A NEW SCHOOL DURING THE SCHOOL YEAR, PLEASE
ANSWER ALL QUESTIONS FOR THE CURRENT SCHOOL.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PIQ.140
[Since the beginning of this school year, have you or the other adults in your household…] Attended a
meeting of a PTA, PTO, or Parent-Teacher Organization?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
PIQ.150
1
2
8
9
[Since the beginning of this school year, have you or the other adults in your household…] Attended a school
or class event, such as a play, sports event, or science fair?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PIQ.170
1
2
8
9
[Since the beginning of this school year, have you or the other adults in your household…] Gone to a
regularly-scheduled parent-teacher conference with {CHILD}'s teacher or meeting with {CHILD}'s teacher?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
PIQ.160
1
2
8
9
1
2
8
9
[Since the beginning of this school year, have you or the other adults in your household…] Served as a
volunteer in {CHILD}’s classroom or elsewhere in the school?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
PIQ.185
During this school year, how many times have you or other adults in your household gone to meetings or
participated in activities at {CHILD}'s school?
CAPI INSTRUCTIONS: RANGE: 1 TO 180.
|___|___|___|
TIMES
REFUSED ................................................... 8
DON'T KNOW ............................................. 9
PIQ.190
For each of the following statements, please tell me how well {CHILD}'s school has done with each activity
during this school year. The school lets you know between report cards how {CHILD} is doing in school.
Would you say {CHILD}'s school…
Does this very well, ............................... 1
Just OK, or ............................................ 2
Doesn’t do this at all? ........................... 3
REFUSED ............................................ 8
DON’T KNOW ...................................... 9
PIQ.200
[For each of the following statements, please tell me how well {CHILD}'s school has done with each activity
during this school year.] The school helps you understand what children at {CHILD}'s age are like. Would you
say {CHILD}'s school…
Does this very well, ............................... 1
Just OK, or ............................................ 2
Doesn’t do this at all? ........................... 3
REFUSED ............................................ 8
DON’T KNOW ...................................... 9
PIQ.210
[For each of the following statements, please tell me how well {CHILD}'s school has done with each activity
during this school year.] The school makes you aware of chances to volunteer at the school. Would you say
{CHILD}'s school…
Does this very well, ............................... 1
Just OK, or ............................................ 2
Doesn’t do this at all? ........................... 3
REFUSED ............................................ 8
DON’T KNOW ...................................... 9
PIQ.220
[For each of the following statements, please tell me how well {CHILD}'s school has done with each
activity during this school year.] The school provides workshops, materials, or advice about how to help
{CHILD} learn at home. Would you say {CHILD}'s school…
Does this very well, ............................... 1
Just OK, or ............................................ 2
Doesn’t do this at all? ........................... 3
REFUSED ............................................ 8
DON’T KNOW ...................................... 9
PIQ.230
[For each of the following statements, please tell me how well {CHILD}'s school has done with each
activity during this school year.] The school provides information on community services to help
{CHILD} or your family. Would you say {CHILD}'s school…
Does this very well, ............................... 1
Just OK, or ............................................ 2
Doesn’t do this at all? ........................... 3
REFUSED ............................................ 8
DON’T KNOW ...................................... 9
PIQ.290
How often in the past month has {CHILD}'s teacher sent home ideas for things to do with {CHILD} at
home? (THIS INCLUDES HOMEWORK.) Would you say…
Never, .................................................1
One or two times, or….……………… 2
Three or more times? .........................3
REFUSED ..........................................8
DON’T KNOW ....................................9
PIQ.300
About how many parents of children in {CHILD}'s class do you talk with regularly, either in person, on
the phone, or by texting, e-mailing, or using a social networking site?
ENTER NUMBER OF PARENTS.
CAPI INSTRUCTION: SOFT RANGE: 0 TO 40. HARD RANGE: 0-80.
|___|___|
NUMBER
REFUSED………………………………. 88
DON’T KNOW………………………….. 99
PIQ.500
How many times was {CHILD} late for school during the past four weeks?
CAPI INSTRUCTION: HARD RANGE CHECK: 0-20 TIMES.
|___|___|
NUMBER OF TIMES
REFUSED .....................................................
DON'T KNOW................................................
PIQ.510
88
99
How often does {CHILD} do homework at home? Would you say…
PROBE: This refers to homework assigned by the school and not extra work provided by the parent.
Never .............................................................
Less than once a week ..................................
1 to 2 times a week ........................................
3 to 4 times a week, or...................................
5 or more times a week? ...............................
REFUSED .....................................................
DON'T KNOW................................................
1
2
3
4
5
8
9
PIQ.515
How do you feel about the amount of homework (CHILD} is assigned? Would you say…
The amount is about right ..............................
It’s too much, or .............................................
It’s too little? ...................................................
REFUSED .....................................................
DON'T KNOW................................................
1
2
3
8
9
BOX 1
IF PIQ.510 = 1, 8, OR 9, GO TO BOX 2. ELSE, GO TO PIQ.520.
PIQ.520
During this school year, how often did you or someone else help {him/her} with {his/her} homework?
Would you say…
CAPI INSTRUCTION: IF PIQ.510=2, PIQ.520 CANNOT EQUAL TO 3, 4, OR 5. IF PIQ.510=3, PIQ.520
CANNOT EQUAL TO 4 OR 5. IF PIQ.510=4, PIQ.520 CANNOT EQUAL TO 5. OTHERWISE, DISPLAY
ERROR MESSAGE: "Child does homework at home {DISPLAY RESPONSE AT PIQ.510} but parent
helped {him/her} with {his/her} homework {DISPLAY RESPONSE AT PIQ.520}."
Never .............................................................
Less than once a week ..................................
1 to 2 times a week ........................................
3 to 4 times a week, or...................................
5 or more times a week? ...............................
REFUSED .....................................................
DON'T KNOW................................................
BOX 2
GO TO SECTION FSQ (FAMILY STRUCTURE).
1
2
3
4
5
8
9
FAMILY STRUCTURE – FSQ
BOX 1
IF THE CASE HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL-KINDERGARTEN,
SPRING-KINDERGARTEN, OR BOTH, GO TO FSQ010. (NOTE: THIS DOES NOT INCLUDE CASES THAT ONLY HAVE
FALL-FIRST GRADE DATA BECAUSE THOSE HAD NO HOUSEHOLD ROSTER INFORMATION COLLECTED).
ELSE, IF THE CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALLKINDERGARTEN OR SPRING-KINDERGARTEN, GO TO FSQ020.
FSQ.010
Now I have a few questions about your household. We have listed that (READ NAMES FROM
MATRIX) lived in this household at the time of our last interview.
As I read each person's name again, please tell me if he or she still lives in this household.
Does {NAME} still live in this household?
CAPI MATRIX INSTRUCTIONS:
1. DISPLAY 'still' IN UNDERLINED TEXT.
2. DISPLAY THE COMPLETED HOUSEHOLD MATRIX FROM THE MOST RECENT COMPLETE OR
PARTIALLY COMPLETE PARENT INTERVIEW IN SPRING-KINDERGARTEN OR FALL-KINDERGARTEN.
THIS INCLUDES THE PERSON TYPE, FIRST NAME, LAST NAME, AGE, AND GENDER COLUMNS.
THESE COLUMNS SHOULD BE PROTECTED, THAT IS, INFORMATION CANNOT BE CHANGED.
CHANGES MADE AT INQ.130, INQ.160, AND AGE QUESTIONS (IF INQ.175 = 1, CALCULATE AGE FROM
BIRTHDATE IN INQ.170. ELSE, GET FROM INQ.176) SHOULD SHOW UP ON THE MATRIX AT FSQ.010.
CHANGES MADE AT INQ.060, INQ.070 INQ.112, AND INQ.116, SHOULD BE REFLECTED IN THE
FSQ.010 MATRIX.
3. ADD AS THE 6TH COLUMN TO THE MATRIX, 'STILL HERE'. DISPLAY 'Y' IF PERSON STILL LIVES IN
THE HOUSEHOLD AND 'N' IF THE PERSON DOES NOT (BASED ON HOW FSQ010 IS CODED).
4. THE CURSOR SHOULD START AT THE 'STILL HERE' COLUMN FOR THE FIRST PERSON LISTED IN
THE MATRIX.
5. DISPLAY BRACKETS [ ] AROUND THE FIRST TWO PARAGRAPHS WHENEVER IN THE 'STILL HERE'
COLUMN FOR SOMEONE OTHER THAN THE FIRST PERSON LISTED ON THE MATRIX. (THE FIRST
TWO PARAGRAPHS SHOULD BE DISPLAYED WITHOUT THE BRACKETS WHEN YOU FIRST ARRIVE
AT THIS QUESTION.)
6. ADD AS THE 7TH COLUMN TO THE MATRIX, 'REASON LEFT’(FSQ.015).
7. IF THE 'STILL IN HH' COLUMN IS CODED 'NO', THE CURSOR SHOULD MOVE RIGHT TO THE
'REASON LEFT' COLUMN. IF THE 'STILL IN HH' IS CODED 'YES', THE CURSOR SHOULD MOVE TO
THE 'STILL HERE' COLUMN FOR THE NEXT PERSON ON THE MATRIX (THE 'REASON LEFT' COLUMN
DOES NOT NEED TO BE COMPLETED IN THIS INSTANCE).
8. ADD AS THE 8TH COLUMN TO THE MATRIX, 'REASON LEFT OTHER' (FSQ.015OS).
9. THE MATRIX CANNOT HAVE MORE THAN 25 ROW ENTRIES.
10. IF QUESTION IS ABOUT THE RESPONDENT AND INQ.030 NE 0 (RESPONDENT IS NOT A NEW
HOUSEHOLD MEMBER) AND FSQ.010 = 2 (NOT IN HH), DISPLAY ERROR MESSAGE: 'THIS PERSON
CANNOT BE THE RESPONDENT AND NOT BE IN THE HOUSEHOLD.'
YES…………… 1 (GO TO 'STILL HERE' COLUMN FOR THE NEXT PERSON IN THE MATRIX)
NO…………….. 2 (FSQ.015)
FSQ.015
Why is {NAME} no longer living in this household?
CODE ALL THAT APPLY
CAPI MATRIX INSTRUCTIONS:
1. DISPLAY THIS QUESTION WHENEVER IN THE 'REASON LEFT' COLUMN.
2. ONCE THIS ITEM IS CODED, THE CURSOR SHOULD MOVE TO THE 'STILL HERE' COLUMN FOR
THE NEXT PERSON ON THE MATRIX.
3. HOWEVER, IF SOME OTHER REASON IS CODED, THEN FSQ015OS MUST FIRST BE COMPLETED
BEFORE MOVING TO THE NEXT PERSON ON THE MATRIX.
SEPARATION OR DIVORCE ................................................................ 1
ATTENDING COLLEGE OR BOARDING SCHOOL.............................. 2
LIVING ELSEWHERE FOR EMPLOYMENT- RELATED REASONS .... 3
DECEASED ........................................................................................... 4
MOVED ON/MOVED ELSEWHERE.................................................. ... 5
ROSTER ERROR .............................................................................. ... 6
MOVED BACK WITH PARENTS ....................................................... .. 7
IN JAIL OR PRISON .......................................................................... ... 8
SOME OTHER REASON (SPECIFY) ................................................... 91
REFUSED ............................................................................................. 88
DON’T KNOW ....................................................................................... 99
FSQ.015OS
[Why is {NAME} no longer living in this household?]
CAPI MATRIX INSTRUCTIONS.
1. DISPLAY 'REASON LEFT OTHER' AS THE 8TH COLUMN IN THE MATRIX.
2. DISPLAY THIS QUESTION WHENEVER IN THE 'REASON LEFT OTHER' COLUMN.
3. THIS COLUMN ONLY NEEDS TO BE COMPLETED IF CODE 91 IS SELECTED AS A REASON IN THE
'WHY REASON LEFT' COLUMN.
_______________________________________
ENTER OTHER REASON
FSQ.020
{Other than the people I just asked about, is there anyone else currently living in this household? For
example, anyone who has moved in or any babies born since our last interview? 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.}
{Now I have a few questions about your household. We have noted that you and {CHILD} currently live in
this household. First I’d like to ask you some questions about yourself, then I’d like you to 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.}
{PROBE: Anyone else (living in this household)?}
{ENTER FIRST NAME OF {NEW} HOUSEHOLD MEMBER OR PRESS ENTER IF MATRIX IS COMPLETE.}
{YOU WILL NEED TO ENTER THE NAME, AGE, AND GENDER OF EACH HOUSEHOLD MEMBER
NAMED BEFORE LEAVING THE MATRIX.}
{PRESS ENTER TO RECORD THE AGE AND GENDER OF THE RESPONDENT OR PRESS THE DOWN
ARROW KEY TO ADD A HOUSEHOLD MEMBER.}
CAPI MATRIX INSTRUCTIONS:
1. DISPLAY THE HOUSEHOLD MATRIX (PERSON TYPE, FIRST NAME, LAST NAME, AGE, AND
GENDER COLUMNS.)
2. THE INTERVIEWER CAN ADD UP TO 25 ROW ENTRIES.
3. THE INTERVIEWER CAN MOVE ALL AROUND THE MATRIX USING THE ARROW KEYS (EXCEPT ON
PROTECTED FIELDS).
4. IF, ACCORDING TO THE PRELOAD, A CASE HAD A COMPLETE OR PARTIALLY COMPLETE
PARENT INTERVIEW IN FALL K, SPRING K, OR BOTH:
a. DISPLAY FIRST PARAGRAPH “Other…else.” WHEN YOU FIRST ARRIVE AT FSQ020. ALSO DISPLAY
THIS PARAGRAPH IN BRACKETS [ ] WHENEVER YOU ARE IN THE FIRST NAME COLUMN FOR ANY
PERSON OTHER THAN PERSON NUMBER 1 (THE RESPONDENT).
b. DISPLAY ALL HOUSEHOLD MEMBERS AND ASSOCIATED INFORMATION AS COLLECTED IN THE
MOST RECENT PARENT INTERVIEW (IN SPRING-KINDERGARTEN OR FALL-KINDERGARTEN)
(INQ.060, INQ.070,INQ.112, INQ.116, INQ.130, INQ.160, AND AGE VARIABLES ((IF INQ.175 = 1,
CALCULATE AGE FROM BIRTHDATE IN INQ.170. ELSE, GET FROM INQ.176)) FOR THE CHILD AND
THE RESPONDENT. HOWEVER, DO NOT DISPLAY THE NAMES OF THOSE HH MEMBERS THAT
WERE CODED '2' AT FSQ010 (NOT IN HH ANYMORE).
c. ALL PREVIOUS HH MEMBER ROWS SHOULD BE PROTECTED. THE CURSOR SHOULD APPEAR
ON THE FIRST BLANK FIRST NAME COLUMN.
d. WHEN ON THE FIRST BLANK FIRST NAME COLUMN DISPLAY "PROBE: … household", "ENTER
FIRST …COMPLETE", AND THE "NEW" IN THAT SCREEN INSTRUCTION.
e. WHEN ON THE SECOND BLANK FIRST NAME COLUMN, THE PROBE AND SCREEN INSTRUCTION
CITED IN “d” ABOVE SHOULD ALSO CONTINUE TO BE DISPLAYED.
5. IF, ACCORDING TO THE PRELOAD, A CASE DID NOT HAVE A COMPLETE OR PARTIALLY
COMPLETE PARENT INTERVIEW IN FALL K, SPRING K, OR BOTH:
a. DISPLAY THE SECOND PARAGRAPH “Now…else.” WHEN YOU FIRST ARRIVE AT FSQ020. ALSO
DISPLAY THIS PARAGRAPH IN BRACKETS [ ] WHENEVER YOU ARE IN THE FIRST NAME COLUMN
FOR ANY PERSON OTHER THAN PERSON NUMBER 1 (THE RESPONDENT).
b. DISPLAY THE RESPONDENT'S FIRST AND LAST NAMES IN THE APPROPRIATE COLUMNS
(COLLECTED AT INQ060, INQ070, INQ.112, OR INQ.116). DISPLAY 'R' IN THE FIRST COLUMN TO
INDICATE THAT PERSON IS THE RESPONDENT.
c. DISPLAY THE NAME OF THE FOCAL CHILD IN THE SECOND ROW OF THE FIRST AND LAST NAME
COLUMNS (FROM INQ.130). DISPLAY 'C' IN THE FIRST COLUMN TO INDICATE THAT PERSON IS THE
FOCAL CHILD. DISPLAY THE AGE (IF INQ.175 = 1, CALCULATE AGE FROM BIRTHDATE IN INQ.170.
ELSE, GET FROM INQ.176) AND GENDER (INQ.160) OF THE CHILD IN THE APPROPRATE COLUMNS
OF THE SECOND ROW. THIS ROW IS PROTECTED.
d. DISPLAY "YOU WILL NEED…THE MATRIX." AND "PRESS ENTER TO…A HOUSEHOLD MEMBER"
WHENEVER THE CURSOR IS POSITIONED IN THE FIRST NAME COLUMN FOR PERSON NUMBER 1.
e. DISPLAY "ENTER FIRST NAME…IF MATRIX IS COMPLETE." WHENEVER THE CURSOR IS
POSITIONED IN THE FIRST NAME COLUMN FOR A ROW OTHER THAN PERSON NUMBER 1 (THE
FIRST BLANK ROW AFTER CHILD).
f. DISPLAY "PROBE:… household)?" WHENEVER THE CURSOR IS POSITIONED IN THE FIRST NAME
COLUMN FOR SOMEONE OTHER THAN PERSON NUMBER 1 OR THE FIRST HOUSEHOLD MEMBER
ADDED AFTER THE CHILD.
FSQ.025
ENTER LAST NAME OF {NAME}.
DISPLAY THIS QUESTION WHEN THE CURSOR IS POSITIONED IN THE LAST NAME COLUMN OF THE
HOUSEHOLD MATRIX.
FSQ.030
How old {are you/is {NAME}}?
ENTER AGE OF {NAME}.
{ENTER ZERO IF PERSON’S AGE IS LESS THAN ONE YEAR.}
DISPLAY THIS QUESTION WHEN THE CURSOR IS POSITIONED IN THE AGE COLUMN OF THE
HOUSEHOLD MATRIX.
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.
DISPLAY “ENTER ZERO…ONE YEAR.” WHEN THE CURSOR IS POSITIONED IN THE AGE COLUMN
FOR SOMEONE OTHER THAN THE RESPONDENT.
CAPI INSTRUCTIONS: SOFT RANGE FOR RESPONDENT’S AGE IS 18 TO 100. IF AGE IS OUTSIDE
THIS RANGE, DISPLAY MESSAGE: “RESPONDENT’S AGE IS OUTSIDE THE RANGE OF 18 TO 100.
PLEASE VERIFY BEFORE CONTINUING.”
HARD RANGE FOR PERSONS OTHER THAN THE RESPONDENT IS: 0 to 120.
REFUSED ............................................ … 8
DON'T KNOW………………………………….9
FSQ.040
CODE IF OBVIOUS. OTHERWISE, ASK: {Are you/Is {NAME} male or female?}
ENTER GENDER OF {NAME}.
CAPI INSTRUCTIONS: DISPLAY THIS QUESTION WHEN THE CURSOR IS POSITIONED IN THE
GENDER COLUMN.
CAPI INSTRUCTIONS: 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.
MALE .............................................................
FEMALE ........................................................
REFUSED .....................................................
DON'T KNOW………………………………….
1
2
8
9
FSQ.045
CHECK HOUSEHOLD MATRIX. IF ANY BLANK FIELDS, RETURN THE CURSOR TO THE BLANK FIELD
ON THE MATRIX AND DISPLAY THE APPROPRIATE ERROR MESSAGE. IF HOUSEHOLD MATRIX IS
COMPLETE, PRESS 1 AND ENTER TO CONTINUE.
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 ............................................................... 1 (FSQ.020)
NO ................................................................. 2 (FSQ.110)
REFUSED ..................................................... 8 (FSQ.110)
DON'T KNOW…………………………………...9 (FSQ.110)
FSQ.110
Do you have a spouse or partner who lives in this household?
YES ............................................................... 1 (FSQ.120)
NO ................................................................. 2 (BOX 2)
REFUSED ..................................................... 8 (BOX 2)
DON'T KNOW…………………………………...9 (BOX 2)
FSQ.120
Who in the household is your spouse or partner?
ENTER THE NUMBER NEXT TO THE NAME OF THE PERSON WHO IS {RESPONDENT}'S
SPOUSE/PARTNER.
IF NAME NOT LISTED, BACK UP AND ADD PERSON (IF PART OF HOUSEHOLD).
CAPI INSTRUCTIONS: DISPLAY HOUSEHOLD MEMBERS OVER 16 YEARS OF AGE AS RESPONSE
CATEGORY CHOICES. (LINES FOR 8 HH MEMBERS ARE SHOWN BELOW, BUT UP TO 25 SHOULD BE
DISPLAYED DEPENDING ON THE HOUSEHOLD). DO NOT DISPLAY THE NAMES OF HOUSEHOLD
MEMBERS CODED AS NO LONGER LIVING IN THE HOUSEHOLD AT FSQ.010.
CAPI INSTRUCTIONS: DO NOT DISPLAY THE RESPONDENT’S NAME.
CAPI INSTRUCTIONS: FLAG PERSON SELECTED AT FSQ.120 AS “RESPONDENT’S
SPOUSE/PARTNER”.
CAPI INSTRUCTIONS: DISPLAY THE RESPONDENT'S FIRST NAME FOR {RESPONDENT}.
CAPI INSTRUCTIONS: ALLOW FOR REFUSED ANSWERS.
{DISPLAY HH MEMBER NAME 1}……………….. 1
{DISPLAY HH MEMBER NAME 2}……………….. 2
{DISPLAY HH MEMBER NAME 3}……………….. 3
{DISPLAY HH MEMBER NAME 4}……………….. 4
{DISPLAY HH MEMBER NAME 5}………………...5
{DISPLAY HH MEMBER NAME 6}………………...6
{DISPLAY HH MEMBER NAME 7}………………...7
{DISPLAY HH MEMBER NAME 8}………………...8
BOX 2
IF THE CASE HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW
IN FALL K, SPRING K, OR BOTH AND FLAGS.SAMERESP = 1 (SAME
RESPONDENT AS THE MOST RECENT INTERVIEW) AND THE RESPONDENT
HAD ONE OF THE FOLLOWING RELATIONSHIPS TO THE CHILD IN THE MOST
RECENT INTERVIEW: STEP OR FOSTER MOTHER OR FATHER, OTHER MALE OR
FEMALE PARENT OR GUARDIAN, BOYFRIEND OR GIRLFRIEND OF PARENT,
OTHER RELATIVE, OR NON-RELATIVE [(FSQ.140 = 3, 4, OR 5) OR (FSQ.150 = 3, 4,
OR 5) OR (FSQ.130 = 5, 6, 12, OR 13))], GO TO FSQ.121.
ELSE, GO TO BOX 2A.
FSQ.121
During our last interview, it was reported that you were {the girlfriend or female partner of {CHILD}’s
parent or guardian}/the boyfriend or male partner of {CHILD}’s parent or guardian/the female guardian of
{CHILD}/the male guardian of {CHILD}/{CHILD}’s relative, but not a guardian/not related to
{CHILD}/{CHILD}'s {RELATIONSHIP}}. Has there been a change in your relationship to {CHILD}?
PROBE: For example, we mean changes in relationship such as becoming a step-parent, adoptive,
parent, or guardian of {CHILD}.
CAPI INSTRUCTIONS: USE THE FOLLOWING DISPLAYS BASED ON PRELOAD INFORMATION
FROM THE MOST RECENT COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K
OR SPRING K: IF FSQ.130 = 5 OR FSQ.180 = 1, DISPLAY “the girlfriend or female partner of {CHILD}’s
parent or guardian”. ELSE, IF FSQ.130 = 6 OR FSQ.180 = 2, DISPLAY “the boyfriend or male partner of
{CHILD}’s parent or guardian”. ELSE, IF FSQ.180 = 3, DISPLAY “the female guardian of {CHILD}.”
ELSE, IF FSQ.180 = 4, DISPLAY “the male guardian of {CHILD}.” ELSE, IF FSQ.130 = 12, DISPLAY
{CHILD}’s relative, but not a guardian”. ELSE, IF FSQ.130 = 13, DISPLAY “not related to {CHILD}”.
ELSE, USE THE DISPLAY FOR “{CHILD}'s {RELATIONSHIP}” AND DO THE FOLLOWING: IF FSQ.140
= 3, DISPLAY “stepmother”. IF FSQ.140 = 4, DISPLAY “foster mother or female guardian”. IF FSQ.140 =
4, DISPLAY “foster mother or female guardian”. IF FSQ.140 = 5, DISPLAY “other female parent or
guardian”. IF FSQ.150 = 3, DISPLAY “stepfather”. IF FSQ.150 = 4, DISPLAY “foster father or male
guardian”. IF FSQ.150 = 5, DISPLAY “other male parent or guardian”.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
8
9
(BOX 2A)
(BOX 2A)
(BOX 2A)
(BOX 2A)
BOX 2A
IF THE CASE HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW
IN FALL K, SPRING K, OR BOTH AND FLAGS.SAMERESP = 1 AND SPOUSE OR
PARTNER IS THE SAME AS IN MOST RECENT INTERVIEW AND HAD ONE OF
THE FOLLOWING RELATIONSHIPS TO THE CHILD IN THE MOST RECENT
INTERVIEW: STEP OR FOSTER MOTHER/FATHER, BOYFRIEND/GIRLFRIEND OF
PARENT, OTHER RELATIVE, OR NON-RELATIVE [(FSQ.140 = 3, 4, OR 5) OR
(FSQ.150 = 3, 4, OR 5) OR (FSQ.130 = 5, 6, 12, OR 13) )]], GO TO FSQ.122.
ELSE, GO TO BOX 3.
FSQ.122
During our last interview, it was reported that {NAME OF SPOUSE/PARTNER} was {the girlfriend or
female partner of {CHILD}’s parent or guardian}/the boyfriend or male partner of {CHILD}’s parent or
guardian/{CHILD}’s relative, but not a guardian/ the female guardian of {CHILD}/the male guardian of
{CHILD}/not related to {CHILD}/{CHILD}'s {RELATIONSHIP}}. Has there been a change in the relationship
of {NAME OF SPOUSE/PARTNER} to {CHILD}?
IF THE RESPONDENT SAYS THAT THE PERSON SHOWN IN THIS QUESTION IS NOT HIS/HER
CURRENT SPOUSE/.PARTNER, BACK UP TO FSQ.120 AND ASK WHO THE SPOUSE/PARTNER IS.
PROBE: For example, we mean changes in relationship such as becoming a step-parent, adoptive,
parent, or guardian of {CHILD}.
CAPI INSTRUCTIONS: USE THE FOLLOWING DISPLAYS BASED ON PRELOAD INFORMATION
FROM THE MOST RECENT COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K
OR SPRING K: IF FSQ.130 = 5 OR FSQ.180 = 1, DISPLAY “the girlfriend or female partner of {CHILD}’s
parent or guardian”. ELSE, IF FSQ.130 = 6 OR FSQ.180 = 2, DISPLAY “the boyfriend or male partner of
{CHILD}’s parent or guardian”. ELSE, IF FSQ.180 = 3, DISPLAY “the female guardian of {CHILD}.”
ELSE, IF FSQ.180 = 4, DISPLAY “the male guardian of {CHILD}.” ELSE, IF FSQ.130 = 12, DISPLAY
{CHILD}’s relative, but not a guardian”. ELSE, IF FSQ.130 = 13, DISPLAY “not related to {CHILD}”.
ELSE, USE THE DISPLAY FOR “{CHILD}'s {RELATIONSHIP}” AND DO THE FOLLOWING: IF FSQ.140
= 3, DISPLAY “stepmother”. IF FSQ.140 = 4, DISPLAY “foster mother or female guardian”. IF FSQ.140 =
5, DISPLAY “other female parent or guardian”. IF FSQ.150 = 3, DISPLAY “stepfather”. IF FSQ.150 = 4,
DISPLAY “foster father or male guardian”. IF FSQ.150 = 5, DISPLAY “other male parent or guardian”.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
8
9
BOX 3
IF IT IS [A CASE THAT HAD A COMPLETE PARENT INTERVIEW IN FALL K,
SPRING K, OR BOTH AND ((THERE WERE NEW HOUSEHOLD MEMBERS ADDED
TO FSQ.020 IN THE CURRENT INTERVIEW) OR (THE RESPONDENT OR
SPOUSE/PARTNER HAS A NEW RELATIONSHIP TO THE CHILD (FSQ.121 = 1 OR
FSQ.122 = 1)))] OR (A CASE WITHOUT A COMPLETE OR PARTIALLY COMPLETE
FALL-KINDERGARTEN OR SPRING–KINDERGARTEN INTERVIEW), GO TO LOOP
1.
ELSE, GO TO BOX 4A.
LOOP 1
IF A CASE WITHOUT A COMPLETE OR PARTIALLY COMPLETE FALLKINDERGARTEN OR SPRING–KINDERGARTEN INTERVIEW, ASK FSQ.130 FSQ.180 FOR EACH PERSON ENUMERATED ON THE HOUSEHOLD MATRIX (AT
FSQ.020) WHO IS NOT THE FOCAL CHILD.
ELSE, IF IT IS A CASE THAT HAD A COMPLETE OR PARTIALLY COMPLETE
PARENT INTERVIEW IN FALL K, SPRING K, OR BOTH, ASK FSQ.130 - FSQ.180
FOR [(EACH NEW PERSON ENUMERATED ON THE HOUSEHOLD MATRIX (AT
FSQ.020) WHO IS NOT THE FOCAL CHILD) OR (EACH OLD PERSON WHO HAS A
NEW RELATIONSHIP TO THE CHILD (FSQ.121 = 1 OR FSQ.122 = 1 FOR THAT
PERSON))].
HELP AVAILABLE
FSQ.130
What is {your/{NAME}'s} relationship to {CHILD}?
{CODE RELATIONSHIP OF NEW HOUSEHOLD MEMBERS ONLY.}
CAPI INSTRUCTION: REFUSED AND DON’T KNOW ARE DISALLOWED FOR FSQ.130.
CAPI INSTRUCTIONS: DISPLAY THE RELATIONSHIP MATRIX.
CAPI INSTRUCTIONS: DO NOT DISPLAY THE FOCAL CHILD'S ROW.
CAPI INSTRUCTIONS: CONSISTENCY CHECK: IF FSQ.040 = 1 (MALE) FOR THE SUBJECT OF THIS
QUESTION, FSQ.130 SHOULD NOT EQUAL 1, 3, 5, 7, OR 9. ELSE, IF FSQ.040 = 2 (FEMALE) FOR THE
SUBJECT OF THIS QUESTION, FSQ.130 SHOULD NOT EQUAL 2, 4, 6, 8, OR 10. IF ANY ANSWERS
VIOLATE THESE RULES, DISPLAY MESSAGE: THIS PERSON CANNOT BE CODED AS BOTH A
{RELATIONSHIP FROM FSQ.130} AND A {GENDER FROM FSQ.040}. PLEASE VERIFY INFORMATION
AND CHANGE THE RELATIONSHIP OR GENDER, AS NECESSARY.
CAPI INSTRUCTIONS: CONSISTENCY CHECK: IF RELATIONSHIP OF NEW PERSON BEING ENTERED
IS “7” OR “8” (GRANDMOTHER OR GRANDFATHER), SOFT AGE RANGE IS 30-120. IF AGE IS NOT IN
THAT RANGE, DISPLAY MESSAGE: UNLIKELY AGE FOR A GRANDPARENT. PLEASE CONFIRM
INFORMATION AND CORRECT RELATIONSHIP OR AGE, IF NECESSARY.
CAPI INSTRUCTIONS: IF RELATIONSHIP OF NEW PERSON BEING ENTERED IS “5” OR “6”
(GIRLFRIEND OR BOYFRIEND OF THE CHILD’S PARENT/GUARDIAN), SOFT AGE RANGE IS 15-100.
IF AGE IS NOT IN THAT RANGE, DISPLAY MESSAGE: UNLIKELY AGE FOR A GIRLFRIEND OR
BOYFRIEND OF THE CHILD’S PARENT. PLEASE CONFIRM INFORMATION AND CORRECT
RELATIONSHIP OR AGE, IF NECESSARY.
CAPI MATRIX INSTRUCTIONS:
1. IF, ACCORDING TO THE PRELOAD, A CASE HAD A COMPLETE OR PARTIALLY COMPLETE
PARENT INTERVIEW IN FALL K, SPRING K, OR BOTH:
a. DO NOT DISPLAY THE NAMES OF HH MEMBERS NOT LIVING IN THE HOUSEHOLD (CODED '2' AT
FSQ010).
b. THE NAMES OF HOUSEHOLD MEMBERS COLLECTED IN THE MOST RECENTLY COMPLETED OR
PARTIALLY COMPLETED INTERVIEW SHOULD BE PROTECTED.
c. THE RELATIONSHIPS OF HOUSEHOLD MEMBERS COLLECTED IN THE MOST RECENTLY
COMPLETED OR PARTIALLY COMPLETED INTERVIEW SHOULD BE PROTECTED UNLESS THERE
HAS BEEN A CHANGE IN RELATIONSHIP FOR THE RESPONDENT OR SPOUSE/PARTNER TO THE
FOCAL CHILD (FSQ.121 = 1 OR FSQ.122 = 1 FOR THAT PERSON). IF FSQ.121 = 1 OR FSQ.122 = 1
FOR THAT PERSON, ALLOW THE RELATIONSHIP FIELD TO BE CHANGED.
d. THE CURSOR SHOULD START IN THE FIELD FOR FIRST PERSON WITH A RELATIONSHIP
CHANGE (IF FSQ.121 = 1 OR FSQ.122 = 1 FOR THAT PERSON) AND THEN MOVE TO THE FIELD FOR
THE FIRST NEW PERSON ADDED AT FSQ020 THIS ROUND. IF THERE IS NO ONE WITH A
RELATIONSHIP CHANGE, START IN THE FIELD FOR THE FIRST NEW PERSON ADDED AT FSQ020
THIS ROUND.
e. DISPLAY "CODE RELATIONSHIP…ONLY."
f. DISPLAY “your” IF LOOPING ON A NEW RESPONDENT. OTHERWISE, DISPLAY “{NAME}’s” USING
THE NAME OF THE NEW HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
g. IF RELATIONSHIP OF NEW PERSON BEING ENTERED IS “7” OR “8” (GRANDMOTHER OR
GRANDFATHER), SOFT AGE RANGE IS 30-120.
2. IF, ACCORDING TO THE PRELOAD, A CASE DID NOT HAVE A COMPLETE OR PARTIALLY
COMPLETE PARENT INTERVIEW IN FALL K, SPRING K, OR BOTH:
a. DISPLAY ALL NAMES COLLECTED AT FSQ.020.
b. THE CURSOR SHOULD BEGIN IN THE COLUMN FOR THE RELATIONSHIP OF THE RESPONDENT
TO THE CHILD.
c. DISPLAY “your” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “{NAME}’s” 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 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.
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."
MOTHER/FEMALE GUARDIAN ...................................................................... 1 (FSQ.140)
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 4)
BOYFRIEND OR MALE PARTNER OF {CHILD}'S PARENT/GUARDIAN ...... 6 (BOX 4)
GRANDMOTHER ............................................................................................ 7 (BOX 4)
GRANDFATHER ............................................................................................. 8 (BOX 4)
AUNT............................................................................................................... 9 (BOX 4)
UNCLE ............................................................................................................ 10 (BOX 4)
COUSIN .......................................................................................................... 11 (BOX 4)
OTHER RELATIVE ......................................................................................... 12 (BOX 4)
OTHER NON-RELATIVE ................................................................................ 13 (FSQ180)
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.
CAPI INSTRUCTIONS: CONSISTENCY CHECK: IF FSQ.140 = 1, THE AGE OF THIS HOUSEHOLD
MEMBER SHOULD BE AT LEAST 10 YEARS OLDER THAN THE CHILD AND AT MOST 50 YEARS
OLDER THAN THE CHILD IN A SOFT RANGE CHECK. IF NOT, DISPLAY MESSAGE: UNLIKELY
ANSWER: THE MOTHER WAS REPORTED TO BE {AGE FROM FSQ.030} YEARS OLD AND THE CHILD
IS {CHILD AGE FROM FSQ.020} YEARS OLD. PLEASE CONFIRM INFORMATION AND CORRECT
RELATIONSHIP OR AGE, IF NECESSARY. ELSE, IF FSQ.140 = 2-5, THE SOFT RANGE FOR THE AGE
OF THIS HOUSEHOLD MEMBER SHOULD BE AT LEAST 10 YEARS OLDER THAN THE CHILD AND AT
MOST 70 YEARS OLDER THAN THE CHILD. IF NOT, DISPLAY MESSAGE: UNLIKELY ANSWER: THE
MOTHER OR FEMALE GUARDIAN WAS REPORTED TO BE {AGE FROM FSQ.030} YEARS OLD AND
THE CHILD IS {CHILD AGE FROM FSQ.020} YEARS OLD. PLEASE CONFIRM INFORMATION AND
CORRECT RELATIONSHIP OR AGE, IF NECESSARY.
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 of 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 ...............................................
1
2
3
4
5
8
9
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
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.
CAPI INSTRUCTIONS: CONSISTENCY CHECK: IF FSQ.150 = 1-5, THE AGE OF THIS HOUSEHOLD
MEMBER SHOULD BE AT LEAST 10 YEARS OLDER THAN THE CHILD’S AGE USING A SOFT EDIT. IF
NOT, DISPLAY MESSAGE: UNLIKELY ANSWER: THE FATHER OR MALE GUARDIAN WAS REPORTED
TO BE {AGE FROM FSQ.030} YEARS OLD AND THE CHILD IS {CHILD AGE FROM FSQ.020} YEARS
OLD. PLEASE CONFIRM INFORMATION AND CORRECT RELATIONSHIP OR AGE, IF NECESSARY.
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 of 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, or .................
Other male parent or guardian? .....................
REFUSED .....................................................
DON’T KNOW ...............................................
1
2
3
4
5
8
9
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
(BOX 4)
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, ...................................................... 1 (BOX 4)
Half sister, ...................................................... 2 (BOX 4)
Step sister, ..................................................... 3 (BOX 4)
Adoptive sister, or .......................................... 4 (BOX 4)
Foster sister? ................................................. 5 (BOX 4)
REFUSED ..................................................... 8 (BOX 4)
DON’T KNOW ............................................... 9 (BOX 4)
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, ................................................... 1 (BOX 4)
Half brother, ................................................... 2 (BOX 4)
Step brother, .................................................. 3 (BOX 4)
Adoptive brother, or ....................................... 4 (BOX 4)
Foster brother? .............................................. 5 (BOX 4)
REFUSED ..................................................... 8 (BOX 4)
DON’T KNOW ............................................... 9 (BOX 4)
HELP AVAILABLE
FSQ.180
CODE NON-RELATIVE RELATIONSHIP BELOW IF MORE DESCRIPTIVE.
CAPI INSTRUCTIONS: IF FSQ.180 IS CODED 1 (GIRLFRIEND), FLAG RESPONSE TO FSQ.130 AS
CODE 5.
CAPI INSTRUCTIONS: IF FSQ.180 IS CODED 2 (BOYFRIEND), FLAG RESPONSE TO FSQ.130 AS
CODE 6.
CAPI INSTRUCTIONS: 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 INSTRUCTIONS: IF FSQ.180 IS CODED 4 (MALE GUARDIAN), FLAG RESPONSE TO FSQ.130 AS
CODE 2 AND RESPONSE TO FSQ.150 AS CODE 4.
CAPI INSTRUCTIONS: CONSISTENCY CHECK: IF RELATIONSHIP OF NEW PERSON BEING
ENTERED IS “1” OR “2” (GIRLFRIEND OR BOYFRIEND OF THE CHILD’S PARENT/GUARDIAN), SOFT
AGE RANGE IS 15-100. IF AGE IS NOT IN THAT RANGE, DISPLAY MESSAGE: UNLIKELY AGE FOR A
GIRLFRIEND OR BOYFRIEND OF THE CHILD’S PARENT. PLEASE CONFIRM INFORMATION AND
CORRECT RELATIONSHIP OR AGE, IF NECESSARY.
ELSE, IF RELATIONSHIP OF NEW PERSON BEING ENTERED IS “3” OR “4”, THE SOFT RANGE FOR
THE AGE OF THIS HOUSEHOLD MEMBER SHOULD BE AT LEAST 10 YEARS OLDER THAN THE CHILD
AND AT MOST 70 YEARS OLDER THAN THE CHILD. IF NOT, DISPLAY MESSAGE: UNLIKELY ANSWER:
THE MOTHER OR FEMALE GUARDIAN WAS REPORTED TO BE {AGE FROM FSQ.030} YEARS OLD
AND THE CHILD IS {CHILD AGE FROM FSQ.020} YEARS OLD. PLEASE CONFIRM INFORMATION AND
CORRECT RELATIONSHIP OR AGE, IF NECESSARY.
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.
GIRLFRIEND OR FEMALE PARTNER OF {CHILD}'S PARENT/GUARDIAN…..1 (BOX 4)
BOYFRIEND OR MALE PARTNER OF {CHILD}'S PARENT/GUARDIAN………2 (BOX 4)
FEMALE GUARDIAN…………………………………………………………………..3 (BOX 4)
MALE GUARDIAN……………………………………………………………………...4 (BOX 4)
DAUGHTER/SON OF {CHILD}'S PARENT’S PARTNER………………………….5 (BOX 4)
OTHER RELATIVE OF {CHILD}'S PARENT’S PARTNER………………………...6 (BOX 4)
OTHER NON-RELATIVE (SPECIFY)………………………………………………..91 (FSQ.181)
REFUSED……………………………………………………………………………...88 (BOX 4)
DON’T KNOW……………………………………………………………………….…99 (BOX 4)
FSQ.181
_______________________________________
SPECIFY OTHER NON-RELATIVE.
BOX 4
END LOOP 1.
ASK FSQ130 - FSQ180 FOR NEXT PERSON ON THE HOUSEHOLD ROSTER WHO IS NOT THE FOCAL CHILD.
IF NO NEXT PERSON, CONTINUE WITH BOX 4A.
BOX 4A
LOOP 2.
IF ANY FOCAL CHILD, RESPONDENT, MOTHER FIGURE, OR FATHER
FIGURE, OR RESPONDENT AND RESPONDENT'S SPOUSE (IF NO MOTHER
OR FATHER FIGURES) (NEW OR OLD HH MEMBERS) IS MISSING ETHNICITY
OR RACE DATA, CONTINUE WITH FSQ.190.
OTHERWISE, GO TO BOX 4B.
HELP AVAILABLE
FSQ.190
{Are you/Is {NAME}} Hispanic or Latino?
{CODE HISPANIC OR LATINO FOR NEW HOUSEHOLD MEMBERS ONLY. IF NO NEW PERSONS,
PRESS ENTER TO CONTINUE.}
CAPI MATRIX INSTRUCTIONS:
DISPLAY IN COLUMN 1 EACH PERSON ENUMERATED ON THE HOUSEHOLD ROSTER (AT FSQ.020)
WHO IS THE FOCAL CHILD, RESPONDENT, MOTHER FIGURE (CODE ‘1’ AT FSQ.130 OR CODE ‘3’ AT
FSQ.180), OR FATHER FIGURE (CODE ‘2’ AT FSQ.130 OR CODE ‘4’ AT FSQ.180).
IF NO MOTHER OR FATHER FIGURES IN THE HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH (A
CODE ‘1’ OR ‘2’ AT FSQ.130) OR (CODE “3” OR “4” AT FSQ.180), 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.
NOTE: DO NOT DISPLAY HOUSEHOLD MEMBERS CODED AS NOT LIVING IN THE HOUSEHOLD AT
FSQ.010.
THE CURSOR SHOULD BE POSITIONED ON THE FIRST BLANK FIELD. IF NO BLANK FIELDS, THE
CURSOR SHOULD BE POSITIONED ON THE LAST COMPLETED FIELD IN THE MATRIX.
IF, ACCORDING TO THE PRELOAD, A CASE HAD A COMPLETE OR PARTIALLY COMPLETE PARENT
INTERVIEW IN FALL K, SPRING K, OR BOTH:
ASK ABOUT HISPANIC OR LATINO ONLY IF NEW HOUSEHOLD MEMBERS ARE THE FOCAL CHILD'S
PARENTS OR THE RESPONDENT, IF PREVIOUS HOUSEHOLD MEMBERS BECAME THE CHILD’S
PARENTS OR THE RESPONDENT, OR IF THERE ARE NO PARENTS, THEN ASK ABOUT THE
RESPONDENT AND RESPONDENT'S SPOUSE/PARTNER (IF THEY ARE NEW). DISPLAY “Are you” IF
LOOPING ON A NEW RESPONDENT. OTHERWISE, DISPLAY “Is {NAME}” USING THE NAME OF THE
NEW HOUSEHOLD MEMBER THAT IS BEING LOOPED ON.
IF, ACCORDING TO THE PRELOAD, A CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE
PARENT INTERVIEW IN FALL K, SPRING K, OR BOTH:
ASK ABOUT HISPANIC OR LATINO FOR THE FOCAL CHILD, RESPONDENT, MOTHER AND FATHER
FIGURES. IF NO MOTHER OR FATHER FIGURES, THEN ASK ABOUT THE FOCAL CHILD, THE
RESPONDENT AND RESPONDENT'S SPOUSE/PARTNER (IF ANY). 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:
Hispanic or Latino: A person of Cuban, Mexican, Puerto Rican, South or Central American, or other
Spanish culture or origin, regardless of race.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW……………………………………
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.
IF ”HISPANIC” or “LATINO” PROBE: Is that White Hispanic, Black Hispanic, both, or something else?
IF RESPONDENT CONTINUES TO SAY ”HISPANIC” or “LATINO” AFTER USING THE PROBE ABOVE,
CODE AS “DON’T KNOW.”
CAPI MATRIX INSTRUCTIONS:
DISPLAY IN COLUMN 1 EACH PERSON ENUMERATED ON THE HOUSEHOLD ROSTER (AT FSQ.020)
WHO IS THE FOCAL CHILD, RESPONDENT, MOTHER FIGURE (CODE ‘1’ AT FSQ.130 OR CODE ‘3’ AT
FSQ.180), OR FATHER FIGURE (CODE ‘2’ AT FSQ.130 OR CODE ‘4’ AT FSQ.180).
IF NO MOTHER OR FATHER FIGURES IN THE HOUSEHOLD (NO HOUSEHOLD MEMBERS WITH A
CODE ‘1’ OR ‘2’ AT FSQ.130) OR (CODE “3” OR “4” AT FSQ.180), 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.
NOTE: DO NOT DISPLAY HOUSEHOLD MEMBERS CODED AS NOT LIVING IN THE HOUSEHOLD AT
FSQ.010.
IF THERE WAS A COMPLETE OR PARTIALLY COMPLETE INTERVIEW IN FALL-KINDERGARTEN OR
SPRING-KINDERGARTEN, ASK ABOUT RACE ONLY IF NEW HOUSEHOLD MEMBERS ARE THE
FOCAL CHILD'S PARENTS OR THE RESPONDENT, IF PREVIOUS HOUSEHOLD MEMBERS BECAME
THE CHILD’S PARENTS OR THE RESPONDENT, OR IF THERE ARE NO PARENTS, THEN ABOUT THE
RESPONDENT AND RESPONDENT'S SPOUSE/PARTNER (IF THEY ARE NEW). DISPLAY “your”, “you”,
“consider”, AND “yourself” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “{NAME}”,
“{NAME}”, “considers” AND (“himself” OR “herself”) USING THE NAME OF THE HOUSEHOLD MEMBER
THAT IS BEING LOOPED ON. DISPLAY “himself” IF THE PERSON IS MALE AND “herself” IF THE
PERSON IS FEMALE. IF GENDER IS MISSING, DISPLAY “himself/herself”.
IF THERE WAS NOT A COMPLETE OR PARTIALLY COMPLETE INTERVIEW IN FALL-KINDERGARTEN
OR SPRING-KINDERGARTEN, ASK ABOUT RACE FOR THE FOCAL CHILD, RESPONDENT, MOTHER
AND FATHER FIGURES. IF NO MOTHER OR FATHER FIGURES, THEN ASK ABOUT THE FOCAL
CHILD, THE RESPONDENT AND RESPONDENT'S SPOUSE/PARTNER (IF ANY). DISPLAY “your”, “you”,
“consider”, AND “yourself” IF LOOPING ON THE RESPONDENT. OTHERWISE, DISPLAY “{NAME}”,
“{NAME}”, “considers” AND (“himself” OR “herself”) USING THE NAME OF THE HOUSEHOLD MEMBER
THAT IS BEING LOOPED ON. DISPLAY “himself” IF THE PERSON IS MALE AND “herself” IF THE
PERSON IS FEMALE. IF GENDER IS MISSING, DISPLAY “himself/herself”.
{CODE RACE OF NEW HOUSEHOLD MEMBERS ONLY. IF NO NEW PERSONS, PRESS ENTER TO
CONTINUE.}
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.
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
BOX 4B
END LOOP 2.
ASK FSQ.190 – FSQ.195 FOR NEXT PERSON WHO IS THE FOCAL CHILD,
MOTHER FIGURE, FATHER FIGURE, OR RESPONDENT OR RESPONDENT'S
SPOUSE (IF NO MOTHER OR FATHER FIGURES) (NEW OR OLD HH
MEMBERS) WHOSE ETHNICITY OR RACE DATA ARE MISSING.
IF NO NEXT PERSON, CONTINUE WITH FSQ.200.
FSQ.200
{FILL 1}
{FILL 2}
Are you
have you
Are you
have you
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
Are CHILD's
adoptive parents
have
they
has she
ParentIsR
BioMoInHH
BioFaInHH
AdopMoInHH
The current
roster shows a
relationship of
biological/
adoptive mother
or biological/
adoptive father
for the person
flagged as the
respondent for
YES
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
{FILL
3}
AdopFaInH
H
The current
roster shows
the
relationship
of adoptive
father for at
least one HH
member (not
the R)
for YES
OtherinHH
SameAdopinHH
The current
roster shows
there is no
biological/ado
ptive
mother/father
in the
household for
YES
The current
roster shows
there are same
sex adoptive
parents (one of
them is not the
R) for YES
The current
roster shows
there are
same sex
biological
parents (one
of them is not
the R) for YES
YES
NO
YES
YES
NO
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
NO
NO
NO
YES
YES
NO
NO
NO
NO
have
they
have
they
SameBioinH
H
to each
other
to each
other
to each
other
NO
{FILL 1} currently married, separated, divorced, widowed, in a domestic partnership, or {FILL 2} never been married {FILL 3}?
PROBE: This question is about parents who live in the household.
MARRIED……………………………………………..1
SEPARATED…………………………………………2
DIVORCED…………………………………………...3
WIDOWED……………………………………………4
NEVER MARRIED ................................................. 5
CIVIL UNIONS/DOMESTIC PARTNERSHIP……...6
REFUSED……………………………………………..8
DON’T KNOW…………………………………………9
YES
YES
BOX 5
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 MALE
SPOUSE/PARTNER (SPOUSE/PARTNER, HERE AND IN OTHER PARTS OF THIS BOX, IS DEFINED AS FSQ.040
= 1 AND A SPOUSE/PARTNER HAVING BEEN SELECTED AT FSQ.120), THE MOTHER SHOULD BE A KEY
PARENT FIGURE AND THE MALE SPOUSE/PARTNER SHOULD BE A KEY PARENT FIGURE. ELSE, IF THERE IS
A MOTHER (RELATION =1) BUT NO FATHER (RELATION=2) AND THERE ARE TWO MOTHERS IN THE
HOUSEHOLD, THE MOTHER (IDENTIFIED WITH THE SAME CRITERIA AS IN BULLET 2 IF THERE ARE TWO
MOTHERS) SHOULD BE A KEY PARENT FIGURE AND THE OTHER MOTHER IN THE HOUSEHOLD (WHO HAS A
DIFFERENT PERSON NUMBER THAN THE MOTHER IDENTIFIED AS A KEY PARENT FIGURE) SHOULD BE A
KEY PARENT FIGURE. ELSE, IF THERE IS A MOTHER (RELATION =1) BUT NO FATHER (RELATION=2) AND
THE MOTHER HAS A SPOUSE/PARTNER WHO IS FEMALE, THE MOTHER (IDENTIFIED WITH THE SAME
CRITERIA AS IN BULLET 2 IF THERE ARE TWO MOTHERS) SHOULD BE A KEY PARENT FIGURE AND HER
FEMALE SPOUSE/PARTNER (WHO HAS A DIFFERENT PERSON NUMBER THAN THE MOTHER IDENTIFIED AS
A KEY PARENT FIGURE) SHOULD BE A KEY PARENT FIGURE. (NOTE: IN HOUSEHOLDS WITH TWO
MOTHERS, EACH MOTHER FIGURE CAN ONLY OCCUPY ONE OF THE TWO KEY PARENT FIGURE SLOTS. IF
MOTHER FIGURE #2 QUALIFIES AS A KEY PARENT AND IS ALSO THE SPOUSE/PARTNER OF A MOTHER
FIGURE #1, MOTHER FIGURE #1 SHOULD BE ONE KEY MOTHER FIGURE AND MOTHER FIGURE #2 SHOULD
BE THE OTHER KEY PARENT FIGURE)
•
4) IF THERE IS A FATHER (RELATION=2) BUT NO MOTHER (RELATION=1) AND THE FATHER HAS A FEMALE
SPOUSE/PARTNER, THE FATHER SHOULD BE A KEY PARENT FIGURE AND THE FEMALE SPOUSE/PARTNER
SHOULD BE A KEY PARENT FIGURE. ELSE, IF THERE IS A FATHER (RELATION =2) BUT NO MOTHER
(RELATION=2) AND THERE ARE TWO FATHERS IN THE HOUSEHOLD, THE FATHER (IDENTIFIED WITH THE
SAME CRITERIA AS IN BULLET 2 IF THERE ARE TWO FATHERS) SHOULD BE A KEY PARENT FIGURE AND
THE OTHER FATHER IN THE HOUSEHOLD (WHO HAS A DIFFERENT PERSON NUMBER THAN THE FATHER
IDENTIFIED AS A KEY PARENT FIGURE) SHOULD BE A KEY PARENT FIGURE.
ELSE, IF THERE IS A FATHER (RELATION=2) BUT NO MOTHER (RELATION=1) AND THE FATHER HAS A MALE
SPOUSE/PARTNER, THE FATHER (IDENTIFIED WITH THE SAME CRITERIA AS IN BULLET 2 IF THERE ARE
TWO FATHERS) SHOULD BE A KEY PARENT FIGURE AND HIS MALE SPOUSE/PARTNER (WHO HAS A
DIFFERENT PERSON NUMBER THAN THE FATHER IDENTIFIED AS A KEY PARENT FIGURE) SHOULD BE A
KEY PARENT FIGURE. NOTE: IN HOUSEHOLDS WITH TWO FATHERS, EACH FATHER FIGURE CAN ONLY
OCCUPY ONE OF THE TWO KEY PARENT FIGURE SLOTS. IF FATHER FIGURE #2 QUALIFIES AS A KEY
PARENT AND IS ALSO THE SPOUSE/PARTNER OF A FATHER FIGURE #1, FATHER FIGURE #1 SHOULD BE
ONE KEY FATHER FIGURE AND FATHER FIGURE #2 SHOULD BE THE OTHER 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 6
IF THE PRELOAD SHOWS THAT SPRING-KINDERGARTEN DATA FOR FSQ.212-FSQ.213 ARE MISSING FOR ONE OR BOTH OF
THE CURRENT 2 “KEY” PARENT FIGURES), ASK FSQ.212-FSQ.213 FOR 2 “KEY” PARENT FIGURES, AS DEFINED IN BOX 5
ABOVE. ELSE, GO TO BOX 8.
FSQ.212
Now I have a few questions about {your/{NAME}'s} country of birth. In what country {were/was} {you/{NAME}} born?
TO ACTIVATE LOOKUP, BEGIN TO TYPE COUNTRY OR TERRITORY.
HIGHLIGHT ***NOT ON LIST*** IN THE LOOKUP FILE AND PRESS ENTER.
IF COUNTRY IS NOT ON THE LIST,
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
CAPI INSTRUCTIONS: DISPLAY "your”, “were” AND “you” IF CURRENT CYCLE OF LOOP IS ASKING ABOUT THE
RESPONDENT. DISPLAY "{NAME}" (AND THAT PERSON'S FIRST NAME), “was” and "{NAME}" (AND THAT
PERSON'S FIRST NAME AGAIN), IF CURRENT CYCLE OF LOOP IS ASKING ABOUT A HOUSEHOLD MEMBER
WHO IS NOT THE RESPONDENT.
CAPI INSTRUCTION: DISPLAY COUNTRY LOOKUP FILE. ALLOW 3 SPACES IN THE RESPONSE FIELD FOR
ENTERING RESPONSE CODES.
BOX 7
IF FSQ.212 = 0 (NOT ON LIST), CONTINUE WITH FSQ.211OS.
IF FSQ.212 = 1 (UNITED STATES), DK, OR RF, GO TO BOX 8.
OTHERWISE, CONTINUE WITH FSQ.213.
FSQ.212OS
[In what country {were/was} {you/{NAME}} born?}
CAPI INSTRUCTIONS: DISPLAY “were” AND “you” IF CURRENT CYCLE OF LOOP IS ASKING ABOUT THE
RESPONDENT. DISPLAY “was” and "{NAME}" (AND THAT PERSON'S FIRST NAME) IF CURRENT CYCLE OF
LOOP IS ASKING ABOUT A HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT.
SPECIFY COUNTRY.
_________________________________________________________
FSQ.213
How old {was/were} {you/{NAME}} when {you/{he/she}} first moved to {any of the fifty states in the United States or the
District of Columbia/the United States}?
CAPI INSTRUCTIONS: DISPLAY “were”, “you”, AND “you” IF CURRENT CYCLE OF LOOP IS ASKING ABOUT
THE RESPONDENT. DISPLAY “was”, "{NAME}" (AND THAT PERSON'S FIRST NAME), AND “he” FOR A
MALE/”she” FOR A FEMALE/”he/she” IF GENDER IS MISSING IF CURRENT CYCLE OF LOOP IS ASKING ABOUT
A HOUSEHOLD MEMBER WHO IS NOT THE RESPONDENT.
CAPI INSTRUCTIONS: DISPLAY “any of the fifty states in the United States or the District of Columbia” IF FSQ.212 =
5, 90, 139, 179, 203, 235 (AMERICAN SAMOA, GUAM, MARIANA ISLAND, PUERTO RICO, SOLOMON ISLANDS,
OR US VIRGIN ISLANDS). ELSE, DISPLAY “the United States.”
CAPI INSTRUCTION: RANGE CHECK: 0 – 75 YEARS OLD. UNLESS AGE IN HOUSEHOLD ROSTER = DK OR
RF, AGE ENTERED AT THIS ITEM SHOULD BE CHECKED IN A SOFT RANGE AGAINST THIS PERSON'S AGE IN
THE HOUSEHOLD ROSTER. OTHERWISE, DISPLAY ERROR MESSAGE: "THIS AGE CANNOT BE GREATER
THAN PERSON'S CURRENT AGE. PLEASE CONFIRM ANSWER.
1.
2.
3.
PRESS G TO REENTER ANSWER.
PRESS C TO ESCAPE OR CANCEL.
PRESS S TO ACCEPT ANSWER ABOUT AGE WHEN FIRST MOVED TO THE UNITED STATES. ADD
COMMENT ABOUT THE PERSON’S CURRENT AGE.”
|___|___|
AGE
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
BOX 8
ASK FSQ.212-FSQ.213 FOR THE NEXT APPROPRIATE KEY PARENT FIGURE IDENTIFIED IN BOX 6. IF THERE IS NOT AN
APPROPRIATE KEY PARENT FIGURE LEFT TO BE ASKED ABOUT, GO TO PLQ.
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 (PLQ.110)
8 (PLQ.110)
9 (PLQ.110)
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.
PLQ.040OS
[What languages other than English are spoken in your home?]
SPECIFY LANGUAGE.
____________________________________________________________
BOX 2
IF ONLY ONE LANGUAGE SPOKEN IN THE HOME ((PLQ.030 = 2, REF, OR DK) AND
(ONLY ONE LANGUAGE IS CODED AT PLQ.040 OR PLQ.040 = REF OR DK)), GO TO
PLQ.083. ELSE, ASK PLQ.060.
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.
CODE ‘16’ IF RESPONDENT CANNOT CHOOSE A PRIMARY LANGUAGE.
CAPI INSTRUCTION: DISPLAY 'primary' IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT EDIT: IF ANY CATEGORY 1-15 IS ANSWERED IN PLQ.060, IT SHOULD HAVE BEEN
A LANGUAGE MENTIONED IN CATEGORIES 1-15 IN PLQ.040. IF A NEW LANGUAGE IS CODED IN PLQ.060
THAT WAS NOT CODED IN PLQ.040, DISPLAY MESSAGE: “THE PRIMARY LANGUAGE IS NOT A LANGUAGE
SPOKEN IN THE HOME ACCORDING TO PLQ.040. PLEASE CONFIRM.” NOTE: THIS IS A SOFT EDIT BECAUSE
A LANGUAGE NOTED IN THE “OTHER SPECIFY” IN PLQ.040 MAY HAVE ACTUALLY HAD A CODE THAT WAS
NOT USED UNTIL PLQ.060.
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 3
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.
____________________________________________________________
PLQ.083
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?
{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 "{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
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 ................................................
1
2
3
4
8
9
PLQ.090
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?
{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
NON-ENGLISH 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 ................................................
1
2
3
4
8
9
BOX 4
IF PLQ.020 = 1 AND [(PLQ.060 NE 0 (ENGLISH IS NOT THE PRIMARY LANGUAGE) OR (PLQ.060 WAS NOT ASKED
BECAUSE ONLY ONE OTHER LANGUAGE WAS SPOKEN IN THE HOME)], GO TO PLQ.095.
ELSE, GO TO PLQ.110.
PLQ.095
This year, has it been harder for you to participate in activities at {CHILD}'s school because you or members of your family
speak a language other than English and meetings are conducted only in English? [Has that made it harder for you to
participate in activities at {CHILD}'s school?]
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
PLQ.096
Does {CHILD} have someone at home who can help {CHILD} with homework that is written in English?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ...............................................
PLQ.110
1
2
8
9
1
2
8
9
{You said that (English/NON-ENGLISH LANGUAGE/a language other than English) is spoken in your home.} When
{CHILD}'s teacher sends home notes or newsletters, are these in (English/NON-ENGLISH LANGUAGE/a language that
you speak)?
CAPI INSTRUCTIONS: IF PLQ.020 = REF/DK, USE A NULL DISPLAY FOR THE FIRST SENTENCE “You…home.”
AND DISPLAY “a language that you speak” IN THE SECOND SENTENCE.
ELSE, DISPLAY THE FIRST SENTENCE FOR ALL CASES.
ELSE, IF PLQ.020=2 (NO OTHER LANGUAGE REGULARLY SPOKEN AT HOME BESIDES ENGLISH) OR (IF
PLQ.060 WAS ASKED AND PLQ060=0 (ENGLISH SPOKEN AS PRIMARY LANGUAGE), DISPLAY 'English' IN THE
FIRST AND SECOND SENTENCES.
OTHERWISE, IF PLQ.060 WAS ASKED, DO THE FOLLOWING:
IF PLQ060 1-15, DISPLAY THE LANGUAGE SPECIFIED IN.PLQ.060.
ELSE, IF PLQ060=91, DISPLAY THE OTHER SPECIFY TEXT.
ELSE, IF PLQ060=16, DK, RF, DISPLAY "a language other than English" IN THE DISPLAY IN THE FIRST SENTENCE
AND "a language that you speak" IN THE DISPLAY IN THE SECOND SENTENCE.
OTHERWISE, IF PLQ.060 WAS NOT ASKED, AND ONE LANGUAGE WAS REPORTED FOR PLQ.040 OR PLQ.040 =
REF/DK, DO THE FOLLOWING:
IF PLQ.040 = 1-15, DISPLAY THE LANGUAGE IN PLQ.040.
ELSE, IF PLQ.040=91, DISPLAY THE OTHER SPECIFY TEXT IN PLQ.040.
ELSE, IF PLQ.040= DK, RF, DISPLAY "a language other than English" AND “a language that you speak”.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
1
2
8
9
BOX 5
GO TO SECTION HEQ (HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE STIMULATION).
HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE STIMULATION - HEQ
HELP AVAILABLE
HEQ.030
In a typical week, how often do you or any other family members read books to {CHILD}? Would you say…
CAPI INSTRUCTION: DISPLAY “week” IN UNDERLINED TEXT.
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 1
IF HEQ.030 =1, REF/DK, GO TO HEQ.040. ELSE, IF (PLQ.020 = 1) CONTINUE
WITH HEQ.035. ELSE, GO TO HEQ.040.
HEQ.035
In a typical week, how often do you or any other family members read books to {CHILD} in {PRIMARY LANGUAGE/a
language other than English}. Would you say…
CAPI INSTRUCTION: DISPLAY “week” IN UNDERLINED TEXT.
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 a week, ....................................
3-6 times a week, or .......................................
Every day? .....................................................
REFUSED .....................................................
DON'T KNOW ...............................................
HEQ.036
1
2
3
4
8
9
Generally, how long is {CHILD} read to at each of these times?
PROBE: Please include reading in any language.
CAPI INSTRUCTION: HARD RANGE CHECK: 1-60 MINUTES.
|___|___|
ENTER MINUTES
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
(HEQ.040)
(HEQ.036)
(HEQ.036)
(HEQ.036)
(HEQ.040)
(HEQ.040)
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 2
IF (PLQ.020 = 1) AND (HEQ.040 IS GREATER THAN OR EQUAL TO 1), GO TO
HEQ.045. ELSE, GO TO HEQ.105.
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 {PRIMARY LANGUAGE/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}. DISPLAY “{PRIMARY LANGUAGE/a language other than English}”ACCORDING
TO THE INSTRUCTIONS BELOW. 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 {PRIMARY LANGUAGE/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, ........................................................................................ 1
{PRIMARY LANGUAGE/A LANGUAGE
OTHER THAN ENGLISH} ................................................................ 2
SAME NUMBER IN ENGLISH AND {PRIMARY LANGUAGE/
A LANGUAGE OTHER THAN ENGLISH} ........................................ 3
REFUSED ...................................................................................... 8
DON'T KNOW .................................................................................. 9
HELP AVAILABLE
HEQ.105
In the past month, that is, since {MONTH} {DAY}, has anyone in your family visited a library or bookstore with {CHILD}?
HELP TEXT:
Do not count visiting a library or bookstore online. We are asking about in person visits to a library or bookstore.
CAPI INSTRUCTION: DISPLAY PREVIOUS MONTH FOR "MONTH" AND DATE OF INTERVIEW FOR "DAY".
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW……………………………………
HEQ.210
1
2
8
9
In the past week, how often did {CHILD} read to {himself/herself} or to others outside of school?
Would you say …
CAPI INSTRUCTION: DISPLAY "past week" IN UNDERLINED TEXT.
Never, ..............................................................1
Once or twice a week, ......................................2
3 to 6 times a week, or. .....................................3
Every day? ........................................................4
REFUSED .........................................................8
DON'T KNOW ...................................................9
HEQ.215
(HEQ.220)
(HEQ.215)
(HEQ.215)
(HEQ.215)
(HEQ.220)
(HEQ.220)
Generally, how long did {CHILD} read to {himself/herself} at each of these times?
CAPI INSTRUCTION: HARD RANGE CHECK: 1-60 MINUTES.
|___|___|
ENTER MINUTES
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
HELP AVAILABLE
HEQ.220
Do you have a home computer or other electronic device that {CHILD} uses?
HELP TEXT:
Electronic device: By electronic device, we mean any type of computer, cell phone, smart phone, iPod, reading device
(such as Kindle or Nook), or game system (including those such as Wii, XBox, DS, iTouch, and Playstation).
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW………………………………….
1
2
8
9
HEQ.280
Is {CHILD} tutored on a regular basis, by someone other than you or a family member, in a specific subject, such as
reading, math, science, or a foreign language?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
HEQ.290
1
2
8
9
(HEQ.290)
(HEQ.300)
(HEQ.300)
(HEQ.300)
What is {CHILD} tutored in?
CODE ALL THAT APPLY.
PROBE: Anything else?
READING....................................................... 1 (HEQ.300)
MATH ............................................................. 2 (HEQ.300)
SCIENCE ....................................................... 3 (HEQ.300)
FOREIGN LANGUAGE .................................. 4 (HEQ.300)
OTHER (SPECIFY) ........................................ 91 (HEQ.290OS)
REFUSED ...................................................... 8 (HEQ.300)
DON'T KNOW ................................................ 9 (HEQ.300)
HEQ.290OS [What is {CHILD} tutored in?]
SPECIFY SUBJECT.
_________________________________________________
HEQ.300
Outside of school hours in the past year, has {CHILD} participated in:
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Academic activities, like science, computers, math lab, or taking a class to learn a language other than English?
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
HEQ.310
[Outside of school hours in the past year, has {CHILD} participated in:]
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Organized athletic activities, like basketball, soccer, baseball, or gymnastics?
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
HEQ.320
[Outside of school hours in the past year, has {CHILD} participated in:]
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Organized clubs or recreational programs, like scouts?
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
HEQ.330
[Outside of school hours in the past year, has {CHILD} participated in:]
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Music lessons, for example, piano, instrumental music or singing lessons?
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
HEQ.340
[Outside of school hours in the past year, has {CHILD} participated in:]
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Drama classes?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW……………………………………
HEQ.350
1
2
8
9
[Outside of school hours in the past year, has {CHILD} participated in:]
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Art classes or lessons, for example, painting, drawing, or sculpture?
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
HEQ.370
[Outside of school hours in the past year, has {CHILD} participated in:]
CAPI INSTRUCTION: DISPLAY "year" IN UNDERLINED TEXT.
Organized performing arts programs, such as children's choirs, dance programs, or theater performances?
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
BOX 2A
IF HEQ.300, HEQ.310, HEQ320, HEQ.340, HEQ.350, OR HEQ.370 = 1, GO TO
HEQ.393. ELSE, GO TO HEQ.400.
HEQ.393
Did {CHILD}’s participation in {this activity/any of these activities} help to cover the hours when you
needed adult supervision for {him/her}?
CAPI INSTRUCTIONS: IF ONLY ONE OF THE ACTIVITY QUESTIONS = 1 (HEQ.300,
HEQ.310, HEQ320, HEQ.340, HEQ.350, OR HEQ.370), DISPLAY “this activity.” ELSE, DISPLAY “any of these
activities”.
YES ..................................................................... 1
NO ...................................................................... 2
REFUSED ........................................................... 8
DON'T KNOW ..................................................... 9
HEQ.400
Now, I have a question about your neighborhood. How safe is it for children to play outside during
the day in your neighborhood?
Would you say it's …
Not at all safe, ................................. 1
Somewhat safe, or .......................... 2
Very safe? ....................................... 3
REFUSED ....................................... 8
DON’T KNOW ................................. 9
HEQ.460
Now, I have some questions about meals. During the last five days {CHILD} was in school, how many breakfasts did
{he/she} eat that were NOT school breakfasts. By breakfast we mean breakfasts eaten at home, at childcare, or at school,
but not part of a school breakfast program. Please count only one breakfast per day.
CAPI INSTRUCTIONS:
1.
2.
3.
DISPLAY "five days {CHILD} was in school " IN UNDERLINED TEXT.
DISPLAY “NOT" IN UNDERLINED TEXT.
HARD RANGE CHECK: 0-5 BREAKFASTS
|___|
NUMBER OF BREAKFASTS
REFUSED…………………………………….8
DON’T KNOW………………………………...9
HELP AVAILABLE
HEQ.520
In a typical week, please tell me the number of days your family eats the evening meal together.
HELP TEXT:
Family: By family, we mean at least one adult and one child.
CAPI INSTRUCTION: RANGE: 0 TO 7.
CAPI INSTRUCTION: DISPLAY "typical week" IN UNDERLINED TEXT.
|___|
NUMBER OF DAYS
REFUSED ...................................................... 8
DON’T KNOW ................................................ 9
HEQ.560
About what time does {CHILD} usually go to bed on weeknights during the school year?
PROBE: If {his/her} bedtime varies a lot from night to night, by an hour or more, you can just say “it varies.”
IF BEDTIMES VARIES, ENTER “77”.
ENTER HOUR THEN MINUTE.
CAPI INSTRUCTION: HARD RANGE CHECK: LOWER RANGE: 1:00. UPPER RANGE: 12:59.
CAPI INSTRUCTION: IF 77 IS ENTERED FOR HOUR, SKIP TO HEQ.580.
|___|___|
HOUR
|___|___|
MINUTE
REFUSED…………………………………….8
DON’T KNOW………………………………...9
BOX 4A
IF HOUR IS REF/DK IN HEQ.560, GO TO HEQ.580. ELSE, GO TO HEQ.565. (NOTE: IF MINUTES ARE REF/DK, WE SHOULD STILL
GO TO HEQ.565).
HEQ.565
[About what time does {CHILD} usually go to bed on weeknights during the school year?]
SELECT A.M. OR P.M.
CAPI INSTRUCTION: IF HEQ.565 = 1, SOFT RANGE FOR HOUR IN HEQ.560 = 12-3. ELSE, IF HEQ.565 = 2, SOFT
RANGE FOR HOUR IN HEQ.560 = 5-11.
A.M. ...............................................................
P.M. ...............................................................
REFUSED ......................................................
DON'T KNOW……………………………………
1
2
8
9
HEQ.580
Next, I have a few questions about your family. How often did at least one member of your family attend religious
services in the past year? Would you say….
Never or almost never, ...................................
Several times a year, .....................................
Several times a month, ..................................
Once a week, or .............................................
Several times a week? ..................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
5
8
9
BOX 5
GO TO SECTION SSQ (SOCIAL SKILLS, PROBLEM BEHAVIORS, AND APPROACHES TO LEARNING).
SOCIAL SKILLS, PROBLEM BEHAVIORS, AND APPROACHES TOWARD LEARNING - SSQ
SSQ.010
Twenty-four items ask parents to rate their children on social skills (including their ability to
exercise self-control and interact with others); problem behaviors (e.g., fighting, arguing, anger,
depression, low self-esteem, impulsiveness, etc.); and learning dispositions or “approaches to
learning” (e.g., curiosity, self-direction, and inventiveness). The social skills items and the
problem behavior items are not listed as they are copyright protected. The learning disposition
items are not copyright protected and are listed below.
Learning disposition items:
j.
m.
o.
r.
v.
x.
Keep working at something until {he/she} is finished? ...................... ___
Show interest in a variety of things? ................................................. ___
Concentrate on a task and ignore distractions? ............................... ___
Help with chores? ............................................................................. ___
Eager to learn new things? ............................................................... ___
Creative in work or in play? .............................................................. ___
Copyrighted items Source: Social Skills Rating System (SSRS). Copyright © 1990 NCS Pearson. Adapted with
permission. All rights reserved.
BOX 1
GO TO SECTION CFQ (CRITICAL FAMILY PROCESSES).
CRITICAL FAMILY PROCESSES - CFQ
CFQ.320
Now I’m going to read some statements. Please tell me whether each statement is never true for you, sometimes true for
you, or always true for you.
{PROBE: Would you say it is never true for you, sometimes true for you, or always true for you?}
CAPI INSTRUCTION: DISPLAY "PROBE ..you" IF ON B-C. DISPLAY "Now … you" IN BRACKETS IF ON B-C.
NEVER
TRUE
a.
b.
c.
If {CHILD} is having problems at school,
there is a friend, relative, or neighbor I
can talk it over with. Would you say
it is never true for you, sometimes true
for you, or always true for you? ................ 1
If I have an emergency and need cash,
family or friends will loan it to me ............. 1
If I have troubles or need advice, I have
someone I can talk to ................................ 1
BOX 1
GO TO SECTION CCQ (CHILD CARE).
SOMETIMES
TRUE
ALWAYS
TRUE
REF
2
3
8
9
2
3
8
9
2
3
8
9
DK
CHILD CARE - CCQ
CCQ.005
Next, I'd like to talk with you about the child care arrangements you have for {CHILD} this year. First, I'd
like to talk to you about all the child care {CHILD} now receives on a regular basis from
someone other than {you/{his/her} parents} {or {his/her} guardians}}. This does not include occasional baby-sitting or
backup care providers.
PRESS ENTER TO CONTINUE.
CAPI INSTRUCTIONS: DISPLAY 'regular basis" IN UNDERLINED TEXT
CAPI INSTRUCTIONS: FOR ALL DISPLAYS, DEFINE 'PARENT FIGURE" AS THE MOTHER OR FATHER OR
MALE OR FEMALE GUARDIAN (FSQ.130= 1 OR 2 - THIS INCLUDES BIRTH, ADOPTIVE, STEP, FOSTER, AND
OTHER PARENTS OR GUARDIANS).
IF RESPONDENT IS A PARENT FIGURE (FSQ.130 = 1 OR 2 FOR THE RESPONDENT) OR (IF THERE IS NO
PARENT IN THE HOUSEHOLD (FSQ.130 NE 1 OR 2 FOR ANY HOUSEHOLD MEMBER)), DISPLAY "you".
OTHERWISE, DISPLAY "{his/her} parents" IF AT LEAST ONE HH MEMBER, NOT THE RESPONDENT, IS A BIRTH,
ADOPTIVE, OR STEP PARENT OR THE RELATIONSHIP IS DK OR RF (FSQ.140 OR FSQ.150 = 1, 2, 3, DK, OR
REF).
DISPLAY “you” AND "or {his/her} guardians" IF THERE IS NO PARENT IN THE HOUSEHOLD (FSQ.130 NE 1 OR 2
FOR ANY HOUSEHOLD MEMBER). ELSE, USE A NULL DISPLAY.
Relative Care
HELP AVAILABLE
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} {or
{CHILD}’s guardians}.
DO NOT INCLUDE CARE FROM A PARENT WHO LIVES IN OR OUTSIDE THE HOUSEHOLD. ALSO, IF NO
PARENTS LIVE WITH THE CHILD, DO NOT INCLUDE CARE FROM GUARDIANS WHO LIVE WITH THE CHILD.
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.
CAPI INSTRUCTIONS: DISPLAY 'now" AND "regular basis" IN UNDERLINED TEXT.
CAPI INSTRUCTIONS: FOR ALL DISPLAYS, DEFINE 'PARENT FIGURE" AS THE MOTHER OR FATHER OR
MALE OR FEMALE GUARDIAN (FSQ.130= 1 OR 2 - THIS INCLUDES BIRTH, ADOPTIVE, STEP, FOSTER, AND
OTHER PARENTS OR GUARDIANS).
IF RESPONDENT IS A PARENT FIGURE (FSQ.130 = 1 OR 2 FOR THE RESPONDENT) OR (IF THERE IS NO
PARENT IN THE HOUSEHOLD (FSQ.130 NE 1 OR 2 FOR ANY HOUSEHOLD MEMBER)), DISPLAY "you".
OTHERWISE, DISPLAY "{CHILD}’s parents" IF AT LEAST ONE HH MEMBER, NOT THE RESPONDENT, IS A
BIRTH, ADOPTIVE, OR STEP PARENT OR THE RELATIONSHIP IS DK OR RF (FSQ.140 OR FSQ.150 = 1, 2, 3,
DK, OR REF).
DISPLAY “you” AND "or {CHILD}’s guardians" IF THERE IS NO PARENT IN THE HOUSEHOLD (FSQ.130 NE 1 OR 2
FOR ANY HOUSEHOLD MEMBER). ELSE, USE A NULL DISPLAY.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
(CCQ.060)
(CCQ.115)
(CCQ.115)
(CCQ.115)
HELP AVAILABLE
CCQ.060
How many different regular care arrangements do you currently have with relatives?
DO NOT INCLUDE CARE FROM A PARENT WHO LIVES IN OR OUTSIDE THE HOUSEHOLD. ALSO, IF NO
PARENTS LIVE WITH THE CHILD, DO NOT INCLUDE CARE FROM GUARDIANS WHO LIVE WITH THE CHILD.
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 INSTRUCTIONS: DISPLAY “regular” AND 'currently" IN UNDERLINED TEXT.
ONE ..............................................................
TWO ..............................................................
THREE ...........................................................
FOUR .............................................................
FIVE OR MORE .............................................
REFUSED ......................................................
DON'T KNOW ................................................
CCQ.065
1
2
3
4
5
8
9
{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.
DO NOT INCLUDE CARE FROM A PARENT WHO LIVES IN OR OUTSIDE THE HOUSEHOLD. ALSO, IF NO
PARENTS LIVE WITH THE CHILD, DO NOT INCLUDE CARE FROM GUARDIANS WHO LIVE WITH THE CHILD.
CAPI INSTRUCTION: DISPLAY “now' IN UNDERLINED TEXT. 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.
GRANDPARENT ...........................................
AUNT .............................................................
UNCLE ...........................................................
BROTHER .....................................................
SISTER ..........................................................
ANOTHER RELATIVE ...................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
5
6
8
9
CCQ.070
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. 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.
OWN HOME ..................................................
OTHER HOME...............................................
BOTH/VARIES ...............................................
REFUSED ......................................................
DON'T KNOW ................................................
CCQ.075
1
2
3
8
9
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". 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 "{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 ................................................
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
CCQ.085
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
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: RANGE CHECK: IF CCQ.085 IS NOT EQUAL TO REF/DK, THE SOFT RANGE IS THE
NUMBER OF DAYS REPORTED IN CCQ.085 MULTIPLIED BY 10 HOURS AND THE HARD RANGE IS THE
NUMBER OF DAYS REPORTED IN CCQ.085 MULTIPLIED BY 24 HOURS. ELSE, IF CCQ.085 IS REF/DK, THE
SOFT RANGE FOR HOURS IS 1-50 AND THE HARD RANGE FOR HOURS IS 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 ................................................
CCQ.093
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
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) ..............................................................
BOX 3
IF CCQ.093E = 1, GO TO CCQ.093OS. ELSE, GO TO CCQ.094.
CCQ.093OS
[Who was that?]
SPECIFY PERSON.
_________________________________________________________
YES
NO
R
DK
1
2
8
9
1
1
1
1
2
2
2
2
8
8
8
8
9
9
9
9
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?
IF NONE, ENTER ZERO.
CAPI INSTRUCTION:
relative."
DISPLAY "{RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5.
OTHERWISE, DISPLAY "that
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: IF CCQ.092=1 AND CCQ.093A – E ALL = 2, THEN CCQ.094 CANNOT EQUAL ZERO—IF IT
DOES, THE FOLLOWING ERROR MESSAGE SHOULD BE DISPLAYED: “IF THERE IS A CHARGE OR FEE, AND
NO ONE ELSE HELPS PAY FOR IT, THE FEE PAID CANNOT BE ZERO. PLEASE CONFIRM ANSWER.” ELSE,
HARD RANGE CHECK: $0 – 9999.
$|___|___|___|___|.|___|___|
ENTER AMOUNT OF PAYMENT .................. (BOX 3A)
REFUSED .................................................... 8 (BOX 4)
DON'T KNOW .............................................. 9 (BOX 4)
BOX 3A
IF CCQ.094 = 0, GO TO BOX 4. ELSE, GO TO CCQ.095.
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:
relative."
DISPLAY "{RELATIVE}" IF CCQ.065 = 1, 2, 3, 4, OR 5.
OTHERWISE, DISPLAY "that
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 ........................
PER DAY ...........................
PER WEEK ........................
PER MONTH .....................
PER YEAR .........................
EVERY TWO WEEKS .......
OTHER (SPECIFY) ............
REFUSED ..........................
DON'T KNOW ....................
1 (BOX 3B)
2 (BOX 3B)
3 (BOX 3B)
4 (BOX 3B)
5 (BOX 3B)
6 (BOX 3B)
91(CCQ.095OS)
8 (BOX 4)
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
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.
CCQ.096
How many children is this amount for, including {CHILD}?
CAPI INSTRUCTION: SOFT RANGE CHECK: THE NUMBER IN THE ANSWER CHOICE SHOULD NOT BE GREATER
THAN THE NUMBER OF CHILDREN IN THE HOUSEHOLD WHO ARE LESS THAN OR EQUAL TO 15 YEARS OLD.
ERROR MESSAGE SHOULD SAY: “NUMBER NOT IN RANGE OF CHILDREN 15 OR YOUNGER IN HOUSEHOLD.
VERIFY THAT THE NUMBER OF CHILDREN IS CORRECT.”
{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
IF THERE IS ONLY ONE CURRENT REGULAR RELATIVE CARE ARRANGEMENT FOR THE CHILD (CCQ.060 = 1 OR 8 OR 9), GO
TO CCQ.115.
OTHERWISE, CONTINUE WITH CCQ.110.
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}?
DO NOT INCLUDE CARE FROM A PARENT WHO LIVES IN OR OUTSIDE THE HOUSEHOLD. ALSO, IF NO
PARENTS LIVE WITH THE CHILD, DO NOT INCLUDE CARE FROM GUARDIANS WHO LIVE WITH THE CHILD.
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 ...................................................... 88
DON'T KNOW ................................................ 99
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" 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 ................................................
1
2
8
9
(CCQ.165)
(CCQ.260)
(CCQ.260)
(CCQ.260)
HELP AVAILABLE
CCQ.165
How many different regular care arrangements do you currently have with nonrelatives?
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.170
Is that care provided in your home or another home?
OWN HOME ..................................................
OTHER HOME...............................................
BOTH/VARIES ...............................................
REFUSED ......................................................
DON'T KNOW ................................................
CCQ.175
1
2
3
4
5
8
9
1
2
3
8
9
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
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 RANGE CHECK: IF CCQ.185 IS NOT EQUAL TO REF/DK, THE SOFT RANGE IS THE
NUMBER OF DAYS REPORTED IN CCQ.185 MULTIPLIED BY 10 HOURS AND THE HARD RANGE IS THE
NUMBER OF DAYS REPORTED IN CCQ.185 MULTIPLIED BY 24 HOURS. ELSE, IF CCQ.185 IS REF/DK, THE
SOFT RANGE FOR HOURS IS 1-50 AND THE HARD RANGE FOR HOURS IS 1-70.
|___|___|
ENTER # OF HOURS
REFUSED ...................................................... 888
DON'T KNOW ................................................ 999
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 ................................................
1
2 (BOX 8)
8 (BOX 8)
9 (BOX 8)
CCQ.193
Do any of the following people or organizations help to pay for this nonrelative to care for {CHILD}?
How about…
CAPI INSTRUCTIONS: DISPLAY 'specifically" IN UNDERLINED TEXT IN ITEM A.
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
1
2
2
2
2
8
8
8
8
9
9
9
9
BOX 7
IF CCQ.193e = 1, GO TO CCQ.193OS. ELSE, GO TO CCQ194.
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?
IF NONE, ENTER ZERO.
CAPI INSTRUCTION: IF CCQ.192=1 AND CCQ.193A – E ALL = 2, THEN CCQ.194 CANNOT EQUAL ZERO—IF IT
DOES, THE FOLLOWING ERROR MESSAGE SHOULD BE DISPLAYED: “IF THERE IS A CHARGE OR FEE, AND NO
ONE ELSE HELPS PAY FOR IT, THE FEE PAID CANNOT BE ZERO. PLEASE CONFIRM ANSWER.” ELSE, HARD
RANGE CHECK: $0 – 9999.
$|___|___|___|___|.|___|___|
ENTER AMOUNT OF PAYMENT .................. (BOX 7A)
REFUSED .................................................... 8 (BOX 8)
DON'T KNOW .............................................. 9 (BOX 8)
BOX 7A
IF CCQ.194 = 0, GO TO BOX 8. ELSE, GO TO CCQ.195.
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
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.
CCQ.196
How many children is this amount for, including {CHILD}?
CAPI INSTRUCTION: SOFT RANGE CHECK: THE NUMBER IN THE ANSWER CHOICE SHOULD NOT BE GREATER
THAN THE NUMBER OF CHILDREN IN THE HOUSEHOLD WHO ARE LESS THAN OR EQUAL TO 15 YEARS OLD.
ERROR MESSAGE SHOULD SAY: “NUMBER NOT IN RANGE OF CHILDREN 15 OR YOUNGER IN HOUSEHOLD.
VERIFY THAT THE NUMBER OF CHILDREN IS CORRECT.”
{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
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.
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." OTHERWISE, DISPLAY
"nonrelatives" AND "these nonrelatives."
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 ...................................................... 88
DON'T KNOW ................................................ 99
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 older (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
8
9
(CCQ.325)
(CCQ.376)
(CCQ.376)
(CCQ.376)
CCQ.325
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.
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 older (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
{CHILD} currently attends?
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 ...............................................
1
2
3
8
9
CCQ.340
HELP AVAILABLE
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 ......................................................
DON'T KNOW ................................................
CCQ.355
8
9
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: RANGE CHECK: IF CCQ.350 IS NOT EQUAL TO REF/DK, THE SOFT RANGE IS THE
NUMBER OF DAYS REPORTED IN CCQ.350 MULTIPLIED BY 10 HOURS AND THE HARD RANGE IS THE
NUMBER OF DAYS REPORTED IN CCQ.350 MULTIPLIED BY 24 HOURS. ELSE, IF CCQ.350 IS REF/DK, THE
SOFT RANGE FOR HOURS IS 1-50 AND THE HARD RANGE FOR HOURS IS 1-70.
|___|___|
ENTER # OF HOURS
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
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 ................................................
1
2 (BOX 14)
8 (BOX 14)
9 (BOX 14)
CCQ.370
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
1
2
2
2
2
8
8
8
8
9
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: IF CCQ.365=1 AND CCQ.370A – E ALL = 2, THEN CCQ.371 CANNOT EQUAL ZERO—IF IT
DOES, THE FOLLOWING ERROR MESSAGE SHOULD BE DISPLAYED: “IF THERE IS A CHARGE OR FEE, AND
NO ONE ELSE HELPS PAY FOR IT, THE FEE PAID CANNOT BE ZERO. PLEASE CONFIRM ANSWER.” ELSE,
HARD RANGE CHECK: $0 – 9999.
$|___|___|___|___|.|___|___|
ENTER AMOUNT OF PAYMENT .................. (BOX 13A)
REFUSED .................................................... 8 (BOX 14)
DON'T KNOW .............................................. 9 (BOX 14)
BOX 13A
IF CCQ.371 = 0, GO TO BOX 14. ELSE, GO TO CCQ.372.
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
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.
CCQ.373
How many children is this amount for, including {CHILD}?
CAPI INSTRUCTION: SOFT RANGE CHECK: THE NUMBER IN THE ANSWER CHOICE SHOULD NOT BE GREATER
THAN THE NUMBER OF CHILDREN IN THE HOUSEHOLD WHO ARE LESS THAN OR EQUAL TO 15 YEARS OLD.
ERROR MESSAGE SHOULD SAY: “NUMBER NOT IN RANGE OF CHILDREN 15 OR YOUNGER IN HOUSEHOLD.
VERIFY THAT THE NUMBER OF CHILDREN IS CORRECT.”
{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
IF ONLY ONE CURRENT REGULAR CENTER OR PROGRAM CARE ARRANGEMENT FOR CHILD (CCQ.325 = 1 OR
REF/DK), GO TO CCQ.376.
OTHERWISE, CONTINUE WITH CCQ.375.
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 ...................................................... 88
DON'T KNOW ................................................ 99
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
BOX 15
GO TO SECTION NRQ (NON-RESIDENT PARENT).
NON-RESIDENT PARENTS - NRQ
BOX 1
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
ASK NRQ.040 - NRQ.210 ONE TIME FOR EACH BIOLOGICAL MOTHER, ADOPTIVE MOTHER, BIOLOGICAL FATHER, AND
ADOPTIVE FATHER NOT LIVING IN THE HOUSEHOLD.
DETERMINING LOOPING ELIGIBILITY:
1. NO BIOLOGICAL/BIRTH MOTHER IN HH: IF NO HOUSEHOLD MEMBER WITH A CODE ‘1’ AT FSQ.140 AND [(THIS IS A CASE
WITHOUT A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW) OR
(CASE WITH A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW THAT
DOES NOT FIT THE CRITERIA FOR BEING INELIGIBLE ACCORDING TO #5 BELOW)], THEN ASK ABOUT BIOLOGICAL MOTHER.
2. NO ADOPTIVE MOTHER IN HH: IF NO BIOLOGICAL OR ADOPTIVE MOTHER IN HOUSEHOLD AND THERE IS ONLY ONE
ADOPTIVE FATHER IN THE HOUSEHOLD (THAT IS, THERE IS NO HOUSEHOLD MEMBER WITH A CODE '1' OR '2' AT FSQ.140,
AND ONLY ONE HOUSEHOLD MEMBER WITH A CODE '2' AT FSQ.150), AND [(THIS IS A CASE WITHOUT A COMPLETE OR
PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW) OR (CASE WITH A COMPLETE OR
PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW THAT DOES NOT FIT THE CRITERIA
FOR BEING INELIGIBLE ACCORDING TO #5 BELOW)], THEN ASK ABOUT ADOPTIVE MOTHER.
3. NO BIOLOGICAL/BIRTH FATHER IN HH: IF NO HOUSEHOLD MEMBER WITH A CODE ‘1’ AT FSQ.150 AND [(THIS IS A CASE
WITHOUT A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW) OR
(CASE WITH A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW THAT
DOES NOT FIT THE CRITERIA FOR BEING INELIGIBLE ACCORDING TO #5 BELOW)], ASK ABOUT BIOLOGICAL FATHER.
4. NO ADOPTIVE FATHER IN HH: IF NO BIOLOGICAL OR ADOPTIVE FATHER IN HOUSEHOLD AND THERE IS ONLY ONE
ADOPTIVE MOTHER IN THE HOUSEHOLD (THAT IS, THERE IS NO HOUSEHOLD MEMBER WITH CODE '1' OR ‘2’ AT FSQ.150,
AND ONLY ONE HOUSEHOLD MEMBER WITH A CODE '2' AT FSQ.140), AND [(THIS IS A CASE WITHOUT A COMPLETE OR
PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW) OR (CASE WITH A COMPLETE OR
PARTIALLY COMPLETE FALL-KINDERGARTEN OR SPRING-KINDERGARTEN INTERVIEW THAT DOES NOT FIT THE CRITERIA
FOR BEING INELIGIBLE ACCORDING TO #5 BELOW)], THEN ASK ABOUT ADOPTIVE FATHER.
5. INELIGIBLE CASES: IF NRQ.030 = 2 (NO ADOPTIVE NON-RESIDENT MOTHER/FATHER) FROM FALL-K, DO NOT LOOP ON
THAT ADOPTIVE NONRESIDENT PARENT.
ELSE, IF NRQ.040 = 5 (PARENT DECEASED), NRQ.040 = 6 (NO CONTACT SINCE ADOPTION), NRQ.040 = 7 (NO ADOPTIVE
(MOTHER/FATHER), OR NRQ.040 = 8 (PARENT UNKNOWN /WAS ONLY A DONOR) IN ANY PREVIOUS ROUND FOR AN
ADOPTIVE NON-RESIDENT PARENT, DO NOT LOOP ON THIS PARENT.
ELSE, IF NRQ.040 = 5 (PARENT DECEASED) OR NRQ.040 = 8 (PARENT UNKNOWN /WAS ONLY A DONOR) IN ANY PREVIOUS
ROUND FOR A BIOLOGICAL NON-RESIDENT PARENT, DO NOT LOOP ON THIS PARENT.
ELSE, IF A BIOLOGICAL PARENT WAS NOT LIVING OR RESPONDENT DID NOT KNOW WHO THE BIOLOGICAL PARENT WAS IN
THE FALL K INTERVIEW (FALL K HRQ.030=2 OR 3), DO NOT LOOP ON THIS PARENT.
IF THERE ARE ANY ELIGIBLE CASES ACCORDING TO THE LOOPING RULES ABOVE, GO TO NRQ.040 FOR EACH ELIGIBLE
CASE UNTIL ALL ELIGIBLES HAVE BEEN ASKED ABOUT IN THE QUESTIONS. ELSE, GO TO BOX 5.
NRQ.040
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, a video call, an e-mail, a text or other electronic
message, or received a card or letter from {his/her} {biological/adoptive} {father/mother}? Would you say …
CAPI INSTRUCTIONS:
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her” IF THE CHILD IS FEMALE. ELSE, IF CHILD GENDER IS
MISSING, DISPLAY “his/her”.
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 BIOLOGICAL PARENTS IN THE HOUSEHOLD (NO HOUSEHOLD
MEMBER WITH A CODE '1' AT FSQ.140 OR FSQ.150). OTHERWISE, USE A NULL DISPLAY.
DISPLAY 'for adoptive parents' IF THE RESPONDENT IS AN ADOPTIVE PARENT (FSQ.140 OR FSQ.150 IS CODED '2'
FOR THE PERSON FLAGGED AS THE RESPONDENT).
Less than one month……..…………………………………….1 (NRQ.050)
More than a month but less than a year……………………...2 (BOX 3)
More than a year…….…………………………………………..3 (BOX 3)
No contact since birth?...........………………………………….4 (BOX 4)
PARENT IS DECEASED……………………………………….5 (BOX 4)
NO CONTACT SINCE ADOPTION……………………………6 (BOX 4)
NO ADOPTIVE {MOTHER/FATHER}………………………….7 (BOX 4)
PARENT UNKNOWN/WAS ONLY A DONOR……………….8 (BOX 4)
REFUSED………………………………………………………88 (BOX 4)
DON’T KNOW………………………………………………….99 (BOX 4)
NRQ.050
How many days has {CHILD} seen {his/her} {biological/adoptive}{father/mother} in the past 4 weeks?
CAPI INSTRUCTIONS:
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her” IF THE CHILD IS FEMALE. ELSE, IF CHILD GENDER IS
MISSING, DISPLAY “his/her”.
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 INSTRUCTIONS: RANGE: 0 TO 28.
|___|___ |
NUMBER OF DAYS
REFUSED…………………………………….8
DON’T KNOW………………………………...9
NRQ.123
How many times have {CHILD} and {his/her} {biological/adoptive} {father/ mother} talked on the telephone or in a video
call to each other, e-mailed, texted, or had some other type of contact that was not in person in the past 4 weeks?
CAPI INSTRUCTIONS:
DISPLAY “his” IF THE CHILD IS MALE. DISPLAY “her” IF THE CHILD IS FEMALE. ELSE, IF CHILD GENDER IS
MISSING, DISPLAY “his/her”.
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 INSTRUCTIONS: RANGE: 0 TO 28.
|___|___ |
NUMBER OF DAYS
REFUSED…………………………………….8
DON’T KNOW………………………………...9
BOX 3
IF THE PRELOAD SHOWS THAT NRQ.200 WAS ASKED FOR THE NONRESIDENT BIOLOGICAL FATHER IN SPRINGKINDERGARTEN, GO TO BOX 4. ELSE, IF LOOPING ON NONRESIDENT BIOLOGICAL FATHER, CONTINUE WITH NRQ200.
OTHERWISE, GO TO BOX 4.
NRQ.200
Did {CHILD}'s biological father ever sign the application for {CHILD}'s birth certificate or sign a statement that legally says
he is {CHILD}'s biological father?
YES ................................................................ 1 (BOX 4)
NO ................................................................. 2 (NRQ.210)
REFUSED ...................................................... 8 (NRQ.210)
DON'T KNOW…………………………………. 9 (NRQ.210)
NRQ.210
Did you or someone in your family go to court to establish that he was {CHILD}'s legal biological father?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW……………………………………
1
2
8
9
BOX 4
ASK NRQ.040 TO NRQ.210 FOR THE NEXT NON-RESIDENTIAL PARENT. IF NO NEXT NON-RESIDENTIAL PARENT, GO TO BOX
5.
BOX 5
GO TO SECTION DWQ (DISCIPLINE AND WARMTH).
DISCIPLINE, WARMTH, AND EMOTIONAL SUPPORTIVENESS - DWQ
BOX 1
IF PERSON FLAGGED AS R SCORES '1' OR '2' AT FSQ.130
OR IF NO HOUSEHOLD MEMBER SCORES '1' OR '2' AT FSQ.130,
CONTINUE WITH DWQ.040.
OTHERWISE, GO TO DWQ.080.
DWQ.040
Now, I'm going to read some statements. Please tell me whether each statement is completely true, mostly true,
somewhat true, or not at all true.
Being a parent is harder than I thought it would be.
[PROBE: Is it completely true, mostly true, somewhat true or not at all true?]
COMPLETELY TRUE .................................... 1
MOSTLY TRUE ............................................. 2
SOMEWHAT TRUE ....................................... 3
NOT AT ALL TRUE ........................................ 4
REFUSED ...................................................... 8
DON’T KNOW ................................................ 9
DWQ.045
[Now, I'm going to read some statements. Please tell me whether each statement is completely true, mostly true,
somewhat true, or not at all true.]
{CHILD} does things that really bother me.
[PROBE: Is it completely true, mostly true, somewhat true or not at all true?]
COMPLETELY TRUE .................................... 1
MOSTLY TRUE ............................................. 2
SOMEWHAT TRUE ....................................... 3
NOT AT ALL TRUE ........................................ 4
REFUSED ...................................................... 8
DON’T KNOW ................................................ 9
DWQ.050
[Now, I'm going to read some statements. Please tell me whether each statement is completely true, mostly true,
somewhat true, or not at all true.]
I find myself giving up more of my life to meet {CHILD}'s needs than I ever expected.
[PROBE: Is it completely true, mostly true, somewhat true or not at all true?]
COMPLETELY TRUE .................................... 1
MOSTLY TRUE ............................................. 2
SOMEWHAT TRUE ....................................... 3
NOT AT ALL TRUE ........................................ 4
REFUSED ...................................................... 8
DON’T KNOW ................................................ 9
DWQ.060
[Now, I'm going to read some statements. Please tell me whether each statement is completely true, mostly true,
somewhat true, or not at all true.]
I often feel angry with {CHILD}.
[PROBE: Is it completely true, mostly true, somewhat true or not at all true?]
COMPLETELY TRUE .................................... 1
MOSTLY TRUE ............................................. 2
SOMEWHAT TRUE ....................................... 3
NOT AT ALL TRUE ........................................ 4
REFUSED ...................................................... 8
DON’T KNOW ................................................ 9
DWQ.077
The following are a number of statements about your family. Please tell me how often it typically occurs in your home.
{PROBE: Would you say this occurs never, almost never, sometimes, often, or always?}
CAPI INSTRUCTIONS: DISPLAY “The..home.” IN SQUARE BRACKETS FOR B-C. ALSO, DISPLAY PROBE FOR
B-C.
ALMOST
NEVER NEVER SOMETIMES OFTEN ALWAYS
a.
b.
c.
You threaten to punish {CHILD} and then do not actually punish {him/her}.
Would you say this occurs never, almost never, sometimes, often, or always?
{CHILD} talks you out of being punished after {he/she} has done something
wrong.
You let {CHILD} out of a punishment early, like lift restrictions
earlier than you originally said.
1
2
3
4
5
1
2
3
4
5
1
2
3
4
5
HELP AVAILABLE
DWQ.080
Now I’d like to ask some questions about {CHILD}’s television viewing. We want you to include television shows, videos,
or DVDs watched on a TV, computer, or handheld device like an iPad or cellphone; but not games played on gaming
systems like Playstation, Wii, Xbox or handheld devices.
On any given weekday, how many hours of television, videotapes, or DVDs on average does {CHILD} watch?
HELP TEXT:
Blu-Ray is also included, as are downloaded or streaming videos or movies.
CAPI INSTRUCTIONS:
1.
DISPLAY THE FOLLOWING MATRIX IN THE RESPONSE FIELD:
HOURS
MINUTES
2.
WHEN CURSOR IS ON THE HOUR FIELD, DISPLAY “ENTER NUMBER OF HOURS. IF LESS THAN AN
HOUR, ENTER '0.' MINUTES CAN BE ENTERED ON THE NEXT SCREEN.”
3.
WHEN CURSOR IS ON THE MINUTES FIELD, DISPLAY ‘ENTER NUMBER OF MINUTES.'
4.
WHEN CURSOR IS ON THE MINUTES FIELD, DISPLAY ‘Now…XBox’ AND ’On…watch?' IN SQUARE
BRACKETS.
5.
DK AND RF ALLOWED AT ALL FIELDS. EMPTY IS ALLOWED FOR MINUTES, BUT NOT FOR HOURS.
6.
IF HOURS ARE REF/DK, SKIP TO DWQ.081. ELSE, CONTINUE WITH MINUTES.
7.
HARD RANGE = 0 – 24 FOR HOURS; 0 – 59 FOR MINUTES. THE HOURS AND MINUTES TOGETHER
SHOULD NOT EXCEED 24 HOURS. OTHERWISE, DISPLAY ERROR MESSAGE: "The total number of time
exceeds 24 hours! Please correct the entries."
8.
DISPLAY “television viewing” IN UNDERLINED TEXT.
DWQ.081
Now I’d like to ask some questions about the amount of time {CHILD} plays video games. We want you to include
games played on systems like Playstation, Wii, or Xbox, or on handheld devices such as a Nintendo DS, Sony PSP,
iPod, iPad, or cellphone, or games played on the computer.
On any given weekday, how much time does {CHILD} spend playing video games? Please do not include time
{CHILD} spends on the computer doing educational activities or homework.
CAPI INSTRUCTIONS:
1.
DISPLAY THE FOLLOWING MATRIX IN THE RESPONSE FIELD:
HOURS
MINUTES
2.
WHEN CURSOR IS ON THE HOUR FIELD, DISPLAY 'ENTER NUMBER OF HOURS. IF LESS THAN AN
HOUR, ENTER '0.' MINUTES CAN BE ENTERED ON THE NEXT SCREEN.
3.
WHEN CURSOR IS ON THE MINUTE FIELD, DISPLAY ‘ENTER NUMBER OF MINUTES.'
4.
WHEN CURSOR IS ON THE MINUTES FIELDS, DISPLAY ‘Now…computer.’ AND ’on any given….homework…'
IN SQUARE BRACKETS.
5.
DK AND RF ALLOWED AT ALL FIELDS. EMPTY IS ALLOWED FOR MINUTES, BUT NOT FOR HOURS.
6.
IF HOURS ARE REF/DK, SKIP TO BOX 2. ELSE, CONTINUE WITH MINUTES.
7.
HARD RANGE = 0 – 24 FOR HOURS; 0 – 59 FOR MINUTES. THE HOURS AND MINUTES TOGETHER
SHOULD NOT EXCEED 24 HOURS. OTHERWISE, DISPLAY ERROR
MESSAGE: "The total number of hours exceeds 24! Please correct the entries."
9.
DISPLAY “plays video games” IN UNDERLINED TEXT.
BOX 2
GO TO SECTION CHQ (CHILD HEALTH AND WELL-BEING).
CHILD’S HEALTH AND WELL-BEING – CHQ
CHQ.010
How long has it been since {CHILD}'s last visit to a dentist or dental hygienist for dental care?
NEVER BEEN TO DENTIST OR DENTAL
HYGENIST FOR DENTAL CARE ..................
LESS THAN 6 MONTHS................................
6 MONTHS TO LESS THAN 1 YEAR ............
1 YEAR TO 2 YEARS ....................................
MORE THAN 2 YEARS .................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.020
1
2
3
4
5
8
9
How long has it been since {CHILD}'s last visit to a clinic, health center, hospital, doctor's office, or other place for
routine health care?
PROBE: Routine health care may include check-ups or immunization appointments.
NEVER HAD ROUTINE HEALTH CARE .......
LESS THAN 6 MONTHS................................
6 MONTHS TO LESS THAN 1 YEAR ............
1 YEAR TO 2 YEARS ....................................
MORE THAN 2 YEARS .................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.021
Has {CHILD} had an ear infection since last spring?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.022
1
2
3
4
5
8
9
1 (CHQ.023)
2
8
9
Has {CHILD} had an ear ache since last spring?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
(CHQ.024)
(CHQ.026)
(CHQ.026)
(CHQ.026)
CHQ.023
Since last spring, 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 ................................................
CHQ.024
8
9
How have {CHILD}’s {ear infections/ear aches} been treated by your doctor, nurse, or other medical professional since
last spring?
PROBE: Anything else?
CODE ALL THAT APPLY FOR 1-6.
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.021 = 1. ELSE, DISPLAY “ear aches”.
NO TREATMENT/WATCH AND WAIT ..................................................... 1
DECONGESTANTS AND/OR ALLERGY MEDICATION .......................... 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
OTHER (SPECIFY) _________________________________________ 91
REFUSED................................................................................................. 88
DON’T KNOW........................................................................................... 99
BOX 1
IF ONE OF THE CODES IN CHQ.024 = 91, GO TO CHQ.024OS. ELSE, GO TO BOX 2.
CHQ.024OS
[How have {CHILD}’s {ear infections/ear aches} been treated by your doctor, nurse, or other medical professional
since last spring?]
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.021 = 1. ELSE, DISPLAY “ear aches”.
SPECIFY TREATMENT.
_________________________________________________________
BOX 2
CHQ.025
IF ONE OF THE CODES IN CHQ.024 = 4, GO TO CHQ.025. ELSE, GO TO CHQ.026.
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 since last spring if {CHILD} had more than one to place ear tubes.
RIGHT EAR. ..................................................
LEFT EAR ......................................................
BOTH EARS ..................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.026
1
2
3
8
9
Has a doctor, nurse, or other medical professional ever told you that {CHILD} has asthma?
YES ............................................................... 1 (CHQ.027)
NO................................................................. 2 (CHQ.030)
REFUSED ..................................................... 8 (CHQ.030)
DON’T KNOW ............................................... 9 (CHQ.030)
CHQ.027
Does {he/she} receive treatment for this condition?
YES.................................................................. 1
NO ................................................................... 2
REFUSED........................................................ 8
DON’T KNOW.................................................. 9
CHQ.030
Is {CHILD} now covered by a health insurance plan which would pay any part of a hospital, doctor's, or surgeon's bill?
PROBE: This includes {Medicaid/ {or STATE NAME FOR MEDICAID}}.
CAPI INSTRUCTIONS: FOR "or STATE MEDICAID PROGRAM NAME"; DISPLAY NAME FOR STATE MEDICAID
PROGRAM, IF ANY, FROM PRELOAD. ELSE, IF MISSING, DISPLAY “Medicaid.”
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.060
1
2
8
9
In a typical week, on how many days does {CHILD} get exercise that causes rapid breathing, perspiration, and a rapid
heartbeat for 20 continuous minutes or more?
CAPI INSTRUCTION: RANGE CHECK 0-7.
|___|
ENTER # OF DAYS
REFUSED ...................................................... 88
DON’T KNOW ................................................ 99
CHQ.095
For the next set of questions, please base your answer on how {CHILD} compares to other children of the same age.
{CHILD} is independent and takes care of {himself/herself} ...
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
DON'T KNOW ...............................................
CHQ.100
Does {CHILD} pay attention ....
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
DON'T KNOW ...............................................
CHQ.105
1
2
3
4
8
9
Does {CHILD} learn, think, and solve problems ...
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.106
1
2
3
4
8
9
1
2
3
4
8
9
Does {CHILD} show good coordination in moving {his/her} arms and legs? Would you say {he/she} does this ...
IF RESPONDENT REPORTS DIFFERENTIALLY FOR ARMS OR LEGS OR FOR SIDES OF THE BODY, SAY:
Answer for the part of the body your child has the most difficulty using.
IF CHILD HAS EPISODIC TROUBLE, SAY: Answer for what you consider a typical day.
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.107
1
2
3
4
8
9
Would you say {CHILD} behaves and relates to other children...
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
1
2
3
4
8
CHQ.108
DON'T KNOW ...............................................
Would you say {CHILD} behaves and relates to adults...
9
CAPI INSTRUCTION: DISPLAY “adults” IN UNDERLINED TEXT.
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.109
Thinking about {CHILD}'s overall activity level, would you say {he/she} is …
Less active than other children of
{his/her} age, .............................................
About as active, .............................................
Slightly more active, or ...................................
A lot more active than other children of
{his/her} age? ............................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.110
1
2
3
4
8
9
Does {CHILD} have any emotional or psychological difficulties?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.111
1
2
3
4
8
9
1
2 (BOX 3)
8 (BOX 3)
9 (BOX 3)
Do you think this is a mild problem, a moderate problem, or a severe problem?
MILD PROBLEM ............................................
MODERATE PROBLEM ................................
SEVERE PROBLEM ......................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
8
9
BOX 3
IF (CHQ.095 = 3 OR 4) OR (CHQ.100 = 3 OR 4) OR (CHQ.105 = 3 OR 4) OR (CHQ.106 = 3 OR 4), OR
(CHQ.107 = 3 OR 4) OR (CHQ.108 = 3 OR 4) OR (CHQ.109 = 4) OR (CHQ.110 = 1), GO TO CHQ.115.
ELSE, GO TO CHQ.200.
CHQ.115
HELP AVAILABLE
{Since last spring has {CHILD}}/Has {CHILD ever} been evaluated by a professional because of an issue with
{independence and taking care of {himself/herself} {or}/paying attention {or}/learning, thinking, and solving problems
{or}/ coordination in moving {his/her} arms and legs {or}/behaving and relating to other children {or}/ behaving and
relating to adults {or}/{his/her} overall activity level {or}/{his/her} emotional or psychological difficulties}?
HELP TEXT: Professional: This includes health professionals such as doctors, pediatricians, and other licensed
persons, including nurses or nurse practitioners, optometrists, ophthalmologists, ear-nose-throat (ENT) doctors,
audiologists, school or other psychologists, school or other psychiatrists, psychiatric social workers, speech-language
pathologists, etc. Do not include teachers or some other non-health professional.
CAPI INSTRUCTIONS: DISPLAY “Since last spring has {CHILD}” IF (THERE WAS A FALL-KINDERGARTEN
COMPLETE OR PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS COMPLETED IN SPRING
KINDERGARTEN) ACCORDING TO THE PRELOAD. ELSE, DISPLAY “Has {CHILD} ever”.
CAPI INSTRUCTIONS: DISPLAY ALL THE ISSUES THAT THE CHILD HAS ACCORDING TO THE INSTRUCTIONS
BELOW. IF THERE IS MORE THAN ONE ISSUE, DISPLAY THE “or” FOLLOWING THE DISPLAY (E.G., IF A CHILD
HAS PROBLEMS WITH BOTH PAYING ATTENTION AND BEHAVING AND RELATING TO ADULTS, THE DISPLAY
WOULD BE “paying attention or behaving and relating to adults.”).
IF CHQ.095 = 3 OR 4, DISPLAY “independence and taking care of {himself/herself}”.
IF CHQ.100 = 3 OR 4, DISPLAY “paying attention”.
IF CHQ.105 = 3 OR 4, DISPLAY “learning, thinking, and solving problems”.
IF CHQ.106 = 3 OR 4, DISPLAY “coordination in moving {his/her} arms and legs”.
IF CHQ.107 = 3 OR 4, DISPLAY “behaving and relating to other children”.
IF CHQ.108 = 3 OR 4, DISPLAY “behaving and relating to adults”.
IF CHQ.109 = 4, DISPLAY “overall activity level”.
IF CHQ.110 = 1, DISPLAY “{his/her} emotional or psychological difficulties”.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2 (CHQ.200)
8 (CHQ.200)
9 (CHQ.200)
HELP AVAILABLE
CHQ.120
{Since last spring, have you obtained/Did you obtain} a diagnosis or diagnoses of a problem from a professional?
HELP TEXT: Professional: This includes health professionals such as doctors, pediatricians, and other licensed
persons, including nurses or nurse practitioners, optometrists, ophthalmologists, ear-nose-throat (ENT) doctors,
audiologists, school or other psychologists, school or other psychiatrists, psychiatric social workers, speech-language
pathologists, etc. Do not include teachers or some other non-health professional.
CAPI INSTRUCTIONS: DISPLAY “Since …obtained” IF (THERE WAS A FALL-KINDERGARTEN COMPLETE OR
PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS COMPLETED IN SPRING KINDERGARTEN)
ACCORDING TO THE PRELOAD. . ELSE, DISPLAY “Did…obtain” FOR THE SECOND DISPLAY.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2 (CHQ.200)
8 (CHQ.200)
9 (CHQ.200)
HELP AVAILABLE
CHQ.125
What was the diagnosis or were the diagnoses?
HELP TEXT:
Learning disability: This is a disorder in one or more of the basic psychological processes involved in understanding
or in using language, spoken or written, which shows up as difficulty to listen, think, speak, read, write, spell, or do
mathematical calculations. In some cases the child can perform at grade level, but only with special help. Some
names of learning disabilities are dyslexia (CODE UNDER DYSLEXIA), dyscalculia (CODE UNDER DYSCALCULIA),
developmental aphasia, minimal brain dysfunction, brain injury, and perceptual disabilities. The term does not include
learning problems that are primarily the result of problems with seeing, hearing, or walking (or visual, hearing or motor
disabilities); intellectual or severe cognitive disability/mental retardation; emotional disturbance; or environmental,
cultural, or economic disadvantage. A commonly used acronym is "LD."
Attention Deficit Disorder (ADD): A childhood syndrome characterized by short attention span that is inappropriate
for his/her age group.
Attention Deficit Hyperactivity Disorder (ADHD): The child displays signs of inattention, impulsivity, and
hyperactivity that are inappropriate for his or her mental and chronological age. Adults in the child’s environment, such
as parents and teachers must report the signs. Inattention means difficulty concentrating, easily distracted, and not
finishing things started. Impulsivity means often acts before thinking, shifts excessively from one activity to another,
needs a lot of supervision. Hyperactivity means runs about or climbs on things excessively, has difficulty staying
seated, always on the go, as if driven by a motor. Onset is typically before age seven and condition lasts at least six
months.
Developmental delay: A condition in which a young child falls significantly behind his/her age-mates in physical,
mental (cognitive), speech (communication), social/emotional, adaptive (behavioral) development. It does not simply
mean that the child talked somewhat later than some children talked or was smaller than average. It is not to be
confused with autism or pervasive developmental delay. If the child's social behavior and relationships with other
people are generally consistent with his or her delayed cognitive development, then the classification of the condition
as developmental delay is probably appropriate. If this is not the case, see the definitions of autism and pervasive
developmental disorder or delay.
Autism is a developmental disability significantly affecting verbal and nonverbal communication as well as social
interaction, generally evident before age three. Other characteristics often associated with autism are a pervasive lack
of responsiveness to other people, and engagement in repetitive activities and stereotyped movements (such as handflapping or rocking). There is also often an insistence on sameness, as shown by stereotyped play, abnormal
preoccupations, or resistance to change. With autism, the impaired social development and delayed or deviant
language development are not merely predictable from the child's cognitive retardation. Some children with autism are
actually advanced in their reading skills, memory skills, or musical abilities. The term autism does not apply if the
child’s educational performance is negatively affected primarily because the child has an emotional disturbance.
Asperger's Disorder, Pervasive Developmental Disorder (PDD), or any other autism spectrum disorder may be
coded here; the subtype will be captured in the next question. Pervasive developmental disorder or delay is also
characterized by gross and sustained impairment in social relationships, but typically has an onset after 30 months of
age. Other characteristics are sudden excessive anxiety, inappropriate affect or emotions, resistance to change in the
environment, oddities of motor movement, abnormalities of speech, hypersensitivity to sensory stimuli, and selfmutilation. This condition generally does not involve delusions, hallucinations, incoherence, or bizarre associations.
Dyslexia: A learning disability (see above definition) marked by impairment of the ability to recognize and
comprehend the written word.
Dyscalculia: A learning disability (see above definition) marked by impairment in the ability to perform and remember
calculations in mathematics.
Intellectual disability/Severe cognitive disability/Mental Retardation: The child's mental development is
significantly and noticeably behind what would ordinarily be expected for a child of his or her age. This significantly
below average general intellectual functioning exists at the same time as problems in adaptive behavior, and
negatively affects the child’s educational performance.
Orthopedic impairment: A bodily (or physical) impairment that is severe enough to negatively affect a child’s
educational performance. Disabling physical problems such as those resulting from poliomyelitis (often called polio or
infantile paralysis), bone tuberculosis, cerebral palsy, amputations, and fractures or contractures (shortening of tissue)
from burns would be considered as orthopedic impairments.
Serious Emotional Disturbance or SED: A condition that has one or more of the following characteristics over a long
period of time that negatively affect a child's educational performance: (a) an inability to learn that cannot be explained
by other factors; (b) an inability to build or maintain satisfactory interpersonal relationships with peers and teachers; (c)
inappropriate behavior or feelings; d) a general mood of unhappiness or depression; or (e) a tendency to develop
physical symptoms or fears associated with personal or school problems. The term includes schizophrenia but does
not apply to children who are socially maladjusted, unless it is determined that they have a serious emotional
disturbance.
Traumatic Brain Injury: An acquired injury to the brain caused by an external force, resulting in total or partial
functional disability or psychosocial impairment, or both, that adversely affects a child's educational performance. The
term applies to open or closed head injuries resulting in impairments in one or more areas, such as cognition;
language; memory; attention; reasoning; abstract thinking; judgment; problem-solving; sensory, perceptual, and motor
abilities; psycho-social behavior; physical functions; information processing; and speech. The term does not apply to
brain injuries that are congenital (there at birth) or degenerative (problem that grows worse over time), or to brain
injuries brought on by birth trauma (injuries during birth). The term is used when an external force has caused the
injury.
Panic Disorder: A disorder in which there is the sudden onset of several different physical signs, such as rapid heart
rate, shaking, sweating, nausea, dizziness, and difficulty breathing. A panic disorder may make a child think that
something horrible is about to happen.
Separation Anxiety Disorder: This is the fear a child has of being separated from his/her parents which is far more
than would be expected for the child’s developmental stage.
Obsessive Compulsive Disorder: A child must have obsessions or compulsions or both to have this disorder, and
these obsessions and/or compulsions must be disabling to the child. Obsessions are thoughts that aren’t visible to
others but cause the child distress. The thoughts occur over and over and the child spends so much time on them that
they have a hard time taking care of themselves or relating to others. Compulsions are mental acts that a child feels
driven to perform in response to an obsession.
Generalized Anxiety Disorder: Children who have this disorder worry all the time over nothing, themselves, other’s
safety, their health, and/or the world to a far greater extent than average. They often have many physical signs of
anxiety such as headache, abdominal pain, cramps, diarrhea, vomiting, and dizziness.
Other Anxiety Disorder: An anxiety disorder that is not one of the specific disorders in this list.
Bipolar Disorder: A child with bipolar disorder displays signs of major mood changes, sometimes sad, as in
depression, or the opposite, mania. All bipolar disorders are a combination of mania with or without depression. Some
signs of mania include inflated self-esteem, decreased need for sleep, distractibility and increased activity. Some signs
of depression are sleeping too much, poor appetite, feelings of severe worthlessness, hallucinations or strange beliefs
about the past.
Depression: Some signs of depression are frequent sadness, loss of interest or enjoyment of activities, low energy,
isolation from friends, sleeping too much, poor appetite, a severe sense of worthlessness, problems with
concentration, frequent complaints of physical illnesses, and thoughts of suicide or destructive behavior.
PROBE: Anything else?
CODE ALL THAT APPLY.
CODE DYSLEXIA AS “6.” CODE DYSCALCULIA AS “7”. CODE “LEARNING DISABILITY” (CODE 1)
ONLY IF THE CHILD HAS AN ADDITIONAL LEARNING DISABILITY THAT IS SEPARATE FROM OR IN
ADDITION TO DYSLEXIA (CODE 6) OR DYSCALCULIA (CODE 7).
IF BOTH ADD (CODE 2) AND ADHD (CODE 3) ARE MENTIONED, CODE AS “3” FOR ADHD.
LEARNING DISABILITY ................................ 1
ATTENTION DEFICIT DISORDER (ADD) ..... 2
ATTENTION DEFICIT HYPERACTIVITY
DISORDER (ADHD) .................................. 3
DEVELOPMENTAL DELAY ........................... 4
AUTISM/ASPERGER’S DISORDER/
PERVASIVE DEVELOPMENTAL DISORDER
(PDD)/OTHER AUTISM SPECTRUM
DISORDER .................................................... 5
DYSLEXIA ..................................................... 6
DYSCALCULIA .............................................. 7
INTELLECTUAL DISABILITY/SEVERE
COGNITIVE DISABILITY/
MENTAL RETARDATION .............................. 8
ORTHOPEDIC IMPAIRMENT........................ 9
SERIOUS EMOTIONAL DISTURBANCE ...... 10
TRAUMATIC BRAIN INJURY ........................ 11
PANIC DISORDER ........................................ 12
SEPARATION ANXIETY DISORDER ............ 13
OBSESSIVE COMPULSIVE DISORDER ...... 14
GENERALIZED ANXIETY DISORDER ......... 15
OTHER ANXIETY DISORDER ..................... 16
BIPOLAR DISORDER ................................... 17
DEPRESSION ............................................... 18
OTHER (SPECIFY) ___________________ 91
REFUSED ...................................................... 88 (CHQ.200)
DON’T KNOW ................................................ 99 (CHQ.200)
BOX 4
IF CHQ.125 = 91, GO TO CHQ.125OS. ELSE, GO TO BOX 5.
CHQ.125OS
[What {was the diagnosis/were the diagnoses?}]
SPECIFY DIAGNOSIS/DIAGNOSES.
_________________________________________________________
BOX 5
IF CHQ.125 HAS A CODE OF 5, GO TO CHQ.126. ELSE, GO TO BOX 6.
CHQ.126
What type of autism spectrum disorder does {CHILD} have? Is it autism, Asperger's Disorder, Pervasive
Developmental Disorder, or something else?
AUTISM ......................................................... 1
ASPERGER'S DISORDER ............................ 2
PERVASIVE DEVELOPMENTAL
DISORDER (PDD) ......................................... 3
OTHER (SPECIFY) ___________________ 91
REFUSED ...................................................... 8
DON'T KNOW ................................................ 9
BOX 5A
IF CHQ.126 = 91, GO TO CHQ.126OS. ELSE, GO TO BOX 6.
CHQ.126OS
[What {was the diagnosis/were the diagnoses?}]
SPECIFY TYPE OF AUTISM SPECTRUM DISORDER.
_____________________________________________________________
BOX 6
LOOP 1
ASK CHQ.130, CHQ.131, CHQ.135, CHQ.140, CHQ.155, AND CHQ.173 (IF APPLICABLE
ACCORDING TO THE SKIPS BETWEEN THE ITEMS) FOR EACH DIAGNOSIS IN CHQ.125, UP
TO 19 TIMES. THE DIAGNOSIS LISTED AS AN “OTHER SPECIFY” SHOULD ALSO BE PART OF
THIS LOOP.
LOOPING ELIGIBILITY:
IF CHQ.125 = 1, ASK ABOUT A LEARNING DISABILITY.
IF CHQ.125 = 2, ASK ABOUT ATTENTION DEFICIT DISORDER (ADD).
IF CHQ.125 = 3, ASK ABOUT ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD).
IF CHQ.125 = 4, ASK ABOUT DEVELOPMENTAL DELAY.
IF CHQ.125 = 5, ASK ABOUT AUTISM/ASPERGER’S DISORDER/PERVASIVE
DEVELOPMENTAL DISORDER (PDD)/ OTHER AUTISM SPECTRUM DISORDER.
IF CHQ.125 = 6, ASK ABOUT DYSLEXIA.
IF CHQ.125 = 7, ASK ABOUT DYSCALCULIA.
IF CHQ.125 = 8, ASK ABOUT INTELLECTUAL DISABILITY/SEVERE COGNITIVE
DISABILITY/MENTAL RETARDATION.
IF CHQ.125 = 9, ASK ABOUT ORTHOPEDIC IMPAIRMENT.
IF CHQ.125 = 10, ASK ABOUT SERIOUS EMOTIONAL DISTURBANCE.
IF CHQ.125 = 11, ASK ABOUT TRAUMATIC BRAIN INJURY.
IF CHQ.125 = 12, ASK ABOUT PANIC DISORDER.
IF CHQ.125 = 13, ASK ABOUT SEPARATION ANXIETY DISORDER.
IF CHQ.125 = 14, ASK ABOUT OBSESSIVE COMPULSIVE DISORDER.
IF CHQ.125 = 15, ASK ABOUT GENERALIZED ANXIETY DISORDER.
IF CHQ.125 = 16, ASK ABOUT OTHER ANXIETY DISORDER.
IF CHQ.125 = 17, ASK ABOUT BIPOLAR DISORDER.
IF CHQ.125 = 18, ASK ABOUT DEPRESSION.
IF CHQ.125 = 91, ASK ABOUT THE DIAGNOSIS AS LISTED IN THE OTHER SPECIFY TEXT OF
CHQ.125OS.
CHQ.130
How old was {CHILD} when the first diagnosis of a problem related to {a learning disability/Attention Deficit Disorder
(ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/developmental delay/autism, Asperger’s disorder, Pervasive
Developmental Disorder (PDD), or other autism spectrum disorder/dyslexia/dyscalculia/an intellectual disability,
severe cognitive disability, or mental retardation/orthopedic impairment/a serious emotional disturbance/a traumatic
brain injury/a panic disorder/separation anxiety disorder/obsessive compulsive disorder/generalized anxiety
disorder/an {other} anxiety disorder/bipolar disorder/depression/{TEXT FROM OTHER SPECIFY}} was made?
CAPI INSTRUCTIONS: DISPLAY THE FOLLOWING FOR THE PARTICULAR LOOP THE R IS ON:
IF CHQ.125 = 1, DISPLAY “a learning disability”.
IF CHQ.125 = 2, DISPLAY “Attention Deficit Disorder (ADD)”.
IF CHQ.125 = 3, DISPLAY “Attention Deficit Hyperactivity Disorder (ADHD)”.
IF CHQ.125 = 4, DISPLAY “developmental delay”.
IF CHQ.125 = 5, DISPLAY “autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism
spectrum disorder”.
IF CHQ.125 = 6, DISPLAY “dyslexia”.
IF CHQ.125 = 7, DISPLAY “dyscalculia”.
IF CHQ.125 = 8, DISPLAY “an intellectual disability, severe cognitive disability, or mental retardation“.
IF CHQ.125 = 9, DISPLAY “orthopedic impairment”.
IF CHQ.125 = 10, DISPLAY “a serious emotional disturbance”.
IF CHQ.125 = 11, DISPLAY “a traumatic brain injury”.
IF CHQ.125 = 12, DISPLAY “a panic disorder”.
IF CHQ.125 = 13, DISPLAY “separation anxiety disorder”.
IF CHQ.125 = 14, DISPLAY “obsessive compulsive disorder”.
IF CHQ.125 = 15, DISPLAY “generalized anxiety disorder”.
IF CHQ.125 = 16, DISPLAY “an {other} anxiety disorder” DISPLAY “other” IF (CHQ.125 = 12 OR CHQ.125 = 13 OR
CHQ.125 = 14 OR CHQ.125 = 15). ELSE, USE A NULL DISPLAY FOR “other”.
IF CHQ.125 = 17, DISPLAY “bipolar disorder”.
IF CHQ.125 = 18, DISPLAY “depression”.
IF CHQ.125 = 91, DISPLAY “{TEXT FROM OTHER SPECIFY}“ FROM CHQ.125OS.
CAPI INSTRUCTIONS: RANGE CHECK: 0-23.
|___|___|
ENTER AGE
REFUSED ...................................................... 88 (CHQ.140)
DON’T KNOW ................................................ 99 (CHQ.135)
CHQ.131
[How old was {CHILD} when the first diagnosis of a problem related to {a learning disability/Attention Deficit Disorder
(ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/developmental delay/autism, Asperger’s disorder, Pervasive
Developmental Disorder (PDD), or other autism spectrum disorder/dyslexia/dyscalculia/an intellectual disability,
severe cognitive disability, or mental retardation/an orthopedic impairment/a serious emotional disturbance/a traumatic
brain injury/a panic disorder/separation anxiety disorder/obsessive compulsive disorder/generalized anxiety
disorder/an {other} anxiety disorder/bipolar disorder/depression/{TEXT FROM OTHER SPECIFY} was made?]
ENTER UNIT.
IF CHQ.125 = 1, DISPLAY “a learning disability”.
IF CHQ.125 = 2, DISPLAY “Attention Deficit Disorder (ADD)”.
IF CHQ.125 = 3, DISPLAY “Attention Deficit Hyperactivity Disorder (ADHD)”.
IF CHQ.125 = 4, DISPLAY “developmental delay”.
IF CHQ.125 = 5, DISPLAY “autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism
spectrum disorder”.
IF CHQ.125 = 6, DISPLAY “dyslexia”.
IF CHQ.125 = 7, DISPLAY “dyscalculia”.
IF CHQ.125 = 8, DISPLAY “an intellectual disability, severe cognitive disability, or mental retardation”.
IF CHQ.125 = 9, DISPLAY “an orthopedic impairment”.
IF CHQ.125 = 10, DISPLAY “a serious emotional disturbance”.
IF CHQ.125 = 11, DISPLAY “a traumatic brain injury”.
IF CHQ.125 = 12, DISPLAY “a panic disorder”.
IF CHQ.125 = 13, DISPLAY “separation anxiety disorder”.
IF CHQ.125 = 14, DISPLAY “obsessive compulsive disorder”.
IF CHQ.125 = 15, DISPLAY “generalized anxiety disorder”.
IF CHQ.125 = 16, DISPLAY “an {other} anxiety disorder” DISPLAY “other” IF (CHQ.125 = 12 OR CHQ.125 = 13 OR
CHQ.125 = 14 OR CHQ.125 = 15). ELSE, USE A NULL DISPLAY FOR “other”.
IF CHQ.125 = 17, DISPLAY “bipolar disorder”.
IF CHQ.125 = 18, DISPLAY “depression”.
IF CHQ.125 = 91, DISPLAY “{TEXT FROM OTHER SPECIFY}“ FROM CHQ.125OS.
CAPI INSTRUCTIONS: RANGE CHECK: 0-23 IF MONTHS IS THE UNIT; 0-“CHILD’S CURRENT AGE” IF YEARS
IS THE UNIT. IF NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE
OF DIAGNOSIS CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND
SUPPRESS IF CURRENT AGE IS INCORRECT.
|___|___|
ENTER UNIT
MONTHS ....................................................... 1 (CHQ.140)
YEARS ........................................................... 2 (CHQ.140)
REFUSED ...................................................... 88 (CHQ.140)
DON’T KNOW ................................................ 99 (CHQ.135)
CHQ.135
What was the month and year when the diagnosis was made?
IF R DOESN'T KNOW MONTH, ASK: Do you remember the year?
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTIONS: RANGE CHECK: 1-12 FOR MONTH, 2003-2012 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE AND
LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
CHQ.140
Is {CHILD} now taking any prescription medicine for the condition related to {his/her] {learning
disability/Attention Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/developmental
delay/autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum
disorder/dyslexia/dyscalculia/intellectual
disability,
severe
cognitive
disability,
or
mental
retardation/orthopedic impairment/a serious emotional disturbance/a traumatic brain injury/a panic
disorder/separation anxiety disorder/obsessive compulsive disorder/generalized anxiety disorder/{other}
anxiety disorder/bipolar disorder/depression/{TEXT FROM OTHER SPECIFY}?
IF CHQ.125 = 1, DISPLAY “learning disability”.
IF CHQ.125 = 2, DISPLAY “Attention Deficit Disorder (ADD)”.
IF CHQ.125 = 3, DISPLAY “Attention Deficit Hyperactive Disorder (ADHD)”.
IF CHQ.125 = 4, DISPLAY “developmental delay”.
IF CHQ.125 = 5, DISPLAY “autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism
spectrum disorder”.
IF CHQ.125 = 6, DISPLAY “dyslexia”.
IF CHQ.125 = 7, DISPLAY “dyscalculia”.
IF CHQ.125 = 8, DISPLAY “intellectual disability, severe cognitive disability, or mental retardation“.
IF CHQ.125 = 9, DISPLAY “orthopedic impairment”.
IF CHQ.125 = 10, DISPLAY “serious emotional disturbance”.
IF CHQ.125 = 11, DISPLAY “traumatic brain injury”.
IF CHQ.125 = 12, DISPLAY “panic disorder”.
IF CHQ.125 = 13, DISPLAY “separation anxiety disorder”.
IF CHQ.125 = 14, DISPLAY “obsessive compulsive disorder”.
IF CHQ.125 = 15, DISPLAY “generalized anxiety disorder”.
IF CHQ.125 = 16, DISPLAY “{other} anxiety disorder” DISPLAY “other” IF (CHQ.125 = 12 OR CHQ.125 = 13 OR
CHQ.125 = 14 OR CHQ.125 = 15). ELSE, USE A NULL DISPLAY FOR “other”.
IF CHQ.125 = 17, DISPLAY “bipolar disorder”.
IF CHQ.125 = 18, DISPLAY “depression”.
IF CHQ.125 = 91, DISPLAY “{TEXT FROM OTHER SPECIFY}“ FROM CHQ.125OS.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
BOX 7
IF CHQ.140 = 1 AND CHQ.125 = 2 OR 3, GO TO CHQ.155. ELSE, IF CHQ.140 =1, GO TO
CHQ.173. ELSE, GO TO BOX 8.
CHQ.155
Is {CHILD} medicated for ADD or ADHD at school, at home, or both?
AT SCHOOL ..................................................
AT HOME.......................................................
BOTH AT SCHOOL AND AT HOME .............
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.173
1
2
3
8
9
How long has {CHILD} taken such prescription medicine for {a learning disability/Attention
Deficit Disorder (ADD)/Attention Deficit Hyperactivity Disorder (ADHD)/developmental delay/autism, Asperger’s
disorder, Pervasive Developmental Disorder (PDD), or other autism spectrum disorder/dyslexia/dyscalculia/an
intellectual disability, severe cognitive disability, or mental retardation/an orthopedic impairment/a serious emotional
disturbance/a traumatic brain injury/a panic disorder/separation anxiety disorder/obsessive compulsive
disorder/generalized anxiety disorder/an {other} anxiety disorder/bipolar disorder/depression/{TEXT FROM OTHER
SPECIFY}}, in total?
IF CHQ.125 = 1, DISPLAY “a learning disability”.
IF CHQ.125 = 2, DISPLAY "Attention Deficit Disorder (ADD)“.
IF CHQ.125 = 3, DISPLAY “Attention Deficit Hyperactivity Disorder (ADHD) “.
IF CHQ.125 = 4, DISPLAY “developmental delay”.
IF CHQ.125 = 5, DISPLAY “autism, Asperger’s disorder, Pervasive Developmental Disorder (PDD), or other autism
spectrum disorder”.
IF CHQ.125 = 6, DISPLAY “dyslexia”.
IF CHQ.125 = 7, DISPLAY “dyscalculia”.
IF CHQ.125 = 8, DISPLAY “an intellectual disability, severe cognitive disability, or mental retardation“.
IF CHQ.125 = 9, DISPLAY “orthopedic impairment”.
IF CHQ.125 = 10, DISPLAY “a serious emotional disturbance”.
IF CHQ.125 = 11, DISPLAY “a traumatic brain injury”.
IF CHQ.125 = 12, DISPLAY “a panic disorder”.
IF CHQ.125 = 13, DISPLAY “separation anxiety disorder”.
IF CHQ.125 = 14, DISPLAY “obsessive compulsive disorder”.
IF CHQ.125 = 15, DISPLAY “generalized anxiety disorder”.
IF CHQ.125 = 16, DISPLAY “an {other} anxiety disorder” DISPLAY “other” IF (CHQ.125 = 12 OR CHQ.125 = 13 OR
CHQ.125 = 14 OR CHQ.125 = 15). ELSE, USE A NULL DISPLAY FOR “other”.
IF CHQ.125 = 17, DISPLAY “bipolar disorder”.
IF CHQ.125 = 18, DISPLAY “depression”.
IF CHQ.125 = 91, DISPLAY “{TEXT FROM OTHER SPECIFY}“ FROM CHQ.125OS.
Less than one month, ....................................
Less than a year, ...........................................
1 to 2 years, ...................................................
3 to 4 years, or ...............................................
5 years or more? ............................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
5
8
9
BOX 8
END OF LOOP 1.
IF ALL CODES INDICATED IN CHQ.125 HAVE BEEN ASKED ABOUT IN LOOP 1 (ALL
DIAGNOSES THE CHILD HAS HAVE BEEN ASKED ABOUT), GO TO CHQ.200. ELSE, GO BACK
UP TO BOX 6 AND ASK ABOUT THE NEXT DIAGNOSIS.
CHQ.200
For the next question, please base your answer on how {CHILD} compares to other children of the same age. Does
{CHILD} pronounce words, communicate with and understand others...
IF RESPONDENT INDICATES CHILD DIFFERS ON ANY OF THE AREAS (E.G., CAN UNDERSTAND BUT NOT
PRONOUNCE), SAY: Answer for the area in which the child has the most difficulty.
CAPI INSTRUCTION: DISPLAY "IF … SAY: IN LIGHT BLUE "AND DISPLAY "Answer ….difficulty" IN BLACK.
Better than other children {his/her} age, .........
As well as other children, ...............................
Slightly less well than other children, or .........
Much less well than other children? ...............
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
8
9
BOX 8A
IF THE PRELOAD INDICATES THAT SECTION CHQ WAS ASKED IN SPRING-KINDERGARTEN,
GO TO BOX 8B. ELSE, IF CHQ.200 = 3 OR 4, GO TO CHQ.206. ELSE, GO TO CHQ.205.
CHQ.205
When {CHILD} was younger, did {he/she} ever have unusual difficulty pronouncing words, communicating with, or
understanding others, as compared to other children {his/her} age?
YES ................................................................
NO ................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.206
a.
Did or does {CHILD} have any of the following?
Problem with talking too loudly
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
b.
1
2
8
9
1
2
8
9
Problem with talking too softly
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
c.
d.
e.
f.
g.
h.
A problem chewing
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
A problem swallowing
A problem with stuttering
A cleft lip and/or palate
Abnormalities of the face or head
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
Malformation of the ear
BOX 8B
IF (THE PRELOAD INDICATES THAT SECTION CHQ WAS ASKED IN SPRINGKINDERGARTEN) AND (THE CURRENT ROUND CHQ.200 = 3 OR 4), GO TO CHQ.210. ELSE,
IF THE PRELOAD INDICATES THAT SECTION CHQ WAS ASKED IN SPRING-KINDERGARTEN,
GO TO CHQ.216.
ELSE, IF (CHQ.200 = 3 OR 4) OR (CHQ.205 = 1) OR (ANY CHQ.206a-h = 1), GO TO CHQ.210.
ELSE, GO TO CHQ.216.
HELP AVAILABLE
CHQ.210
{Since last spring has {CHILD}/Has {CHILD} ever} been evaluated by a professional because of {his/her} ability to
communicate?
HELP TEXT: Professional: This includes health professionals such as doctors, pediatricians, and other licensed
persons, including nurses or nurse practitioners, optometrists, ophthalmologists, ear-nose-throat (ENT) doctors,
audiologists, school or other psychologists, school or other psychiatrists, psychiatric social workers, speech-language
pathologists, etc. Do not include teachers or some other non-health professional.
CAPI INSTRUCTIONS: DISPLAY “Since last spring has {CHILD}” IF (THERE WAS A FALL-KINDERGARTEN
COMPLETE OR PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS COMPLETED IN SPRING
KINDERGARTEN) ACCORDING TO THE PRELOAD. .ELSE, DISPLAY “Has {CHILD} ever”.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.215
Did you obtain a diagnosis or diagnoses of a problem related to {his/her} ability to communicate from a professional?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.216
1
2 (CHQ.216)
8 (CHQ.216)
9 (CHQ.216)
1
2
8
9
Which best describes {CHILD}’s hearing? If {CHILD} has a hearing aid or other assistive device, please
consider {his/her} hearing without the hearing aid or assistive device. Would you say {CHILD} has...
excellent hearing, ...........................................
good hearing, .................................................
a little trouble hearing, ....................................
moderate trouble hearing,. .............................
a lot of trouble hearing, or ..............................
is deaf? ..........................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
5
6
8
9
(CHQ.221)
(CHQ.221)
(CHQ.221)
(CHQ.221)
CHQ.217
Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid
or other assistive device, please consider {his/her} hearing without the hearing aid or assistive device.
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person whispers to
{him/her} from across a quiet room.
IF NEEDED, SAY: These questions are routinely asked in studies like these to get a better understanding of how well
a child can hear.
CAPI INSTRUCTIONS: DISPLAY “hear and understand” AND “whispers” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.218
1 (CHQ.221)
2
8
9
[Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other
assistive device, please consider {his/her} hearing without the hearing aid or assistive device.]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person talks in a
normal voice to {him/her} from across a quiet room.
IF NEEDED, SAY: These questions are routinely asked in studies like these to get a better understanding of how well
a child can hear.
CAPI INSTRUCTIONS: DISPLAY “hear and understand” AND “talks in a normal voice” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.219
1 (CHQ.221)
2
8
9
[Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other
assistive device, please consider {his/her} hearing without the hearing aid or assistive device.]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person shouts to
{him/her} from across a quiet room.
IF NEEDED, SAY: These questions are routinely asked in studies like these to get a better understanding of how well
a child can hear.
CAPI INSTRUCTIONS: DISPLAY “hear and understand” AND “shouts” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1 (CHQ.221)
2
8
9
CHQ.220
[Please indicate whether the following statement describes {CHILD}'s hearing. If {CHILD} has a hearing aid or other
assistive device, please consider {his/her} hearing without the hearing aid or assistive device.]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person speaks
loudly into {his/her} ears or better ear.
IF NEEDED, SAY: These questions are routinely asked in studies like these to get a better understanding of how well
a child can hear.
CAPI INSTRUCTIONS: DISPLAY “hear and understand” AND “speaks loudly” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.221
Is {CHILD}’s hearing worse in one ear?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.222
1
2
8
9
1
2 (CHQ.235)
8 (CHQ.235)
9 (CHQ.235)
HELP AVAILABLE
Which best describes {CHILD}'s hearing in {his/her} worse ear? If {CHILD} has a hearing aid or other
assistive device, please consider {his/her} hearing without the hearing aid or assistive device.
Is {CHILD}’s hearing…
CAPI INSTRUCTIONS: DISPLAY “worse” IN UNDERLINED TEXT.
Excellent, .......................................................
Good, .............................................................
A little trouble hearing, ...................................
Moderate trouble hearing, ..............................
A lot of trouble hearing, or ..............................
Deaf? .............................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
5
6
8
9
CHQ.235
{Since last spring has/Has} {CHILD}'s hearing {ever} been evaluated by a professional?
HELP TEXT: Professional: This includes health professionals such as doctors, pediatricians, and other licensed
persons, including nurses or nurse practitioners, optometrists, ophthalmologists, school or other psychologists, school
or other psychiatrists, psychiatric social workers, speech pathologists, etc. Do not include teachers or some other nonhealth professional.
For the vision and hearing questions, having been evaluated at the school by a health professional does count as
being evaluated by a professional.
CAPI INSTRUCTIONS: DISPLAY “Since last spring has” AND USE A NULL DISPLAY FOR “ever” IF (THERE WAS A
FALL-KINDERGARTEN COMPLETE OR PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS
COMPLETED IN SPRING KINDERGARTEN) ACCORDING TO THE PRELOAD. ELSE, DISPLAY “Has” AND “ever”.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
BOX 9
IF CHQ.235 = 1, GO TO CHQ.245. ELSE, IF CHQ215=1, GO TO BOX 10. ELSE, GO TO
CHQ.285.
CHQ.245
Did you obtain a diagnosis of a problem from a professional?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2 (BOX 10)
8 (BOX 10)
9 (BOX 10)
CHQ.246
What was the diagnosis?
PROBE: Anything else?
CODE ALL THAT APPLY.
DUE TO EAR WAX (EXTERNAL EAR CANAL EAR WAX) ......................
DUE TO EAR CANAL DEFORMITY (“ATRESIA” (EAR CANAL NOT
NORMALLY FORMED), CRANIAL-FACIAL DISORDER,
ETC.) ....................................................................................................
DUE TO EAR INFECTION (ACUTE OR RECURRENT EPISODES
(INFECTION BEGINS AND PROGRESSES QUICKLY OR KEEPS
COMING BACK) OFTEN WITH EAR ACHE AND FEVER –
ACUTE OTITIS MEDIA) .......................................................................
DUE TO FLUID IN THE EAR (FLUID BEHIND THE EARDRUM,
RUNNY EARS, FLUID OR PUS DRAINING FROM THE MIDDLE
EAR SPACE, CHRONIC OTITIS MEDIA, GLUE EAR) ........................
DUE TO EAR DRUM PROBLEM (INCLUDES PERFORATED/
TORN/RUPTURED) EARDRUM) .........................................................
DUE TO ILLNESS (MENINGITIS, MEASLES, MUMPS, RUBELLA,
SCARLET FEVER, ETC.) .....................................................................
DUE TO CMV (CYTOMEGALOVIRUS, A TYPE OF HERPES
VIRUS) .................................................................................................
DUE TO OTOTOXIC EXPOSURE TO DRUGS/MEDICINES (DAMAGE
TO THE EARS BY DRUGS OR CHEMICALS. INCLUDES
DAMAGE FROM MYCIN DRUGS, SUCH AS, STREPTOMYCIN,
GENTAMYCIN, ETC., SALICYLATE, LASIX, CISPLATIN – MAY
RESULT FROM TREATMENT OF RESPIRATORY PROBLEMS OF
PRETERM INFANTS, OR AS TREATMENTS DUE TO CHILDHOOD
CANCER, ETC.) ...................................................................................
DUE TO NOISE EXPOSURE (FROM GUNFIRE, FIRE
CRACKERS, etc.).................................................................................
DUE TO GENETIC CAUSE (INCLUDES CONGENITAL (THERE AT
BIRTH) HEARING LOSS, HEREDITARY HEARING LOSS,
SYNDROMAL HEARING LOSS – DOWN SYNDROME, USHER’S
SYNDROME, ETC.) .............................................................................
DUE TO INJURY OR TRAUMA TO HEAD & NECK ................................
DUE TO EAR OR FACIAL SURGERY .....................................................
DUE TO NERVE DEAFNESS (NERVE HEARING LOSS OR SENSORINEURAL HEARING LOSS) ..................................................................
DUE TO CENTRAL AUDITORY PROCESSING DISORDER
(PROBLEM WITH BEING ABLE TO RECOGNIZE, TELL THE
DIFFERENCE BETWEEN, OR UNDERSTAND SOUNDS) .................
DEAF ........................................................................................................
OTHER (SPECIFY) _________________________________________
DON’T KNOW...........................................................................................
REFUSED.................................................................................................
CHQ.246OS
[What was the diagnosis?]]
SPECIFY DIAGNOSIS.
___________________________________________
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
91
88
99
BOX 10
IF THE CASE HAD A SPRING KINDERGARTEN INTERVIEW, DETERMINE FROM THE PRELOAD IF
CHQ.250A WAS ASKED IN SPRING-KINDERGARTEN FOR ABILITY TO COMMUNICATE, HEARING, OR
BOTH. IF SO, DETERMINE IF CHQ.250 WOULD BE ASKED ABOUT THE SAME CURRENT ISSUE(S) (E.G.,
CHILD HAD A HEARING DIAGNOSIS IN SPRING-KINDERGARTEN AND GOT ANOTHER HEARING
DIAGNOSIS, IN SPRING-FIRST GRADE) ACCORDING TO THE DIRECTIONS BELOW.
DO THE FOLLOWING IF THE DIAGNOSES ARE THE SAME FOR SPRING-K AND SPRING-FIRST:
SPRING-K
ONLY HEARING
BOTH (HEARING AND COMMUNICATION)
ONLY COMMUNICATION
SPRING-1
ONLY HEARING
BOTH
ONLY COMMUNICATION
SKIP TO:
CHQ.256
CHQ.256
CHQ.285
DO THE FOLLOWING IF THE DIAGNOSES ARE NOT THE SAME FOR SPRING-K AND SPRING-FIRST:
SPRING-K
BOTH
BOTH
ONLY HEARING
SPRING-1
ONLY COMMUNICATION
ONLY HEARING
BOTH
SKIP TO:
CHQ.285
CHQ.256
IF CHQ.215 = 1 AND
CHQ.245 NE 1, GO
TO CHQ.250A AND
ASK ABOUT
ABILITY TO
COMMUNICATE.
ONLY COMMUNICATION
BOTH
IF CHQ.215 NE 1
AND CHQ.245 = 1,
GO TO CHQ.250A
AND ASK ABOUT
HEARING.
ONLY HEARING
ONLY COMMUNICATION
IF CHQ.215 = 1 AND
CHQ.245 NE 1, GO
TO CHQ.250A AND
ASK ABOUT
ABILITY TO
COMMUNICATE.
ONLY COMMUNICATION
ONLY HEARING
IF CHQ.215 NE 1
AND CHQ.245 = 1,
GO TO CHQ.250A
AND ASK ABOUT
HEARING.
ELSE, FOLLOW DIRECTIONS BELOW.
ASK CHQ.250a, CHQ.250b (IF APPLICABLE), CHQ.250c (IF APPLICABLE), AND CHQ.255 (IF APPLICABLE)
FOR THE FOLLOWING:
IF CHQ.215 = 1 AND CHQ.245 NE 1, ASK ABOUT ABILITY TO COMMUNICATE.
IF CHQ.215 NE 1 AND CHQ.245 = 1, ASK ABOUT HEARING.
IF CHQ.215 = 1 AND CHQ.245 = 1, ASK ABOUT BOTH ABILITY TO COMMUNICATE AND HEARING
SEPARATELY IN A LOOP.
ELSE, GO TO CHQ.285.
CHQ.250a
How old was {CHILD} when the first diagnosis of a problem related to {his/her} {ability to communicate/hearing} was made?
CAPI INSTRUCTIONS: IF CHQ.215 =1 AND CHQ.245 NE 1, DISPLAY “ability to communicate”. ELSE, IF CHQ.215 NE 1
AND CHQ.245 = 1, DISPLAY “hearing”. ELSE, IF CHQ.215 = 1 AND CHQ.245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY “hearing” THE SECOND TIME THE LOOP IS ASKED.
ENTER UNIT
MONTHS…………………………………………………………1 (CHQ.250b)
YEARS……………………………………………………………2 (CHQ.250c)
DON’T KNOW ..................................................................... 8 (CHQ.255)
REFUSED ........................................................................... 9 (BOX 11)
CHQ.250b
[How old was {CHILD} when the first diagnosis of a problem related to {his/her} {ability to communicate/hearing} was
made?]
ENTER THE NUMBER OF MONTHS.
CAPI INSTRUCTIONS: IF CHQ.215 =1 AND CHQ.245 NE 1, DISPLAY “ability to communicate”. ELSE, IF CHQ.215 NE 1
AND CHQ.245 = 1, DISPLAY “hearing”. ELSE, IF CHQ.215 = 1 AND CHQ.245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY “hearing” THE SECOND TIME THE LOOP IS ASKED.
CAPI INSTRUCTIONS: RANGE CHECK: 0-23.
|___|___|
MONTHS (BOX 14)
DON’T KNOW ........................................................................... 88 (CHQ.255)
REFUSED ................................................................................. 99 (BOX 11)
CHQ.250c
[How old was {CHILD} when the first diagnosis of a problem related to {his/her} {ability to communicate/hearing} was
made?]
ENTER THE NUMBER OF YEARS.
CAPI INSTRUCTIONS: IF CHQ.215 =1 AND CHQ.245 NE 1, DISPLAY “ability to communicate”. ELSE, IF CHQ.215 NE 1
AND CHQ.245 = 1, DISPLAY “hearing”. ELSE, IF CHQ.215 = 1 AND CHQ.245 = 1 DISPLAY “ability to communicate” THE
FIRST TIME THE LOOP IS ASKED AND DISPLAY “hearing” THE SECOND TIME THE LOOP IS ASKED.
CAPI INSTRUCTIONS: RANGE CHECK: 0-“CHILD’S CURRENT AGE”. IF NUMBER OF YEARS IS GREATER
THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF DIAGNOSIS CANNOT BE GREATER
THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS IF CURRENT AGE IS
INCORRECT.
|___|___|
YEARS
DON’T KNOW ........................................................................... 88 (CHQ.255)
REFUSED ................................................................................. 99 (BOX 11)
BOX 11
IF CHQ.215 = 1 AND CHQ.245 = 1, AND THE FIRST LOOP IN BOX 10 FOR ABILITY TO
COMMUNICATE HAS BEEN ANSWERED BUT NOT THE LOOP FOR HEARING, GO BACK TO
CHQ.250a AND ASK ABOUT HEARING. ELSE, IF CHQ.245 = 1, GO TO CHQ.256. ELSE, GO TO
CHQ.285.
CHQ.255
What was the month and year the problem with {CHILD}'s {ability to communicate/hearing} was diagnosed?
IF R DOESN'T KNOW MONTH, ASK: Do you remember the year?
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTIONS: IF CHQ.215 =1 AND CHQ.245 NE 1, DISPLAY “ability to communicate”. ELSE, IF CHQ.215
NE 1 AND CHQ.245 = 1, DISPLAY “hearing”. ELSE, IF CHQ.215 = 1 AND CHQ.245 = 1 DISPLAY “ability to
communicate” THE FIRST TIME THE LOOP IS ASKED AND DISPLAY “hearing” THE SECOND TIME THE LOOP IS
ASKED.
CAPI INSTRUCTIONS: RANGE CHECK: 1-12 FOR MONTH, 2003-2012 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE
AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|
AND
ENTER MONTH
|___|___|___|___|
ENTER YEAR
DON’T KNOW.................................................................... 88
REFUSED.......................................................................... 99
BOX 12
IF CHQ.215 = 1 AND CHQ.245 = 1, AND THE FIRST LOOP IN BOX 10 FOR ABILITY TO
COMMUNICATE HAS BEEN ANSWERED BUT NOT THE LOOP FOR HEARING, GO BACK TO
CHQ.250a AND ASK ABOUT HEARING. ELSE, IF CHQ.245 =1, GO TO CHQ.256. ELSE, GO TO
CHQ.285.
CHQ.256
HELP AVAILABLE
{Since last spring, has {CHILD} gotten/Has {CHILD} ever worn} a hearing aid?
HELP TEXT: Hearing Aid: A small electronic sound amplifier worn in or behind the ear that compensates for
impaired hearing.
IF RESPONDENT SAYS “Yes” OR “CHILD USED TO WEAR ONE,” ASK “Does {CHILD} wear one now?”
CAPI INSTRUCTION: DISPLAY “Since…gotten” IF (THERE WAS A FALL-KINDERGARTEN COMPLETE OR
PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS COMPLETED IN SPRING KINDERGARTEN)
ACCORDING TO THE PRELOAD. .. ELSE, DISPLAY “Has {CHILD} ever worn”
YES, CURRENTLY ........................................
YES, IN THE PAST ........................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3 (CHQ.263)
8 (CHQ.263)
9 (CHQ.263)
BOX 12A
IF CHQ.257 WAS ASKED IN SPRING-KINDERGARTEN, GO TO CHQ.258. ELSE, GO TO
CHQ.257.
HELP AVAILABLE
CHQ.257
At what age was the recommendation that {CHILD} wear a hearing aid first made?
HELP TEXT: This question asks the age at which the recommendation to wear a hearing aid was first made, not the
age at which the child first started wearing a hearing aid. Some children may have started wearing a hearing aid right
after the recommendation was first made. For other children, there may have been a period of time between when the
recommendation was first made and when the child started wearing a hearing aid.
ALLOW RESPONSES IN MONTHS OR YEARS, BUT NOT BOTH.
CAPI INSTRUCTIONS: RANGE CHECK: 0-36 IF MONTHS IS THE UNIT; 0-“CHILD’S CURRENT AGE”. IF
NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF DIAGNOSIS
CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS IF CURRENT
AGE IS INCORRECT.
|___|___|
ENTER AGE
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
ENTER UNIT
MONTHS .......................................................
YEARS ...........................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
BOX 12A2
IF CHQ.256 = 2, GO TO CHQ.270.
CHQ.258
How often does {CHILD} use the hearing aid(s) in school? Would you say…
All of the time, ................................................
Most of the time, ............................................
Sometimes, ....................................................
Rarely, or .......................................................
Never? ...........................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
5
8
9
CHQ.259
Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her}
hearing aid(s).
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person whispers to
{him/her} from across a quiet room.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} hearing aid(s)”, “hear and understand”, AND “whispers” IN
UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
CHQ.260
1 (CHQ.270)
2
8
9
[Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her}
hearing aid(s). ]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person talks in a
normal voice to {him/her} from across a quiet room.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} hearing aid(s)”, “hear and understand”, AND “talks in a
normal voice” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
CHQ.261
1 (CHQ.270)
2
8
9
[Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her}
hearing aid(s). ]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person shouts to
{him/her} from across a quiet room.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} hearing aid(s)”, “hear and understand”, AND “shouts” IN
UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
1 (CHQ.270)
2
8
9
CHQ.262
[Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her}
hearing aid(s). ]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person speaks
loudly into {his/her} {better} ear.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} hearing aid(s)”, “hear and understand”, AND “speaks
loudly” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY “better” IF CHQ.221 = 1. ELSE, USE A NULL DISPLAY.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
1
2
8
9
(CHQ.270)
(CHQ.270)
(CHQ.270)
(CHQ.270)
HELP AVAILABLE
CHQ.263
{Since last spring has/Has} a doctor or other health care professional {ever} recommended that {CHILD} wear a
hearing aid?
HELP TEXT: Hearing Aid: A small electronic sound amplifier worn in or behind the ear that compensates for
impaired hearing.
CAPI INSTRUCTIONS: DISPLAY “Since last spring has” AND USE A NULL DISPLAY FOR “ever” IF (THERE WAS A
FALL-KINDERGARTEN COMPLETE OR PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS
COMPLETED IN SPRING KINDERGARTEN) ACCORDING TO THE PRELOAD. ELSE, DISPLAY “Has” AND “ever”.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
CHQ.264
1
2 (CHQ.270)
8 (CHQ.270)
9 (CHQ.270)
At what age was the recommendation that {CHILD} wear a hearing aid first made?
CAPI INSTRUCTION: RANGE CHECK: 0-36 IF UNIT IS MONTHS; 0-“CHILD’S CURRENT AGE” IF UNIT IS
YEARS. IF NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF
DIAGNOSIS CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS
IF CURRENT AGE IS INCORRECT.
|___|___|
ENTER NUMBER
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
ENTER UNIT
MONTH .........................................................
YEAR ............................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
CHQ.270
Does {CHILD} have a cochlear implant?
PROBE: IF RESPONDENT SAYS “YES” BUT WHICH EAR IS NOT SPECIFIED, PROBE Is the cochlear implant in
the right or left ear or does {CHILD} have them in both ears?
HELP TEXT: Cochlear Implants: An electronic device that is surgically placed in the inner ear which is designed to
provide useful hearing and improved communication ability to individuals who are profoundly hearing impaired and
unable to understand speech with hearing aids.
YES, ONE EAR ONLY – RIGHT EAR ...........
YES, ONE EAR ONLY – LEFT EAR ..............
YES, IN BOTH EARS ....................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
4
8
9
(CHQ.273)
(CHQ.285)
(CHQ.285)
(CHQ.285)
BOX 12B
IF CHQ.271 WAS ASKED IN SPRING-KINDERGARTEN AND [(CHQ.270 IN BOTH SPRINGKINDERGARTEN AND SPRING-FIRST GRADE = 1) OR
(CHQ.270 IN BOTH SPRING-KINDERGARTEN AND SPRING-FIRST GRADE = 2)], GO TO
CHQ.277.
ELSE, IF CHQ.273 WAS ASKED IN SPRING-KINDERGARTEN AND CHQ.270 IN BOTH SPRINGKINDERGARTEN AND SPRING-FIRST GRADE = 3, GO TO CHQ.277.
ELSE, IF CHQ.270 = 1 OR 2, GO TO CHQ.271. ELSE, IF CHQ.270 = 3, GO TO CHQ.273.
CHQ.271
In what year was it implanted?
CAPI INSTRUCTION: RANGE CHECK: 2003-2012.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE
AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___| (CHQ.277)
ENTER YEAR
REFUSED ...................................................... 88 (CHQ.272)
DON'T KNOW ................................................ 99 (CHQ.272)
CHQ.272
How old was {CHILD} when it was implanted?
CAPI INSTRUCTION: RANGE CHECK: 0-36 IF UNIT IS MONTHS; 0-“CHILD’S CURRENT AGE IF UNIT IS YEARS. IF
NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF DIAGNOSIS
CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS IF CURRENT AGE
IS INCORRECT.
|___|___| (CHQ.277)
ENTER NUMBER
REFUSED ...................................................... 88 (CHQ.277)
DON'T KNOW ................................................ 99 (CHQ.277)
ENTER UNIT
MONTHS .......................................................
YEARS ...........................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.273
1
2
8
9
(CHQ.277)
(CHQ.277)
(CHQ.277)
(CHQ.277)
In what years were they implanted?
ENTER YEAR FOR LEFT EAR.
PROBE: When was it implanted in the left ear?
CAPI INSTRUCTION: RANGE CHECK: 2003-2012.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE
AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___|
ENTER YEAR FOR LEFT EAR
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
CHQ.274
[In what years were they implanted?]
ENTER YEAR FOR RIGHT EAR.
PROBE: When was it implanted in the right ear?
CAPI INSTRUCTION: RANGE CHECK: 2003-2012.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE
AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|___|___|
ENTER YEAR FOR RIGHT EAR
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
BOX 12C
IF A YEAR WAS ENTERED FOR BOTH THE LEFT EAR AND THE RIGHT EAR (BOTH
CHQ.274 AND CHQ.273 NE REFUSED OR DON’T KNOW), GO TO CHQ.277.
ELSE, IF (A YEAR WAS ONLY ENTERED FOR THE RIGHT EAR (CHQ.274 NE
REFUSED OR DON’T KNOW) AND (CHQ.273 EQ REFUSED OR DON’T KNOW)) OR A
(YEAR WAS NOT ENTERED FOR EITHER THE LEFT EAR OR THE RIGHT EAR (BOTH
CHQ.274 AND CHQ.273 EQ REFUSED OR DON’T KNOW), GO TO CHQ.275.
ELSE, IF A YEAR WAS ONLY ENTERED FOR THE LEFT EAR (CHQ.273 NE REFUSED
OR DON’T KNOW) AND (CHQ.274 EQ REFUSED OR DON’T KNOW), GO TO CHQ.276.
CHQ.275
{How old was {CHILD} when it was implanted in the left ear?} {How old was {CHILD} when they were implanted?}
ENTER AGE IN MONTHS OR YEARS FOR LEFT EAR.
{PROBE: How old was {CHILD} when it was implanted in the left ear?}
CAPI INSTRUCTION: IF A YEAR WAS ONLY ENTERED FOR THE RIGHT EAR (CHQ.274 NE REFUSED OR
DON’T KNOW) AND (CHQ.273 EQ REFUSED OR DON’T KNOW), DISPLAY THE FIRST DISPLAY “How old was
{CHILD} when it was implanted in the left ear?}” AND USE A NULL DISPLAY FOR THE SECOND DISPLAY AND THE
PROBE. ELSE, USE A NULL DISPLAY FOR THE FIRST DISPLAY AND DISPLAY THE SECOND DISPLAY AND
THE PROBE.
CAPI INSTRUCTION: RANGE CHECK: 0-36 IF UNIT IS MONTHS; 0- “CHILD’S CURRENT AGE IF UNIT IS
YEARS. IF NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF
DIAGNOSIS CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS
IF CURRENT AGE IS INCORRECT.
|___|___|
ENTER NUMBER FOR LEFT EAR
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
ENTER UNIT
MONTHS .......................................................
YEARS ...........................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
BOX 12D
IF A YEAR WAS ONLY ENTERED FOR THE RIGHT EAR (CHQ.274 NE REFUSED OR DON’T
KNOW) AND (CHQ.273 EQ REFUSED OR DON’T KNOW), GO TO CHQ.277. ELSE, GO TO
CHQ. 276.
CHQ.276
{How old was {CHILD} when it was implanted in the right ear?} {[How old was {CHILD} when they were implanted?]}
ENTER AGE IN MONTHS OR YEARS FOR RIGHT EAR.
{PROBE: How old was {CHILD} when it was implanted in the right ear?}
CAPI INSTRUCTION: IF A YEAR WAS ONLY ENTERED FOR THE LEFT EAR (CHQ.273 NE REFUSED OR DON’T
KNOW) AND (CHQ.274 EQ REFUSED OR DON’T KNOW), DISPLAY THE FIRST DISPLAY “How old was {CHILD}
when it was implanted in the right ear?}” AND USE A NULL DISPLAY FOR THE SECOND DISPLAY AND THE
PROBE. ELSE, USE A NULL DISPLAY FOR THE FIRST DISPLAY AND DISPLAY THE SECOND DISPLAY AND
THE PROBE.
CAPI INSTRUCTION: RANGE CHECK: 0-36 IF UNIT IS MONTHS; 1-“CHILD’S CURRENT AGE IF UNIT IS
YEARS. IF NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF
DIAGNOSIS CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS
IF CURRENT AGE IS INCORRECT.
|___|___|
ENTER NUMBER FOR RIGHT EAR
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
ENTER UNIT
MONTHS .......................................................
YEARS ...........................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.277
1
2
8
9
Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant
{s}.
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person whispers to
{him/her} from across a quiet room.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} cochlear implant(s)”, “hear and understand” AND
”whispers” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1 (CHQ.285)
2
8
9
CHQ.278
[Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant
{s}.]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person talks in a
normal voice to {him/her} from across a quiet room.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} cochlear implant(s)”, “hear and understand” AND ”talks in a
normal voice” IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.279
1 (CHQ.285)
2
8
9
[Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant
{s}.]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person shouts to
{him/her} from across a quiet room.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} cochlear implant(s)”, “hear and understand” AND ”shouts”
IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.280
1 (CHQ.285)
2
8
9
[Please indicate whether the following statement describes {CHILD}'s hearing when wearing {his/her} cochlear implant
{s}.]
{CHILD} can usually hear and understand what a person says without seeing his or her face if that person speaks
loudly into {his/her} {better} ear.
CAPI INSTRUCTIONS: DISPLAY “when wearing {his/her} cochlear implant(s)”, “hear and understand” AND “speaks
loudly” IN UNDERLINED TEXT.
CAPI INSTRUCTION: DISPLAY “better” IF CHQ.221 = 1. ELSE, USE A NULL DISPLAY.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.285
1
2
8
9
Now I want to ask you about {CHILD}’s vision. Without the use of eyeglasses or contact lenses, does {CHILD} have
difficulty seeing objects in the distance or letters on paper?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
(CHQ.286)
(CHQ.290)
(CHQ.290)
(CHQ.290)
CHQ.286
Is {CHILD}’s difficulty with seeing objects in the distance, things up close, like letters on paper, or both?
SEEING THINGS UP CLOSE ........................
SEEING THINGS IN THE DISTANCE ...........
BOTH .............................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
3
8
9
HELP AVAILABLE
CHQ.290
{Since last spring has/Has} {CHILD}'s vision {ever} been evaluated by an eye care professional?
HELP TEXT: Eye Care Professional: This includes optometrists and ophthalmologists. Include a school nurse who
gives a vision test, but do not include teachers or some other non-health professional, or a doctor who simply looks in
the child’s eyes.
For the vision and hearing questions, having been evaluated at the school by a health professional does count as
being evaluated by a professional.
CAPI INSTRUCTIONS: DISPLAY “Since last spring has” AND USE A NULL DISPLAY FOR “ever” IF (THERE WAS A
FALL-KINDERGARTEN COMPLETE OR PARTIALLY COMPLETE INTERVIEW) OR (SECTION CHQ WAS
COMPLETED IN SPRING KINDERGARTEN) ACCORDING TO THE PRELOAD. ELSE, DISPLAY “Has” AND “ever”.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.300
1
2 (CHQ.330)
8 (CHQ.330)
9 (CHQ.330)
Did you obtain a diagnosis of a vision-related problem from an eye care professional?
CAPI INSTRUCTION: DISPLAY "vision-related" IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2 (CHQ.330)
8 (CHQ.330)
9 (CHQ.330)
CHQ.301
What was the diagnosis?
PROBE: Anything else?
CODE ALL THAT APPLY.
NEARSIGHTEDNESS (MYOPIA) .................. 1
FARSIGHTED (HYPEROPIA)........................ 2
COLOR BLINDNESS OR DEFICIENCY ........ 3
ASTIGMATISM .............................................. 4
CROSSED OR WANDERING EYE
(STRABISMUS) .......................................... 5
AMBLYOPIA OR “LAZY EYE” ...................... 6
RETINOPATHY ............................................. 7
BLINDNESS................................................... 8
OTHER (SPECIFY) ___________________ 91
REFUSED ...................................................... 88
DON’T KNOW ................................................ 99
BOX 13
IF CHQ.301 = 91, CONTINUE WITH CHQ.301OS. OTHERWISE, GO TO BOX 13A.
CHQ.301OS
[What was the diagnosis?]
SPECIFY DIAGNOSIS.
_________________________________________________________
BOX 13A
IF CHQ.305 WAS ASKED IN SPRING-KINDERGARTEN, GO TO CHQ.311. ELSE, GO TO
CHQ.305.
CHQ.305
How old was {CHILD} when the first diagnosis of a problem was made?
ENTER AGE IN MONTHS OR YEARS.
CAPI INSTRUCTION: RANGE CHECK: 0-36 IF UNIT IS MONTHS; 0- “CHILD’S CURRENT AGE IF UNIT IS
YEARS. IF NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF
DIAGNOSIS CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS
IF CURRENT AGE IS INCORRECT.
|___|___|
ENTER NUMBER
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
ENTER UNIT
MONTH ..........................................................
YEAR .............................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.310
1
2
8
9
(CHQ.311)
(CHQ.311)
(CHQ.311)
(CHQ.310)
What was the month and year the diagnosis was made?
IF R DOESN'T KNOW MONTH, ASK: Do you remember the year?
IF THERE WAS MORE THAN ONE DIAGNOSIS, ASK FOR THE EARLIEST.
CAPI INSTRUCTIONS: RANGE CHECK: 1-12 FOR MONTH, 2003-2012 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE AND
LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.311
8
9
Has {CHILD} been prescribed glasses or contact lenses to improve {his/her} vision?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2 (CHQ.330)
8 (CHQ.330)
9 (CHQ.330)
CHQ.312
How often does {CHILD} wear glasses or contact lenses?
All of the time, ................................................
Most of the time, ............................................
Sometimes, ....................................................
Rarely, or .......................................................
Never? ...........................................................
CHILD DOES NOT HAVE GLASSES OR
CONTACTS................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.313
6 (CHQ.330)
8 (CHQ.330)
9 (CHQ.330)
1
2 (CHQ.330)
8 (CHQ.330)
9 (CHQ.330)
Do {CHILD}’s glasses or contacts help {him/her} see things up close, see things in the distance, or both?
SEE THINGS UP CLOSE ..............................
SEE THINGS IN THE DISTANCE .................
BOTH .............................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.330
(CHQ.314)
(CHQ.314)
(CHQ.314)
(CHQ.314)
(CHQ.313)
Does {CHILD} have glasses or contact lenses?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.314
1
2
3
4
5
1
2
3
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 14
IF CHILD DOES NOT HAVE ANY DISABILITIES AND HIS OR HER HEALTH IS GOOD TO EXCELLENT, THAT IS:
CHQ.095=1, 2, 8, 9 (INDEPENDENCE)
AND
CHQ.100=1, 2, 8, 9 (ATTENTION)
AND
CHQ.105=1, 2, 8, 9 (THINK/LEARN/SOLVE)
AND
CHQ.106=1, 2, 8, 9 (COORDINATION)
AND
CHQ.107=1, 2, 8, 9 (BEHAVIOR WITH OTHER CHILDREN)
AND
CHQ.108=1, 2, 8, 9 (BEHAVIOR WITH ADULTS)
AND
CHQ.109=1, 2, 3, 8, 9 (HYPERACTIVE)
AND
CHQ.110=2, 8, 9 (EMOTIONAL/PSYCHOLOGICAL DIFICULTIES)
AND
CHQ.200=1, 2, 8, 9 (COMMUNICATION)
AND
CHQ205=2, 8, 9, OR -1 (COMMUNICATION WHEN YOUNGER).
AND
CHQ.216=1, 2, 8, 9 (HEARING)
AND
CHQ.285=2, 8, 9 (VISION)
AND
CHQ.330=1, 2, 3, 8, 9 (HEALTH),
GO TO BOX 18.
OTHERWISE, CONTINUE WITH CHQ.340.
CHQ.340
During this school year, has {CHILD} received therapy services or taken part in a program for children with disabilities?
HELP TEXT: Children with disabilities include children with developmental delays, communication impairments, or
special health care needs.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
BOX 14B
IF CHQ.340 = 1 AND CHQ.341 WAS ASKED IN SPRING-KINDERGARTEN, GO TO CHQ.385. ELSE, IF CHQ.341 WAS ASKED IN
SPRING-KINDERGARTEN, GO TO BOX 18. ELSE, ASK CHQ.341.
CHQ.341
Prior to this school year, did {CHILD} ever receive therapy services or take part in a program for children with
disabilities?
HELP TEXT: Children with disabilities include children with developmental delays, communication impairments, or
special health care needs.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
BOX 14C
IF (CHQ.341 = 2, 8, OR 9), GO TO CHQ.385. ELSE, ASK CHQ.345a.
CHQ.345a
I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this service
before this school year to help with {CHILD}'s special needs.
YES
a.
Speech or language therapy? ................................................. 1
NO
DK
REF
2
8
9
HELP TEXT:
Speech or language therapy: Therapy involving the evaluation or treatment of the student’s speech or language
abilities. Impairments to speech can include one or more of the following: articulation errors (includes omitting words,
substituting words, or distorting sounds), inappropriate voice (including pitch, loudness, or voice quality), or abnormal
fluency (including abnormal rate of speaking, speech interruptions, repetitions of sounds, words, phrases or
sentences). Impairments to language can include improper use of phonemes, syntax, or semantics. Language
impairments can also stem from improper practical use of language. Therapy includes special techniques to overcome
speech or language limitations. Therapy should be provided only by a teacher of the speech or language impaired who
is certified by the state, or by a certified Speech and Language Therapist/Pathologist.
CHQ.345b
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
b.
Occupational therapy? ............................................................ 1
NO
DK
REF
2
8
9
HELP TEXT
Occupational therapy: Therapy involving the evaluation or treatment of the student’s level of independence in daily
living activities. The goal of occupational therapy is to promote maximum independence in daily living. Therapy can
include the use of work, play, or self-care activities to improve functional ability, promote health, prevent injury or
further disability. Therapy should be provided only by a therapist who has been certified by the American Occupational
Therapy Association or by an occupational therapy assistant who provides therapy under the supervision of a certified
occupational therapist.
CHQ.345c
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
c.
Physical therapy? .................................................................... 1
NO
DK
REF
2
8
9
HELP TEXT:
Physical therapy: Therapy involving the evaluation or treatment of health problems resulting from injury or disease. It
is also sometimes called physiotherapy. Physical therapists assess joint motion, muscle strength and endurance, how
well the heart and lungs work, and how well children can do activities required for daily living. Treatment includes
therapeutic exercise, cardiovascular endurance training, and training in activities of daily living, as well as the use of
massage, light, cold, heat, electricity, and mechanical devices to treat physical disorders. Physical therapy does not
include the use of X-Ray technology. Therapy should be provided only by a therapist who has been state-certified to
provide such services.
CHQ.345d
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
d.
Vision services? ...................................................................... 1
NO
DK
REF
2
8
9
HELP AVAILABLE
Vision services: Therapy combines health and education professions to improve the student’s independence in daily
living and access to educational materials. Health professionals include ophthalmologists and optometrists.
Ophthalmologists are medical doctors who specialize in medical and surgical care of the eyes and visual system.
Optometrists are health service providers who evaluate vision conditions such as nearsightedness, farsightedness,
astigmatism, and presbyopia. They test the student’s ability to focus and coordinate the eyes, judge depth, and see
colors accurately. They prescribe eyeglasses, contact lenses, low vision aids, and vision therapy. Teachers of the
visually impaired are state-certified to teach students who are visually impaired or blind.
HELP AVAILABLE
CHQ.345e
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
e.
Hearing services? ................................................................... 1
NO
DK
REF
2
8
9
HELP AVAILABLE
Hearing services: Hearing services include hearing testing and techniques used to help people who are hearing
impaired improve their speech and communication. Children may have their hearing tested to determine the need for
hearing aids or other assistive devices, evaluate how well these devices are performing, or monitor for changes in
hearing ability due to medical conditions or drug treatments. They may receive therapy to improve their auditory skills,
enable them to use visual cues and contextual information to enhance understanding, and handle difficult listening
situations. Children may also be taught to use assistive technologies, such as hearing aids or cochlear implants, or to
use alternative communication strategies, such as sign language or cued speech. These services could be given by a
medical doctor, an audiologist, or other health professional.
CHQ.345f
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
f.
Social work services? .............................................................. 1
NO
DK
REF
2
8
9
HELP TEXT:
Social work services: Services that provide support to students and their families to meet individual human needs.
Particular attention is devoted to the needs and empowerment of students and their families who are disadvantaged,
vulnerable, or at risk. Social workers strive to focus on the well being of the student and his/her family in the context of
their school and community. Social workers attend to the environmental forces that create, contribute to, and address
problems of daily living. Services should be provided only by a social worker who has been certified by the state to
provide such services.
CHQ.345g
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
g.
Psychological services? .......................................................... 1
NO
DK
REF
2
8
9
HELP TEXT:
Psychological services: Services that involve the assessment of academic skills and learning aptitudes, personality
and emotional development, social skills and school climates, and eligibility for special education. Treatment involves
one-on-one interaction with students or parents to resolve personal conflicts and problems in learning and adjustment,
psychological counseling for students and parents, social skills training, and assistance through separation and loss.
Within school systems, psychological services are typically provided by certified school psychologists. However,
assessment and treatment can be extended to the health community and include services provided by clinical
psychologists, psychiatric social workers, or psychiatrists (who are medical doctors).
CHQ.345h
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
h.
Home visits? ............................................................................ 1
NO
DK
REF
2
8
9
HELP TEXT:
Home visits: Refer to formal visits to the homes of students by a certified health or education professional. Home
visits can involve therapy or education services. Home visits are typically made by teachers of preschool or
kindergarten age students with disabilities, occupational or physical therapists, school social workers, school
psychologists, or regular classroom teachers.
CHQ.345i
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
i.
Parent support or training? ...................................................... 1
NO
DK
REF
2
8
9
HELP TEXT:
Parent support or training: Refer to assistance provided by the schools or other organizations to parents who have
students with unique educational needs, such as the student with a disability. Parent support ranges from the provision
of information or referral to assistance in accessing community services for their child. Parent training can involve
learning to use special instructional techniques, assistive devices (such as low vision aids) or other equipment needed
by their child, or general understanding of the unique educational needs of their child.
CHQ.345j
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
j.
Special class with other children some or all of whom
also had special needs? .......................................................... 1
NO
DK
REF
2
8
9
HELP TEXT:
Special class with other children some or all of whom also had special needs: Refers to a classroom with a
smaller number of students than found in the regular classroom. Students in special classes have unique learning
needs often resulting from a disability or limited English proficiency. All students in such classrooms require individual
attention to their educational needs.
CHQ.345k
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
k.
Private tutoring or schooling for learning problems? ............... 1
NO
DK
REF
2
8
9
HELP TEXT:
Private tutoring or schooling for learning problems: Refers to education or training associated with a specific
learning problem or need. The term “private” suggests either that there is a cost associated with the service or
education is not provided by the public school system. Individuals, organizations, or businesses in school, home, or
community settings can provide private tutoring designed to improve the student’s educational achievement, typically
in math or reading. Special schools are available to students with particular needs such as emotional problems,
learning disabilities, blindness, or deafness. Such schools charge parents for their child’s education. However, the
education of students with disabilities may be subsidized by their home school district if the district cannot provide a
similar appropriate education.
BOX 15
IF CHILD DOES NOT HAVE DIFFICULTY SEEING (CHQ.285=2, 8, 9) , GO TO BOX 16. OTHERWISE,
CONTINUE WITH CHQ.345l.
CHQ.345l
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
I.
Instruction in Braille ................................................................. 1
NO
DK
REF
2
8
9
HELP TEXT:
Instruction in Braille: Braille is a touch system of reading using as the basic graphic symbol a cell composed of six
dots, two dots wide and three dots high. The dots are “read” by running the hand over the paper rather than looking at
it. Sixty-three possible dot combinations of the cell form the basis of the Braille code, and numerous rules govern the
usage of the code. Learners who are totally blind, near-blind, and with profound low vision need mastery of reading
Braille since it is likely their only means of gaining access to educational information in print form. Reading in Braille is
a system of reading that differs in many significant ways from reading in print. Teachers receive special training to
teach Braille.
BOX 16
IF CHILD DOES NOT HAVE DIFFICULTY HEARING (CHQ.216=1, 2, 8, 9), GO TO CHQ.345n.
OTHERWISE, CONTINUE WITH CHQ.345m.
CHQ.345m
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
m.
NO
DK
REF
2
8
9
Instruction in sign language, Cued Speech, ASL, total
communication ........................................................................ 1
HELP TEXT:
Instruction in sign language, Cued speech, ASL, TOCO: Refers to various manual methods that replace the use of
speech only as a means of communication. Manual communication is a system of teaching individuals with hearing
impairments that makes use of sign language and fingerspelling. Sign language is a general term for using the hands
to form words and phrases. There are many forms of sign language, including American Sign Language (ASL), Signed
English, Sign Exact English (SEE), etc. Cued Speech uses hand signals to symbolize sounds. TOCO refers to total
communication. TOCO employs a combination of oral and manual approaches to communication and includes
speech, sign language, lip-reading, natural gestures, fingerspelling, residual hearing, reading and writing.
CHQ.345n
[I'm going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}'s special needs.]
YES
n.
NO
DK
REF
2
8
9
Any other service? (SPECIFY) ________________________ 1
BOX 17
IF CHQ.345n = 1, GO TO CHQ.345nOS. ELSE, GO TO CHQ.375.
CHQ.345nOS
[I’m going to read a list of services. For each service, please tell me if {CHILD} or your family ever received this
service before this school year to help with {CHILD}’s special needs.]
SPECIFY OTHER SERVICE.
_____________________________________________________________
CHQ.375
How old was {CHILD} when {this service/the earliest of these services} began?
ENTER MONTHS OR YEARS.
CAPI INSTRUCTION: DISPLAY “this service” IF ONLY ONE ITEM CODED 1 (YES) FOR CHQ.345/LETTERS A-N).
OTHERWISE, DISPLAY “the earliest of these services.”
CAPI INSTRUCTION: RANGE CHECK: 0-36 IF UNIT IS MONTHS; 1- “CHILD’S CURRENT AGE IF UNIT IS
YEARS. IF NUMBER OF YEARS IS GREATER THAN THE CHILD’S AGE, DISPLAY A MESSAGE: THE AGE OF
DIAGNOSIS CANNOT BE GREATER THAN CHILD’S CURRENT AGE. VERIFY INFORMATION AND SUPPRESS
IF CURRENT AGE IS INCORRECT.
|___|___|
ENTER NUMBER
REFUSED ...................................................... 88 (CHQ.385)
DON'T KNOW ................................................ 99 (CHQ.380)
ENTER UNIT
MONTH(S) .....................................................
YEAR(S) ........................................................
REFUSED ......................................................
DON'T KNOW ................................................
CHQ.380
1
2
8
9
(CHQ.385)
(CHQ.385)
(CHQ.385)
(CHQ.380)
What is the month and year when {{CHILD} first received {{NAME OF SINGLE SERVICE}/{this service}/{the first of
these services began}}?
IF R DOESN'T KNOW MONTH, ASK: Do you remember the year?
CAPI INSTRUCTION: DISPLAY "{{CHILD}} first received {NAME OF SINGLE SERVICE}}" IF ONLY ONE ITEM
CODED 1 (YES) FOR CHQ.345/LETTERS A-N). FOR “{NAME OF SINGLE SERVICE}” DISPLAY THE NAME OF
THE SERVICE CODED AT CHQ.345A-N. ELSE, IF CHQ.340 = 1 AND EVERY ITEM AT CHQ.345/ LETTERS A-N =
2, 8, OR 9. DISPLAY "{{CHILD} first received this service}." OTHERWISE, DISPLAY "the first of these services
began."
CAPI INSTRUCTIONS: RANGE CHECK: 1-12 FOR MONTH, 2003-2012 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE IN
INQ.170 (OR YEAR OF BIRTH ESTIMATED FROM CHILD’S AGE IN INQ.175/INQ.176) AND LESS THAN OR
EQUAL TO INTERVIEW DATE.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED ...................................................... 888
DON’T KNOW ................................................ 999
CHQ.385
Is {CHILD} still receiving {this service/any of these services}?
CAPI INSTRUCTION: DISPLAY "this service" IF ONLY ONE ITEM CODED 1 (YES) FOR
CHQ.345/LETTERS A-N) OR IF CHQ.340 = 1 AND EVERY ITEM AT CHQ.345 = 2, 8, OR 9.
OTHERWISE, DISPLAY "any of these services."
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
CHQ.390
1 (CHQ.420)
2
8 (CHQ.420)
9 (CHQ.420)
What is the month and year when {{CHILD} last received {NAME OF SINGLE SERVICE}/the last of these services
was received}?
IF R DOESN’T KNOW MONTH, ASK: Do you remember the year?
CAPI INSTRUCTION: DISPLAY "{CHILD} last received {NAME OF SINGLE SERVICE}" IF ON”Y
ONE ITEM CODED 1 (YES) FOR CHQ.345/LETTERS A-N) OR IF CHQ.340 = 1 AND EVERY ITEM AT
CHQ.345 = 2, 8, OR 9. OTHERWISE, DISPLAY "the last of these services was received."
CAPI INSTRUCTION: DISPLAY "this service" FOR {NAME OF SINGLE SERVICE} IF CHQ.340 = 1
AND EVERY ITEM AT CHQ.345 = 2, 8, OR 9. OTHERWISE, DISPLAY THE NAME OF THE SERVICE CODED AT
CHQ.345.
CAPI INSTRUCTIONS: RANGE CHECK: 1-12 FOR MONTH, 2003-2012 FOR YEAR.
CAPI INSTRUCTION: EDIT: YEAR ENTERED MUST BE EQUAL TO OR GREATER THAN CHILD'S BIRTHDATE
AND LESS THAN OR EQUAL TO INTERVIEW DATE.
|___|___|
ENTER MONTH
AND
|___|___|___|___|
ENTER YEAR
REFUSED ...................................................... 88
DON'T KNOW ................................................ 99
CHQ.420
During this school year, did {CHILD} receive any services for children with special needs such as speech or
occupational therapy or did {he/she} participate in a special education program?
CAPI INSTRUCTIONS: DISPLAY 'this school year' IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
(CHQ.430)
(BOX 18)
(BOX 18)
(BOX 18)
CHQ.430
Overall, how satisfied are you with the progress {CHILD} has made in the special services or special education
program this school year? Are you…
CAPI INSTRUCTIONS: DISPLAY 'this school year' IN UNDERLINED TEXT.
Completely satisfied, ......................................
Very satisfied, ................................................
Fairly satisfied, ...............................................
Somewhat dissatisfied, or ..............................
Very dissatisfied? ...........................................
REFUSED ......................................................
DON'T KNOW ................................................
BOX 18
GO TO SECTION FDQ (FOOD SECURITY).
1
2
3
4
5
8
9
FOOD SECURITY – FDQ
FDQ.130a
These next questions are about whether your family is able to afford the food that you need. I am going to read you
several statements that people have made about their food situation. For these statements, please tell me whether the
statement was often true, sometimes true, or never true for {you/your household} {since the date of your last interview in
{MONTH YEAR}/in the last 12 months, that is, since last {CURRENT MONTH}, 2011}.
{[PROBE: Was that often true, sometimes true, or never true for {you/your household} in the last 12 months?]}
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM THE SPRING-K INTERVIEW, DISPLAY “since the date of your last interview in {MONTH, YEAR}”
AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. ELSE, DISPLAY ”in the last
12 months, that is, since last {CURRENT MONTH}, 2011}” AND DISPLAY THE CURRENT MONTH.
CAPI INSTRUCTIONS: DISPLAY "often," "sometimes," AND "never" IN THE MAIN QUESTION TEXT
AND PROBE AS UNDERLINED.
CAPI INSTRUCTIONS: USE "you," "I," AND "my" IF THE RESPONDENT IS THE ONLY HOUSEHOLD MEMBER AGE
18 OR OVER OR IF THERE ARE NO HOUSEHOLD MEMBERS 18 OR OVER OR WITH AN AGE OTHER THAN DK OR
RF. OTHERWISE, DISPLAY “your household,” “we,” “we were,” AND “our.”
CAPI INSTRUCTIONS: DISPLAY “These…2011.” IN SQUARE BRACKETS FOR B AND C.
CAPI INSTRUCTIONS: DISPLAY “PROBE…months?” IN SQUARE BRACKETS FOR C. ELSE, USE A NULL DISPLAY.
OFTEN
TRUE
SOMETIMES
TRUE
NEVER
TRUE
REF
DK
a. {I/We} worried whether {my/our} food would run
out before {I/we} got money to buy more. Was that
often true, sometimes true, or never true for
{you/your household} in the last 12 months?
1
2
3
8
9
{I/we} didn’t have money to get more. Was that
often true, sometimes true, or never true for
{you/your household} in the last 12 months?
1
2
3
8
9
c.{I/We} couldn’t afford to eat balanced meals.
1
2
3
8
9
b. The food that {I/we} bought just didn’t last, and
BOX 1
IF (FDQ.130a = 1 OR 2) OR (FDQ.130b = 1 OR 2) OR (FDQ.130c = 1 OR 2), THEN GO TO FDQ.140. ELSE, GO TO FDQ.192.
FDQ.140
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months}, did {you/you or other adults in your
household} ever cut the size of your meals
or skip meals because there wasn't enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH, YEAR}”
AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE NAME OF
THE MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY ”in the last 12 months.
CAPI INSTRUCTIONS: DISPLAY "you" IF THE RESPONDENT IS THE ONLY HOUSEHOLD MEMBER AGE 18 OR
OVER OR IF THERE ARE NO HOUSEHOLD MEMBERS 18 OR OVER OR WITH AN AGE OTHER THAN DK OR REF.
OTHERWISE, DISPLAY “you or other adults in your household.”
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
FDQ.150
How often did this happen? Would you say…
Almost every month .......................................
Some months, but not every month, or ..........
In only 1 or 2 months? ...................................
REFUSED ......................................................
DON’T KNOW ................................................
FDQ.160
1
2 (FDQ.160)
8 (FDQ.160)
9 (FDQ.160)
1
2
3
8
9
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months},did you ever eat less than you felt you
should because there wasn't enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH, YEAR}” AND
DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE NAME OF THE
MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
FDQ.170
1
2
8
9
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months}, were you ever hungry but didn't eat
because there wasn't enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH, YEAR}” AND
DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE NAME OF THE
MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
FDQ.180
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months},did you lose weight because there wasn't
enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH, YEAR}”
AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE NAME OF
THE MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
BOX 2
IF (FDQ.140=1) OR (FDQ.160 =1) OR (FDQ.170 = 1) OR (FDQ.180=1), ASK FDQ.190.
OTHERWISE, GO TO FDQ.192.
FDQ.190
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months}, did {you/you or other adults in your
household} ever not eat for a whole day because there wasn't enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH, YEAR}”
AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE NAME OF
THE MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
CAPI INSTRUCTIONS: DISPLAY "you" IF THE RESPONDENT IS THE ONLY HOUSEHOLD MEMBER AGE 18 OR
OVER OR IF THERE ARE NO HOUSEHOLD MEMBERS 18 OR OVER OR WITH AN AGE OTHER THAN DK OR REF.
OTHERWISE, DISPLAY “you or other adults in your household.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
FDQ.191
1
2 (FDQ.192)
8 (FDQ.192)
9 (FDQ.192)
How often did this happen? Would you say…
Almost every month .......................................
Some months, but not every month, or ..........
In only 1 or 2 months? ...................................
REFUSED ......................................................
DON’T KNOW ................................................
1
2
3
8
9
FDQ.192
Now I am going to read you several statements that people have made about the food situation of their children. For
these statements, please tell me whether the statement was often true, sometimes true, or never true {since the date of
your last interview in {MONTH YEAR}/in the last 12 months, that is, since last {CURRENT MONTH}, 2011} for
{your child/children living in the household who are under 18 years old}.
{[PROBE: Was that often true, sometimes true, or never true for {you/your household} {since the date of your last
interview in {MONTH YEAR}/in the last 12 months?]}
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE WHOLE
FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “since the date of your last interview in {MONTH, YEAR}” AND
DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. ELSE, DISPLAY “in the last 12
months, that is, since last {CURRENT MONTH}, 2011}” AND DISPLAY THE CURRENT MONTH. FOR BOTH MONTH
DISPLAYS, DISPLAY THE NAME OF THE MONTH NOT THE NUMBER OF THE MONTH.
CAPI INSTRUCTIONS: DISPLAY "often," "sometimes," AND "never" IN THE MAIN QUESTION TEXT AND PROBE AS
UNDERLINED.
CAPI INSTRUCTIONS: USE “I,” “I was,” and “you” IF THE RESPONDENT IS THE ONLY
HOUSEHOLD
MEMBER
AGE 18 OR OVER OR IF THERE ARE NO HOUSEHOLD MEMBERS 18 OR OVER OR WITH AN AGE OTHER THAN
DK OR RF. OTHERWISE, DISPLAY “your household,” “we,” AND “we were”
CAPI INSTRUCTIONS: DISPLAY “children living in the household who are under 18 years old “ AND “the children” IF
(NumberOfChildren > 1) OR (THERE ARE CHILDREN IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN
THE FOCAL CHILD). OTHERWISE, DISPLAY “{CHILD}” AND
“{CHILD} was.”
CAPI INSTRUCTIONS: DISPLAY “Now…2011.” IN SQUARE BRACKETS FOR B AND C.
CAPI INSTRUCTIONS: DISPLAY "PROBE:…months?" IN SQUARE BRACKETS FOR C. ELSE, USE A NULL DISPLAY.
OFTEN SOMETIMES NEVER
TRUE
TRUE
TRUE
REF
DK
a. {I/We} relied on only a few kinds of low-cost food
to feed {{CHILD}/the children} because
{I was/we were} running out of money to buy food.
Was that often true, sometimes true, or never true for
{you/your household} {since the date of your last
interview in {MONTH YEAR}/in the last 12 months}? 1
2
3
8
9
b.{I/We} couldn't feed {{CHILD}/the children} a
balanced meal because {I/we} couldn't afford that. ..
Was that often true, sometimes true, or never true for
{you/your household} {since the date of your last
interview in {MONTH YEAR}/in the last 12 months}? 1
2
3
8
9
c. {{CHILD} was/The children were} not eating
enough because {I/we} just couldn't afford enough food.
2
3
8
9
1
BOX 3
IF (FDQ.192a = 1 OR 2) OR (FDQ.192b = 1 OR 2) OR (FDQ.192c = 1 OR 2), GO TO FDQ.210. ELSE, GO TO BOX 4.
FDQ.210
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months, that is, since last {CURRENT MONTH},
2011}, did you ever cut the size of {CHILD}'s/any of the children's} meals because there wasn't enough money for
food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE
WHOLE FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH,
YEAR}” AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. ELSE, DISPLAY
”in the last 12 months, that is, since last {CURRENT MONTH}, 2011}” AND DISPLAY THE CURRENT MONTH. FOR
BOTH MONTH DISPLAYS, DISPLAY THE NAME OF THE MONTH NOT THE NUMBER OF THE MONTH.
CAPI INSTRUCTIONS: DISPLAY “any of the children’s” IF (NumberOfChildren > 1) OR (THERE ARE CHILDREN IN
THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD). OTHERWISE, DISPLAY
“{CHILD}’s.”
CAPI INSTRUCTIONS: DISPLAY THE CURRENT MONTH IN {CURRENT MONTH}
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
FDQ.240
1
2
8
9
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months} {was {CHILD}/were any of the children}
ever hungry but you just couldn't afford more food?
CAPI INSTRUCTIONS: IF,ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE
WHOLE FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH,
YEAR}” AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE
NAME OF THE MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
CAPI INSTRUCTIONS: DISPLAY “were any of the children” IF (NumberOfChildren > 1) OR (THERE ARE CHILDREN
IN THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD). OTHERWISE, DISPLAY “was
{CHILD}.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW…………………………………..
1
2
8
9
FDQ.242
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months}, did {{CHILD}/any of the children} ever
skip a meal because there wasn't enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE
WHOLE FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH,
YEAR}” AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE
NAME OF THE MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
CAPI INSTRUCTIONS: DISPLAY “any of the children” IF (NumberOfChildren > 1) OR (THERE ARE CHILDREN IN
THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD). OTHERWISE, DISPLAY “{CHILD}.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW…………………………………..
FDQ.243
How often did this happen? Would you say…
Almost every month, ......................................
Some months, but not every month, or ..........
In only 1 or 2 months? ...................................
REFUSED ......................................................
DON’T KNOW ................................................
FDQ.250
1
2 (FDQ.250)
8 (FDQ.250)
9 (FDQ.250)
1
2
3
8
9
{Since the date of your last interview in {MONTH YEAR}/In the last 12 months}, did {CHILD}/any of the children} ever
not eat for a whole day because there wasn't enough money for food?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS FDQ DATA FOR THE
WHOLE FDQ SECTION FROM SPRING-K INTERVIEW, DISPLAY “Since the date of your last interview in {MONTH,
YEAR}” AND DISPLAY THE MONTH AND YEAR OF THE SPRING-KINDERGARTEN INTERVIEW. DISPLAY THE
NAME OF THE MONTH, NOT THE NUMBER OF THE MONTH. ELSE, DISPLAY “in the last 12 months.”
CAPI INSTRUCTIONS: DISPLAY “any of the children” IF (NumberOfChildren > 1) OR (THERE ARE CHILDREN IN
THE HOUSEHOLD AGE 17 OR YOUNGER OTHER THAN THE FOCAL CHILD). OTHERWISE, DISPLAY “{CHILD}.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW…………………………………..
BOX 4
GO TO SECTION PEQ (PARENT EDUCATION).
1
2
8
9
PARENT EDUCATION - PEQ
BOX 1
•
ASK PEQ.020-PEQ.062 (IF APPLICABLE) FOR 2 "KEY" PARENT FIGURES IN THE
HOUSEHOLD. THIS PERSON OR PERSONS SHOULD BE CHOSEN AS DEFINED IN FSQ
BOX 5.
•
AFTER DETERMINING FOR WHOM THE EDUCATION QUESTIONS WILL BE ASKED,
CHECK PRELOAD TO DETERMINE IF EACH PERSON HAD NONMISSING EDUCATION
DATA FROM THE BASE YEAR. IF SO, GO TO PEQ.030 FOR THAT PERSON.
•
OTHERWISE, GO TO PEQ.020 FOR EACH APPROPRIATE PERSON.
HELP AVAILABLE
PEQ.020
Now I have a few questions about education and job training. What is the highest grade or year of school that
{you/{NAME}} {have/has} completed?
CAPI INSTRUCTION: DISPLAY "you" AND “have” IF LOOPING ON RESPONDENT (PERSONTYPE = R).
OTHERWISE, DISPLAY "{NAME}" and “has” USING NAME OF THE KEY PARENT FIGURE.
HELP TEXT:
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.
NEVER WENT TO SCHOOL .................................................................... 0
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
12TH GRADE BUT NO DIPLOMA ........................................................... 12
HIGH SCHOOL EQUIVALENT/GED ........................................................ 13
HIGH SCHOOL DIPLOMA........................................................................ 14
VOC/TECH PROGRAM
AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA ...................... 15
VOC/TECH PROGRAM AFTER HIGH SCHOOL, DIPLOMA .................... 16
SOME COLLEGE BUT NO DEGREE ...................................................... 17
ASSOCIATE'S DEGREE .......................................................................... 18
BACHELOR'S DEGREE ........................................................................... 19
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE ............ 20
MASTER'S (MA, MS)................................................................................ 21
DOCTORATE DEGREE (PHD, EDD) ....................................................... 22
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE
(MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.) ..................... 23
REFUSED................................................................................................. 88
DON'T KNOW ........................................................................................... 99
PEQ.021
(PEQ.030)
(PEQ.030)
(PEQ.030)
(PEQ.030)
(PEQ.030)
(PEQ.030)
(PEQ.030)
{Do/Does} {you/{NAME}} have a high school diploma, or its equivalent, such as a GED, or neither?
CAPI INSTRUCTION: DISPLAY "Do you" IF LOOPING ON RESPONDENT (PERSONTYPE = R). OTHERWISE,
DISPLAY "Does {NAME}" USING NAME OF THE KEY PARENT FIGURE.
HIGH SCHOOL DIPLOMA ............................
HIGH SCHOOL EQUIVALENT (GED) ...........
NO HIGH SCHOOL DIPLOMA/EQUIVALENT
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
3
8
9
PEQ.030
Are you/Is {NAME}} currently attending or enrolled in any courses from a school, college, or university?
CAPI INSTRUCTION: DISPLAY "Are you" IF LOOPING ON RESPONDENT (PERSONTYPE = R). OTHERWISE,
DISPLAY "Is {NAME}" USING NAME OF MOTHER/FATHER FIGURE OR RESPONDENT'S SPOUSE FROM HH
ROSTER.
YES ................................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2 (PEQ.050)
8 (PEQ.050)
9 (PEQ.050)
HELP AVAILABLE
PEQ.040
{Are you/Is {NAME}} currently taking courses full-time or part-time?
HELP TEXT:
Full-time: A person is considered to be attending school full-time if he or she is carrying a full load of class hours in a
semester or quarter. This is typically 12 credit hours or more.
Part-time: A person is considered to be attending school part-time if he or she is carrying less than a full load of class
hours in a semester or quarter. This is typically less than 12 credit hours.
FULL-TIME ...................................................
PART-TIME ...................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
HELP AVAILABLE
PEQ.050
{Are you/Is {NAME}} currently participating in a job training or on the job training program? Please do not report
participation in any vocational or technical programs taken at a college or university that you just told me about.
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), 4year 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.060
1
2 (BOX 2)
8 (BOX 2)
9 (BOX 2)
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 1-200.
|___|___|___|
ENTER HOURS
REFUSED ..................................................... 888
DON'T KNOW ............................................... 999
BOX 2
IF PEQ.030 OR PEQ.050 = 1, GO TO PEQ.062. ELSE, GO TO BOX 3.
HELP AVAILABLE
PEQ.062
What type of school or job training {are you/Is {NAME}} currently in?
CODE ALL THAT APPLY.
HELP TEXT:
Basic skills or high school/GED completion classes. These are classes taken to learn basic skills such as writing
or math. In some cases, they may be taken to complete high school or earn a high school equivalent or GED. A 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).
Vocational/technical program: 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 "associate's degree" and not vocational or
trade school.
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."
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.
On-the-job-training: 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. Do not include high school equivalency
degrees (GED), 2-year colleges (A.A. degree), 4-year college degree (B.A.), master’s, doctorates, or professional
degree programs after a bachelor’s degree (MA, MS, PHD, EDD, MD, DDS, LAW/JD/LLB).
Job training: 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 high school equivalency degrees (GED), 2-year colleges (A.A.
degree), 4-year college degree (B.A.), master’s, doctorates, or professional degree programs after a bachelor’s degree
(MA, MS, PHD, EDD, MD, DDS, LAW/JD/LLB).
CAPI INSTRUCTION: DISPLAY "Are you" IF LOOPING ON RESPONDENT (PERSONTYPE = R). OTHERWISE,
DISPLAY "Is {NAME}" USING NAME OF MOTHER/FATHER FIGURE OR RESPONDENT'S SPOUSE FROM HH
ROSTER.
BASIC SKILLS OR HIGH SCHOOL/GED COMPLETION CLASSES ..................... 1
VOCATIONAL OR TECHNICAL DEGREE PROGRAM.......................................... 2
ASSOCIATE’S DEGREE PROGRAM..................................................................... 3
BACHELOR’S DEGREE PROGRAM ..................................................................... 4
MASTER'S (MA, MS) DEGREE PROGRAM .......................................................... 5
DOCTORATE DEGREE (PHD, EDD) PROGRAM ................................................. 6
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE PROGRAM
(MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.) .................................. 7
ON-THE-JOB TRAINING AT CURRENT JOB TO GET NEW SKILLS ................... 8
JOB TRAINING TO GET A JOB/LEARN NEW JOB ............................................... 9
REFUSED............................................................................................................... 88
DON’T KNOW......................................................................................................... 99
BOX 3
LOOP 2.
GO BACK TO BOX 1 TO DETERMINE IF EDUCATION IS MISSING/NONMISSING AND ASK
PEQ.020/PEQ.030 - PEQ.062 ABOUT NEXT MOTHER OR FATHER FIGURE IN THE
HOUSEHOLD OR RESPONDENT AND RESPONDENT'S PARTNER IF NO MOTHER AND
FATHER FIGURES.
IF NO NEXT MOTHER OR FATHER FIGURE, GO TO BOX 4.
BOX 4
GO TO SECTION EMQ (PARENT EMPLOYMENT).
PARENT EMPLOYMENT - EMQ
BOX 1
LOOP 1
•
ASK EMQ.020 - EMQ.150 FOR 2 “KEY” PARENT FIGURES IN THE HOUSEHOLD AS
DEFINED IN FSQ, BOX 5.
•
AFTER DETERMINING FOR WHOM THE EMPLOYMENT SECTION WILL BE ASKED,
CHECK PRELOAD TO DETERMINE IF EACH PERSON WAS EMPLOYED OR ON LEAVE
FROM A JOB IN ROUND 1. IF SO, WE WILL ONLY VERIFY EMPLOYMENT STATUS FROM
ROUND 1 FOR THIS PERSON AND GO TO EMQ.010.
•
OTHERWISE, ASK EMQ.020 - EMQ.150 FOR EACH APPROPRIATE PERSON.
EMQ.010
Since (DATE OF INTERVIEW}, has {your/{NAME’s}} job title, place of or type of employment changed?
PROBE: During another interview, we recorded that you worked for {EMPLOYER NAME} as a {JOB TITLE}.
CAPI INSTRUCTION: FROM THE PRELOAD, DISPLAY THE DATE OF THE MOST RECENTLY COMPLETED OR
PARTIALLY COMPLETED INTERVIEW IN WHICH THE EMQ SECTION WAS COLLECTED. DISPLAY THE NAME
OF THE MONTH, NOT THE NUMBER OF THE MONTH, FOLLOWED BY THE DAY WITH THE APPROPRIATE
th
LETTERS AT THE END TO GO WITH THE DATE, AND THEN THE YEAR (E.G., September12 , 2010).
CAPI INSTRUCTION: FROM PRELOAD, DISPLAY EMPLOYER NAME FROM EMQ.120 AND JOB TITLE FROM
EMQ.140.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
1
2
7
9
(EMQ.020)
(EMQ.040)
(EMQ.020)
(EMQ.020)
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 ...............................................
EMQ.040
1
2 (EMQ.060)
8 (EMQ.060)
9 (EMQ.060)
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 ...............................................
8
9
EMQ.050
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
(BOX 1A)
REFUSED ...................................................... 888 (BOX 1A)
DON'T KNOW ................................................ 999 (BOX 1A)
BOX 1A
IF EMQ.010=2, GO TO BOX 5.
OTHERWISE, GO TO BOX 4.
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 .....................................................
1
2 (EMQ.080)
8 (EMQ.080)
EMQ.070
DON'T KNOW ............................................... 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
BOX 2
IF ANY CATEGORY IN EMQ.070 BETWEEN "1" AND "5" IS 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)
EMQ.080OS
DON'T KNOW ............................................... 9 (BOX 3)
[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
EMQ.100
IF DOING SOMETHING ELSE IN THE PAST 4 WEEKS (EMQ.070 = 91),
CONTINUE WITH EMQ.100.
OTHERWISE, GO TO BOX 4.
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 ...............................................
BOX 4
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.
1
2
8
9
EMQ.120
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 ..........................................................................................
EMQ.130
8
9
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 ...........................................................................................
8
9
EMQ.140
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 ...........................................................................................
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
ASK EMQ.020 - EMQ.150 FOR NEXT PERSON.
IF NO NEXT PERSON, GO TO WPQ (WELFARE AND OTHER PUBLIC TRANSFERS.
WELFARE AND OTHER PUBLIC TRANSFERS - WPQ
WPQ.100
HELP AVAILABLE
{Since {DATE OF LAST INTERVIEW}/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 formerly known as Aids to Families with Dependent Children, or AFDC.
IF NEEDED:
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 INSTRUCTION: DISPLAY STATE TANF PROGRAM NAME.
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS WPQ DATA FOR THE WHOLE
WPQ SECTION FROM A COMPLETED OR PARTIALLY COMPLETED SPRING-K INTERVIEW, DISPLAY “Since {DATE
OF LAST INTERVIEW}” AND DISPLAY THE MONTH, DAY, AND YEAR OF THE LAST INTERVIEW. DISPLAY THE
NAME OF THE MONTH, NOT THE NUMBER OF THE MONTH, FOLLOWED BY THE DAY WITH THE APPROPRIATE
LETTERS AT THE END TO GO WITH THE DATE, AND THEN THE YEAR (E.G., March 5th, 2011). ELSE, DISPLAY ”In
the past 12 months.”
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW ...............................................
1
2
8
9
HELP AVAILABLE
WPQ.110
{Since {DATE OF LAST INTERVIEW}/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)?
CAPI INSTRUCTIONS: IF, ACCORDING TO THE PRELOAD, THERE ARE PREVIOUS WPQ DATA FOR THE WHOLE
WPQ SECTION FROM A COMPLETED OR PARTIALLY COMPLETED SPRING-K INTERVIEW, DISPLAY “Since {DATE
OF LAST INTERVIEW}” AND DISPLAY THE MONTH, DAY, AND YEAR OF THE LAST INTERVIEW. DISPLAY THE
NAME OF THE MONTH, NOT THE NUMBER OF THE MONTH, FOLLOWED BY THE DAY WITH THE APPROPRIATE
th
LETTERS AT THE END TO GO WITH THE DATE, AND THEN THE YEAR (E.G., March 5 , 2011). ELSE, DISPLAY ”In
the past 12 months.”
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.
Past 12 Months: For this question, consider whether or not food stamps were received in the past 12 calendar months,
not the last calendar year.
YES. ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW…………………………………..
WPQ.150
Does {CHILD}'s school offer lunch for its students?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.160
1
2
8
9
1
2
8
9
(WPQ.160)
(WPQ.200)
(WPQ.200)
(WPQ.200)
Does {CHILD} usually receive a complete lunch offered at school?
PROBE: By complete school lunch, I mean a complete meal such as a salad, soup, a sandwich, or a hot meal that is
offered each day at a fixed price, not just milk, snacks, or ice cream. This does not include a lunch {he/she} brought from
home.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.170
1
2
8
9
(WPQ.170)
(WPQ.200)
(WPQ.200)
(WPQ.200)
Does {CHILD} receive free or reduced price lunches at school?
CAPI INSTRUCTION: DISPLAY 'free' AND 'reduced price' IN UNDERLINED TEXT.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
(WPQ.180)
(WPQ.200)
(WPQ.200)
(WPQ.200)
WPQ.180
Are these lunches free or reduced price?
FREE .............................................................
REDUCED PRICE .........................................
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.190
1
2
8 (WPQ.200)
9 (WPQ.200)
During the last five days {CHILD} was in school, how many complete school lunches did {he/she} receive?
CAPI INSTRUCTIONS: RANGE: 0 TO 5.
|___|
NUMBER OF DAYS
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.200
Does {CHILD}'s school offer breakfast for its students?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.210
1
2
8
9
(WPQ.210)
(BOX 2)
(BOX 2)
(BOX 2)
Does {CHILD} usually receive a breakfast provided by the school?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.215
8
9
1
2 (BOX 2)
8 (BOX 2)
9 (BOX 2)
Does {CHILD} receive free or reduced price breakfasts at school?
CAPI INSTRUCTION: DISPLAY "free" AND "reduced price" IN UNDERLINED TEXT
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
WPQ.216
1
2
8
9
(WPQ.216)
(BOX 2)
(BOX 2)
(BOX 2)
Are these breakfasts free or reduced price?
FREE .............................................................
REDUCED PRICE .........................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8 (BOX 2)
9 (BOX 2)
WPQ.220
During the last five days {CHILD} was in school, how many school breakfasts did {he/she} receive?
CAPI INSTUCTIONS: RANGE: 0 TO 5.
|___|
NUMBER OF DAYS
REFUSED ......................................................
DON'T KNOW ................................................
BOX 2
GO TO SECTION PAQ (PARENT INCOME AND ASSETS).
8
9
PARENT INCOME AND ASSETS – PAQ
BOX 1
IF, ACCORDING TO THE PRELOAD, THERE WERE NONMISSING VALUES FOR PAQ.110 IN SPRING-KINDERGARTEN (ANY
VALUE OF 1-18) GO TO PAQ.090. ELSE, GO TO PAQ.100.
PAQ.090
In studies like this, households are sometimes grouped according to income. In the last interview, it was reported that the
household income was {$5,000 or less/from INCOME RANGE IN PRELOAD FROM PAQ.110}. Was the total income of
all persons in your household over the past year, including salaries or other earnings, interest, retirement, and so on for all
household members still in that range?
CAPI INSTRUCTIONS: DISPLAY “$5,000 or less” IF THE PRELOAD SHOWS THAT WAS THE VALUE FROM PAQ.110
FROM THE MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW IN WHICH PAQ.110 WAS
ASKED. ELSE, DISPLAY THE PRELOAD VALUE FOR ONE OF THE RANGES 1-18 FROM PAQ.110 IN THE MOST
RECENTLY COMPLETED INTERVIEW.
YES ...............................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
PAQ.100
1 (BOX 2)
2
8 (PAQ.138)
9 (PAQ.138)
{In studies like this, households are sometimes grouped according to income.} What was the total income of all persons
in your household over the past year, including salaries or other earnings, interest, retirement, and so on for all household
members?
Was it…
CAPI INSTRUCTIONS: DISPLAY “In..income.” IF PAQ.090 WAS ASKED.
$25,000 or less, or ........................................
More than $25,000? .......................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8 (PAQ.138)
9 (PAQ.138)
PAQ.110
Was it…
CAPI INSTRUCTION: IF PAQ.100=1, DISPLAY SET 1. IF PAQ.100=2, DISPLAY SET 2.
[SET 1]
$5,000 or less…………………… 1
$5,001 to $10,000……………… 2
$10,001 to $15,000…………… 3
$15,001 to $20,000…………… 4
$20,001 to $25,000…………… 5
REFUSED……………………… 88
DON’T KNOW……………………99
[SET 2]
$25,001 to $30,000………………..6
$30,001 to $35,000………………..7
$35,001 to $40,000………………..8
$40,001 to $45,000………………..9
$45,001 to $50,000……………….10
$50,001 to $55,000……………….11
$55,001 to $60,000……………….12
$60,001 to $65,000……………….13
$65,001 to $70,000……………….14
$70,001 to $75,000……………….15
$75,001 to $100,000……………...16
$100,001 to $200,000…………….17
$200,001 or more………………... 18
REFUSED………………………… 88
DON’T KNOW………………………99
BOX 2
IF PAQ.110 (SET 1 OR SET 2) IS RF/DK, GO TO PAQ.138.
IF PAQ.090 WAS NOT ASKED, PAQ.120 IS ASKED IF THE HOUSEHOLD IS AT 200 PERCENT OF POVERTY OR BELOW.
ASK PAQ.120 IF
(NUMBER IN HH = 1 AND PAQ.110 < 6) OR
(NUMBER IN HH = 2 AND PAQ.110 < 7) OR
(NUMBER IN HH = 3 AND PAQ.110 < 8) OR
(NUMBER IN HH = 4 AND PAQ.110 < 10) OR
(NUMBER IN HH = 5 AND PAQ.110 < 12) OR
(NUMBER IN HH = 6 AND PAQ.110 < 13) OR
(NUMBER IN HH = 7 AND PAQ.110 < 15) OR
(NUMBER IN HH = 8 AND PAQ.110 < 17) OR
(NUMBER IN HH g.e. 9 AND PAQ.110 < 17).
ELSE, GO TO PAQ.138.
ELSE, IF PAQ.090= 1, A PRELOADED VALUE OF THE INCOME RANGE IN PAQ.110 FROM A PREVIOUS INTERVIEW IS USED TO
DETERMINE IF HOUSEHOLD IS AT 200 PERCENT OF POVERTY OR BELOW:
ASK PAQ.120 IF
(NUMBER IN CURRENT HH = 1 AND PRELOADED VALUE OF PAQ.110 < 6) OR
(NUMBER IN CURRENT HH = 2 AND PRELOADED VALUE OF PAQ.110 < 7) OR
(NUMBER IN CURRENT HH = 3 AND PRELOADED VALUE OF PAQ.110 < 8) OR
(NUMBER IN CURRENT HH = 4 AND PRELOADED VALUE OF PAQ.110 < 10) OR
(NUMBER IN CURRENT HH = 5 AND PRELOADED VALUE OF PAQ.110 < 12) OR
(NUMBER IN CURRENT HH = 6 AND PRELOADED VALUE OF PAQ.110 < 13) OR
(NUMBER IN CURRENT HH = 7 AND PRELOADED VALUE OF PAQ.110 < 15) OR
(NUMBER IN CURRENT HH = 8 AND PRELOADED VALUE OF PAQ.110 < 17) OR
(NUMBER IN CURRENT HH g.e. 9 AND PRELOADED VALUE OF PAQ.110 < 17).
ELSE, GO TO PAQ.138.
PAQ.120
What was your total household income last year, to the nearest thousand?
CAPI INSTRUCTION: RANGE CHECK-TOTAL INCOME SHOULD BE IN RANGE OF ANSWER TO PAQ. 110.
|___|___|___|,|___|___|___|,|___|___|___|.
TOTAL INCOME
REFUSED……………………………888
DON’T KNOW………………………..999
PAQ.138
Since last spring, have you had to move from your home because you couldn’t afford it?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
1
2
8
9
PAQ.140
What is your current housing situation? Do you…
own your own house or condominium ...................................................... 1
rent your house or apartment.................................................................... 2
exchange services for housing ................................................................. 3
not pay for housing ................................................................................... 4
live in temporary housing or a shelter, or .................................................. 5
have another type of arrangement (SPECIFY)? ________________ ...... 91
REFUSED................................................................................................. 7
DON’T KNOW........................................................................................... 9
BOX 3
IF PAQ.140=91, CONTINUE WITH PAQ.140OS. OTHERWISE, GO TO BOX 4.
PAQ.140OS [What is your current housing situation?]
SPECIFY TYPE OF ARRANGEMENT.
__________________________________________________________
CAPI INSTRUCTION: DK AND REF DISALLOWED.
BOX 4
GO TO SECTION CMQ (MOBILITY AND TRACKING UPDATES).
MOBILITY AND TRACKING UPDATES – CMQ
CMQ.010
Since the spring of 2011, how many different places has {CHILD} 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 since spring 2011 for four months or more?
CAPI INSTRUCTION: RANGE CHECK: 0 – 10 PLACES.
|___|___|
ENTER NUMBER OF PLACES
OR
REFUSED ...................................................... 77
DON'T KNOW ................................................ 99
BOX 0
IF CMQ.010=1, RF, OR DK, GO TO BOX 1. OTHERWISE, CONTINUE WITH
CMQ.020.
CMQ.020
Why did you move?
PROBE: Any other reason?
CODE ALL THAT APPLY.
SO CHILD COULD GO TO A BETTER SCHOOL ....................................
BOUGHT A HOUSE .................................................................................
MOVED TO BE NEARER JOB; JOB-RELATED REASONS ....................
MOVED TO NICER APARTMENT/HOUSE ..............................................
MOVED TO SAFER AREA, CRIME-RELATED REASONS .....................
MOVED TO LESS EXPENSIVE LIVING QUARTERS ..............................
BANK HAD TO BUY BACK THE HOME (FORECLOSED).......................
WAS EVICTED, COULD NOT PAY RENT IN PREVIOUS RESIDENCE .
OLD HOUSE/APARTMENT WAS DAMAGED .........................................
MOVED BECAUSE OF MARITAL SEPARATION, DIVORCE, DEATH
IN FAMILY ..............................................................................................
OTHER .....................................................................................................
REFUSED.................................................................................................
DON'T KNOW ...........................................................................................
1
2
3
4
5
6
7
8
9
10
11
88
99
BOX 1
IF THE CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K OR SPRING K,
CONTINUE WITH CMQ.060.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN SPRING-KINDERGARTEN)
AND (THERE WAS A TELEPHONE NUMBER IN SPRING-KINDERGARTEN CMQ.100 THAT WAS CORRECT (CMQ.100=1) OR A
TELEPHONE NUMBER IN SPRING-KINDERGARTEN GIVEN IN CMQ.140) AND (THE RESPONDENT IS THE SAME AS IN SPRINGKINDERGARTEN), GO TO CMQ.100.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL-KINDERGARTEN)
AND (THERE IS A TELEPHONE NUMBER FOR CMQ.080) AND (THE RESPONDENT IS THE SAME AS IN FALL-KINDERGARTEN),
GO TO CMQ.100.
ELSE, CONTINUE WITH CMQ.060.
CMQ.060
Just to make sure I can reach you for the next interview, which will take place next school year, I'd like to ask a few
questions about how to find you.
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 ................................................
CMQ.100
1
2
8
9
(CMQ.140)
(BOX 2)
(BOX 2)
(BOX 2)
Just to make sure I can reach you for the next interview, which will take place next school year, I'd like to ask a few
questions about how to find you. I have recorded {PHONE NUMBER} as a second phone
number where you can
sometimes be reached. Is this the right number?
CAPI INSTRUCTION: DISPLAY SECOND PHONE NUMBER FROM (SPRING-K CMQ.100 IF SPRING-K CMQ.100=1)
OR (TELEPHONE NUMBER IN SPRING-K CMQ.140). IF SPRING-K INFORMATION IS MISSING, DISPLAY FALL-K
TELEPHONE NUMBER FROM FALL K CMQ.080.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON'T KNOW ................................................
CMQ.140
1
2
8
9
(BOX 2)
(CMQ.140)
(BOX 2)
(BOX 2)
What is that telephone number?
ENTER {NEW} SECOND PHONE NUMBER.
CAPI INSTRUCTION: DISPLAY 'NEW' IF CMQ.100=2. OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: EXTENSION FIELD SHOULD BE LIMITED TO TEN NUMBERS.
|__|__|__| – |__|__|__| –|__|__|__|__|
SECOND TELEPHONE NUMBER
REFUSED ......................................................
DON'T KNOW ................................................
CMQ.150
_______________
EXTENSION
8 (BOX 2)
9 (BOX 2)
Where is that telephone located?
OFFICE/PLACE OF BUSINESS .................... 1 (BOX 2)
RELATIVE (SPECIFY) _________________ 2 (CMQ.155)
NEIGHBOR (SPECIFY) ________________ 3 (CMQ.155)
FRIEND (SPECIFY) ___________________ 4 (CMQ.155)
BEEPER NUMBER ........................................ 5 (BOX 2)
CELL PHONE ................................................ 6 (BOX 2)
HOME ............................................................ 7 (BOX 2)
OTHER (SPECIFY) ___________________ 91 (CMQ.155)
REFUSED ...................................................... 88 (BOX 2)
DON’T KNOW ................................................ 99 (BOX 2)
CMQ.155
[Where is that telephone located?]
SPECIFY {RELATIVE / NEIGHBOR / FRIEND / OTHER}.
CAPI INSTRUCTION: DISPLAY 'RELATIVE' IF CMQ.150=2.
CAPI INSTRUCTION: DISPLAY 'NEIGHBOR' IF CMQ.150=3.
CAPI INSTRUCTION: DISPLAY 'FRIEND' IF CMQ.150=4.
CAPI INSTRUCTION: DISPLAY 'OTHER' IF THE OTHER SPECIFY BOX OF CMQ.150 IS CHECKED.
BOX 2
IF THE CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K OR SPRING K, GO TO
CMQ.205.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN SPRING-KINDERGARTEN)
AND (THERE WAS A FIRST CONTACT PERSON GIVEN IN SPRING-KINDERGARTEN CMQ.200 THAT WAS CORRECT
(CMQ.200=1) OR A FIRST CONTACT PERSON IN SPRING-KINDERGARTEN GIVEN OR CORRECTED IN CMQ.210-CMQ.280) AND
(THE RESPONDENT IS THE SAME AS IN SPRING-KINDERGARTEN), GO TO CMQ.200.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL-KINDERGARTEN)
AND (THERE IS A FIRST CONTACT NAME, PHONE NUMBER, AND ADDRESS FOR CMQ.110) AND (THE RESPONDENT IS THE
SAME AS IN FALL-KINDERGARTEN), CONTINUE WITH CMQ.200.
ELSE, GO TO CMQ.205.
CMQ.200
I have recorded that {NAME OF RELATIVE/FRIEND}
at {PHONE NUMBER}
on
{STREET ADDRESS, LINE 1}
{STREET ADDRESS, LINE 2}
{CITY} {STATE} {ZIP CODE}
will always know where you are if you move. Is this still true?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
MAKE CORRECTIONS TO ANY INFORMATION THAT IS UNKNOWN OR SHOWN AS REFUSED (RF) OR DON’T
KNOW (DK).
CAPI INSTRUCTION: FROM PRELOAD, DISPLAY FIRST CONTACT NAME, PHONE NUMBER, AND ADDRESS FROM
(SPRING-K CMQ.200 IF CMQ.200=1) OR (FIRST CONTACT PERSON IN SPRING-K CMQ.210-CMQ.280). ELSE, IF
SPRING-K INFORMATION IS MISSING, DISPLAY FIRST CONTACT NAME, PHONE NUMBER, AND ADDRESS FROM
FALL K CMQ.110.
IF THERE WAS NO TELEPHONE IN PRELOAD (TELEPHONE NUMBER WAS RECORDED AS '000' OR WAS
MISSING, REFUSED, OR DON’T KNOW), DISPLAY “AN UNKNOWN TELEPHONE NUMBER” FOR “PHONE NUMBER”
DISPLAY. IF ANY PART OF THE STREET ADDRESS IS MISSING, REFUSED, OR DON’T KNOW FROM THE
PRELOAD, FOR STREET ADDRESS LINE 1, DISPLAY “AN UNKNOWN STREET”. IF STREET ADDRESS LINE 2 IS
MISSING, REFUSED, OR DON’T KNOW, USE A NULL DISPLAY. IF CITY IS MISSING, DISPLAY “AN UNKNOWN
CITY”. IF STATE IS MISSING OR DON’T KNOW, DISPLAY “DK” FOR THE STATE DISPLAY. IF STATE IS REFUSED,
DISPLAY “RF” FOR THE STATE DISPLAY. IF ZIP CODE IS MISSING OR DON’T KNOW, DISPLAY “DK” FOR THE ZIP
CODE DISPLAY. ELSE, IF ZIP CODE WAS REFUSED, DISPLAY “RF” FOR THE ZIP CODE DISPLAY.
CAPI INSTRUCTION: DISPLAY CITY, STATE, AND ZIP ON 1 LINE.
YES --- NO CORRECTION NEEDED………..1 (BOX 3)
YES --- MINOR CORRECTIONS NEEDED…2 (CMQ.210)
NO………………………………………………..3 (CMQ.205)
REFUSED……………………………………….8 (BOX 3)
DON’T KNOW…………………………………...9 (BOX 3)
CMQ.205
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 ................................................
1
2
8
9
(CMQ.210)
(BOX 5)
(BOX 3)
(BOX 3)
CMQ.210
What is the name, address, and telephone number of that person?
{ENTER / CORRECT / ENTER NEW} FIRST AND LAST NAME.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY FIRST CONTACT FIRST AND LAST NAME FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR
(SPRING-K CMQ.210). ELSE, IF THE HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY FIRST
CONTACT FIRST AND LAST NAME FROM FALL-K CMQ.110 IN THE RESPONSE FIELDS. ELSE, USE A NULL
DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
CMQ.220
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} STREET ADDRESS, LINE 1.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY STREET ADDRESS LINE 1 FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR (SPRING-K
CMQ.220). ELSE, IF THE HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY STREET ADDRESS
LINE 1 FROM FALL-K CMQ.110 IN THE RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.230
8
9
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} STREET ADDRESS, LINE 2.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY STREET ADDRESS LINE 2 FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR (SPRING-K
CMQ.230). ELSE, IF THE HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY STREET ADDRESS
LINE 1 FROM FALL-K CMQ.110 IN THE RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
CMQ.240
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} CITY.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY CITY FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR (SPRING-K CMQ.240). ELSE, IF THE
HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY CITY FROM FALL-K CMQ.110 IN THE
RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.250
8
9
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} STATE ABBREVIATION BY USING LOOKUP FILE.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
TO ACTIVATE LOOKUP, BEGIN TO TYPE STATE NAME. IF NOT IN THE UNITED STATES, HIGHLIGHT “**NOT IN
THE UNITED STATES*** IN THE LOOKUP FILE AND PRESS ENTER.
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
CAPI INSTRUCTION: DISPLAY ”TO ….MATCH.” WHEN ON STATE ENTRY FIELD.”
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY STATE FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR (SPRING-K CMQ.250). ELSE, IF THE
HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY STATE FROM FALL-K CMQ.110 IN THE
RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
BOX 2B
IF CMQ.250 = 0 (NOT IN THE UNITED STATES), CONTINUE WITH CMQ.255. ELSE, GO TO CMQ.260.
CMQ.255
[What is the name, address, and telephone number of that person?]
ENTER COUNTRY OR TERRITORY BY USING LOOKUP FILE.
TO ACTIVATE LOOKUP, BEGIN TO TYPE COUNTRY OR TERRITORY.
HIGHLIGHT ***NOT ON LIST*** IN THE LOOKUP FILE AND PRESS ENTER.
IF COUNTRY IS NOT ON THE LIST,
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
CAPI INSTRUCTION: DISPLAY COUNTRY LOOKUP FILE. ALLOW 3 SPACES IN THE RESPONSE FIELD FOR
ENTERING RESPONSE CODES.
REFUSED ....................................................... 8
DON’T KNOW ................................................. 9
BOX 2C
IF CMQ.255 = 0 (NOT ON LIST), CONTINUE WITH CMQ.255OS. OTHERWISE, GO TO CMQ.260.
CMQ.255OS [What is the name, address, and telephone number of that person?]
SPECIFY COUNTRY NAME
___________________________________________________________
CMQ.260
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} ZIP CODE.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY ZIP CODE FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR (SPRING-K CMQ.260). ELSE, IF
THE HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY ZIP CODE FROM FALL-K CMQ.110 IN THE
RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
CMQ.270
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} PHONE NUMBER, INCLUDING AREA CODE.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY TELEPHONE NUMBER FROM (SPRING-K CMQ.200 IF CMQ.200=1) OR (SPRING-K CMQ.270)
IN THE RESPONSE FIELD. ELSE, IF THE HOUSEHOLD HAD A FALL-KINDERGARTEN INTERVIEW, DISPLAY
TELEPHONE NUMBER FROM FALL-K CMQ.110 IN THE RESPONSE FIELD. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION."
OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF NO TELEPHONE, ENTER '000.'
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.280
8
9
What is the person's relationship to you?
{ENTER / CORRECT / ENTER NEW} RELATIONSHIP OF PERSON TO RESPONDENT.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: ACCORDING TO THE PRELOAD, IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY RELATIONSHIP FROM SPRING-K CMQ.280. ELSE, IF (SPRING-K CMQ.200=1) OR (THE
HOUSEHOLD HAD A FALL-K INTERVIEW BUT NOT A SPRING-K INTERVIEW), DISPLAY RELATIONSHIP FROM
FALL-K CMQ.110 IN THE RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'CORRECT." IF CMQ.200=3, DISPLAY 'ENTER NEW."
OTHERWISE, DISPLAY 'ENTER."
CAPI INSTRUCTION: IF CMQ.200=2, DISPLAY 'IF FIELD…INFORMATION." IF FIELD IS INCOMPLETE, ASK FOR
NEW INFORMATION. OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
BOX 3
IF THE CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K OR SPRING K:
IF CMQ.205=DK OR RF, GO TO BOX 5.
IF CMQ.205=1, GO TO CMQ.305.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN SPRING-KINDERGARTEN)
AND (THERE WAS A SECOND CONTACT PERSON GIVEN IN SPRING-KINDERGARTEN CMQ.300 THAT WAS CORRECT
(CMQ.300=1) OR A FIRST CONTACT PERSON IN SPRING-KINDERGARTEN GIVEN OR CORRECTED IN CMQ.310-CMQ.380) AND
(THE RESPONDENT IS THE SAME AS IN SPRING-KINDERGARTEN), CONTINUE WITH CMQ.300.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL-KINDERGARTEN)
AND (THERE IS A SECOND CONTACT NAME, PHONE NUMBER, AND ADDRESS FOR CMQ.140) AND (THE RESPONDENT IS
THE SAME AS IN FALL-KINDERGARTEN), CONTINUE WITH CMQ.300.
ELSE, IF SPRING-FIRST GRADE CMQ.205= DK OR RF, GO TO BOX 5.
ELSE, IF (SPRING-FIRST GRADE CMQ.205 =1) OR (SPRING-FIRST GRADE CMQ.205 WAS NOT ASKED) OR (THE RESPONDENT
IN THE SPRING IS NOT THE SAME AS IN THE FALL), GO TO CMQ.305.
CMQ.300
I have also recorded that {NAME OF RELATIVE/FRIEND}
at {PHONE NUMBER}
on
{STREET ADDRESS, LINE 1}
{STREET ADDRESS, LINE 2}
{CITY}
{STATE}
{ZIP CODE}
will always know where you are if you move. Is this still true?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
MAKE CORRECTIONS TO ANY INFORMATION THAT IS UNKNOWN OR SHOWN AS REFUSED (RF) OR DON’T
KNOW (DK).
CAPI INSTRUCTION: DISPLAY SECOND CONTACT NAME, PHONE NUMBER, AND ADDRESS FROM (SPRING-K
CMQ.300 IF CMQ.300=1) OR (SECOND CONTACT PERSON IN SPRING-K CMQ.310-CMQ.380). IF SPRING-K
INFORMATION IS MISSING, DISPLAY SECOND CONTACT NAME, PHONE NUMBER, AND ADDRESS FROM FALL K
CMQ.140.
IF THERE WAS NO TELEPHONE IN PRELOAD (TELEPHONE NUMBER WAS RECORDED AS '000' OR WAS
MISSING, REFUSED, OR DON’T KNOW), DISPLAY “AN UNKNOWN TELEPHONE NUMBER” FOR “PHONE NUMBER”
DISPLAY. IF ANY PART OF THE STREET ADDRESS IS MISSING, REFUSED, OR DON’T KNOW FROM THE
PRELOAD, FOR STREET ADDRESS LINE 1, DISPLAY “AN UNKNOWN STREET”. IF STREET ADDRESS LINE 2 IS
MISSING, REFUSED, OR DON’T KNOW, USE A NULL DISPLAY. IF CITY IS MISSING, DISPLAY “AN UNKNOWN
CITY”. IF STATE IS MISSING OR DON’T KNOW, DISPLAY “DK” FOR THE STATE DISPLAY. IF STATE IS REFUSED,
DISPLAY RF FOR THE STATE DISPLAY. IF ZIP CODE IS MISSING OR DON’T KNOW, DISPLAY “DK” FOR THE ZIP
CODE DISPLAY. ELSE, IF ZIP CODE WAS REFUSED, DISPLAY “RF” FOR THE ZIP CODE DISPLAY.
CAPI INSTRUCTION: DISPLAY CITY, STATE, AND ZIP ON 1 LINE.
YES --- NO CORRECTION NEEDED………..1 (BOX 5)
YES --- MINOR CORRECTIONS NEEDED…2 (CMQ.310)
NO………………………………………………..3 (BOX 4)
REFUSED……………………………………….8 (BOX 5)
DON’T KNOW…………………………………...9 (BOX 5)
BOX 4
IF CMQ.205=DK, RF, GO TO BOX 5.
IF CMQ.205= 1 OR WAS NOT ASKED, CONTINUE WITH CMQ.305.
CMQ.305
Besides {PERSON AT SPRING-FIRST GRADE CMQ.210/PERSON AT SPRING-KINDERGARTEN CMQ.300 OR
CMQ.310-383/PERSON AT FALL-KINDERGARTEN 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: IF CMQ.200 = REF/DK, DISPLAY NAME FROM FIRST CONTACT PERSON IN SPRINGKINDERGARTEN CMQ.300 IF THAT WAS CORRECT (CMQ.300=1) OR FIRST CONTACT PERSON NAME FROM
SPRING-KINDERGARTEN THAT WAS GIVEN IN CMQ.310-CMQ.380. ELSE, IF CMQ.200 = REF/DK AND SPRINGKINDERGARTEN FIRST CONTACT PERSON INFORMATION IS MISSING, DISPLAY NAME FROM PERSON IN FALL
CMQ.110. ELSE, DISPLAY NAME FROM PERSON IN SPRING-FIRST GRADE CMQ.210.
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.310
1
2
8
9
(CMQ.310)
(BOX 5)
(BOX 5)
(BOX 5)
What is the name, address, and telephone number of that person?
{ENTER / CORRECT / ENTER NEW} FIRST AND LAST NAME.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY SECOND CONTACT FIRST AND LAST NAME FROM
(SPRING-K CMQ.300 IF CMQ.300=1) OR (SECOND CONTACT PERSON IN SPRING-K CMQ.310). IF SPRING-K
INFORMATION IS MISSING, DISPLAY SECOND CONTACT FIRST AND LAST NAME FROM FALL K CMQ.140. ELSE,
USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
CMQ.320
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} STREET ADDRESS, LINE 1.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY STREET ADDRESS LINE 1 FROM (SPRING-K CMQ.300
IF CMQ.300=1) OR (SPRING-K CMQ.320). IF SPRING-K INFORMATION IS MISSING, DISPLAY STREET ADDRESS
LINE 1 FROM FALL K CMQ.140. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
CMQ.330
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} STREET ADDRESS, LINE 2.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY STREET ADDRESS LINE 2 FROM (SPRING-K CMQ.300
IF CMQ.300=1) OR (SPRING-K CMQ.330). IF SPRING-K INFORMATION IS MISSING, DISPLAY STREET ADDRESS
LINE 2 FROM FALL K CMQ.140. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.340
8
9
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} CITY.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY CITY FROM (SPRING-K CMQ.300 IF CMQ.300=1) OR
(SPRING-K CMQ.340). IF SPRING-K INFORMATION IS MISSING, DISPLAY CITY FROM FALL K CMQ.140. ELSE,
USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
HELP AVAILABLE
CMQ.350
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} STATE ABBREVIATION BY USING LOOKUP FILE.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: DISPLAY STATE ABBREVIATIONS.
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY STATE FROM (SPRING-K CMQ.300 IF CMQ.300=1) OR
(SPRING-K CMQ.350). IF SPRING-K INFORMATION IS MISSING, DISPLAY STATE FROM FALL K CMQ.140. ELSE,
USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
BOX 4B
IF CMQ.250 = 0 (NOT IN THE UNITED STATES), CONTINUE WITH CMQ.355. ELSE, GO TO CMQ.360.
CMQ.355
[What is the name, address, and telephone number of that person?]
ENTER COUNTRY OR TERRITORY BY USING LOOKUP FILE.
TO ACTIVATE LOOKUP, BEGIN TO TYPE COUNTRY OR TERRITORY.
HIGHLIGHT ***NOT ON LIST*** IN THE LOOKUP FILE AND PRESS ENTER.
IF COUNTRY IS NOT ON THE LIST,
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
CAPI INSTRUCTION: DISPLAY COUNTRY LOOKUP FILE. ALLOW 3 SPACES IN THE RESPONSE FIELD FOR
ENTERING RESPONSE CODES.
REFUSED ....................................................... 8
DON’T KNOW ................................................. 9
BOX 4C
IF CMQ.355 = 0 (NOT ON LIST), CONTINUE WITH CMQ.355OS. OTHERWISE, GO TO CMQ.260.
CMQ.355OS [What is the name, address, and telephone number of that person?]
SPECIFY COUNTRY NAME
___________________________________________________________
CMQ.360
[What is the name, address, and telephone number of that person?]
{ENTER / CORRECT / ENTER NEW} ZIP CODE.
{IF FIELD IS INCOMPLETE, ENTER NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY ZIP CODE FROM (SPRING-K CMQ.300 IF CMQ.300=1)
OR (SPRING-K CMQ.360). IF SPRING-K INFORMATION IS MISSING, DISPLAY ZIP CODE FROM FALL K CMQ.140.
ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.370
8
9
[What is the name, address, and telephone number of that person?]
IF NO TELEPHONE, ENTER '000.'
{ENTER / CORRECT / ENTER NEW} PHONE NUMBER, INCLUDING AREA CODE.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: DISPLAY TELEPHONE NUMBER FROM (SPRING-K CMQ.300 IF
CMQ.300=1) OR (SPRING-K CMQ.320). IF SPRING-K INFORMATION IS MISSING, DISPLAY TELEPHONE NUMBER
FROM FALL K CMQ.140. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
CAPI INSTRUCTION: IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
CMQ.380
What is the person's relationship to you?
{ENTER / CORRECT / ENTER NEW} RELATIONSHIP OF PERSON TO RESPONDENT.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELDS: IF THE HOUSEHOLD HAD A SPRING-KINDERGARTEN
INTERVIEW, DISPLAY RELATIONSHIP FROM SPRING-K CMQ.380. ELSE, IF (SPRING-K CMQ.300=1) OR (THE
HOUSEHOLD HAD A FALL-K INTERVIEW BUT NOT A SPRING-K INTERVIEW), DISPLAY RELATIONSHIP FROM
FALL-K CMQ.140 IN THE RESPONSE FIELDS. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'CORRECT.'
IF CMQ.300=3, DISPLAY 'ENTER NEW.'
OTHERWISE, DISPLAY 'ENTER.'
CAPI INSTRUCTION: IF CMQ.300=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
REFUSED ......................................................
DON’T KNOW ................................................
8
9
BOX 5
IF THE CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K OR SPRING K, GO TO
CMQ.383.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN SPRING-KINDERGARTEN)
AND (THERE WAS AN E-MAIL ADDRESS GIVEN IN SPRING-KINDERGARTEN CMQ.382 THAT WAS CORRECT (CMQ.382=1) OR
(AN E-MAIL ADDRESS IN SPRING-KINDERGARTEN GIVEN OR CORRECTED IN CMQ.384) AND (THE RESPONDENT IS THE
SAME AS IN SPRING-KINDERGARTEN), CONTINUE WITH CMQ.382.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL-KINDERGARTEN)
AND (THERE IS AN EMAIL ADDRESS FOR CMQ.092) AND (THE RESPONDENT IS THE SAME AS IN FALL-KINDERGARTEN),
CONTINUE WITH CMQ.382.
ELSE, GO TO CMQ.383.
CMQ.382
I have also recorded that your e-mail address is {EMAIL ADDRESS}. Is that correct?
CAPI INSTRUCTION: DISPLAY E-MAIL ADDRESS FROM (SPRING-K CMQ.382 IF CMQ.382=1) OR (E-MAIL
ADDRESS IN SPRING-K CMQ.384). IF SPRING-K INFORMATION IS MISSING, DISPLAY E-MAIL ADDRESS FROM
FALL K CMQ.092.
YES --- NO CORRECTION NEEDED………..1 (BOX 6)
YES --- MINOR CORRECTIONS NEEDED…2 (CMQ.384)
NO………………………………………………..3 (CMQ.383)
REFUSED……………………………………….8 (BOX 6)
DON’T KNOW…………………………………..9 (BOX 6)
CMQ.383
Is there an e-mail address where we could reach you?
YES ................................................................
NO .................................................................
REFUSED ......................................................
DON’T KNOW ................................................
CMQ.384
1
2 (BOX 6)
7 (BOX 6)
9 (BOX 6)
What is your e-mail address?
IF EMAIL ADDRESS WILL NOT FIT THE SPACE PROVIDED, ENTER IT IN COMMENTS.
{CORRECT / ENTER NEW} E-MAIL ADDRESS.
{IF FIELD IS INCOMPLETE, ASK FOR NEW INFORMATION.}
CAPI INSTRUCTION: IN THE RESPONSE FIELD: DISPLAY E-MAIL ADDRESS FROM (SPRING-K CMQ.382 IF
CMQ.382=1) OR (E-MAIL ADDRESS IN SPRING-K CMQ.384). IF SPRING-K INFORMATION IS MISSING, DISPLAY
E-MAIL ADDRESS FROM FALL K CMQ.092. ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTIONS: IF CMQ.382=2, DISPLAY 'CORRECT.' IF CMQ382=3, DISPLAY 'ENTER NEW.'
CAPI INSTRUCTIONS: IF CMQ.382=2, DISPLAY 'IF FIELD…INFORMATION.'
OTHERWISE, USE A NULL DISPLAY.
CAPI INSTRUCTIONS: ALLOW 70 TOTAL CHARACTERS FOR THE E-MAIL ADDRESS.
CAPI INSTRUCTIONS: IF THE EMAIL ADDRESS DOES NOT CONTAIN THE “@” SIGN, DISPLAY THE
FOLLOWING MESSAGE ”THE EMAIL ADDRESS SHOULD CONTAIN THE “@” SIGN. PLEASE CONFIRM AND
CHANGE.”
IF THE EMAIL ADDRESS DOES NOT CONTAIN A “.” (PERIOD), DISPLAY THE FOLLOWING MESSAGE ”THE
EMAIL ADDRESS SHOULD CONTAIN AT LEAST ONE PERIOD. PLEASE CONFIRM AND CHANGE.”
CAPI INSTRUCTIONS: ALLOW FOR REFUSED AND DON’T KNOW ANSWERS.
______________________________________________________________________
ENTER E-MAIL ADDRESS
BOX 6
IF THE CASE DID NOT HAVE A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL K OR SPRING K, GO TO
BOX 7.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN SPRING-KINDERGARTEN)
AND (THE CHILD CURRENTLY HAS AT LEAST ONE NON-RESIDENTIAL PARENT WHO THE CHILD HAS CONTACT WITH
(SPRING-FIRST GRADE NRQ.040 = 1 OR 2 FOR AT LEAST ONE NON-RESIDENTIAL PARENT)) AND (SPRING-KINDERGARTEN
HAD COMPLETE NON-RESIDENT PARENT INFORMATION EITHER GIVEN IN SPRING-KINDERGARTEN CMQ.395 THAT WAS
CORRECT (CMQ.395=1) OR GIVEN OR CORRECTED IN SPRING-KINDERGARTEN CMQ.400) AND (THE RESPONDENT IS THE
SAME AS IN SPRING-KINDERGARTEN), CONTINUE WITH CMQ.395.
ELSE, IF (THE HOUSEHOLD HAD A COMPLETE OR PARTIALLY COMPLETE PARENT INTERVIEW IN FALL-KINDERGARTEN)
AND (THE CHILD CURRENTLY HAS AT LEAST ONE NON-RESIDENTIAL PARENT WHO THE CHILD HAS CONTACT WITH
(SPRING-FIRST GRADE NRQ.040 = 1 OR 2 FOR AT LEAST ONE NON-RESIDENTIAL PARENT)) AND (FALL K CMQ170 HAD
COMPLETE NON-RESIDENT PARENT INFORMATION) AND (THE RESPONDENT IS THE SAME AS IN FALL-KINDERGARTEN),
CONTINUE WITH CMQ.395.
ELSE, GO TO BOX 7.
DEFINITION OF "COMPLETE" NON-RESIDENT PARENT INFORMATION:
EITHER NAME + PHONE NUMBER OR NAME + CITY+ STATE WERE COLLECTED IN SPRING OR FALL K.
IF THE NON-RESIDENT PARENT ADDRESS COLLECTED IN SPRING K OR FALL K DOES NOT MEET THE DEFINITION OF
"COMPLETE," THEN CAPI ROUTES THAT CASE TO BOX 7.
CMQ.395
I have recorded {NAME OF NONRESIDENTIAL PARENT} at {PHONE NUMBER}
on
{STREET ADDRESS, LINE 1}
{STREET ADDRESS, LINE 2}
{CITY} {STATE} {ZIP CODE}
is {CHILD}'s {RELATIONSHIP AT CMQ170}.
Is this information still correct?
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
CAPI INSTRUCTION: DISPLAY NAME, ADDRESS, PHONE NUMBER, AND RELATIONSHIP OF NON-RESIDENTIAL
PARENT FROM (SPRING-K CMQ.395 IF CMQ.395=1) OR (SPRING-K CMQ.400). IF SPRING-K INFORMATION IS
MISSING, DISPLAY NAME, ADDRESS, PHONE NUMBER, AND RELATIONSHIP OF NON-RESIDENTIAL PARENT
FROM FALL K CMQ.170.
IF THERE WAS NO TELEPHONE IN PRELOAD (TELEPHONE NUMBER WAS RECORDED AS '000' OR WAS
MISSING, REFUSED, OR DON’T KNOW), DISPLAY “AN UNKNOWN TELEPHONE NUMBER” FOR “PHONE NUMBER”
DISPLAY. IF ANY PART OF THE STREET ADDRESS IS MISSING, REFUSED, OR DON’T KNOW FROM THE
PRELOAD, FOR STREET ADDRESS LINE 1, DISPLAY “AN UNKNOWN STREET”. IF STREET ADDRESS LINE 2 IS
MISSING, REFUSED, OR DON’T KNOW, USE A NULL DISPLAY. IF CITY IS MISSING, DISPLAY “AN UNKNOWN
CITY”. IF STATE IS MISSING OR DON’T KNOW, DISPLAY “DK” FOR THE STATE DISPLAY. IF STATE IS REFUSED,
DISPLAY RF FOR THE STATE DISPLAY. IF ZIP CODE IS MISSING OR DON’T KNOW, DISPLAY “DK” FOR THE ZIP
CODE DISPLAY. ELSE, IF ZIP CODE WAS REFUSED, DISPLAY “RF” FOR THE ZIP CODE DISPLAY.
CAPI INSTRUCTION: DISPLAY CITY, STATE, AND ZIP ON 1 LINE.
YES --- NO CORRECTION NEEDED…………………………………..1 (CMQ.680)
YES --- MINOR CORRECTIONS NEEDED……………………………2 (CMQ.400)
NO…………………………………………………………………………..3 (BOX 7)
INFORMATION ALREADY PROVIDED IN PREVIOUS ITEMS……..4 (CMQ.680)
REFUSED………………………………………………………………….8 (CMQ.680)
DON’T KNOW……………………………………………………………...9 (CMQ.680)
BOX 7
IF CMQ.395 WAS NOT ASKED AND IF FOCAL CHILD HAS AT LEAST ONE NON-RESIDENT PARENT WHO THE CHILD HAS HAD
CONTACT WITH (NRQ.040=1 OR 2 FOR AT LEAST ONE NON-RESIDENT PARENT), CONTINUE WITH CMQ.400.
IF CMQ.395=3 (NO) AND THE FOCAL CHILD HAS AT LEAST ONE NON-RESIDENT PARENTS WHO THE CHILD HAS HAD
CONTACT WITH (NRQ.040=1 OR 2 FOR AT LEAST ONE NON-RESIDENT PARENT), ALSO CONTINUE WITH CMQ.400.
OTHERWISE, GO TO CMQ.680.
CMQ.400
What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?
ENTER FIRST AND LAST NAME.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
IF NECESSARY SAY: I will only contact this person if I cannot locate you for the next interview.
REFUSED .........................................................8
DON’T KNOW ...................................................9
CMQ.410
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or}
adoptive mother / {or} adoptive father}?]
ENTER STREET ADDRESS, LINE 1.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED .........................................................8
DON’T KNOW ...................................................9
CMQ.420
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?]
ENTER STREET ADDRESS, LINE 2.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED .........................................................8
DON’T KNOW ...................................................9
CMQ.430
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?]
ENTER CITY.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED .........................................................8
DON’T KNOW ...................................................9
CMQ.440
HELP AVAILABLE
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?]
ENTER STATE ABBREVIATION BY USING LOOKUP FILE.
TO ACTIVATE LOOKUP, BEGIN TO TYPE STATE NAME. IF NOT IN THE UNITED STATES, HIGHLIGHT “**NOT IN
THE UNITED STATES*** IN THE LOOKUP FILE AND PRESS ENTER.
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED .........................................................8
DON’T KNOW ...................................................9
BOX 7B
IF CMQ.440 = 0 (NOT IN THE UNITED STATES), CONTINUE WITH CMQ.445. ELSE, GO TO CMQ.450.
CMQ.445
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?]
ENTER COUNTRY OR TERRITORY BY USING LOOKUP FILE.
TO ACTIVATE LOOKUP, BEGIN TO TYPE COUNTRY OR TERRITORY.
HIGHLIGHT ***NOT ON LIST*** IN THE LOOKUP FILE AND PRESS ENTER.
IF COUNTRY IS NOT ON THE LIST,
USE THE ARROW KEYS TO HELP YOU LOCATE A MATCH.
CAPI INSTRUCTION: DISPLAY COUNTRY LOOKUP FILE. ALLOW 3 SPACES IN THE RESPONSE FIELD FOR
ENTERING RESPONSE CODES.
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED ....................................................... 8
DON’T KNOW ................................................. 9
BOX 7C
IF CMQ.355 = 0 (NOT ON LIST), CONTINUE WITH CMQ.445OS. OTHERWISE, GO TO CMQ.450.
CMQ.445OS [What is the name, address, and telephone number of that person?]
SPECIFY COUNTRY NAME
___________________________________________________________
CMQ.450
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?]
ENTER ZIP CODE.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED .........................................................8
DON’T KNOW ...................................................9
CMQ.460
[What is the name, address, and telephone number of {CHILD}'s {biological mother/ {or} biological father / {or} adoptive
mother / {or} adoptive father}?]
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
IF NO TELEPHONE, ENTER '000.'
ENTER PHONE NUMBER, INCLUDING AREA CODE.
CAPI INSTRUCTION: DISPLAY 'biological mother' IF NRQ.040=1 OR 2 FOR A NON-RESIDENT BIOLOGICAL
MOTHER.
CAPI INSTRUCTION: 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 NON-RESIDENT
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 NON-RESIDENT
BIOLOGICAL FATHER ALSO.
REFUSED .........................................................8
DON’T KNOW ...................................................9
CMQ.470
{Let me just confirm our information}. What is the person's relationship to {CHILD}?
ENTER RELATIONSHIP OF PERSON TO CHILD.
IF THE PARENT IS DECEASED OR THERE HAS BEEN NO CONTACT SINCE BIRTH/ADOPTION OR THERE IS NO
ADOPTIVE MOTHER/FATHER, THEN CODE “8.”
CAPI INSTRUCTION: DISPLAY “Let me…information” IF ONLY ONE TYPE OF NONRESIDENT PARENT WAS
DISPLAYED IN CMQ.460 (E.G., ONLY “BIOLOGICAL MOTHER” AND NOT “BIOLOGICAL FATHER”, “ADOPTIVE
MOTHER”, OR “ADOPTIVE FATHER”. ELSE, USE A NULL DISPLAY.
REFUSED………………………………………….8
DON’T KNOW……………………………………...9
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 (BOX 7D)
SPANISH ..................................................................... 2 (BOX 7D)
ANOTHER LANGUAGE ............................................... 91 (CMQ.690OS)
CMQ.690OS SPECIFY OTHER LANGUAGE.
[WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?]
BOX 7D
IF CMQ.680 =2, GO TO CMQ.695. ELSE, GO TO BOX 8.
CMQ.695
WHERE WAS THIS INTERVIEW CONDUCTED?
CHILD’S HOME ...........................................................
CHILD’S SCHOOL .......................................................
SOMEWHERE ELSE ...................................................
1
2
3
BOX 8
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 1 AND ENTER TO CONTINUE.
BOX 9
GO TO CMQ.720.
CMQ.701
We would like to call the parent or guardian for {CHILD} at the household where {he/she} lives. Could you 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.
PRESS 1 AND ENTER TO CONTINUE.
BOX 10
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.
PRESS 1 AND ENTER TO CONTINUE.
BOX 11
GO TO CMQ.720.
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.
PRESS 1 AND ENTER TO CONTINUE.
CMQ.720
PRESS 1 AND ENTER TO SAVE AND EXIT THIS CASE.
Fall Second-Grade Parent Interview
INTRODUCTION (FALL SECOND GRADE)- INQ
Box 1
IF THE CASE HAS A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRINGKINDERGARTEN, FALL-FIRST GRADE, OR SPRING‐FIRST GRADE INTERVIEW, GO TO INQ.005. ELSE, GO TO
INQ.040.
INQ005
{In the fall of 2010/In the spring of 2011/In the fall of 2011/In the spring of 2012}, we spoke with {NAME OF
RESPONDENT} who took part in the Early Childhood Longitudinal Study, Kindergarten Class of 2010‐2011
on {DATE OF LAST INTERVIEW}. Am I talking to the same person?
VERIFY NAME, AGE AND RELATIONSHIP WITH RESPONDENT:
NAME: {FIRST NAME} {LAST NAME}.
AGE: {APPROXIMATELY {UPDATED AGE FROM PRELOAD} YEARS OLD/UNKNOWN}.
RELATIONSHIP TO CHILD: {RELATIONSHIP TO CHILD/UNKNOWN}.
ENTER “1” FOR YES EVEN IF THE AGE LISTED IS A YEAR OR TWO DIFFERENT FROM THE AGE OF THE
RESPONDENT IF YOU HAVE CONFIRMED IT IS THE SAME PERSON.
1
2
3
YES
INQ090
NO
INQ010
YES, SAME PERSON, BUT CHILD LIVES ELSEWHERE NOW CMQ701
PROGRAMMER INSTRUCTIONS:
ACCORDING TO THE PRELOAD, DISPLAY “In the fall of 2010” IF THE MOST RECENTLY COMPLETED PARENT
INTERVIEW WAS IN THE FALL OF KINDERGARTEN. DISPLAY “In the spring of 2011” IF THE MOST RECENTLY
COMPLETED OR PARTIALLY COMPLETED INTERVIEW WAS IN THE SPRING OF KINDERGARTEN. DISPLAY
“In the fall of 2011” IF THE MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED PARENT INTERVIEW
WAS IN THE FALL OF FIRST GRADE. DISPLAY “In the spring of 2012” IF THE MOST RECENTLY COMPLETED
OR PARTIALLY COMPLETED INTERVIEW WAS IN THE SPRING OF FIRST GRADE.
FOR “NAME OF RESPONDENT” DISPLAY FIRST AND LAST NAME OF RESPONDENT FROM MOST RECENTLY
COMPLETED OR PARTIALLY COMPLETED INTERVIEW FROM PRELOAD. USE THE NAME OF
PERSONTYPE=R.
FOR “FIRST NAME” AND “LAST NAME” DISPLAY FIRST AND LAST NAME OF RESPONDENT FROM MOST
RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW FROM PRELOAD. USE THE NAME OF
PERSONTYPE=R.
IF AGE IS NOT ONE OF THESE MISSING VALUES (MISSING, REFUSED, OR DON'T KNOW), DISPLAY
"APPROXIMATELY…OLD". FOR “UPDATED AGE FROM FALL OR SPRING” DISPLAY AGE OF MOST RECENT
ROUND RESPONDENT FROM PRELOAD. IF AGE IS MISSING, REFUSED, OR DON'T KNOW, DISPLAY
"UNKNOWN."
FOR “RELATIONSHIP TO CHILD” DISPLAY RELATIONSHIP OF RESPONDENT TO CHILD FROM PRELOAD. IF
RELATIONSHIP IS MISSING, REFUSED, OR DON’T KNOW, DISPLAY “UNKNOWN”.
FLAG THE RESPONDENT IN THE HOUSEHOLD ROSTER AND SET A FLAG CALLED "FLAGS.SAMERESP" THAT
EQUALS 1 IF INQ.005 = 1.
REFUSED AND DON'T KNOW DISALLOWED.
INQ010
May I please speak with {NAME OF PREVIOUS ROUND RESPONDENT}?
NOTE: IF THIS PERSON ASKED FOR IN THIS QUESTION IS AVAILABLE AND YOU CAN SPEAK TO HIM/HER
NOW, 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 BECAUSE HE/SHE IS AWAY
OR DOES NOT CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, CODE “3” TO ASK FOR SOMEONE
ELSE. IF THE CHILD DOES NOT LIVE THERE NOW, CODE “4” FOR “CHILD LIVES ELSEWHERE.”
CODES
1
AVAILABLE
INQ005
2
NOT AVAILABLE BUT WILL BE BEFORE END OF FIELD PERIOD (CALLBACK APPT.) CMQ702
3
NOT AVAILABLE IN FIELD PERIOD
INQ015
4
CHILD LIVES ELSEWHERE
CMQ701
REFUSED
INQ015
DON'T KNOW INQ015
PROGRAMMER INSTRUCTIONS:
DISPLAY FIRST AND LAST NAME OF RESPONDENT FROM MOST RECENTLY COMPLETED OR PARTIALLY
COMPLETED INTERVIEW FROM PRELOAD.
IF INQ.010 = 1, HARD ERROR CHECK SHOULD READ:
PLEASE GO BACK TO THE PREVIOUS QUESTION (INQ.005) TO VERIFY THE RESPONDENT.
PRESS G TO GO BACK NOW.
PRESS C TO CANCEL.
INQ015
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.”
CODES
1
YES
INQ030
2
NO
INQ020
3
CHILD LIVES ELSEWHERE
REFUSED
INQ020
DON'T KNOW INQ020
CMQ701
INQ020
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 BECAUSE HE/SHE IS AWAY OR DOES NOT
CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, 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.”
CODES
1
AVAILABLE
INQ030
2
NOT AVAILABLE BUT WILL BE BEFORE END OF FIELD PERIOD (CALLBACK APPT.) CMQ702
3
NOT AVAILABLE IN FIELD PERIOD
INQ025
4
NO PARENT OR GUARDIAN IN HH KNOWS ABOUT CHILD INQ025
5
CHILD LIVES ELSEWHERE
CMQ701
REFUSED
INQ025
DON'T KNOW INQ025
INQ025
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 BECAUSE HE/SHE IS AWAY OR DOES NOT
CURRENTLY LIVE WITH THE CHILD IN THIS HOUSEHOLD, 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.”
CODES
1
PERSON ON PHONE
INQ030
2
NOT AVAILABLE BUT WILL BE BEFORE END OF FIELD PERIOD (CALLBACK APPT.) CMQ702
3
NOT AVAILABLE IN FIELD PERIOD
CMQ703
4
NO ADULT IN HH KNOWS ABOUT CHILD CMQ703
5
CHILD LIVES ELSEWHERE
CMQ701
REFUSED
CMQ703
DON'T KNOW CMQ703
INQ030
May I have your name please?
SELECT NAME FROM LIST BELOW.
IF THE NAME IS ON THE LIST OF HOUSEHOLD MEMBERS, ENTER THE NUMBER NEXT TO THE PERSON ON
THE HOUSEHOLD ROSTER WHO WILL BE THE CURRENT ROUND RESPONDENT. SELECT THIS PERSON’S
NAME EVEN IF THE AGE LISTED IS A YEAR OR TWO DIFFERENT FROM THE AGE OF THE RESPONDENT.
VERIFY NAME, RELATIONSHIP, AND AGE WITH RESPONDENT.
IF NAME NOT LISTED, ENTER 0.
ENTER TEXT
Length 2
PROGRAMMER INSTRUCTIONS:
1. DISPLAY NAME, RELATIONSHIP, AND AGE OF HOUSEHOLD MEMBERS FROM THE MOST RECENT
UPDATED HOUSEHOLD ROSTER FROM THE PRELOAD. AT THE TOP OF THE ROSTER, DISPLAY "0 NOT ON
LIST. IF RELATIONSHIP OR AGE IS MISSING, REFUSED, OR DON'T KNOW, DISPLAY "UNKNOWN". IF AGE IS
NOT MISSING, REFUSED, OR DON'T KNOW, NEXT TO AGE DISPLAY THE WORD “APPROXIMATELY”. IF
THERE IS NOT A HOUSEHOLD ROSTER BECAUSE THERE IS ONLY FALL‐FIRST GRADE DATA, SEE
INSTRUCTION 2.
2. DISPLAY HOUSEHOLD MEMBERS 15 YEARS OR OLDER AS RESPONSE CATEGORIES (IN CASE OF
RESPONDENT/INTERVIEWER ERROR EARLY IN THE INTERVIEW, INCLUDE THE RESPONDENT FROM THE
MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW IN THIS DISPLAY EVEN THOUGH
HE/SHE SHOULD HAVE BEEN SELECTED AT INQ.005). IN HOUSEHOLDS THAT ONLY HAVE FALL‐FIRST
GRADE DATA AND NOT FALL‐K, SPRING‐K, OR SPRING‐FIRST GRADE DATA, THE ONLY PERSON DISPLAYED
WILL BE THE FALL‐FIRST GRADE RESPONDENT BECAUSE HOUSEHOLD MATRIX QUESTIONS WERE NOT
ASKED IN FALL‐FIRST GRADE.
3. IF THE RESPONDENT FROM THE MOST RECENTLY COMPLTED OR PARTIALLY COMPLETED INTERVIEW
IS SELECTED AT THIS SCREEN (EVEN THOUGH HE/SHE SHOULD HAVE BEEN SELECTED AT INQ.005), SET
"FLAGS.SAMERESP" =1 AND GO TO INQ.090.
4. IF ZERO IS ENTERED, GO TO INQ.060. ELSE, IF IT IS A CONTINUING HOUSEHOLD BUT A NEW
RESPONDENT WHO WAS ALREADY IN THE HOUSEHOLD MATRIX, GO TO INQ.080.
5.
DISALLOW DK AND RF.
6.
FLAG THE RESPONDENT.
INQ040
(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. The interview should take about 15 minutes.
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, except
as required by law.
This call will be recorded for quality control purposes.
CODES
1
2
CONTINUE WITH RECORDING Box 2
CONTINUE WITHOUT RECORDING
INQ040b
INQ040b
THIS INTERVIEW IS NOT BEING RECORDED.
IF NEEDED: That’s fine. This interview will not be recorded.
PRESS 1 AND ENTER TO CONTINUE.
ENTER TEXT
Length 1
Box 2
IF INQ.040 HAS BEEN ASKED TWICE, GO TO INQ.060. ELSE, GO TO INQ.041.
INQ041
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.”
CODES
1
YES
INQ060
2
NO
INQ042
3
CHILD LIVES ELSEWHERE
REFUSED
INQ042
DON'T KNOW INQ042
CMQ701
INQ042
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.”
CODES
1
AVAILABLE
INQ040
2
NOT AVAILABLE BUT WILL BE BEFORE END OF FIELD PERIOD (CALLBACK APPT.) CMQ702
3
NOT AVAILABLE IN FIELD PERIOD
INQ043
4
NO PARENT OR GUARDIAN IN HH KNOWS ABOUT CHILD
INQ043
5
CHILD LIVES ELSEWHERE
CMQ701
REFUSED
INQ043
DON'T KNOW INQ043
INQ043
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.”
CODES
1
2
3
4
PERSON ON PHONE
INQ060
NOT AVAILABLE BUT WILL BE BEFORE END OF FIELD PERIOD (CALLBACK APPT.) CMQ702
NOT AVAILABLE IN FIELD PERIOD
CMQ703
NO ADULT IN HH KNOWS ABOUT CHILD CMQ703
5
CHILD LIVES ELSEWHERE
REFUSED
CMQ703
DON'T KNOW CMQ703
CMQ701
INQ060
{[}May I have your name, please?{]}
ENTER THE RESPONDENT’S FIRST NAME.
VERIFY SPELLING.
FIRST NAME
ENTER TEXT
Length 50
PROGRAMMER INSTRUCTIONS:
DISPLAY “[“ AND “]” IF INQ.030 WAS ASKED. ELSE, USE A NULL DISPLAY.
REFUSED AND DON'T KNOW DISALLOWED.
INQ070
[May I have your name, please?]
ENTER LAST NAME.
VERIFY SPELLING.
LAST NAME
ENTER TEXT
Length 50
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: REFUSED AND DON'T KNOW DISALLOWED.
Box 3
FOR NON‐RESPONDENTS, GO TO INQ.130 AND ASK INQ130 THROUGH BOX 8. ELSE, GO TO INQ.080.
INQ080
(As I mentioned earlier), you and {CHILD} were 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. The interview should take about 15 minutes.
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, except
as required by law.
This call will be recorded for quality control purposes.
CODES
1
2
CONTINUE WITH RECORDING Box 4
CONTINUE WITHOUT RECORDING
INQ080b
INQ080b
THIS INTERVIEW IS NOT BEING RECORDED.
IF NEEDED: That’s fine. This interview will not be recorded.
PRESS 1 AND ENTER TO CONTINUE.
ENTER TEXT
Length 1
Box 4
FOR NEW FALL‐SECOND GRADE RESPONDENTS, GO TO INQ.130.
INQ090
{In the fall of 2010/In the spring of 2011/In the fall of 2011/In the spring of 2012}, you and {CHILD} took 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 since our last
interview.
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. The interview should take
about 15 minutes.
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, except
as required by law.
This call will be recorded for quality control purposes.
CODES
1
2
CONTINUE WITH RECORDING INQ110
CONTINUE WITHOUT RECORDING
INQ090b
PROGRAMMER INSTRUCTIONS:
ACCORDING TO THE PRELOAD, DISPLAY “In the fall of 2010” IF THE MOST RECENTLY COMPLETED OR
PARTIALLY COMPLETED PARENT INTERVIEW WAS IN THE FALL OF KINDERGARTEN. DISPLAY “In the spring
of 2011” IF THE MOST RECENTLY COMPLETED OR PARTIALLY COMPLETED INTERVIEW WAS IN THE
SPRING OF KINDERGARTEN. DISPLAY “In the fall of 2011” IF THE MOST RECENTLY COMPLETED OR
PARTIALLY COMPLETED PARENT INTERVIEW WAS IN THE FALL OF FIRST GRADE. DISPLAY “In the spring of
2012” IF THE MOST RECENTLY COMPLETED INTERVIEW WAS IN THE SPRING OF FIRST GRADE.
INQ090b
THIS INTERVIEW IS NOT BEING RECORDED.
IF NEEDED: That’s fine. This interview will not be recorded.
PRESS 1 AND ENTER TO CONTINUE.
ENTER TEXT
Length 1
INQ110
I would like to verify the spelling of your name for our records. Is your first name spelled {FIRST NAME
OF PREVIOUS ROUND RESPONDENT}?
CODES
1
2
YES
NO
INQ115
INQ112
PROGRAMMER INSTRUCTIONS:
FROM THE PRELOAD, DISPLAY FIRST NAME OF RESPONDENT FROM THE MOST RECENTLY COMPLTED
OR PARITIALLY COMPLETED INTERVIEW.
INQ112
How do you spell your first name?
VERIFY SPELLING.
ENTER TEXT
Length 50
INQ115
[I would like to verify the spelling of your name for our records.] Is your last name spelled {LAST NAME
OF PREVIOUS ROUND RESPONDENT}?
CODES
1
2
YES
NO
INQ130
INQ116
PROGRAMMER INSTRUCTIONS:
FROM THE PRELOAD, DISPLAY LAST NAME OF RESPONDENT FROM THE MOST RECENTLY COMPLTED OR
PARITIALLY COMPLETED INTERVIEW.
INQ116
How do you spell your last name?
VERIFY SPELLING.
ENTER TEXT
Length 50
INQ130
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'.
{CHILD'S FIRST NAME}
{CHILD'S MIDDLE NAME}
{CHILD'S LAST NAME}
FIRST NAME: [___________________]
MIDDLE NAME: [___________________]
LAST NAME: [___________________]
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS. HOWEVER, DO NOT ALLOW INTERVIEWER TO
CHANGE 'REAL DATA' TO '8' (REFUSED) OR '9' (DON'T KNOW).
FOR CHILD'S FIRST, MIDDLE, AND LAST NAME, DISPLAY CHILD'S FULL NAME FROM PRELOAD.
USE PRELOAD LENGTH FOR CHILD'S NAME.
Box 5
IF (THIS CASE DOES NOT HAVE A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRINGKINDERGARTEN, FALL-FIRST GRADE, OR SPRING-FIRST GRADE INTERVIEW) OR (THE CASE HAS A
COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN, FALL-FIRST
GRADE, OR SPRING-FIRST GRADE INTERVIEW AND THE CHILD’S SEX IS MISSING), GO TO INQ.160. ELSE,
GO TO BOX 6.
INQ160
ASK IF NOT OBVIOUS: {I have {CHILD} recorded as {male/female}. Is that correct?}{/{Is {CHILD} male or
female?}
{MAKE CORRECTIONS TO SEX BELOW OR PRESS ENTER TO ACCEPT CURRENT SEX.}
{Current Info: [MALE/FEMALE]}
CODES
1
MALE
2
FEMALE
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
DISPLAY CORRECTED INFORMATION ABOUT CHILD'S SEX FROM PRELOAD. IF SEX IS NONMISSING IN THE
PRELOAD, DISPLAY “I have…{male/female}. Is that correct?” AND “MAKE CORRECTIONS TO SEX BELOW
OR PRESS ENTER TO ACCEPT CURRENT SEX. 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 SEX IS MISSING IN THE PRELOAD, DISPLAY “Is {CHILD}…female?” AND USE A NULL DISPLAY FOR
“MALE/FEMALE” AND DO NOT DISPLAY “CURRENT INFO”.
REFUSED AND DON'T KNOW ALLOWED.
Box 6
IF (THIS CASE DOES NOT HAVE A COMPLETE OR PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRINGKINDERGARTEN, FALL-FIRST, OR SPRING-FIRST GRADE INTERVIEW) OR (THE CASE HAS A COMPLETE OR
PARTIALLY COMPLETE FALL-KINDERGARTEN, SPRING-KINDERGARTEN, FALL-FIRST, OR SPRING-FIRST
GRADE INTERVIEW AND THE CHILD’S DATE OF BIRTH IS MISSING), GO TO INQ.170. ELSE, GO TO BOX 8.
INQ170
{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.}
{CURRENT INFO: |___|___| / |___|___| / |___|___||___|___|}
|___|___| / |___|___| / |___|___||___|___|
ENTER DATE OF BIRTH (MONTH/DAY/YEAR)
ENTER TEXT
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
DISPLAY INFORMATION ABOUT CHILD'S DATE OF BIRTH FROM PRELOAD. DISPLAY THE NAME OF THE
MONTH, NOT THE NUMBER OF THE MONTH, FOLLOWED BY THE DAY WITH THE APPROPRIATE LETTERS
AT THE END TO GO WITH THE DATE, AND THEN THE YEAR (E.G., August 12th, 2005).
IF DATE OF BIRTH IS NOT AVAILABLE IN THE PRELOAD, ENTRY FOR DATE OF BIRTH IS REQUIRED.
REFUSED AND DON'T KNOW ALLOWED IF THERE ARE NO PRELOADED DATA. IF THERE ARE PRELOADED
DATA DO NOT ALLOW THEM TO BE OVERWRITTEN BY REFUSED/DON’T KNOW.
IF A DATE OF BIRTH IS AVAILABLE FOR THE FOCAL CHILD FROM THE PRELOAD, DISPLAY "I have recorded
that {CHILD} was born on {DATE OF BIRTH}. Is that correct?" AND "MAKE CORRECTIONS … BIRTH.”‘
ALSO, IF DATE OF BIRTH IS AVAILABLE IN THE PRELOAD, DISPLAY IT NEXT TO “CURRENT INFO” BELOW.
OTHERWISE, IF DATE OF BIRTH IS NOT AVAILABLE IN THE PRELOAD, DISPLAY "What is {child}'s date of
birth?" AND USE A NULL DISPLAY FOR DATE OF BIRTH AND DO NOT DISPLAY “CURRENT INFO”.
RANGE CHECK: 1‐12 FOR MONTH, 1‐31 FOR DAY, 2003‐2007 FOR YEAR. IF MONTH IS OUT OF RANGE,
DISPLAY ERROR MESSAGE ”THE BIRTHDAY MONTH SHOULD BE BETWEEN 1 AND 12.” IF DAY IS OUT OF
RANGE, DISPLAY ERROR MESSAGE “THE BIRTHDAY DAY SHOULD BE BETWEEN 1 AND 31.” IF YEAR IS
OUT OF RANGE, DISPLAY ERROR MESSAGE “THE BIRTHDAY YEAR SHOULD BE IN THE RANGE OF 2003 –
2007.
CONFIRM THE YEAR THE CHILD WAS BORN AND, IF STILL NOT IN RANGE, ENTER “DON’T KNOW” AND A
COMMENT.”
Box 7
IF ANY FIELD IN DATE OF BIRTH INQ.170 = REFUSED OR DK, GO TO INQ.176.
ELSE, CONTINUE WITH INQ.175.
INQ175
So {CHILD} is {AGE CALCULATED FROM DATE OF BIRTH AT INQ.170} years old. Is that correct?
IF AGE IS INCORRECT, GO BACK TO INQ170 AND CORRECT DATE OF BIRTH.
IF AGE IS STILL INCORRECT, ANSWER “NO” TO THIS QUESTION (INQ175).
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
Box 8
SEE BELOW
INQ176
INQ176
PROGRAMMER INSTRUCTIONS:
USE ERROR MESSAGE THAT SAYS: IF AGE INCORRECT, CORRECT DATE OF BIRTH.
1. PRESS G or ENTER TO REENTER DATE OF BIRTH.
2. PRESS C OR ESCAPE TO CANCEL.
“S” FOR SUPPRESS SHOULD ALSO BE AN OPTION ON THIS SCREEN, IN ADDITION TO G FOR “GO TO” AND
“C” FOR CLOSE.
INQ176
How old is {CHILD}?
ENTER NUMBER
Range 5 to 9
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
RANGE CHECK 5‐9.
IF DK OR RF, DISPLAY "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 '7' IF YOU CAN'T GUESS AT THE CHILD'S AGE."
Box 8
IF PREVIOUS ADDRESS IS IN THE PRELOAD, GO TO INQ.180. ELSE, IF PREVIOUS ADDRESS IS NOT IN THE
PRELOAD, GO TO INQ.190.
INQ180
I have recorded that {CHILD}'s home address is:
STREET ADDRESS1
: [___________________]
STREET ADDRESS2
: [___________________]
CITY : [___________________]
STATE : [___________________]
ZIP CODE
: [___________________]
Is this still correct?
CODES
1
YES, CORRECT ADDRESS
INQ200
2
YES, SAME ADDRESS – MINOR CORRECTIONS
3
NO, NEW ADDRESS
INQ190
REFUSED
DON'T KNOW
INQ190
PROGRAMMER INSTRUCTIONS:
IN THE RESPONSE FIELD, DISPLAY CURRENT ADDRESS INFO FROM THE PRELOAD.
IF REFUSED OR DON'T KNOW, GO TO BOX 9.
INQ190
{What is {CHILD}’s home address?}
{MAKE CORRECTIONS TO ADDRESS BELOW.}
{TO ACTIVATE LOOKUP, BEGIN TO TYPE STATE NAME. USE THE ARROW KEYS TO HELP YOU LOCATE A
MATCH.}
[STREET ADDRESS1]
[STREET ADDRESS2]
[CITY]
[STATE]
[ZIP CODE]
STREET ADDRESS1
: [___________________]
STREET ADDRESS2
: [___________________]
CITY : [___________________]
STATE : [___________________]
ZIP CODE
: [___________________]
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: IF THE HOME ADDRESS WAS NOT IN THE PRELOAD, DISPLAY “What is…address?”
ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF INQ.180 = 2 OR 3, DISPLAY “MAKE CORRECTIONS…BELOW.” ELSE, USE A NULL
DISPLAY.
REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
DISPLAY ”TO ACTIVATE LOOKUP, BEGIN TO TYPE STATE NAME. USE THE ARROW KEYS TO HELP YOU
LOCATE A MATCH.” WHEN ON STATE ENTRY FIELD.
DISPLAY CURRENT ADDRESS INFO IN THE RESPONSE FIELD IF PREVIOUS ADDRESS INFORMATION WAS IN
PRELOAD.
FOR THIS ITEM ONLY, DO NOT DISPLAY PUERTO RICO IN THE STATE LOOKUP FILE.
Box 9
IF TELEPHONE NUMBER IS IN THE PRELOAD, GO TO INQ.200. ELSE, IF TELEPHONE NUMBER IS NOT IN
THE PRELOAD, GO TO INQ.205.
INQ200
I have recorded that {PHONE NUMBER} is {CHILD}'s family's current home phone number. Is this
correct?
CODES
1
YES, CORRECT TELEPHONE NUMBER Box 10
2
YES, SAME TELEPHONE NUMBER – MINOR CORRECTIONS
3
NO, NEW TELEPHONE NUMBER INQ205
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
DISPLAY CURRENT PHONE NUMBER FROM PRELOAD.
REFUSED AND DON'T KNOW GO TO BOX 10.
INQ205
{What is {CHILD}'s family's current home phone number?}
{MAKE CORRECTIONS TO TELEPHONE NUMBER BELOW.}
IF NO TELEPHONE, ENTER '000'.
[CURRENT TELEPHONE NUMBER]
ENTER TEXT
Length 10
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
INQ205
CAPI INSTRUCTION: IF TELEPHONE NUMER WAS MISSING IN PRELOAD, DISPLAY “What is…number?”.
ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: IF INQ.200 = 2 OR 3, DISPLAY “MAKE…BELOW.” ELSE, USE A NULL DISPLAY.
CAPI INSTRUCTION: REFUSED AND DON'T KNOW ALLOWED AT ALL FIELDS.
IF AVAILABLE, DISPLAY CURRENT TELEPHONE NUMBER ON THE SCREEN AND IN THE RESPONSE FIELD.
Box 10
IF THE PRELOAD SHOWS THAT THE CASE WAS PART OF THE FALL-FIRST GRADE SUBSAMPLE AND
CONSENT FOR THE HEARING SCREENING WAS ALREADY OBTAINED, GO TO BOX 11. ELSE, IF THE CASE
WAS PART OF THE FALL-FIRST GRADE SUBSAMPLE, GO TO INQ210. ELSE, GO TO BOX 11.
INQ210 USE CONSENT SCRIPT BEFORE READING THE TEXT BELOW.
As part of the study, we are testing children's hearing. We would like to get your permission to do this
with {CHILD}. For our records, please state your name, your relationship to {CHILD}, {CHILD}’s name, and
that you give us permission to test {CHILD}'s hearing.
DID PARENT GIVE PERMISSION?
CODES
1
YES
2
NO
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: REFUSED AND DON’T KNOW ARE NOT ALLOWED.
Box 11
GO TO SECTION TUQ (TIME USE).
TIME USE (FALL SECOND GRADE) - TUQ
TUQ040
HELP AVAILABLE
Some children go away during the summer for short periods of time to stay with relatives, to go to
camp, or to go to other places. Please tell me, during the time that {CHILD} was out of regular school,
how many weeks was {he/she} not staying with you, either at home or at another place?
ENTER NUMBER OF WEEKS.
HELP TEXT:
If child was away from parent on a regular basis a few days a week (e.g., every weekend), do not count
this.
|___|___|
ENTER WEEKS
ENTER NUMBER
Range 0 to 16
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
HARD RANGE CHECK 0 – 16 WEEKS.
Box 1
IF CHILD WAS AWAY FROM HOME AT LEAST A WEEK (TUQ.040 GE 1), GO TO TUQ.060. OTHERWISE, GO
TO BOX 2.
TUQ060
Where was {CHILD} when {he/she} was not with you?
CODE ALL THAT APPLY.
CODES Code All That Apply
1
WITH A PARENT
2
WITH ANOTHER RELATIVE
3
AT CAMP
91
SOME OTHER PLACE (SPECIFY)
REFUSED
DON'T KNOW
Box 2
IF TUQ.060 IS CODED 91, CONTINUE WITH TUQ.060OS. OTHERWISE, GO TO BOX 3.
TUQ060OS
[Where was {CHILD} when {he/she} was not with you?]
SPECIFY OTHER PLACE.
_______________________________________
OTHER PLACE
ENTER TEXT
Length 100
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DK AND RF DISALLOWED.
Box 3
GO TO SECTION HEQ (HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE STIMULATION).
HOME ENVIRONMENT, ACTIVITIES, AND COGNITIVE STIMULATION (FALL SECOND GRADE) - HEQ
HEQ010a
HELP AVAILABLE
Now I'd like to talk with you about {CHILD}'s activities with family members during a typical week of the
summer. {Since {CHILD} was not with you for a lot of the summer, please just answer questions about
activities that you happen to know about, or tell us if you can’t answer because {he/she} was away from
you for the whole summer.} How often did you or any other family member …
a. Do math activities with {CHILD}, such as learning numbers, adding, subtracting, or measuring. Would
you say never, once or twice, 3‐6 times, or every day?
IF CHILD WAS AWAY FROM THE RESPONDENT THE WHOLE SUMMER, ENTER "5."
HELP TEXT:
If respondent asks what family means, say that we mean any person who lives in the child's household
and any relative of the child living outside the child's household.
CODES
1
NEVER
2
ONCE OR TWICE
3
3 TO 6 TIMES
4
EVERY DAY
5
AWAY THE WHOLE SUMMER
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
DISPLAY "Since {CHILD} … summer." IF TUQ.040 >= 4. OTHERWISE, USE A NULL DISPLAY.
DISPLAY "typical" IN UNDERLINED TEXT.
IF “5” IS ENTERED FOR A, B, OR C, SKIP TO HEQ.090.
HEQ010b
HELP AVAILABLE
[Now I'd like to talk with you about {CHILD}'s activities with family members during a typical week of the
summer. {Since {CHILD} was not with you for a lot of the summer, please just answer questions about
activities that you happen to know about, or tell us if you can’t answer because {he/she} was away from
you for the whole summer.} How often did you or any other family member …]
b. Do writing activities with {him/her}?
IF CHILD WAS AWAY FROM THE RESPONDENT THE WHOLE SUMMER, ENTER "5."
[PROBE: Would you say never, once or twice, 3‐6 times, or every day?]
HELP TEXT:
If respondent asks what family means, say that we mean any person who lives in the child's household
and any relative of the child living outside the child's household.
CODES
1
NEVER
2
ONCE OR TWICE
3
3 TO 6 TIMES
4
EVERY DAY
5
AWAY THE WHOLE SUMMER
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "Since {CHILD} … summer." IF TUQ.040 >= 4. OTHERWISE, USE A NULL
DISPLAY.
CAPI INSTRUCTION: DISPLAY “Now…member…” IN SQUARE BRACKETS IF AT B OR C.
CAPI INSTRUCTION: DISPLAY "typical" IN UNDERLINED TEXT
CAPI INSTRUCTION: IF “5” IS ENTERED FOR A, B, OR C, SKIP TO HEQ.090.
HEQ010c
HELP AVAILABLE
[Now I'd like to talk with you about {CHILD}'s activities with family members during a typical week of the
summer. {Since {CHILD} was not with you for a lot of the summer, please just answer questions about
activities that you happen to know about, or tell us if you can’t answer because {he/she} was away from
you for the whole summer.} How often did you or any other family member …]
c. Read books to {him/her}?
IF CHILD WAS AWAY FROM THE RESPONDENT THE WHOLE SUMMER, ENTER "5."
[PROBE: Would you say never, once or twice, 3‐6 times, or every day?]
HELP TEXT:
If respondent asks what family means, say that we mean any person who lives in the child's household
and any relative of the child living outside the child's household.
CODES
1
NEVER
2
ONCE OR TWICE
3
3 TO 6 TIMES
4
EVERY DAY
5
AWAY THE WHOLE SUMMER
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "Since {CHILD} … summer." IF TUQ.040 >= 4. OTHERWISE, USE A NULL
DISPLAY.
CAPI INSTRUCTION: DISPLAY “Now…member…” IN SQUARE BRACKETS IF AT B OR C.
CAPI INSTRUCTION: DISPLAY "typical" IN UNDERLINED TEXT.
CAPI INSTRUCTION: IF “5” IS ENTERED FOR A, B, OR C, SKIP TO HEQ.090.
BOX 1
IF HEQ.010c = 1, REF, or DK, GO TO HEQ.030. OTHERWISE, ASK HEQ.020.
HEQ020
Thinking about a typical week during the summer, when you or another family member read to {CHILD},
how long was {he/she} generally read to each time? Would you say …
CODES
1
2
3
4
REFUSED
DON'T KNOW
15 minutes or less,
16 to 29 minutes,
30 to 45 minutes, or
46 minutes or more?
HEQ030a
During a typical week during the summer, how often did {CHILD}...
a. Look at or read books on {his/her} own? Would you say never, once or twice, 3‐6 times, or every day?
CODES
1
NEVER
2
ONCE OR TWICE
3
3 TO 6 TIMES
4
EVERY DAY
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "on {his/her} own" IN UNDERLINED TEXT.
HEQ030b
HELP AVAILABLE
[During a typical week during the summer, how often did {CHILD}…]
b. Use a computer or other electronic device for educational purposes?
[PROBE: Would you say never, once or twice, 3‐6 times, or every day?]
HELP TEXT:
Electronic device: By electronic device, we mean any type of computer, cell phone, smart phone, iPod,
reading device (such as Kindle or Nook), or game system (including those such as Wii, XBox, DS, iTouch,
and Playstation).
CODES
1
NEVER
2
ONCE OR TWICE
3
3 TO 6 TIMES
4
EVERY DAY
REFUSED
DON'T KNOW
HEQ030c
[During a typical week during the summer, how often did {CHILD}…]
c. Play outside actively (for example, running, jumping, or swinging)?
[PROBE: Would you say never, once or twice, 3‐6 times, or every day?]
CODES
1
NEVER
2
ONCE OR TWICE
3
3 TO 6 TIMES
4
EVERY DAY
REFUSED
DON'T KNOW
HEQ038a
HELP AVAILABLE
Now I’d like to ask some questions about {CHILD}’s television or video watching during the summer. We
want you to include television shows, videos, or DVDs watched on a TV, computer, or handheld device
like an iPad or cellphone; but not games played on gaming systems like Playstation, Wii, or Xbox or
handheld devices.
On a typical summer day, how many hours of television, videotapes, or DVDs on average did {CHILD}
watch?
HELP TEXT:
Blu‐Ray is also included, as are downloaded or streaming videos or movies.
ENTER NUMBER OF HOURS. IF LESS THAN AN HOUR, ENTER '0.' MINUTES CAN BE ENTERED ON THE
NEXT SCREEN.
l__l__l
HOURS
ENTER NUMBER
Range 0 to 24
REFUSED
HEQ39a
DON'T KNOW HEQ39a
PROGRAMMER INSTRUCTIONS:
THE HOURS (HEQ038a) AND MINUTES (HEQ038b) TOGETHER SHOULD NOT EXCEED 24 HOURS.
OTHERWISE, DISPLAY ERROR MESSAGE: "The total number of time exceeds 24 hours! Please correct the
entries."
EMPTY NOT ALLOWED FOR HOURS
HEQ038b
HELP AVAILABLE
[Now I’d like to ask some questions about {CHILD}’s television or video watching during the summer. We
want you to include television shows, videos, or DVDs watched on a TV, computer, or handheld device
like an iPad or cellphone; but not games played on gaming systems like Playstation, Wii, or Xbox or
handheld devices. ]
[On a typical summer day, how many hours of television, videotapes, or DVDs on average did {CHILD}
watch?]
HELP TEXT:
Blu‐Ray is also included, as are downloaded or streaming videos or movies.
ENTER NUMBER
Range 0 to 59
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
EMPTY IS ALLOWED FOR MINUTES
THE HOURS (HEQ038a) AND MINUTES (HEQ038b) TOGETHER SHOULD NOT EXCEED 24 HOURS.
OTHERWISE, DISPLAY ERROR MESSAGE: "The total number of time exceeds 24 hours! Please correct the
entries."
HEQ039a
Now I’d like to ask some questions about the amount of time {CHILD} played video games over the
summer. We want you to include games played on systems like Playstation, Wii, or Xbox, or on handheld
devices such as a Nintendo DS, Sony PSP or an iPod, iPad, or cellphone, or games played on the
computer.
On a typical summer day, how much time did {CHILD} spend playing video games? Please do not include
time {CHILD} spent on the computer doing educational activities.
ENTER NUMBER OF HOURS. IF LESS THAN AN HOUR, ENTER '0.' MINUTES CAN BE ENTERED ON THE
NEXT SCREEN
l__l__l
HOURS
ENTER NUMBER
Range 0 to 24
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
THE HOURS (HEQ039a) AND MINUTES (HEQ039b) TOGETHER SHOULD NOT EXCEED 24 HOURS.
OTHERWISE, DISPLAY ERROR MESSAGE: "The total number of time exceeds 24 hours! Please correct the
entries."
EMPTY NOT ALLOWED FOR HOURS
HEQ039b
[Now I’d like to ask some questions about the amount of time {CHILD} played video games over the
summer. We want you to include games played on systems like Playstation, Wii, or Xbox, or on handheld
devices such as a Nintendo DS, Sony PSP or an iPod, iPad, cellphone, or games played on the computer. ]
[On a typical summer day, how much time did {CHILD} spend playing video games? Please do not include
time {CHILD} spent on the computer doing educational activities.]
l__l__l
MINUTES
ENTER NUMBER OF MINUTES.
ENTER NUMBER
Range 0 to 59
REFUSED
DON'T KNOW
THE HOURS (HEQ039a) AND MINUTES (HEQ039b) TOGETHER SHOULD NOT EXCEED 24 HOURS.
OTHERWISE, DISPLAY ERROR MESSAGE: "The total number of time exceeds 24 hours! Please correct the
entries."
EMPTY IS ALLOWED FOR MINUTES
HEQ050
HELP AVAILABLE
About how many times during the summer did {CHILD} go to the library or a bookstore?
ENTER NUMBER OF TIMES.
l__l__l
ENTER NUMBER
HELP TEXT:
Do not count visiting a library or bookstore online. We are asking about in‐person visits to a library or
bookstore.
Range 0 to 97
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
DISPLAY "the summer" IN UNDERLINED TEXT.
BOX 2
IF HEQ.050 = 0, REF, or DK, GO TO HEQ.090. OTHERWISE, GO TO HEQ.060.
HEQ060
Did {he/she} participate in any story hours at the library or bookstore?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ090
Did {CHILD}'s school give you a book list with particular books to read over the summer?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ095
Box 3
Box 3
Box 3
HEQ095
How many books on that list did {CHILD} read during the summer?
PROBE: IF PARENT SAYS “ALL OF THEM”: Can you tell me the number of books?
ENTER NUMBER OF BOOKS.
|___|___|___|
ENTER NUMBER
Range 0 to 100
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTIONS: RANGE CHECK 0‐100
BOX 3
IF ANY HEQ.010a‐c = 5, GO TO HEQ.220. ELSE, GO TO HEQ.150.
HEQ150a
During the summer, did you or another family member take {CHILD} to any of the following places?
a. An art gallery, museum, or historical site?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ150b
[During the summer, did you or another family member take {CHILD} to any of the following places?]
b.
Zoos or aquariums?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ150c
[During the summer, did you or another family member take {CHILD} to any of the following places?]
c.
Amusement parks?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ150d
[During the summer, did you or another family member take {CHILD} to any of the following places?]
d.
Beaches, lakes, rivers, or state or national parks?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ150e
[During the summer, did you or another family member take {CHILD} to any of the following places?]
e.
Plays or concerts?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ150f
[During the summer, did you or another family member take {CHILD} to any of the following places?]
f.
A large city (other than where {CHILD} lives)?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ220
HELP AVAILABLE
Summer school includes programs that schools suggest or require a child to attend, and also school
enrichment programs that are optional. Did {CHILD} attend summer school this summer? Please don't
include summer camp.
HELP TEXT:
Summer programs called “interventions” should be included in summer school.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
BOX 4
IF HEQ.220 = 1, GO TO HEQ.230A. ELSE, GO TO HEQ.290.
HEQ230A
How long did {CHILD} attend summer school this summer?
ENTER NUMBER OF DAYS, WEEKS, OR MONTHS.
|___|___|
ENTER NUMBER
Range 1 to 123
REFUSED
HEQ250
DON'T KNOW HEQ250
HEQ230B
[How long did {CHILD} attend summer school this summer? ]
ENTER UNIT
CODES
1
DAYS
2
WEEKS
3
MONTHS
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
RANGE CHECK: IF HEQ.230B = 1, THEN THE RANGE FOR HEQ.230A = 1‐123. ELSE IF HEQ.230B = 2, THEN
THE RANGE FOR HEQ.230A = 1‐16. ELSE IF HEQ.230B = 3, THEN HEQ.230A = 1‐4.
HEQ250
How many days a week did {CHILD} attend summer school or the school enrichment program?
|___|___|
ENTER DAYS
ENTER NUMBER
Range 1 to 7
Soft Range
1 to 5
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "days a week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE 1‐5; HARD RANGE 1‐7.
HEQ260
How many hours a day did {CHILD} attend this program?
|___|___|
ENTER HOURS
ENTER NUMBER
Range 1 to 8
Soft Range
1 to 6
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "hours a day" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE 1‐6; HARD RANGE 1‐8.
HEQ270a
Did this program include…
a.
Reading?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ270b
[Did this program include…]
b.
Math?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ270c
[Did this program include…]
c.
Science?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ270d
[Did this program include…]
d. Art?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ270e
[Did this program include…]
e. Music?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ270f
HELP AVAILABLE
[Did this program include…]
f. Computers?
HELP TEXT:
If computers were used during other activities at summer school, for example while learning math, or if
computers were used to learn computer skills, count that as a “yes” answer.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
BOX 5
IF [SPQ.155=1 FROM SPRING K (OTHER LANGUAGE REGULARLY SPOKEN AT HOME BESIDES ENGLISH)
AND SPQ.157 NE 0 (ENGLISH NOT SPOKEN AS PRIMARY LANGUAGE)], GO TO HEQ.270g.
ELSE, IF [PLQ.020=1 FROM FALL K (OTHER LANGUAGE REGULARLY SPOKEN AT HOME BESIDES ENGLISH)
AND ((PLQ.060 WAS ASKED IN FALL K AND PLQ.060 NE 0 FROM FALL K (ENGLISH NOT SPOKEN AS
PRIMARY LANGUAGE) OR (PLQ.060 WAS NOT ASKED IN FALL K AND PLQ.041 NE 0 FOR RESPONDENT
FROM FALL K (ENGLISH NOT SPOKEN AS PRIMARY LANGUAGE‐NOTE: THIS STATEMENT INCLUDES CASES
FOR WHICH PLQ.041 WAS ALSO NOT ASKED))], GO TO HEQ.270g.
ELSE, GO TO HEQ.280.
HEQ270g
[Did this program include…]
g. English language instruction?
PROBE: This is English language instruction for children with a home language other than English.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ280
Was the summer school a program …
CODES
1
Required by the school,
2
Suggested by the school, or
3
A program you decided to send {him/her} to?
REFUSED
DON'T KNOW
HEQ290
During this past summer, did {CHILD} receive any type of services for children with special needs, such as
speech or occupational therapy, or did {he/she} participate in a summer special education program?
CODES
1
YES
2
NO
HEQ300
REFUSED
HEQ300
DON'T KNOW HEQ300
HEQ298a
HELP AVAILABLE
Did {CHILD} receive…
a.
Speech or language therapy?
HELP TEXT:
Speech or language therapy: Therapy involving the evaluation or treatment of the student’s speech or
language abilities. Impairments to speech can include one or more of the following: articulation errors
(includes omitting words, substituting words, or distorting sounds), inappropriate voice (including pitch,
loudness, or voice quality), or abnormal fluency (including abnormal rate of speaking, speech
interruptions, repetitions of sounds, words, phrases or sentences). Impairments to language can include
improper use of phonemes, syntax, or semantics. Language impairments can also stem from improper
practical use of language. Therapy includes special techniques to overcome speech or language
limitations. Therapy should be provided only by a teacher of the speech or language impaired who is
certified by the state, or by a certified Speech and Language Therapist/Pathologist.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ298b
HELP AVAILABLE
[Did {CHILD} receive… ]
b.
Occupational therapy?
HELP TEXT:
Occupational therapy: Therapy involving the evaluation or treatment of the student’s level of
independence in daily living activities. The goal of occupational therapy is to promote maximum
independence in daily living. Therapy can include the use of work, play, or self‐care activities to improve
functional ability, promote health, prevent injury or further disability. Therapy should be provided only
by a therapist who has been certified by the American Occupational Therapy Association or by an
occupational therapy assistant who provides therapy under the supervision of a certified occupational
therapist.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ298c
HELP AVAILABLE
[Did {CHILD} receive…]
c.
Physical therapy?
HELP TEXT:
Physical therapy: Therapy involving the evaluation or treatment of health problems resulting from injury
or disease. It is also sometimes called physiotherapy. Physical therapists assess joint motion, muscle
strength and endurance, how well the heart and lungs work, and how well children can do activities
required for daily living. Treatment includes therapeutic exercise, cardiovascular endurance training, and
training in activities of daily living, as well as the use of massage, light, cold, heat, electricity, and
mechanical devices to treat physical disorders. Physical therapy does not include the use of X‐Ray
technology. Therapy should be provided only by a therapist who has been state‐certified to provide such
services.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
HEQ298d
HELP AVAILABLE
[Did {CHILD} receive…]
d.
Psychological services?
HELP TEXT:
Psychological services: Services that involve the assessment of academic skills and learning aptitudes,
personality and emotional development, social skills and school climates, and eligibility for special
education. Treatment involves one‐on‐one interaction with students or parents to resolve personal
conflicts and problems in learning and adjustment, psychological counseling for students and parents,
social skills training, and assistance through separation and loss. Within school systems, psychological
services are typically provided by certified school psychologists. However, assessment and treatment
can be extended to the health community and include services provided by clinical psychologists,
psychiatric social workers, or psychiatrists (who are medical doctors).
CODES
1
2
YES
NO
REFUSED
DON'T KNOW
HEQ298e
[Did {CHILD} receive…]
e. Any other kind of therapy?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CONSISTENCY CHECK: IF ALL OF HEQ298 (A‐E)= 2 AND HEQ290= 1, HARD ERROR CHECK SHOULD READ:
QUESTIONS ABOUT SERVICES (HEQ298A‐E) WERE ALL ANSWERED “NO,” BUT THE CHILD RECEIVED
SERVICES FOR SPECIAL NEEDS OR PARTICIPATED IN A SUMMER SPECIAL EDUCATION PROGRAM (HEQ290).
VERIFY ANSWERS. IF THE CHILD DID NOT RECEIVE SERVICES OR A SPECIAL EDUCATION PROGRAM OVER
THE SUMMER, PRESS “G” TO CHANGE THE ANSWER TO HEQ290. OTHERWISE, PRESS “C” TO CANCEL AND
USE ARROW KEY TO CHANGE ANY ANSWERS TO HEQ298A‐D. IF THE SERVICES THE CHILD RECEIVED DO NOT
FIT CATEGORIES IN HEQ298A‐D, ANSWER HEQ298E AS “YES” AND SPECIFY ANSWER.
PRESS G TO GO BACK TO HEQ290.
PRESS C TO CANCEL.
BOX 6
IF HEQ.298e IS CODED '1' (YES), CONTINUE WITH HEQ.298OS. OTHERWISE, GO TO HEQ.300.
HEQ298OS
[Did {CHILD} receive any other kind of therapy?]
SPECIFY SERVICE.
_______________________________________
SERVICE
ENTER TEXT
Length 150
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DK AND RF DISALLOWED.
HEQ300
Did {CHILD} attend any day or overnight camps over the summer?
CODES
1
YES
2
NO
HEQ430
REFUSED
HEQ430
DON'T KNOW HEQ430
PROGRAMMER INSTRUCTIONS:
CONSISTENCY CHECK: IF TUQ060 = 3 AND HEQ300= 2, HARD ERROR CHECK SHOULD READ:
THE CHILD DID NOT GO TO ANY CAMPS, BUT THE CHILD WAS AWAY PART OF THE SUMMER AT CAMP
(TUQ060). VERIFY ANSWERS. IF THE CHILD WAS NOT AWAY AT CAMP THIS SUMMER, PRESS “G” TO GO
BACK TO TUQ060 AND CHANGE THE ANSWER (THEN HIT END TO GET BACK TO HEQ300). IF THE CHILD WAS
IN CAMP, PRESS “C” TO CANCEL AND CHANGE THE ANSWER TO HEQ300 TO “1 ” (YES).
PRESS G TO GO BACK TO TUQ060.
PRESS C TO CANCEL.
HEQ305
How many camps did {CHILD} go to?
PROBE: Different sessions of camp should be counted as different "camps," even if they are held at the
same location.
ENTER NUMBER OF CAMPS.
|___|___|
ENTER NUMBER
Range 1 to 16
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: HARD RANGE 1‐16.
HEQ330
{Please answer for the camp where {CHILD} spent the most time during the summer.} How many days a
week did {CHILD} attend the camp?
ENTER NUMBER OF DAYS.
|___|
ENTER NUMBER
SOFT RANGE 1‐5. HARD RANGE 1‐7.
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY FIRST SENTENCE IF CHILD ATTENDED MORE THAN ONE CAMP (HEQ.305 >=
2, DK, OR RF). OTHERWISE, DO NOT USE THIS DISPLAY.
CAPI INSTRUCTION: DISPLAY "days a week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: HARD RANGE 1‐7.
HEQ340
How many hours a day did {CHILD} attend the camp?
ENTER NUMBER OF HOURS.
ENTER 24 HOURS IF CHILD WAS IN OVERNIGHT CAMP.
|___|___|
ENTER NUMBER
Range 1 to 24
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "hours a day" IN UNDERLINED TEXT.
CAPI INSTRUCTION: HARD RANGE CHECK 1‐24.
HEQ350
About how many weeks did {CHILD} attend the camp?
ENTER NUMBER OF WEEKS.
|___|___|
ENTER NUMBER
Range 1 to 16
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "weeks" IN UNDERLINED TEXT.
CAPI INSTRUCTION: HARD RANGE CHECK 1 – 16 WEEKS.
HEQ360a
{Now, I’d like to ask you about all the camps that {CHILD} went to during the summer.} {Now, I’d like to
ask you about both camps that {CHILD} went to during the summer.} Did the camp{s} include…
a.
CODES
Sports?
1
YES
2
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTIONS: IF HEQ.305 GE 3, DISPLAY “Now, I’d like to ask you about all the camps that
{CHILD} went to during the summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, IF
HEQ.305 = 2, DISPLAY “Now, I’d like to ask you about both camps that {CHILD} went to during the
summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, USE A NULL DISPLAY FOR ALL
DISPLAYS.
HEQ360b
[{Now, I’d like to ask you about all the camps that {CHILD} went to during the summer.} {Now, I’d like to
ask you about both camps that {CHILD} went to during the summer.} Did the camp{s} include…]
b.
Arts and crafts?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTIONS: IF HEQ.305 GE 3, DISPLAY “Now, I’d like to ask you about all the camps that
{CHILD} went to during the summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, IF
HEQ.305 = 2,
DISPLAY “Now, I’d like to ask you about both camps that {CHILD} went to during the summer.” AND
DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, USE A NULL DISPLAY FOR ALL DISPLAYS.
HEQ360c
HELP AVAILABLE
[{Now, I’d like to ask you about all the camps that {CHILD} went to during the summer.} {Now, I’d like to
ask you about both camps that {CHILD} went to during the summer.} Did the camp{s} include…]
c.
Computers?
HELP TEXT:
If computers were used during other activities at camp or if computers were used to learn computer
skills, count that as a “yes” answer.
CODES
1
2
YES
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTIONS: IF HEQ.305 GE 3, DISPLAY “Now, I’d like to ask you about all the camps that
{CHILD} went to during the summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, IF
HEQ.305 = 2, DISPLAY “Now, I’d like to ask you about both camps that {CHILD} went to during the
summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, USE A NULL DISPLAY FOR ALL
DISPLAYS.
HEQ360d
[{Now, I’d like to ask you about all the camps that {CHILD} went to during the summer.} {Now, I’d like to
ask you about both camps that {CHILD} went to during the summer.} Did the camp{s} include…]
d. Academic activities?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTIONS: IF HEQ.305 GE 3, DISPLAY “Now, I’d like to ask you about all the camps that
{CHILD} went to during the summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, IF
HEQ.305 = 2, DISPLAY “Now, I’d like to ask you about both camps that {CHILD} went to during the
summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, USE A NULL DISPLAY FOR ALL
DISPLAYS.
HEQ360e
[{Now, I’d like to ask you about all the camps that {CHILD} went to during the summer.} {Now, I’d like to
ask you about both camps that {CHILD} went to during the summer.} Did the camp{s} include…]
e.
Music, performing arts or drama?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTIONS: IF HEQ.305 GE 3, DISPLAY “Now, I’d like to ask you about all the camps that
{CHILD} went to during the summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, IF
HEQ.305 = 2, DISPLAY “Now, I’d like to ask you about both camps that {CHILD} went to during the
summer.” AND DISPLAY THE “s” AFTER THE WORD “camps”. ELSE, USE A NULL DISPLAY FOR ALL
DISPLAYS.
HEQ393
Did {CHILD}’s participation in {this camp/any of these camps/either of these camps} help to cover the
hours when you needed adult supervision for {him/her}?
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
IF HEQ.305 GE 3, DISPLAY “any of these camps “. ELSE, IF HEQ.305 = 2, DISPLAY “either of these camps”.
ELSE, DISPLAY “this camp”.
HEQ430
HELP AVAILABLE
Was {CHILD} tutored over the summer on a regular basis, by someone other than you or a family
member, in a specific subject, such as reading, math, science, or a foreign language?
HELP TEXT:
Tutored: This means being taught individually or in a small group setting. DO NOT include therapy as
tutoring.
Regular Basis: A program occurring on a routine schedule (i.e., occurring at least weekly or on some
other schedule).
Not a family member: A person who is not related to the focal child and is not living in the same
household with the focal child.
CODES
1
YES
2
NO
REFUSED
DON'T KNOW
BOX 7
IF HEQ.430 = 1, CONTINUE WITH HEQ.440. OTHERWISE, GO TO BOX 9.
HEQ440
What was {CHILD} tutored in?
CODE ALL THAT APPLY.
CODE ENGLISH LANGUAGE TUTORING PROGRAMS AS “4”.
CODE TUTORING IN LANGUAGES OTHER THAN ENGLISH AS “5”.
PROBE: Anything else?
CODES Code All That Apply
1
READING
2
MATH
3
SCIENCE
4
ENGLISH LANGUAGE SKILLS
5
FOREIGN LANGUAGE
91
OTHER (SPECIFY)
REFUSED
DON'T KNOW
BOX 8
IF HEQ.440 IS CODED 91, CONTINUE WITH HEQ.440OS.
OTHERWISE, GO TO HEQ.450.
HEQ440OS
[What was {CHILD} tutored in?]
SPECIFY SUBJECT.
_______________________________________
SUBJECT
ENTER TEXT
Length 50
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DK AND RF DISALLOWED.
HEQ450
How many days a week was {CHILD} tutored?
ENTER NUMBER OF DAYS.
|___|
ENTER NUMBER
Range 1 to 7
Soft Range
1 to 5
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "days a week" IN UNDERLINED TEXT.
CAPI INSTRUCTION: SOFT RANGE CHECK 1‐5; HARD RANGE CHECK 1‐7.
HEQ460
DISPLAY INSTRUCTIONS:
DISPLAY "hours a day" IN UNDERLINED TEXT.
How many hours a day was {CHILD} tutored?
ENTER NUMBER OF HOURS.
|___|___|
ENTER NUMBER
Range 1 to 8
Soft Range
1 to 6
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: SOFT RANGE 1‐6. HARD RANGE CHECK 1‐8.
HEQ470
DISPLAY INSTRUCTIONS:
DISPLAY "weeks" IN UNDERLINED TEXT.
About how many weeks was {CHILD} tutored?
ENTER NUMBER OF WEEKS.
IF LESS THAN A WEEK, ENTER '1.'
|___|___|
ENTER NUMBER
Range 1 to 16
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: DISPLAY "weeks" IN UNDERLINED TEXT.
CAPI INSTRUCTION: HARD RANGE CHECK 1 – 16 WEEKS.
BOX 9
GO TO CCQ (CHILD CARE).
CHILD CARE (FALL SECOND GRADE)- CCQ
CCQ011
HELP AVAILABLE
Did {CHILD} receive child care during the summer on a regular basis from someone other than you or
another parent or guardian? This does not include occasional baby‐sitting or backup care providers. It
also does not include summer camp.
IF NEEDED, SAY: This may include grandparents, brothers and sisters, or any relatives other than you or
another parent or guardian. It also may include home child care providers, regular sitters or neighbors,
in addition to day care centers or extended day programs.
HELP TEXT:
Care from a relative: Record care or programs provided by someone 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.
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.
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 that include children who are older (some of
which may be sponsored by the state) are also included.
Extended Day Program: Center‐based program that provides care after or before day time hours.
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. Also, do not include going away to stay with a relative for a period of
time during the summer. We are asking about child care given on a routine schedule.
CODES
1
YES
2
NO
Box 1
REFUSED
Box 1
DON'T KNOW Box 1
CCQ012
HELP AVAILABLE
Let's talk about the child care that {CHILD} spent the most time in on a regular basis during the summer.
Did {CHILD} spend the most time receiving child care from a relative, a non‐relative in a private home, or
a day care center or extended day program?
IF HOURS OF CARE ARE EQUAL BETWEEN TYPES OF CARE, USE CODES “4”, “5”, “6,” OR “7”.
HELP TEXT:
Care from a relative: Record care or programs provided by someone 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.
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.
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 that include children who are older (some of
which may be sponsored by the state) are also included.
Extended Day Program: Center‐based program that provides care after or before day time hours.
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. Also, do not include going away to stay with a relative for a period of
time during the summer. We are asking about child care given on a routine schedule.
CODES
1
RELATIVE
2
NON‐RELATIVE
3
DAY CARE CENTER OR EXTENDED DAY PROGRAM
4
RELATIVE AND NON‐RELATIVE CARE HAD EQUAL HOURS
5
RELATIVE CARE AND DAY CARE CENTER/EXTENDED DAY PROGRAM HAD EQUAL HOURS
6
NON‐RELATIVE CARE AND DAY CARE CENTER/EXTENDED DAY PROGRAM HAD EQUAL HOURS
7
ALL THREE TYPES OF CARE HAD EQUAL HOURS
REFUSED
Box 1
DON'T KNOW Box 1
CCQ013
HELP AVAILABLE
How many hours each week did {CHILD} {receive care from {his/her} relative/receive care from {his/her}
non‐relative/go to the day care center or extended day program}?
ENTER “77” IF CHILD DID NOT GO TO CHILD CARE AT LEAST ONCE EACH WEEK.
RECORD THE HOURS EACH WEEK IN WHOLE HOURS.
|___|___|
HELP TEXT:
Record the hours each week in whole hours.
If the respondent reports daily hours, probe for weekly hours.
If the hours per week varied, ask for the number of hours in a typical week.
Include only the number of hours that the child received care when the parent was not at home.
ENTER NUMBER
Range 1 to 77
Soft Range
1 to 50
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
CAPI INSTRUCTION: SOFT RANGE CHECK 1‐50. HARD RANGE CHECK 1‐70, 77.
IF “77” IS ENTERED, GO TO BOX 1.
DISPLAY receive care from {his/her} relative" IF CCQ.012 = 1 OR 4. DISPLAY “receive care from {his/her}
non‐relative” IF CCQ.012 = 2. DISPLAY “go to the day care center or extended day program” IF CCQ.012
= 3, 5, 6, OR 7.
RANGE ERROR MESSAGE TEXT: "Invalid response. Entry not in range. Please reenter."
CCQ014
How many weeks during the summer did {CHILD} receive care from {his/her} relative/{his/her} non‐
relative/the day care center or extended day program/both {his/her} relative and non‐relative
combined/both {his/her) relative and the day care center or extended day program combined/both
{his/her} non‐relative and the day care center or extended day program combined/{his/her} relative,
non‐relative, and the day care center or extended day program combined}?
ENTER NUMBER OF WEEKS.
|___|___|
ENTER NUMBER
Range 1 to 16
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
DISPLAY "weeks" IN UNDERLINED TEXT.
HARD RANGE CHECK 1 ‐ 16.
DISPLAY receive care from {{his/her} relative" IF CCQ.012 = 1. DISPLAY “receive care from {his/her} non‐
relative” IF CCQ.012 = 2. DISPLAY “go to the day care center or extended day program” IF CCQ.012 = 3,
DISPLAY “both {his/her} relative and non‐relative combined” IF CCQ.012 = 4. DISPLAY “both {his/her)
relative and the day care center or extended day program combined” IF CCQ.012 = 5. DISPLAY “both
{his/her} non‐relative and the day care center or extended day program combined” IF CCQ.012 = 6.
DISPLAY “{his/her} relative, non‐relative, and the day care center or extended day program combined” IF
CCQ.012 = 7.
Box 1
GO TO SECTION CMQ (CLOSING).
CLOSING – CMQ
CMQ680
WAS THIS INTERVIEW CONDUCTED BY TELEPHONE OR IN‐PERSON?
CODES
1
2
TELEPHONE
IN‐PERSON
CMQ690
WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?
CODES
1
2
3
ENGLISH
Box 1
SPANISH
Box 1
ANOTHER LANGUAGE CMQ690OS
CMQ690OS
[WAS THIS INTERVIEW CONDUCTED IN ENGLISH, SPANISH, OR ANOTHER LANGUAGE?]
SPECIFY OTHER LANGUAGE
______________________
ENTER TEXT
Length 50
Box 1
IF CMQ.680 = 2, GO TO CMQ.695. ELSE, GO TO BOX 2.
CMQ695
WHERE WAS THIS INTERVIEW CONDUCTED?
CODES
1
2
3
CHILD'S HOME
CHILD'S SCHOOL
SOMEWHERE ELSE
Box 2
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.
CMQ700
Thank you very much for your cooperation and for taking the time to participate in the Early Childhood
Longitudinal Study.
PRESS 1 AND ENTER TO CONTINUE.
ENTER TEXT
Box 3
GO TO CMQ.720.
CMQ701
We would like to call the parent or guardian for {CHILD} at the household where {he/she} lives. Could
you 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.
PRESS 1 AND ENTER TO CONTINUE.
ENTER TEXT
Length 200
REFUSED
DON'T KNOW
Box 4
GO TO CMQ.720.
CMQ702
We would like to call back when {this person/{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.
PRESS 1 AND ENTER TO CONTINUE.
ENTER TEXT
Length 100
REFUSED
DON'T KNOW
PROGRAMMER INSTRUCTIONS:
IF (INQ042=4 and INQ043=2) OR (INQ020=4 and INQ025=2), THEN DISPLAY “this person”. ELSE, DISPLAY
“{CHILD}’s parent or guardian”.
BOX 5
GO TO CMQ.720.
CMQ703
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.
PRESS 1 AND ENTER TO CONTINUE.
CMQ720
PRESS 1 AND ENTER TO SAVE AND EXIT THIS CASE.
THE QUESTIONS BELOW ASK PARENTS ABOUT THEIR CHILD’S HEARING. THEY ARE THE SAME
QUESTIONS THAT HAVE BEEN ASKED IN PRIOR ROUNDS OF THE STUDY. THEY WILL BE INCORPORATED
INTO THE FINAL VERSION OF THE FALL 2ND GRADE PARENT INTERVIEW (IN THE CHILD HEALTH SECTION)
TO OBTAIN INFORMATION FROM PARENTS THAT IS CONTEMPORANEOUS TO THE HEARING SCREENING.
CHQ.021
Has {CHILD} had an ear infection since last spring?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
CHQ.022
Has {CHILD} had an ear ache since last spring?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
CHQ.023
1 (CHQ.023)
2
8
9
1
2
8
9
(CHQ.024)
(CHQ.216)
(CHQ.216)
(CHQ.216)
Since last spring, 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................................................
CHQ.024
8
9
Since last spring, how have {CHILD}’s {ear infections/ear aches} been treated by your doctor,
nurse, or other medical professional?
PROBE: Anything else?
CODE ALL THAT APPLY FOR 1-7.
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.021 = 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.216)
OTHER (SPECIFY) ..................................................................................................... 91
REFUSED ................................................................................................................... 8
DON’T KNOW .......... ................................................................................................... 9
1
BOX 1
IF ONE OF THE CODES IN CHQ.024 = 91, GO TO CHQ.024OS. ELSE, GO TO
BOX 2.
CHQ.024OS
[Since last spring, how have {CHILD}’s {ear infections/ear aches} been treated by your doctor,
nurse, or other medical professional? ]
CAPI INSTRUCTION: DISPLAY “ear infections” IF CHQ.021 = 1. ELSE, DISPLAY “ear aches”.
SPECIFY TREATMENT.
SPECIFY TREATMENT.
_________________________________________________________
BOX 2
IF ONE OF THE CODES IN CHQ.024 = 4, GO TO CHQ.025. ELSE, GO TO
CHQ.216.
CHQ.025
Since last spring, 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 SINCE LAST SPRING IF {CHILD} HAD
MORE THAN ONE TO PLACE EAR TUBES.
RIGHT EAR ................................................... 1
LEFT EAR ..................................................... 2
BOTH EARS .................................................. 3
REFUSED ..................................................... 8
DON'T KNOW ............................................... 9
Hearing
CHQ.216
Which best describes {CHILD}’s hearing? If {CHILD} has a hearing aid or other assistive device,
please consider {his/her} hearing without the hearing aid or assistive device. Would you say {CHILD}
has...
excellent hearing,...........................................
good hearing, .................................................
a little trouble hearing, ...................................
moderate trouble hearing,. .............................
a lot of trouble hearing, or ..............................
is {CHILD} deaf? ............................................
REFUSED .....................................................
DON'T KNOW................................................
2
1
2
3
4
5
6
8
9
CHQ.221
Is {CHILD}’s hearing worse in one ear?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
CHQ.222
1
2 (CHQ.235)
8 (CHQ.235)
9 (CHQ.235)
HELP AVAILABLE
Which best describes {CHILD}'s hearing in {his/her} worse ear? If {CHILD} has a hearing aid or other
assistive device, please consider {his/her} hearing without the hearing aid or assistive device.
Is {CHILD}’s hearing…
CAPI INSTRUCTIONS: DISPLAY “worse” IN UNDERLINED TEXT.
Excellent, .......................................................
Good, .............................................................
A little trouble hearing, ...................................
Moderate trouble hearing, ..............................
A lot of trouble hearing, or .............................
Deaf? .............................................................
REFUSED .....................................................
DON'T KNOW................................................
CHQ.235
1
2
3
4
5
6
8
9
{Since last spring has/Has} {CHILD}'s hearing {ever} been evaluated by a professional?
HELP TEXT: Professional: This includes health professionals such as doctors, pediatricians, and
other licensed persons, including nurses or nurse practitioners, optometrists, ophthalmologists,
school or other psychologists, school or other psychiatrists, psychiatric social workers, speech
pathologists, etc. Do not include teachers or some other non-health professional.
For the vision and hearing questions, having been evaluated at the school by a health
professional does count as being evaluated by a professional.
CAPI INSTRUCTIONS: DISPLAY “Since last spring has” AND USE A NULL DISPLAY FOR “ever”
IF THERE WAS A PREVIOUS INTERVIEW ACCORDING TO THE PRELOAD. ELSE, DISPLAY
“Has” AND “ever”.
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
CHQ.245
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
Did you obtain a diagnosis of a problem from a professional?
YES ...............................................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
3
1
2 (BOX 4)
8 (BOX 4)
9 (BOX 4)
CHQ.246
What was the diagnosis?
PROBE: Anything else?
CODE ALL THAT APPLY.
DUE TO EAR WAX (EXTERNAL EAR CANAL EAR WAX)......................
DUE TO EAR CANAL DEFORMITY (“ATRESIA” (EAR CANAL NOT
NORMALLY FORMED), CRANIAL-FACIAL DISORDER,
ETC.) ....................................................................................................
DUE TO EAR INFECTION (ACUTE OR RECURRENT EPISODES
(INFECTION BEGINS AND PROGRESSES QUICKLY OR KEEPS
COMING BACK) OFTEN WITH EAR ACHE AND FEVER –
ACUTE OTITIS MEDIA) .......................................................................
DUE TO FLUID IN THE EAR (FLUID BEHIND THE EARDRUM,
RUNNY EARS, FLUID OR PUS DRAINING FROM THE MIDDLE
EAR SPACE, CHRONIC OTITIS MEDIA, GLUE EAR) ........................
DUE TO EAR DRUM PROBLEM (INCLUDES PERFORATED/
TORN/RUPTURED) EARDRUM) .........................................................
DUE TO ILLNESS (MENINGITIS, MEASLES, MUMPS, RUBELLA,
SCARLET FEVER, ETC.) ....................................................................
DUE TO CMV (CYTOMEGALOVIRUS, A TYPE OF HERPES
VIRUS) .................................................................................................
DUE TO OTOTOXIC EXPOSURE TO DRUGS/MEDICINES (DAMAGE
TO THE EARS BY DRUGS OR CHEMICALS. INCLUDES
DAMAGE FROM MYCIN DRUGS, SUCH AS, STREPTOMYCIN,
GENTAMYCIN, ETC., SALICYLATE, LASIX, CISPLATIN – MAY
RESULT FROM TREATMENT OF RESPIRATORY PROBLEMS OF
PRETERM INFANTS, OR AS TREATMENTS DUE TO CHILDHOOD
CANCER, ETC.) ...................................................................................
DUE TO NOISE EXPOSURE (FROM GUNFIRE, FIRE
CRACKERS, etc.) ................................................................................
DUE TO GENETIC CAUSE (INCLUDES CONGENITAL (THERE AT
BIRTH) HEARING LOSS, HEREDITARY HEARING LOSS,
SYNDROMAL HEARING LOSS – DOWN SYNDROME, USHER’S
SYNDROME, ETC.) .............................................................................
DUE TO INJURY OR TRAUMA TO HEAD & NECK ...............................
DUE TO EAR OR FACIAL SURGERY .....................................................
DUE TO NERVE DEAFNESS (NERVE HEARING LOSS OR SENSORINEURAL HEARING LOSS)..................................................................
DUE TO CENTRAL AUDITORY PROCESSING DISORDER
(PROBLEM WITH BEING ABLE TO RECOGNIZE, TELL THE
DIFFERENCE BETWEEN, OR UNDERSTAND SOUNDS) .................
DEAF ........................................................................................................
OTHER (SPECIFY) _________________________________________
DON’T KNOW ..........................................................................................
REFUSED ................................................................................................
BOX 3
IF CHQ.246 = 91, GO TO CHQ.246OS. ELSE, GO TO CHQ.256.
4
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
91
88
99
CHQ.246OS
[What was the diagnosis?]]
SPECIFY DIAGNOSIS.
___________________________________________
CHQ.256
HELP AVAILABLE
{Since last spring, has {CHILD} gotten/Has {CHILD} ever worn} a hearing aid?
HELP TEXT: Hearing Aid: A small electronic sound amplifier worn in or behind the ear that
compensates for impaired hearing.
IF RESPONDENT SAYS “Yes” OR “CHILD USED TO WEAR ONE,” ASK “Does {CHILD} wear one
now?”
CAPI INSTRUCTION: DISPLAY “Since…gotten” IF SECTION CHQ WAS COMPLETED IN A
PREVIOUS INTERVIEW ACCORDING TO THE PRELOAD. ELSE, DISPLAY “Has {CHILD} ever
worn”
YES, CURRENTLY........................................
YES, IN THE PAST .......................................
NO .................................................................
REFUSED .....................................................
DON'T KNOW................................................
BOX 4
GO TO CMQ.
5
1
2
3
8
9
| File Type | application/pdf |
| File Modified | 2011-09-13 |
| File Created | 2011-07-26 |