Questionnaire

Attachment 1 - Questions to be evaluated OMB #0920-0222; Expiration Date: 06/30/2015

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Attitudes
I would like to ask you some questions about schooling.
AT1. Do you agree with the following statements? [A] Boys should attend primary school [B] Girls should attend primary school [C] Boys should attend secondary school [D] Girls should attend secondary school	Yes 1 No 2 DK / Not sure 9 Yes 1 No 2 DK / Not sure 9 Yes 1 No 2 DK / Not sure 9 Yes 1 No 2 DK / Not sure 9
AT2A. Now I would like to ask you some questions about schooling for children with disabilities. Do you think children with seeing or hearing disabilities should attend a regular school, special school for children with disabilities or not attend school at all?	Regular school 1 Special school for children with disabilities 2 Not attend school at all 3 DK / Not sure 9	If 1 or 9, skip to AT3A If 2, GO to AT2B If 3, skip to AT2C
AT2B. We would like to now understand why you answered as you did. Do you agree with the following statements?	Yes No Special schools are better prepared to meet their needs 1 2 These children feel most comfortable in special schools 1 2 These children are most safe in special schools 1 2 It is better for children without disabilities to be separated from children with disabilities 1 2

AT2C. We would like to now understand why you answered as you did. Do you agree with the following statements?	Yes No These children do not need to be educated 1 2 These children are not able to learn 1 2 Schools cannot meet the needs of these children 1 2 These children would not be safe at school 1 2 It would be bad for children without disabilities if children with disabilities went to school 1 2
AT3A. Do you think children with physical disabilities should attend a regular school, special school for children with disabilities or not attend school at all?	Regular school 1 Special school for children with disabilities 2 Not attend school at all 3 DK / Not sure 9	If 1 or 9, skip to AT4A If 3, skip to AT3C
AT3B. We would like to now understand why you answered as you did. Do you agree with the following statements?	Yes No Special schools are better prepared to meet their needs 1 2 These children feel most comfortable in special schools 1 2 These children are most safe in special schools 1 2 It is better for children without disabilities to be separated from children with disabilities 1 2
AT3C. We would like to now understand why you answered as you did. Do you agree with the following statements?	Yes No These children do not need to be educated 1 2 These children are not able to learn 1 2 Schools cannot meet the needs of these children 1 2 These children would not be safe at school 1 2 It would be bad for children without disabilities if children with disabilities went to school 1 2
AT4A. Do you think children with learning disabilities should attend a regular school, special school for children with disabilities or not attend school at all?	Regular school 1 Special school for children with disabilities 2 Not attend school at all 3 DK / Not sure 9	If 1 or 9, skip to AT5A If 3, skip to AT4C
AT4B. We would like to now understand why you answered as you did. Do you agree with the following statements?	Yes No Special schools are better prepared to meet their needs 1 2 These children feel most comfortable in special schools 1 2 These children are most safe in special schools 1 2 It is better for children without disabilities to be separated from children with disabilities 1 2

AT4C. We would like to now understand why you answered as you did. Do you agree with the following statements?		Yes No These children do not need to be educated 1 2 These children are not able to learn 1 2 Schools cannot meet the needs of these children 1 2 These children would not be safe at school 1 2 It would be bad for children without disabilities if children with disabilities went to school 1 2
AT5A. Do you think children with behavioral disabilities should attend a regular school, special school for children with disabilities or not attend school at all?		Regular school 1 Special school for children with disabilities 2 Not attend school at all 3 DK / Not sure 9		If 1 or 9, skip to next section If 3, skip to AT5C
AT5B. We would like to now understand why you answered as you did. Do you agree with the following statements?		Yes No Special schools are better prepared to meet their needs 1 2 These children feel most comfortable in special schools 1 2 These children are most safe in special schools 1 2 It is better for children without disabilities to be separated from children with disabilities 1 2
AT5C. We would like to now understand why you answered as you did. Do you agree with the following statements?		Yes No These children do not need to be educated 1 2 These children are not able to learn 1 2 Schools cannot meet the needs of these children 1 2 These children would not be safe at school 1 2 It would be bad for children without disabilities if children with disabilities went to school 1 2
school environment
	SE1. which of the following applies to your child?  child attends school  continue with SE2  child does not attend school  go to out of school section
	SE2. Can (name) get to school by him/herself?	Yes 1 No 2
	SE3. How does (name) usually get to school?	Walking 1 Bicycle 2 Tricycle/wheelchair 3 Family vehicle (car, motorcycle, boat, donkey) 4 Public vehicle (school bus, ferry) 5
	SE4. Using this means of transportation, how long does it usually take (name) to get to school?	Less than 30 minutes 1 30-60 minutes 2 More than 1 hour 3 DK 9
	SE5. Is (name) safe travelling to/from school?	Yes 1 No 2 DK 9
	SE6. In the (20XX) school year, did your household pay for the following items? [A] School tuition fees [B] Transportation to/from school [C] Meals at school [D] Boarding fees [E] Private tutoring [F] School materials and supplies (books, uniforms, stationaries, etc.) [G] Assistive devices/technology (braille textbook, hearing aid, wheelchair, etc.) [H] Special services and assistance (speech therapist, sign language interpretation, support worker, etc.) [I] Other fees (exam fees, admission fees)	YES NO School tuition fees 1 2 Transportation 1 2 Meals 1 2 Boarding fees 1 2 Private tutoring 1 2 School materials and supplies 1 2 Assistive devices/technology 1 2 Special services 1 2 Other 1 2
	SE7. Did you receive any assistance in cash or in kind for any of these expenses?	Yes 1 No 2	If 2, skip to SE9
	SE8. Where did you receive the assistance from? [A] RESOURCES FROM (name)’S EXTENDED FAMILY NOT LIVING IN HOUSEHOLD [B] GIFT FROM A NON-RELATIVE WHO LIVES OUTSIDE THE HOUSEHOLD [C] BURSARY OR SCHOLARSHIP [D] PRIVATE AID ORGANIZATION [E] OTHER GOVERNMENT PROGRAMS	YES NO Family not in household…...... 1 2 Gift.................................. 1 2 Bursary/Scholarship ......... 1 2 Private aid organization ... 1 2 Other government programs........ 1 2

	I am now interested in knowing about the school that (name) is attending. SE9. Do (name)’s teachers care about (his/her) success in school?		Yes 1 No 2 DK 9
	SE10. Do (name)’s teachers help (him/her) learn?		Yes 1 No 2 DK 9
	SE11. Do (name)’s teachers make (him/her) feel welcome in the classroom?		Yes 1 No 2 DK 9
	SE12. Do (name)’s teachers come to class every school day?		Yes 1 No 2 DK 9
	SE13. Are there too many students in (name)’s class?		Yes 1 No 2 DK 9
	SE14. Are there seats for every student in (name)’s class?		Yes 1 No 2 DK 9
	SE15. Does (name)’s classroom have enough light for (him/her) to do (his/her) work?		Yes 1 No 2 DK 9
	SE16. Is there too much noise in (name)’s classroom for (him/her) to do (his/her) work?		Yes 1 No 2 DK 9
	SE17. Does (name) move around the school easily?		Yes 1 No 2 DK 9
	SE18A. Does (name) use drinking water facilities at school?		Yes 1 No 2 DK 9	If 1 or 9, skip to SE19A
	SE18B. If no, why?		Not available 1 Not able to access 2 Not acceptable for use 3 DK 9
	SE19A. Does (name) use a toilet at school?		Yes 1 No 2 DK 9	If 1 or 9, skip to SE20A
	SE19B. If no, why?		Not available 1 Not able to access 2 Not acceptable for use 3 DK 9
	SE20A. Does (name) use play and recreation areas at school?		Yes 1 No 2 DK 9	If 1 or 9, skip to SE21
	SE20B. If no, why?		Not available 1 Not able to access 2 Not acceptable for use 3 DK 9
	SE21. Does (name) have books that (he/she) is able to use?		Yes 1 No 2 DK 9
	SE22. Does (name) receive special services or assistance (speech therapist, support worker, sign language interpretation) in school?		Yes 1 No 2 Does not need special services 3 DK 9
	SE23. What is the main type of school that (name) attends?		Regular classroom in a regular school 1 Special classroom in a regular school 2 Special school for children with disabilities 3 Other 4
	SE24. Is the school responsive if you have concerns about (name)’s education?		Yes 1 No 2 DK 9
	SE25. Is (name) safe at school?		Yes 1 No 2 DK 9
	SE26. Does (name) feel accepted by (his/her) classmates?		Yes 1 No 2 DK 9
	SE27. Do you expect (name) to successfully complete his/her current level of education?		Yes 1 No 2 DK 9
	out of school
OS1. Does (name) receive schooling at home?		Yes 1 No 2			If 2, skip to OS4
OS2. Is this schooling from a travelling teacher, a parent, or another family member?		YES NO Travelling teacher............ 1 2 Parent............ 1 2 Another family member...... 1 2
We are interested in understanding the main reasons why (name) does not attend school. I’m going to read a set of statements. Tell me if they apply. OS3. (Name) can get a better education at home		Yes 1 No 2 DK 9
We are interested in understanding the main reasons why (name) does not attend school. I’m going to read a set of statements. Tell me if they apply. (Do not repeat if OS1 is 1) OS4. There is not enough money to pay the costs of (his/her) schooling		Yes 1 No 2 DK 9
OS4. (Name) needs to work, earn money or help out at home		Yes 1 No 2 DK 9

OS5. It is unsafe for (name) to travel to/from school	Yes 1 No 2 DK 9
OS6. It is unsafe for (name) to be in school	Yes 1 No 2 DK 9
OS7. School is too far away	Yes 1 No 2 DK 9
OS8. No one is available to travel with (name) to/from school	Yes 1 No 2 DK 9
OS9. Transport services are inadequate	Yes 1 No 2 DK 9
OS10. (Name) does not receive special services or assistance (speech therapist, support worker, sign language interpretation) that he/she needs to attend school	Yes 1 No 2 DK 9
OS11. (Name) does not have assistive devices/technology (braille textbook, hearing aid, wheelchair, etc.) that he/she needs to attend school	Yes 1 No 2 DK 9
OS12. Teachers do not know how to teach a child like (name)	Yes 1 No 2 DK 9
OS13. Teachers mistreat (name) at school	Yes 1 No 2 DK 9
OS14. (Name) was refused entry into the school	Yes 1 No 2 DK 9
OS15. (Name) cannot move around the school or classroom	Yes 1 No 2 DK 9
OS16. (Name) cannot use the toilet	Yes 1 No 2 DK 9
OS17. School does not have a program that meets (name)’s learning needs	Yes 1 No 2 DK 9
OS18. (Name) has a health condition that prevents (him/her) from going to school	Yes 1 No 2 DK 9
OS19. (Name) is too old to attend school	Yes 1 No 2 DK 9
OS20. (Name) is not mature enough to attend school	Yes 1 No 2 DK 9

OS21. (Name) has completed enough schooling	Yes 1 No 2 DK 9
OS22. (Name) is married or about to get married	Yes 1 No 2 DK 9
OS23. (Name) has a child or is about to have a child	Yes 1 No 2 DK 9
OS24. (Name) is not interested in going to school	Yes 1 No 2 DK 9
OS25. Schooling is not important for (name)	Yes 1 No 2 DK 9
OS26. School does not help (name) in finding a good job	Yes 1 No 2 DK 9

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