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pdfAppendix B.
NHES:2015 Screener Survey
24114019
OMB No. 1850-0803: Approval Expires 09/30/2016
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
National Household Education Survey
The National Center for Education Statistics is authorized to conduct this survey under U.S. Code Title 20, Section
9543 (20 USC § 9543). Your participation is voluntary. Your answers 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 (20 USC §
9573). The information you provide will be combined with information from other participants to produce statistical
summaries and reports.
NHES-1B
(12/06/2013)
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National Household Education Survey
Start Here
▼
▼
▼
The Department of Education is
studying the education and training
experiences of adults and children.
Each household is different, and we
need your response so we can send
you a survey that is right for your
household.
Return this form even if there
are only one or two people in
the household.
This survey should be filled out
by an adult household member
living at this address.
Please use a blue or black pen if
available.
Continue answering
questions 2 through 6 for
each person living in this
household. Include all
adults and children. Start
with yourself.
Person 2
▼
▼
2. What is his or
her first name,
initials, or
nickname?
First names will
First name/initials/nickname
be used only to
ask you questions
about the education
of a specific person.
3. What is this
person’s
month and
year of birth?
First name/initials/nickname
/
month
4. What is this
person’s sex?
1. How many people live in this
household?
Include adults and children who
are temporarily away from home
(for example, living in college
housing) if they have no other
permanent home.
You / Person 1
5. Is this person
currently in . . .
Mark [X] ONE only.
6. What is this
person’s
current grade
or equivalent?
/
year
month
Male
Male
Female
Female
Homeschool instead
of school for some
or all classes,
Homeschool instead
of school for some
or all classes,
Public or private
school, or preschool,
Public or private
school, or preschool,
College, university or
vocational school, or
College, university or
vocational school, or
Not in school?
Not in school?
GO TO person 2.
GO TO person 3.
Preschool
Preschool
Kindergarten
Kindergarten
write grade
1 through 12
NHES-1B
2
year
write grade
1 through 12
College, university or
vocational school
College, university or
vocational school
None of these
None of these
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Conducted for:
U.S. Department of Education
National Center for Education Statistics
Person 3
Person 4
Person 5
▼
▼
▼
First name/initials/nickname
First name/initials/nickname
First name/initials/nickname
/
month
/
year
month
year
month
year
Male
Male
Male
Female
Female
Female
Homeschool instead
of school for some
or all classes,
Homeschool instead
of school for some
or all classes,
Homeschool instead
of school for some
or all classes,
Public or private
school, or preschool,
Public or private
school, or preschool,
Public or private
school, or preschool,
College, university or
vocational school, or
College, university or
vocational school, or
College, university or
vocational school, or
Not in school?
Not in school?
Not in school?
GO TO person 4.
GO TO person 5.
GO TO page 4.
Preschool
Preschool
Preschool
Kindergarten
Kindergarten
Kindergarten
write grade
1 through 12
▼
/
write grade
1 through 12
write grade
1 through 12
College, university or
vocational school
College, university or
vocational school
College, university or
vocational school
None of these
None of these
None of these
If there are more than 5 people in your household, continue on the next page. Otherwise, stop here and
return this form in the postage-paid envelope provided.
NHES-1B
3
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24114043
National Household Education Survey
Continue
If there are more than 5 people in
your household, please continue
answering for each person living
in this household.
If you have finished answering about
everyone in the household please
return the survey in the postage-paid
envelope provided.
Person 6
Person 7
▼
▼
2. What is his or
her first name,
initials, or
nickname?
First names will
First name/initials/nickname
be used only to
ask you questions
about the education
of a specific person.
3. What is this
person’s
month and
year of birth?
First name/initials/nickname
/
month
4. What is this
person’s sex?
5. Is this person
currently in . . .
Mark [X] ONE only.
6. What is this
person’s
current grade
or equivalent?
/
year
month
Male
Male
Female
Female
Homeschool instead
of school for some
or all classes,
Homeschool instead
of school for some
or all classes,
Public or private
school, or preschool,
Public or private
school, or preschool,
College, university or
vocational school, or
College, university or
vocational school, or
Not in school?
Not in school?
GO TO person 7.
GO TO person 8.
Preschool
Preschool
Kindergarten
Kindergarten
write grade
1 through 12
NHES-1B
4
year
write grade
1 through 12
College, university or
vocational school
College, university or
vocational school
None of these
None of these
§9,IL¤
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Conducted for:
U.S. Department of Education
National Center for Education Statistics
Person 8
Person 9
Person 10
▼
▼
▼
First name/initials/nickname
First name/initials/nickname
First name/initials/nickname
/
month
/
year
month
year
month
year
Male
Male
Male
Female
Female
Female
Homeschool instead
of school for some
or all classes,
Homeschool instead
of school for some
or all classes,
Homeschool instead
of school for some
or all classes,
Public or private
school, or preschool,
Public or private
school, or preschool,
Public or private
school, or preschool,
College, university or
vocational school, or
College, university or
vocational school, or
College, university or
vocational school, or
Not in school?
Not in school?
Not in school?
GO TO person 9.
GO TO person 10.
Return survey.
Preschool
Preschool
Preschool
Kindergarten
Kindergarten
Kindergarten
write grade
1 through 12
▼ ▼
/
write grade
1 through 12
write grade
1 through 12
College, university or
vocational school
College, university or
vocational school
College, university or
vocational school
None of these
None of these
None of these
Please verify you have filled out a column for everyone in your household.
Thank you. Please return this form in the postage-paid envelope provided or mail it to:
U.S. Census Bureau
ATTN: DCB 60-A
1201 E. 10th Street
Jeffersonville, IN 47132-0001
Toll-free number for questions: 1-888-840-8353
NHES-1B
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NHES-1B
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Thank you.
Please return this questionnaire in the postage-paid envelope provided.
If you have lost the envelope, mail the completed questionnaire to:
U.S. Census Bureau
ATTN: DCB 60-A
1201 E. 10th Street
Jeffersonville, IN 47132-0001
NHES-1B
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24114084
Commonly Asked Questions
Q:
How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation. It was
selected using scientific sampling methods to represent other households in the U.S.
Q:
Why don’t you ask more questions about education in this questionnaire?
A: The purpose of this questionnaire is to find out if anyone in your household is eligible for the next
stage of the survey. If so, we will send a second questionnaire that will ask about educational
experiences of a member of your household.
Q:
If there are no children or anyone currently in school in my household, should I respond?
A: Yes, you should respond to this survey. Once you return the questionnaire, the study will be able
to see if anyone in your household is eligible for the next and final survey. If no one is eligible,
you will not receive another survey.
Q:
Why should I take part in this study? Do I have to do this?
A: This survey is the only way that the Department of Education can learn about children’s afterschool care and adult training and education from your perspective. You represent thousands of
other households like yours, and you cannot be replaced. Your answers and opinions are very
important to the success of this study. You may choose not to answer any or all questions in this
survey. In order for the survey to be representative, it is important that you complete and return
this questionnaire. Those who do not return the survey will not be represented in key statistics
used by policymakers and researchers.
Q:
How will the information I provide be used? Will my privacy be protected?
A: Your responses will be combined with those of others to produce statistical summaries and
reports. Your individual data will not be reported. Your answers 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 (20 USC § 9573).
Q:
How much time will it take?
A: On average, it should take 8 minutes or less for you to respond, including the time for
reviewing instructions and completing and reviewing the collection of information.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics, within the U.S. Department of Education, is authorized
to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this study on behalf of the
U.S. Department of Education. This study has been approved by the Office of Management and Budget,
the office that reviews all federally sponsored surveys.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The average time required to complete this survey is estimated to average 5-10
minutes per response, including the time to review instructions, gather the data needed, and complete and
review the survey. If you have any comments concerning the accuracy of the time estimate, suggestions for
improving the survey, or any comments or concerns regarding the status of your individual submission of
this survey, please write to: Andrew Zukerberg, National Center for Education Statistics, National
Household Education Surveys (NHES), 1990 K Street NW, Washington, DC 20006-5650. You may send
email to [email protected].
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to [email protected] or you may call
the Census Bureau toll-free at 1-888-840-8353
NHES-1B
8
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Appendix C. NHES:2015 Topical Surveys
C.1 Credentials for Work Survey (CWS)
C.2 Training for Work Survey (TWS)
C.3 Early Childhood Program Participation (ECPP) Survey
C.4 Parent and Family Involvement in Education (PFI) Survey for Enrolled Students
C.5 Parent and Family Involvement in Education (PFI) Survey for Homeschooled Students
C.1 Credentials for Work Survey (CWS)
OMB No. 1850-0803: Approval Expires 09/30/2016
ul
Adult Training and Education Survey
Part of the 2015 National Household Education Survey
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
Ad
t
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2
Instructions
In response to the survey you answered earlier, we recorded that the
person listed below is between the ages of 16 to 65, is not in high school,
and lives in this household. If this information is not correct, please call us
at the toll-free number below so we can be sure you received the correct
survey.
These questions should be filled out by:
No one else in the household should fill out the survey.
You might be asked to skip questions that do not apply to you. Follow the
arrows to answer the questions that apply to you. Please see the example
below:
No
Yes
GO TO question 12
To answer a question, simply mark the box [X] that best represents your
answer.
Use a black or blue pen, if available, to complete this survey.
Please return the completed survey using the postage-paid envelope
provided.
If you have any questions about this survey, please call us at our toll-free
number: 1-888-840-8353.
We are authorized to collect this information by U.S. Code, Title 20, Section 9543. You do not have to provide the
information requested. However, the information you provide will help the Department of Education’s ongoing efforts to
learn more about the educational experiences of adults. There are no penalties should you choose not to participate in
this study. Your answers 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 (U.S. Code, Title 20, Section 9573). Your responses will be
combined with those from other participants to produce summary statistics and reports.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this voluntary survey is 1850-0803.
The time required to complete this survey is estimated to average 10 minutes per response, including the time to
review instructions, gather the data needed, and complete and review the survey. If you have any comments
concerning the accuracy of the time estimate, suggestions for improving this survey, or any comments or concerns
regarding the status of your individual submission of this survey, please write to: Lisa Hudson, National Center for
Education Statistics, National Household Education Surveys (NHES), 1990 K Street, NW, Washington, DC 20006. You
may send email to [email protected].
3
2. What was the major or field of study for your
highest degree or level of education? (Mark one.)
Level of Education
If there was more than one, please choose the one
you consider most important.
1. What is the highest degree or level of school you
have completed? (Mark one.)
Elementary or high school,
but no high school diploma
or GED®
General studies, no major, undeclared major
Accounting, finance, insurance, real estate
High school diploma
Administrative support
GED® or alternative high school
credential
Some college credit but less than
one year of college credit
Arts, music, design
Audio, broadcasting, multimedia, or graphics
technologies
Business management, marketing
Communications, journalism
1 or more years of college credit,
no degree
Associate’s degree (for example, AA, AS)
Computer science, information technology
Bachelor’s degree (for example, BA, BS)
Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)
Construction, repair, manufacturing,
transportation
Education
Professional degree beyond a bachelor’s
degree (for example, MD, DDS, DVM, LLB, JD)
Engineering, architecture
Doctorate degree (for example, PhD, EdD)
English language, literature
Family or consumer science
Healthcare, nursing, medicine
Law enforcement, security, firefighting
Law, legal studies
Liberal arts
Political science, economics, history, other
social sciences
Psychology
Religious vocations, theology
Sciences (biological or physical), mathematics
Social or human services, public
administration
Other (specify)
4
Certifications and Licenses
3. Do you have a currently active professional
certification or a state or industry license? Do not
include business licenses, such as a liquor license or
vending license.
A professional certification or license shows you are
qualified to perform a specific job and includes things
like Licensed Realtor, Certified Medical Assistant,
Certified Teacher, or an IT certification.
No
Yes
GO TO question 10
4. If yes, how many certifications and licenses do you
have?
If you had to get a certification in order to get a
license, count each certification and license
separately.
Number of certifications and licenses
CONTINUE on the next page.
5
5. Please answer questions 5a – 5d for each currently active certification and license you have, up to three.
If you have more than three, answer for the three you last earned or renewed.
Certification or License
#1
Certification or License
#2
Certification or License
#3
5a. What is the name of the
certification or license?
Do not include college
degrees.
5b. Using Table A on the next
page, what is its subject
field?
5c. Was it issued by the
federal, state, or local
government?
(For example, by a state
board of education or
other state board, OSHA,
or FAA)
5d. Is it for your current job?
(Mark one.)
If you are not employed,
answer “no”.
Number
from Table A
Number
from Table A
Number
from Table A
No
No
No
Yes
Yes
Yes
Don’t know
Don’t know
Don’t know
No
No
No
Yes, and it is
required
Yes, and it is
required
Yes, and it is
required
Yes, but it is not
required
Yes, but it is not
required
Yes, but it is not
required
6. Of the certifications and licenses that you listed
above, which did you earn or renew last?
(Mark one.)
Certification or license #1
Certification or license #2
Certification or license #3
CONTINUE on page 8.
6
TABLE A. FIELD OF CERTIFICATION OR LICENSE CODES FOR QUESTION 5b
1. EMT, CPR, basic first aid
12. Notary public
2. Health care (for fitness use code 13) Includes
nursing, health care technologist or technician,
medical practitioners (such as MD, OD, PA, DC,
PharmD, DVM), and health care specialties.
Nursing (use code 2)
13. Physical fitness
Includes personal or athletic trainer, yoga
instructor, and other fitness instruction.
3. Accounting, finance, insurance, real estate
(for notary public use code 12)
14. Public safety , security
Includes law enforcement, firefighting,
flight attendant, and other public safety
services (for water and hazardous waste
treatment use code 9).
4. Business management or operations
Includes project management, Six Sigma, Lean
Manufacturing, and other business management
and operations.
15. Religious ordination
5. Childcare
6. Computer science, information technology
Includes software development and applications,
networking, and other computer and information
technologies.
16. Skilled trades
Includes auto repair, HVAC installation and
maintenance, construction trades, welder,
machinist, and manufacturing or production
technician.
7. Cosmetology, barbering
17. Social work, counseling
8. Engineering, architecture, energy
Includes engineering and engineering technologies, architecture, drafting, LEED, energy auditing
and other similar fields.
18. Teaching
Includes preschool through grade 12 teaching,
TESOL, and adult education. (For other
instructional fields, use the code for that field;
for example, flight instructors use code 19 for
transportation.)
9. Food handling, sanitation
Includes food handling, water treatment and
sanitation, hazardous waste operations, and other
sanitation fields.
19. Transportation
Includes CDL, aviation or marine
piloting, and other transportation
work (for flight attendant use code
14).
10. Funeral, mortuary, taxidermy
11. Legal practice
20. Other fields not listed above
7
The rest of this section asks about the certification
or license from question 6 that you last earned or
renewed.
8. Did you do any of the following to prepare for
earning your last certification or license? (Mark
ONE box in each row below.)
No
▼
7. How useful has your last certification or license
been for each of the following?
a. Earned a college degree
a. Getting a job (Mark one.)
b. Took classes from a college,
technical school, or trade
school (no degree)
Not useful
Somewhat useful
Very useful
Too soon to tell
c. Took classes or training
from a company,
association, union, or
private instructor
b. Keeping a job (Mark one.)
Yes
▼
d. Studied on my own using
textbooks or on-line
resources
Not useful
Somewhat useful
Very useful
Too soon to tell
e. Participated in on-the-job
training, an internship, or
apprenticeship
c. Increasing your pay (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
9. The next time your last certification or license is up
for renewal, do you plan to renew it or let it expire?
(Mark one.)
d. Keeping you marketable to employers or
clients (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
Renew it
Let it expire
Have not decided
It does not have to be renewed
CONTINUE on the next page.
e. Improving your work skills (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
8
12. What was the field of study for your last
post-secondary certificate? (Mark one.)
Certificates
10. People sometimes earn certificates for completing
an education or training program. A certificate is
different from a certification or license. Do NOT
include certifications/licenses here; include them
in the previous section only. Have you ever earned
any of the following types of certificates?
a. A certificate for completing a training program
from an employer, employment agency, union,
software or equipment manufacturer, or other
training provider, but NOT from a school.
No
Yes
b. A certificate for completing a vocational
program at a high school.
No
Yes
c. A high school equivalency certificate, such as a
GED®.
No
Yes
d. A certificate—rather than a degree—for
completing a program at a community or technical college, or other school after high school.
Do not include teaching certificates or college
degrees.
No
Yes
Accounting, finance, insurance, real estate
Administrative support
Agriculture
Arts, music, design
Audio, broadcasting, multimedia, or graphics
technologies
Business management, marketing
Computer science, information technology
Construction trades
Cosmetology
Culinary arts
Drafting, engineering technologies
Education
Family or consumer science
Funeral or mortuary science
Healthcare, nursing
Law enforcement, security, firefighting
Law, legal studies
Liberal arts
Manufacturing, production (for example
machinist, welder, boilermaker)
Mechanic, repair technologies
Transportation, materials moving
Other (specify)
GO TO question 19
11. (If yes.) We will refer to the certificates in question
10d as “post-secondary certificates.” Where did
you get your last post-secondary certificate? (Mark
one.)
A community college
A vocational, technical, trade, or business
school
Another college or university
Someplace else
Specify:______________
If you do NOT have a post-secondary certificate, go
to question 19.
9
13. About how many hours of instruction did you
complete in order to earn your last post-secondary
certificate? (Mark one.)
16. Is your last post-secondary certificate related to
your current job?
If you are not employed, answer “no.”
480 or more hours (12 or more full-time
weeks)
160 to 479 hours (4 full-time weeks to
less than 12 full-time weeks)
40-159 hours (1 full-time week to less
than 4 full-time weeks)
Less than 40 hours (less than 1 full-time
week)
No
Yes
17. How useful has your last post-secondary certificate
been for each of the following?
a. Getting a job (Mark one.)
14. Which one of the following best describes the
requirement for enrolling in your last postsecondary certificate program? (Mark one.)
It required enrollment in or prior
completion of an advanced degree program
(Master’s or higher).
b. Increasing your pay (Mark one.)
It required enrollment in or prior
completion of a Bachelor’s degree program.
It required prior completion of high school
or high school equivalency.
It did not have any of these educational
requirements.
Yes
▼
▼
Not useful
Somewhat useful
Very useful
Too soon to tell
c. Improving your work skills (Mark one.)
15. Did completing your last post-secondary certificate
require any of the following? (Mark ONE box in
each row below.)
No
Not useful
Somewhat useful
Very useful
Too soon to tell
Not useful
Somewhat useful
Very useful
Too soon to tell
18. Was your last post-secondary certificate part of
the training you took for a professional certification or license?
a. Passing a test or exam
b. Some other evaluation of
my knowledge or
performance
c. Completion of a minimum
number of credits
d. Completion of a minimum
number of instructional
hours
10
No
Yes
Work Experience Programs
College and Other Classes
19. People sometimes prepare to enter a trade or
profession through a program that combines work
experience with education or formal training. Have
you ever COMPLETED one of these types of work
experience programs—an internship, student
teaching, co-op, practicum, clerkship, externship,
residency, clinical experience, or apprenticeship?
No
Yes
21. Since leaving high school, have you taken any of the
following types of classes?
a. Classes to learn English as a second language,
sometimes called ESL classes.
GO TO question 21
No
Yes
b. Literacy classes to help improve my reading. Do
not include college classes.
If you did NOT complete any of the types of
work experience programs listed above, go to
question 21. If you DID complete a program,
answer the following question about the last
work experience program you completed.
No
Yes
c. Classes to earn a high school equivalency (such
as the GED®).
20. If yes, do any of the following statements describe
your last work experience program? (Mark ONE box
in each row below.)
No
Yes
▼
▼
b. I got college credit for it.
No
Yes
22. How many college classes have you taken in the
past 12 months, including for-credit and non-credit
classes?
a. It did or will help me earn a
certification or license.
c. I received journeyman
status at the end of an
apprenticeship.
None
GO TO question 24
One
Two
Three or more
23. If one or more, did you take these classes as part of
a degree program, or to transfer to a degree
program?
d. I got a state or federal
apprenticeship registration
number.
No
Yes, as part of a degree program
Yes, to transfer to a degree program
CONTINUE on the next page.
11
Employment
Training for Work
26. Last week, were you employed for pay at a job or
business?
24. People often participate in courses, training, or
other instruction for work.
If you were temporarily absent from a job or
business (on vacation, temporarily ill, on
maternity leave, etc.), answer “Yes”.
These trainings can include classes, seminars, workshops, or on-line instruction. They can be taken at the
workplace or somewhere else, and can include topics
such as:
Job safety, security, sexual harassment,
ethics, or other regulations,
Equipment use,
Communication, sensitivity, or team-building,
Computer or technical skills,
Management skills, and
Other job skills.
No
Yes
GO TO question 32
27. If yes, for the job or business you were in last
week, were you a member of a labor union or of
an employee association similar to a union (for
example, AFL-CIO, Change to Win Federation,
NEA)?
Have you completed any work-related training in
the past 12 months?
No
Yes
No
Yes
GO TO question 26
28. Last week, how many jobs did you have?
Number of jobs
25. If yes, how many work-related trainings have you
completed in the past 12 months?
29. Last week, did you work at a full-time job (a job
where you work 35 hours or more per week)?
Count multiple sessions of the same training as one
training.
No
Yes
Number of trainings
30. Last week, did you work at a part-time job (a job
where you work fewer than 35 hours per week)?
No
Yes
GO TO question 36
31. If yes, would you have preferred to work at a fulltime job?
12
No
Yes
GO TO question 36
38. In your current or last job, which one of the
following were you? (Mark one.)
32. Last week, were you on layoff from a job?
No
Yes
If you had more than one job, describe the one at
which you worked the most hours. If you had no job
or business last week, give information for your last
job or business.
33. During the last 4 weeks, have you been actively
looking for work?
No
Yes
GO TO question 35
34. If no, do you intend to look for work within the
next 5 years?
No
Yes
Don’t know
35. When did you last work, even for a few days?
(Mark one.)
Never worked
for pay
Over 12 months
ago
Within the past
12 months
An employee of a private (for-profit or not-forprofit) company or business, or of an individual,
for wages, salary, or commission
A local (city, county, etc.), state, or federal
government employee
Self-employed in own business, professional
practice, or farm
Working without pay in family business or farm
39. For whom did you work?
GO TO question
48
GO TO question
38
If now on active duty in the Armed Forces, mark
(X) this box and print the branch of the Armed
Forces below. All others, enter name of
company, business, or other employer below.
Name of company, business, or other employer:
36. During the past 12 months (52 weeks), how many
weeks did you work, including paid vacation, paid
sick leave, and military service? (Mark one.)
50 to 52 weeks
48 to 49 weeks
40 to 47 weeks
27 to 39 weeks
14 to 26 weeks
13 weeks or less
40. What kind of business or industry was this?
(For example: hospital, newspaper publishing,
mail order house, auto engine manufacturing,
bank)
37. During the past 12 months, in the weeks you
worked, how many hours did you usually work
each WEEK?
Usual hours worked each WEEK
13
45. What kind of position did you hold? (Mark one.)
41. What kind of work were you doing?
(For example: registered nurse, personnel manager,
supervisor of order department, secretary,
accountant)
Permanent
Temporary
GO TO question
47
46. Would you have preferred to work at a
permanent job?
47. How many people worked for your employer?
Count employees at all locations. (Mark one.)
42. What were your most important activities or
duties?
If you were self-employed, how many people
worked for you, including yourself?
(For example: patient care, directing hiring policies,
supervising order clerks, typing and filing,
reconciling financial records)
43. Did you have a license that was required by a
federal, state, or local government agency to do
this job?
No
Yes
44. Which category best fits your earnings from
wages, salary, commissions, bonuses or tips, from
your current or last job over the past 12 months?
(Mark one.)
Report amount before deductions for taxes,
bonds, dues, or other items.
No
Yes
$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $75,000
$75,001 to $150,000
$150,001 or more
14
1—49 people
50—499 people
500—999 people
1,000 or more people
Background
54. Do you speak a language other than English at
home?
48. Have you ever served on active duty in the U.S.
Armed Forces, Reserves, or National Guard?
(Mark one.)
No, never served
in the military
No
Yes
GO TO question 56
55. How well do you speak English? (Mark one.)
GO TO
question 50
Yes, but only on active duty
for training in the Reserve or
National Guard
Very well
Well
Not well
Not at all
Yes, on active duty now or in past
56. How old are you?
49. Have you served on active duty since September
2001?
years old
No
Yes
57. Are you of Hispanic or Latino origin?
50. Are you male or female?
Male
Female
58. What is your race? Choose one or more.
51. What is your current marital status? (Mark one.)
Now Married
Widowed
Divorced
Separated
Never married
No
Yes
GO TO question 54
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
52. Are you currently living with a boyfriend/girlfriend
or partner?
Thank You.
No
Yes
Please return this questionnaire in the
postage-paid envelope provided. If you have
lost the envelope, mail the completed
questionnaire to:
53. Are you currently in a registered domestic
partnership or civil union?
National Household Education Survey
[RETURN ADDRESS HERE]
No
Yes
15
Commonly Asked Questions
Q: How was my household chosen?
A: Your address was randomly selected from among all of the home addresses in the nation. It was selected
using scientific sampling methods to represent other U.S. households. The sample was designed so that surveys of only a few thousand people will accurately describe the educational experiences of almost all Americans.
Q: Why should I participate? Do I have to do this?
A: Your answers are very important to the success of this study. You represent thousands of other adults like
yourself, and you cannot be replaced. This survey is voluntary. You may choose not to answer any or all
questions in this survey, but in order for the survey to be representative, it is important that you complete and
return it. Those who do not return the survey will not be represented in statistics used by policymakers and
researchers. There are no penalties should you choose not to participate in the study.
Q: Will the information I provide be kept confidential? Will my privacy be protected?
A: Your responses will be combined with those from other adults to produce statistical summaries about
education and training in the United States. Your individual data will not be reported. Your answers 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 (20 USC § 9573).
Q: How will my response help the Federal Government?
A: The U.S. Departments of Education and Labor want to understand how adults acquire and maintain the skills
they need for work. This survey is the only way these Departments can learn about the education and training that adults receive from schools, employers, and other training sponsors. The survey will allow policymakers and researchers to better understand the demand for education and training programs, and can help
direct national policy in these areas. Your responses will be combined with those from other households to
inform educators, policy makers, and schools about how adults in the U.S. learn the skills needed for work.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics, within the U.S. Department of Education, is authorized
to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this study on behalf of the
U.S. Department of Education. This study has been approved by the Office of Management and Budget,
the office that reviews all federally sponsored surveys.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The average time required to complete this survey is estimated to average 10
minutes per response, including the time to review instructions, gather the data needed, and complete and
review the survey. If you have any comments concerning the accuracy of the time estimate, suggestions
for improving the survey, or any comments or concerns regarding the status of your individual submission
of this survey, please write to: Lisa Hudson, National Center for Education Statistics, National Household
Education Surveys (NHES), 1990 K Street NW, Washington, DC 20006-5650. You may send email to
[email protected].
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to [email protected] or you may call
the Census Bureau toll-free at 1-888-840-8353
16
C.2 Training for Work Survey (TWS)
OMB No. 1850-0803: Approval Expires 09/30/2016
Adult Training and Education Survey
Part of the 2015 National Household Education Survey
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
This page left blank intentionally.
2
Instructions
In response to the survey you answered earlier, we recorded that the
person listed below is between the ages of 16 to 65, is not in high school,
and lives in this household. If this information is not correct, please call us
at the toll-free number below so we can be sure you received the correct
survey.
These questions should be filled out by:
No one else in the household should fill out the survey.
You might be asked to skip questions that do not apply to you. Follow the
arrows to answer the questions that apply to you. Please see the example
below:
No
Yes
GO TO question 12
To answer a question, simply mark the box [X] that best represents your
answer.
Use a black or blue pen, if available, to complete this survey.
Please return the completed survey using the postage-paid envelope
provided.
If you have any questions about this survey, please call us at our toll-free
number: 1-888-840-8353.
We are authorized to collect this information by U.S. Code, Title 20, Section 9543. You do not have to provide the
information requested. However, the information you provide will help the Department of Education’s ongoing efforts to
learn more about the educational experiences of adults. There are no penalties should you choose not to participate in
this study. Your answers 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 (U.S. Code, Title 20, Section 9573). Your responses will be
combined with those from other participants to produce summary statistics and reports.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information
unless it displays a valid OMB control number. The valid OMB control number for this voluntary survey is 1850-0803.
The time required to complete this survey is estimated to average 10 minutes per response, including the time to
review instructions, gather the data needed, and complete and review the survey. If you have any comments
concerning the accuracy of the time estimate, suggestions for improving this survey, or any comments or concerns
regarding the status of your individual submission of this survey, please write to: Lisa Hudson, National Center for
Education Statistics, National Household Education Surveys (NHES), 1990 K Street, NW, Washington, DC 20006. You
may send email to [email protected].
3
2. What was the major or field of study for your
highest degree or level of education? (Mark one.)
Level of Education
If there was more than one, please choose the one
you consider most important.
1. What is the highest degree or level of school you
have completed? (Mark one.)
Elementary or high school,
but no high school diploma
or GED®
General studies, no major, undeclared major
Accounting, finance, insurance, real estate
High school diploma
Administrative support
GED® or alternative high school
credential
Some college credit but less than
one year of college credit
Arts, music, design
Audio, broadcasting, multimedia, or graphics
technologies
Business management, marketing
Communications, journalism
1 or more years of college credit,
no degree
Associate’s degree (for example, AA, AS)
Computer science, information technology
Bachelor’s degree (for example, BA, BS)
Master’s degree (for example, MA, MS,
MEng, MEd, MSW, MBA)
Construction, repair, manufacturing,
transportation
Education
Professional degree beyond a bachelor’s
degree (for example, MD, DDS, DVM, LLB, JD)
Engineering, architecture
Doctorate degree (for example, PhD, EdD)
English language, literature
Family or consumer science
Healthcare, nursing, medicine
Law enforcement, security, firefighting
Law, legal studies
Liberal arts
Political science, economics, history, other
social sciences
Psychology
Religious vocations, theology
Sciences (biological or physical), mathematics
Social or human services, public
administration
Other (specify)
4
Certifications and Licenses
3. Do you have a currently active professional
certification or a state or industry license? Do not
include business licenses, such as a liquor license or
vending license.
A professional certification or license shows you are
qualified to perform a specific job and includes things
like Licensed Realtor, Certified Medical Assistant,
Certified Teacher, or an IT certification.
No
Yes
GO TO question 5
4. If yes, how many certifications and licenses do you
have?
If you had to get a certification in order to get a
license, count each certification and license
separately.
Number of certifications and licenses
CONTINUE on the next page.
5
7. About how many hours of instruction did you
complete in order to earn your last post-secondary
certificate? (Mark one.)
Certificates
5. People sometimes earn certificates for completing
an education or training program. A certificate is
different from a certification or license. Do NOT
include certifications/licenses here; include them
in the previous section only. Have you ever earned
any of the following types of certificates?
a. A certificate for completing a training program
from an employer, employment agency, union,
software or equipment manufacturer, or other
training provider, but NOT from a school.
No
Yes
b. A certificate for completing a vocational
program at a high school.
No
Yes
c. A high school equivalency certificate, such as a
GED®.
No
Yes
d. A certificate—rather than a degree—for
completing a program at a community or technical college, or other school after high school.
Do not include teaching certificates or college
degrees.
No
Yes
GO TO question 8
6. If yes, in the rest of this section we will refer to the
certificates described in question 5d as “postsecondary certificates.” Where did you get your
last post-secondary certificate? (Mark one.)
A community college
A vocational, technical, trade, or business
school
Another college or university
Someplace else
Specify:______________
If you do NOT have a post-secondary certificate, go
to question 8.
6
480 or more hours (12 or more full-time
weeks)
160 to 479 hours (4 full-time weeks to
less than 12 full-time weeks)
40-159 hours (1 full-time week to less
than 4 full-time weeks)
Less than 40 hours (less than 1 full-time
week)
11. During your last work experience program, did you
do any of the following? (Mark ONE box in each row
below.)
No
Yes
▼
▼
a. Took classes from a college,
technical school, or trade
school
Work Experience Programs
8. People sometimes prepare to enter a trade or
profession through a program that combines work
experience with education or formal training. Have
you ever COMPLETED one of these types of work
experience programs—an internship, student
teaching, co-op, practicum, clerkship, externship,
residency, clinical experience, or apprenticeship?
No
Yes
b. Took classes or training
from a company,
association, union, or
private instructor
GO TO question 18
c. Studied on my own using
textbooks or on-line
resources
If you did NOT complete any of the types of
work experience programs listed above, go to
question 18. If you DID complete a program, answer the rest of this section about the last work
experience program you completed.
d. Got instruction from a
mentor or coworker at my
worksite
e. Got evaluated by a mentor
or supervisor
9. If yes, how long was your last work experience program? (Mark one.)
Less than 3 months
3 months to less than 6 months
6 months to less than 1 year
1 year to less than 2 years
2 years to less than 3 years
3 years or more
10. What wage did you earn as part of your last work
experience program? (Mark one.)
No wage
A training wage that was lower than the
wage of a fully qualified worker
The same wage as a fully qualified worker
7
14. What type of work was your last work experience
program for? (Mark one.)
12. Did you take your last work experience program
as part of a school’s education or training
program? (Mark one.)
No
Yes, as part of a high school program
Yes, as part of a post-secondary certificate
program from a community college,
technical college, or other school after
high school
Yes, as part of an associate’s degree
program
Yes, as part of a bachelor’s degree program
Yes, as part of an advanced degree
program
Building or construction trades
Carpenter
Electrician
Plumber, pipefitter
Sheet metal worker, structural-steel
worker
Other building and construction trades
Health care, nursing, medicine
Medical doctor
Nursing
Other healthcare
Accounting, finance, insurance, real estate
Chef, cook, food preparation
Computer networking, programming
Cosmetology, barbering
Driving, piloting, or other transport
Engineering, architecture
Funeral/mortuary services
Legal practice
Machinist, tool and die maker
Management
Mechanic or repair work
Printing
Public safety or security, corrections
Social work, counseling, religious vocations
Teaching
Utility or telecommunications technician
Other (specify)
13. Do any of the following statements describe your
last work experience program? (Mark ONE box in
each row below.)
No
▼
Yes
▼
b. I got college credit for it.
a. It did or will help me earn a
certification or license.
c. I received journeyman
status at the end of an
apprenticeship.
d. I got a state or federal
apprenticeship registration
number.
8
15. Are you currently working in a job related to your
last work experience program?
No
Yes
16. In your current job, how often do you use the
skills or knowledge that you learned during your
last work experience program?
If you are not employed, please answer “Never or
almost never”.
Never or almost never
Sometimes
All or most of the time
17. How useful was your last work experience program for each of the following?
a. Getting a job (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
b. Increasing your pay (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
c. Improving your work skills (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
9
20. If one or more, did you take these classes as part of
a degree program, or to transfer to a degree
program?
College and Other Classes
18. Since leaving high school, have you taken any of the
following types of classes?
a. Classes to learn English as a second language,
sometimes called ESL classes.
Yes, as part of a degree program
Yes, to transfer to a degree program
No
Yes
Don’t know
None
One
Two
Three or more
GO TO question 27
Go to question 27 if you do not know how many college
classes you took, or if you did not take any in the last 12
months.
No
Yes
If you took more than one non-credit class during the
same time period, please answer the following questions for the class you took earlier in the week or if on
the same day, earlier in the day.
19. How many college classes have you taken in the
past 12 months, including for-credit and non-credit
classes?
c. Classes to earn a high school equivalency (such
as the GED®).
No
21. Among all the college classes you have taken in the
past 12 months, how many were not for college
credit (that is, non-credit)?
No
Yes
b. Literacy classes to help improve my reading. Do
not include college classes.
GO TO question 27
None
One
Two
Three or more
The rest of this section asks about the last non-credit
class you took.
22. What was the primary subject or field of study for
your last non-credit class?
CONTINUE with question 20.
10
25. Was your last non-credit class required by your
employer?
23. Did you take your last non-credit class for any of
the following reasons? (Mark ONE box in each
row below.)
No
Yes
▼
▼
a. To prepare for or to
consider further education
If you were self-employed or not employed when
you took the class, answer “does not apply.”
b. For personal interest
c. To earn or renew a
professional certification
or license
26. Did your employer pay for your last non-credit
class? Include reimbursements from your
employer. (Mark one.)
If you were self-employed or not employed when
you took the class, answer “does not apply.”
d. For my current job
e. For a future job
24. How useful was your last non-credit class for each
of the following?
a. Increasing your pay (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
b. Keeping you marketable to employers or
clients (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
c. Improving your work skills (Mark one.)
Not useful
Somewhat useful
Very useful
Too soon to tell
No
Yes
Does not apply
11
No
Yes, partly
Yes, completely
Does not apply
Training for Work
27. People often participate in courses, training, or
other instruction for work.
These trainings can include classes, seminars, workshops, or on-line instruction. They can be taken at the
workplace or somewhere else, and can include topics
such as:
Job safety, security, sexual harassment,
ethics, or other regulations,
Equipment use,
Communication, sensitivity, or team-building,
Computer or technical skills,
Management skills, and
Other job skills.
Have you completed any work-related training in
the past 12 months?
No
Yes
GO TO question 31
28. If yes, how many work-related trainings have you
completed in the past 12 months?
Count multiple sessions of the same training as one
training.
Number of trainings
If none, go to question 31. If one or more,
continue on page 14.
12
This page left blank intentionally.
13
29. Answer questions 29a – 29f in the following grid for each work-related training you have completed in the past
12 months.
If you had more than three, answer for the last three you had.
Training
Training
Training
#1
#2
#3
29a. What was the topic or title of
this training?
29b. Using Table A on the next
page, which category best fits
this training?
Number from
Table A
29c. In total, how many hours did
this training take? Round to
the nearest hour. Count less
than 1 hour as 1 hour.
29d. Was this training for your
current job? (Mark one.)
Number from
Table A
Hours
If you are not employed,
answer “No”.
29e. Did you take this training to
earn or renew a professional
certification or license?
29f. How useful was this training
for improving your work
skills? (Mark one.)
No
Yes, and it was
required
Yes, but it was not
required
Hours
No
Yes
Not useful
Somewhat useful
Very useful
Too soon to tell
14
Number from
Table A
Hours
No
Yes, and it was
required
Yes, but it was not
required
No
Yes
Not useful
Somewhat useful
Very useful
Too soon to tell
No
Yes, and it was
required
Yes, but it was not
required
No
Yes
Not useful
Somewhat useful
Very useful
Too soon to tell
TABLE A. TRAINING CATEGORIES FOR QUESTION 29b
1 Compliance training: Provides information on
company, professional, or government policies
and regulations concerning legal and ethical
issues.
4 Supervisory/management training: Includes
training in supervising employees and in
implementing employment practices,
regulations, and policies related to personnel or
budget management.
2 Safety training: Provides information on
workplace safety, including safety procedures
and processes.
5 Job skills training: Includes all other training to
develop the professional or technical skills
needed to do your work, such as sales and
customer relations training, use of computer
applications, and other skills that you use on
your job.
3 Communication or team training: Includes
training to improve communication in the
workplace or how to work in teams or groups.
15
30. How much do each of the following factors
motivate you to take work-related training?
a. Your employer’s requirements. (Mark one.)
Not at all
Somewhat
A great deal
b. Certification or licensing requirements.
(Mark one.)
Not at all
Somewhat
A great deal
c. Your desire to get a job. (Mark one.)
Not at all
Somewhat
A great deal
d. Your desire to move up in your career. (Mark
one.)
Not at all
Somewhat
A great deal
e. Your desire to increase your pay. (Mark one.)
Not at all
Somewhat
A great deal
CONTINUE on the next page
16
37. Last week, were you on layoff from a job?
Employment
31. Last week, were you employed for pay at a job or
business?
38. During the last 4 weeks, have you been actively
looking for work?
If you were temporarily absent from a job or
business (on vacation, temporarily ill, on
maternity leave, etc.), answer “Yes”.
No
Yes
No
Yes
GO TO question 40
39. If no, do you intend to look for work within the
next 5 years?
GO TO question 37
32. If yes, for the job or business you were in last
week, were you a member of a labor union or of
an employee association similar to a union (for
example, AFL-CIO, Change to Win Federation,
NEA)?
No
Yes
No
Yes
Don’t know
40. When did you last work, even for a few days?
(Mark one.)
No
Yes
33. Last week, how many jobs did you have?
Never worked
for pay
Over 12 months
ago
Within the past
12 months
GO TO question
55
GO TO question
43
Number of jobs
41. During the past 12 months (52 weeks), how many
weeks did you work, including paid vacation, paid
sick leave, and military service? (Mark one.)
34. Last week, did you work at a full-time job (a job
where you work 35 hours or more per week)?
No
Yes
35. Last week, did you work at a part-time job (a job
where you work fewer than 35 hours per week)?
No
Yes
42. During the past 12 months, in the weeks you
worked, how many hours did you usually work
each WEEK?
GO TO question 41
36. If yes, would you have preferred to work at a fulltime job?
No
Yes
50 to 52 weeks
48 to 49 weeks
40 to 47 weeks
27 to 39 weeks
14 to 26 weeks
13 weeks or less
Usual hours worked each WEEK
GO TO question 41
17
43. In your current or last job, which one of the
following were you? (Mark one.)
46. What kind of work were you doing?
(For example: registered nurse, personnel manager,
supervisor of order department, secretary,
accountant)
If you had more than one job, describe the one at
which you worked the most hours. If you had no job
or business last week, give information for your last
job or business.
An employee of a private (for-profit or not-forprofit) company or business, or of an individual,
for wages, salary, or commission
A local (city, county, etc.), state, or federal
government employee
Self-employed in own business, professional
practice, or farm
Working without pay in family business or farm
47. What were your most important activities or
duties?
(For example: patient care, directing hiring policies,
supervising order clerks, typing and filing,
reconciling financial records)
44. For whom did you work?
If now on active duty in the Armed Forces, mark
(X) this box and print the branch of the Armed
Forces below. All others, enter name of
company, business, or other employer below.
48. Did you have a license that was required by a
federal, state, or local government agency to do
this job?
Name of company, business, or other employer:
No
Yes
49. Which category best fits your earnings from
wages, salary, commissions, bonuses or tips, from
your current or last job over the past 12 months?
(Mark one.)
45. What kind of business or industry was this?
(For example: hospital, newspaper publishing,
mail order house, auto engine manufacturing,
bank)
Report amount before deductions for taxes,
bonds, dues, or other items.
18
$0 to $10,000
$10,001 to $20,000
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
$60,001 to $75,000
$75,001 to $150,000
$150,001 or more
50. What kind of position did you hold? (Mark one.)
Permanent
Temporary
Background
GO TO question
52
55. Have you ever served on active duty in the U.S.
Armed Forces, Reserves, or National Guard?
(Mark one.)
51. Would you have preferred to work at a
permanent job?
No
Yes
52. How many people worked for your employer?
Count employees at all locations. (Mark one.)
If you were self-employed, how many people
worked for you, including yourself?
No, never served
in the military
Yes, but only on active duty
for training in the Reserve or
National Guard
Yes, on active duty now or in past
56. Have you served on active duty since September
2001?
1—49 people
50—499 people
500—999 people
1,000 or more people
Not at all supportive
Somewhat supportive
Very supportive
Not applicable
54. When you started your current or last job, did it
have a clear training path laid out, or did you need
to figure out on your own what training you needed? (Mark one.)
Male
Female
58. What is your current marital status? (Mark one.)
No
Yes
57. Are you male or female?
53. How supportive was your employer of your
training needs? (Mark one.)
GO TO
question 57
Now Married
Widowed
Divorced
Separated
Never married
GO TO question 61
59. Are you currently living with a boyfriend/girlfriend
or partner?
A clear training path was laid out
Some parts of the training path were
clear
I needed to figure it out on my own
There was no training path
No
Yes
60. Are you currently in a registered domestic
partnership or civil union?
19
No
Yes
61. Do you speak a language other than English at
home?
No
Yes
GO TO question 63
62. How well do you speak English? (Mark one.)
Very well
Well
Not well
Not at all
63. How old are you?
years old
64. Are you of Hispanic or Latino origin?
No
Yes
65. What is your race? Choose one or more.
White
Black or African American
Asian
American Indian or Alaska Native
Native Hawaiian or other Pacific Islander
Thank You.
Please return this questionnaire in the
postage-paid envelope provided. If you have
lost the envelope, mail the completed
questionnaire to:
National Household Education Survey
[RETURN ADDRESS HERE]
20
Commonly Asked Questions
Q: How was my household chosen?
A: Your address was randomly selected from among all of the home addresses in the nation. It was selected
using scientific sampling methods to represent other U.S. households. The sample was designed so that surveys of only a few thousand people will accurately describe the educational experiences of almost all Americans.
Q: Why should I participate? Do I have to do this?
A: Your answers are very important to the success of this study. You represent thousands of other adults like
yourself, and you cannot be replaced. This survey is voluntary. You may choose not to answer any or all
questions in this survey, but in order for the survey to be representative, it is important that you complete and
return it. Those who do not return the survey will not be represented in statistics used by policymakers and
researchers. There are no penalties should you choose not to participate in the study.
Q: Will the information I provide be kept confidential? Will my privacy be protected?
A: Yes. Your responses will be combined with those from other adults to produce statistical summaries about
education and training in the United States. Your individual data will not be reported. Your answers 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 (20 USC § 9573).
Q: How will my response help the Federal Government?
A: The U.S. Departments of Education and Labor want to understand how adults acquire and maintain the skills
they need for work. This survey is the only way these Departments can learn about the education and training that adults receive from schools, employers, and other training sponsors. The survey will allow policymakers and researchers to better understand the demand for education and training programs, and can help
direct national policy in these areas. Your responses will be combined with those from other households to
inform educators, policy makers, and schools about how adults in the U.S. learn the skills needed for work.
Q: Who is sponsoring this study?
A: The National Center for Education Statistics, within the U.S. Department of Education, is authorized
to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this study on behalf of the
U.S. Department of Education. This study has been approved by the Office of Management and Budget,
the office that reviews all federally sponsored surveys.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The average time required to complete this survey is estimated to average 10
minutes per response, including the time to review instructions, gather the data needed, and complete and
review the survey. If you have any comments concerning the accuracy of the time estimate, suggestions
for improving the survey, or any comments or concerns regarding the status of your individual submission
of this survey, please write to: Lisa Hudson, National Center for Education Statistics, National Household
Education Surveys (NHES), 1990 K Street NW, Washington, DC 20006-5650. You may send email to
[email protected].
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to [email protected] or you may call
the Census Bureau toll-free at 1-888-840-8353
21
C.3 Early Childhood Program Participation (ECPP) Survey
OMB No. 1850-0768: Approval Expires 11/30/2014
The National Household Education Survey
Our Children’s Future: A Survey of Young Children’s Care and Education
§9:52¤
24252017
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
NHES-21AC
(02/14/2011)
Instructions
◆ In response to the survey you answered earlier, we recorded that the
child/youth listed below has not yet started kindergarten. If this child is
attending public or private school or is homeschooled for kindergarten
through 12th grade or equivalent, please call us at the toll-free number
below so we can be sure you received the correct survey.
◆ These questions should be filled in by a parent or guardian who knows
about:
Please answer all the survey questions thinking about this child or youth.
◆ To answer a question, simply mark X the box that best represents your
answer.
◆ Please use a black or blue pen, if available, to complete this survey.
◆ If this questionnaire has been sent to the wrong household or the
child/youth listed above does not live here, please call to let us know.
We are authorized to collect this information by Section 9543, 20 U.S. Code. You do not have to
provide the information requested. However, the information you provide will help the Department
of Education’s ongoing efforts to learn more about the educational experiences of children and
families. There are no penalties should you choose not to participate in this study. Your answers
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 (Section 9573, 20 U.S. Code). Your responses will
be combined with those from other participants to produce summary statistics and reports.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The time required to complete this survey is estimated to average 20 minutes per response,
including the time to review instructions, gather the data needed, and complete and review the survey. If you have
any comments concerning the accuracy of the time estimate, suggestions for improving this survey, or any
comments or concerns regarding the status of your individual submission of this survey, please write to: Andrew
Zukerberg, National Center for Education Statistics, National Household Education Surveys (NHES), 1990 K Street,
NW, Washington, DC 20006. You may send email to [email protected].
NHES-21AC
2
§9:5:¤
24252025
◆ Our toll-free number is 1-888-840-8353.
▼
▼
1. Childhood Care and
Programs
4.
Thank you for your help with the
previous survey your household
completed.
How old is the relative who provides the
most care to this child?
age
5.
Answer all the survey questions
thinking about the child listed
below:
Is this care provided in your home or
another home?
Own home
▼
Other home
Both
Care Your Child Receives from
Relatives
6.
i
●
These questions ask about different
types of child care this child may now receive
on a regular basis from someone other than
his/her parents or guardians.
1.
days each week
7.
Is this child now receiving care from a
relative other than a parent or guardian
on a regular basis, for example, from
grandparents, brothers or sisters, or any
other relatives?
No
8.
GO TO question 17
9.
What language does this relative speak
most when caring for this child?
GO TO question 17
Spanish
A language other than English or Spanish
English and Spanish equally
These next questions are about the care
that this child receives from the relative
who provides the most care. How is that
relative related to this child?
§9:5B¤
English and another language equally
Mark X ONE only.
Grandmother/Grandfather
24252033
months
English
Yes
3.
How old was this child in years and
months when this particular regular care
arrangement with this relative began?
years
Are any of these care arrangements
regularly scheduled at least once a
week?
No
How many hours each week does this
child receive care from this relative?
hours each week
Yes
2.
How many days each week does this
child receive care from this relative?
Aunt/Uncle
Brother/Sister
Another relative
NHES-21AC
3
Will this relative care for this child when
the child is...
No
Yes
▼
▼
13.
a. Sick but does not have
a fever? . . . . . . . . . . . . . . . . . .
Write ’0’ if your household does not pay this
relative for care.
b. Sick and has a fever?. . . . . . . .
11.
$
Is there any charge or fee for the care
this child receives from this relative,
paid either by you or some other person
or agency?
No
How much does your household pay for
this relative to care for this child, not
counting any money that may be received
from others to help pay for care?
.00
Is that amount per...
Hour
GO TO question 15
Day
Yes
12.
Week
Month
Do any of the following people, programs,
or organizations help pay for this relative
to care for this child?
Year
Mark X ONE box for each item below.
a. A relative of this child
No
outside your household
▼
who provides money
specifically for that care,
not including general
child support . . . . . . . . . . . . . .
Every 2 weeks
Other — Specify:
Yes
▼
14.
b. Temporary Assistance for
Needy Families, or TANF . . . . .
How many children from your household
is this amount for, including this child?
This child only
c. Another social service,
welfare, or child care agency . .
2 children
d. An employer, not including
a tax-free spending account
for child care . . . . . . . . . . . . . .
3 children
e. Someone else . . . . . . . . . . . . .
5 or more children
4 children
15.
Does this child have any other care
arrangements with a relative on a regular
basis?
GO TO question 17
No
24252041
Yes
16.
How many total hours each week does
this child spend in those other care
arrangements with relatives?
hours each week
NHES-21AC
4
§9:5J¤
10.
▼
Care Your Child Receives from
Non-relatives
22.
How many hours each week does this
child receive care from this person?
i
●
hours each week
The next questions ask about any care
this child receives from someone not related
to him/her, either in your home or someone
else’s home. This includes home child care
providers or neighbors, but not day care
centers or preschools.
23.
How old was this child in years and
months when this particular regular care
arrangement with this person began?
years
17.
Is this child now receiving care in your
home or another home on a regular
basis from someone who is not related
to him/her?
No
24.
Was this care provider someone you
already knew?
No
GO TO question 35
Yes
Yes
18.
months
25.
Are any of these care arrangements
regularly scheduled at least once a
week?
Is this child’s care provider age 18 or
older?
No
Yes
No
GO TO question 35
26.
Yes
What language does this care provider
speak most when caring for this child?
English
These next questions are about the care
that this child receives from someone
who is not related to him/her who
provides the most care.
Spanish
Is this care provided in your own home
or in another home?
English and Spanish equally
A language other than English or Spanish
English and another language equally
Own home
27.
Other home
Both
20.
a. Sick but does not have
a fever? . . . . . . . . . . . . . . . . . .
Does this person who cares for this child
live in your household?
b. Sick and has a fever?. . . . . . . .
No
24252058
Yes
21.
Will this care provider care for this child
when this child is...
No
Yes
▼
▼
How many days each week does this
child receive care from this person?
days each week
NHES-21AC
5
§9:5[¤
19.
28.
29.
Would you recommend this care provider
to another parent?
31.
No
How much does your household pay for
this person to care for this child, not
counting any money that may be received
from others to help pay for care?
Yes
Write ’0’ if your household does not pay
this non-relative for care.
Is there any charge or fee for the care this
child receives from this care provider,
paid either by you or some other person
or agency?
No
$
.00
Is that amount per...
GO TO question 33
Hour
Yes
Day
30.
Do any of the following people, programs,
or organizations help pay for this person
to care for this child?
Week
Month
Mark X ONE box for each item below.
a. A relative of this child
No
outside your household
▼
who provides money
specifically for that care,
not including general
child support . . . . . . . . . . . . . .
Year
Yes
▼
Every 2 weeks
Other — Specify:
b. Temporary Assistance for
Needy Families, or TANF . . . . .
32.
c. Another social service,
welfare, or child care agency . .
How many children from your household
is this amount for, including this child?
This child only
d. An employer, not including
a tax-free spending account
for child care . . . . . . . . . . . . . .
2 children
3 children
e. Someone else . . . . . . . . . . . . .
4 children
33.
Does this child have any other homebased care arrangements on a regular
basis with someone who is not a relative?
Do not include arrangements at day care
centers or preschools.
GO TO question 35
24252066
No
Yes
34.
How many total hours each week does
this child spend in those other care
arrangements with non-relatives?
hours each week
NHES-21AC
6
§9:5c¤
5 or more children
▼
Day Care Centers and Preschool
Programs Your Child Attends
39.
Mark X ONE only.
In a church, synagogue, or other place
of worship
●
i The next questions ask about any day
care centers and early childhood programs
that this child attends. This does not include
care provided in a private home.
35.
Where is this program located?
In a public elementary or secondary
school
In a private elementary or secondary
school
Is this child now attending a day care
center, preschool, or prekindergarten
not in a private home?
At a college or university
At a community center
No
GO TO question 54
At a public library
Yes
Does this child go to a day care center,
preschool, or prekindergarten, at least
once each week?
No
Some other place – Specify:
GO TO question 54
40.
Yes
37.
No
The next questions ask about the
program where this child spends the
most time.
Yes
Is this child’s current program a day care
program, a preschool program, or a
prekindergarten program?
41.
Yes
Preschool
42.
Prekindergarten
Is this program a Head Start or Early
Head Start program?
How many days each week does this
child go to this program?
days each week
43.
i
●
Head Start and Early Head Start are
federally sponsored preschool programs
primarily for children from low-income
families.
24252074
Is this program located at your workplace
or this child’s other parent’s workplace?
No
Day care
38.
Is this program run by a church,
synagogue, or other religious group?
How many hours each week does this
child go to this program?
hours each week
44.
No
How old was this child in years and
months when he/she started going to
this particular program?
Yes
Don’t know
years
NHES-21AC
7
months
§9:5k¤
36.
In its own building, office space, or
storefront
What language does this child’s main
care provider or teacher at this program
speak most when caring for this child?
49.
Mark X ONE box for each item below.
English
a. A relative of this child
No
outside your household
▼
who provides money
specifically for that care,
not including general
child support . . . . . . . . . . . . . .
Spanish
A language other than English or Spanish
English and Spanish equally
Would you recommend this program to
another parent?
c. Another social service,
welfare, or child care agency . .
No
d. An employer, not including
a tax-free spending account
for child care . . . . . . . . . . . . . .
Yes
47.
Does this program provide any of the
following services to this child or your
family?
e. Someone else . . . . . . . . . . . . .
50.
Mark X ONE box for each item below.
No
▼
Yes
▼
How much does your household pay for
this child to go to this program, not
counting any money that you may receive
from others to help pay for care?
Write ‘0’ if your household does not pay for
this program.
a. Hearing, speech, or
vision testing . . . . . . . . . . . . . .
$
b. Physical examinations . . . . . . .
c. Dental examinations. . . . . . . . .
.00
Is that amount per...
d. Formal testing for
developmental or
learning problems . . . . . . . . . .
Hour
e. Sick child care when
this child is sick but
does not have a fever . . . . . . .
Week
Day
Month
f. Sick child care when
this child is sick and
has a fever. . . . . . . . . . . . . . . .
Year
Every 2 weeks
Is there any charge or fee for this
program, paid either by you or some
other person or agency?
24252082
48.
No
Yes
▼
b. Temporary Assistance for
Needy Families, or TANF . . . . .
English and another language equally
46.
Do any of the following people, programs,
or organizations help pay for this child to
go to this program?
Other — Specify:
GO TO question 52
Yes
NHES-21AC
8
§9:5s¤
45.
51.
2. Finding and Choosing
Care for Your Child
How many children from your household
is this amount for, including this child?
This child only
54.
2 children
Has this child ever attended a Head Start
or Early Head Start program?
3 children
●
i Head Start and Early Head Start are
federally sponsored preschool programs
primarily for children from low-income
families.
4 children
5 or more children
52.
Does this child have any other care
arrangements at a day care center or
preschool on a regular basis?
No
Yes
GO TO question 54
No
Don’t know
Yes
55.
53.
How many total hours each week does
this child spend at those day care centers
or preschools?
What is the main reason your household
wanted a care program for this child in
the past year?
Mark X ONE only.
To provide care when a parent was at
work or school
hours each week
▼
To prepare child for school
Continue with section 2.
To provide cultural or language learning
To make time for running errands or
relaxing
Some other reason
24252090
§9:5{¤
Did not have care in the past year
NHES-21AC
9
57.
Do you feel there are good choices for
child care or early childhood programs
where you live?
d. The learning activities at the
arrangement?
No
Not at all important
Yes
A little important
Don’t know
Somewhat important
Very important
How much difficulty did you have finding
the type of child care or early childhood
program you wanted for this child?
Have not tried
to find care
e. The child spending time with other
kids his/her age?
GO TO question 59
Not at all important
A little important
Did not find the child care program
you wanted
Somewhat important
A lot of difficulty
Very important
Some difficulty
f. The times during the day that this
caregiver is able to provide care?
A little difficulty
No difficulty
58.
Not at all important
How important was each of these
reasons when you chose the child care
arrangement or program where this child
spends the most time?
A little important
a. The location of the arrangement?
Very important
Somewhat important
g. The number of other children in the
child’s care group?
Not at all important
A little important
Not at all important
Somewhat important
A little important
Very important
Somewhat important
b. The cost of the arrangement?
Very important
Not at all important
h. Your city or state's Quality Rating and
Improvement System (QRIS).
A little important
A QRIS is a voluntary "star" rating system
that informs families about the quality of
early learning programs (including child
care and preschools) in their communities.
Some areas do not have a QRIS.
24252108
Somewhat important
Very important
c. The reliability of the arrangement?
Did not use a QRIS
Not at all important
Not at all important
A little important
A little important
Somewhat important
Somewhat important
Very important
Very important
NHES-21AC
10
§9:6)¤
56.
3. Family Activities
c. Sang songs with this child?
Not at all
1 or 2 times
i
●
The next questions ask about this child’s
activities with family members in the past
week or month.
59.
3 or more times
d. Worked on arts and crafts with this
child?
About how many books does this child
have of his/her own, including those
shared with brothers or sisters?
Not at all
1 or 2 times
number of books
60.
3 or more times
How many times have you or someone in
your family read to this child in the past
week?
Not at all
63.
In the past month, have you or someone
in your family visited a library with this
child?
GO TO question 62
No
Yes
times
61.
64.
About how many minutes on each of
those times did you or someone in your
family read to this child?
In the past month, have you or someone
in your family visited a bookstore with
this child?
No
minutes
62.
Yes
In the past week, how many times has
anyone in your family done the following
things with this child?
65.
a. Told this child a story? (Do not include
reading to this child.)
In the past week, how many days has
your family eaten the evening meal
together?
Write ‘0’ if none.
Not at all
days
▼
1 or 2 times
3 or more times
Continue with section 4 on the
next page.
§9:61¤
b. Taught this child letters, words, or
numbers?
Not at all
24252116
1 or 2 times
3 or more times
NHES-21AC
11
4. Things Your Child May
be Learning
70. Can this child write his/her first name,
even if some of the letters are
backwards?
No
●
i These next questions ask about things
that different children do at different ages.
These things may or may not be true for this
child.
71. Does this child ever read or pretend to
read storybooks on his/her own?
No
Is this child under 2 years old or is
he/she 2 years old or older?
Under 2 years
Yes
GO TO question 74
72.
2 years or older
67.
GO TO question 74
Can this child identify the colors red,
yellow, blue, and green by name?
Does this child actually read the words
written in the book, or does he/she look
at the book and pretend to read?
Pretends to read
Actually reads the
written words
No
Yes, some of them
Does both
Yes, all of them
73.
68.
Can this child recognize the letters of
the alphabet?
No
69.
{
66.
Yes
GO TO question 74
When this child pretends to read a book,
does it sound like a connected story, or
does he/she tell what is in each picture
without much connection between
them?
Yes, some of them
Sounds like connected story
Yes, most of them
Tells what’s in each picture
Yes, all of them
Does both
Does neither
How high can this child count?
▼
This child cannot count
Up to 5
Continue with section 5, question 74
on the next page.
§9:69¤
Up to 10
Up to 20
24252124
Up to 50
Up to 100 or more
NHES-21AC
12
5. This Child’s Health
74.
76.
In general, how would you describe this
child’s health?
No
Excellent
Yes
Very good
Child is age 3 or older
Good
77.
Fair
Poor
75.
(If child is under 3 years old) Has a health,
education, or early intervention
professional told you this child is “at-risk”
for a substantial developmental delay?
Did you mark yes to any condition in
question 75 or question 76?
No
Has a health, education, or early
intervention professional told you
that this child has any of the following
conditions?
Yes
78.
Mark X ONE box for each item below.
No
▼
GO TO question 85
Is this child receiving services for his/her
condition?
No
Yes
▼
GO TO question 83
Yes
a. A specific learning disability. . .
79.
b. An intellectual disability
(mental retardation) . . . . . . . . .
Are these services provided by any of
the following sources?
Mark X ONE box for each item below.
c. A speech or language
impairment . . . . . . . . . . . . . . .
No
▼
d. A serious emotional
disturbance . . . . . . . . . . . . . . .
Yes
▼
a. Your local school district . . . . .
e. Deafness or another hearing
impairment . . . . . . . . . . . . . . .
b. A state or local health or
social service agency . . . . . . . .
f. Blindness or another visual
impairment not corrected
with glasses. . . . . . . . . . . . . . .
c. A doctor, clinic, or other
health care provider . . . . . . . . .
g. An orthopedic impairment. . . .
h. Autism. . . . . . . . . . . . . . . . . . .
§9:6A¤
24252132
i. Pervasive Developmental
Disorder (PDD) . . . . . . . . . . . . .
j. Attention Deficit Disorder,
ADD or ADHD . . . . . . . . . . . . .
k. A developmental delay. . . . . . .
l. Traumatic brain injury . . . . . . .
m. Another health impairment
lasting 6 months or more. . . . .
NHES-21AC
13
80.
c. The service provider’s or school’s
ability to accommodate this child’s
special needs?
Are any of these services provided
through an Individualized Family
Service Plan (IFSP) or an Individualized
Education Program (IEP)?
Very satisfied
GO TO question 83
No
Somewhat satisfied
Yes
Somewhat dissatisfied
81.
Did any adult in your household work
with the service provider or school to
develop or change this child’s IFSP or
IEP?
Very dissatisfied
Does not apply
No
d. The service provider’s or school’s
commitment to help this child learn?
Yes
82.
Very satisfied
Since September, how satisfied or
dissatisfied have you been with the
following aspects of this child’s IFSP
or IEP?
Somewhat satisfied
Somewhat dissatisfied
a. The service provider’s or school’s
communication with your family?
Very dissatisfied
Very satisfied
Does not apply
Somewhat satisfied
83.
Somewhat dissatisfied
Is this child currently enrolled in any
special education classes or services?
No
Very dissatisfied
Yes
Does not apply
84.
b. The child’s special needs teacher or
therapist?
Does this child’s condition interfere with
his/her ability to do any of the following
things?
Mark X ONE box for each item below.
Very satisfied
Somewhat satisfied
24252140
Very dissatisfied
a. Learn . . . . . . . . . . . . . . . . . . . .
Does not apply
b. Participate in play with
other children . . . . . . . . . . . . . .
Yes
▼
c. Go on outings . . . . . . . . . . . . .
▼
d. Make friends . . . . . . . . . . . . . .
NHES-21AC
14
Continue with section 6, question 85,
on the next page.
§9:6I¤
No
▼
Somewhat dissatisfied
6. Child’s Background
In what month and year was this child
born?
Do not include vacation properties.
/
month
86.
Since September, has this child usually
lived at this address or another address
(for example, because of a joint custody
arrangement)?
Child usually lived at this address
year
Child usually lived at another address
Where was this child born?
Child lived at at this address and another
address for an equal amount of time
One of the 50 United States or the
District of Columbia
91.
GO TO question 88
What language does this child speak
most at home?
Mark X ONE only.
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Child has not
started to speak
English
Another country
87.
Spanish
How old was this child when he/she first
moved to the 50 United States or the
District of Columbia?
{
85.
90.
GO TO section 7
A language other than English or Spanish
English and Spanish equally
92.
English and another language equally
age
88.
Is this child currently enrolled in
English as a second language, bilingual
education, or an English immersion
program?
Is this child of Spanish, Hispanic, or
Latino origin?
No
No
Yes
89a. What is this child’s race? You may mark
one or more races.
▼
Yes
American Indian or Alaska Native
Continue with section 7 on the
next page.
Asian
§9:6Z¤
Black or African American
Native Hawaiian or other Pacific Islander
24252157
White
89b. What is this child’s sex?
Male
Female
NHES-21AC
15
7. Child’s Family
98. What was the first language this parent
or guardian learned to speak?
Mark X ONE only.
PARENT 1 LIVING IN HOUSEHOLD
Answer questions 93 to 109 about yourself if you are
the child’s parent or guardian.
English
GO TO question
100
If you are not the child’s parent or guardian, answer
questions 93 to 109 about one of this child’s parents
or guardians living in the household.
A language other than English or Spanish
93.
English and Spanish equally
Spanish
Is this parent or guardian the child’s...
Biological parent
English and another language equally
Adoptive parent
99. What language does this person speak
most at home now?
Stepparent
Mark X ONE only.
Foster parent
English
Grandparent
Spanish
Other guardian
A language other than English or Spanish
94.
Is this person male or female?
English and Spanish equally
Male
English and another language equally
Female
100. Where was this parent or guardian born?
95. What is this person’s current marital
One of the 50 United States or the
District of Columbia
status?
Mark X ONE only.
GO TO question
GO TO question 98
102
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Widowed
Divorced
Another country
Separated
101. How old was this person when he or she
Never married
first moved to the 50 United States or
the District of Columbia?
96. Is this person currently living with a
24252165
boyfriend/girlfriend or partner in this
household?
age
No
102. Is this person of Spanish, Hispanic, or
Latino origin?
Yes
No
97. Is this person currently in a registered
domestic partnership or civil union?
Yes
No
Yes
NHES-21AC
16
§9:6b¤
Now married
106. Which of the following best describes this
103. What is this person’s race? You may
person’s employment status?
mark one or more races.
Mark X ONE only.
American Indian or Alaska Native
Asian
Employed for pay or income
Black or African American
Self-employed
Native Hawaiian or other Pacific Islander
Unemployed or
out of work
White
Full-time student
Stay at home
parent
school that this parent or guardian
completed?
Retired
Mark X ONE only.
Disabled or
unable to work
8th grade or less
{
104. What is the highest grade or level of
GO TO question
108
GO TO question
109
107. (If employed or self-employed) About how
High school, but no diploma
many hours per week does he or she
usually work for pay or income, counting
all jobs?
High school diploma or equivalent (GED)
Vocational diploma after high school
GO TO question
109
Some college, but no degree
hours
108. (If unemployed or out of work) Has this
Associate’s degree (AA, AS)
parent or guardian been actively looking
for work in the past 4 weeks?
Bachelor’s degree (BA, BS)
Some graduate or professional
education, but no degree
No
Master’s degree (MA, MS)
Yes
109. In the past 12 months, how many
Doctorate degree (PhD, EdD)
months (if any) has this person worked
for pay or income?
Professional degree beyond
bachelor’s degree (MD, DDS, JD, LLB)
105. Is he or she currently attending or
months
enrolled in a school, college, university,
or adult learning center, or receiving
vocational education or job training?
No
age
Yes
24252173
111. How old was this person when he or she
first became a parent to any child?
age
Don’t know
NHES-21AC
17
§9:6j¤
110. How old is this person?
118. What was the first language this parent
PARENT 2 LIVING IN HOUSEHOLD
or guardian learned to speak?
Answer questions 110 to 127 about a second parent
or guardian living in the household.
Mark X ONE only.
112. Is there a second parent or guardian
English
living in this household?
GO TO question
132
120
Spanish
A language other than English or Spanish
Yes
English and Spanish equally
113. Is this person the child’s...
English and another language equally
Biological parent
119. What language does this person speak
most at home now?
Adoptive parent
Mark X ONE only.
Stepparent
Foster parent
English
Grandparent
Spanish
Other guardian
A language other than English or Spanish
English and Spanish equally
114. Is this person male or female?
English and another language equally
Male
120. Where was this parent or guardian born?
Female
115. What is this person’s current marital
One of the 50 United States or the
District of Columbia
status?
Mark X ONE only.
Now married
GO TO question
GO TO question 118
122
Widowed
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Divorced
Another country
121. How old was this person when he or she
Separated
first moved to the 50 United States or
the District of Columbia?
Never married
116. Is this person currently living with a
24252181
boyfriend/girlfriend or partner in this
household?
age
122. Is this person of Spanish, Hispanic, or
No
Latino origin?
Yes
No
117. Is this person currently in a registered
Yes
domestic partnership or civil union?
No
Yes
NHES-21AC
18
§9:6r¤
No
GO TO question
126. Which of the following best describes this
123. What is this person’s race? You may
person’s employment status?
mark one or more races.
Mark X ONE only.
American Indian or Alaska Native
Asian
Employed for pay or income
Black or African American
Self-employed
Native Hawaiian or other Pacific Islander
Unemployed or
out of work
White
Full-time student
Stay at home
parent
school that this parent or guardian
completed?
Retired
Mark X ONE only.
Disabled or
unable to work
8th grade or less
{
124. What is the highest grade or level of
GO TO question
128
GO TO question
129
127. (If employed or self-employed) About how
High school, but no diploma
many hours per week does he or she
usually work for pay or income, counting
all jobs?
High school diploma or equivalent (GED)
Vocational diploma after high school
GO TO question
129
Some college, but no degree
hours
128. (If unemployed or out of work) Has this
Associate’s degree (AA, AS)
parent or guardian been actively looking
for work in the past 4 weeks?
Bachelor’s degree (BA, BS)
Some graduate or professional
education, but no degree
No
Master’s degree (MA, MS)
Yes
129. In the past 12 months, how many
Doctorate degree (PhD, EdD)
months (if any) has this person worked
for pay or income?
Professional degree beyond
bachelor’s degree (MD, DDS, JD, LLB)
125. Is he or she currently attending or
months
enrolled in a school, college, university,
or adult learning center, or receiving
vocational education or job training?
No
age
Yes
24252199
131. How old was this person when he or she
first became a parent to any child?
age
Don’t know
NHES-21AC
19
§9:6ƒ¤
130. How old is this person?
8. Your Household
134. How are you related to this child?
Mark X ONE only.
132. Including yourself, how many total
Mother (birth, adoptive, step, or foster)
people live in this household?
Father (birth, adoptive, step, or foster)
people
Aunt
133. Other than the parents or guardians
already reported, how many of the
following people live in the household
with this child?
Example: Brother(s)
2
This child’s...
Write ’0’ if none.
Number
Uncle
Grandmother
Grandfather
Parent’s girlfriend/boyfriend/partner
Other relationship – Specify:
Brother(s) . . . . . . . . . . . . .
135. Which language(s) are spoken at home
Sister(s) . . . . . . . . . . . . . .
by the adults in this household?
Mark X all that apply.
Aunt(s) . . . . . . . . . . . . . . .
English
Uncle(s) . . . . . . . . . . . . . .
Spanish or Spanish Creole
French (including Patois, Creole, Cajun)
Grandmother(s) . . . . . . . .
Chinese
Grandfather(s). . . . . . . . . .
Other languages – Specify:
Cousin(s) . . . . . . . . . . . . .
▼
Parent’s girlfriend/
boyfriend/partner . . . . . . .
Continue with question 136 on the
next page.
Other relative(s) . . . . . . . .
24252207
§9:7(¤
Other non-relative(s). . . . .
NHES-21AC
20
138. How many years have you lived at this
136. In the past 12 months, did your family
address?
ever receive benefits from any of the
following programs?
Write ’0’ if less than 1 year.
Mark X ONE box for each item below.
No
▼
Yes
▼
years at this address
139. Is this house...
a. Temporary Assistance for
Needy Families, or TANF . . . . .
Mark X ONE only.
b. Your state welfare or
family assistance program. . . .
Owned or being bought by someone
in this household,
c. Women, Infants, and
Children, or WIC . . . . . . . . . . . .
Rented by someone in this household, or
d. Food Stamps . . . . . . . . . . . . . .
Occupied by some other arrangement?
e. Medicaid . . . . . . . . . . . . . . . . .
140. Do you have access to the Internet at
f. Child Health Insurance
Program (CHIP) . . . . . . . . . . . . .
this address?
No
g. Section 8 housing assistance . .
Yes
137. Which category best fits the total
141. Is there at least one telephone inside this
income of all persons in your household
over the past 12 months?
home that is currently working and not a
cell phone?
Include your own income.
No
Include money from jobs or other earnings,
pensions, interest, rent, Social Security
payments, and so on.
Yes
142. Do you have a working cell phone?
$0 to $10,000
$10,001 to $20,000
No
$20,001 to $30,000
Yes
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
§9:70¤
$60,001 to $75,000
24252215
$75,001 to $100,000
$100,001 to $150,000
$150,001 or more
NHES-21AC
21
Thank you.
Please return this questionnaire in the postage-paid envelope provided.
If you have lost the envelope, mail the completed questionnaire to:
24252223
§9:78¤
U.S. Census Bureau
ATTN: DCB 60-A (7198)
1201 E. 10th Street
Jeffersonville, IN 47132-0001
NHES-21AC
22
24252231
§9:7@¤
THIS PAGE INTENTIONALLY LEFT BLANK
NHES-21AC
23
Commonly Asked Questions
Q:
How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation.
It was selected using scientific sampling methods to represent other households in the
United States.
Q:
How did you get my child’s name and age?
A: When you returned the initial National Household Education Survey to us, we randomly
chose one child to ask additional questions about. We are interested in understanding
your child’s experiences with care and early education.
Q:
Why should I take part in this study? Do I have to do this?
A: You represent thousands of other households like yours, and you cannot be replaced.
Your answers and opinions are very important to the success of this study. You may
choose not to answer any or all questions in this survey. In order for the survey to be
representative, it is important that you complete and return this questionnaire. Those who
do not return the survey will not be represented in key statistics used by policymakers and
researchers.
Q:
How will the information I provide be used? Will my privacy be protected?
A: Your responses will be combined with those of others to produce statistical summaries
and reports. Your individual data will not be reported. Your answers 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 (Section 9573, 20 U.S. Code).
Q:
I have more than one child in my household. Will I receive additional surveys for
the other children in my household?
A: No, each household will receive a survey for only one child, even if there are multiple
children living in the household. In households with multiple children, one child was
randomly selected to be included in the study.
Q:
How will my response help the Department of Education?
A: The Department of Education wants to understand the care and early education of
children. This survey is the only way that the Department of Education can learn about
the types of care and early learning activities children receive. Your responses will be
combined with those from other households to inform educators, policymakers, schools,
and universities about changes in the condition of education in the United States. Reports
from past surveys can be found at www.nces.ed.gov/nhes.
Q: Who is sponsoring this study?
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a
collection of information unless it displays a valid OMB control number. The valid OMB control
number for this voluntary survey is 1850-0803. The average time required to complete this
survey is estimated to average 20 minutes per response, including the time to review
instructions, gather the data needed, and complete and review the survey. If you have any
comments concerning the accuracy of the time estimate, suggestions for improving the survey,
or any comments or concerns regarding the status of your individual submission of this survey,
please write to: Andrew Zukerberg, National Center for Education Statistics, National Household
Education Surveys (NHES), 1990 K Street NW, Washington, DC 20006-5650. You may send
email to [email protected].
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to [email protected] or you may call
the Census Bureau toll-free at 1-888-840-8353
NHES-21AC
24
§9:7R¤
24252249
A: The National Center for Education Statistics, within the U.S. Department of Education, is authorized
to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this study on
behalf of the U.S. Department of Education. This study has been approved by the Office of
Management and Budget, the office that reviews all federally sponsored surveys.
C.4 Parent and Family Involvement in Education Survey for Enrolled Students
OMB No. 1850-0768: Approval Expires 11/30/2014
The National Household Education Survey
A Survey about Students’ and Families’ Experience with Their Schools
§9W5,¤
24542011
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
NHES-42BC
(02/09/2012)
Instructions
◆ In response to the survey you answered earlier, we recorded that the
child/youth listed below attends school. If this child is homeschooled
instead of attending public or private school, or if this child has not yet
started kindergarten, please call us at the toll-free number below so we
can be sure you received the correct survey.
◆ These questions should be filled in by a parent or guardian who knows
about:
Please answer all the survey questions thinking about this child or youth.
◆ To answer a question, simply mark X the box that best represents your
answer.
◆ Please use a black or blue pen, if available, to complete this survey.
◆ If this questionnaire has been sent to the wrong household or the
child/youth listed above does not live here, please call to let us know.
We are authorized to collect this information by Section 9543, 20 U.S. Code. You do not have to
provide the information requested. However, the information you provide will help the Department
of Education’s ongoing efforts to learn more about the educational experiences of children and
families. There are no penalties should you choose not to participate in this study. Your answers
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 (Section 9573, 20 U.S. Code). Your responses will
be combined with those from other participants to produce summary statistics and reports.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The time required to complete this survey is estimated to average 20 minutes per response,
including the time to review instructions, gather the data needed, and complete and review the survey. If you have
any comments concerning the accuracy of the time estimate, suggestions for improving this survey, or any
comments or concerns regarding the status of your individual submission of this survey, please write to: Andrew
Zukerberg, National Center for Education Statistics, National Household Education Surveys (NHES), 1990 K Street,
NW, Washington, DC 20006. You may send email to [email protected].
NHES-42BC
2
§9W5>¤
24542029
◆ Our toll-free number is 1-888-840-8353.
5.
1.
Thank you for your help with the
previous survey your household
completed.
No
Yes
Answer all the survey questions
thinking about the child listed
below:
6.
No
Yes
Child has not yet started kindergarten
Don’t know
Please STOP now and call
1-888-840-8353 so we can verify that
you received the correct survey.
7.
No
Partial-day kindergarten
Yes
8.
What type of school does this child
attend?
Private, religious
but not Catholic
Private, not religious
Public school
{
Private, Catholic
24542037
GO TO question 9
In deciding between schools, did you
seek information on the performance of
the schools you were considering, like
test scores, dropout rates, and so on?
No
Yes
GO TO question 5
9.
Is the school this child attends your first
choice, that is, the school you wanted
most for him/her to attend?
No
Yes
Is it his/her regularly assigned school?
10.
No
Yes
4.
Did you consider other schools for this
child?
Full-day kindergarten
grade (1 through 12)
3.
Does your public school district let you
choose which public school you want
this child to attend?
This may include applying to a magnet
program in a public school, transferring to
another public school within the district, or
transferring to a public school outside of the
district.
What is this child’s current grade or year
of school?
If this child is not assigned a specific grade,
mark or write the grade he/she would be in
at a school with regular grades.
2.
Did you move to your current
neighborhood so that this child could
attend his/her current school?
Since the beginning of this school year,
has this child been in the same school?
No
Yes
Is this school a charter school?
11.
No
In which month did this child start at
his/her current school this school year?
Yes
month (1 through 12)
NHES-42BC
3
§9W5F¤
▼
▼
1. Child’s Schooling
12.
17.
How much do you agree or disagree with
the following statement:
Since starting kindergarten, has this
child repeated any grades?
"This child enjoys school."
No
Strongly agree
GO TO question 19
Yes
Agree
18.
Disagree
What grade or grades did he/she repeat?
Mark X all that apply.
Strongly disagree
Please tell us about this child’s grades
during this school year. Overall, across all
subjects, what grades does this child get?
Kindergarten
First grade
Mostly A’s
Second grade
Mostly B’s
Third grade
Mostly C’s
Fourth grade
Mostly D’s or lower
Fifth grade
This child’s school does not
give these grades
14.
Sixth grade
Is he/she currently enrolled in Advanced
Seventh grade
Placement (AP) classes?
Eighth grade
No
High school
Yes
Ninth grade - freshman
Tenth grade - sophomore
Does not apply
15.
Eleventh grade - junior
Since the beginning of this school year,
how many times have any of this child’s
teachers or school staff contacted your
household about...
Write ’0’ if none.
Twelfth grade - senior
19.
Number
Mark X ONE box for each item below.
a. Behavior problems this child
is having in school . . . . . . . . . . . .
No
▼
b. Problems this child is having
with school work . . . . . . . . . . . . .
24542045
Has this child ever had the following
experiences?
Yes
▼
a. An out-of-school suspension . .
b. An in-school suspension not
counting detentions . . . . . . . . .
c. Very good behavior . . . . . . . . . . .
c. Been expelled from school. . . .
d. Very good school work. . . . . . . . .
Since the beginning of this school year,
how many days has this child been
absent from school?
▼
16.
days
NHES-42BC
4
Continue with question 20 on the
next page.
§9W5N¤
13.
Elementary through Middle school
20.
How far do you expect this child to go in
his/her education?
24.
Is there a charge or fee for that
instruction?
Mark X ONE only.
No
Complete less than a high school diploma
Yes
Graduate from high school
25. What is the main reason this child took schoolrelated courses over the internet?
Attend a vocational or technical school
after high school
Mark X ONE only.
Attend two or more years of college
Extra-credit
Earn a bachelor’s degree
Tutoring
Improve basic reading, writing, math or
science skills
School did not offer the class or subject
Earn a graduate degree or professional
degree beyond a bachelor’s
21.
How would you describe his/her work at
school?
To earn college credit
Mark X ONE only.
Due to an illness or health condition
Excellent
Above average
Other — Specify:
Average
Below average
26.
Failing
22.
Some students take school-related
courses over the Internet. Is this child
receiving any instruction this way?
No
Some parents decide to educate their children at
home rather than send them to a public or
private school. Is this child being schooled at
home instead of at school for atleast some classes
or subjects?
GO TO question 31
No
GO TO question 31
Yes
Yes
Is that instruction provided by any of the
following places?
This child is homeschooled
for all classes or subject areas.
Mark X all that apply.
This child is homeschooled for some
classes or subject areas and also
attends a public or private school.
Your local public school
A charter school
24542052
Another public school
GO TO
question 28
This child is not homeschooled. This
child attends a public or private school
for all classes or subject areas.
GO TO
A private school
question 31
A college, community college, or
university
28.
Someplace else — Specify:
How many hours each week does this child
usually go to a public or private school for
instruction? Do not include time spent in
extracurricular activities.
hours
NHES-42BC
5
§9W5U¤
23.
Which of the following statements best describes
your homeschooling arrangement for this child?
{
27.
29.
There are many different reasons that parents
choose to homeschool their children. Did your
family choose to homeschool this child because:
Mark X ONE box for each item below.
No
a. You are concerned about the school ▼
environment, such as safety, drugs,
or negative peer pressure? . . . . . . . .
Yes
▼
b. You are dissatisfied with the
academic instruction at other
schools?. . . . . . . . . . . . . . . . . . . . . .
c. You prefer to teach this child at
home so that you can provide
religious instruction? . . . . . . . . . . .
d. You prefer to teach this child at
home so that you can provide
moral instruction? . . . . . . . . . . . . . . .
e. This child has a phsyical or mental
health problem that has lasted six
months or more?. . . . . . . . . . . . . . .
f.
This child has a temporary illness
that prevents him/her from going
to school?. . . . . . . . . . . . . . . . . . . . . . .
g.
This child has other special needs
that you feel the school can't or
won't meet?. . . . . . . . . . . . . . . . . . . . .
h. You are interested in a
nontraditional approach to
children's education?. .. . . . . . . . . . .
24542052
30.
§9W5U¤
i. You have reason for homeschooling
your child? . . . . . . . . . . . . . . . . . . . . . .
Specify:
Of the reasons your family chose to homeschool
this child, which one would you say is the most
important to you?
Write the letter from question 29 for the most
important reason you chose to homeschool your child.
▼
letter from question 29.
Continue with question 31 on the
next page.
NHES-42BC
5
2. Families & School
31.
33.
a. Notes or emails specifically about this
child from his/her teachers or school
administrators?
Since the beginning of this school year,
has any adult in this child’s household
done any of the following things at this
child’s school?
No
Mark X ONE box for each item below.
a. Attended a school or class
event, such as a play, dance,
sports event, or science fair. . .
No
▼
Yes
▼
Yes
b. Newsletters, memos, emails, or
notices addressed to all parents?
No
b. Served as a volunteer in
this child’s classroom or
elsewhere in the school . . . . . .
Yes
c. Attended a general school
meeting, for example, an
open house, or a back-toschool night. . . . . . . . . . . . . . .
c. Phone calls specifically about this
child from his/her teachers or school
administrators?
No
d. Attended a meeting of the
parent-teacher organization
or association . . . . . . . . . . . . . .
Yes
34.
e. Gone to a regularly
scheduled parent-teacher
conference with this child’s
teacher. . . . . . . . . . . . . . . . . . .
How well has this child’s school been
doing the following things during this
school year?
a. Letting you know how this child is
doing in school between report cards.
f. Participated in fundraising
for the school. . . . . . . . . . . . . .
Very well
g. Served on a school
committee . . . . . . . . . . . . . . . .
Just okay
h. Met with a guidance
counselor in person . . . . . . . . .
32.
During this school year, has your family
received any of the following:
Not very well
Does not do it at all
During this school year, how many times
has any adult in the household gone to
meetings or participated in activities at
this child’s school?
b. Providing information about how to
help this child with homework.
Very well
number of times
Not very well
24542060
Does not do it at all
NHES-42BC
6
§9W5]¤
Just okay
35.
c. Providing information about why this
child is placed in particular groups or
classes.
How satisfied or dissatisfied are you
with each of the following:
a. The school this child attends this year?
Very well
Very satisfied
Just okay
Somewhat satisfied
Not very well
Somewhat dissatisfied
Does not do it at all
Very dissatisfied
d. Providing information on your
expected role at this child’s school.
b. The teachers this child has this year?
Very well
Very satisfied
Just okay
Somewhat satisfied
Not very well
Somewhat dissatisfied
Does not do it at all
Very dissatisfied
c. The academic standards of the school?
e. Providing information on how to help
this child plan for college or vocational
school.
Very satisfied
Very well
Somewhat satisfied
Just okay
Somewhat dissatisfied
Not very well
Very dissatisfied
d. The order and discipline at the school?
Does not do it at all
Very satisfied
Does not apply
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied
Very satisfied
Somewhat satisfied
24542078
Somewhat dissatisfied
Very dissatisfied
NHES-42BC
7
§9W5o¤
e. The way that school staff interacts
with parents?
3. Homework
36.
41.
How often does this child do homework
at home, at an after-school program, or
somewhere else outside of school?
Never
Rarely
Less than once a week
Sometimes
1 to 2 days a week
Always
3 to 4 days a week
42.
5 or more days a week
Child does not have
homework
37.
{
Never
How often does any adult in your
household check to see that this child’s
homework is done?
GO TO section 4,
question 43
During this school year, about how many
days in an average week does anyone in
your household help this child with
his/her homework?
Less than once a week
1 to 2 days a week
In an average week, how many hours
does this child spend on homework
outside of school?
3 to 4 days a week
5 or more days a week
number of hours per week
Never
How do you feel about the amount of
homework this child is assigned?
▼
38.
The amount is about right
Continue with section 4, question 43, on
the next page.
It’s too much
It’s too little
39.
How does this child feel about the
amount of homework he or she is
assigned?
The amount is about right
It’s too much
It’s too little
Is there a place in your home that is set
aside for this child to do homework?
§9W5w¤
40.
24542086
No
Yes
Child does not do homework at home
NHES-42BC
8
4. Family Activities
43.
45.
In the past week, has anyone in your
family done the following things with
this child?
In the past month, has anyone in your
family done the following things with
this child?
Mark X ONE box for each item below.
No
▼
Mark X ONE box for each item below.
No
▼
Yes
▼
a. Visited a library . . . . . . . . . . . .
a. Told him/her a story (Do not
include reading to this child.). .
b. Visited a bookstore . . . . . . . . .
c. Gone to a play, concert, or
other live show . . . . . . . . . . . .
b. Done activities like arts and
crafts, coloring, painting,
pasting, or using clay. . . . . . . .
d. Visited an art gallery,
museum, or historical site . . . .
c. Played board games or did
puzzles with him/her . . . . . . . .
e. Visited a zoo or aquarium . . . .
d. Worked on a project like
building, making, or fixing
something. . . . . . . . . . . . . . . . .
f. Attended an event sponsored
by a community, religious, or
ethnic group . . . . . . . . . . . . . .
e. Played sports, active games,
or exercised together . . . . . . . .
g. Attended an athletic or
sporting event outside of
school in which this child
was not a player . . . . . . . . . . .
f. Discussed with him/her how
to manage time . . . . . . . . . . . .
▼
g. Talked with him/her about
the family’s history or ethnic
heritage . . . . . . . . . . . . . . . . . .
44.
Yes
▼
In the past week, how many days has
your family eaten the evening meal
together?
Continue with section 5, question 46, on
the next page.
Write ‘0’ if none.
24542094
§9W5¡¤
days
NHES-42BC
9
5. Child’s Health
46.
48.
In general, how would you describe this
child’s health?
Did you mark yes to any condition in
question 47?
No
GO TO question 52
Yes
Excellent
49.
Very good
Is this child receiving services for his/her
condition?
Good
No
GO TO question 54
Fair
Yes
Poor
47.
50.
Has a health or education professional
told you that this child has any of the
following conditions?
Are these services provided by any of
the following sources?
Mark X ONE box for each item below.
Mark X ONE box for each item below.
No
▼
No
▼
Yes
▼
Yes
▼
a. Your local school district . . . . .
a. A specific learning disability. . .
b. A state or local health or
social service agency . . . . . . . .
b. An intellectual disability
(mental retardation) . . . . . . . . .
c. A doctor, clinic, or other
health care provider . . . . . . . . .
c. A speech or language
impairment . . . . . . . . . . . . . . .
51.
d. A serious emotional
disturbance . . . . . . . . . . . . . . .
e. Deafness or another hearing
impairment . . . . . . . . . . . . . . .
No
f. Blindness or another visual
impairment not corrected
with glasses. . . . . . . . . . . . . . .
Yes
52.
g. An orthopedic impairment. . . .
GO TO question 54
Did any adult in your household work
with the service provider or school to
develop or change this child’s IEP?
No
i. Pervasive Developmental
Disorder (PDD) . . . . . . . . . . . . .
Yes
§9W6#¤
h. Autism. . . . . . . . . . . . . . . . . . .
j. Attention Deficit Disorder,
ADD or ADHD . . . . . . . . . . . . .
24542102
Are any of these services provided
through an Individualized Education
Program (IEP)?
k. A developmental delay. . . . . . .
l. Traumatic brain injury . . . . . . .
m. Another health impairment
lasting 6 months or more. . . . .
NHES-42BC
10
53.
54.
During this school year, how satisfied or
dissatisfied have you been with the
following aspects of this child’s IEP?
Is this child currently enrolled in any
special education classes or services?
No
a. The service provider’s or school’s
communication with your family?
Yes
Very satisfied
55.
Somewhat satisfied
Does this child’s condition interfere with
his/her ability to do any of the following
things?
Somewhat dissatisfied
Mark X ONE box for each item below.
Very dissatisfied
No
▼
Does not apply
Yes
▼
a. Learn . . . . . . . . . . . . . . . . . . . .
b. The child’s special needs teacher or
therapist?
Very satisfied
b. Participate in sports, clubs,
or other organized activities. . .
Somewhat satisfied
c. Attend school on a regular
basis . . . . . . . . . . . . . . . . . . . .
Somewhat dissatisfied
d. Make friends . . . . . . . . . . . . . .
▼
Very dissatisfied
Does not apply
Continue with section 6, question 56, on the
next page.
c. The service provider’s or school’s
ability to accommodate this child’s
special needs?
Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied
§9W6+¤
Does not apply
d. The service provider’s or school’s
commitment to help this child learn?
24542110
Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied
Does not apply
NHES-42BC
11
6. Child’s Background
In what month and year was this child
born?
Do not include vacation properties.
/
month
57.
Child usually lives at this address
year
Child usually lives at another address
Where was this child born?
Child lived at at this address and another
address for an equal amount of time
One of the 50 United States or the
District of Columbia
62.
GO TO question 59
What language does this child speak
most at home?
Mark X ONE only.
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Child is not able to
speak
Another country
58.
For this school year, does this child
usually live at this address or another
address (for example, because of a joint
custody arrangement)?
English
How old was this child when he/she first
moved to the 50 United States or the
District of Columbia?
Spanish
{
56.
61.
GO TO section 7
A language other than English or Spanish
English and Spanish equally
age
59.
English and another language equally
Is this child of Spanish, Hispanic, or
Latino origin?
63.
No
Is this child currently enrolled in
English as a second language, bilingual
education, or an English immersion
program?
Yes
No
60a. What is this child’s race? You may mark
Yes
one or more races.
▼
American Indian or Alaska Native
Asian
Continue with section 7 on the
next page.
§9W6=¤
Black or African American
Native Hawaiian or other Pacific Islander
24542128
White
60b. What is this child’s sex?
Male
Female
NHES-42BC
12
69.
7. Child’s Family
What was the first language this parent
or guardian learned to speak?
Mark X ONE only.
PARENT 1 LIVING IN HOUSEHOLD
Answer questions 64 to 85 about yourself if you are
the child’s parent or guardian.
English
GO TO question 74
If you are not the child’s parent or guardian, answer
questions 64 to 85 about one of this child’s parents
or guardians living in the household.
A language other than English or Spanish
64.
English and Spanish equally
Spanish
Is this parent or guardian the child’s...
Biological parent
English and another language equally
70.
Adoptive parent
Stepparent
What language does this person speak
most at home now?
Mark X ONE only.
Foster parent
English
GO TO question 74
Grandparent
Spanish
Other guardian
65.
A language other than English or Spanish
Is this person male or female?
English and Spanish equally
Male
English and another language equally
Female
71.
66. Whatisthisperson’scurrentmarital
status?
Mark X ONE only.
Now married
How difficult is it for this person to
participate in activities at this child’s
school because he/she speaks a
language other than English?
Very difficult
GO TO question 69
Somewhat difficult
Widowed
Not at all difficult
Divorced
72. Does the school have interpreters who
Separated
speak this person’s native language for
meetings or parent-teacher conferences?
Never married
24542136
67. Is this person currently living with a
Yes
boyfriendsgirlfriend or partner in this
household
No
73.
Yes
68.
Does the school have written materials,
such as newsletters or school notices,
that are translated into this person’s
native language?
No
Is this person currently in a registered
domestic partnership or civil union?
Yes
No
Yes
NHES-42BC
13
§9W6E¤
No
74.
78.
Where was this parent or guardian born?
One of the 50 United States or the
District of Columbia
Mark X ONE only.
GO TO question 76
8th grade or less
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
High school, but no diploma
High school diploma or equivalent (GED)
Another country
75.
What is the highest grade or level of
school that this parent or guardian
completed?
Vocational diploma after high school
How old was this person when he or she
first moved to the 50 United States or
the District of Columbia?
Some college, but no degree
Associate’s degree (AA, AS)
Bachelor’s degree (BA, BS)
age
76.
77.
Some graduate or professional
education, but no degree
Is this person of Spanish, Hispanic, or
Latino origin?
Master’s degree (MA, MS)
No
Doctorate degree (PhD, EdD)
Yes
Professional degree beyond
bachelor’s degree (MD, DDS, JD, LLB)
What is this person’s race? You may
mark one or more races.
79.
American Indian or Alaska Native
Is he or she currently attending or
enrolled in a school, college, university,
or adult learning center, or receiving
vocational education or job training?
Asian
No
Black or African American
Yes
Native Hawaiian or other Pacific Islander
Continue with question 80 on the
next page.
24542144
§9W6M¤
▼
White
NHES-42BC
14
80.
PARENT 2 LIVING IN HOUSEHOLD
Which of the following best describes this
person’s employment status?
Answer questions 86 to 108 about a second parent or
guardian living in the household.
Mark X ONE only.
86. Is there a second parent or guardian
Employed for pay or income
living in this household?
Self-employed
No
Unemployed or
out of work
Stay at home
parent
Retired
Disabled or
unable to work
81.
{
Full-time student
GO TO question 82
GO TO question 109
Yes
87.
Is this person the child’s...
Biological parent
GO TO question 83
Adoptive parent
Stepparent
Foster parent
(If employed or self-employed) About how
many hours per week does he or she
usually work for pay or income, counting
all jobs?
Grandparent
Other guardian
GO TO question 83
88. Is this person male or female?
hours
Male
82. (If unemployed or out of work) Has this
Female
parent or guardian been actively looking
for work in the past 4 weeks?
89. What is this person’s current marital
status?
No
Mark X ONE only.
Yes
Now married
83. In the past 12 months, how many
months (if any) has this person worked
for pay or income?
GO TO question 92
Widowed
Divorced
Separated
months
84. How old is this person?
90.
24542151
age
85. How old was this person when he or she
Is this person currently living with a
boyfriend/girlfriend or partner in this
household?
No
first became a parent to any child?
Yes
91.
age
Don’t know
Is this person currently in a registered
domestic partnership or civil union?
No
Yes
NHES-42BC
15
§9W6T¤
Never married
92. What was the first language this parent
97. Where was this parent or guardian born?
or guardian learned to speak?
One of the 50 United States or the
District of Columbia
Mark X ONE only.
English
GO TO question 97
GO TO question 99
Spanish
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
A language other than English or Spanish
English and Spanish equally
Another country
English and another language equally
98. How old was this person when he or she
first moved to the 50 United States or
the District of Columbia?
93. What language does this person speak
most at home now?
Mark X ONE only.
English
GO TO question 97
age
99. Is this person of Spanish, Hispanic, or
Spanish
Latino origin?
A language other than English or Spanish
No
English and Spanish equally
Yes
English and another language equally
100. What is this person’s race? You may
mark one or more races.
94. How difficult is it for this person to
participate in activities at this child’s
school because he/she speaks a
language other than English?
American Indian or Alaska Native
Asian
Very difficult
Black or African American
Somewhat difficult
Native Hawaiian or other Pacific Islander
Not at all difficult
White
95. Does the school have interpreters who
▼
speak this person’s native language for
meetings or parent-teacher conferences?
§9W6f¤
No
Yes
96. Does the school have written materials,
24542169
Continue with question 101 on
the next page.
such as newsletters or school notices,
that are translated into this person’s
native language?
No
Yes
NHES-42BC
16
103. Which of the following best describes this
101. What is the highest grade or level of
person’s employment status?
school that this parent or guardian
completed?
Mark X ONE only.
Mark X ONE only.
Employed for pay or income
8th grade or less
Self-employed
High school, but no diploma
Unemployed or
out of work
Vocational diploma after high school
Full-time student
Some college, but no degree
Stay at home
parent
Associate’s degree (AA, AS)
Retired
Bachelor’s degree (BA, BS)
Disabled or
unable to work
Some graduate or professional
education, but no degree
GO TO question 105
{
High school diploma or equivalent (GED)
GO TO question 106
104. (If employed or self-employed) About how
many hours per week does he or she
usually work for pay or income, counting
all jobs?
Master’s degree (MA, MS)
Doctorate degree (PhD, EdD)
GO TO question 106
Professional degree beyond
bachelor’s degree (MD, DDS, JD, LLB)
hours
105. (If unemployed or out of work) Has this
102. Is he or she currently attending or
parent or guardian been actively looking
for work in the past 4 weeks?
enrolled in a school, college, university,
or adult learning center, or receiving
vocational education or job training?
No
No
Yes
Yes
106. In the past 12 months, how many
months (if any) has this person worked
for pay or income?
months
age
24542177
108. How old was this person when he or she
first became a parent to any child?
age
▼
Don’t know
NHES-42BC
17
Continue with section 8, question 109, on
the next page.
§9W6n¤
107. How old is this person?
8. Your Household
111. How are you related to this child?
Mark X ONE only.
109. Including yourself, how many total
Mother (birth, adoptive, step, or foster)
people live in this household?
Father (birth, adoptive, step, or foster)
people
Aunt
110. Other than the parents or guardians
already reported, how many of the
following people live in the household
with this child?
Example: Brother(s)
2
This child’s...
Write ’0’ if none.
Number
Uncle
Grandmother
Grandfather
Parent’s girlfriend/boyfriend/partner
Other relationship – Specify:
Brother(s) . . . . . . . . . . . . .
112. Which language(s) are spoken at home
Sister(s) . . . . . . . . . . . . . .
by the adults in this household?
Mark X all that apply.
Aunt(s) . . . . . . . . . . . . . . .
English
Uncle(s) . . . . . . . . . . . . . .
Spanish or Spanish Creole
French (including Patois, Creole, Cajun)
Grandmother(s) . . . . . . . .
Chinese
Grandfather(s). . . . . . . . . .
Other languages – Specify:
Cousin(s) . . . . . . . . . . . . .
▼
Parent’s girlfriend/
boyfriend/partner . . . . . . .
Other relative(s) . . . . . . . .
24542185
§9W6v¤
Other non-relative(s). . . . .
Continue with question 113 on the
next page.
NHES-42BC
18
115. How many years have you lived at this
113. In the past 12 months, did your family
address?
ever receive benefits from any of the
following programs?
Write ’0’ if less than 1 year.
Mark X ONE box for each item below.
No
▼
Yes
▼
years at this address
116. Is this house...
a. Temporary Assistance for
Needy Families, or TANF . . . . .
Mark X ONE only.
b. Your state welfare or
family assistance program. . . .
Owned or being bought by someone
in this household,
c. Women, Infants, and
Children, or WIC . . . . . . . . . . . .
Rented by someone in this household, or
Occupied by some other arrangement?
d. Food Stamps . . . . . . . . . . . . . .
117. Do you have access to the Internet at
e. Medicaid . . . . . . . . . . . . . . . . .
this address?
f. Child Health Insurance
Program (CHIP) . . . . . . . . . . . . .
No
Yes
g. Section 8 housing assistance . .
118. Is there at least one telephone inside this
114. Which category best fits the total
home that is currently working and not a
cell phone?
income of all persons in your household
over the past 12 months?
Include your own income.
No
Include money from jobs or other earnings,
pensions, interest, rent, Social Security
payments, and so on.
Yes
119. Do you have a working cell phone?
$0 to $10,000
No
$10,001 to $20,000
Yes
▼
$20,001 to $30,000
$30,001 to $40,000
Continue with question 120 on the
next page.
$40,001 to $50,000
$50,001 to $60,000
§9W6~¤
$60,001 to $75,000
24542193
$75,001 to $100,000
$100,001 to $150,000
$150,001 or more
NHES-42BC
19
120. We would like to identify this child’s school so we can include information about the school
in our study.
Using the list of schools below, mark X the box next to the school this child attends.
If this child’s school is not in this list, GO TO question 121.
Address
▼
City
▼
24542201
§9W7"¤
School Name
▼
NHES-42BC
20
If you found and marked this child’s school in the list provided in
question 120, then SKIP this question and return your survey in the
postage-paid envelope. Otherwise, continue with question 121.
!
121. To help us identify the school this child attends, write the name and address of this child’s
school in the spaces below.
S C H O O L
Please use block or capital letters, for example:
a. School name
SCHOOL NAME
b. School street address
NUMBER AND STREET ADDRESS
c. School city
CITY
d. School state
STATE
e. School zip code
ZIP
§9W74¤
Thank you.
24542219
Please return this questionnaire in the
postage-paid envelope provided.
If you have lost the envelope, mail the
completed questionnaire to:
U.S. Census Bureau
ATTN: DCB 60-A (7198)
1201 E. 10th Street
Jeffersonville, IN 47132-0001
NHES-42BC
21
24542227
§9W7<¤
THIS PAGE INTENTIONALLY LEFT BLANK
NHES-42BC
22
24542235
§9W7D¤
THIS PAGE INTENTIONALLY LEFT BLANK
NHES-42BC
23
Commonly Asked Questions
Q:
How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation.
It was selected using scientific sampling methods to represent other households in the
United States.
Q: How did you get my child’s name and grade?
A: When you returned the initial National Household Education Survey to us, we randomly
chose one child to ask additional questions about. We are interested in understanding
your child’s experiences with schooling.
Q:
Q:
Why should I take part in this study? Do I have to do this?
A: You represent thousands of other households like yours, and you cannot be replaced.
Your answers and opinions are very important to the success of this study. You may
choose not to answer any or all questions in this survey. In order for the survey to be
representative, it is important that you complete and return this questionnaire. Those who
do not return the survey will not be represented in key statistics used by policymakers and
researchers.
How will the information I provide be used? Will my privacy be protected?
A: Your responses will be combined with those of others to produce statistical summaries
and reports. Your individual data will not be reported. Your answers 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 (Section 9573, 20 U.S. Code).
Q:
I have more than one child in my household. Will I receive additional surveys for
the other children in my household?
A: No, each household will receive a survey for only one child, even if there are multiple
children living in the household. In households with multiple children, one child was
randomly selected to be included in the study.
Q:
How will my response help the Department of Education?
A: The Department of Education wants to understand the condition of education in the
United States. This survey is the only way that the Department of Education can learn
about schooling from your perspective. Your responses will be combined with those
from other households to inform educators, policymakers, schools, and universities
about changes in the condition of education in the United States. Reports from past
surveys can be found at www.nces.ed.gov/nhes.
Q: Who is sponsoring this study?
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection
of information unless it displays a valid OMB control number. The valid OMB control number for this
voluntary survey is 1850-0803. The average time required to complete this survey is estimated to
average 20 minutes per response, including the time to review instructions, gather the data needed,
and complete and review the survey. If you have any comments concerning the accuracy of the time
estimate, suggestions for improving the survey, or any comments or concerns regarding the status of
your individual submission of this survey, please write to: Andrew Zukerberg, National Center for
Education Statistics, National Household Education Surveys (NHES), 1990 K Street NW, Washington,
DC 20006-5650. You may send email to [email protected].
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to [email protected] or you may call
the Census Bureau toll-free at 1-888-840-8353
NHES-42BC
24
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24542243
A: The National Center for Education Statistics, within the U.S. Department of Education, is authorized
to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this study on behalf of
the U.S. Department of Education. This study has been approved by the Office of Management and
Budget, the office that reviews all federally sponsored surveys.
C.5 Parent and Family Involvement in Education Survey for Homeschooled Students
OMB No. 1850-0768: Approval Expires 11/30/2014
The National Household Education Survey
A Survey About Homeschooling in America
§9D50¤
24352015
Thank you for helping us with this
survey. Based on the information
we received from your household
in your last survey, we’re asking
you to complete this final step.
Conducted by
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
U.S. Census Bureau
NHES-31AC
(02/16/2012)
Instructions
◆ In response to the survey you answered earlier, we recorded that the
child/youth listed below is currently homeschooled for at least some classes.
If this child attends public or private school instead of homeschooling, or is
not homeschooled for kindergarten through 12th grade or equivalent, please
call us at the toll-free number below so we can be sure you received the
correct survey.
◆ These questions should be filled in by a parent or guardian who knows
about:
Please answer all the survey questions thinking about this child or youth.
◆ To answer a question, simply mark X the box that best represents your
answer.
◆ Please use a black or blue pen, if available, to complete this survey.
◆ If this questionnaire has been sent to the wrong household or the
child/youth listed above does not live here, please call to let us know.
We are authorized to collect this information by Section 9543, 20 U.S. Code. You do not have to
provide the information requested. However, the information you provide will help the Department
of Education’s ongoing efforts to learn more about the educational experiences of children and
families. There are no penalties should you choose not to participate in this study. Your answers
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 (Section 9573, 20 U.S. Code). Your responses will
be combined with those from other participants to produce summary statistics and reports.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The time required to complete this survey is estimated to average 20 minutes per response,
including the time to review instructions, gather the data needed, and complete and review the survey. If you have
any comments concerning the accuracy of the time estimate, suggestions for improving this survey, or any
comments or concerns regarding the status of your individual submission of this survey, please write to: Andrew
Zukerberg, National Center for Education Statistics, National Household Education Surveys (NHES), 1990 K Street,
NW, Washington, DC 20006. You may send email to [email protected].
NHES-31AC
2
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24352023
◆ Our toll-free number is 1-888-840-8353.
▼
▼
1. Child’s Homeschooling
5.
Thank you for your help with the
previous survey your household
completed.
Mark X all that apply.
Public school (K - 12)
Answer all the survey questions
thinking about the child listed
below:
Private school (K - 12)
College, community college, or university
6.
1.
What type of school(s) does this child
attend?
Who is the person that mainly provides
this child’s home instruction?
How many hours each week does this child
usually go to a school for instruction? Do
not include time spent in extracurricular
activities.
hours
Mother
Father
Grandparent
Brother/sister
Another person
Who is that?
2.
Is any of this child’s home instruction
provided by a private tutor or teacher?
No
Yes
3.
Is any of this child’s instruction provided
by a local homeschooling group or co-op?
No
Does this child attend a public or private
school or a college or university for
instruction?
24352031
4.
§9D5@¤
Yes
No
GO TO question 7
Yes
NHES-31AC
3
7.
What grade or year would this child be in
if he/she was attending school?
11.
Mark X ONE only.
Thinking about sources of curriculum or
books you use to homeschool this child,
please tell us about all the sources that
apply to you.
Since September, have you used
materials from...
Kindergarten
Mark X ONE box for each item below.
No
▼
Grade (1 through 12)
8.
These next questions ask you to estimate
the amount of time you homeschool this
child.
a. A public library?. . . . . . . . . . . .
b. A homeschooling catalog,
publisher, or individual who
specializes in homeschooling
materials? . . . . . . . . . . . . . . . .
a. How many days each week is this
child homeschooled?
days each week
c. Another educational
publisher? . . . . . . . . . . . . . . . .
b. About how many total hours each
week is he/she homeschooled?
d. A homeschooling
organization? . . . . . . . . . . . . . .
hours per week
9.
10.
Yes
▼
e. A church, synagogue, or
other religious organization? . .
Since September, has this child
participated in activities with other
children who are homeschooled?
f. Your local public school or
school district?. . . . . . . . . . . . .
No
g. A private school?. . . . . . . . . . .
Yes
h. A bookstore or other store
(including online)? . . . . . . . . . .
Which of the following statements best
describes the teaching style used to
homeschool this child?
i. Websites, excluding retailers? .
j. Other source — Specify:
..
Mark X ONE only.
We strictly follow a formal curriculum.
12.
We mostly follow a formal curriculum,
but also use informal learning (i.e. childled learning, "teaching moments").
We mostly use informal learning, but
sometimes use a formal curriculum.
In the past year, have you or another
family member taken any courses, either
online or in-person, to help you prepare
your child’s home instruction?
We always use informal learning, and
never follow a formal curriculum.
Yes, both online and in-person
24352049
Yes, online only
Yes, in-person only
NHES-31AC
4
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No
13.
Some homeschooled children take
courses over the Internet taught by
people outside the household. Is this
child receiving any instruction this way?
No
16.
Thinking about typical grade levels, for
which grades was this child schooled at
home for at least some classes or
subjects?
Mark X all that apply.
GO TO question 16
Include the current year.
Yes
Elementary through Middle School
14.
Is that instruction provided by any of the
following places?
Kindergarten (Including transitional K and
Pre-first grade)
Mark X all that apply.
First grade
Your local public school
Second grade
A charter school
Third grade
Another public school
Fourth grade
A private school
Fifth grade
A college, community college, or
university
Sixth grade
Offered by my state
Seventh grade
Someplace else — Specify:
Eighth grade
High School
15.
Ninth grade - freshman
Is there a charge or fee for that
instruction?
Tenth grade - sophomore
No
Eleventh grade - junior
Yes
24352056
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Twelfth grade - senior
NHES-31AC
5
17.
There are many different reasons that
parents choose to homeschool their
children. Did your family choose to
homeschool this child because:
18.
Write the letter from question 17 for the most
important reason you chose to homeschool
your child.
Mark X ONE box for each item below.
No
▼
Of the reasons your family chose to
homeschool this child, which one would
you say is the most important to you?
Yes
▼
a. You are concerned about the
school environment, such as
safety, drugs, or negative
peer pressure? . . . . . . . . . . . . .
letter from question 17
19.
b. You are dissatisfied with the
academic instruction at other
schools?. . . . . . . . . . . . . . . . . .
How far do you expect this child to go in
his/her education?
Mark X ONE only.
Complete less than a high school diploma
c. You prefer to teach this child
at home so that you can
provide religious instruction?. .
Graduate from high school
Attend a vocational or technical school
after high school
d. You prefer to teach this child
at home so that you can
provide moral instruction? . . . .
Attend two or more years of college
e. This child has a physical or
mental health problem that
has lasted six months or
more?. . . . . . . . . . . . . . . . . . . .
Earn a bachelor’s degree
Earn a graduate degree or professional
degree beyond a bachelor’s
f. This child has a temporary
illness that prevents him/her
from going to school? . . . . . . .
g. This child has other special
needs that you feel the
school can’t or won’t meet?. . .
h. You are interested in a
nontraditional approach
to children’s education? . . . . . .
24352064
§9D5a¤
i. You have another reason for
homeschooling your child? . . .
Specify:
NHES-31AC
6
20.
Thinking about all years this child has
been homeschooled, which of the
following subject areas has this child
been taught during his or her home
instruction?
Mark X all that apply.
Art
Music
Basic algebra (Algebra I)
Advanced algebra (Algebra II)
Geometry
Calculus
Probability
Scientific inquiry or experiments
Earth sciences or geology
Biology
Chemistry or physics
Geography
English or literature
Computer science (e.g., computer
programming)
Social science, history, social studies
Continue with section 2, question 21
on the next page.
24352072
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▼
Foreign language
NHES-31AC
7
2. Family Activities
21.
23.
In the past week, has anyone in your
family done the following things with
this child?
In the past month, has anyone in your
family done the following things with
this child?
Mark X ONE box for each item below.
No
▼
Mark X ONE box for each item below.
No
▼
Yes
▼
a. Visited a library . . . . . . . . . . . .
a. Told him/her a story (Do not
include reading to this child.). .
b. Visited a bookstore . . . . . . . . .
c. Gone to a play, concert, or
other live show . . . . . . . . . . . .
b. Done activities like arts and
crafts, coloring, painting,
pasting, or using clay. . . . . . . .
d. Visited an art gallery,
museum, or historical site . . . .
c. Played board games or did
puzzles with him/her . . . . . . . .
e. Visited a zoo or aquarium . . . .
d. Worked on a project like
building, making, or fixing
something. . . . . . . . . . . . . . . . .
f. Attended an event sponsored
by a community, religious, or
ethnic group . . . . . . . . . . . . . .
e. Played sports, active games,
or exercised together . . . . . . . .
g. Attended an athletic or
sporting event outside of
school in which this child
was not a player . . . . . . . . . . .
f. Discussed with him/her how
to manage time . . . . . . . . . . . .
g. Talked with him/her about
the family’s history or ethnic
heritage . . . . . . . . . . . . . . . . . .
22.
Yes
▼
24.
In the past week, how many days has
your family eaten the evening meal
together?
Does your family participate in the
activities or meetings of a local
homeschooling association, co-op,
or other local homeschool group?
GO TO question 26
No
Write ‘0’ if none.
Yes
25.
days
Since September, how many times
has your family gone to meetings or
participated in the activities of a local
homeschooling association, co-op, or
other local homeschool group?
24352080
26.
Is your family or someone in your
household a member of a national
homeschooling organization?
No
Yes
NHES-31AC
8
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number of times
3. Child’s Health
27.
29.
In general, how would you describe this
child’s health?
Did you mark yes to any condition in
question 28?
No
GO TO question 37
Yes
Excellent
Very good
30.
Is this child receiving services for his/her
condition?
Good
No
GO TO question 35
Fair
Yes
Poor
28.
31.
Has a health or education professional
told you that this child has any of the
following conditions?
Are these services provided by any of
the following sources?
Mark X ONE box for each item below.
Mark X ONE box for each item below.
No
▼
No
▼
Yes
▼
Yes
▼
a. Your local school district . . . . .
a. A specific learning disability. . .
b. A state or local health or
social service agency . . . . . . . .
b. An intellectual disability
(mental retardation) . . . . . . . . .
c. A doctor, clinic, or other
health care provider . . . . . . . . .
c. A speech or language
impairment . . . . . . . . . . . . . . .
32.
d. A serious emotional
disturbance . . . . . . . . . . . . . . .
e. Deafness or another hearing
impairment . . . . . . . . . . . . . . .
No
f. Blindness or another visual
impairment not corrected
with glasses. . . . . . . . . . . . . . .
Yes
33.
g. An orthopedic impairment. . . .
GO TO question 35
Did any adult in your household work
with the service provider or school to
develop or change this child’s IEP?
No
i. Pervasive Developmental
Disorder (PDD) . . . . . . . . . . . . .
Yes
§9D5¥¤
h. Autism. . . . . . . . . . . . . . . . . . .
j. Attention Deficit Disorder,
ADD or ADHD . . . . . . . . . . . . .
24352098
Are any of these services provided
through an Individualized Education
Program (IEP)?
k. A developmental delay. . . . . . .
l. Traumatic brain injury . . . . . . .
m. Another health impairment
lasting 6 months or more. . . . .
NHES-31AC
9
34.
During this school year, how satisfied or
dissatisfied have you been with the
following aspects of this child’s IEP?
35.
Is this child currently enrolled in any
special education classes or services?
No
a. The service provider’s or school’s
communication with your family?
Yes
Very satisfied
36.
Somewhat satisfied
Does this child’s condition interfere with
his/her ability to do any of the following
things?
Somewhat dissatisfied
Mark X ONE box for each item below.
Very dissatisfied
No
▼
Does not apply
Yes
▼
a. Learn . . . . . . . . . . . . . . . . . . . .
b. The child’s special needs teacher or
therapist?
Very satisfied
b. Participate in sports, clubs,
or other organized activities. . .
Somewhat satisfied
c. Attend school on a regular
basis . . . . . . . . . . . . . . . . . . . .
Somewhat dissatisfied
d. Make friends . . . . . . . . . . . . . .
▼
Very dissatisfied
Does not apply
Continue with section 4, question 37
on the next page.
c. The service provider’s or school’s
ability to accommodate this child’s
special needs?
Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied
§9D6’¤
Does not apply
d. The service provider’s or school’s
commitment to help this child learn?
24352106
Very satisfied
Somewhat satisfied
Somewhat dissatisfied
Very dissatisfied
Does not apply
NHES-31AC
10
4. Child’s Background
In what month and year was this child
born?
Do not include vacation properties.
/
month
38.
Child usually lives at this address
year
Child usually lives at another address
Where was this child born?
Child lived at at this address and another
address for an equal amount of time
One of the 50 United States or the
District of Columbia
43.
GO TO question 40
What language does this child speak
most at home?
Mark X ONE only.
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Child is not able to
speak
Another country
39.
For this school year, does this child
usually live at this address or another
address (for example, because of a joint
custody arrangement)?
English
How old was this child when he/she first
moved to the 50 United States or the
District of Columbia?
Spanish
{
37.
42.
GO TO section 5
A language other than English or Spanish
English and Spanish equally
age
40.
English and another language equally
Is this child of Spanish, Hispanic, or
Latino origin?
44.
No
Is this child currently enrolled in
English as a second language, bilingual
education, or an English immersion
program?
Yes
No
41a. What is this child’s race? You may mark
one or more races.
Yes
▼
American Indian or Alaska Native
Asian
Continue with section 5, on the
next page.
§9D6/¤
Black or African American
Native Hawaiian or other Pacific Islander
24352114
White
41b. What is this child’s sex?
Male
Female
NHES-31AC
11
5. Child’s Family
50.
What was the first language this parent
or guardian learned to speak?
Mark X ONE only.
PARENT 1 LIVING IN HOUSEHOLD
Answer questions 45 to 61 about yourself if you are
the child’s parent or guardian.
English
GO TO question 52
If you are not the child’s parent or guardian, answer
questions 45 to 61 about one of this child’s parents
or guardians living in the household.
A language other than English or Spanish
45.
English and Spanish equally
Spanish
Is this parent or guardian the child’s...
Biological parent
English and another language equally
Adoptive parent
51. What language does this person speak
most at home now?
Stepparent
Mark X ONE only.
Foster parent
English
Grandparent
Spanish
Other guardian
A language other than English or Spanish
46.
Is this person male or female?
English and Spanish equally
Male
English and another language equally
Female
52. Where was this parent or guardian born?
47. What is this person’s current marital
One of the 50 United States or the
District of Columbia
status?
Mark X ONE only.
GO TO question 50
Widowed
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Divorced
Another country
Separated
53. How old was this person when he or she
first moved to the 50 United States or
the District of Columbia?
Never married
48. Is this person currently living with a
24352122
boyfriend/girlfriend or partner in this
household?
age
No
54.
Is this person of Spanish, Hispanic, or
Latino origin?
Yes
No
49. Is this person currently in a registered
domestic partnership or civil union?
Yes
No
Yes
NHES-31AC
12
§9D67¤
Now married
GO TO question 54
58. Which of the following best describes
55. What is this person’s race? You may
this person’s employment status?
mark one or more races.
Mark X ONE only.
American Indian or Alaska Native
Asian
Employed for pay or income
Black or African American
Self-employed
Native Hawaiian or other Pacific Islander
Unemployed or
out of work
White
Full-time student
Stay at home
parent
school that this parent or guardian
completed?
Retired
Mark X ONE only.
Disabled or
unable to work
8th grade or less
High school, but no diploma
{
56. What is the highest grade or level of
GO TO question 60
GO TO question 61
59. (If employed or self-employed) About how
many hours per week does he or she
usually work for pay or income, counting
all jobs?
High school diploma or equivalent (GED)
Vocational diploma after high school
GO TO question 61
Some college, but no degree
hours
Associate’s degree (AA, AS)
60. (If unemployed or out of work) Has this
Bachelor’s degree (BA, BS)
parent or guardian been actively looking
for work in the past 4 weeks?
Some graduate or professional
education, but no degree
No
Master’s degree (MA, MS)
Yes
Doctorate degree (PhD, EdD)
61. In the past 12 months, how many
months (if any) has this person worked
for pay or income?
Professional degree beyond
bachelor’s degree (MD, DDS, JD, LLB)
57. Is he or she currently attending or
enrolled in a school, college, university,
or adult learning center, or receiving
vocational education or job training?
§9D6?¤
months
No
24352130
Yes
NHES-31AC
13
62. How old is this person?
PARENT 2 LIVING IN HOUSEHOLD
Answer questions 62 to 79 about a second parent or
guardian living in the household.
64. Is there a second parent or guardian
age
living in this household?
63. How old was this person when he or she
No
first became a parent to any child?
GO TO question
84
Yes
age
65. Is this person the child’s...
Don’t know
Biological parent
Adoptive parent
Stepparent
Foster parent
Grandparent
Other guardian
66. Is this person male or female?
Male
Female
67. What is this person’s current marital
status?
Mark X ONE only.
Now married
GO TO question 70
Widowed
Divorced
Separated
68. Is this person currently living with a
24352148
boyfriend/girlfriend or partner in this
household?
No
Yes
69.
Is this person currently in a registered
domestic partnership or civil union?
No
Yes
NHES-31AC
14
§9D6Q¤
Never married
70. What was the first language this parent
74. Is this person of Spanish, Hispanic, or
or guardian learned to speak?
Latino origin?
Mark X ONE only.
English
GO TO question
No
72
Yes
Spanish
75. What is this person’s race? You may
mark one or more races.
A language other than English or Spanish
American Indian or Alaska Native
English and Spanish equally
Asian
English and another language equally
Black or African American
71. What language does this person speak
most at home now?
Native Hawaiian or other Pacific Islander
Mark X ONE only.
White
English
76. What is the highest grade or level of
Spanish
school that this parent or guardian
completed?
A language other than English or Spanish
Mark X ONE only.
English and Spanish equally
8th grade or less
English and another language equally
High school, but no diploma
72. Where was this parent or guardian born?
High school diploma or equivalent (GED)
One of the 50 United States or the
District of Columbia
Vocational diploma after high school
Some college, but no degree
GO TO question 74
Associate’s degree (AA, AS)
One of the U.S. territories
(Puerto Rico, Guam, American Samoa,
U.S. Virgin Islands, or Mariana Islands)
Bachelor’s degree (BA, BS)
Another country
Some graduate or professional
education, but no degree
73. How old was this person when he or she
Master’s degree (MA, MS)
first moved to the 50 United States or
the District of Columbia?
Professional degree beyond
bachelor’s degree (MD, DDS, JD, LLB)
24352155
age
NHES-31AC
15
§9D6X¤
Doctorate degree (PhD, EdD)
81. In the past 12 months, how many
77. Is he or she currently attending or
months (if any) has this person worked
for pay or income?
enrolled in a school, college, university,
or adult learning center, or receiving
vocational education or job training?
No
months
Yes
82. How old is this person?
78. Which of the following best describes
this person’s employment status?
Mark X ONE only.
age
Employed for pay or income
83. How old was this person when he or she
first became a parent to any child?
Self-employed
Stay at home
parent
Retired
Disabled or
unable to work
GO TO question 80
age
Don’t know
GO TO question 810
▼
Full-time student
{
Unemployed or
out of work
Continue with section 6, question 84 on
the next page.
79. (If employed or self-employed) About how
many hours per week does he or she
usually work for pay or income, counting
all jobs?
GO TO question 80
hours
80. (If unemployed or out of work) Has this
parent or guardian been actively looking
for work in the past 4 weeks?
No
24352163
§9D6‘¤
Yes
NHES-31AC
16
6. Your Household
86. How are you related to this child?
Mark X ONE only.
84. Including yourself, how many total
Mother (birth, adoptive, step, or foster)
people live in this household?
Father (birth, adoptive, step, or foster)
people
Aunt
85. Other than the parents or guardians
already reported, how many of the
following people live in the household
with this child?
Example: Brother(s)
2
This child’s...
Write ’0’ if none.
Number
Uncle
Grandmother
Grandfather
Parent’s girlfriend/boyfriend/partner
Other relationship – Specify:
Brother(s) . . . . . . . . . . . . .
Sister(s) . . . . . . . . . . . . . .
87. Which language(s) are spoken at home
by the adults in this household?
Mark X all that apply.
Aunt(s) . . . . . . . . . . . . . . .
English
Uncle(s) . . . . . . . . . . . . . .
Spanish or Spanish Creole
French (including Patois, Creole, Cajun)
Grandmother(s) . . . . . . . .
Chinese
Grandfather(s). . . . . . . . . .
Other languages – Specify:
Cousin(s) . . . . . . . . . . . . .
▼
Parent’s girlfriend/
boyfriend/partner . . . . . . .
Other relative(s) . . . . . . . .
24352171
§9D6h¤
Other non-relative(s). . . . .
Continue with question 88 on the
next page.
NHES-31AC
17
90. How many years have you lived at this
88. In the past 12 months, did your family
address?
ever receive benefits from any of the
following programs?
Write ’0’ if less than 1 year.
Mark X ONE box for each item below.
No
▼
Yes
▼
years at this address
91. Is this house...
a. Temporary Assistance for
Needy Families, or TANF . . . . .
Mark X ONE only.
b. Your state welfare or
family assistance program. . . .
Owned or being bought by someone
in this household,
c. Women, Infants, and
Children, or WIC . . . . . . . . . . . .
Rented by someone in this household, or
d. Food Stamps . . . . . . . . . . . . . .
Occupied by some other arrangement?
92.
e. Medicaid . . . . . . . . . . . . . . . . .
f. Child Health Insurance
Program (CHIP) . . . . . . . . . . . . .
Do you have access to the Internet at
this address?
No
Yes
g. Section 8 housing assistance . .
93. Is there at least one telephone inside this
89. Which category best fits the total
home that is currently working and not a
cell phone?
income of all persons in your household
over the past 12 months?
Include your own income.
No
Include money from jobs or other earnings,
pensions, interest, rent, Social Security
payments, and so on.
Yes
94. Do you have a working cell phone?
$0 to $10,000
No
$10,001 to $20,000
Yes
$20,001 to $30,000
$30,001 to $40,000
$40,001 to $50,000
$50,001 to $60,000
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$60,001 to $75,000
24352189
$75,001 to $100,000
$100,001 to $150,000
$150,001 or more
NHES-31AC
18
Thank you.
Please return this questionnaire in the postage-paid envelope provided. If you have lost
the envelope, mail the completed questionnaire to:
24352197
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U.S. Census Bureau
ATTN: DCB 60-A (7198)
1201 E. 10th Street
Jeffersonville, IN 47132-0001
NHES-31AC
19
Commonly Asked Questions
Q:
How did you get my address?
A: Your address was randomly selected from among all of the home addresses in the nation.
It was selected using scientific sampling methods to represent other households in the
United States.
Q:
How did you get my child’s name and age?
A: When you returned the initial National Household Education Survey to us, we randomly
chose one child to ask additional questions about. We are interested in understanding
your child’s experiences with homeschooling.
Q:
Why should I take part in this study? Do I have to do this?
A: You represent thousands of other households like yours, and you cannot be replaced.
Your answers and opinions are very important to the success of this study. You may
choose not to answer any or all questions in this survey. In order for the survey to be
representative, it is important that you complete and return this questionnaire. Those who
do not return the survey will not be represented in key statistics used by policymakers and
researchers.
Q:
How will the information I provide be used? Will my privacy be protected?
A: Your responses will be combined with those of others to produce statistical summaries
and reports. Your individual data will not be reported. Your answers 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 (Section 9573, 20 U.S. Code).
Q:
I have more than one child in my household. Will I receive additional surveys for
the other children in my household?
A: No, each household will receive a survey for only one child, even if there are multiple
children living in the household. In households with multiple children, one child was
randomly selected to be included in the study.
Q:
How will my response help the Department of Education?
A: The Department of Education wants to understand the condition of education in the
United States. This survey is the only way that the Department of Education can learn
about homeschooling from your perspective. It is the Department of Education’s primary
source of information on homeschooling in America. Your responses will be combined
with those from other households to inform educators, policymakers, schools, and
universities about changes in the condition of education in the United States. Reports
from past surveys can be found at www.nces.ed.gov/nhes.
24352205
A: The National Center for Education Statistics, within the U.S. Department of Education, is authorized
to conduct this study (20 USC § 9543). The U.S. Census Bureau is conducting this study on behalf of the
U.S. Department of Education. This study has been approved by the Office of Management and Budget,
the office that reviews all federally sponsored surveys.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of
information unless it displays a valid OMB control number. The valid OMB control number for this voluntary
survey is 1850-0803. The average time required to complete this survey is estimated to average 20
minutes per response, including the time to review instructions, gather the data needed, and complete and
review the survey. If you have any comments concerning the accuracy of the time estimate, suggestions for
improving the survey, or any comments or concerns regarding the status of your individual submission of
this survey, please write to: Andrew Zukerberg, National Center for Education Statistics, National
Household Education Surveys (NHES), 1990 K Street NW, Washington, DC 20006-5650. You may send
email to [email protected].
Q: What if I have other questions?
A: If you have any questions about the study, you may send e-mail to [email protected] or you may call
the Census Bureau toll-free at 1-888-840-8353
NHES-31AC
20
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Q: Who is sponsoring this study?
| File Type | application/pdf |
| Author | sbielick |
| File Modified | 2014-09-03 |
| File Created | 2014-07-08 |