Spring Fourth-Grade Data Collection & Recruitment for Fifth-Grade

Appendix A ECLS-K2011 Spring 4th Grade Child Questionnaire-Redacted

Spring Fourth-Grade Data Collection & Recruitment for Fifth-Grade

OMB: 1850-0750

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APPENDIX A
FOURTH-GRADE
CHILD QUESTIONNAIRE SPECIFICATIONS

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11
(ECLS-K:2011)

Spring Fourth-Grade National Data Collection
and Fifth-Grade Recruitment
OMB Clearance Package
#1850-0750 v.16

This appendix includes the programmer specifications for the audio-CASI child questionnaire, which indicate
the exact instructions to be provided to the child and the items that will be administered.

Social Distress
The child questionnaire to be fielded in the spring fourth-grade data collection will include three
items (CLQ435, CLQ450, and CLQ470) used to evaluate children’s social anxiety, specifically
their fear of negative evaluation by their peers. The exact wording of these items is not included
here because they are copyright protected.
Source: Social anxiety scale for children-revised: Factor structure and concurrent validity.
©1993 A.M. LaGreca and W.L. Stone. Used with permission.

Spring 2015 Child Assessment: ECLS-K:2011
Section

CLQ

[Child Questionnaire ACASI]

Sequence: 2

CLQGLB005

RAPID RESPONSE
IF A CHILD SELECTS A COMMAND BUTTON (NEXT, BACK) OR A RESPONSE BEFORE ACASI HAS READ THE
ENTIRE CONTENTS OF THE SCREEN, PROGRAM SHOULD ACCEPT THE CHILD'S SELECTION BY FOLLOWING
THE COMMAND OR ACCEPTING THE ANSWER.

CLQGLB010

INACTIVITY SETTINGS
FOR SCREEN CLQ401:
AFTER 8 SECONDS OF IDLE TIME [FROM WHEN THE LAST WORD HAS BEEN READ], THE FOLLOWING
MESSAGE SHOULD BE READ ON AUDIO.
When you're ready to move on, please touch the "NEXT" button to move to the next screen.
FOR SCREEN CLQ403:
AFTER 8 SECONDS OF IDLE TIME ON ONE SCREEN [FROM WHEN THE LAST RESPONSE CATEGORY HAS BEEN
READ], THE FOLLOWING MESSAGE SHOULD BE READ ON AUDIO.
Please touch the "NEXT" button to move on to the next screen.
FOR SCREENS CLQ402 and CLQ405-CLQ549:
AFTER 8 SECONDS OF IDLE TIME ON ONE SCREEN [FROM WHEN THE LAST RESPONSE CATEGORY HAS BEEN
READ], THE FOLLOWING MESSAGE SHOULD BE READ ON AUDIO.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
FOR SCREENS CLQ401-CLQ549:
AFTER THE INACTIVITY MESSAGE HAS BEEN READ THREE TIMES, REPEAT THE SCREEN TEXT.
FOR SCREEN CLQ550:
ACASI SHOULD REPEAT THE SCREEN TEXT EVERY 15 SECONDS.

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CLQGLB015

CONFIRMATION SCREEN
IF THE CHILD TOUCHES THE NEXT BUTTON BEFORE TOUCHING AN ANSWER TO A QUESTION, THEN
PROGRAM SHOULD MOVE TO THE CONFIRMATION SCREEN.
DISPLAY PREVIOUS ITEM TEXT AND CONFIRMATION QUESTION AT THE TOP OF THE SCREEN. DISPLAY
RESPONSE OPTIONS IN THE MIDDLE OF THE SCREEN BELOW THE QUESTION.
PROGRAM READS CONFIRMATION QUESTION (THAT IS TEXT IN THE SPECS BETWEEN AND
): Do you want to skip this question?
PROGRAM READS RESPONSE OPTIONS:
Yes. (1)
No. (2)
IF THE CHILD CHOOSES 1, THEN PROGRAM MOVES TO THE NEXT SCREEN WITHOUT NEEDING TO PRESS ANY
OTHER BUTTONS. 1 = REFUSED (code 8)
IF THE CHILD CHOOSES 2, THEN PROGRAM MOVES TO THE PREVIOUS SCREEN WITHOUT NEEDING TO PRESS
ANY OTHER BUTTONS.

CLQGLB020

CHANGE RESPONSE PROCEDURE
THE CHILD'S ANSWER SELECTION SHOULD ALWAYS BE VISUALLY EMPHASIZED.
IF THE CHILD WANTS TO CHANGE AN ANSWER, HE OR SHE CAN TOUCH THE "ERASE" BUTTON AND THEN
TOUCH HIS/HER NEW ANSWER. ACASI SHOULD DO THE FOLLOWING:
REMOVE THE VISUAL EMPHASIS FROM THE OLD ANSWER BUTTON
VISUALLY EMPHASIZE THE NEW ANSWER BUTTON
THE CHILD CAN CHANGE AN ANSWER MULTIPLE TIMES. ACASI SHOULD ACCEPT THE LAST ANSWER.

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CLQGLB025
DISPLAY INSTRUCTIONS
WHEN TOUCHED, THE CHILD'S ANSWER SELECTION SHOULD BE VISUALLY EMPHASIZED.

CLQGLB030

AUDIO INSTRUCTIONS
WORDS IN ALL CAPS SHOULD BE EMPHASIZED WHEN READ OVER AUDIO.
THE PHRASE "Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to
skip this question" IS DISPLAYED BUT SHOULD NOT BE READ ON AUDIO FOR ITEMS CLQ405-CLQ549 (EXCEPT
AFTER A PERIOD OF INACTIVITY; SEE CLQGLO010).
THE RESPONSE SETS ARE READ FOR ALL QUESTIONS.

CLQGBL035

ADMINISTRATION TIMING
FOR ENTIRE CQ ADMINISTRATION TIMINGS, BEGIN TIMING WHEN THE OPENING SCREEN FOR THE
ASSESSOR APPEARS (CLQ400) AND END TIMING WHEN THE ASSESSOR PRESSES THE NEXT BUTTON TO
LEAVE THE CLOSING SCREEN (CLQ555).

CLQGLB040

ANSWER BUTTON DISPLAY CHARACTERISTICS
Vertical spacing: 15 pixels
Button height: 50 pixels

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Button width: 200 pixels
BUTTON DISPLAY
PLACE A "NEXT" BUTTON AT THE BOTTOM RIGHT OF EACH SCREEN.
PLACE A "BACK" BUTTON AT THE BOTTOM LEFT OF EACH SCREEN. EXCEPTION IS CLQ400, CLQ550, AND
CLQ555--DO NOT HAVE A BACK BUTTON ON THOSE SCREENS. FOR SCREENS CLQ401 AND CLQ403, SHOW
THE BUTTONS BUT DISABLE THEM SO THEY CANNOT BE USED.
PLACE AN "ERASE" BUTTON AT THE BOTTOM CENTER OF EACH SCREEN. EXCEPTION IS CLQ400, CLQ550,
AND CLQ555--DO NOT HAVE AN ERASE BUTTON ON THOSE SCREENS. FOR SCREENS CLQ401 AND CLQ403,
SHOW THE BUTTONS BUT DISABLE THEM SO THEY CANNOT BE USED.

CLQGLB045

BREAKOFF
ADD F8 AS A KEY COMBINATION TO BREAKOFF THE INTERVIEW.
THE FIELD AT WHICH THE BREAKOFF OCCURS IS STORED IN THE WBA AUDIT TRAIL.

CLQ400

QUESTION TEXT:
PLUG HEADPHONES INTO THE COMPUTER. POSITION LAPTOP IN FRONT OF THE CHILD.
Now, you are going to use the computer to tell us a little more about yourself. The computer will read some
sentences while you listen on the headphones. [HOLD UP HEADPHONES]
Then you will pick the answer that best describes you by touching your answer on the computer screen.
[TOUCH THE MIDDLE OF THE COMPUTER SCREEN WITH ONE FINGER]
You can change the volume by pressing this button [POINT TO THE RIGHT BUTTON ABOVE STICKER] to make
it louder and this button [POINT TO THE LEFT BUTTON ABOVE STICKER] to make it softer. If you don't want
the questions and answers read to you, just turn the volume all the way down.
SHOW THE CHILD HOW TO ADJUST THE SIZE OF THE HEADPHONES.
Okay, go ahead and put these headphones on and adjust them so they fit. Then, you will hear directions
about what to do.
TURN LAPTOP AROUND. ROTATE LAPTOP SCREEN TO FACE THE CHILD.

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ENTER TEXT
PROGRAMMER INSTRUCTIONS:
TURN OFF CONFIRMATION SCREEN.

CLQ401

QUESTION TEXT:
Hello. Before you begin, please change the volume if this voice is too loud or too soft.
In a minute, sentences will appear on the screen, and they will be read to you along with a list of answers. For
these questions, there are no right or wrong answers, and all your answers are private. No one will be told
the answers that you pick.
To choose your answer, just touch it on the computer screen. You don't have to wait for the computer to
finish reading all the answers before you choose your answer.
If you want to change your answer, touch the "ERASE" button and then touch the new answer you want to
pick.
If you want to go back and change an answer, touch the "BACK" button to move to earlier screens.
If you have any questions, or if you need help adjusting the volume or the size of your headphones, please ask
for help now.
When you're ready to move on, please touch the "NEXT" button to move to the next screen.
ENTER TEXT
PROGRAMMER INSTRUCTIONS:
TURN OFF CONFIRMATION SCREEN.

CLQ402

QUESTION TEXT:
Now let's practice. Touch the answer that best describes you, and then touch the "NEXT" button.
How often do you watch TV?
CODES

Never

Rarely

Sometimes

Often

Very often

PROGRAMMER INSTRUCTIONS:
TURN OFF CONFIRMATION SCREEN.

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CLQ403

QUESTION TEXT:
Great, thanks for practicing.
One last thing before you begin. If there is a question you do not want to answer, just touch the "NEXT"
button to skip it. If you touch the "NEXT" button without answering, the computer will ask you if you want to
skip the question, just to make sure you didn't skip the question by accident.
Please touch the "NEXT" button to move to the next screen.
ENTER TEXT
PROGRAMMER INSTRUCTIONS:
TURN OFF CONFIRMATION SCREEN.

CLQ405

QUESTION TEXT:
Think about yourself and your experiences this school year. How often do the following things happen?
I try hard to do well in school.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ410

QUESTION TEXT:
In class, I work as hard as I can.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

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Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ415

QUESTION TEXT:
When I'm in class, I participate in class discussions.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ420

QUESTION TEXT:
I pay attention in class.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ425

QUESTION TEXT:
When I'm in class, I listen very carefully.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ430

QUESTION TEXT:
Kids in my class make me feel better if I'm having a bad day.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ440

QUESTION TEXT:
I feel lonely at school.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ445

QUESTION TEXT:
Kids in my class let me play with them.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ455

QUESTION TEXT:
I feel left out at school.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ460

QUESTION TEXT:
Kids in my class make me feel happy.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ465

QUESTION TEXT:
Kids in my class would help me if I hurt myself on the playground.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ475

QUESTION TEXT:
Kids in my class tell me that I'm their friend.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ480

QUESTION TEXT:
I feel alone at school.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ485

QUESTION TEXT:
Kids in my class would help me if other kids were being mean to me.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ486

QUESTION TEXT:
Next, please think about experiences that you have had with other students. During this school
year, how often have other students teased you, made fun of you, or called you names?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ487

QUESTION TEXT:
During this school year, how often have other students told lies or untrue stories about
you?

Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ488

QUESTION TEXT:
During this school year, how often have other students pushed, shoved, slapped, hit, or kicked
you?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ489

QUESTION TEXT:
During this school year, how often have other students left you out from playing with them on
purpose?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

1
2

Never
Rarely

Sometimes

Often

Very often
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

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CLQ490

QUESTION TEXT:
How often do you send texts, messages, or emails using an app, cell phone, computer, iPad or
tablet, or other electronic device?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Never

Less than once a week

A few times a week

About once a day

Many times a day
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ495

QUESTION TEXT:
Does your family have rules about who you can send texts, messages, or emails to?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

YES

NO
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.
DISPLAY "who" in UNDERLINED TEXT.

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CLQ500

QUESTION TEXT:
Does your family have rules about when you can send texts, messages, or emails?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

YES

NO
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.
DISPLAY "when" in UNDERLINED TEXT.

CLQ505

QUESTION TEXT:
Do you have a pet?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

YES

NO
REFUSED

Box 1

IF YES, GO TO CLQ515
IF NO OR REFUSED, GO TO CLQ510

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CLQ510
QUESTION TEXT:
Have you ever had a pet?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

YES

NO
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

Box 2

IF YES, CONTINUE
IF NO OR REFUSED, GO TO CLQ550

CLQ515

QUESTION TEXT:
How old were you when you got your first pet? If you can't remember exactly how old you were,
please take your best guess.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Younger than 5 years old

5 years old

6 years old

7 years old

8 years old

9 years old

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Box 3
IF CLQ505=NO OR REFUSED, GO TO CLQ550

CLQ520

QUESTION TEXT:
How many pets do you have right now?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

One

More than one
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

CLQ525

QUESTION TEXT:
What kind of {pet/pets} do you have? You can choose more than one answer if you have more than
one pet.
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Dog

Cat

Rabbit, guinea pig, chincilla, ferret, gerbil,
hamster, rat or mouse

Bird

Fish

Snake, lizard, turtle, frog or other kind of reptile
or amphibian

Horse

Other kind of pet
REFUSED
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PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS. THIS ITEM IS MARK ALL THAT APPY.
IF CLQ520=ONE, USE FILL “pet”. IF CLQ520=MORE THAN ONE, USE FILL “pets”

Box 4

If CLQ520=ONE OR REFUSED, GO TO CLQ540
IF CLQ520=MORE THAN ONE, GO TO CLQ530

CLQ530

QUESTION TEXT:
Do you have a favorite pet?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

YES

NO
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.

Box 5

If CLQ530=YES, GO TO CLQ535
IF CLQ530=NO OR REFUSED, GO TO CLQ540

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CLQ535
QUESTION TEXT:
Which pet is your favorite pet?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Dog

Cat

Rabbit, guinea pig, chincilla, ferret, gerbil,
hamster, rat or mouse

Bird

Fish

Snake, lizard, turtle, frog or other kind of reptile
or amphibian

Horse

Other kind of pet
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.
ONLY LIST RESPONSE OPTION(S) THAT WERE CHOSEN AT CLQ525.

Box 6
IF CLQ525=FISH ONLY OR IF CLQ535=FISH, GO TO CLQ545

CLQ540
QUESTION TEXT:
How often do you spend time playing with {your pet/your favorite pet/any of your pets}?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Every day

Almost every day

About one or two days a week

Less than once a week
REFUSED
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PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.
IF CLQ520=ONE OR REFUSED, USE FILL “your pet”. IF CLQ520=MORE THAN ONE AND CLQ530=YES, USE FILL
“your favorite pet”. IF CLQ520=MORE THAN ONE AND CLQ530=NO OR REFUSED, USE FILL “any of your pets”

Box 7

IF CLQ525=HORSE ONLY OR CLQ535=HORSE, SKIP TO CLQ547

CLQ545

QUESTION TEXT:
How often do you have {your pet/your favorite pet/any of your pets} near you when you do
homework, study, read, or watch TV?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Almost Always

Often

Sometimes

Almost never
REFUSED

CLQ547

QUESTION TEXT:
When you feel bad or sad, how often do you go to {your pet/your favorite pet/any of your pets} to
help you feel better?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.

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CODES

Almost Always

Often

Sometimes

Almost never
REFUSED

CLQ549

QUESTION TEXT:
Do you consider {your pet/your favorite pet/any of your pets} to be {a member/members} of your
family?
Please pick an answer and then touch the "NEXT" button or just touch the "NEXT" button to skip this
question.
CODES

Yes, always

Yes, sometimes

I'm not sure
REFUSED

PROGRAMMER INSTRUCTIONS:
DISPLAY ITEM AND RESPONSE OPTIONS.
IF CLQ520=ONE OR REFUSED, USE FILLS “your pet” AND “a member”. IF CLQ520=MORE THAN ONE AND
CLQ530=YES, USE FILLs “your favorite pet” AND “a member”. IF CLQ520=MORE THAN ONE AND CLQ530=NO
OR REFUSED, USE FILLS “any of your pets” AND “members”

CLQ550

QUESTION TEXT:
Thank you for working with me.
You are done answering questions on the computer. Please take off the headphones now.
ENTER TEXT
PROGRAMMER INSTRUCTIONS:
TURN OFF CONFIRMATION SCREEN.

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CLQ555

QUESTION TEXT:
TAKE THE HEADPHONES FROM THE CHILD. UNPLUG HEADPHONES FROM COMPUTER.
TAKE THE LAPTOP FROM THE CHILD AND PLACE THE LAPTOP DIRECTLY IN FRONT OF YOU.

SAY: Thank you. Now we are going to do something else.

TOUCH THE "NEXT" BUTTON TO CONTINUE.
ENTER TEXT

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