Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011) Spring Fifth-Grade National Data Collection

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011) Spring Fifth-Grade National Data Collection

Attachment D ECLSK-2023 Preschool Field Test Item Matrix (1).xlsx

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 (ECLS-K:2011) Spring Fifth-Grade National Data Collection

OMB: 1850-0750

Document [xlsx]
Download: xlsx | pdf

Overview

Contents of Tabs
Screener
Parent Survey
Fall Follow-up Survey


Sheet 1: Contents of Tabs

This file contains a listing of every question that will be asked of household parent respondents in the Early Childhood Longitudinal Study, Kindergarten Class of 2022-23 (ECLS-K:2023) preschool field test. For each question, the question wording is provided, along with the item section and number, the construct the item measures, and the specific research question in Part C of this OMB submission for which the item is intended to provide information.

Each worksheet in this file pertains to one data collection instrument. Below is a list of the worksheet name and the instrument to which the worksheet pertains. The instruments themselves are provided in Attachment B of this submission.



Worksheet Name
ECLS-K:2023 Preschool Field Test Data Collection Instrument
Screener
Preschool Field Test Household Screener
Parent Survey
Preschool Field Test Parent Survey
Fall Follow-up Survey
Preschool Field Test Fall Follow-up Survey

Sheet 2: Screener

Section Item # Item Wording Construct Research Question





Screener MyECLS Are there any children age 10 or younger living in this household?
1 Yes
2 No
Whether there are children age 10 or younger in the household NA
Screener SCR020 How many children age 10 or younger live in this household? Include small children, foster children, babies, and those living away at school (if they have no other permanent home). Number of children age 10 or younger NA
Screener SCR030 Please list the first names of all the children age 10 or younger who live in this household. You may provide nicknames or initials if you prefer. Be sure to include all small children, foster children, and babies. Start with the youngest child who is age 10 or younger. Enter one child on each line. Enter names until you have listed all children age 10 or younger in this household, then click Next.

Child {NUMBER}.
Current household child roster NA
Screener SCR040 How old is {SCR030} in years? For babies less than 1 year old, enter 0. Current household child roster 1, 2, 5
Screener SCR050 What is {SCR030}'s sex?
1 Male
2 Female
Current household child roster 1, 2, 5
Screener SCR060 Is {SCR030} currently…
Select All That Apply 1 Not in school?
2 In public or private school, including preschools?
3 In child care in a home or center?
4 Homeschooled INSTEAD of attending a public school or private school (including preschools) for some or all classes?
School or preschool enrollment 1
Screener SCR070 What is {SCR030}'s current grade or grade equivalent?

Child care for infants or toddlers in a home or center includes early childhood education programs, child care, or day care in a center, or child care with a relative or nonrelative other than a parent/guardian.

Preschool or child care for preschool-aged children in a home or center includes early childhood education programs, child care, or day care in a center, nursery school, preschool, prekindergarten, or child care with a relative or nonrelative other than a parent/guardian.

Kindergarten includes Transitional Kindergarten (TK), Early Transitional Kindergarten (ETK), Readiness Kindergarten, Transitional or Prefirst Grade, or a program that is a kindergarten equivalent but is ungraded or has multiple grades.
0 Child care for infants or toddlers in a home or center 1 Preschool or child care for preschool-aged children in a home or center
2 Kindergarten
3 First
4 Second
5 Third
6 Fourth
7 Fifth or above 8 None of these
Current grade/equivalent 1
Screener SCR080 What grade or grade equivalent will {SCR030} be in fall 2020?

Child care for infants or toddlers in a home or center includes early childhood education programs, child care, or day care in a center, or child care with a relative or nonrelative other than a parent/guardian.

Preschool or child care for preschool-aged children in a home or center includes early childhood education programs, child care, or day care in a center, nursery school, preschool, prekindergarten, or child care with a relative or nonrelative other than a parent/guardian.

Kindergarten includes Transitional Kindergarten (TK), Early Transitional Kindergarten (ETK), Readiness Kindergarten, Transitional or Prefirst Grade, or a program that is a kindergarten equivalent but is ungraded or has multiple grades.

0 Child care for infants or toddlers in a home or center
1 Preschool or child care for preschool-aged children in a home or center
2 Kindergarten
3 First
4 Second
5 Third
6 Fourth
7 Fifth or above
8 None of these
Expected grade/equivalent next fall 1
Screener SCR095 {Does/Did} {SCR030} go to a public school for kindergarten?
1 Yes
2 No
Kindergarten identification for catchment area information NA
Screener SCR100 What public school {does/did} {SCR030} attend for kindergarten? Select the public school {SCR030} {attends/attended} for kindergarten from the list below. If you don’t find a match, select “School not on list” and then type in the full school name. If {SCR030} {has attended/went to} more than one kindergarten, please select or enter the last one attended.”


Kindergarten identification for catchment area information NA
Screener SCR100OS What public school {does/did} {SCR030} attend for kindergarten? Other specify for kindergarten identification for catchment area information NA
Screener SCR105 Has {SCR030} always lived at this address?
1 Yes
2 No
Mobility NA
Screener SCR106a In what month did {SCR030} start living at this address? 1 January
2 February
3 March
4 April
5 May
6 June
7 July
8 August
9 September
10 October
11 November
12 December
Mobility NA
Screener SCR106b In what year did {SCR030} start living at this address? Mobility NA
Screener SCR110a This survey is part of the Early Childhood Longitudinal Study, which is sponsored by the U.S. Department of Education, National Center for Education Statistics. The next questions should take you about 30 minutes to complete. To show our appreciation for your time, you will receive $10 after you finish the questions. {You may stop and start the survey as needed to work with your schedule}. Before we begin, please enter your name.
First Name:
Parent survey introduction and information for reminder mailings NA
Screener SCR110b Last Name: Information for reminder mailings NA
Screener SCR111a To allow your answers to be saved so that you can stop and start the survey as needed to work with your schedule, please {enter/confirm} your contact information.

Email Address:
Email address to allow login if exit survey before finishing and contact information was not provided earlier NA
Screener SCR111b To allow your answers to be saved so that you can stop and start the survey as needed to work with your schedule, please {enter/confirm} your contact information.

Mobile Number:
Mobile number to allow login if exit survey before finishing and contact information was not provided earlier

Sheet 3: Parent Survey

Section Item # Item Wording Research Question





INQ - Introduction INQ001 We would like to collect some information about {CHILD}'s care and home experiences. Your answers will be extremely valuable in better understanding the development of young children and their involvement in early care and education.

All of the information you provide 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 U.S.C. §9573 and 6 U.S.C. §151).

Yes, I can answer questions about {CHILD}'s care and education. No, I am not able to answer questions about {CHILD}'s care and education.
Introduction NA

INQ005a We would like to contact a parent or adult who lives in this household and knows about {CHILD}'s care and education. Please provide the contact information for such a person, in this household, so that we can contact him or her for the survey.

First Name:
Alternate respondent selection NA

INQ005b Last Name: Alternate respondent selection NA

INQ005c Email Address: Alternate respondent selection NA

INQ005d Please confirm the mailing address.
Address Line 1:
Address Line 2:

Alternate respondent selection NA

INQ005e City: Alternate respondent selection NA

INQ005f State:

Please select a state, district, or territory.
Alternate respondent selection NA

INQ005g Zip code: Alternate respondent selection NA

INQ010 We asked you earlier for {CHILD’s} first name so that we can ask questions about {CHILD} in the following survey. If there is a typo, or you gave a nickname or initials for this child, you may correct it here before continuing.
What is {CHILD}'s first name?
First Name:
Child name NA

INQ015 How old is {CHILD} in years? Child age NA
PSQ - Preschool Skills PSQ020 Can {CHILD} identify the colors red, yellow, blue, and green by name?
This can be done in any language.
1 No, none of them
2 Yes, some of them
3 Yes, all of them
Ratings of child competence in literacy, language, and mathematics 2

PSQ025 Can {CHILD} correctly recognize the letters of the alphabet?
This can be done in any language.
1 No, none of them
2 Yes, some of them
3 Yes, most of them
4 Yes, all of them
Ratings of child competence in literacy, language, and mathematics 2

PSQ030 Can {CHILD} write {his/her} first name, even if some of the letters are backwards?
This can be done in any language.
1 Yes
2 No
Ratings of child competence in literacy, language, and mathematics 2

PSQ035 How often can {CHILD} explain things {he/she} has seen or done so that you get a very good idea of what happened?
This can be done in any language.
1 Never
2 Sometimes
3 About half the time
4 Usually
5 Always
Ratings of child competence in literacy, language, and mathematics 2

PSQ040 How high can {CHILD} count?
This can be done in any language.
1 This child cannot count
2 Up to 5
3 Up to 10
4 Up to 20
5 Up to 50
6 Up to 100 or more
Ratings of child competence in literacy, language, and mathematics 2

PSQ045 Can {CHILD} identify basic shapes such as a triangle, rectangle, circle, or square?
This can be done in any language.
1 No, none of them
2 Yes, some of them
3 Yes, most of them
4 Yes, all of them
Ratings of child competence in literacy, language, and mathematics 2

PSQ050 a-d Please select whether {CHILD} does the following. Have you observed that {CHILD}... Child language use 2

PSQ050a Tries repeatedly to communicate information which has not been understood?
1 Yes
2 No
Child language use 2

PSQ050b Asks questions about information which is unclear?
1 Yes
2 No
Child language use 2

PSQ050c Responds to questions in a thoughtful way that makes sense?
1 Yes
2 No
Child language use 2

PSQ050d Rephrases questions or asks follow-up questions if {he/she} does not get the information {he/she} wanted.
1 Yes
2 No
Child language use 2

PSQ055 1-25 Please select the words your child uses in English. If {CHILD} uses a different pronunciation of a word, that’s OK. Does {CHILD} say... Child vocabulary 2

PSQ055(1) hungry
1 Yes
2 No
Child vocabulary 2

PSQ055(2) baby
1 Yes
2 No
Child vocabulary 2

PSQ055(3) doctor
1 Yes
2 No
Child vocabulary 2

PSQ055(4) down
1 Yes
2 No
Child vocabulary 2

PSQ055(5) bird
1 Yes
2 No
Child vocabulary 2

PSQ055(6) fruit
1 Yes
2 No
Child vocabulary 2

PSQ055(7) triangle
1 Yes
2 No
Child vocabulary 2

PSQ055(8) turtle
1 Yes
2 No
Child vocabulary 2

PSQ055(9) plant
1 Yes
2 No
Child vocabulary 2

PSQ055(10) last
1 Yes
2 No
Child vocabulary 2

PSQ055(11) caterpillar
1 Yes
2 No
Child vocabulary 2

PSQ055(12) castle
1 Yes
2 No
Child vocabulary 2

PSQ055(13) excited
1 Yes
2 No
Child vocabulary 2

PSQ055(14) stamp
1 Yes
2 No
Child vocabulary 2

PSQ055(15) parent
1 Yes
2 No
Child vocabulary 2

PSQ055(16) lucky
1 Yes
2 No
Child vocabulary 2

PSQ055(17) furniture
1 Yes
2 No
Child vocabulary 2

PSQ055(18) drip
1 Yes
2 No
Child vocabulary 2

PSQ055(19) measure
1 Yes
2 No
Child vocabulary 2

PSQ055(20) calm
1 Yes
2 No
Child vocabulary 2

PSQ055(21) lonely
1 Yes
2 No
Child vocabulary 2

PSQ055(22) dive
1 Yes
2 No
Child vocabulary 2

PSQ055(23) skeleton
1 Yes
2 No
Child vocabulary 2

PSQ055(24) uncomfortable
1 Yes
2 No
Child vocabulary 2

PSQ055(25) courage
1 Yes
2 No
Child vocabulary 2
PLQ - Primary Language(s) Spoken PLQ060 What is the primary language spoken in your home?
1 English
2 A language other than English
3 Two or more languages are spoken the same amount
Primary home language 1, 2

PLQ060a You mentioned a language other than English as your primary language spoken at home. What is it?
1 Spanish
2 A European language other than Spanish such as French, German or Russian
3 A Chinese language or dialect
4 A Filipino language
5 A Southeast Asian language such as Vietnamese, Thai, or Khmer
6 A South Asian language such as Hindi or Tamil
7 Another Asian language such as Japanese or Korean
8 A Middle Eastern language such as Arabic or Farsi
9 An African language such as Swahili or Amharic
91 Another language (Please specify):
Primary home language 1, 2

PLQ060aOS You mentioned a language other than English as your primary language spoken at home. What is it?
Other specify field for primary home language

PLQ060b You mentioned that more than two or more languages are spoken equally at home. What are these languages?
Select one or more choices below for the languages that are spoken in your home. If more than one language falls in the same category below, select that category. If there is not a choice for the language(s) spoken in your home, type the language(s) in under “Another language (Please specify).”


0 English
1 Spanish
2 A European language other than Spanish such as French, German or Russian
3 A Chinese language or dialect
4 A Filipino language
5 A Southeast Asian language such as Vietnamese, Thai, or Khmer
6 A South Asian language such as Hindi or Tamil
7 Another Asian language such as Japanese or Korean
8 A Middle Eastern language such as Arabic or Farsi
9 An African language such as such as Swahili or Amharic
91 Other language(s) (Please specify):
Primary home language 1, 2

PLQ060bOS You mentioned that more than two or more languages are spoken equally at home. What are these languages?
Select one or more choices below for the languages that are spoken in your home. If more than one language falls in the same category below, select that category. If there is not a choice for the language(s) spoken in your home, type the language(s) in under “Another language (Please specify).”
Other specify field for primary home language
HEQ - Home Environment, Activities, and Cognitive Stimulation HEQ010 a-i In a typical week, how often do you or any other family members do the following things with {CHILD}? Home learning activities 2

HEQ010a Tell stories to {CHILD}
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010b Sing songs with {CHILD}
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010c Help {CHILD} to do arts and crafts
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010d Involve {CHILD} in household chores, like cooking, cleaning, setting the table, or caring for pets
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010e Play games or do puzzles with {CHILD}
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010f Talk about nature or do science projects with {CHILD}
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010g Build something or play with construction toys with {CHILD}
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010h Play a sport or exercise together
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ010i Practice reading, writing or working with numbers
1 Not at all
2 Once or twice a week
3 3-6 times a week
4 Every day
Home learning activities 2

HEQ020 How often do you or other family members use a language other than English when doing any of the activities listed in the previous question?
1 Always
2 Most of the time
3 Sometimes
4 Never
Language other than English used in the home for home learning activities 2

HEQ030 In a typical week, how often do you or any other family members read books to {CHILD}?
Include only times family members have read books to the child. Do not include times when the child reads or looks at books by him or herself. Please include reading of books in any language.
1- Not at all
2- Once or twice a week
3 - 3-6 times a week
4- Every day
Reading to the child 2

HEQ036 Generally, how long is {CHILD} read to at each of these times?
Please include reading in any language.

Minutes:




Reading to the child 2

HEQ036a-c How often do you and {CHILD} do the following: Reading to the child 2

HEQ036a When you and your child are reading together, how often does she or he start talking about the story or something it has reminded her or him of?
1 Almost never
2 Rarely
3 Sometimes
4 Often
5 Very often
6 Almost always
Reading to the child 2

HEQ036b When you and your child are reading books with pictures together, how often do you spend time talking about the pictures?
1 Almost never
2 Rarely
3 Sometimes
4 Often
5 Very often
6 Almost always
Reading to the child 2

HEQ036c How often do you and your child talk about a book you read sometime in the past?
1 Almost never
2 Rarely
3 Sometimes
4 Often
5 Very often
6 Almost always
Reading to the child 2

HEQ060 Now, please think about the past week. How often did {CHILD} look at picture books in the past week?
1 Never
2 Once or twice a week
3 3 to 6 times a week
4 Every day
Reading to the child 2

HEQ070 Read to or pretend to read to {himself/herself} or to others?
1 Never
2 Once or twice a week
3 3 to 6 times a week
4 Every day
Reading to the child 2

HEQ071 a-l How often does {CHILD}: Math activities 2

HEQ071a Count objects?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071b Add or subtract things?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071c Write numbers?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071d Match or identify shapes?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071e Play cards or board games?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071f Play with jigsaw puzzles?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071g Play with blocks or construction toys?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071h Identify or create patterns?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071i Put objects in order (for example, small to large)?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071j Measure things (for example, using a ruler, in cooking, etc.)?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071k Keep score in games?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ071l Answer/ask questions about "How many things are there?" (for example, "How many plates are on the table?")?
0 Never/almost never
1 Less than once a week
2 Once a week to several times a week
3 Every day or almost every day
Math activities 2

HEQ072 How often do you play number games or talk about numbers with {CHILD}?
1 Never
2 Once a month
3 Less than once a week
4 Once a week
5 2-3 times a week
6 Every day
7 More than once a day
Math activities 2

HEQ073 How much does {CHILD} enjoy number or math activities like counting objects, making patterns, measuring things, etc.?
1 Not at all
2 A little
3 A fair amount
4 Much
5 Very much
Math activities 2

HEQ075 a-h How much do you agree or disagree with the following statements about what it is usually like living in your home? Amount of chaos in the home 2, 5

HEQ075a We almost always seem to be rushed.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075b We are usually able to stay on top of things.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075c No matter how hard we try, we always seem to be running late.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075d No matter what our family plans, it usually doesn't seem to work out.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075e You can't hear yourself think.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075f It is a good place to relax.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075g The atmosphere is calm.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ075h In the morning, we have a regular routine.
1 Strongly disagree
2
3
4
5 Strongly agree
Amount of chaos in the home 2, 5

HEQ272 a-h Do you have the following in your home that {CHILD} may use? Media engagement and usage 2

HEQ272a Smartphone
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272b Cell phone (for example, not a smartphone or other phone that can also access the internet)
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272c Tablet (for example, iPad or other tablet)
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272d Laptop or desktop computer
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272e Reading device (for example, Kindle or Fire)
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272f iPod
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272g Electronic assistant or smart speaker (for example, Alexa, Google Assistant, or Siri)
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ272h Game system (for example, Playstation, Wii, or Xbox, or handheld devices such as a Nintendo DS, or Sony PSP)
1 Yes, {CHILD} shares this with other family member(s)
2 Yes, {CHILD} has his/her own
3 No
Media engagement and usage 2

HEQ273a On any given weekday, how much time does {CHILD} spend watching shows, movies, and videos?
Hours:
Media engagement and usage-hours 2

HEQ273b On any given weekday, how much time does {CHILD} spend watching shows, movies, and videos?
Minutes:
Media engagement and usage-minutes 2

HEQ274a On any given weekday, how much time does {CHILD} spend playing video, computer, or mobile games?

Hours:




Media engagement and usage-hours 2

HEQ274b On any given weekday, how much time does {CHILD} spend playing video, computer, or mobile games?

Minutes:
Media engagement and usage-minutes 2

HEQ275 How often does {CHILD} have a TV, smartphone, tablet, or laptop in {his/her} room overnight?
1 Every night
2 Most nights
3 Some nights
4 Hardly ever
5 Never
Media engagement and usage 2

HEQ276 a-b When {CHILD} is doing the following, how often do you or another adult in the household do it with {him/her}? Media engagement and usage 2

HEQ276a Watching {his/her} shows, movies, and videos
1 Most of the time
2 Some of the time
3 Hardly ever
4 Never
5 {CHILD} does not do this
Media engagement and usage 2

HEQ276b Playing video, computer, or mobile games
1 Most of the time
2 Some of the time
3 Hardly ever
4 Never
5 {CHILD} does not do this
Media engagement and usage 2

HEQ277 Do you have Internet (cable, Wifi, wireless, or DSL) in your home?
1 Yes
2 No
Media engagement and usage 2

HEQ278 Does {CHILD} use any digital device(s) to get on the Internet in your home?
1 Yes
2 No
Media engagement and usage 2

HEQ279 Do you ever use any type of software, app, or device to monitor or limit {CHILD}'s access to the Internet?
1 Yes
2 No
Media engagement and usage 2

HEQ285 Are there family rules about how many hours {CHILD} may spend on screen time?

Screen time refers to the amount of time the child is using a TV, computer, or any other digital device in which the child is looking at a screen during use.

1 Yes
2 No
Media engagement and usage 2

HEQ285a In what ways do you limit {CHILD}'s screen time?

Please Select All That Apply

1 With a device or app
2 Ask my child to end screen time
3 Redirect my child to other activity
4 Take away the device from my child
91 Other (Please specify):
Media engagement and usage 2

HEQ285aOS In what ways do you limit {CHILD}'s screen time? Other specify for media engagement and usage

HEQ288 Now we'd like to ask you about some of the activities your child might do. Has {CHILD} ever participated in any of the following activities?

Select All That Apply

1 Organized athletic activities, like basketball, soccer, baseball, swimming, or gymnastics
2 Dance groups, classes, or lessons
3 Music, for example, piano, instrumental music, or singing lessons
4 Drama groups, classes, or lessons
5 Art groups, classes, or lessons, for example, painting, drawing, sculpture
6 Craft groups, classes, or lessons
7 Language groups, classes, or lessons (to learn English or another language)
Children's organized activities 2

HEQ289 In the past month, that is, since {MONTH} {DAY}, has anyone in your family visited the following with {CHILD}?

Select All That Apply

1 Visited a library or bookstore (Do not count visiting a library or bookstore online. We are asking about in person visits to a library or bookstore.)
2 Gone to a play, concert, or other live show
3 Visited an art gallery, museum, or historical site
4 Visited a zoo, aquarium, or petting farm
5 Attended an athletic or sporting event in which {CHILD} was not a player
6 Gone to a park

Outings 2

HEQ520 In a typical week, please indicate the number of days your family eats any meal together. By family, we mean at least one adult and one child.
Eating a meal together 2

HEQ521 In a typical week, please indicate the number of days your family eats the evening meal together.
By family, we mean at least one adult and one child.
Eating the evening meal together 2

HEQ540 During a typical week, how often does {CHILD} play outside actively (for example, running, jumping, or swinging?
1 Never
2 Once or twice
3 3 to 6 times
4 Every day



HEQ545 How safe is it for children to play outside during the day in your neighborhood?
1 Not at all safe
2 Somewhat safe
3 Very safe



HEQ550 Does {CHILD} usually go to bed at about the same time each night, or does {his/her} bedtime vary a lot from night to night?
1 Has usual bedtime
2 Bedtime varies
Whether child has a regular bedtime 2

HEQ600a On an average weeknight, how many hours of sleep does {CHILD} get?

Hours:
Sleep-hours 2

HEQ600b On an average weeknight, how many hours of sleep does {CHILD} get?

Minutes:
Sleep-minutes 2
SSQ Social Skills, Problem Behaviors, and Approaches Toward Learning SSQ010 a-n Please indicate how often {CHILD} acts this way. Approaches to Learning 2, 5

SSQ010a Keeps working at something until {he/she} is finished
1 Never
2 Sometime
3 Often
4 Very often
Approaches to Learning 2, 5

SSQ010b Shows interest in a variety of things
1 Never
2 Sometime
3 Often
4 Very often
Approaches to Learning 2, 5

SSQ010c Concentrates on a task and ignores distractions
1 Never
2 Sometime
3 Often
4 Very often
Approaches to Learning 2, 5

SSQ010d Helps with chores
1 Never
2 Sometime
3 Often
4 Very often
Approaches to Learning 2, 5

SSQ010e Is eager to learn new things
1 Never
2 Sometime
3 Often
4 Very often
Approaches to Learning 2, 5

SSQ010f Is creative in work or in play
1 Never
2 Sometime
3 Often
4 Very often
Approaches to Learning 2, 5

SSQ010g Item wording is redacted due to copyright Social interaction 2, 5

SSQ010h Item wording is redacted due to copyright Social interaction 2, 5

SSQ010i Item wording is redacted due to copyright Social interaction 2, 5

SSQ010j Item wording is redacted due to copyright Self-control 2, 5

SSQ010k Item wording is redacted due to copyright Self-control 2, 5

SSQ010l Item wording is redacted due to copyright Self-control 2, 5

SSQ010m Item wording is redacted due to copyright Self-control 2, 5

SSQ010n Item wording is redacted due to copyright Self-control 2, 5

SSQ020 a-f Please rate how true each of these statements is for {CHILD}. Attention Focusing 2, 5

SSQ020a When practicing an activity, has a hard time keeping {her/his} mind on it.
1 Extremely untrue of your child
2
3
4
5
6
7 Extremely true of your child
Attention Focusing 2, 5

SSQ020b Will move from one task to another without completing any of them.
1 Extremely untrue of your child
2
3
4
5
6
7 Extremely true of your child
Attention Focusing 2, 5

SSQ020c When drawing or coloring in a book, shows strong concentration.
1 Extremely untrue of your child
2
3
4
5
6
7 Extremely true of your child
Attention Focusing 2, 5

SSQ020d When building or putting something together, becomes very involved in what {he/she} is doing, and works for long periods of time.
1 Extremely untrue of your child
2
3
4
5
6
7 Extremely true of your child
Attention Focusing 2, 5

SSQ020e Is easily distracted when listening to a story.
1 Extremely untrue of your child
2
3
4
5
6
7 Extremely true of your child
Attention Focusing 2, 5

SSQ020f Sometimes becomes absorbed in a picture book and looks at it for a long time.
1 Extremely untrue of your child
2
3
4
5
6
7 Extremely true of your child
Attention Focusing 2, 5

SSQ025 a-f Please rate how true each of these statements is for {CHILD}. Inhibitory Control 2, 5

SSQ025a Can wait before entering into new activities if asked to
1 Extremely untrue of your child
2
3
4
5 Extremely true of your child
Inhibitory Control 2, 5

SSQ025b Plans for new activities or changes in routine to make sure s/he has what will be needed
1 Extremely untrue of your child
2
3
4
5 Extremely true of your child
Inhibitory Control 2, 5

SSQ025c Has trouble sitting still when s/he is told to (story time, etc.)
1 Extremely untrue of your child
2
3
4
5 Extremely true of your child
Inhibitory Control 2, 5

SSQ025d Is good at following instructions
1 Extremely untrue of your child
2
3
4
5 Extremely true of your child
Inhibitory Control 2, 5

SSQ025e Approaches places that s/he thinks might be "risky" slowly and cautiously
1 Extremely untrue of your child
2
3
4
5 Extremely true of your child
Inhibitory Control 2, 5

SSQ025f Can easily stop an activity when told "no"
1 Extremely untrue of your child
2
3
4
5 Extremely true of your child
Inhibitory Control 2, 5

SSQ030 a-e How much do you agree or disagree with the following statements about {CHILD}. Affective empathy 2, 5

SSQ030a My child becomes sad when other children are sad.
1 Strongly disagree
2
3 Neither disagree nor agree
4
5 Strongly agree
Affective empathy 2, 5

SSQ030b My child gets upset seeing another child being punished for being naughty.
1 Strongly disagree
2
3 Neither disagree nor agree
4
5 Strongly agree
Affective empathy 2, 5

SSQ030c My child seems to react to the moods of people around them.
1 Strongly disagree
2
3 Neither disagree nor agree
4
5 Strongly agree
Affective empathy 2, 5

SSQ030d My child gets upset when another person is acting upset.
1 Strongly disagree
2
3 Neither disagree nor agree
4
5 Strongly agree
Affective empathy 2, 5

SSQ030e My child cries or gets upset when seeing another child cry.
1 Strongly disagree
2
3 Neither disagree nor agree
4
5 Strongly agree
Affective empathy 2, 5
FSQ -Family Structure FSQ010 Please confirm the names or initials of the household members you already told us about before and add the first names of all the other people who normally live here, including both adults and children. Please do not include anyone staying here temporarily who usually lives somewhere else.
We ask for first names so that we can ask questions about each person in the survey. If there is a typo, or you gave a nickname or initials, you may correct it here before continuing.

Please list each person in your household on a separate line, until you have listed all the people in your household.
Don't forget…
-your spouse or partner, or
-someone who is temporarily away from home or living in a dorm at school, or
-any babies or small children.

First name
{DISPLAY FIRST NAME OF RESPONDENT}
{DISPLAY FIRST NAME OF SAMPLED CHILD}
{DISPLAY FIRST NAMES OF ALL OTHER CHILDREN LISTED IN SCREENER, IF APPLICABLE}
Current household roster 1, 2, 5

FSQ030 How old {are you/is {NAME}}?

For babies less than 1 year old, enter 0.

Current household roster 1, 2, 5

FSQ040 {Are you/Is {NAME}} male or female?}.
1 Male
2 Female
Current household roster 1, 2, 5

FSQ110 Do you have a spouse or partner who lives in this household?
1 Yes
2 No
Marital status of the primary caregivers 1, 2, 5

FSQ120 Who in the household is your spouse or partner?

Select the number next to the name of the person who is your spouse/partner.
If name not listed, select "not on list."

1 {DISPLAY HH MEMBER NAME 1}
2 {DISPLAY HH MEMBER NAME 2}
3 {DISPLAY HH MEMBER NAME 3}
4 {DISPLAY HH MEMBER NAME 4}
5 {DISPLAY HH MEMBER NAME 5}
6 {DISPLAY HH MEMBER NAME 6}
7 {DISPLAY HH MEMBER NAME 7}
8 {DISPLAY HH MEMBER NAME 8}

|_| Not on list
Marital status of the primary caregivers 1, 2, 5

FSQ120a What is the first name of your spouse or partner?

First name:
Marital status of the primary caregivers 1, 2, 5

FSQ120b How old is {NAME}?


Current household roster 1, 2, 5

FSQ120c Is {NAME} male or female?
1 Male
2 Female
Current household roster 1, 2, 5

FSQ130 What is {your/{NAME}'s} relationship to {CHILD}?
1 Mother/female guardian
2 Father/male guardian
3 Other parent/guardian
4 Sister
5 Brother
6 Girlfriend or female partner of {CHILD}'s parent/guardian
7 Boyfriend or male partner of {CHILD}'s parent/guardian
8 Other partner of {CHILD}'s parent/guardian
9 Grandmother
10 Grandfather
11 Aunt
12 Uncle
13 Cousin
14 Other relative
15 Other non-relative
Relationship of household member to child 1, 2, 5

FSQ140 {Are you/Is {NAME}} {CHILD}'s…
1 Biological or birth mother
2 Adoptive mother
3 Step mother
4 Foster mother or legal female guardian
5 Other female parent or guardian
Relationship of household member to child 1, 2, 5

FSQ150 {Are you/Is {NAME}} {CHILD}'s…
1 Biological or birth father
2 Adoptive father
3 Step father
4 Foster father or legal male guardian
5 Other male parent or guardian
Relationship of household member to child 1, 2, 5

FSQ155 {Are you/Is {NAME}} {CHILD}'s…
1 Biological or birth parent
1 Adoptive parent
3 Step parent
4 Foster parent or legal guardian
5 Other parent or guardian
Relationship of household member to child 1, 2, 5

FSQ160 {Are you/Is {NAME}} {CHILD}'s…
1 Full sister
2 Half sister
3 Step sister
4 Adoptive sister
5 Foster sister
Relationship of household member to child 1, 2, 5

FSQ170 {Are you/Is {NAME}} {CHILD}'s…
1 Full brother
2 Half brother
3 Step brother
4 Adoptive brother
5 Foster brother
Relationship of household member to child 1, 2, 5

FSQ180 {Are you/Is {NAME}} {CHILD}'s…
1 Girlfriend or female partner of {CHILD}'s parent/guardian
2 Boyfriend or male partner of {CHILD }'s parent/guardian
3 Other partner of {CHILD}'s parent/guardian
4 Female guardian
5 Male guardian
6 Other guardian
7 Daughter/son of {CHILD}'s parent's partner
8 Other relative of {CHILD}'s parent's partner
91 Other non-relative (Please specify):
Relationship of household member to child 1, 2, 5

FSQ180OS {Are you/Is {NAME}} {CHILD}'s… Other specify for relationship of household member to child 1, 2, 5

FSQ190 {Are you/Is {NAME}} Hispanic or Latina/Latino?

A person who is Hispanic or Latino is of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.

1 Yes
2 No
Ethnicity of child, parent figures, or respondent and respondent's spouse (if no mother or father figures) 1, 2, 5

FSQ195 What is {your/{NAME}'s} race? You may name one or more races to indicate what {you/NAME} {consider/considers} {yourself/himself/herself/themself} to be.

For the purposes of this study, Hispanic origins are not races.

Please Select All That Apply.

1 American Indian or Alaska Native
2 Asian
3 Black or African American
4 Native Hawaiian or other Pacific Islander
5 White
Race of child, parent figures, or respondent and respondent's spouse (if no mother or father figures) 1, 2, 5

FSQ200 {FILL 1} currently married, separated, divorced, widowed, in a domestic partnership, or {FILL 2} never been married?
1 Married
2 Separated
3 Divorced
4 Widowed
5 Never married
6 Civil unions/domestic parthership
Don't know
Marital status of the primary caretakers 1, 2, 5
CCQ - Child Care CCQ010 Is {CHILD} now receiving care from a relative on a regular basis? This may include grandparents, brothers and sisters, or any relatives other than {you/{CHILD}'s {parents/guardians}}.
Care from a relative would be with any relative other than the child’s parents and would take place in a private home. It may be free or cost money. It should be a regular child care arrangement rather than occasional babysitting or back-up care. If you are separated or divorced, please do not include visitation with a parent who does not have custody.
1 Yes
2 No
Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ015 Has {CHILD} ever received care from a relative on a regular basis?
1 Yes
2 No
Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ020a How old was {CHILD} in years and months when {he/she} first received care from any relative on a regular basis?
Type and amount of ECE arrangements (relative)-years 1, 2, 3

CCQ020b How old was {CHILD} in years and months when {he/she} first received care from any relative on a regular basis?
Type and amount of ECE arrangements (relative)-months 1, 2, 3

CCQ060 How many different regular care arrangements do you currently have with relatives?
Please do not include care from a parent or guardian who lives in the home or elsewhere.
1 One
2 Two
3 Three
4 Four
5 Five or more
Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ065 {We’d like to know more about the relative who provides the most care for {CHILD} now.} Who is the relative who cares for {CHILD}?

Please do not include care from a parent or guardian who lives in the home or elsewhere.

1 Grandparent
2 Aunt
3 Uncle
4 Brother
5 Sister
6 Another relative
Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ085 How many days each week does {CHILD} receive care from {{his/her} RELATIVE}/that relative}?

Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ090 How many hours each week does {CHILD} receive care from {{his/her} RELATIVE}/that relative}?

Enter the hours each week in whole hours.

Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ095 How long has {CHILD} received care from {his/her} relative in the last year?

1 One to two months
2 Three to five months
3 Six to eight months
4 Nine to eleven months
5 Twelve months
Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ096 What language does {CHILD}’s relative speak most when caring for {CHILD}?
0 English
1 Spanish
2 A European language other than Spanish such as French, German or Russian
3 A Chinese language or dialect
4 A Filipino language
5 A Southeast Asian language such as Vietnamese, Thai, or Khmer
6 A South Asian language such as Hindi or Tamil
7 Another Asian language such as Japanese or Korean
8 A Middle Eastern language such as Arabic or Farsi
9 An African language such as Swahili or Amharic
91 Another language (Please specify):
Characteristics of providers (relative) 1, 2, 3

CCQ096OS What language does {CHILD}’s relative speak most when caring for {CHILD}? Other specify for characteristics of providers (relative) 1, 2, 3

CCQ097 Is this relative 18 years of age or older?
1 Yes
2 No
Characteristics of providers (relative) 1, 2, 3

CCQ098 Head Start is a federally sponsored preschool program mainly for children from low-income families. {Is the regular care arrangement that {CHILD} has with a relative/Are any of the regular care arrangements that {CHILD} has with relatives} Head Start?}

Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is related to the child but is not his or her parent. If your child participates in a home Head Start program where and a parent is the caregiver, select no.

1 Yes
2 No
Don't know
Head Start (relative) 1, 2, 3

CCQ099 Is the relative who provides the most care for {CHILD} providing the care as part of a Head Start program?

Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home).
For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is related to the child but is not his or her parent.

1 Yes
2 No
Head Start (relative) 1, 2, 3

CCQ100 How many days each week does {CHILD} receive care from a relative in Head Start? Head Start (relative) 1, 2, 3

CCQ101 How many hours each week does {CHILD} receive care from this relative in Head Start?

Enter the hours each week in whole hours.
Head Start (relative) 1, 2, 3

CCQ110 How many hours each week does {CHILD} receive care from {these/this} other {relatives/relative}?

Do not include care from a parent or guardian who lives in the household or in another home.
Type and amount of ECE arrangements (relative) 1, 2, 3

CCQ115 Is {CHILD} now receiving care in a private home on a regular basis from someone who is not related to/ {him/her} (including care provided before or after school)? This includes home child care providers, regular sitters, or neighbors. {It does not include child care centers.}

Non-relative care is provided by someone not related to the child and is located in a private home. The private home may be the child’s home, the caregiver’s home, or another home. If there is at least one parent in the household, any nonrelative living in the household is eligible to be counted as a care arrangement, if the care is given on a regularly scheduled basis. If neither parent lives in the household, do not include care provided by guardians who live with the child (they are treated the same as parents). Non-relative care arrangements or programs may or may not have a charge or fee.

1 Yes
2 No
Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ120 Has {CHILD} ever received care in a private home from a nonrelative on a regular basis?
1 Yes
2 No
Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ125a How old was {CHILD} in years and months when {he/she} first received regular care in a private home from any nonrelative? Type and amount of ECE arrangements (nonrelative)-years 1, 2, 3

CCQ125b How old was {CHILD} in years and months when {he/she} first received regular care in a private home from any nonrelative? Type and amount of ECE arrangements (nonrelative)-months 1, 2, 3

CCQ165 How many different regular care arrangements do you currently have with nonrelatives?
1 One
2 Two
3 Three
4 Four
5 Five or more
affective empathy 1, 2, 3

CCQ170 Is that care provided in your home or another home?
1 Own home
2 Other home
3 Both/Varies
Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ185 How many days each week does {CHILD} receive care from that person?

Days:
Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ190 How many hours each week does {CHILD} receive care from that person?

Enter the hours each week in whole hours.

Hours:
Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ191 How long has {CHILD} received care from the nonrelative in the last year?
1 One to two months
2 Three to five months
3 Six to eight months
4 Nine to eleven months
5 Twelve months
Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ192 What language does {CHILD}’s nonrelative speak most when caring for {CHILD}?
0 English
1 Spanish
2 A European language other than Spanish such as French, German or Russian
3 A Chinese language or dialect
4 A Filipino language
5 A Southeast Asian language such as Vietnamese, Thai, or Khmer
6 A South Asian language such as Hindi or Tamil
7 Another Asian language such as Japanese or Korean
8 A Middle Eastern language such as Arabic or Farsi
9 An African language such as Swahili or Amharic
91 Another language (Please specify):
Characteristics of providers (nonrelative) 1, 2, 3

CCQ192OS What language does {CHILD}’s nonrelative speak most when caring for {CHILD}? Other specify for characteristics of providers (nonrelative) 1, 2, 3

CCQ193 Is this nonrelative 18 years of age or older?
1 Yes
2 No
Characteristics of providers (nonrelative) 1, 2, 3

CCQ194 {Head Start is a federally sponsored preschool program mainly for children from low-income families.} {Is the regular care arrangement that {CHILD} has with a nonrelative /Are any of the regular care arrangements that {CHILD} has with nonrelatives} Head Start?
Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is not his or her parent and is not related to the child.

1 Yes
2 No
Head Start (nonrelative) 1, 2, 3

CCQ195 Is the nonrelative who provides the most care for {CHILD} now providing the care as part of a Head Start program?

Head Start is a federally funded early childhood education program designed to improve the school readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a family child care program in a private home where the child is cared for by someone who is not his or her parent and is not related to the child.

1 Yes
2 No
Head Start (nonrelative) 1, 2, 3

CCQ196 How many days each week does {CHILD} receive care from that person in Head Start? Head Start (nonrelative) 1, 2, 3

CCQ197 How many hours each week does {CHILD} receive care from that person in Head Start?

Enter the hours each week in whole hours.
Head Start (nonrelative) 1, 2, 3

CCQ205 How many hours each week does {CHILD} receive care from {this nonrelative/these nonrelatives}? Type and amount of ECE arrangements (nonrelative) 1, 2, 3

CCQ260 Is {CHILD} now attending a day care center, nursery school, preschool, prekindergarten, or a before- or after-school program at a school or in a center on a regular basis?

Please include any type of formal program that provides care and supervision. It may be in a child's school or in another location, such as a church or a free-standing building. Head Start programs, nursery schools, preschools, and prekindergarten programs that include children who are now in kindergarten (some of which may be sponsored by the state) are also included.

1 Yes
2 No
Type and amount of ECE arrangements (center) 1, 2, 3

CCQ265 Has {CHILD} ever attended a day care center, nursery school, preschool, prekindergarten, or before- or afterschool program at a school or in a center on a regular basis?
1 Yes
2 No
Type and amount of ECE arrangements (center) 1, 2, 3

CCQ275a How old was {CHILD} in years and months when {he/she} first attended any day care center, nursery school, preschool, prekindergarten, or before- or after-school program on a regular basis? Type and amount of ECE arrangements (center)-years 1, 2, 3

CCQ275b How old was {CHILD} in years and months when {he/she} first attended any day care center, nursery school, preschool, prekindergarten, or before- or after-school program on a regular basis? Type and amount of ECE arrangements (center)-months 1, 2, 3

CCQ280 How many different day care centers or before- or after-school care programs does {CHILD} currently go to on a regular basis?
1 One
2 Two
3 Three
4 Four
5 Five or more
Type and amount of ECE arrangements (center) 1, 2, 3

CCQ285 Where is the program that {CHILD} attends {most} located? For example, is it in its own building, a school, a place of worship, or some other place?
1 Its own building
2 A public elementary, junior high, or high school
3 A private elementary, junior high, or high school
4 A college or university
5 A church, mosque, synagogue, or other place of worship
6 Your home
7 Another home
8 A community center
9 A public library
10 A building or storefront that shares walls with other businesses
11 More than one place
12 Some other place
Type and amount of ECE arrangements (center) 1, 2, 3

CCQ295 How many days each week does {CHILD} go to that program? Type and amount of ECE arrangements (center) 1, 2, 3

CCQ300 How many hours each week does {CHILD} go to that program?

Enter the hours each week in whole hours.
Type and amount of ECE arrangements (center) 1, 2, 3

CCQ305 How long has {CHILD} received care at that program in the last year?
1 One to two months
2 Three to five months
3 Six to eight months
4 Nine to eleven months
5 Twelve months
Type and amount of ECE arrangements (center) 1, 2, 3

CCQ310 What language does {CHILD}’s main care provider or teacher at that program speak most when caring for {CHILD}?
0 English
1 Spanish
2 A European language other than Spanish such as French, German or Russian
3 A Chinese language or dialect
4 A Filipino language
5 A Southeast Asian language such as Vietnamese, Thai, or Khmer
6 A South Asian language such as Hindi or Tamil
7 Another Asian language such as Japanese or Korean
8 A Middle Eastern language such as Arabic or Farsi
9 An African language such as Swahili or Amharic
91 Another language (Please specify):
Characteristics of providers (center) 1, 2, 3

CCQ310OS What language did {CHILD}’s main care provider or teacher at that program speak most when caring for {CHILD}? Other specify for characteristics of providers (center) 1, 2, 3

CCQ320 When {CHILD}'s teacher sends home notes or newsletters, are these in a language that you speak?
1 Yes
2 No
Whether the ECE provides translated materials 1, 2, 3

CCQ325 {Is/Are any of } {CHILD}’s care arrangement{s} in a day care center, nursery school, preschool, or prekindergarten program Head Start?

Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a center setting.

1 Yes
2 No
Head Start (center) 1, 2, 3

CCQ326 Is the care arrangement in a day care center, nursery school, preschool, or prekindergarten program where {CHILD} spends the most time a Head Start program?

Head Start is a federally funded early childhood education program designed to improve the school-readiness of disadvantaged children who are usually 3 to 5 years old. Head Start may be offered in a variety of locations (center or home). For this question, we are interested in Head Start services in a center setting.

1 Yes
2 No
Head Start (center) 1, 2, 3

CCQ327 How many days each week does {CHILD} receive care from Head Start? Head Start (center) 1, 2, 3

CCQ328 How many hours each week does {CHILD} receive care from Head Start?

Enter the hours each week in whole hours.
Head Start (center) 1, 2, 3

CCQ329 {Is the day care center, nursery school, preschool, or prekindergarten program}/{Are any of the day care centers, nursery schools, preschools, or prekindergarten programs} a state-sponsored preschool or state sponsored prekindergarten program?
1 Yes
2 No
State-sponsored ECE program 1, 2, 3

CCQ375 You said that {CHILD} attended {NUMBER} other day care {center/centers} or before- or after-school {program/programs} on a regular basis. How many hours each week does {CHILD} attend {this program/these programs}? Type and amount of ECE arrangements (center) 1, 2, 3

CCQ500 a-e Please answer the following questions about the child care arrangement that {CHILD} spends the most time in right now. Parent endorsement of the ECE setting 1, 2, 3

CCQ500a I feel welcome and comfortable with the people at {CHILD}’s arrangement.
1 Strongly disagree
2 Disagree
3 Not sure
4 Agree
5 Strongly agree
Parent endorsement of the ECE setting 1, 2, 3

CCQ500b {CHILD}’s arrangement has been a good place for {him/her} to be.
1 Strongly disagree
2 Disagree
3 Not sure
4 Agree
5 Strongly agree
Parent endorsement of the ECE setting 1, 2, 3

CCQ500c The people at {CHILD}’s arrangement are doing good things for {him/her}.
1 Strongly disagree
2 Disagree
3 Not sure
4 Agree
5 Strongly agree
Parent endorsement of the ECE setting 1, 2, 3

CCQ500d I have confidence in the people at {CHILD}’s arrangement.
1 Strongly disagree
2 Disagree
3 Not sure
4 Agree
5 Strongly agree
Parent endorsement of the ECE setting 1, 2, 3

CCQ500e {CHILD}’s arrangement is doing a good job of preparing {him/her} for school.
1 Strongly disagree
2 Disagree
3 Not sure
4 Agree
5 Strongly agree
Parent endorsement of the ECE setting 1, 2, 3

CCQ550 About how far would you say it is from your home to the child care arrangement {CHILD} attends?
1 Less than 1/8th mile (less than 3 blocks)
2 1/8th mile to 1/4 mile (3-5 blocks)
3 More than 1/4 mile, but less than 1/2 mile (6-9 blocks)
4 1/2 mile to less than 1 mile (10-19 blocks)
5 One mile to 2.5 miles
6 2.6 miles to 5 miles
7 5.1 miles to 7.5 miles
8 7.6 miles to 10 miles
9 10.1 miles or more
Distance to ECE setting 1, 2, 3

CCQ555 About how far would you say it is from your home to the child care arrangement {CHILD} attends?
1 Less than 5 minutes away
2 Between 5-10 minutes away
3 Between 11 and 15 minutes away
4 Between 16 and 20 minutes away
5 Between 21 and 30 minutes away
6 More than 30 minutes away
Distance to ECE setting 1, 2, 3

CCQ555a How do you usually take {CHILD} to the child care arrangement {he/she} attends?
1 Walking
2 Driving
3 Public transportation
91 Other (Please specify):
How long to ECE setting 1, 2, 3

CCQ555aOS How do you usually take {CHILD} to the child care arrangement {he/she} attends? Other specify for how long to ECE setting 1, 2, 3

CCQ560 Even though many factors matter when choosing child care or a preschool, which three factors below were the most important to you? Please choose only three choices.
For me, the THREE (3) most important factors were that the child care or program…
a. Offers convenient hours (for example, is a full-day program, or offers before- or after-school care)
b. Offers services for children with special needs
c. Teaches children how to get along well with others
d. Is in a convenient location (close to your home, work, or public transportation)
e. Has a warm and nurturing caregiver(s)/teacher(s)
f. Provides a safe and clean environment
g. Provides transportation
h. Is free or was the least expensive option
i. Teaches children letters, numbers, and other academic skills
j. Accepts payment from a child care assistance program in my state
k. Also serves my other children (for example, the program is located in a school where an older sibling is enrolled
l. Teaching philosophy (for example, Montessori, Reggio Emelia, etc.)
m. Provides specialized programs (for example, dual language instruction)
n. Offered in same location as kindergarten
o. Has good reputation or high rating (for example, heard good things about the school from friends, family, neighbors, etc.)
p. Very good value
q. Promotes racial/cultural inclusivity
r. A language other than English is used as the teaching language

Reasons for choosing child care 1, 2, 3

CCQ565 Now please choose the TWO things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program. Please choose only two choices.
The TWO (2) things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program are:
a. Offer more convenient hours
b. Be in a more in a convenient location
c. It is not helping my child learn (for example, I wish my child got more practice development social skills or academic school skills)
d. The way the caregiver/teacher interacts with my child (for example, I wish my child’s caregiver/teacher was more warm and affectionate)
e. The environment at my child’s child care/preschool program (for example, I wish the program was more inviting with more books and toys for my child)
f. The way my child’s caregiver/teacher communicates with me about my child (for example, I wish my child’s caregiver/teacher talked to me more about my child’s progress)
g. The cost
h. Other (Please specify):
i. None. If there is nothing you would change about your child care/preschool program, please mark here.
Improvements that the parent would make in the child care 1, 2, 3

CCQ565hOS Now please choose the TWO things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program. Please choose only two choices.
The TWO (2) things that MOST NEED IMPROVEMENT at {CHILD}’s child care or preschool program are:




CCQ570 Has anyone in any of {CHILD}’s care arrangements contacted you or another adult in your household about any behavior problems {he/she/{CHILD}} is having, such as:

Select All That Apply

1 Biting
2 Being aggressive
3 Not following directions
4 Being overly active
5 Being impulsive or having little or not self-control
6 Another behavior problem
7 None of these
How behavior problems are handled in the ECE setting 1, 2, 3, 5

CCQ575 How helpful was this care arrangement(s) in providing tips  or assistance in dealing with {CHILD}’s problem behaviors?
1 Very helpful
2 Somewhat helpful
3 Not at all helpful
4 Did not receive assistance or tips
How behavior problems are handled in the ECE setting 1, 2, 3, 5

CCQ580 Have you ever been asked to remove {CHILD} from care for the day due to one or more behavior issues he/she was having, such as biting, being aggressive, not following directions, being overly active, being impulsive, or having little or no self-control?

1 Yes
2 No
Whether the child has ever been asked to leave the ECE program  for the day 1, 2, 3, 5

CCQ585 Have you ever been asked to remove {CHILD} from care and not return to the care setting?
1 Yes
2 No
Whether the child has ever been asked to leave the ECE program and not return 1, 2, 3, 5

CCQ590 You reported before that {CHILD} has received {his/her/{CHILD}’s} current care from {a relative {and}/a non-relative {and}/ a day care center, nursery school, preschool, prekindergarten, or before- or after-school program} for less than twelve months. Where else was {CHILD} in care in the last year?

1 Head Start program (Head Start is a federally sponsored pre-kindergarten program mainly for children from low income families)
2 Preschool in a public school
3 An early education center, child care center, parochial child care center, or nursery school other than Head Start
4 An in-home child care program or family child care program
5 An “extended-day” program, that is, before- or after-school care at the child’s regular school
6 Care by a parent
7 Care by another member of your family or household
8 Care by someone other than a member of your family or household
91 Other (Please specify):
Child care type if in current care for less than a year 1, 2, 3, 5

CCQ590OS Where else was {CHILD} in care in the last year? Other specify for child care type if in current care for less than a year
KSQ - Kindergarten Selection and Choice KSQ005 Some parents know in advance where their children will attend kindergarten. Do you know where {CHILD} will attend kindergarten?
1 Yes
2 No
School where child is expected to attend kindergarten 4

KSQ010 What is the name of the school where {CHILD} will attend {kindergarten/next year}?

Select the school from the list below. If you don't find the school, select "School not on list" and then type in the full school name. If you are considering more than one school, enter the name of the school that is most likely.
School where child is expected to attend kindergarten 4

KSQ010OS What is the name of the school where {CHILD} will attend {kindergarten/next year}? Other specifiy for school where child is expected to attend kindergarten 4

KSQ015a What is the mailing address of the school?

Address Line 1:
Address Line 2:
School where child is expected to attend kindergarten 4

KSQ015b City: School where child is expected to attend kindergarten 4

KSQ015c State:

Please select a state, district, or territory.
School where child is expected to attend kindergarten 4

KSQ015d Zip code: School where child is expected to attend kindergarten 4

KSQ020 How did you learn about the school where {CHILD} will attend kindergarten?

Select All That Apply

1 It is the assigned school for our neighborhood
2 Word of mouth/recommendation from family, friends, etc.
3 District/school website
4 Looked at school's profile online
5 Looked at school's ratings online from other parents
91 Other (specify)
How respondent learned of selected kindergarten 4

KSQ020OS How did you learn about the school where {CHILD} will attend kindergarten? Other specify for how respondent learned of selected kindergarten

KSQ025 Even though many factors matter when choosing a kindergarten, which three factors below are the most important to you? Please choose only three choices.
a Offers convenient hours (for example, is a full day kindergarten program, or offers before- or after-school care)
b Offers services for children with special needs
c Teaches children how to get along well with others
d Is in a convenient location (close to your home, work, or public transportation)
e Has a warm and nurturing teacher(s)
f Provides a safe and clean environment
g Provides transportation
h Is free or is the least expensive option
i Teaches children letters, numbers, and other academic skills
j Accepts payment from a tuition assistance/voucher program in my state
k Also serves my other children (for example, the program is located in a school where an older sibling is enrolled)
l Offers specialized programs or curriculum (for example, drama, arts, foreign languages, Montessori, modified calendar, etc.)
m Is in an elementary school that feeds into a desired middle or high school
n Has a good reputation or high rating (for example, heard good things about the school from friends, family, neighbors, etc.)
o Very good value
p Promotes racial/cultural inclusivity
q A language other than English is used as the teaching language
r It is the assigned public school for the neighborhood
Reasons for choosing kindergarten 4
CHQ -Child's Health and Well-Being CHQ004 Would you say {CHILD}'s health is …
1 Excellent,
2 Very good,
3 Good,
4 Fair, or
5 Poor?
Overall health 1, 2

CHQ060 In a typical week, on how many days does {CHILD} get exercise that causes rapid breathing, perspiration, and a rapid heartbeat for 20 continuous minutes or more? Exercise 1, 2

CHQ086 How tall is {CHILD} without shoes?

1 Answer in feet and inches
2 Answer in meters and centimeters
Don't know
Height 1, 2

CHQ086a [Please answer for how tall {CHILD} is in feet and inches without shoes?] Height-feet 1, 2

CHQ086b [Please answer for how tall {CHILD} is in feet and inches without shoes?] Height-inches 1, 2

CHQ086c [Please answer for how tall {CHILD} is in meters and centimeters without shoes?] Height-meters 1, 2

CHQ086d [Please answer for how tall {CHILD} is in meters and centimeters without shoes?] Height-centimeters 1, 2

CHQ087 How much does {CHILD} weigh without shoes?

1 Answer in pounds
2 Answer in kilograms
Don't know
Weight 1, 2

CHQ087a [Please answer for how much {CHILD} weighs in pounds without shoes?] Weight-pounds 1, 2

CHQ087b [Please answer for how much {CHILD} weighs in kilograms without shoes?] Weight-kilograms 1, 2

CHQ095 a-g Please answer the following questions based on how {CHILD} compares to other children of the same age. Perception of child compared to other similar-aged children 1, 2

CHQ095a {CHILD} is independent and takes care of {himself/herself}
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ095b {CHILD} pays attention
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ095c {CHILD} learns, thinks, and solves problems
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ095d {CHILD} shows good coordination in moving {his/her} arms and legs?
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ095e {CHILD} behaves and relates to other children
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ095f {CHILD} behaves and relates to adults
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ095g {CHILD}'s overall activity level is
1 Better than other children {his/her} age
2 As well as other children
3 Slightly less well than other children
4 Much less well than other children
Perception of child compared to other similar-aged children 1, 2

CHQ110 Does {CHILD} have any emotional or psychological difficulties?
1 Yes
2 No
Emotional or psychological difficulties 1, 2

CHQ111 Do you think this is a mild problem, a moderate problem, or a severe problem?
1 Mild problem
2 Moderate problem
3 Severe problem
Emotional or psychological difficulties 1, 2

CHQ116 Has a health, education, or early intervention professional told you that {CHILD} is "at risk" for problems with health, physical disabilities, learning, or behavior?
1 Yes
2 No
Whether a health, education, or early intervention profession indicted child is at-risk 1, 2

CHQ117 Has {CHILD} ever been diagnosed with a disability?
1 Yes
2 No
Disability 1, 2

CHQ118 Has {CHILD} ever received services from a program called Early Intervention Services or have an Individualized Family Service Plan (IFSP)?

Early Intervention Services are services to a family with a child who has been identified as having a developmental delay and/or a specific health condition when the child is between birth and age 3. An Individualized Family Service Plan or IFSP is a plan developed to support children and families involved in early intervention (birth to age 3).

1 Yes
2 No
Disability 1, 2

CHQ118a Is {CHILD} currently receiving services from a program called Early Intervention Services or have an Individualized Family Service Plan (IFSP)?

Early Intervention Services are services to a family with a child who has been identified as having a developmental delay and/or a specific health condition when the child is between birth and age 3. An Individualized Family Service Plan or IFSP is a plan developed to support children and families involved in early intervention (birth up to age 3).

1 Yes
2 No
Disability 1, 2

CHQ119 Has {CHILD} ever received any services through an Individualized Education Program (IEP)?

An Individualized Education Program (IEP) is a plan for children age 3 or older identified as needing special education and related services.

1 Yes
2 No
Disability 1, 2

CHQ119a Is {CHILD} currently receiving any services through an Individualized Education Program (IEP)?

An Individualized Education Program (IEP) is a plan for children age 3 or older identified as needing special education and related services.

1 Yes
2 No
Disability 1, 2

CHQ121 Has {CHILD} ever received any services through a 504 plan?

A 504 plan is a formal plan schools use to provide accommodations to children with disabilities. A 504 plan does not include individualized instruction, and children do not have to qualify for special education services to be eligible for a 504 plan.

1 Yes
2 No
Disability 1, 2

CHQ121a Is {CHILD} currently receiving any services through a 504 plan?

A 504 plan is a formal plan schools use to provide accommodations to children with disabilities. A 504 plan does not include individualized instruction, and children do not have to qualify for special education services to be eligible for a 504 plan.

1 Yes
2 No
Disability 1, 2
DWQ - Discipline, Warmth, and Emotional Supportiveness DWQ010 a-h Please think about whether each statement is completely true, mostly true, somewhat true, or not at all true. Parental warmth 5

DWQ010a {CHILD} and I often have warm, close times together.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parental warmth 5

DWQ010b Most of the time I feel that {CHILD} likes me and wants to be near me.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parental warmth 5

DWQ010c Even when I'm in a bad mood, I show {CHILD} a lot of love.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parental warmth 5

DWQ010d I express affection by hugging, kissing, and holding {CHILD}.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parental warmth 5

DWQ010e Being a parent is harder than I thought it would be.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parenting stress 5

DWQ010f {CHILD} does things that really bother me.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parenting stress 5

DWQ010g I find myself giving up more of my life to meet {CHILD}'s needs than I ever expected.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parenting stress 5

DWQ010h I often feel angry with {CHILD}.
1 Completely true
2 Mostly true
3 Somewhat true
4 Not at all true
Parenting stress 5

DWQ100 Do you ever spank {CHILD}?
1 Yes
2 No
Disciplinary practices 5

DWQ101 Sometimes kids do as they are told and sometimes they don't. About how many times, if any, have you spanked {CHILD} in the past week?
Disciplinary practices 5
PPQ - Parent's Psychological Well-Being and Health PPQ225 During the past 12 months, would you say that you experienced a lot of stress, a moderate amount of stress, relatively little stress, or almost no stress at all?
1 A lot of stress
2 A moderate amount of stress
3 Relatively little stress
4 Almost no stress at all
Life stress 5
PEQ - Parent Education PEQ020 What is the highest grade or year of school that {you/{NAME}'} {have/has} completed?
0 Never went to school
1 1st grade
2 2nd grade
3 3rd grade
4 4th grade
5 5th grade
6 6th grade
7 7th grade
8 8th grade
9 9th grade
10 10th grade
11 11th grade
12 12th grade but no diploma
13 High school equivalent/GED
14 High school diploma
15 Voc/tech program after high school but no voc/tech diploma
16 Voc/tech program after high school, diploma
17 Some college but no degree
18 Associate's degree
19 Bachelor's degree
20 Graduate or professional school but no degree
21 Master's (MA, MS)
22 Doctorate degree (PhD, EdD)
23 Professional degree after bachelor's degree (medicine/MD; dentistry/DDS; Law/JD/LLB; etc.)
Parent education 1
EMQ - Parent Employment EMQ200 Which best describes {your/{NAME}'s} current employment situation?
1 Working part-time
2 Working full-time
3 A stay-at-home parent or guardian
4 Not working
Parent employment 1
PAQ - Parent Income and Assets PAQ110 In studies like this, households are sometimes grouped according to income. What was the total income of all persons in your household over the past year, including salaries or other earnings, interest, retirement, and so on for all household members?
1 $5,000 or less
2 $5,001 to $10,000
3 $10,001 to $15,000
4 $15,001 to $20,000
5 $20,001 to $25,000
6 $25,001 to $30,000
7 $30,001 to $35,000
8 $35,001 to $40,000
9 $40,001 to $45,000
10 $45,001 to $50,000
11 $50,001 to $55,000
12 $55,001 to $60,000
13 $60,001 to $65,000
14 $65,001 to $70,000
15 $70,001 to $75,000
16 $75,001 to $100,000
17 $100,001 to $200,000
18 $200,001 or more
Annual family income 1

PAQ120 What was your total household income last year, to the nearest thousand?

Total Income:
Annual family income 1

PAQ135 Do any of the child care or early care and education programs that {CHILD} attends charge tuition or a fee?
1 Yes
2 No
Tuition 1

PAQ140 Do you use a child care subsidy voucher that pay for part or all of the cost of tuition for {CHILD}'s current child care or early care and education program?
1 Yes
2 No
Tuition 1
CMQ - Mobility and Tracking Updates CMQ001 Are you, or another parent or guardian, planning to move with {CHILD} before the fall of 2020?
1 Yes
2 No
Plans to move before the child begins kindergarten NA

CMQ025a Please confirm the mailing address where you would like to have the money sent for completing this survey.

Address Line 1:
Address Line 2:
Confirmation of address NA

CMQ025b City: Confirmation of address NA

CMQ025c State:

Please select a state, district, or territory.
Confirmation of address NA

CMQ025d Zip code: Confirmation of address NA

CMQ026a Please enter your contact information.
Email Address:
Confirmation of address NA

CMQ026b Mobile Number: Cell number NA

CMQ030 We would like to contact you in the fall to ask a few brief questions about where {CHILD} ended up going to kindergarten. Do we have permission to text you?
1 Yes
2 No
Permission to text NA






Sheet 4: Fall Follow-up Survey

Section Item # Item Wording Construct Research Question





Fall Follow-up Survey FFS001 Does {CHILD} still live with you?
1 Yes
2 No
Mobility NA
Fall Follow-up Survey FFS005 Is {CHILD} currently…
Select All That Apply
1 Not in school?
2 In public or private school, including preschools?
3 In child care in a center INSTEAD of attending a public or private school?
4 In child care in a home INSTEAD of attending a public or private school?
5 Homeschooled INSTEAD of attending a public or private school (including preschools) for some or all classes?
School or preschool enrollment 1
Fall Follow-up Survey FFS010 What is {CHILD}’s current grade or equivalent?

Preschool or child care for preschool-aged children in a home or center includes early childhood education programs, child care, or day care in a center, nursery school, preschool, prekindergarten, or child care with a relative or nonrelative other than a parent/guardian.

Kindergarten includes Transitional Kindergarten (TK), Early Transitional Kindergarten (ETK), Readiness Kindergarten, Transitional or Prefirst Grade, or a program that is a kindergarten equivalent but is ungraded or has multiple grades.

1 Preschool or child care for preschool-aged children in a home or center
2 Kindergarten
3 First
4 Second
5 Third
6 Fourth
7 Fifth or above
8 None of these
Current grade/equivalent 1, 4
Fall Follow-up Survey FFS011 Have you moved since {DATE OF LAST INTERVIEW}? 1 Yes 2 No Mobility NA
Fall Follow-up Survey FFS012a Do you still live in {STATE}? 1 Yes 2 No Mobility NA
Fall Follow-up Survey FFS012b What state do you now live in? Start by typing the first letter of the state, district, or territory name. If you find a match in the list, select it from the list. If you live in another country, select “Moved out of the country.” If you don’t find a match, select “Not on list.”

State:
Mobility NA
Fall Follow-up Survey FFS013a Do you still live in {COUNTY}? 1 Yes 2 No Mobility NA
Fall Follow-up Survey FFS013b What county do you now live in? Start by typing the first letter of the county name. If you find a match in the list, select it from the list. If you don’t find a match, select “Not on list.”

County:
Mobility NA
Fall Follow-up Survey FFS015 Is {CHILD} attending {SCHOOL NAMED IN SPRING PARENT SURVEY}? 1 Yes 2 No Whether child is attending school named in parent survey last spring 4
Fall Follow-up Survey FFS020 Does {CHILD} go to a public or private school for kindergarten?
1 Public school
2 Private school
3 Homeschooled
4 Not in school
School enrollment 4
Fall Follow-up Survey FFS025 What is the name of the public school where {CHILD} attends kindergarten? Select the school from the list below. If you don’t find the school, select “School not on list” and then type in the full school name.
{DISPLAY LIST OF UP TO 25 SCHOOLS}
School child attends 4
Fall Follow-up Survey FFS025OS What is the name of the public school where {CHILD} attends kindergarten? Other specify for school child attends 4
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