Early Childhood Longitudinal Study, Kindergarten Class of 2022-23 (ECLS-K:2023) Preschool Field Test

Early Childhood Longitudinal Study,
Kindergarten Class of 2022-23 (ECLS-K:2023)
Kindergarten and First-Grade Field Test Data
Collection, National Sampling, and National
Recruitment

OMB# 1850-0750 v.22

$WWDFKPHQWD2
Fall KindergartenChild-Level
TeacherPaper 6XUYH\
National Center for Education Statistics
U.S. Department of Education

September 2020

Teacher Survey
(Child-Level)
2021

S_ID

T_ID
T

Link_ID
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C_ID
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Completing this survey will help us learn more about children and their
experiences in different schools and classrooms.
Thank you for your time!
To show our appreciation, we have included with your invitation a check that
equals $20 for the teacher background survey plus $7 for every child for
whom you’ve been asked to complete a survey.
Please return the survey to your school coordinator or an ECLS staff member.
The survey should be sealed in the envelope we provided you. Do not mail this survey
unless you are provided with an additional mailing envelope.
Photo is for illustrative purposes only. Any person depicted in the photo is a model.

The National Center for Education Statistics (NCES) is authorized to conduct the Early Childhood Longitudinal Study (ECLS) by the Education Sciences Reform
Act of 2002 (ESRA 2002, 20 U.S.C. §9543). The data are being collected for NCES by Westat, a U.S.-based research organization. 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). According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it
displays a valid OMB control number. The valid OMB control number for this voluntary information collection is 1850-0750 v.22. The time required to complete
this information collection is estimated to average approximately 15 minutes per child-level survey including the time to review instructions and complete and
review the information collection. If you have any comments concerning the accuracy of the time estimate, suggestions for improving this information collection,
or any comments or concerns regarding the status of your individual submission of these data, please write directly to: Early Childhood Longitudinal Study,
National Center for Education Statistics, PCP, 550 12th St., SW, 4th floor, Washington, DC 20202. # 1850-0750 v.22.
OMB No. 1850-0750, v.22. Approval expires xx/xx/xxxx
TQCFK-FT

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Early Childhood Longitudinal Study
Kindergarten Teacher Survey (Child Level)
Fall 2021 - Form TQCFK-FT

INTRODUCTION
Dear Teacher,
Your school has agreed to participate in the Early Childhood Longitudinal Study (ECLS),
a nation-wide study of elementary-aged children, their schools, teachers, and parents. As
part of the study, we are asking teachers at your school to complete surveys. You have
been asked to complete this survey because one or more of the children in your class(es)
are participants in this study. The child who is the subject of this survey is identified on the
cover. This survey contains questions about this child’s skills and abilities.
The ECLS collects information from teachers of children who are in the study to investigate
the relationship between children’s academic progress and various school, classroom,
teacher, and home characteristics.
Taking part in the study is voluntary. You may stop at any time or choose not to answer a
question you do not want to answer. However, only you can provide this information.
Although we realize you are very busy, we urge you to complete this survey as completely
and accurately as possible.

THANK YOU VERY MUCH FOR YOUR HELP.

i

TQCFKTQCFK-FT
FT

MARKING DIRECTIONS
PLEASE READ CAREFULLY AND USE A BLACK OR BLUE BALL POINT PEN TO COMPLETE THIS
SURVEY. DO NOT USE PENCIL OR FELT-TIP PEN.
MARKING BOXES
It is important that you mark an “X” in the box next to your answers and print clearly.
Shown below is the correct way to mark your answers, along with examples of incorrect ways.
Correct Mark:

Incorrect Marks:
Light and thin, outside the box, thick or scrawled.

How to Change an Answer:
Completely black out the box of the incorrect answer and mark an “X” in the box next to the correct
answer.

PRINTING ANSWERS IN BOXES:
Answers should be printed clearly and should not touch or cross any of the box lines. Do not
cross zeroes or sevens. That is, do not write a zero with a line through it like this –
write a seven with a line through it like this – 7.

0, and do not

Write one number per box like this:

1

2

3

4

5

6

7

8

9

0

Write words like this:

John Smith

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Draft

ACADEMIC RATING SCALE
We would like for you to rate this child's current skills, knowledge, and behaviors within language and literacy
(section 1), science (section 2), and mathematical thinking (section 3), based on your experience with him or her.
This is NOT a test and should NOT be administered directly to the child.
Examples are meant to help you think of the range of situations in which the child may demonstrate the
identified skills and behaviors. These examples do not exhaust all the ways the child may demonstrate
what he or she knows or can do. The examples do, however, indicate a level of proficiency a child should
have reached in order to receive the highest ratings. Some of these examples describe a very high level of
performance (beyond typical students) in order to evaluate achievement levels of the highest performing
students.
Rate this child compared to other children of the same age level. Please consider the full range of ratings
when answering.

The following five-point scale is used for each of the questions. It reflects the degree to which a child has
acquired and demonstrated the targeted skills, knowledge, and behaviors.

Not yet

=

Child has not yet demonstrated skill, knowledge, or behavior.

Beginning

=

Child is just beginning to demonstrate skill, knowledge, or behavior but
does so very inconsistently.

In progress

=

Child demonstrates skill, knowledge, or behavior with some regularity
but varies in level of competence.

Intermediate

=

Child demonstrates skill, knowledge, or behavior with increasing
regularity and average competence but is not completely proficient.

Proficient

=

Child demonstrates skill, knowledge, or behavior competently and
consistently.

Not Applicable or
Skill Not Yet Taught

=

Skill, knowledge, or behavior has not been introduced in classroom
setting.

If this child has limited English proficiency or is an English language learner, answer with his or her native
language in mind if he or she does not yet demonstrate skills in English but does demonstrate them in his or
her native language.
If this child has a disability, it may be necessary to consider adaptations for some questions to make them
more inclusive for this child's skills and/or use of adaptive equipment. Some children may utilize alternative
forms of verbal communication (for example, sign language, communication boards) or written communication
(for example, word processors, Braille, dictation). Please answer the questions with these adaptations in mind.

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41294

SECTION 1: LANGUAGE AND LITERACY
A1.

First, please rate this child's current skills, knowledge, and behaviors in LANGUAGE AND LITERACY.
MARK ONE RESPONSE ON EACH ROW.

THIS CHILD...

Not yet

Beginning

In progress

Intermediate

Proficient

a. Contributes relevant information to
classroom discussions – for example, during
a class discussion, can express an idea or a
personal opinion on a topic and the reasons
behind the opinion.
b. Engages in higher-level thinking and
reasoning during classroom discussions – for
example, answers questions that are not just an
explicit recall of facts, makes inferences, asks
on-topic questions, and can have a cohesive
exchange of ideas that are centered on a given
topic for at least three conversational turns.
c. Uses correct endings on verbs and nouns
when speaking – for example, says "dog plays"
and "dogs play" or uses present tense ("she runs"
or "she is running") and past tense correctly for
both regular and irregular verbs ("he walks" and
"he walked"; "I run" and "I ran").
d. Uses morphemes to figure out the meanings
of words – for example, knows that “–s” means
“more than 1” as in “trucks”; “–er” means a
“person who” as in “farmer” and “painter”; “un”
means “not” as in “unlike” and “unfriendly”; or
“re” means “again” as in “reread” and “replay.”
e. Uses morphemes to decode new words – for
example, decodes “jellyfish” by recognizing it is
made up of two familiar words “jelly” and “fish”
or decodes “preheat” as “pre” and “heat” and
“fearless” as “fear” and “less.”
f. Uses complex sentence structures – for
example, says "If she had brought her umbrella,
she wouldn't have gotten wet," or "Yesterday it
was raining cats and dogs," or "Why can't we
go on the field trip at the same time as the first
grade?"
g. Understands and interprets a story or other
text read to him/her – for example, by retelling a
story just read to the group, or telling about why
a story ended as it did, or connecting part of the
story to his or her own life.
1

TQCFK-FT

Not
applicable
or
Skill not
yet taught

41294

A1.

(Cont.) Please rate this child's current skills, knowledge, and behaviors in LANGUAGE AND LITERACY.
MARK ONE RESPONSE ON EACH ROW.

THIS CHILD...

Not yet

Beginning

In progress

Intermediate

Proficient

h. Easily and quickly names all upper- and
lower-case letters of the alphabet.
i. Predicts what will happen next in stories
by using the pictures and storyline for clues.
j. Reads simple books independently – for
example, reads books with a repetitive
language pattern.
k. Demonstrates early writing behaviors – for
example, by using initial consonants to spell
words ("d" for the word "dog"), or using letter
names to represent sounds ("r" for the word
"are"), or phonetic spelling ("hrt") for the word
"heart," to convey words or ideas.
l. Composes simple stories – for example, by
writing about a personal experience in a
journal.
m. Composes informative/explanatory text – for
example, uses a combination of drawing,
dictating, and writing to state what is being
written about, supply some information about
the topic, and provide some sense of closure.
n. Demonstrates an understanding of some
of the conventions of print – for example, by
using both upper- and lower-case letters when
writing, or putting spaces between words, or
using a period at the end of a sentence.
o. Finds meaningful units in words such as
prefixes, suffixes, and base words.

2

TQCFK-FT

Not
applicable
or
Skill not
yet taught

41294

SECTION 2: SCIENCE
B1.

Next, please rate this child's current skills, knowledge, and behaviors in SCIENCE.
MARK ONE RESPONSE ON EACH ROW.

THIS CHILD...

Not yet

Beginning

In progress

Intermediate

Proficient

a. Uses his/her senses to explore and observe –
for example, observes and notes the habits of
classroom pets, or describes the differences in
clay before and after water is added.
b. Forms explanations based on observations
and explorations – for example, describes or
draws the conditions (water, soil, sun) that help
a plant grow, or explains that a block will slide
more quickly down a steeper slope.
c. Classifies and compares living and non-living
things in different ways – for example,
classifies objects according to "things that are
alive and not alive," or "things that fly and
things that crawl."
d. Directly compares two objects with a
measurable attribute in common to see
which object has “more of”/”less of” the
attribute and describes the difference – for
example, directly compares the heights of two
children and describes one child as
taller/shorter.
e. Makes logical predictions when pursuing
scientific investigations – for example,
observes and identifies patterns in nature and
predicts what happens next (for example,
predicts if a new object will float or sink).
f. Communicates scientific information – for
example, records or describes the properties
of common objects verbally or through
drawings or graphs.
g. Shows curiosity about the world by asking
how and why things happen – for example,
asks how rocks are formed or why it is warmer
in the daytime than at night.

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Not
applicable
or
Skill not
yet taught

41294

B1.

(Cont.) Please rate this child's current skills, knowledge, and behaviors in SCIENCE.
MARK ONE RESPONSE ON EACH ROW.

THIS CHILD...

Not yet

Beginning

In progress

Intermediate

Proficient

h. Generates different strategies to solve a
problem – for example, when a design solution
does not work as intended, tries other tools,
materials, or methods to solve the problem.
i. Shows an understanding of cause and effect
– for example, knows if he or she pushes a ball
harder, it will go faster.

4

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Not
applicable
or
Skill not
yet taught

41294

SECTION 3: MATHEMATICAL THINKING
C1.

Now, please rate this child's current skills, knowledge, and behaviors in MATHEMATICAL THINKING.
MARK ONE RESPONSE ON EACH ROW.

THIS CHILD...
a. Counts forward beginning from a given
number within the known sequence,
instead of having to begin at 1 – for
example, child starts with 5 objects and is
given 2 more and child counts “6, 7” instead
of “1, 2, 3, 4, 5, 6, 7” to get the answer of 7.

Not yet

Beginning

In progress

Intermediate

Proficient

b. Orders a group of objects – for example,
by ordering rods or sticks by length, or
arranging paints from lightest to darkest or
musical instruments from softest to loudest.
c. Shows an understanding of the
relationship between quantities – for
example, knows that a group of ten small
stones is the same quantity as a group of
ten larger blocks.
d. Demonstrates consistent understanding of
one-to-one correspondence – for example,
when counting objects, says the number names
in the standard order, pairing each object with
one and only one number name and each
number name with one and only one object.
e. For any number from 1 to 9, finds the
number that makes 10 when added to the
given number (for example, by using objects
or drawings) and records the answer with a
drawing or equation (for example, 3 + _ = 10
and 4 + _ = 10).
f. Uses place value to compose and
decompose numbers from 11 to 19 into
tens and ones (for example, by using objects
or drawings) and records each composition
or decomposition by a drawing or
equation (for example, 18 = 10 + 8).
g. Solves problems involving numbers using
concrete objects – for example, "Vera has six
blocks, George has three, how many blocks
are there in all?" or “How many do I need to
give George so he will have the same
number of blocks as Vera?"

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Not
applicable
or
Skill not
yet taught

41294

C1.

(Cont.) Please rate this child's current skills, knowledge, and behaviors in MATHEMATICAL THINKING.
MARK ONE RESPONSE ON EACH ROW.

THIS CHILD...

Not yet

Beginning

In progress

Intermediate

Proficient

h. Demonstrates an understanding of
graphing activities – for example, by looking
at a picture graph on favorite ice-cream
flavors and knowing which flavor is the most
popular and which one is the least popular.
i. Measures length to the nearest whole
number using common objects – for example,
uses a paperclip or a pencil to measure a desk
and specifies the length in terms of those units.
j. Correctly names squares, circles, triangles,
and rectangles regardless of their
orientations or overall size.

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Not
applicable
or
Skill not
yet taught

41294

SECTION 4: EARLY LANGUAGE SKILLS
D1.

For this set of questions, please focus on this child’s early language skills in English based on your
experience with this child at school. Think about your experience with this child at school. Mark the
response option that best indicates how often this child exhibits the following early language skills
when at school. Your best guess is fine. MARK ONE RESPONSE ON EACH ROW.
How Often?
Never

THIS CHILD...
a.

Recalls and communicates personal experiences
he/she has had to peers in a logical way.

b.

Answers questions that are not just an explicit
recall of facts but that require some higher-level
thinking.

c.

Is a good listener in conversations with peers.

d.

Uses a varied vocabulary in spoken language.

e.

Responds to questions in a thoughtful way that
makes sense.

f.

Uses grammatically correct sentences when
speaking.

g.

Recalls and communicates the meaning of a
story or other experiences/events which he/she
has heard.

h.

Uses correct endings on verbs and nouns when
speaking – for example, says “dog plays” and
“dogs play” or uses present tense (“she runs” or
“she is running”) and past tense correctly for
both regular and irregular verbs (“he walks”
and “he walked”; “I run” and “I ran”).

i.

Asks on-topic questions that are relevant to the
discussion in the classroom.

j.

Uses complex sentences with two or more
clauses of various types (for example,
independent, dependent) in spoken language,
rather than using only simple, short sentences
with a subject and a verb.

k.

Is a good listener in conversations with adults.

l.

Instructs peers in tasks which need to be done
in a certain order.

Rarely

Sometimes

Often

m. Uses academic language learned in the
classroom when speaking.

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Very
often

41294

D1.

(Cont.) For this set of questions, please focus on this child’s early language skills in English based on
your experience with this child at school. Think about your experience with this child at school. Mark
the response option that best indicates how often this child exhibits the following early language
skills when at school. Your best guess is fine. MARK ONE RESPONSE ON EACH ROW.
How Often?
Never

THIS CHILD...
n.

Uses language effectively to initiate appropriate
interactions with other children.

o.

Tries repeatedly to communicate information
which has not been understood.

p.

Uses evidence from a text or word problem to
support his or her answer.

q.

Uses morphemes to figure out the meanings of
words – for example, knows that “–s” means
“more than 1” as in “trucks”; “–er” means a
“person who” as in “farmer” and “painter”; “un”
means “not” as in “unlike” and “unfriendly”; or
“re” means “again” as in “reread” and “replay.”

r.

Uses long sentences with descriptive language
and connecting words in a grammatically
appropriate way when speaking.

s.

Asks questions about information which is unclear
to him/her.

t.

Shows understanding of spoken instructions and
daily conversations.

u.

Tries out new words (for example, heard in stories
or from teacher) when speaking.

v.

Uses language effectively to initiate appropriate
interactions with adults.

Rarely

Sometimes

Often

w. Relates and communicates personal experiences
in a logical way or “in a way that makes sense."
x.

Uses descriptive vocabulary such as adjectives
and/or adverbs when speaking to provide detail.

y.

Rephrases questions or asks follow-up questions
if he/she does not get the information he/she
wanted.

z.

Uses morphemes to decode new words – for
example, decodes “jellyfish” by recognizing it is
made up of two familiar words “jelly” and “fish”
or decodes “preheat” as “pre” and “heat” and
“fearless” as “fear” and “less."
8

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Very
often

41294

D1.

(Cont.) For this set of questions, please focus on this child’s early language skills in English based on
your experience with this child at school. Think about your experience with this child at school. Mark
the response option that best indicates how often this child exhibits the following early language
skills when at school. Your best guess is fine. MARK ONE RESPONSE ON EACH ROW.
How Often?
Never

THIS CHILD...

Rarely

Sometimes

Often

aa. Maintains a conversation with others that has
at least three conversational turns focused on
a single topic.
bb. Actively contributes within a classroom discussion.
cc. Finds meaningful units in words such as prefixes,
suffixes, and base words.

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Very
often

41294

D2.

Next, please think about this child's written language. Which of the following writing levels
(ordered below from lowest to highest) best describes the highest level at which this child is
currently performing (independently, without teacher help)? MARK ONE RESPONSE.
Scribbling
Drawing a picture
Can copy his or her name
Can copy sentences from the board
Write his or her name without copying
Can write most letters when asked to write the letter
Write initial sounds for many words
Write simple 2-4 letter words with invented spelling
Write multi-syllabic words with invented spelling with most sounds represented
Compose and write a full sentence with invented spelling with most sounds represented
Compose and write 2 or more consecutive full sentences with invented spelling with most
sounds represented
Other (Please specify):

D3.

How much does this child enjoy writing? MARK ONE RESPONSE.
Not at all
A little bit
Somewhat
Quite a bit
Very much

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SECTION 5: SOCIAL SKILLS AND APPROACHES-TO-LEARNING
E1.

For this set of items, please think about this child's behavior during the past month or two. Decide
how often the child demonstrates the behavior described. MARK ONE RESPONSE ON EACH ROW.
Never
Sometimes
Often
Very often
No opportunity

→
→
→
→
→

Child never exhibits this behavior.
Child exhibits this behavior occasionally or sometimes.
Child exhibits this behavior regularly but not all the time.
Child exhibits this behavior most of the time.
No opportunity to observe this behavior.
How Often?

Never
a.

Fights with others.

b.

Withdraws from others.

c.

Acts lonely.

d.

Gets angry easily.

e.

Disturbs ongoing activities.

f.

Keeps belongings organized.

g.

Says bad things about self.

h.

Shows eagerness to learn new things.

i.

Works independently.

j.

Acts impulsively.

k.

Argues with others.

l.

Easily adapts to change in routines.

Sometimes

Often

Very
often

No
opportunity
to observe

m. Acts sad or depressed.
n.

Persists in completing tasks.

o.

Pays attention well.

p.

Follows classroom rules.

q.

Is aggressive toward people or objects.

r.

Disobeys rules or requests.

s.

Gets embarrassed easily.

Source: Social Skills Rating System (SSRS). Copyright © 1990, NCS Pearson. Adapted with permission. All rights reserved; Social Skills Improvement
System (SSIS). Copyright © 2008, NCS Pearson. Adapted with permission. All rights reserved.

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41294

E1.

(Cont.) For this set of items, please think about this child's behavior during the past month or two.
Decide how often the child demonstrates the behavior described. MARK ONE RESPONSE ON EACH ROW.
Never
Sometimes
Often
Very often
No opportunity

→
→
→
→
→

Child never exhibits this behavior.
Child exhibits this behavior occasionally or sometimes.
Child exhibits this behavior regularly but not all the time.
Child exhibits this behavior most of the time.
No opportunity to observe this behavior.
How Often?

Never
t.

Has low energy or is lethargic.

u.

Acts anxious with others.

v.

Talks during quiet study time.

Sometimes

Often

Very
often

No
opportunity
to observe

Source: Social Skills Rating System (SSRS). Copyright © 1990, NCS Pearson. Adapted with permission. All rights reserved; Social Skills Improvement
System (SSIS). Copyright © 2008, NCS Pearson. Adapted with permission. All rights reserved.

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SECTION 6: CLASSROOM BEHAVIORAL REGULATION
F1.

Now we would like you to think about this child's behavior with other children and adults in the
classroom and his or her work with materials. Select the response that best indicates the frequency
this child exhibits the behavior described. MARK ONE RESPONSE ON EACH ROW.

Never
a.

Observes rules and follows directions
without requiring repeated reminders.

b.

Completes learning tasks involving two or
more steps (for example, cutting and pasting)
in organized way.

c.

Completes tasks successfully.

d.

Attempts new challenging tasks.

e.

Concentrates when working on a task; is not
easily distracted by surrounding activities.

f.

Responds to instruction and then begins an
appropriate task without being reminded.

g.

Takes time to do his or her best on a task.

h.

Finds and organizes materials and works in an
appropriate place when activities are initiated.

i.

Sees own errors in a task and corrects them.

j.

Returns to unfinished tasks after interruption.

Rarely

Sometimes

Frequently/
Usually
Always

Source: Bronson, M. B., Goodson, B. D., Layzer, J. I., and Love, J. (1990). Child Behavior Rating Scale. Cambridge, MA: Abt Associates. Adapted and
used with permission.

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41294

SECTION 7: CLASSROOM BEHAVIORS
G1.

For this set of items, please read each statement and decide whether it is a “true” or “untrue” description
of this child’s reaction to a number of situations within the past six months. If you cannot answer one of
the items because you have never seen this child in that situation, then select “not applicable."
MARK ONE RESPONSE ON EACH ROW.

Extremely
untrue

Quite
untrue

Slightly
untrue

Neither
true nor
untrue

Slightly
true

Quite
true

Extremely
Not
true
applicable

a. When practicing an activity, has a
hard time keeping her/his mind
on it.
b. Will move from one task to another
without completing any of them.
c. When drawing or coloring in a
book, shows strong concentration.
d. When building or putting something
together, becomes very involved in
what he/she is doing, and works for
long periods.
e. Is easily distracted when listening
to a story.
f. Sometimes becomes absorbed in
a picture book and looks at it for a
long time.
g. Can wait before entering into new
activities if s/he is asked to.
h. Plans for new activities or changes
in routine to make sure s/he has
what will be needed.
i. Has trouble sitting still when s/he
is told to (story time, etc.).
j. Is good at following instructions.
k. Approaches places that s/he thinks
might be "risky" slowly and
cautiously.
l. Can easily stop an activity when
s/he is told "no."

Source: Putnam, S. P., & Rothbart, M. K. (2006). Development of Short and Very Short forms of the Children's Behavior Questionnaire.
Journal of Personality Assessment, 87(1): 103-113. Used with permission.

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SECTION 8: SCHOOL LIKING AND AVOIDANCE
H1.

For the items below, please indicate how often each of these items applies to this child.
MARK ONE RESPONSE ON EACH ROW.

a.

Likes to come to school.

b.

Dislikes school.

c.

Has fun at school.

d.

Likes being in school.

e.

Seems unhappy in school.

f.

Enjoys most classroom activities.

g.

Groans or complains about
suggested activities.

Doesn't apply

Sometimes applies

Certainly applies

Seldom displays
this behavior

Occasionally displays
this behavior

Often displays
this behavior

Source: School Liking and Avoidance Questionnaire. Adapted from Ladd and Price, 1987 and Ladd, 1990. Used with permission.

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41294

SECTION 9: STRATEGIC PLANNING
I1. Please read the statements below and indicate how often each applies to this child’s behaviors
observed across the past month. MARK ONE RESPONSE ON EACH ROW.

Does not apply
a.

Shows a basic understanding of the
relationship between cause and effect
(for example, child moves a cup that is
about to be knocked over).

b.

Compares new task or problem to previous
one in terms of what solution worked and
what did not.

c.

Develops plan of action after considering
the possible consequences.

d.

Verbalizes the possible consequences of
a particular act or event (for example, "If I
take his ball, then he may cry.").

e.

Self-corrects errors while working on
projects or activities.

f.

Develops a plan for multi-step activity (for
example, "First, I'm going to turn on the
oven. Then, I will mix the cake and bake it.").

g.

Changes strategies when one solution to a
problem doesn't work.

h.

Teaches another child a new task or skill.

i.

Maintains an essential role when participating
in a small group activity (for example, other
children depend on this child for direction).

j.

Communicates that problems may have
more than one acceptable solution.

Sometimes applies Consistently applies

Source: Adapted from the Learning-to-Learn Scales © 2019 by Edumetric and Clinical Science. All rights reserved. Used with permission.
McDermott, P. A. (2018). Learning-To-Learn Scales. Philadelphia: Edumetric and Clinical Science.

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SECTION 10: PEER RELATIONSHIPS
J1.

Please indicate how often each of these items applies to this child, particularly in the context of his
or her behavior with peers. MARK ONE RESPONSE ON EACH ROW.

a.

Seems concerned when other
children are distressed.

b.

Is not chosen as playmate by peers.

c.

Peers avoid this child.

d.

Is kind toward peers.

e.

Is excluded from peers' activities.

f.

Is cooperative with peers.

g.

Shows concern for moral issues (for
example, fairness, welfare of others).

h.

Is ignored by peers.

i.

Offers help or comfort when other
children are upset.

Doesn't apply

Sometimes applies

Certainly applies

Seldom displays
this behavior

Occasionally displays
this behavior

Often displays
this behavior

Source: Adapted from the Child Behavior Scale © 2010 Gary W. Ladd. Used with permission.

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SECTION 11: STUDENT INFORMATION
K1.

In what type of program is this child enrolled? MARK ONE RESPONSE.
Full-day program
Morning part-day program
Afternoon part-day program

K2.

Is the 2021-22 school year this child's...? MARK ONE RESPONSE.
Kindergarten includes regular kindergarten, transitional (or readiness) kindergarten, and
transitional first (or pre-first) grade.
First year in kindergarten
Second year in kindergarten
Third year or more in kindergarten

K3.

How often does this child wear eye glasses or contact lenses in the classroom? MARK ONE RESPONSE.
Never
Seldom
Usually
Always

K4.

How many instructional groups based on achievement or ability levels in reading do you currently
have in this child’s class? MARK ONE RESPONSE.
I do not use instructional groups for reading



GO TO QK6 on page 19

Two
Three
Four
Five or more
K5.

In which reading instructional group is this child currently placed? USE "1" FOR THE HIGHEST
INSTRUCTIONAL GROUP. ENTER IN THE NUMBER OF THE CHILD'S INSTRUCTIONAL GROUP BELOW.
Instructional Group

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K6.

How many instructional groups based on achievement or ability levels in mathematics do you
currently have in this child’s class? MARK ONE RESPONSE.
I do not use instructional groups for mathematics



GO TO QK8

Two
Three
Four
Five or more
K7.

In which mathematics instructional group is this child currently placed? USE "1" FOR THE HIGHEST
INSTRUCTIONAL GROUP. ENTER IN THE NUMBER OF THE CHILD'S INSTRUCTIONAL GROUP BELOW.
Instructional Group

K8.

Are you this child's primary teacher in the following subject areas? MARK ALL THAT APPLY.
A primary teacher is the teacher who is responsible for all learning in that subject area. The primary teacher
writes all lesson plans and handles all activities and assessments in that subject area. If you co-teach a subject
area with another teacher, but think you could report about this child, please report that you are the child’s
primary teacher for that subject area.
Reading/Language Arts
Mathematics
Science
Social Studies

K9.

Please fill in the boxes below with the date the survey was completed.

2 0 2 1
MONTH

DAY

YEAR

Thank you very much for answering these questions
and for taking the time to participate in the
Early Childhood Longitudinal Study.
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