Early Childhood Longitudinal Study, Kindergarten Class of 2023-24
(ECLS-K:2024)
OMB# 1850-0750 v.24
Attachment D-10
Spring First-Grade Special Education Child-Level
Teacher Paper Survey
National Center for Education Statistics
U.S. Department of Education
August 2021
Note: Some items in these surveys are copyright protected and as such are redacted in public review copies.
Special
Education
Teacher
Survey
(Child-Level)
2022
T
C
S_ID T_ID
C_ID
Completing this survey will help us learn more about children participating in special education and their experiences in
different schools and classrooms.
Link_ID
S |
|
|
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.24.
The
time
required
to
complete
this
information
collection
is
estimated
to
average
approximately
7
minutes
per
child-level
survey
including
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.
OMB
No.
1850-0750,
v.24.
Approval
expires
xx/xx/xxxx
SPB1-FT
Fall 2022 – Form SPB1-FT
Dear Special Education Teacher or Related Service Provider,
Your school has agreed to participate in the Early Childhood Longitudinal Study (ECLS), a nationwide study of elementary-aged children, their schools, teachers, and parents. As part of the study, we are asking teachers and other service providers at your school to complete surveys. You have been asked to complete them because one or more of the children you serve are participants in this study. The teacher survey contains questions about you and your practices. There are also brief surveys for each of the sampled children that you teach or serve. These surveys contain questions about the children’s skills, abilities, and special education and related services.
The ECLS collects information from the special education teachers or related service providers of sampled children who have Individualized Education Programs (IEPs). We are gathering information from these children’s general education classroom teachers as well, if they have one. Our purpose is to investigate the relationship between the 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. You may find at least some of the information we are asking for in the child’s IEP.
PLEASE READ CAREFULLY AND USE A BLACK OR BLUE BALL POINT PEN TO COMPLETE THIS SURVEY. DO NOT USE PENCIL OR FELT-TIP PEN.
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.
Completely black out the box of the incorrect answer and mark an “X” in the box next to the correct
answer.
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 – 0,
and
do not
write
a
seven
with a
line
through
it
like
this
–
7.
Write one number per box like this:
1
2
3
4
5
6
7
8
9
0
Write words like this:
1.
2.
3a.
Is this child currently receiving gifted/talented services through an IEP, or has the child received such services during this school year? MARK ONE RESPONSE.
Yes
No
Yes
No
Provide
instruction directly to this child
Provide related
services directly
to this
child
Provide consultation services directly to this child
Provide
indirect consultation services (for example, consultation to this
child's teacher) Provide
case management
Other (Please specify):
None
of the
above
In what capacity or capacities have you taught or provided services to this child using virtual or distance learning in the current school year? Please note, virtual or distance learning means teachers or service providers and students do not meet in a classroom but use the internet, e-mail, mail, etc. to have class. MARK ALL THAT APPLY.
Provided
virtual instruction directly to this child
Provided virtual
related services
directly to
this child
Provided virtual consultation services directly to this child
Provided
virtual indirect consultation services (for example, consultation to
this child's teacher,
preparation of
accessible materials)
Provided
virtual case management Other
(Please specify):
None
of the
above
Before
kindergarten
During
transitional kindergarten During
kindergarten
During
transitional first grade During
first grade
During
second grade Don't
know
Yes
No
Don't
know
Before
kindergarten
During
transitional kindergarten During
kindergarten
During transitional first grade
During
first grade
During
second grade
Don't
know
Not
at all Somewhat
Extensively
Not
at all Somewhat
Extensively
I provided special education to this child last year.
Yes
No,
I don't have access to
the records.
No,
I have access to the records
but have not reviewed them.
No,
I provided
special education
or early
intervention to
this child
last year.
What is this child's primary disability as identified on the child's IEP? PLEASE MARK THE CATEGORY BELOW INTO WHICH THE CHILD'S PRIMARY DISABILITY FITS BEST. MARK ONLY ONE.
Speech
or language impairments Specific
learning disabilities Emotional
disturbance Intellectual
disability Developmental
delay
Visual
impairments (including blindness)
Hearing impairments (including deafness)
Orthopedic impairments
Other
health impairments Autism
Traumatic
brain injury Deaf-blindness
Multiple disabilities (children included in this category should be those who have more than one primary disability which do not include deaf-blindness or developmental delay)
No
classification is given
No
other disabilities
Speech
or language impairments Specific
learning disabilities Emotional
disturbance Intellectual
disability Developmental
delay
Visual
impairments (including blindness)
Hearing impairments (including deafness)
Orthopedic impairments
Other
health impairments Autism
Traumatic brain injury
Deaf-blindness
Multiple
disabilities (children included in this category should be those who
have more than one
primary disability
which do
not include
deaf-blindness or
development delay)
No
classification given
MARK ONE RESPONSE.
Yes
No
Academics
Reading
Mathematics Language
Arts Science
Social
Social
skills
General
appropriateness of
behavior
Life Skills
Adaptive
behavior or
self-help skills
Speech and Language
Auditory
processing Listening
comprehension Oral
expression Voice/speech
articulation Language
pragmatics
Physical/Mobility
Fine
motor skills Gross
motor skills
Orientation and mobility
Other/None
Other
(Please specify):
None
of the
above
Audiology
Counseling services
Occupational therapy
Physical therapy
Psychological services
Health services
Social
work services Special
transportation
Speech
or language therapy Orientation
services Mobility
services Rehabilitation
services Other
(Please specify):
No
related services
were provided.
During this school year, has this child received any of the following? MARK ALL THAT APPLY.
Adaptive
physical education
Assistance
from classroom aides (for example, teacher aide, behavioral
assistant, special
education aide)
Interpreter
for the deaf or hard of hearing (oral or sign)
Teacher used
Braille to
provide instruction
Child was taught how to use Braille
Teacher
used American Sign Language to provide instruction
Child was taught how to use American Sign Language
Teacher used
Manual English
to provide instruction
Child
was taught how to use Manual English
Teacher used Cued Speech to provide instruction
Child was
taught how to
use Cued Speech
Mental health services, personal/group counseling, therapy, or psychiatric care provided to the child
Tutoring/remediation
from special
education teacher
Training,
counseling, and other support/services provided to child's family
None of the above
MARK ONE RESPONSE.
Yes
No
Hours
per week
Hours
per week
PLEASE
NOTE THE FOLLOWING DEFINITION
THAT
IS
RELEVANT
TO
QUESTION
19
BELOW:
Co-teaching is when a general education teacher and a special
education service provider share the
teaching responsibility, with the special education service
provider providing specialized differentiated
lessons for students with special needs.
The two teachers participate in lesson or activity planning
together and
work together in
the same classroom
to instruct
both students
with and
without disabilities
Oneonone
instruction Smallgroup
instruction Largegroup
instruction
Co-teaching
Cooperative learning Peer
tutoring
Computer-based
instruction Direct
instruction
Cognitive
strategies Self-management
Behavior management
Instruction
received through a sign interpreter
None of the above
During this school year, which of the following best describes the curriculum materials used with this child in the general education classroom? MARK ONE RESPONSE.
General
education curriculum materials were used without modification.
General education
curriculum materials
were used
with some
modifications.
General
education curriculum materials were used with substantial
modifications.
Specially-designed
commercial materials
were used.
Teacher-designed
materials were used. Child
not in this
setting.
Don't know
During this school year, which of the following best describes the curriculum materials used with this child in the special education classroom or program? MARK ONE RESPONSE.
General
education curriculum materials were used without modification.
General education
curriculum materials
were used
with some
modifications.
General
education curriculum materials were used with substantial
modifications.
Specially-designed
commercial materials
were used.
Teacher-designed
materials were used. Child
not in this
setting.
Don't know
Did this child use any assistive technologies this year? MARK ONE RESPONSE.
Yes
No
During this school year, which of the following assistive technologies and devices has this child used? MARK ALL THAT APPLY.
Mobility aids
Vans,
vehicles Wheelchair
Walker
White cane
Communication aids
Electronic
with voice output (for
example, Touch Talker)
Electronic without voice output
(for example,
device with
visual
display or printed speech output)
Non-electronic
(for example, manual printing
board)
Hearing assistance
Hearing
aids FM loops
TTYs/TDDs
Cochlear
implants Real-time
captioning
Visual aids
Braille
texts
Electronic
Braille devices Digital
texts
Magnifying devices
Close-captioned
television (CCTV)
Learning aids (non-computer)
Tape
recorder Calculator
Electronic spelling devices
switch interface)
Used
solely by individual child
Shared with
other children
Reading
Writing Mathematics
Other/None
Other
assistive technologies or devices
(Please specify):
No
assistive technologies or devices were used
Yes
No
Not
applicable because I am the child's
general education teacher
Not
applicable to my work
with this child
Every
day or several times a week Once
a week or several times a month
Once a month
A
few times over the school year
Once during this
school year
Never
during this
school year
1
to 15
minutes
16
to 30
minutes
31
to 45
minutes
46
to 60 minutes More
than 60
minutes
MARK ONE RESPONSE.
Every
day or several times a week Once
a week or several times a month
Once a month
A few times over the school year
Once
during this school year Never
during this
school year
IF
THIS
BOX
IS
CHECKED,
PLEASE
SKIP
THIS
QUESTION
AND
GO
TO
Q27
ON
PAGE
14
Now we would like to ask you about your relationship with this child. Below is a series of statements about your relationship with him or her. For each statement, please mark the category that most applies to your relationship with this child. MARK ONE RESPONSE FOR EACH.
Definitely
does not
apply
Not
really
Neutral, not sure
Applies sometimes
Definitely
applies
b.
Xxxx
xxxxx xxx
X xxxxxx
xxxx xx
xx
xxxxxxxxxx
xxxx
xxxx
xxxxx.
d. Xxxx xxxxx xx xxxxxxxxxxxxx xxxx xxxxxxxx xxxxxxxxx xx xxxxx xxxx xx.
f. Xxxx
X
xxxxxx
xxxx
xxxxx,
xx
xx
xxx
xxxxx
xxxx xxxxx.
h. Xxxx xxxxx xxxxxx xxxxxxx xxxxx xx xx.
j. Xxxx
xxxxx xxxxxxx xxxxx xx xx
xxxxxxxxx
xxxxx
xxxxx
xxxxxxxxxxx.
l. Xxxx xxxx xxxxx xx xx x xxx xxxx, X xxxx xx'xx xx xxx x xxxx xxx xxxxxxxxx xxx.
n.
Xxxx
xxxxx
xx
xxxxxx
xx
xxxxxxxxxxxx
xxxx
xx.
Source: Pianta, R. C., & Stuhlman, M. W. (2004). Teacher-child relationships and children's success in the first years of school. School Psychology Review, 33(3), 444-458. Used with permission.
Psychological
Speech/language
Vision
Hearing
Learning style Motor
skills Academics
Other
(Please specify):
No evaluations for developing IEP goals were conducted this year
This
child is
expected to
attain grade
level achievement
for all
of the
academic content
standards.
This
child is
expected to
attain grade
level achievement
for some
of the
academic content
standards.
This
child is expected to attain grade level achievement for only a few
of the academic content
standards.
This
child is not expected to attain grade level achievement for
any of the academic content standards.
There are no
academic content standards at
this grade level.
Don't know
76
to 100
percent
51
to 75 percent
26
to 50 percent
1
to 25 percent
0
percent
Definitely
will continue in special education
Very likely to continue in special education
Likely to continue in special education
Unlikely to
continue in
special education
Very unlikely
to continue
in special
education
Definitely will not continue in special education (will be dismissed from services)
Child
did not participate in the school's testing or assessment program.
Child participated
in alternate
assessments and no
regular assessments.
Child
participated in some alternate assessments and some regular
assessments. Child
participated fully
in the school's
regular testing
or assessment program.
There
is no testing or assessment program at this grade level.
Don't know
How far in school do you expect this child to go? MARK ONE RESPONSE.
Receive
less than a high school diploma
Graduate from
high school
Attend
a vocational or technical school after high school
Attend two or more
years of college
Finish
a four- or five-year college degree
Earn a
master's degree
or equivalent
Finish a Ph.D., MD, or other advanced degree
2
0
2
2
MONTH DAY YEAR
Thank you very much for answering these questions and for taking the time to participate in the Early Childhood Longitudinal Study.
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Michael Ladd |
File Modified | 0000-00-00 |
File Created | 2022-01-14 |