Instrument 10 EMA teacher survey rev040522_clean

Head Start Evaluation of a Trauma-Informed Care Program

Instrument 10 EMA teacher survey rev040522_clean

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EMA Survey Questions


Administered on the first survey of each new assessment period:


PAPERWORK REDUCTION ACT OF 1995 (Pub. L. 104-13) STATEMENT OF PUBLIC BURDEN: The purpose of this information collection is to identify teacher practices for supporting children’s social-emotional development and to identify training and implementation factors that may enhance these practices. Public reporting burden for this collection of information is estimated to average 4 minutes per respondent, including the time for reviewing instructions, gathering and maintaining the data needed, and reviewing the collection of information. This is a voluntary collection of information. Additionally, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information subject to the requirements of the Paperwork Reduction Act of 1995, unless it displays a currently valid OMB control number. The OMB number for this information collection is OMB Control #: XXXX-XXXX and it expires on [DATE]. If you have any comments on this collection of information, please contact [NAME AND CONTACT INFORMATION].


  • Have you set up a calm corner where children in your class can go if they have overwhelming feelings? If Y, ask:

    • Have you practiced use of the calm corner with your class?

    • Do you have sensory objects such as stress balls, drawing materials, fidgets in your calm corner?

  • Have you made stress balls with your class as described in RLR Toolkit? Y (1), N (0);

If Y, ask:

    • How often do you use stress balls with the children?

      • Rarely or only once (0)

      • Once a week (1)

      • Once a day (2)

      • Several times a day (3)


For last survey of the day only:

Today did you:

  • Create opportunities for children to interact in pairs. Y N

  • Celebrate a child in a text, note, or other message to their caregiver? Y (1), N (0)

  • Use books, songs, or other activities to talk with children in your class about feelings? Y (1), N (0)

  • Practice any relaxation exercises/ coping strategies (e.g., belly breaths, yoga, mindfulness, progressive muscle relaxation) with children in your class? Y (1), N (0) If Y, what did you do (check all that you used)?

      • Belly breathing

      • Happy box

      • Stress balls

      • Muscle relaxation (e.g., lemon squeezy)

      • Use of art to relax

      • Yoga

      • Mindfulness

      • Other: [text box]

  • Was there a child who harmed another child (verbally or physically)? If Y:

    • Did you focus on helping them understand the impact of their actions on others and restoring the relationship?

  • Do something to promote children’s awareness and acceptance of peers who are different from them (e.g., book reading, celebrating different cultures and holidays)? Y N


Provider Self-Care

  • Select all of the self-care activities that you did yesterday:

    • Exercised

    • Got support from a friend or loved one

    • Practiced meditation in a formal way that focused my attention and awareness

    • Planned time off/ vacation

    • I did not do any self-care activities yesterday (0)

    • Another wellness activity [describe]

  • If you used any self-care strategies yesterday, how effective was this in improving your mood/ stress level? (1-5 scale, from 1= not at all effective to 5 very effective)


Every survey: The next set of questions asks about what happened in the last hour specifically:


What activities were the children doing?

  • Center time

  • Circle time

  • Outdoor play

  • Snack/lunch

  • Other: ____________________________________


Creating a Safe Environment

Responses for the following items: Y N No Opportunity

In the last hour, did you:

  • Redirect a child by telling them what to do instead of what NOT to do.

  • Acknowledge a child’s feelings when they didn’t want to do something

  • Give choices.

  • Stay calm with children even when you felt upset.

  • Follow through with classroom expectations.

  • Remind children about transitions and schedule changes.

  • Notice your own thoughts and reactions to children.


Building Relationships and Connectedness

In the last hour, did you:

Use reflective listening (that is, listen with full attention to children, repeat back, reflect a feeling)? Y(1), N(0)

  • No Opportunity

    • Not at all (0)

    • Once (1)

    • Two times(2)

    • Three or more times (3)

  • Talk with a child(ren) about specific feelings using feeling words? Y (1), N (0)

  • How many times did you praise children very specifically for what they did (use labeled praise)?

    • Not at all (0)

    • Once (1)

    • Two times (2)

    • Three or more times (3)

  • Notice and comment when children meet classroom behavioral expectations. Y (1) N (0)

  • Actively ignore difficult (but not unsafe) behaviors Y N N/A

    • If Y, how effective was this strategy? (1-5 scale, from 1= not at all effective to 5 very effective)


Supporting and Teaching Emotion Regulation

In the last hour, did you:

  • Anticipate when children might feel challenged or frustrated.

  • Help children identify feelings they were having. Y N If Y:

    • Not at all (0)

    • Once (1)

    • More than once (2)

  • Encourage children to use sensory objects to help with emotion regulation. Y N

  • Did a child (or children) need help calming down? If Y:

    • Did they use the calm corner?

      • I don’t have a calm corner (0)

      • I verbally encouraged them to use it (1)

      • I physically guided them to the corner (0)

      • They used it on their own (3)

      • Some children required encouragement, others used it on their own (2)

    • Did they use a sensory item to help calm down? Y (1), N (0)


Stress and Self-Care

In the last hour:

  • How would you describe your stress level?

    • I did not feel stressed (2)

    • A little stressed

    • Moderately stressed (1)

    • Very stressed

    • Unmanageable—I was overwhelmed (0)

  • In the last hour, how supported have you felt in your teaching work by colleagues and/or administrators?

    • I did not feel supported

    • I felt a little supported

    • I felt moderately supported

    • I felt very supported

  • What did you do (or are you doing) to manage your stress?

    • I did not do anything

    • Took a short break during the day

    • Got support from peers/colleagues

    • Laughed/ Cried

    • Remind myself of the good things I do or the positive qualities I bring to my teaching

    • Prayed or took deep breaths

    • Said “No” to something

    • Other

How did this impact your classroom practices? Select all that apply:

      • I didn’t notice a difference

      • I was better able to model coping skills with children (e.g., deep breathing, taking a break)

      • I was better able to use reflective listening (listen with full attention to children, repeat back, reflect a feeling) and keep a calm voice


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AuthorAlexandra Verhoye
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