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PDF Version, B&W Printable PDF Version of this report


OMB No.: 0970-0143

Expiration Date: 8/31/2000

 

 

 

EARLY HEAD START PARENT INTERVIEW

FOR PARENTS OF 2-YEAR-OLD CHILDREN

 

This report may contain external links. ACF cannot attest to the accuracy of information provided by external links. Providing links to a non-ACF Website does not constitute an endorsement by ACF or any of its employees of the sponsors of the site or the information or products presented on the site. Also, be aware that the privacy protection provided on the ACF domain (see ACF's Privacy Policy) may not be available at the external link.

Table of Contents

 

Public reporting burden for this collection of information is estimated to average 2½ hours per response for the interview and assessments, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to ACF Reports Clearance Officer, Paperwork Reduction Project (OMB# 0970-0143), Administration for Children and Families, Office of Information Services, 370 L’Enfant Promenade, S.W., Washington, DC 20447. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. The OMB number for this project is 0970-0143.

 

MPR ID #: |___|___|___|___|___|___|___|
DATA COLLECTOR ID #: |___|___|___|___|
DATE:
|___|___| / |___|___| / 19 |___|___|
MONTH DAY YEAR
TIME START: |___|___| : |___|___| AM/PM
TIME END: |___|___| : |___|___| AM/PM

 

Teddy Bear Logo

Conducted for
Mathematica Policy Research, Inc.
P.O. Box 2393 Princeton, NJ 08543-2393
and
Administration on Children, Youth, and Families
U.S. Department of Health and Human Services

 

COPYRIGHT INFORMATION FOR MEASURES INCLUDED IN THIS DOCUMENT

Items 1.1 A-H. KIDI. MacPhee, D. Manual: Knowledge of Infant Development. Unpublished manuscript. University of North Carolina, 1983.

Items 1.2 A-J. PMS. Parental Modernity Scale. Schaefer, Earl and Marianna Edgerton. “Parental and Child Correlates of Parental Modernity.” In I. E. Sigel, Ed., Parental Belief Systems: The Psychological Consequences for Children. Hillsdale, NJ: Lawrence Erlbaum Associates, Inc., 1985.

Items 1.3 A-C. BRTR. Beliefs Regarding Talking and Reading. Luster, Tom, Kelly Rhoades, and Bruce Haas. “The Relation Between Parental Values and Parenting Behavior: A Test of the Kohn Hypothesis.” Journal of Marriage and the Family, vol. 51 (February 1989), pp. 139-147.

Items 1.4 A-W and 1.5. PSI. Abidin, Richard R. Parenting Stress Index, Third Edition: Professional Manual. Odessa, FL: Psychological Assessment Resources, Inc., 1995. “Adapted and reproduced by special permission of the Publisher, Psychological Assessment Resources, Inc., Odessa, FL 33556, from the Parenting Stress Index by Richard R. Abidin, Ed.D., Copyright 1990 by PAR, Inc.. Further reproduction is prohibited without permission from PAR, Inc.”

Items various, starting at 2.3. HOME. Caldwell, Bettye M., and Robert H. Bradley.
Administration Manual: Home Observation for Measurement of the Environment. Little Rock, AR: University of Arkansas at Little Rock, 2003.

Items 3.5 A-E. FES. Reproduced by special permission of the Publisher, Mind Garden, Inc., www.mindgarden.com from the Family Environment Scale by Rudolf H. Moos and Bernice S. Moos. Copyright 1974, 1994, and 2002 by Rudolf Moos. All rights reserved. Further reproduction is prohibited without the Publisher’s written consent.

Items 4.16 A-J. PRS. Parent-Caregiver Relationship Scale. Copyright James Elicker, Illene C. Noppe, and Lloyd D. Noppe, 1996.

Items 7.14 1-58. WJPICVOCAB. Woodcock-Munoz Language Survey, Picture
Vocabulary Test.
Copyright (c) 1993 by The Riverside Publishing Company.
Reproduced from Woodcock-Munoz Language Survey, English and Spanish Forms by
Richard W. Woodcock and Ana F. Munoz-Sandoval with permission of the
publisher. All rights reserved.

Items 10.1-10.3 MacArthur Communicative Development Inventory. MacArthur Communicative Development Inventories (CDI) Instruments are copyrighted by the MacArthur CDI Advisory Board.

Items 11.1 A-FF. CBC. Achenbach System of Empirically-Based Assessment, Child Behavior Checklist. Achenbach, Thomas M. and Leslie A. Rescorla. Manual for the ASEBA Preschool Forms and Profiles. Burlington, VT: University of Vermont Department of Psychiatry, 2000.

Items 13.2-13.41. CIDI DEP, ANX, ALC, DRUGS. Composite International Diagnostic Inventories. An updated version of the Composite International Diagnostic Inventories (CIDI) – Short Form and scoring rules can be found at: www.who.int/msa/cidi/cidisf.htm.

 

INTRODUCTION

Hello. Thank you for agreeing to talk with us again. As I mentioned (on the phone/when we made the appointment), the entire visit will take about 2½ hours. The visit has three parts. (Just as we did last time.) I will need to spend about a half hour with (CHILD), letting (him/her) show me some of the things (he/she) has been learning. Next, I will take out different toys for (CHILD) to play with while I videotape you and (him/her) together. While you, (CHILD) and I are working together, it would be best if we were not interrupted. Finally, I will be asking you some questions about (CHILD) and your family routines. (Many of these questions are the same or similar to questions we asked you when [CHILD] was 14 months old.) As we go along, I will be telling you what we need you to do. And please, if you have any questions, feel free to ask them!

If at any time you need to take a break to take care of (CHILD) (or your other children), please let me know.

All the information you give me is confidential. Neither your name nor (CHILD)’s will be attached to any of the information you give us. If there is ever anything you are not comfortable talking about or doing, please let me know and we will skip that part.

Is this a good time for (CHILD)? We can start with (his/her) activities or with the interview if you think (he/she) isn’t at (his/her) best right now.

 
IS THIS A GOOD TIME FOR CHILD?
YES
01
arrow GO TO SECTION 0
NO
00
arrow START INTERVIEW, RETURN TO
SECTION 0 WHEN CHILD IS READY
     
SECTION 0

CHILD ASSESSMENT AND VIDEOTAPE

     
INTERVIEWER: WHEN ARE YOU DOING THE BAYLEY?
AT START OF VISIT
01
     
AFTER START OF QUESTIONNAIRE
00
arrow Which section? box for answer
     
WHEN YOU DO THE BAYLEY OR AT ANY TIME WHEN THE CHILD IS PRESENT, PRAISE (HIM/HER) AND NOTE PARENT’S REACTION.

YOU WILL CODE PARENT’S REACTION IN QUESTION 9.12.

     
INTRODUCTION TO THE BAYLEY:
0.1 Now I would like to give (CHILD) a chance to show us some of the skills (he/she) has been learning. These activities are designed to be fun for children and we think (he/she) will enjoy most of them.

I will need a few minutes to get my materials set up. Would you please see if (CHILD) needs anything such as (changing/a bathroom break) or a snack so that (he/she) will be comfortable. (Also, we need to make sure that the other children let (CHILD) do these tasks by (him/her)self).

     
0.2 All the toys we will use are non-toxic, clean and safe, and have been thoroughly washed. We don’t expect (CHILD) to be able to do all the tasks. They are designed for a wide range of children. Please don’t try and help (him/her) out.
     
WHEN YOU DO THE BAYLEY, IF POSSIBLE, HAVE THE PARENT COMPLETE THE SELF ADMINISTERED QUESTIONNAIRE 1. [QUESTIONS 1.2, 1.3, 1.4, 7.1, 11.1 AND 12.1.] DO NOT GIVE SAQ2 (MacARTHUR , SECTION 10) NOW.
     
PROCEED WITH BAYLEY BOOKLET.
     
SECTION 1

RAISING A CHILD

1.1 ITEMS DELETED FROM THIS VERSION TO PROTECT
AUTHOR/PUBLISHER COPYRIGHT. SEE PAGE ii FOR FULL CITATION.
     
1.2 ITEMS DELETED FROM THIS VERSION TO PROTECT
AUTHOR/PUBLISHER COPYRIGHT. SEE PAGE ii FOR FULL CITATION.
     
1.3 ITEMS DELETED FROM THIS VERSION TO PROTECT
AUTHOR/PUBLISHER COPYRIGHT. SEE PAGE ii FOR FULL CITATION.
     
1.4 ITEMS DELETED FROM THIS VERSION TO PROTECT
AUTHOR/PUBLISHER COPYRIGHT. SEE PAGE ii FOR FULL CITATION.
     
1.5 ITEMS DELETED FROM THIS VERSION TO PROTECT
AUTHOR/PUBLISHER COPYRIGHT. SEE PAGE ii FOR FULL CITATION.
     
SECTION 2

CHILD'S HEALTH

     
The next questions are about (CHILD)’s health.
     
2.1 Overall, since (THIS MONTH) of last year, would you say (CHILD)'s health has been . . .
PROBE: In the last 12 months.
 
CIRCLE ONE
Excellent,
01
Very good,
02
Good,
03
Fair, or
04
Poor?
05
     
2.2 A. Since (his/her) first birthday, how many different times has (CHILD) stayed in a hospital for at least one night?

|___ |___| TIMES
NONE
00
arrow GO TO Q2.3
     
  B. Altogether, since (his/her) first birthday, how many nights did (CHILD) stay in a hospital?

|___ |___|___| NIGHTS

     
  C. (Was this/Were any of these) hospitalization(s) because of an accident or injury?
YES
01
   
NO
00
arrow GO TO D
     
    1) How many of these hospitalizations were because of an accident or injury?

|___ |___| NUMBER OF HOSPITALIZATIONS

     
    2) How many nights did (CHILD) stay in the hospital because of an accident or injury?

|___ |___| NUMBER OF NIGHTS

     
  D. CODE WITHOUT ASKING IF KNOWN:
How many of the (NUMBER IN Q2.2A) hospitalizations were because of . . .
1) Dehydration/diarrhea?
|___|___|___| TIMES
2) Asthma/bronchitis? |___|___|___| TIMES
3) Pneumonia/acute respiratory infection? . . . . . . . . . . . . . . . |___|___|___| TIMES
4) Ear infection (otitis media)? |___|___|___| TIMES
5) Surgery or an operation (SPECIFY) |___|___|___| TIMES
_____________________________________________ |___|___|
6) Something else? (SPECIFY) |___|___|___| TIMES
_____________________________________________ |___|___|
     
2.3   Since (CHILD)’s first birthday, how many times has (he/she) gone for well-baby checkups? Was it . . .

PROBE: These are visits to the doctor when (he/she) isn’t sick, but to get (him/her) checked over or to get vaccinations.

 
CIRCLE ONE
Never,
01
Once,
02
Twice, or
03
3 or more times?
04
     
2.4   The next few questions are about ways in which children can get hurt.

If (CHILD) swallows something dangerous or poisonous, do you have anything in the house to make (him/her) vomit?

PROBE: Dangerous or poisonous products such as drain opener, cleansers, dish detergents, floor cleaners, rug cleaners, disinfectants, adult medications, etc.

YES
01
   
NO
00
arrow GO TO Q2.5
     
  A. What do you use?
IPECAC
01
OTHER (SPECIFY)
02
_____________________________________________ |___|___|
FINGER/TONGUE DEPRESSOR 03
MILK 04
CASTOR OIL 05
     
2.5   If you had to get the phone number of the poison control center in an emergency, do you know how to find it?

PROBE: This is a hotline that provides information to callers on what to do for specific types of poisoning.

YES
01
   
NO
00
arrow GO TO Q2.6
     
  A. What would you do?
  CIRCLE ONE    
CALL 411 OR 911 01 GO TO Q2.6
WOULD HAVE TO LOOK IT UP 02
SEARCH AROUND FOR NUMBER 03
HAVE AVAILABLE 04 arrow ASK B
OTHER (SPECIFY) 05 arrow GO TO Q2.6
_____________________________________________ |___|___|    
CALL HOSPITAL 06    
CALL PEDIATRICIAN OR FAMILY DOCTOR’S OFFICE/ CALL NURSE’S LINE 07    
     
  B. Where do you keep the number?
  CIRCLE ONE
NEXT TO OR NEAR PHONE, ON SPEED DIAL 01
TAPED TO CABINET, KITCHEN WALL, OR REFRIGERATOR 02
IN OWN PHONE BOOK, PHONE LIST 03
OTHER (SPECIFY) 04
_____________________________________________ |___|___|
     

2.6 INTERVIEWER CODE: FAMILY LIVES:

      IN AN APARTMENT 01 arrow
A. WHAT FLOOR?
|__|__| FLOOR
      IN A HOUSE 02  
      PUBLIC SHELTER 03    
     

A. INTERVIEWER CODE: FAMILY LIVES IN:

      SINGLE FLOOR APARTMENT/HOUSE 01 arrow GO TO Q2.8
      MULTI-FLOOR HOUSE 02    
     
2.7   CODE WITHOUT ASKING IF OBSERVED:
Do you use gates for the top of the stairs or use something else so (CHILD) stays off them?
  CIRCLE ONE
HAS GATES 01
HAS SOMETHING ELSE (SPECIFY) 02
_____________________________________________ |___|___|
DON’T NEED 03
NEED BUT DON’T HAVE 04
DOOR 05
     
2.8   CODE WITHOUT ASKING IF OBSERVED:
Do you use guards or gates for your windows?

PROBE: Do not include gates for burglars.

  CIRCLE ONE
HAS GATES 01
DON’T HAVE GATES 02
PARENT STATES DOESN’T NEED GATES 03
PARENT STATES HAS SCREENS OR STORM WINDOWS, DOESN’T NEED GATES 04
     
2.9   Do you have covers on all your electrical outlets that don’t have plugs in them?

PROBE: Covers can be plastic safety covers, tape or other coverings.

YES
01
arrow GO TO Q2.10
NO
00
   
     
  A. Do you have covers on the electrical outlets that (CHILD) can reach?
  CIRCLE ONE
HAS OUTLET COVERS 01
DOESN’T HAVE OUTLET COVERS 02
PARENT STATES ALL OUTLETS ARE INACCESSIBLE 03
PARENT STATES DOESN’T NEED COVERS 04
     

2.10 INTERVIEWER CODE: DOES HOME HAVE SMOKE ALARMS?

YES 01 arrow GO TO Q2.11A
NO 00    
DON’T KNOW, NOT OBSERVED -1    
     
2.11   Does your (house/apartment) have smoke alarms?
YES
01
   
NO
00
arrow GO TO Q2.12
     
  A. As far as you know, are the batteries working in the smoke alarms?
  CIRCLE ONE
YES 01
HARD WIRED TO ELECTRICAL SYSTEM 02
NO 00
DON’T KNOW -1
     
2.12   How often does (CHILD) ride in a private car? Would you say . . .
  CIRCLE ONE  
Every day, 01  
A few times a week, 02  
A few times a month, or 03  
Never? 04 arrow GO TO Q3.1
     
  A. When you take (CHILD) in a car, do you usually put (him/her) in a car seat, booster seat, in the regular seat with a seatbelt on, or does (he/she) just sit in the car?
  CIRCLE ONE
CAR SEAT 01
BOOSTER SEAT 02
REGULAR SEATBELT 03
PARENT'S LAP 04
NO RESTRAINT 05
     
  B. When you take (CHILD) in a car, does (he/she) usually sit in the front seat or back seat?
  CIRCLE ONE
FRONT 01
BACK 02
VARIES 03
     
SECTION 3

HOUSEHOLD COMPOSITION

     
3.1   Not including you and (CHILD), how many other people lived in this (house/apartment) with you last month?

PROBE: In the last 30 days.

|___ |___|

NO ONE ELSE--ONLY SELF AND (CHILD)
01
arrow GO TO Q4.1
     
3.2   Are any of these people (your/MOTHER’S) spouse or partner?
YES
01
NO
00
     
3.3   How (are these people/is this person) related to (CHILD)?

CIRCLE CODE THEN RECORD NUMBER OF PEOPLE IN BOXES.

FATHER 1 arrow |___|___|
STEPPARENT 2 arrow |___|___|
AUNT, UNCLE, GREAT-AUNT OR GREAT-UNCLE 3 arrow |___|___|
GRANDPARENT OR GREAT GRANDPARENT 4 arrow |___|___|
SIBLING (BROTHER OR SISTER) 5 arrow |___|___|
STEPBROTHER OR STEPSISTER 6 arrow |___|___|
NEPHEW OR NIECE 7 arrow |___|___|
COUSIN 8 arrow |___|___|
OTHER RELATIVE OR IN-LAW 9 arrow |___|___|
NON-RELATIVE ADULT (INCLUDE MOTHER’S PARTNER, BOYFRIEND) 10 arrow |___|___|
NON-RELATIVE CHILD 11 arrow |___|___|
OTHER (SPECIFY) 12 arrow |___|___|
__________________________________________________________________ |___|___|
MOTHER 13 arrow |___|___|
TOTAL SHOULD EQUAL NUMBER IN Q3.1      
     
3.4   INTERVIEWER: CHECK Q3.1, PAGE 15. DO MOTHER AND CHILD LIVE WITH ANYONE ELSE?
YES
01
   
NO
00
arrow GO TO Q4.1
     
3.5   I’m going to read you some statements about how the people who live with you get along and settle arguments. For each statement, please tell me if you strongly agree, mildly agree, mildly disagree, or strongly disagree with it for your household.

(READ ITEM) Do you strongly agree, mildly agree, mildly disagree, or strongly disagree with this?

CODE ONLY ONE RESPONSE FOR EACH STATEMENT.

  STRONGLY AGREE MILDLY AGREE MILDLY DISAGREE STRONGLY
DISAGREE
A. We fight a lot 04 03 02 01
B. We hardly ever lose our tempers 04 03 02 01
C. We sometimes get so angry we throw things 04 03 02 01
D. We often criticize each other 04 03 02 01
E. We sometimes hit each other 04 03 02 01


 

 

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