ACF OPRE: Early Head Start Research and Evaluation Project (EHSRE)

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OMB No.: 0970-0143

Expiration Date: 10/31/99

EARLY HEAD START PARENT INTERVIEW

REVISED - 3/23/98

FOR PARENTS OF 14-MONTH-OLD INFANTS

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Public reporting burden for this collection of information is estimated to average 2.5 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 #:

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DATA COLLECTOR ID #:

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DATE:

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MONTH	DAY	YEAR

TIME START:

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TIME END:

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TIME START:

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TIME END:

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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-N. KIDI. MacPhee, D. Manual: Knowledge of Infant Development. Unpublished manuscript. University of North Carolina, 1983.

Items 1.2 A-M. EASI. Buss, Arnold H. and Robert Plomin. Temperament: Early Developing Personality Traits. Hillsdale, NJ: Lawrence Erlbaum Associates, 1984.

Items 1.3 A-W and 1.4. 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 4.27 A-I. PRS. Parent-Caregiver Relationship Scale. Copyright James Elicker, Illene C. Noppe, and Lloyd D. Noppe, 1996.

Items various, starting at 5.13. 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 6.9 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 10.13-10.14. MacArthur Communicative Development Inventory. MacArthur Communicative Development Inventories (CDI) Instruments are copyrighted by the MacArthur CDI Advisory Board.

Items 12.1 A-G. Pearlin. Pearlin, L.I. and Schooler, C. “The Structure of Coping.” Journal of Health and Social Behavior, vol. 22 (1978), pp. 337-356.

INTERVIEWER:

PLEASE NOTE: IN QUESTIONS THAT REFER TO THE PARENT/MOTHER OF THE FOCUS CHILD, WE MEAN “THE PERSON FUNCTIONING IN THAT ROLE WHO IS THE RESPONDENT.” THIS COULD BE THE MOTHER, FATHER, GRANDMOTHER OR SOME OTHER RELATIVE. PLEASE ADAPT THE SPECIFIC QUESTION LANGUAGE AS NECESSARY.

INTRODUCTION

Hello. Thank you for agreeing to talk with us. As I mentioned (on the phone/when we made the appointment), the entire visit will take between 2½ and 3 hours. The visit has three parts. 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. 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		GO TO SECTION 0
NO	00		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		Which section?

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 10.12.

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 toddlers 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 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.

PROCEED WITH BAYLEY BOOKLET.

0.3

AFTER BAYLEY IS COMPLETED ASK PARENT:

How typical was your child’s behavior? Did (CHILD) play the way (he/she) usually does? Was (he/she) as happy or upset as usual? As alert and active as usual?

	CIRCLE ONE
VERY ATYPICAL; PARENT NEVER SEES THIS TYPE OF BEHAVIOR	01
MOSTLY ATYPICAL	02
SOMEWHAT ATYPICAL; PARENT SEES THIS TYPE OF BEHAVIOR ON SOME OCCASIONS	03
TYPICAL	04
VERY TYPICAL; PARENT ALWAYS SEES THIS TYPE OF BEHAVIOR	05

Do you think (CHILD) did as well as (he/she) could? Have you seen (CHILD) do better or worse on the type of things we worked on?

	CIRCLE ONE
POOR INDICATOR OF CHILD'S OPTIMAL PERFORMANCE; CHILD ALWAYS PERFORMS MUCH BETTER	01
BARELY ADEQUATE	02
ADEQUATE; CHILD PERFORMS AS WELL, ON AVERAGE	03
GOOD	04
EXCELLENT; CHILD NEVER PERFORMS BETTER	05

0.4

COMPLETE SECTIONS 1 (BAYLEY DISRUPTION RATINGS) AND 2 (BEHAVIOR RATING SCALE) IN CHILD ASSESSMENT AND VIDEOTAPE PROTOCOL--CHILD RECORD BOOKLET.

0.5

START VIDEOTAPE PROTOCOL.

READ GENERAL INTRODUCTION
SET UP EQUIPMENT
OBTAIN CONSENT
CONDUCT TASKS

SECTION 1

RAISING A BABY

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.

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

Has (CHILD) had a cold or other kind of respiratory infection in the past week?

YES	01
NO	00

2.3

Last night, how did (CHILD) sleep? Did (he/she) sleep through the night or wake up?

	CIRCLE ONE
SLEPT THROUGH THE NIGHT	01
WOKE UP DURING THE NIGHT AND NEEDED CHANGING OR FEEDING	02
DID NOT SLEEP WELL	03

2.4-2.9

DELETED FROM THIS VERSION - MOVED TO PSI.

2.10

Since (CHILD) was released from the hospital after (he/she) was born, has (he/she) stayed overnight in a hospital?

YES	01
NO	00		GO TO Q2.12

Up until (his/her) first birthday, how many different times has (CHILD) stayed in a hospital for at least one night?

PROBE: Please do not include time spent in hospital at birth.

|___|___| TIMES

NONE	00		GO TO Q2.11A
DON'T KNOW, DID NOT HAVE CUSTODY THEN	-1

Altogether, up until (his/her) first birthday, how many nights did (CHILD) stay in a hospital?

PROBE: Please do not include time spent in hospital at birth.

|___|___|___| NIGHTS

(Was this/Were any of these) hospitalization(s) because of an accident or injury?

YES	01
NO	00		GO TO D(2)

CODE WITHOUT ASKING IF ONLY ONE HOSPITALIZATION:

How many of the (NUMBER IN Q2.10A) hospitalizations were because of . . .

1) An accident or injury?	\|___\|___\|___\| TIMES
2) Dehydration?	\|___\|___\|___\| TIMES
3) Pneumonia?	\|___\|___\|___\| TIMES
4) Jaundice (yellowing of skin)?	\|___\|___\|___\| TIMES
5) Something else? (SPECIFY)	\|___\|___\|___\| TIMES
_____________________________________________	\|___\|___\|
6) Bronchitis/respiratory stress/lung or breathing problems	\|___\|___\|___\| TIMES

2.11

And since (his/her) first birthday, how many different times has (CHILD) stayed in a hospital for at least one night?

|___ |___| TIMES

NONE

GO TO Q2.12

Altogether, since (his/her) first birthday, how many nights did (CHILD) stay in a hospital?

|___ |___|___| NIGHTS

(Was this/Were any of these) hospitalization(s) because of an accident or injury?

YES	01
NO	00		GO TO D(2)

CODE WITHOUT ASKING IF ONLY ONE HOSPITALIZATION:

How many of the (NUMBER IN Q2.11A) hospitalizations were because of . . .

1) An accident or injury?	\|___\|___\|___\| TIMES
2) Dehydration?	\|___\|___\|___\| TIMES
3) Pneumonia?	\|___\|___\|___\| TIMES
4) Jaundice (yellowing of skin)?	\|___\|___\|___\| TIMES
5) Something else? (SPECIFY)	\|___\|___\|___\| TIMES
_____________________________________________	\|___\|___\|

2.12

Since (CHILD) was born, 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 or twice,	02
3-4 times	03
5-9 times, or	04
10 times or more?	05

2.13

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		GO TO Q2.14

What do you use?

IPECAC	01
OTHER (SPECIFY)	00
_____________________________________________	\|___\|___\|
FINGER/TONGUE DEPRESSOR	03
MILK	04
CASTOR OIL	05

2.14

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		GO TO Q2.15

What would you do?

Where do you keep the number?

2.15 INTERVIEWER CODE: FAMILY LIVES:

IN AN APARTMENT

A. WHAT FLOOR?
|__|__| FLOOR

IN A HOUSE

PUBLIC SHELTER

2.16

CODE WITHOUT ASKING IF OBSERVED:

Do you use gates for the top of the stairs or use something else so (CHILD) stays off them?

2.17

CODE WITHOUT ASKING IF OBSERVED:

Do you use guards or gates for your windows?

PROBE: Do not include gates for burglars.

2.18

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
NO	00		GO TO Q2.19

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

2.19 INTERVIEWER CODE: DOES HOME HAVE SMOKE ALARMS?

YES	01	GO TO Q2.20A
NO	00
DON’T KNOW, NOT OBSERVED	-1

2.20

Does your (house/apartment) have smoke alarms?

YES	01
NO	00		GO TO Q2.21

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

2.21

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	GO TO Q3.1

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

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)

GO TO Q3.4

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	\|___\|___\|
STEPPARENT	2	\|___\|___\|
AUNT, UNCLE, GREAT-AUNT OR GREAT-UNCLE	3	\|___\|___\|
GRANDPARENT OR GREAT GRANDPARENT	4	\|___\|___\|
SIBLING (BROTHER OR SISTER)	5	\|___\|___\|
STEPBROTHER OR STEPSISTER	6	\|___\|___\|
NEPHEW OR NIECE	7	\|___\|___\|
COUSIN	8	\|___\|___\|
OTHER RELATIVE OR IN-LAW	9	\|___\|___\|
NON-RELATIVE ADULT (INCLUDE MOTHER’S PARTNER, BOYFRIEND)	10	\|___\|___\|
NON-RELATIVE CHILD	11	\|___\|___\|
OTHER (SPECIFY)	12	\|___\|___\|
__________________________________________________________________		\|___\|___\|
MOTHER	13	\|___\|___\|
TOTAL SHOULD EQUAL NUMBER IN Q3.1		________

3.4

(Do/Does) (READ PERSON) live in this state, in another state or outside of mainland USA?

FOR CATEGORIES WITH MULTIPLE PEOPLE, CIRCLE ALL THAT APPLY

		THIS STATE	OTHER STATE	OUTSIDE MAINLAND USA	DECEASED/ NO SUCH RELATIVE
a.	Your mother	01	02	03	-4
b.	Your father	01	02	03	-4
c.	Any of your brothers or sisters	01	02	03	-4
d.	A present or past husband	01	02	03	-4
e.	Any other of your children	01	02	03	-4

f.	Any other family members who you are close to	01	02	03	-4

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