ACF OPRE: Head Start Family and Child Experiences Survey (FACES)

		OMB#: 0970-0151 EXPIRATION DATE: 6/2000
	Spring 1998

KINDERGARTEN FOLLOWUP

of the

Head Start Family and Child Experiences Survey
Kindergarten Parent Survey

LABEL

Hello, may I speak with [SPRING ’97 RESPONDENT]?

S1.

SPRING ’97 RESPONDENT IS:

THERE AND AVAILABLE	1	(GO TO MAIN INTRODUCTION)
NOT CURRENTLY AVAILABLE	2
NO LONGER THERE	3	(GO TO S3)

S2.

When would be the best time for me to call back to reach (him/her)?

BEST DAY:_______________________ TIME:______________________

THANK RESPONDENT AND END CONVERSATION. RECORD CALLBACK
INFORMATION ON CALL RECORD.

S3.

I am trying to reach the person most responsible for [CHILD]. Would that (still) be [SPRING ’97 RESPONDENT]?

YES ......................................................... 1
NO............................................................ 2 (GO TO S5)

S4.

Could you please tell me how I can reach (him/her)?

STREET: ____________________________________________________________

CITY: _____________________________________ STATE: ________ ZIP:_______

TELEPHONE: ________________________________________________________

THANK RESPONDENT AND END CONVERSATION. USE INFORMATION OBTAINED ABOVE TO CONTACT SPRING ’97 RESPONDENT.

S5.

Who is most responsible for [CHILD]’s care?

NAME: ____________________________________________________________

ADDRESS: ________________________________________________________

CITY: ___________________________________ STATE: ________ ZIP:_______

TELEPHONE: ______________________________________________________

S6.

What is (your/his/her) relationship to [CHILD]? (DO NOT READ LIST. CIRCLE ONE RESPONSE.)

MOTHER (BIRTH/ADOPTIVE)	01
FATHER (BIRTH/ADOPTIVE)	02
STEPMOTHER	03
STEPFATHER	04
GRANDMOTHER	05
GRANDFATHER	06
GREAT GRANDMOTHER	07
GREAT GRANDFATHER	08
SISTER/STEPSISTER	09
BROTHER/STEPBROTHER	10
OTHER RELATIVE OR IN-LAW (FEMALE)	11
OTHER RELATIVE OR IN-LAW (MALE)	12
FOSTER PARENT (FEMALE)	13
FOSTER PARENT (MALE)	14
OTHER NON-RELATIVE (FEMALE)	15
OTHER NON-RELATIVE (MALE)	16
PARENT’S PARTNER (FEMALE)	17
PARENT’S PARTNER (MALE)	18

S7.

Since last spring, how many months (have/has (you/he/she) been the person most responsible for [CHILD]’s care?

NUMBER OF MONTHS: __________

S8.

MOST RESPONSIBLE PERSON IS:

PERSON YOU ARE CURRENTLY SPEAKING WITH	1	(GO TO MAIN INTRODUCTION)
SOMEONE ELSE	2	(THANK R AND END CONVERSATION. USE INFORMATION FROM S5 TO CONTACT MOST RESPONSIBLE PERSON)

MAIN INTRODUCTION

(Hello), my name is __________ and I am (calling) from Westat. We are part of the research team that is conducting a study of the Head Start Program. (You may remember that) someone from the research team talked to (you/SPRING ’97 RESPONDENT) last Spring, while your child, [CHILD’S NAME], was attending Head Start.

As part of this same study, the Family and Child Experiences Survey, we would like to again interview you, administer a child assessment to [CHILD] and ask [CHILD]’s current teacher some questions. The study will help us learn more about what happens to children and families who participate in Head Start and what happens when the children enter kindergarten. We want to get your point of view on how [CHILD] is doing in kindergarten and what is now happening in your family. This information will be used to help Head Start better serve children and families. To thank you and [CHILD] for your participation, you will receive $15.00 and [CHILD] will receive a toy.

S9.

We would like to ask you a few questions now, (similar to the interview you did in person last spring). It should take about 30 minutes.

IF THIS IS NOT A GOOD TIME TO COMPLETE THE INTERVIEW, RECORD APPOINTMENT TIME BELOW AND ON THE CALL RECORD. THEN COMPLETE THE CONSENT/TEACHER PERMISSION FORM.

APPOINTMENT INFORMATION:

BEST DAY:_______________________ BEST TIME: _______________________

A. DEMOGRAPHIC CHARACTERISTICS

First, I want you to know that your participation is completely voluntary and your responses will be kept completely confidential.

A1.

Now, I'd like to confirm [CHILD]'s age. We have (his/her) birthday listed as [BIRTHDATE]? Is that correct?

YES	1	(GO TO A3)
NO	2

A2.

What is [CHILD]’s correct birthdate?

______	/	_____	/	______
MONTH		DAY		YEAR

A3.

Now, about your language background. What was the first language you learned to speak?

ENGLISH	01
SPANISH	02
ENGLISH AND SPANISH EQUALLY	03
ENGLISH AND ANOTHER LANGUAGE EQUALLY	04
ANOTHER LANGUAGE	05
(SPECIFY) _____________________________________

A4.

What language do you speak most at home now?

ENGLISH	01
SPANISH	02
ENGLISH AND SPANISH EQUALLY	03
ENGLISH AND ANOTHER LANGUAGE EQUALLY	04
ANOTHER LANGUAGE	05
(SPECIFY) _____________________________________

B. CURRENT SCHOOL STATUS

B1.

Now I'd like to talk with you about [CHILD]'s school experiences. Is [CHILD] attending (or enrolled in) school?

YES	1
NO	2	(GO TO B9)

B2.

What grade or year is [CHILD] attending?

HEAD START	01	(GO TO Q1 ON PAGE 36)
NURSERY/PRESCHOOL/PREKINDERGARTEN	02	(GO TO B9)
TRANSITIONAL KINDERGARTEN (BEFORE K)	03	(GO TO B3)
KINDERGARTEN	04	(GO TO B3)
PREFIRST GRADE (AFTER K)	05	(GO TO B3)
FIRST GRADE	06	(GO TO B4)
SECOND GRADE	07	(GO TO B4)
UNGRADED	08	(GO TO B8)

B3.

Does [CHILD] go to a full-day or part-day (kindergarten/prefirst grade)?

FULL-DAY	1
PART-DAY	2

B4.

How many hours each day does (he/she) spend in (kindergarten/prefirst grade/first grade/second grade)?

NUMBER OF HOURS PER DAY: __________

B5.

How many days each week does (he/she) spend in (kindergarten/prefirst grade/first grade/second grade)?

NUMBER OF DAYS PER WEEK: __________

B6.

Approximately how many days has [CHILD] been absent from class since the beginning of the school year that is, since last September?

NUMBER OF DAYS ABSENT: __________

IF NUMBER OF DAYS ABSENT IS GREATER THAN 5 CHECK THIS BOX…

THEN ASK B7. OTHERWISE, GO TO C1.

B7.

What is the most frequent reason for [CHILD]'s missing class?

ILLNESS OF CHILD	01
ILLNESS OF FAMILY MEMBER	02
CONFLICT WITH PARENT’S WORK OR SCHOOL SCHEDULE	03
LACK OF TRANSPORTATION	04
BAD WEATHER	05
CHILD DID NOT WANT TO GO	06
PARENT DECISION NOT TO SEND CHILD OR TO SEND CHILD ELSEWHERE	07
OTHER (PLEASE SPECIFY) ____________________________	08

SKIP TO SECTION C

B8.

What grade would [CHILD] be in if (he/she) were attending [school/a school with regular grades]?

NURSERY/PRESCHOOL/PREKINDERGARTEN/HEAD START	01
TRANSITIONAL KINDERGARTEN (BEFORE K)	02	(GO TO C1)
KINDERGARTEN	03	(GO TO C1)
PREFIRST GRADE (AFTER K)	04	(GO TO C1)
FIRST GRADE	05	(GO TO C1)
SECOND GRADE	06	(GO TO C1)
UNGRADED, NO EQUIVALENT	07

B9.

Do you expect [CHILD] to be enrolled in kindergarten next year or the year after that?

NEXT YEAR	1
YEAR AFTER THAT	2
NEITHER, DON'T EXPECT CHILD TO ATTEND KINDERGARTEN	3
DON'T KNOW	8

SKIP TO SECTION G, PAGE 11

C. SCHOOL CHARACTERISTICS

Now let's talk about the school [CHILD] goes to (now).

C1.

Does [CHILD] go to a public or private school?

PUBLIC	1	(GO TO C4)
PRIVATE	2

C2.

Is the school church-related or not church-related?

CHURCH-RELATED	1
NOT CHURCH-RELATED	2	(GO TO C4)

C3.

Is it a Catholic school?

YES	1
NO	2

C4.

Approximately how many students are in [CHILD]'s class?

NUMBER OF STUDENTS IN CLASS: ______________

C5.

How many teachers are in [CHILD]'s class?

NUMBER OF TEACHERS IN CLASS: ___________

C6.

Since the beginning of this school year, has [CHILD] been in the same school?

YES	1
NO	2

D. SCHOOL PRACTICES

D1.

For each statement that I read you, please tell me how well [CHILD]'s school has been doing the following things (during this school year):

[IF NECESSARY, READ AFTER STATEMENTS FOLLOWING THE FIRST STATEMENT.]: Would you say [CHILD]'s school does this very well, just O.K., or doesn't do it at all.

	Does it very well	Just O.K.	Dos not do it at all	Don't know
Lets you know (between report cards) how [CHILD] is doing in school.	1	2	3	8
Helps you understand what children at [CHILD]'s age are like	1	2	3	8
Makes you aware of chances to volunteer at the school	1	2	3	8
Provides workshops, materials, or advice about how to help [CHILD] learn at home	1	2	3	8
Provides information on community services to help [CHILD] or your family	1	2	3	8
IF LANGUAGE MOST SPOKEN AT HOME (A4) IS NOT ENGLISH ASK:	1	2	3	8
Understands the needs of families who don't speak English	1	2	3	8

E. FAMILY/SCHOOL INVOLVEMENT AND SCHOOL PRACTICES

Now I'd like to ask you about your involvement with [CHILD]'s current school.

E1.

Since the beginning of this school year, have you …

	YES	NO
Attended a general school meeting, for example, an open house, a back-to-school night or a meeting of a parent-teacher organization?	1	2
Gone to a regularly-scheduled parent-teacher conference with [CHILD]'s teacher?	1	2
Attended a school or class event, such as a play, (or) sports event because of [CHILD]?	1	2
Acted as a volunteer at the school or served on a committee?	1	2

E2.

During this school year, about how many times have you gone to meetings or participated in activities at [CHILD]'s school?

NUMBER OF TIMES: __________

F. TEACHER FEEDBACK ON CHILD’S SCHOOL PERFORMANCE AND BEHAVIOR

Here are some things teachers tell parents about how their children are doing in school. For each one, please tell me if a teacher said something like this about [CHILD], or wrote it in a note or on a report card during this school year, even if you didn’t agree.

F1.

Since the beginning of this school year, has a teacher said or written that [CHILD].

		YES	NO
a.	has been doing really well in school?	1	2
b.	has not been learning up to (his/her) capabilities?	1	2
c.	has been acting up in school or disrupting the class?	1	2
d.	has been having trouble taking turns, sharing or cooperating with other children?	1	2
e.	gets along with other children or works well in a group?	1	2
f.	is very enthusiastic and interested in a lot of different things?	1	2
g.	is often sleepy or tired in class?	1	2
h.	likes to speak out in class and express (his/her) ideas?	1	2
i.	is often bored in class?	1	2

F2.

As far as you know, is [CHILD] going to be promoted to (first grade/second grade) this coming fall, or will he/she spend another year in (kindergarten/first grade)?

YES, WILL BE PROMOTED TO (FIRST/SECOND) GRADE	1
NO, WILL SPEND ANOTHER YEAR IN KINDERGARTEN/ FIRST GRADE	2
NO, WILL GO INTO A TRANSITIONAL CLASS (PREFIRST GRADE)	3

F3.

Now that [CHILD] has been in (kindergarten/first grade) for most of a school year, how satisfied are you with what Head Start did to help [CHILD] and your family be prepared for school? Are you.

Very dissatisfied,	1
Somewhat dissatisfied,	2
Somewhat satisfied,	3
or Very satisfied?	4

G. YOUR CHILD’S ABILITIES

These next questions are about things that different children do at different ages. These things may or may not be true for [CHILD].

G1.

Can [CHILD] identify the colors red, yellow, blue, and green by name? Would you say...

All of them	1
Some of them, or	2
None of them?	3

G2.

Can (he/she) recognize...

All of the letters of the alphabet	1
Most of them	2
Some of them, or	3
None of them?	4

G3.

How high can [CHILD] count? Would you say...

Not at all	1
Up to five	2
Up to ten	3
Up to twenty	4
Up to fifty, or	5
Up to 100 or more?	6

G4.

Does [CHILD]….

		YES	NO
a.	mostly write and draw rather than scribble?	1	2
b.	write (his/her) first name, even if some of the letters are backwards?	1	2
c.	trip, stumble, or fall easily?	1	2
d.	stutter or stammer?	1	2
e.	When [CHILD] speaks, is (he/she) understandable to a stranger?	1	2

G5.

Is [CHILD] able to read story books on (his/her) own now?

YES	1
NO	2	(GO TO G8)

G6.

Does [CHILD] actually read the words written in the book, or does (he/she) look at the book and pretend to read?

READS THE WRITTEN WORDS	1
PRETENDS TO READ	2	(GO TO G9)
DOES BOTH	3

G7.

How old was [CHILD] in years and months when (he/she) began reading simple, whole sentences?

YEARS____________ MONTHS___________ (GO TO H1)

G8.

Does (he/she) ever look at a book with pictures and pretend to read?

YES	1
NO	2	(GO TO H1)

G9.

When (he/she) pretends to read a book, does it sound like a connected story, or does (he/she) tell what's in each picture without much connection between them?

SOUNDS LIKE CONNECTED STORY	1
TELLS WHAT'S IN EACH PICTURE	2
DOES BOTH	3

H. YOUR CHILD’S BEHAVIOR

H1.

In general, thinking about [CHILD] over the past six months, tell me how well the following statements describe [CHILD]’s usual behavior. For each one, tell me if it is very true or often true, sometimes or somewhat true, or not true.

(READ ALL ITEMS. CIRCLE ONE RESPONSE FOR EACH.)

		Very true or often true	Somewhat or sometimes true	Not true
a.	Makes friends easily?	1	2	3
b.	Enjoys learning?	1	2	3
c.	Has temper tantrums or hot temper?	1	2	3
d.	Can't concentrate, can't pay attention for long?	1	2	3
e.	Is very restless, and fidgets a lot?	1	2	3
f.	Likes to try new things?	1	2	3
g.	Shows imagination in work and play?	1	2	3
h.	Is unhappy, sad, or depressed?	1	2	3
i.	Comforts or helps others?	1	2	3
j.	Hits and fights with others?	1	2	3
k.	Worries about things for a long time?	1	2	3
l.	Accepts friends' ideas in sharing and playing?	1	2	3
m.	Doesn't get along with other kids?	1	2	3
n.	Wants to hear that he/she is doing okay?	1	2	3
o.	Feels worthless or inferior?	1	2	3
p.	Makes changes from one activity to another with difficulty?	1	2	3
q.	Is nervous, high-strung, or tense?	1	2	3
r.	Acts too young for his/her age?	1	2	3
s.	Is disobedient at home?	1	2	3

I. ACTIVITIES WITH YOUR CHILD

Now I have some questions about you and your child at home.

I1.

How many times have you or someone in your family read to [CHILD] in the past week? Would you say..

Not at all,	1
Once or twice,	2
3 or more times,	3
or Every day?	4

I2.

In the past week, have you or someone in your family done the following things with [CHILD]?

IF YES, ASK: How many times have you or someone in your family done this in the past week? Would you say one or two times, or three or more times?

		YES	NO	1-2 TIMES	3+ TIMES
a.	Told (him/her) a story?	1	2	1	2
b.	Taught (him/her) letters, words, or numbers?	1	2	1	2
c.	Taught (him/her) songs or music?	1	2	1	2
d.	Worked in arts and crafts with (him/her)?	1	2	1	2
e.	Played a game, sport, or exercised together?	1	2	1	2
f.	Took (him/her) along while doing errands like going to the post office, the bank, or the store?	1	2	1	2
g.	Involved (him/her) in household chores like cooking, cleaning, setting the table, or caring for pets?	1	2	1	2

I3.

In the past month, have you or someone in your family done the following things with [CHILD]?

		YES	NO
a.	Visited a library?	1	2
b.	Gone to a movie?	1	2
c.	Gone to a play, concert, or other live show?	1	2
d.	Gone to a mall?	1	2
e.	Visited an art gallery, museum, or historical site?	1	2
f.	Visited a playground, park, or gone on a picnic?	1	2
g.	Visited a zoo or aquarium?	1	2
h.	Talked with [CHILD] about (his/her) family history or ethnic heritage?	1	2
i.	Attended an event sponsored by a community, ethnic, or religious group?	1	2
j.	Attended an athletic or sporting event in which [CHILD] was not a player?	1	2

J. HOUSEHOLD RULES

Now I'd like to ask you a few questions about rules and setting limits at home.

J1.

In your house, are there general rules about.

		YES	NO
a.	What TV programs [CHILD] can watch?	1	2
b.	How many hours [CHILD] can watch TV?	1	2
c.	What kinds of food [CHILD] eats?	1	2
d.	What time [CHILD] goes to bed?	1	2
e.	What chores [CHILD] does?	1	2

J2.

About how many hours a day does [CHILD] watch television?

HOURS A DAY: __________

J3.

Sometimes kids mind pretty well and sometimes they don't. Have you spanked [CHILD] in the past week for not minding?

YES	1
NO	2	(GO TO KI)

J4.

About how many times in the past week?

NUMBER OF TIMES: __________

K. HEALTH AND DISABILITY

Now I have a few questions about [CHILD]'s health.

K1.

Does [CHILD] have any special needs or disabilities - for example, physical, emotional, language, hearing, learning difficulty, or other special needs?

YES	1
NO	2	(GO TO K6)

K2.

How would you describe [CHILD]’s needs? Does (she/he) have…

		YES	NO	DON'T KNOW
a.	A specific learning disability?	1	2	8
b.	Mental retardation?	1	2	8
c.	A speech impairment?	1	2	8
d.	A serious emotional disturbance?	1	2	8
e.	Deafness or another hearing impairment?	1	2	8
f.	Blindness or another visual impairment?	1	2	8
g.	An orthopedic impairment?	1	2	8
h.	Another health impairment lasting 6 months or more?	1	2	8

IF NO TO K2a-h, CHECK THIS BOX.

THEN SKIP TO K6

K3.

(Does/Do) [CHILD]'s (disability/disabilities) affect (his/her) ability to learn?

YES	1
NO	2

K4.

Did you or another family member participate in developing an Individualized Education Program or Plan (IEP) for [CHILD]?

YES	1
NO	2	(GO TO K6)

K5.

How satisfied are you with the plan? Would you say you are.

Very dissatisfied,	1
Somewhat dissatisfied,	2
Somewhat satisfied,	3
or Very satisfied?	4

K6.

Overall, would you say [CHILD]'s health is.

Excellent,	1
Very good,	2
Good,	3
Fair, or	4
Poor?	5

K7.

Does [CHILD] have a regular health care provider for routine medical care, for example, well-child care and check-ups?

YES	1
NO	2

K8.

About how long has it been since [CHILD] last saw a medical doctor or other health professional for a checkup or other routine care? Would you say.

Less than 1 year,	1
1 year, but less than 2 years,	2
or 2 years, or more?	3

K9.

Has [CHILD] ever been to a dentist or dental hygienist for dental care?

YES	1
NO	2	(GO TO K1I)

K10.

About how long has it been since [CHILD] last saw a dentist or dental hygienist for dental care? Would you say.

Less than 1 year,	1
1 year, but less than 2 years,	2
or 2 years, or more?	3

K11.

Now some questions about your health. Would you say your health in general is…

Excellent,	1
Very good,	2
Good,	3
Fair, or	4
Poor?	5

K12.

Does any impairment or health problem now keep you from working at a job or business?

YES	1
NO	2	(GO TO K14)

K13.

Are you limited in the kind or amount of work you can do because of any impairment or health problem?

YES	1
NO	2

K14.

Do you have a regular health care provider for your own routine medical care, for example, checkups?

YES	1
NO	2

K15.

Does anyone in your household smoke cigarettes regularly?

YES	1
NO	2

L. YOU AND YOUR FAMILY

Now I'm going to ask you some questions about you and your family.

L1.

What is your current marital status?

Single, never married	1
Married	2
Separated	3
Divorced	4
Widowed	5

L2.

Including yourself, how many adults age 18 and older live in your household?

NUMBER OF ADULTS: __________

L3.

Including [CHILD], how many children age 17 and younger live in your household?

NUMBER OF CHILDREN: __________

L4.

What is the highest grade or year of school that you have completed?

UP TO 8TH GRADE	01
9TH TO 11TH GRADE	02
12TH GRADE BUT NO DIPLOMA	03
HIGH SCHOOL DIPLOMA/EQUIVALENT	04
VOC/TECH PROGRAM AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA	05
VOC/TECH DIPLOMA AFTER HIGH SCHOOL	06
SOME COLLEGE BUT NO DEGREE	07
ASSOCIATE'S DEGREE	08
BACHELOR'S DEGREE	09
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE	10
MASTER'S DEGREE (MA, MS)	11
DOCTORATE DEGREE (PhD, EDD)	12
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE (MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.)	13
DON’T KNOW	98

L5.

Are you currently working towards any certificate, diploma, or degree?

YES	1
NO	2	(GO TO L6)

L5A.

What kind of certificate, diploma, or degree?

TRADE LICENSE OR CERTIFICATE	01
GED CERTIFICATE (OR EQUIVALENT)	02
HIGH SCHOOL DIPLOMA	03
ASSOCIATES DEGREE	04
CHILD DEVELOPMENT ASSOCIATE (CDA)	05
BACHELOR'S DEGREE	06
GRADUATE DEGREE	07
OTHER (PLEASE SPECIFY) ___________________________________	08

L6.

Have you completed a certificate, diploma, or degree since last spring?

YES	1
NO	2	(GO TO BOX BEFORE L8)

L7.

What kind of certificate, diploma, or degree? (CIRCLE ONE RESPONSE.)

TRADE LICENSE OR CERTIFICATE	01
GED CERTIFICATE (OR EQUIVALENT)	02
HIGH SCHOOL DIPLOMA	03
ASSOCIATES DEGREE	04
CHILD DEVELOPMENT ASSOCIATE (CDA)	05
BACHELOR'S DEGREE	06
GRADUATE DEGREE	07
OTHER (PLEASE SPECIFY) ___________________________________	08

RESPONDENT IS:

[CHILD]’s MOTHER....................................... 1 (GO TO BOX BEFORE L18)
NOT [CHILD]’s MOTHER .............................. 2 (CONTINUE WITH L8)

L8.

Is [CHILD]'s mother in this household?

MOTHER IN HOUSEHOLD	1	(GO TO L12)
MOTHER NOT IN HOUSEHOLD	2
MOTHER DECEASED	3	(GO TO L16)

L9.

Does [CHILD]'s mother live in the same city or county as [CHILD]?

YES	1
NO	2

L10.

In the past year, on about how many days has [CHILD] seen (his/her) mother?

NUMBER OF DAYS: _________

L11.

How long has it been since [CHILD] last had contact with (his/her) mother?

[CHILD] NEVER HAD CONTACT	00	(GO TO L16)
DON'T KNOW	98

NUMBER: ______________________	DAYS	1
	WEEKS	2
	MONTHS	3
	YEARS	4

IF NO CONTACT IN LAST 12 MONTHS, CHECK THIS BOX…

THEN SKIP TO L13.

L12.

Since (the beginning of this school year), has [CHILD]'s mother.

		YES	NO	DON'T KNOW
a.	Attended a general school meeting, for example, an open house, a back-to-school night, or a meeting of a parent teacher organization?	1	2	8
b.	Gone to a regularly scheduled parent-teacher conference with [CHILD]'s teacher?	1	2	8
c.	Attended a school or class event, such as a sports event because of [CHILD]?	1	2	8
d.	Acted as a volunteer at the school or served on a committee?	1	2	8

L13.

What is the highest grade or year of school that [CHILD'S] mother completed?

UP TO 8TH GRADE	01
9TH TO 11TH GRADE	02
12TH GRADE BUT NO DIPLOMA	03
HIGH SCHOOL DIPLOMA/EQUIVALENT	04
VOC/TECH PROGRAM AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA	05
VOC/TECH DIPLOMA AFTER HIGH SCHOOL	06
SOME COLLEGE BUT NO DEGREE	07
ASSOCIATE'S DEGREE	08
BACHELOR'S DEGREE	09
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE	10
MASTER'S DEGREE (MA, MS)	11
DOCTORATE DEGREE (PhD, EDD)	12
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE (MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.)	13
DON’T KNOW	98

L14.

Is she currently working, in school, in a training program, or is she doing something else? (CIRCLE ONE RESPONSE.)

WORKING	01
UNEMPLOYED	02
LOOKING FOR WORK	03
LAID OFF	04
IN SCHOOL/TRAINING	05
IN JAIL/PRISON	06
IN MILITARY	07
SOMETHING ELSE (PLEASE SPECIFY) ___________________________	08
DON'T KNOW	98

IF CHILD’S MOTHER IS IN HOUSEHOLD, CHECK THIS BOX…

THEN SKIP TO BOX L18.

L15.

In the past 12 months, (have you/has your family) received any child support payments for [CHILD] from (his/her) mother?

YES	1
NO	2

L16.

Is there anyone else who is like a mother to [CHILD]?

YES	1
NO	2	(GO TO L18)

L17.

Who is this person? Is she.

[THE RESPONDENT],	1
Your (spouse/partner)	2
A relative of the child who lives in the household	3
A relative of the child who doesn't live in the household	4
A friend of the family who lives in the household, or	5
A friend of the family who doesn't live in the household	6

RESPONDENT IS:

[CHILD]’s FATHER....................................... 1 (GO TO M1)
NOT [CHILD]’s FATHER ............................... 2 (CONTINUE WITH L18)

L18.

Is [CHILD]'s father in this household?

FATHER IN HOUSEHOLD	1	(GO TO L22)
FATHER NOT IN HOUSEHOLD	2
FATHER DECEASED	3	(GO TO L26)

L19.

Does [CHILD]'s father live in the same city or county as [CHILD]?

YES	1
NO	2
DON'T KNOW	8

L20.

In the past year, on about how many days has [CHILD] seen (his/her) father?

NUMBER OF DAYS: _________

L21.

How long has it been since [CHILD] last had contact with (his/her) father?

[CHILD] NEVER HAD CONTACT	00	(GO TO L23)
DON'T KNOW	98

NUMBER: ____________	DAYS	1
	WEEKS	2
	MONTHS	3
	YEARS	4

IF NO CONTACT IN LAST 12 MONTHS, CHECK THIS BOX…

THEN SKIP TO L26.

L22.

Since (the beginning of this school year), has [CHILD]'s father.

		YES	NO	DON'T KNOW
a.	Attended a general school meeting, for example, an open house, a back-to-school night, or a meeting of a parent teacher organization?	1	2	8
b.	Gone to a regularly scheduled parent-teacher conference with [CHILD]'s teacher?	1	2	8
c.	Attended a school or class event, such as a play or sports event because of [CHILD]?	1	2	8
d.	Acted as a volunteer at the school or served on a committee?	1	2	8

L23.

What is the highest grade or year of school that [CHILD'S] father completed?

UP TO 8TH GRADE	01
9TH TO 11TH GRADE	02
12TH GRADE BUT NO DIPLOMA	03
HIGH SCHOOL DIPLOMA/EQUIVALENT	04
VOC/TECH PROGRAM AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA	05
VOC/TECH DIPLOMA AFTER HIGH SCHOOL	06
SOME COLLEGE BUT NO DEGREE	07
ASSOCIATE'S DEGREE	08
BACHELOR'S DEGREE	09
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE	10
MASTER'S DEGREE (MA, MS)	11
DOCTORATE DEGREE (PhD, EDD)	12
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE (MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.)	13
DON’T KNOW	98

L24.

Is he currently working, in school, in a training program, or is he doing something else? (CIRCLE ONE RESPONSE.)

WORKING	01
UNEMPLOYED	02
LOOKING FOR WORK	03
LAID OFF	04
IN SCHOOL/TRAINING	05
IN JAIL/PRISON	06
IN MILITARY	07
SOMETHING ELSE (PLEASE SPECIFY) ___________________________	08
DON'T KNOW	98

IF CHILD’S FATHER IS IN HOUSEHOLD, CHECK THIS BOX…

THEN SKIP TO M1.

L25.

In the past 12 months, (have you/has your family) received any child support payments for [CHILD] from (his/her) father?

YES	1
NO	2
DON'T KNOW	8

L26.

Is there anyone else who is like a father to [CHILD]?

YES	1
NO	2	(GO TO M1)

L27.

Who is this person? Is he.

[THE RESPONDENT],	1
Your (spouse/partner)	2
A relative of the child who lives in the household	3
A relative of the child who doesn't live in the household	4
A friend of the family who lives in the household, or	5
A friend of the family who doesn't live in the household	6

M. PARENT EDUCATION AND HUMAN CAPITAL

Now I have some questions about you and your parents.

M1.

What grades (do/did) you usually get in high school?

MOSTLY A'S (NUMERICAL AVERAGE OF 90-100)	01
MOSTLY A'S AND B'S (85-89)	02
MOSTLY B'S (80-84)	03
MOSTLY B'S AND C'S (75-79)	04
MOSTLY C'S (70-74)	05
MOSTLY C'S AND D'S (65-69)	06
MOSTLY D'S AND LOWER (64 AND BELOW)	07
NEVER IN HIGH SCHOOL	08	(GO TO M4)

M2.

(Is/Was) your high school program…

Academic or college preparatory, or	1
Commercial or business training, or	2
Vocational or technical?	3

M3.

Now I have a list of high school mathematics and technical courses. As I read each one, please tell me whether you have taken that course in high school.

		YES	NO
a.	Elementary Algebra or Algebra I?	1	2
b.	Plane geometry?	1	2
c.	Business Math?	1	2
d.	Computer Science?	1	2
e.	Intermediate Algebra or Algebra II?	1	2
f.	Trigonometry?	1	2
g.	Calculus?	1	2
h.	Physics?	1	2

M4.

What is the highest grade or year of school that your father completed?

UP TO 8TH GRADE	01
9TH TO 11TH GRADE	02
12TH GRADE BUT NO DIPLOMA	03
HIGH SCHOOL DIPLOMA/EQUIVALENT	04
VOC/TECH PROGRAM AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA	05
VOC/TECH DIPLOMA AFTER HIGH SCHOOL	06
SOME COLLEGE BUT NO DEGREE	07
ASSOCIATE'S DEGREE	08
BACHELOR'S DEGREE	09
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE	10
MASTER'S DEGREE (MA, MS)	11
DOCTORATE DEGREE (PhD, EDD)	12
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE (MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.)	13
DON’T KNOW	98

M5.

What is the highest grade or year of school that your mother completed?

UP TO 8TH GRADE	01
9TH TO 11TH GRADE	02
12TH GRADE BUT NO DIPLOMA	03
HIGH SCHOOL DIPLOMA/EQUIVALENT	04
VOC/TECH PROGRAM AFTER HIGH SCHOOL BUT NO VOC/TECH DIPLOMA	05
VOC/TECH DIPLOMA AFTER HIGH SCHOOL	06
SOME COLLEGE BUT NO DEGREE	07
ASSOCIATE'S DEGREE	08
BACHELOR'S DEGREE	09
GRADUATE OR PROFESSIONAL SCHOOL BUT NO DEGREE	10
MASTER'S DEGREE (MA, MS)	11
DOCTORATE DEGREE (PhD, EDD)	12
PROFESSIONAL DEGREE AFTER BACHELOR'S DEGREE (MEDICINE/MD; DENTISTRY/DDS; LAW/JD/LLB; ETC.)	13
DON’T KNOW	98

M6.

When you were growing up, did your family ever receive public assistance?

YES	1
NO	2
DON'T KNOW	8

M7.

What is your religious background?

BAPTIST	01
METHODIST	02
LUTHERAN	03
PRESBYTERIAN	04
EPISCOPAL	05
PENTECOSTAL	06
OTHER PROTESTANT	07
ROMAN CATHOLIC	08
EASTERN ORTHODOX	09
MORMON	10
OTHER CHRISTIAN	11
JEWISH	12
MOSLEM	13
EASTERN RELIGION (BUDDHIST, HINDU, TAO)	14
OTHER RELIGION (SPECIFY) _______________________________	15
NONE	16

M8.

In the past year, about how often have you attended religious services? Would you say.

About once a week,	1
2 or 3 times a month,	2
About once a month,	3
Several times during the year, or,	4
Not at all?	5

N. EMPLOYMENT AND INCOME

Now I would like to ask you some questions about the sources of income for your household. This information will remain confidential.

N1.

Do you have any earnings from a job or jobs, including self-employment?

YES	1
NO	2	(GO TO N5)

N2.

How many jobs do you have currently?

NUMBER OF JOBS: __________

N3.

What do you do in (this job/ the first job/the second job/the third job)?

a.	JOB 1 ________________________ ______________________________
b.	JOB 2 ________________________ ______________________________
c.	JOB 3 ________________________ ______________________________

N4. Is this job full-time, 30 or more hours per week; part-time, less than 30 hours per week; or seasonal or occasional during certain times of the year?

FULL-TIME	PART-TIME	SEASONAL
1	2	3
1	2	3
1	2	3

N5.

In how many of the last six months have you worked?

MONTHS WORKED:_________

N6.

Are you currently looking for (a/another) job?

YES	1
NO	2

N7.

Not including yourself, how many other adults contribute to your household income?

NUMBER OF ADULTS:_________

N8.

Does your family have health insurance other than Medicaid through (your job) or the job of another employed adult in the household?

YES	1
NO	2
DON'T KNOW	8

N9.

Did you receive any of the following other sources of household income or support in the past six months?

		YES	NO
a.	Welfare or general assistance	1	2
b.	Unemployment insurance	1	2
c.	Food Stamps	1	2
d.	WIC -- Special supplemental food program for Women, Infants, and Children	1	2
e.	Child support	1	2
f.	SSI or Social Security Retirement, Disability, or Survivor's benefits	1	2
g.	Payments for providing foster care	1	2

IF N9 a, c, OR d WERE ANSWERED YES, CHECK THIS BOX…

THEN ASK N10. OTHERWISE, GO TO N11.

N10.

In some states people who receive different types of public assistance are being required to do certain things such as take courses, get job training, or find a job. Are you now required to or will you soon be required to.

		YES	NO
a.	attend job training?	1	2
b.	attend school or a GED class?	1	2
c.	get a job?	1	2
d.	do something else? (please specify) ____________________	1	2

N11.

Thinking about all of the sources of income you just told me about, what was the total income for your household last month before taxes and other deductions? Your best guess would be fine.

HOUSEHOLD INCOME .......................... $ __ , __ __ __ (GO TO N13)

REFUSED	7	(GO TO N13)
DON'T KNOW	8	(GO TO N12)

N12.

Would you say it was.

less than $250	01
between $251 and $500	02
between $501 and $1,000	03
between $1,001 and $1,500	04
between $1,501 and $2,000	05
between $2,001 and $2,500, or	06
over $2,500	07
REFUSED	97
DON'T KNOW	98

Our next questions are about housing.

N13.

Do you now live in .

a house, apartment, or trailer of your own,	1
a house, apartment, or trailer you share with another family	2
transitional housing (apartment) or a homeless shelter, or	3
somewhere else? (please specify) ______________________________	4

N14.

How many times have you moved in the last six months?

TIMES: ___________

N15.

Do you currently live in public or subsidized housing?

YES	1
NO	2

N16.

Has [CHILD] ever lived apart from [you/(his/her) mother] for six months or longer, not including vacations or shared custody arrangements?

YES	1
NO	2

N17.

In the last year, has [CHILD] ever been a witness to a crime or domestic violence?

YES	1
NO	2
REFUSED	7
DON'T KNOW	8

N18.

In the last year, has [CHILD] ever been the victim of a crime or domestic violence?

YES	1
NO	2
REFUSED	7
DON'T KNOW	8

N19.

Since [CHILD] was born, has anyone in your household or ([CHILD]'s (biological) (father/mother)) been arrested or charged with any crime by the police?

YES	1
NO	2	(GO TO 01)
REFUSED	7	(GO TO 01)
DON'T KNOW	8	(GO TO 01)

N20.

Did this person spend any time in jail?

YES	1
NO	2
REFUSED	7
DON'T KNOW	8

O. CHILD CARE

Now let's talk about any child care arrangements that you are currently using for [CHILD]. Child care does not include time in kindergarten class, but may include separate child care arrangements at school before or after class.

O1 .

Is [CHILD] in child care?

YES	1
NO	2	(GO TO P1)

O2.

In how many different child care arrangements does [CHILD] spend time each week?

NUMBER OF ARRANGEMENTS: __________

O3.

Where is the primary care provided??

IN [CHILD]’S HOME WITH SOMEONE OTHER THAN PARENT	1
RELATIVE’S HOME	2
NONRELATIVE’S HOME	3
AT THE SCHOOL IN A BEFORE- OR AFTER-SCHOOL PROGRAM (OR WRAP-AROUND CARE)	4
OTHER CHILD CARE CENTER	5
OTHER (PLEASE SPECIFY) __________________________________	6

O4.

How many hours per week is this care used?

HOURS PER WEEK: _______

O5.

Who pays for this child care?

		YES	NO
a.	Do you pay for it yourself?	1	2
b.	Does a government agency pay?	1	2
c.	Does an employer pay?	1	2
d.	Do you trade child care with someone else?	1	2
e.	Other (please specify) ________________________________	1	2

O6.

Now I'm going to ask you about [CHILD]'s experiences in child care. Please let me know which of these answers best describes [CHILD]'s experience: never, sometimes, often, or always:

		Never	Some- times	Frequently	Always
a.	[CHILD] feels safe and secure in care.	1	2	3	4
b.	[CHILD] gets lots of individual attention	1	2	3	4
c.	[CHILD]’s caregiver is open to new information and learning	1	2	3	4

P. YOUR FEELINGS

P1.

I'm going to read a list of feelings or attitudes people have about themselves. After I read each one please tell me if you strongly disagree, disagree, agree, or strongly agree that you feel this way.

		Strongly disagree	Disagree	Agree	Strongly agree
a.	There is really no way I can solve some of the problems I have	1	2	3	4
b.	Sometimes I feel that I’m being pushed around in life	1	2	3	4
c.	I have little control over the things that happen to me	1	2	3	4
d.	I can do just about anything I really set my mind to do	1	2	3	4
e.	I often feel helpless in dealing with the problems of life	1	2	3	4
f.	What happens to me in the future depends mostly on me	1	2	3	4
g.	There is little I can do to change many of the important things in my life	1	2	3	4

P2.

I am going to read a list of ways you may have felt or behaved. Please tell me how often you have felt this way during the past week: rarely or never, some or a little, occasionally or moderately, or most or all of the time.

		Rarely of never	Some or a little	Occasionally or moderately	Most or all of the time
a.	Bothered by things that usually don't bother you	1	2	3	4
b.	You did not feel like eating; your appetite was poor	1	2	3	4
c.	That you could not shake off the blues, even with help from your family and friends	1	2	3	4
d.	You had trouble keeping your mind on what you were doing	1	2	3	4
e.	Depressed	1	2	3	4
f.	That everything that you did was an effort	1	2	3	4
g.	Fearful	1	2	3	4
h.	Your sleep was restless	1	2	3	4
i.	You talked less than usual	1	2	3	4
j.	You felt lonely	1	2	3	4
k.	You felt sad	1	2	3	4
l.	You could not get "going"	1	2	3	4

Those are all the questions that I have right now. I would like to thank you very much for participating in this interview. (INTERVIEWER CIRCLE ONE.)

CONSENT/TEACHER INFO ALREADY OBTAINED	1	(GO TO BOX BELOW)
CONSENT/TEACHER INFO NEEDED	2	(GO TO CONSENT FORM)

Please remember that our research team will be in your area during the weeks of [DATES FROM SCHEDULE]. Someone from that team will contact you to schedule a time to bring [CHILD] in for an assessment. As I mentioned before, once the assessment has been completed, you will receive $15 and [CHILD] will receive a toy.

COMMENTS:________________________________________________________________________

_____________________________________________________________________________________

Q. HEAD START TRACKING INFORMATION
(ONLY IF CHILD IN HEAD START)

Q1.

Which Head Start Center is [CHILD] currently attending?

CENTER NAME: _____________________________________________________

STREET: ____________________________________________________________

CITY: ____________________________ STATE: ____________ ZIP: ___________

Q2.

Is that the same center he/she attended last year?

YES	1	(GO TO BOX BELOW)
NO	2

Q3.

When did [CHILD] begin attending this center?

________
MONTH

/________
YEAR

We may want to include [CHILD] in the Head Start part of this study. One of our other team members will be contacting you with further information.

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KINDERGARTEN FOLLOWUP

of the

Head Start Family and Child Experiences Survey Kindergarten Parent Survey

Head Start Family and Child Experiences Survey
Kindergarten Parent Survey