2010 May 51 Number 1,ies Ser

Design and Operation of

the National Survey of

Adoptive Parents of

Children with Special

Health Care Needs, 2008
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Suggested citation

Bramlett MD, Brooks KS, Foster EB, et al. Design and operation of the National

Survey of Adoptive Parents of Children with Special Health Care Needs, 2008.

National Center for Health Statistics. Vital Health Stat 1(51). 2010.

Library of Congress Cataloging-in-Publication Data

Design and operation of the National Survey of Adoptive Parents of Children

with Special Health Care Needs, 2008.

p. ; cm.— (Vital and health statistics. Ser. 1, Program and collection

procedures ; no. 51) (DHHS publication ; no. (PHS) 2010–1327)

‘‘February 2010.’’

Includes bibliographical references.

ISBN-13: 978–0-8406–0634-1

ISBN-10: 0–8406-0634–6

1. National Survey of Adoptive Parents of Children with Special Health Care

Needs (U.S.) 2. Special needs adoption—United States—Statistics. 3.

Chronically ill children—United States—Statistics. 4. Health surveys—United

States. I. National Center for Health Statistics (U.S.) II. Series: Vital and health

statistics. Ser. 1, Programs and collection procedures ; no. 51. III. Series: DHHS

publication ; no. (PHS) 2010–1327.

[DNLM: 1. National Survey of Adoptive Parents of Children with Special

Health Care Needs (U.S.) 2. Adoption—United States—Statistics. 3. Data

Collection—methods—United States—Statistics. 4. Disabled Children—United

States—Statistics. 5. Health Surveys—United States—Statistics. 6. Parent-Child

Relations—United States—Statistics. W2 A N148va no.51 2010]

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Printed on acid-free paper.
Series 1, Number 51

Design and Operation of

the National Survey of Adoptive

Parents of Children with Special

Health Care Needs, 2008

Program and Collection Procedures

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Hyattsville, Maryland

May 2010

DHHS Publication No. (PHS) 2010–1327
National Center for Health Statistics

Edward J. Sondik, Ph.D., Director

Jennifer H. Madans, Ph.D., Associate Director for Science

Division of Health Interview Statistics

Jane F. Gentleman, Ph.D., Director
Contents 

Acknowledgments ......................................................................................... vi 

Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1 

Introduction ............................................................................................... 1 

The State and Local Area Integrated Telephone Survey (SLAITS) Program.......................................... 2 

2005–2006 National Survey of Children with Special Health Care Needs (NS-CSHCN) ............................... 2 

Background ............................................................................................... 3 

Development of the Survey Instrument ....................................................................... 4 

Sample Design............................................................................................. 5 

The National Immunization Survey (NIS) Sampling Plan ........................................................ 5 

NS-CSHCN Sample Design and Allocation.................................................................... 5 

Drawing the NS-CSHCN Sample............................................................................ 6 

Conducting the NS-CSHCN Interviews ....................................................................... 6 

Conducting the National Survey of Adoptive Parents of Children with Special Health Care Needs (NSAP-SN) Interviews . . . 6 

Questionnaire .............................................................................................. 6 

Content................................................................................................. 6 

Significant Changes During Data Collection ................................................................... 7 

Computer-assisted Telephone Interview (CATI) Programming ..................................................... 7 

Interviewer Training ........................................................................................ 7 

Training Sessions......................................................................................... 7 

Mock Interviews ......................................................................................... 8 

Locator Training ......................................................................................... 8 

Data Collection . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

Pretesting . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 8 

Advance Letters.......................................................................................... 8 

Toll-free Telephone Number ................................................................................ 8 

Selection of Sampled Child ................................................................................ 8 

Selection of Respondent ................................................................................... 8 

Informed Consent ........................................................................................ 9 

Assurance of Confidentiality................................................................................ 9 

Interview Length ......................................................................................... 9 

Interview Breakoffs....................................................................................... 9 

Cases Pending at Close of Data Collection ................................................................... 10 

Incentive Effort ......................................................................................... 10 

Response Rates ......................................................................................... 10 

Efforts to Maximize Response Rates ........................................................................ 11 

Locating Respondents .................................................................................... 11 

Quality Control ........................................................................................... 13 

Quality Control of Interviewing ............................................................................ 13 

Data Quality Control ..................................................................................... 13 

Weighting and Estimation Procedures ......................................................................... 13 

Base Weight............................................................................................ 13 

iii
Adjustment for Incomplete Interviews ....................................................................... 13 

Raking Adjustment to External Control Totals ................................................................ 14 

Quality Control ......................................................................................... 14 

Imputation of Relevant Variables ........................................................................... 14 

Public-use Data File . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Editing ................................................................................................ 14 

Missing Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14 

Coding of Verbatim Answers Into Question Responses ......................................................... 15 

Edits to Protect Confidentiality............................................................................. 15 

Derived Variables ....................................................................................... 17 

Dummy Variables ....................................................................................... 17 

Additional Data Notes.................................................................................... 18 

Quality Control ......................................................................................... 18 

Estimation and Hypothesis Testing............................................................................ 18 

Variables Used for Variance Estimation ...................................................................... 18 

Variance Estimation Using SUDAAN or Stata ................................................................ 19 

Variance Estimation for Subsets of the Data .................................................................. 19 

Weighted Frequencies, Prevalence Estimates, and Standard Errors ................................................ 19 

Guidelines for Data Use . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 

Further Information . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20 

References ............................................................................................... 20 

Appendix I............................................................................................... 21 

Weighting Technical Summary ............................................................................. 21 

Appendix II .............................................................................................. 23 

Questionnaire ........................................................................................... 23 

Appendix III ............................................................................................. 97 

Summary of Questionnaire Changes During Data Collection..................................................... 97 

Appendix IV ............................................................................................. 98 

Letters Sent to Sampled Households ........................................................................ 98 

Appendix V ............................................................................................. 108 

Incentive Effort ........................................................................................ 108 

Appendix VI ............................................................................................ 110 

Nonresponse Bias Analysis............................................................................... 110 

Appendix VII............................................................................................ 116 

Coding of Verbatim Answers Into Question Responses ........................................................ 116 

Appendix VIII ........................................................................................... 118 

Prevalence Estimates and Weighted Frequencies.............................................................. 118 

Text Tables

A.	 Percentage of main sample called only for NS-CSHCN (augmentation sample), by state........................... 6 

B.	 Number and percentage of respondents, by relationship to sampled child ....................................... 9 

C.	 Mean and median length of the NSAP-SN interview (in minutes and seconds).................................. 10 

D.	 Final disposition of the NSAP-SN sample ............................................................... 10 

E.	 Number of completed interviews and unweighted interview completion rates, by type of adoption as of the 2005–2006 

NS-CSHCN........................................................................................ 11 

F.	 Weighted interview completion rates, by type of adoption as of the 2005–2006 NS-CSHCN ...................... 11 

G.	 Unweighted and weighted NSAP-SN overall response rates ................................................. 11 

Appendix Tables

I.	 Summary statistics for the NSAP-SN final weight......................................................... 22 

II.	 Completion rates, by NSAP-SN incentive type .......................................................... 108 

iv
III. Percentage of children, by demographic and health characteristics, for respondents and nonrespondents in NSAP-SN . 110

IV. Percentage of children, by household socioeconomic and demographic characteristics, for respondents and

nonrespondents in NSAP-SN ......................................................................... 111

V. Percentage of children, by NS-CSHCN characteristics similar to NSAP-SN data elements for respondents and

nonrespondents in NSAP-SN ......................................................................... 112

VI. Percentage of children, by demographic and health characteristics in the final NSAP-SN, and for all NSAP-SNeligible cases...................................................................................... 113

VII. Percentage of children, by household socioeconomic and demographic characteristics in the final NSAP-SN, and

for all NSAP-SN-eligible cases ....................................................................... 114

VIII. Percentage of children, by NS-CSHCN characteristics similar to NSAP-SN data elements in the final NSAP-SN,

and for all NSAP-SN-eligible cases.................................................................... 115

IX. Unweighted and weighted estimates of the frequency and prevalence of type of adoption for adopted CSHCN ...... 118

v
Acknowledgments 

The National Survey of Adoptive

Parents of Children with Special Health

Care Needs (NSAP-SN) was sponsored

and funded by the Office of the

Assistant Secretary for Planning and

Evaluation and the Administration for

Children and Families, both of the U.S.

Department of Health and Human

Services. The project director is Laura

Radel.

The survey was conducted by the

Centers for Disease Control and

Prevention’s (CDC) National Center for

Health Statistics (NCHS) as a module of

the State and Local Area Integrated

Telephone Survey (SLAITS). The

SLAITS director is Marcie Cynamon

and the NSAP-SN survey director is

Matthew Bramlett. Design, production,

and analytic assistance for this project

were provided by Rosa Avila, Stephen

Blumberg, Julian Luke, and Kathleen

O’Connor. CDC’s National Center for

Immunization and Respiratory Diseases

graciously permitted the use of the

National Immunization Survey sampling

frame for this survey.

NORC at the University of Chicago

conducted all interviews for this project.

Technical assistance was contributed by

Nada Ganesh, Tracie Carroll, Shannon

Ten Broeck, Enyinnaya Adighibe, and

Erin Raasch. Gretchen Caspary, Kirk

Wolter, Kennon Copeland, and Tiffani

Balok provided management support.

This report was edited by Betsy M.

Finley and Demarius V. Miller,

CDC/NCHM/Division of Creative

Services, Writer-Editor Services Branch

and typeset by Annette F. Holman of

CDC/NCHM/Division of Creative

Services, Graphic Services Branch. The

report’s outline and some text were

borrowed with permission from an

earlier Vital and Health Statistics report

(‘‘Design and Operation of the National

Survey of Adoptive Parents, 2007’’).

Finally, we extend our appreciation

to the thousands of parents and other

family members who were willing to

share their stories. Their efforts made

this project a reality.

vi
Objective

This report presents the

development, plan, and operation of the

National Survey of Adoptive Parents of

Children with Special Health Care

Needs (NSAP-SN), a module of the

State and Local Area Integrated

Telephone Survey conducted by the

Centers for Disease Control and

Prevention’s National Center for Health

Statistics. The survey was designed to

produce national estimates of the

characteristics, health, and well-being of

adopted children with special health

care needs (CSHCN) and their families,

the preadoption experiences of the

adoptive parents, and their access to

and utilization of postadoption services.

Funding was provided by the Office of

the Assistant Secretary for Planning

and Evaluation and the Administration

for Children and Families, both of the

U.S. Department of Health and Human

Services.

Methods

The National Survey of Children with

Special Health Care Needs 2005–2006

(NS-CSHCN), a random-digit-dial

telephone survey of households with

children, included questions that

identified whether the sampled child

was adopted. Adopted CSHCN under

age 18 in 2008 who lived in households

where English was spoken were eligible

for the NSAP-SN follow-up interview.

The NSAP-SN interview was a

follow-back telephone call 1 to 3 years

after the original NS-CSHCN interview.

Sampled children included CSHCN

adopted from other countries, from the

U.S. foster care system, and from

private domestic sources. Respondents

were either the adoptive mother or the

adoptive father.

Results

A total of 1,007 NSAP-SN interviews

were completed from February 2008 to

July 2008. The interview completion

rate (i.e., cooperation rate) for eligible

respondents was 67.3%. The overall

response rate, taking account of

nonresponse to NS-CSHCN, was

37.7%.

Keywords: adoption c foster care c

adoption services c child health

Design and Operation of the

National Survey of Adoptive

Parents of Children with Special

Health Care Needs, 2008

by Matthew D. Bramlett, Ph.D., National Center for Health Statistics,

Division of Health Interview Statistics; Keeshawna S. Brooks, M.A.,

Erin B. Foster, M.S.T., Jennifer Satorius, M.S.W., Alicia M. Frasier,

M.P.H., Benjamin J. Skalland, M.S., Kari L. Nysse-Carris, Ph.D.,

Heather M. Morrison, M.A., and Sadeq R. Chowdhury, Ph.D., NORC

at the University of Chicago

Introduction

Several agencies within the U.S.

Department of Health and Human

Services (HHS), including the Office of

the Assistant Secretary for Planning and

Evaluation (ASPE), the Administration

for Children and Families (ACF), and

the Centers for Disease Control and

Prevention’s (CDC) National Center for

Health Statistics (NCHS) have

collaborated to develop the National

Survey of Adoptive Parents of Children

with Special Health Care Needs

(NSAP-SN). Administered for the first

time in 2008, NSAP-SN focuses on the

characteristics and needs of adopted

children with special health care needs

(CSHCN) and their parents. The survey

is tailored to collect data from three

types of adoptive families:

+	 Those who adopted through the U.S.

foster care system.

+	 Those who adopted internationally.

+	 Those who adopted through

domestic private sources.

Due to the relatively low prevalence

of adoptive families of children with

special health care needs in the United

States, surveying this population would

typically represent a significant

challenge in terms of identifying a

sample large enough for analysis that is

nationally representative of all adopted

CSHCN. NSAP-SN cases, however,

were screened via administration of a

parent survey, the National Survey of

Children with Special Health Care

Needs (NS-CSHCN).

The 2005–2006 NS-CSHCN

provided a nationally representative

sample of adopted CSHCN in the

United States. Households containing

these adopted children identified in the

2005–2006 NS-CSHCN were

subsequently called back to administer

the NSAP-SN instrument if English was

spoken in the household and the child

had not yet reached age 18. As a result

of its link with NS-CSHCN, the

NSAP-SN sample has coverage that

represents all adopted CSHCN who

were aged 0–15 in 2005–2006 and

living in English-speaking households in

the United States, and is able to provide

much needed data on:

+	 Adopted child and family

characteristics.

+	 Parent and child well-being.

+	 Adoption agreements and

postadoption financial services.

+	 Postadoption nonfinancial support.

These data, combined with those

collected in the NS-CSHCN interview,

will provide researchers with previously

Page 1
Page 2 [ Series 1, No. 51

unavailable insights into the health and

well-being of adopted CSHCN and their

families. The content of NS-CSHCN is

broad, addressing a variety of physical,

emotional, and behavioral health

indicators and measures of children’s

health experiences with the health care

system (1).

Both NS-CSHCN and NSAP-SN

were administered as modules of the

State and Local Area Integrated

Telephone Survey (SLAITS), a

telephone survey mechanism designed to

benefit from the extensive random-digitdial (RDD) sampling investment made

by the National Immunization Survey

(NIS). The synchronicity between NIS,

NS-CSHCN, and NSAP-SN enables

NSAP-SN to take advantage of a

singularly robust RDD sample design

and field a new survey in a highly

cost-effective manner. Furthermore, the

association with NS-CSHCN enriches

each NSAP-SN case with a wealth of

additional information on the health,

well-being, and health care system

experiences of adopted CSHCN and

their families.

The National Survey of Adoptive

Parents (NSAP) instrument was also

administered to a sample of adoptive

parents identified through the 2007

National Survey of Children’s Health

(NSCH) in 2007 and early 2008. The

selected children in NSAP represented

all adopted children aged 0–17 in 2007,

not just those with special health care

needs. For more detail on the NSCH

sample design, readers are encouraged

to refer to the 2007 NSCH design and

operations report (2). Detail about the

NSAP sample design is available in the

NSAP design and operations report (3).

The SLAITS Program

The SLAITS program, conducted

by NCHS, is a broad-based, ongoing

survey system available at the national,

state, and local levels for tracking and

monitoring the health and well-being of

children and adults. Surveys conducted

as part of the SLAITS system use the

same sampling frame as NIS, and

immediately follow NIS in selected

households, using its sample for

efficiency and economy. NIS is a

large-scale RDD telephone survey that

screens households for the presence of

young children and collects

immunization history information for

children aged 19–35 months. To achieve

an adequate sample of households with

children in this age range, NIS contacts

over 1 million households per year to

determine if they contain age-eligible

children. The process of identifying this

large number of households—most of

which are ineligible for NIS—provides

an economical opportunity to administer

other surveys on a range of health- and

welfare-related topics in an operationally

seamless, cost-effective, and statistically

sound manner.

Surveys conducted as part of the

SLAITS system vary in content,

duration, and sample size based on the

research needs of their sponsors.

Sponsors work with NCHS to establish

parameters, including sample size,

questionnaire design, and other survey

requirements. Since 2005, NORC at the

University of Chicago has implemented

all aspects of the survey operations

under contract with NCHS, including

development and testing of the

computer-assisted telephone interview

(CATI) instrument, recruiting and

training interviewers, completing the

targeted number of interviews, and

preparing data files and documentation.

NCHS is responsible for all aspects of

SLAITS administration.

SLAITS began in 1997 with a pilot

in two states (Iowa and Washington)

with a series of questions on health,

including issues of access to care, health

status, and insurance. In 1998, a

SLAITS module concerning child

well-being and welfare issues was

implemented using three samples: a

Texas RDD sample, known Medicaid

program participants seeded into the

Texas RDD sample, and known

Medicaid or MinnesotaCare participants

in Minnesota. The first national SLAITS

module was fielded in 2000: the

National Survey of Early Childhood

Health collected data from a national

sample regarding parents’ perceptions of

their children’s pediatric care and

examined relationships between the

promotion of health in the pediatric

office and promotion of health in the

home (4).

In 2000–2002, SLAITS fielded the

first National Survey of CSHCN,

designed to collect data on CSHCN,

children’s health insurance coverage,

and uninsured children from low-income

households (5). This was the first

SLAITS module to take full advantage

of the NIS sampling frame to produce

state-level estimates. In 2003, SLAITS

fielded the first iteration of the National

Survey of Children’s Health, which

examined the physical and emotional

health of children aged 0–17 years (6).

In 2003, SLAITS also fielded the

National Asthma Survey, which

examined the health, socioeconomic,

behavioral, and environmental factors

that relate to better control of asthma for

children and adults (7). In 2005–2006,

SLAITS fielded the second iteration of

NS-CSHCN (1), and in 2007, SLAITS

fielded the second iteration of NSCH

(2), concurrently with NSAP (3).

2005–2006 NS-CSHCN

The 2005–2006 NS-CSHCN marked

the second time that SLAITS has been

used to conduct this survey. From April

2005 to February 2006, a total of 40,840

interviews were completed with parents

of CSHCN, approximately evenly

distributed among the 50 states and

Washington, D.C. In addition to English,

interviews were conducted in Cantonese,

Korean, Mandarin, Spanish, and

Vietnamese.

NS-CSHCN was funded by the

Maternal and Child Health Bureau

(MCHB) of the Health Resources and

Services Administration. MCHB defines

CSHCN as:

... those who have or are at

increased risk for a chronic

physical, developmental, behavioral,

or emotional condition and who

also require health and related

services of a type or amount beyond

that required by children generally.

(8)
Series 1, No. 51 [ Page 3

Of the 40,840 children who were

the subjects of completed interviews in

the 2005–2006 NS-CSHCN, 1,912 were

identified as adopted children who did

not live with a biological parent.

Adopted CSHCN living with a

biological parent were ineligible for

NSAP-SN in order to exclude stepparent

adoptions. Those children who had not

yet reached age 18 by the time of the

follow-back call and lived in

English-speaking households were

eligible for NSAP-SN. Because most of

the children aged 16 and 17 during the

original data collection reached age 18

by the time of the follow-up interview,

the few who had not yet reached age 18

were also excluded in order to yield a

sample representative of adopted

CSHCN aged 0–15 in 2005–2006. A

total of 1,607 cases were thus eligible

for NSAP-SN.

Background

NSAP-SN was jointly funded by

ASPE and ACF, both of HHS.

ASPE advises the Secretary of HHS

across the many topical areas within the

Department’s areas of responsibility. ASPE

leads special initiatives, coordinates the

Department’s evaluation, research, and

demonstration activities, and manages

cross-Department planning activities such

as strategic planning, legislative planning,

and review of regulations. Integral to this

role, ASPE conducts research and

evaluation studies, develops policy

analyses, and estimates the cost and

benefits of policy alternatives under

consideration by the Department and

Congress. Within ASPE, the Office of

Human Services Policy focuses on

economic self sufficiency and human

services delivery issues, as well as policies

affecting children, youth, and families. The

office works closely with ACF and a

variety of other agencies and departments.

ASPE has a long history of research in

foster care and adoption issues, publishing

over 40 research reports on the topic over

the past two decades. All of ASPE’s related

publications may be found on their website,

http://aspe.hhs.gov, under the topical

heading ‘‘child welfare.’’

ACF is responsible for federal

programs that promote the economic

and social well-being of families,

children, individuals, and communities.

Within ACF, support for NSAP came

from the Children’s Bureau, which

works with state and local agencies to

develop programs that focus on the

prevention and protection of children

from maltreatment, the provision of

services to children and families to

assist with reunification efforts, and

finding permanent placements for those

children who cannot safely be returned

to their birth families. The Children’s

Bureau seeks to provide for the safety,

permanency, and well-being of children

through leadership, support for

necessary services, and productive

partnerships with states, tribes, and

communities. The Bureau administers

over $2 billion in funding for adoption

programs under several legislative

authorities. These programs are intended

to support state and local efforts to

recruit adoptive families for children in

foster care and to support these families

over time and include: the title IV-E

Adoption Assistance Program, which

provides adoption subsidies to many

families that adopt children with special

needs from the foster care system; the

Adoption Opportunities Program, which

funds demonstration grants to fuel

innovation in foster care adoption

practice; the Promoting Safe and Stable

Families Program, which includes

funding for adoption promotion and

support services; and the Adoption

Incentives Program, which provides

incentive funds to states that increase

the number of foster care adoptions they

perform in several categories. The

Children’s Bureau also administers the

Infant Adoption Awareness Training

Program, authorized by the Children’s

Health Act, which trains staff of eligible

health centers in providing adoption

information and referrals to pregnant

women. The Children’s Bureau funds

the national adoption recruitment

campaign, in partnership with the Ad

Council, as well as the AdoptUsKids

project, which provides fulfillment

activities to the campaign, operates the

national photo-listing site of waiting

children, and provides training and

technical assistance to states on the

recruitment and retention of foster and

adoptive parents. In addition, the Bureau

funds the National Resource Center for

Adoption, which provides training and

technical assistance on a variety of other

adoption issues to states.

NSAP was intended to gather

information on the characteristics of

adopted children and their families and

to gain insights into their adoptionrelated experiences and postadoption

service utilization and needs. Much of

the social services literature uses

adoption as an end point to the search

for a family and gives relatively little

attention to children’s needs and

well-being after the adoption has been

finalized, or to families’ potential

ongoing challenges. As the number of

children adopted both from foster care

and international sources has grown in

recent years, there has been increased

interest in understanding children’s

long-term well-being following

adoption. However, for government

agencies involved in adoption, contact

with families is usually extremely

limited following finalization. In

addition, because children’s names,

social security numbers, and other

potentially identifying information may

change at the time of adoption, it is not

usually possible to use administrative

data to track children’s use of

government assistance or services from

the preadoption to the postadoption

periods.

Most federal activity and funding

related to adoption relates to adoptions

from foster care. However, in recent

years the negotiation and ratification of

the Hague Convention on Intercountry

Adoption has increased the role of the

State Department with respect to

children adopted internationally. This

international treaty, which entered force

in the United States in 2008, is intended

to protect the rights of all parties

involved in intercountry adoptions—the

child, the birth parents, and the adoptive

parents. The enhancement of a

population-based survey made it

possible to look across adoption types

for a view of the full range of adoptive

families as well as to provide the

opportunity for comparisons among

families adopting from different sources.

While not a formal partner in NSAP,

staff at the State Department with

expertise in intercountry adoption issues
Page 4 [ Series 1, No. 51

were consulted at several points during

the survey’s development to assure that

issues specific to international adoptions

were addressed as much as possible.

The number of children adopted

from foster care increased dramatically

in the late 1990s, in part as a result of

the Adoption and Safe Families Act of

1997, which emphasized the need to

find permanent alternatives for children

in foster care who could not be

reunified with their birth families. As a

result, in many states the number of

adopted children receiving adoption

subsidies currently exceeds the number

of children in foster care. Information

on the experiences of families who have

adopted can provide insights into the

factors that facilitate or hinder the

success of adoptions and the

postadoption support that may be

helpful to assure the continued

well-being of adopted children and their

families. In addition, with respect to

children adopted from foster care, a

better understanding of how families

utilize adoption subsidy funds for their

children’s well-being may help

demonstrate their utility in recruiting

families for children in foster care.

The prevalence of special health

care needs, as defined by MCHB and

assessed by NS-CSHCN, is higher

among children adopted from foster care

than among children adopted by other

means: slightly more than half of

children adopted from foster care have

special health care needs, while fewer

than one-third of children adopted

internationally or through domestic

private sources have special health care

needs, based on analysis of NSAP data.

NSAP-SN allows for a focus of analysis

on a larger sample of adopted children

of greatest interest to ASPE and ACF

and with the highest policy relevance:

children adopted from the U.S. foster

care system who have special health

care needs. The needs of these families

and their use of and satisfaction with

postadoption support and services are of

great interest to ASPE and ACF because

these are the families most likely to

need and request support and services,

and the larger sample will permit more

extensive analysis of this particular

group.

The information obtained through

NSAP-SN will be used to develop ways

to better identify and communicate with

potential adoptive parents for children in

the U.S. foster care system by

describing the reasons why families

adopt and the characteristics of adoptive

families and CSHCN they adopt. The

information will also improve our

understanding of the support adoptive

families find most helpful. In addition,

NSAP-SN will provide data on openness

in adoptions, transracial and

transcultural aspects of adoption, and

adoption satisfaction across adoption

types for CSHCN.

Development of the Survey

Instrument

In August 2005, ASPE issued a task

order to The Urban Institute and NORC

at the University of Chicago to develop

the instrument for the National Survey

of Adoptive Families. Instrument

development began with an effort to

locate as many previous adoption

surveys as possible. Urban Institute staff

conducted an extensive literature review

of adoption research to identify past

surveys and other related research

regarding adoption. Survey instruments

used in these research efforts were

obtained and categorized according to

the part of the adoption process they

addressed and by the topics covered.

Results were compiled into a

comprehensive planning document

identifying existing survey questions on

each topic of importance. The planning

document was used to construct the

survey instrument, choosing the most

relevant questions on desired topics

from existing surveys and constructing

new questions on several topics that

were not adequately addressed in any of

the preexisting instruments. The

ordering of questions was adjusted to

flow in a way that made sense as a

telephone interview, and transitional

scripts were added to guide the

respondent from one section of the

survey to another.

ASPE and ACF staff reviewed draft

questions, suggested new topics for

inclusion and sources of questions, and

provided overall supervision throughout

the questionnaire and survey design

process. Staff at the State Department’s

Office of Children’s Issues concerned

with intercountry adoptions was also

consulted to ensure the survey

adequately addressed issues regarding

intercountry adoption and that questions

were worded in ways that made sense

for families adopting from international

as well as domestic sources.

Before finalizing the instrument,

both cognitive interviews and a small

instrument pretest were conducted. The

cognitive interviews were conducted

with a convenience sample of

participants: five parents who adopted

through foster care, one who adopted

privately, and one who adopted

internationally. The goal of the cognitive

interviews was to learn how the survey

questions sounded in the ear of an

adoptive parent (i.e., assessing whether

the terminology made sense, if the order

of the questions flowed well, and

whether parents were able to answer the

questions as they were asked). After

each subsection of the questionnaire

participants were asked about certain

items that might have been confusing.

Feedback from the cognitive interviews

was used to inform a new draft of the

instrument, which was used in the

instrument pretest. The instrument

pretest was also a convenience sample

and consisted of three international

adoptive parents, three parents who

adopted through foster care, and two

who adopted privately. The main goal of

the instrument pretest was to learn about

the timing and the flow of the

instrument. However, participants also

provided feedback on the items

themselves, and so this also served to

inform the wording and content of the

instrument.

Following the instrument pretest,

decisions were made about the final

inclusion of questions, with a number of

items being dropped to ensure the

survey fit within time constraints of an

approximately 30-minute interview. The

NSAP questionnaire was programmed as

a CATI instrument and pretested in

December 2006. Following final

revisions based on the CATI pretest

results, the instrument was administered

to the NSAP households identified in
Series 1, No. 51 [ Page 5

NSCH from April 2007 to July 2008,

and to the NSAP-SN households

identified in NS-CSHCN from February

2008 to July 2008. Details about the

CATI pretest and revisions made to the

instrument during the administration of

NSCH and NSAP are available in the

NSAP design and operations report (3).

By the time NSAP-SN interviewing

began in February 2008, the instrument

was in its final form and did not change

during the NSAP-SN administration

period. Minor changes were made to the

NSAP instrument to modify it for

NSAP-SN, including revisions to the

designation of variables from the base

survey that drive certain skips in the

questionnaire, revisions to accommodate

the span of time between the original

interview and the follow-up interview,

and revisions to exclude sample children

who were discovered to have reached

age 18 by the time of follow-up

interviewing.

Sample Design

Eligibility screening for NSAP-SN

was conducted as part of the 2005–2006

NS-CSHCN. Therefore, the initial

sample of telephone numbers for

NSAP-SN was a subset of the sample of

telephone numbers for the 2005–2006

NS-CSHCN. To adequately describe the

origin of the NSAP-SN sample, then, it

is necessary to describe the NS-CSHCN

sample.

The NS-CSHCN was designed to

identify households with children, screen

all children in the household for special

needs, and conduct a detailed interview

about one child with special health care

needs in the household (randomly

selected if there was more than one

child with special health care needs in

the household). Like all SLAITS

modules, NS-CSHCN took advantage of

the large number of screening calls

required for NIS.

To accomplish the goal of 750

completed special-needs interviews in

each state, telephone numbers were

initially selected from the telephone

numbers randomly selected for the NIS

screening effort. Therefore, the

procedures for drawing the NIS sample

were the first steps in the procedures for

drawing the NS-CSHCN sample.

However, because of the scope of

NS-CSHCN, there were some states for

which the NIS sample was not large

enough to achieve the desired number of

completed interviews. In these cases,

additional sample (called ‘‘augmentation

sample’’) was drawn for the purpose of

administering the NS-CSHCN interview,

but without going through NIS first.

The next two sections describe the

basic NIS sample design and serve as a

nontechnical description of the

NS-CSHCN sample design and

allocation procedures. Appendix I of this

report includes a more technical

description of NSAP-SN sample design

and weighting procedures. For more

detail on NIS sample design, readers are

referred to the 2007 methodology report

for NIS (9), which is available from

NCHS. Further information regarding

NIS itself can be found in ‘‘National

Immunization Survey: The Methodology

of a Vaccination Surveillance System’’

(10). For more detail on NS-CSHCN

sample design, readers are referred to

the 2005–2006 NS-CSHCN design and

operations report (1).

The NIS Sampling Plan

NIS was established to monitor

vaccination levels of very young

children within states and local areas.

These ‘‘estimation areas,’’ consisting of

one or more ‘‘sampling areas,’’ are

nonoverlapping, encompass the United

States, and are each enclosed within the

borders of a single state. In effect, each

quarter-year NIS conducts a separate

survey in each estimation area, sharing a

common sample design that employs

list-assisted RDD (9,10). The target

number of completed interviews in each

sampling area reflects the goal of

obtaining equally precise estimates in

each estimation area. If necessary, the

target for a sampling area in each

quarter is adjusted to compensate for its

total shortfall or excess in the previous

quarters.

The target population for NIS is

children aged 19 to 35 months, the

primary targets of immunization

programs. Because less than 5% of

households in the United States contain

children in this age range, NIS screens

over 1 million households per year to

identify a sufficient number of

households with eligible children.

SLAITS modules use this NIS screening

sample.

NIS uses the list-assisted method of

RDD (11). This method selects a

random sample of telephone numbers

from ‘‘banks’’ of 100 consecutive

telephone numbers (e.g., 773–256–0000

to 773–256–0099) that contain at least

one directory-listed residential telephone

number. The sampling frame of

telephone numbers is updated each

quarter to reflect new telephone

exchanges and area codes. Although the

number of cellular telephone users in

the United States has increased rapidly,

most households with children continue

to maintain landline telephone service

(12). Also, most cellular telephone users

pay for incoming calls. Therefore, the

NIS sampling frame excluded cellular

telephone exchanges in 2005–2006.

NS-CSHCN Sample Design

and Allocation

The goal of the NS-CSHCN sample

design was to generate samples

representative of the state populations of

children and sufficiently large enough to

permit analysis of the characteristics of

CSHCN in each state. To achieve this

goal, state samples were initially designed

to obtain completed interviews with

parents of 850 CSHCN. The number of

CSHCN to be selected in each sampling

area was determined by allocating the

total of 850 children in the state to each

sampling area within the state in

proportion to the total estimated number

of households with CSHCN in the

sampling area. (During the sixth quarter of

data collection, the targets were reduced

by 100 to 750 per state.) Given this

allocation, the number of households that

needed to be screened in each sampling

area was calculated using the expected

proportion of households with children

under age 18 in the sampling area. Then,

the number of telephone lines that needed

to be called was computed using the

expected working residential number rate,

accounting for expected nonresponse.
Page 6 [ Series 1, No. 51

Drawing the NS-CSHCN

Sample

After the number of telephone lines

necessary to achieve the target number

of completed interviews in each

sampling area had been estimated, the

samples were drawn. The sample draw

proceeded in three steps.

First, telephone lines were sampled

in each sampling area as described

above. Next, a portion of these

telephone lines in each sampling area

was flagged for NS-CSHCN. Finally,

any remaining telephone lines that were

not flagged were left for the sole use of

NIS. Thus, after these three steps, every

telephone line to be called for NIS

screening fell into one of two

categories: 1) NIS and NS-CSHCN

sample, or 2) NIS-only sample.

In 14 states (Alaska, Arkansas,

Colorado, Delaware, Hawaii, Idaho,

Iowa, Louisiana, Minnesota, Mississippi,

Nevada, North Carolina, Oregon, and

Utah), there was insufficient NIS sample

available to obtain the desired number

of completed NS-CSHCN interviews.

Therefore, samples of additional

telephone lines were drawn in these

states. Table A shows the proportion of

the total NS-CSHCN sample that was

augmented for each state. That is, for

each state in Table A, the proportion

listed is the proportion of the total

sample called only for NS-CSHCN and

not for NIS.

Conducting the NSCSHCN Interviews

Each telephone line selected for

NS-CSHCN was called and screened for

residential status and the presence of

NIS age-eligible children. (The

augmentation sample was the one

exception to this rule, as it was selected

and called solely for NS-CSHCN and

not NIS. These households were not

screened for NIS age-eligible children.)

NIS interviews were conducted if NIS

age-eligible children lived in the

household. If NIS age-eligible children

did not live in the household,

interviewers asked if there were any

children under age 18 living in the

Table A. Percentage of main sample called

only for NS-CSHCN (augmentation sample),

by state

State Percent

Alaska ............. 4.1

Arkansas ........... 0.4

Colorado . . . . . . . . . . . 14.0

Delaware . . . . . . . . . . . 2.4

Hawaii . . . . . . . . . . . . . 4.5

Idaho ............. 34.2

Iowa . . . . . . . . . . . . . . 20.7

Louisiana ........... 0.6

Minnesota .......... 6.7

Mississippi . . . . . . . . . . 3.7

Nevada ............ 16.6

North Carolina . . . . . . . . 3.5

Oregon ............ 16.8

Utah . . . . . . . . . . . . . . 35.5

NOTE: NS-CSHCN is National Survey of Children with

Special Health Care Needs.

household.

Regardless of whether an NIS

interview was conducted, if any children

lived in the household, information

about the sex and date of birth was

gathered for each child. (If this

information had been collected during

the NIS interview, the questions were

not asked again. An instrument change

was made in late 2005 to eliminate the

date of birth question and replace it with

a simpler question asking each child’s

age.) The respondent was then asked the

NS-CSHCN screener questions to

determine the special health care needs

status of each child in the household. If

any children in the household were

identified as having special health care

needs, one was randomly selected to be

the subject of a detailed interview.

Conducting the NSAP-SN

Interviews

CSHCN with a complete

NS-CSHCN interview were identified as

eligible for the NSAP-SN interview if

they lived in English-speaking

households, were aged 0–15 as of the

2005–2006 interview and had not

reached age 18 by the time of the

follow-up interview, and had been

identified as adopted (i.e., they lived

with an adoptive parent and no

biological parent lived in the

household—to exclude stepparent

adoptions). These households were then

called between February 2008 and June

2008 to conduct an NSAP interview

about the child. In some cases,

respondent households had moved or

could not be reached at the number

called for the NS-CSHCN interview. In

anticipation, interviewers received

special training on locating respondent

households; that training is described

below.

Questionnaire

Content

Introduction and consent

Upon determination that a

household from NS-CSHCN had been

found for NSAP-SN, the interviewer

asked to speak with the selected child’s

parent. After the parent came to the

phone, or after the person who answered

the telephone identified herself or

himself as the parent, the respondent

was asked screening questions to

determine if he or she was eligible (i.e.,

the respondent was an adoptive parent

and the child was under age 18). After

eligibility was determined, the

respondent was informed of her or his

rights as a survey participant. Verbal

consent for study participation was then

obtained and documented in the CATI

system. The informed consent statement

informed respondents of the voluntary

nature of the survey, assured them that

their responses would be kept

confidential, and indicated that there

was no penalty for not answering

questions. In addition, the informed

consent statement provided information

about the content of the survey and the

expected duration. The respondent was

also told that he or she would receive

$25 (or $30 if the household met certain

refusal pattern benchmarks) in

appreciation of his or her time. Finally,

the respondent was told that the

interview might be recorded and

monitored by a supervisor for quality

purposes.
Series 1, No. 51 [ Page 7

The NSAP-SN interview covered

the six topics described below. A copy

of the questionnaire appears in

Appendix II.

+	 Adoption-eligibility screening and

demographic characteristics. This

section asked about the country of

origin (for international adoptions

only), relationship of the respondent

to the child, current marital status of

the adoptive parent(s), adoption

agencies involved in the adoption,

whether the adoption was an

interstate adoption, and questions

regarding the foster parent(s) and

length of stay if the adoptive parent

was a foster parent to the child prior

to adoption. Demographic data

collected in NSCH were not

repeated in the NSAP interview.

+	 Characteristics. This section

gathered information about the

adopted child and his or her

situation before adoption, including

age at adoption finalization, age at

first placement in home, whether the

child ever lived with the birth

family or had birth siblings, whether

the child had any of several

behavioral disorders or

developmental problems, whether

the child had needed treatment from

mental health professionals, had

used alcohol or drugs (asked only

for teenagers), had been arrested

(asked only for teenagers), or had

been pregnant (asked only for

teenagers), and the child’s native

language and education experiences.

In addition, this section gathered

information about the adoptive

parent(s), including whether the

adoptive parent(s) had their own

biological children, their reasons for

adopting, what types of adoption

they considered, their reasons for

choosing a specific type of adoption,

and whether they chose activities or

moved because of the child’s race or

culture. This section also collected

data on information provided to the

adoptive parent(s) before adoption,

including whether it was an open

adoption, whether there was any

relationship with the birth family,

the level of involvement of adoption

attorneys or caseworkers, and

whether any psychological report,

medical history, or educational

records were provided.

+	 Parent and child well-being. This

section gathered data on the

relationship of the respondent with

the adopted child in terms of

affection, understanding, distance,

and trust; the child’s relations with

other members of the family; the

child’s feelings about being adopted;

whether the respondent would

recommend adoption to others based

on his or her experience; whether

the child had spent time away from

home due to behavioral issues; and

whether the respondent had thought

about or taken action on ending the

adoption and, if applicable, what his

or her reasons were for wanting to

end the adoption.

+	 Adoption agreement and

postadoption financial services. This

section inquired about the existence

of an adoption agreement and a

monthly subsidy, the total costs

associated with adoption, the

respondent’s Medicaid experience,

the mental health care needs of the

child, mental health medications,

dental care needs, medical care

needs including vision and hearing,

who paid for all of these services

for the adopted child, and the

federal tax credit for adoption.

+	 Postadoption nonfinancial support.

This section contained questions on

postadoption services, adoption

support groups for the adopted child,

adoption support groups for the

respondent or his or her spouse or

partner, mental health care or

counseling for the adopted child,

family counseling, crisis counseling,

alcohol or drug evaluation or

treatment for the adopted child,

education and childcare services,

respite care, residential treatment or

psychiatric care, and information or

education received about adoption.

+	 Final demographics. This section

collected other demographics not

previously collected in NS-CSHCN,

including the year of the

respondent’s birth, the year of the

respondent’s spouse’s or partner’s

birth, ethnicity and race of the

respondent and of the spouse or

partner, and the respondent’s

employment status.

Significant Changes During

Data Collection

No significant changes to the

questionnaire occurred during the data

collection period. Some minor protocol

changes are described in Appendix III.

CATI Programming

NSAP-SN was conducted using a

CATI system. The CATI data collection

software presents the questionnaire on a

computer screen to each interviewer.

The program guides the interviewer

through the questionnaire, automatically

routing the interviewer to appropriate

questions based on the respondent’s

answers to previous questions.

Interviewers enter survey responses

directly into the computer; the CATI

program determines whether the selected

response is within an allowable range

and saves the responses in a survey data

file. Online help screens and text are

available to aid interviewers. This data

collection technology reduces the time

required for transferring, processing, and

releasing data, and ensures accurate

questionnaire flow. Once initial

programming was completed, the

instrument underwent rigorous testing to

ensure correct functioning of the CATI

system.

Interviewer Training

NORC at the University of Chicago

conducted all interviews for NSAP-SN.

Interviewer training was conducted by

NORC at the University of Chicago

staff at the production center located in

Chicago, IL. All interviewers selected to

attend the training were previously

certified staff. Twenty NSAP-SN

interviewers were trained at the Chicago

production center in February 2008, and

all 20 passed the training.

Training Sessions

Interviewer training sessions began

with an introduction and project
Page 8 [ Series 1, No. 51

overview. Interviewers were informed

about project goals, the purpose and

history of the study, study sponsors, and

the study design. A review of the

screener and each section of the

questionnaire were taught, with

emphasis on quality data collection. The

relationship between NS-CSHCN and

NSAP-SN was also covered.

Several cooperation-gaining

exercises were conducted throughout the

training to ensure that interviewers were

equipped to answer frequently asked

questions (FAQs) and handle refusals.

Part of the exercises included a review

of FAQs and other job aids provided for

interviewers.

Mock Interviews

NSAP-SN training utilized two

round robin mock interviews. During the

mock interviews the interviewers were

acclimated to the questionnaire, the

CATI system, and methods of gaining

cooperation. Each mock interview was

designed to highlight various sections of

the screener and the main questionnaire,

and to provide different cooperation

scenarios.

Locator Training

A subset of seven of the NSAP-SN

interviewers was selected to attend the

locator training. Locators were informed

about locating goals and objectives and

about how to utilize specific free

Internet search engines and identify

viable leads to locate the NS-CSHCN

household. Locators also reviewed the

locator scripts, job aids, and relevant

FAQs.

Several mock-locating cases were

given to each locator to generate a new

lead. The locators were required to

demonstrate their proficiency at

effectively using the recommended

Internet search engines and identifying

viable leads. The class proceeded to a

round robin mock locating case using

the prompting script and FAQs to

contact the lead and determine if they

had located the 2005–2006 NS-CSHCN

household.

Data Collection

Pretesting

NSAP-SN survey administration

preparations did not involve a pretest as

the questionnaire contained minimal

changes from the previously and

concurrently fielded NSAP study. A

detailed description of the NSAP pretest

that occurred prior to NSAP data

collection is available in the NSAP

design and operations report (3).

Advance Letters

When a mailing address was

available, an advance letter (see

Appendix IV) describing the nature of

the study was mailed to the household.

Letters were mailed for 82.8% of

eligible NSAP-SN sample cases. The

letter reminded recipients that they had

completed a prior survey about

children’s health care and indicated that

additional information about their

children’s health, well-being, and use of

services was desired. A toll-free number

was provided for those who wished to

participate immediately or learn more

about the study, and for those who

wished to learn more about their rights

as a respondent.

Toll-free Telephone

Number

A toll-free telephone line was

established for NSAP-SN that offered

respondents the flexibility to call at their

convenience if they had questions about

the survey, wanted to complete the

interview, or wished to submit feedback

on any aspect of the survey. Advance

letters, incentive letters, answering

machine scripts, and closing scripts

referenced the toll-free number, and

interviewers provided the number to

respondents who requested it during the

interview. The telephone line was

answered by interviewers trained on NIS

who subsequently connected respondents

to an NSAP-SN-trained interviewer.

During the course of the NSAP-SN data

collection effort, two calls were made to

the toll-free line for NSAP-SN, with

both cases completing the survey during

that toll-free call.

Selection of Sampled Child

In the 2005–2006 NS-CSHCN

sample, all households with children

under age 18 living or staying in the

household were screened for the

presence of CSHCN. If a household

only had one child with special needs,

that child was selected as the focus of

the interview by default. In households

with multiple children with special

needs, one child was randomly selected

to be the focus of the detailed interview.

During the 2005–2006 NS-CSHCN

interview, it was determined if any

parent of the selected child was an

adoptive parent. To be eligible for

NSAP-SN, no biological parents of the

child could be living in the household

(to exclude stepparent adoptions). In

addition, the NS-CSHCN interview had

to be completed in English. Nine cases

were ineligible for NSAP-SN because

the NS-CSHCN interview was not

completed in English.

Households from the 2005–2006

NS-CSHCN that were identified to be

NSAP-SN-eligible (i.e., there was an

adoptive parent but no biological parent

in the household, the household was

English speaking, and the child was

under age 18 at re-interview) were

recontacted to conduct NSAP-SN on the

same selected child.

Selection of Respondent

Participation was limited to the

adoptive mother or adoptive father of

the selected child. Most often, the

mother of the adopted child completed

the NSAP-SN interview. The parent who

completed NS-CSHCN was most likely

to complete NSAP-SN (for 83.6% of

completed NSAP-SN interviews),

although this was not a requirement of

NSAP-SN participation. Table B shows

the frequency distribution of the

relationship of study respondents to the

sampled child.
Table B. Number and percentage of

respondents, by relationship to sampled

child

Relationship of respondent

to sampled child Number Percent

Total . . . . . . . . . . . . . . . . . . . 1,007 100.0

Adoptive mother ........... 786 78.1

Adoptive father ............ 221 21.9

Don’t know, refused, or missing . . 0 0.0

Informed Consent

The NSAP-SN informed consent

script informed respondents of the

voluntary nature of the survey, assured

them that their responses would be kept

confidential, and indicated that there

was no penalty for refusing to answer

questions and that participation had no

effect on any benefits the family might

receive. In addition, the informed

consent statement provided information

about the expected interview duration.

Respondents were also told that they

would receive $25 (or $30 if the

household met certain refusal pattern

benchmarks; described in Appendix V)

in appreciation of their time. Finally, the

respondent was told that the interview

might be recorded and monitored by a

supervisor for quality purposes.

In accordance with HHS regulations

(45 CFR 46), these procedures were

reviewed by the NCHS Research Ethics

Review Board (ERB) and the NORC at

the University of Chicago Institutional

Review Board (IRB). Approval for data

collection was received in August 2007

from the NCHS ERB and in November

2007 from the NORC at the University

of Chicago IRB. The Office of

Management and Budget (OMB) control

number for this collection of

information was 0920–0406.

Assurance of

Confidentiality

Participation in surveys conducted

by NCHS is voluntary, and information

collected on individuals is confidential.

For NSAP-SN, an assurance of

confidentiality was provided to potential

respondents as part of the informed

consent procedures. In the CATI system,

interviewers acknowledged that they had

read the following statement to

respondents:

Before we continue, I’d like you to

know that taking part in this

research is voluntary. You may

choose not to answer any question

you don’t wish to answer or stop at

any time. Whether or not you take

part in this survey has no effect on

any benefits you may receive and

there are no known risks. We are

required by Federal law to develop

and follow strict procedures to

protect your information and use

your answers only for statistical

research. I can describe these laws

if you wish. In appreciation for

your time in taking the survey, we

will send you $25/$30. The survey

will take about half an hour. In

order to review my work, my

supervisor may record and listen as

I ask the questions. I’d like to

continue now unless you have any

questions.

If respondents requested to hear

more about the federal laws, they were

read the following statements:

The Public Health Service Act is

Volume 42 of the US Code, Section

242k. The collection of information

in this survey is authorized by

Section 306 of this Act. The

confidentiality of your responses is

assured by Section 308d of this Act

and by the Confidential Information

Protection and Statistical Efficiency

Act. Would you like me to read the

Confidential Information Protection

provisions to you?

If the respondent indicated that he

or she would like to hear the

Confidential Information Protection

provisions, the interviewer read the

following statement:

The information you provide will be

used for statistical purposes only. In

accordance with the Confidential

Information Protection provisions of

Title V, Subtitle A, Public Law

107–347 and other applicable

Federal laws, your responses will be

kept confidential and will not be

disclosed in identifiable form to

anyone other than employees or

Series 1, No. 51 [ Page 9

agents. By law, every employee of

the National Center for Health

Statistics, the National Center for

Immunization and Respiratory

Diseases, and its agent, the National

Opinion Research Center, who

works on this survey has taken an

oath and is subject to a jail term of

up to 5 years, a fine of up to

$250,000, or both, if he or she

willingly discloses ANY identifiable

information about you or your

household members.

If respondents had any additional

questions or concerns, they were

directed to the project website for more

information: http://www.cdc.gov/nchs/

slaits.htm.

When NCHS (including its

contractors and agents) collects

personally identifiable information under

a pledge of confidentiality for

exclusively statistical purposes, Section

308d of the Public Health Service Act

and Section 512b of the Confidential

Information Protection and Statistical

Efficiency Act (CIPSEA) require that

confidentiality be maintained without

exception. Violations of CIPSEA are a

class E felony, punishable by

imprisonment for not more than 5 years,

a fine not more than $250,000, or both.

Strict procedures are used by NCHS, its

data collection contractors, and other

agents to prevent disclosure of

confidential data in survey operations

and data dissemination.

Interview Length

The average NSAP-SN interview

length was 35 minutes, 52 seconds, and

the median time was 34 minutes, 36

seconds. Mean and median interview

lengths appear in Table C.

Interview Breakoffs

When NSAP-SN interviews were

terminated prior to completion,

interviewers attempted to convert the

incomplete interview into a completed

interview using refusal conversion

strategies developed for NS-CSHCN and

NSAP. By the end of data collection, 48

interviews were completed with

households that had initially refused to
Page 10 [ Series 1, No. 51

Table C. Mean and median length of the NSAP-SN interview (in minutes and seconds)

Interview length

Section of interview Mean Median

Overall length ..................................... 35:52 34:36

Section S: Screener ................................. 03:26 03:06

Section C: Characteristics ............................. 12:41 12:10

Section W: Parent and child well-being ..................... 05:28 05:06

Section F: Adoption agreement and postadoption services (financial) . . . 04:39 04:12

Section N: Postadoption support (nonfinancial)................. 09:32 08:52

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs.

participate (4.8% of completed

interviews).

There were 113 households

contacted from 2005–2006 NS-CSHCN

where NSAP-SN was unable to be

completed. It was determined that 49 of

the households could not participate in

NSAP-SN based on screening criteria

(the child had to be less than 18 years

old, adopted, and still living with the

adoptive parent, and the adoptive parent

needed to be able to complete the

interview in English). Of the remaining

64 cases, 12 cases broke off before

screening was completed, 13 cases

broke off after screening but before

giving informed consent, and 14 cases

gave consent but continued no further.

There was little commonality in the

location of the questionnaire where the

interview was terminated for the

remaining 25 breakoff cases.

Cases Pending at Close of

Data Collection

Of the 1,607 cases in the NSAP-SN

sample, 1,120 households were

successfully contacted (69.7%). Of the

1,120 households, it was determined that

1,059 could participate in NSAP-SN

based on screening criteria. Of these

1,059 households, 1,007 completed the

NSAP-SN interview. A partial NSAP-SN

complete was defined as a case that

completed the interview up to and

including question F20 in Section F

titled ‘‘Adoption Agreement and Post

Adoption Services—Financial.’’ Only one

case out of the 1,007 cases included on

the final dataset was a partially

completed interview. The final case

dispositions are shown in Table D.

Incentive Effort

While all NSAP-SN-eligible

households were offered an incentive

payment of $25 for participation,

households that presented with a certain

pattern of nonresponse were offered an

additional incentive of $5 (total

incentive of $30). The NSAP-SN

incentive plan was in place shortly after

data collection began in February 2008.

Respondents who completed the survey

on a cell phone were offered an

additional $10 to defray any costs

associated with their cell phone usage. A

more detailed discussion of the

NSAP-SN incentive model, the

processes by which incentive-eligible

cases were identified and subsequently

offered an incentive, and response rates

for incentive-eligible cases are included

in Appendix V.

Response Rates

Table E provides the number of

completed interviews and unweighted

interview completion rates by adoption

type. Table F provides the corresponding

weighted interview completion rates.

Overall, the project completed 1,007

interviews. Two interview completion

rates have been calculated. Interview

completion rate I is the ratio of the

number of completed interviews to the

total sample. Interview completion rate

II is an alternative rate using released

sample as opposed to total sample and

where known out-of-scope cases have

been excluded from the released sample

count. The weighted interview

completion rate, or ‘‘cooperation rate,’’

indicating the response propensity of

identified eligible adoptive parents

(excluding out-of-scope cases) was

67.3%.

It is important to note the

NSAP-SN interview completion rate is

only one component of the overall

response rate since the NSAP-SN

sample originated from adopted children

with a complete 2005–2006 NS-CSHCN

interview. To obtain the overall response

rate, by taking account of nonresponse

to NS-CSHCN, the NSAP-SN interview

completion rate must be multiplied by

the response rate from the 2005–2006

NS-CSHCN. Details on the derivation of

the NS-CSHCN response rate, based on

Table D. Final disposition of the NSAP-SN sample

Percent

Number of total

of selected selected

Final disposition households households

Total ............................... 1,607 100.0

Not released .......................... 31 1.9

Nonresidential ......................... 18 1.1

Disconnect ........................... 81 5.0

Noncontact........................... 36 2.2

Answering machine ..................... 40 2.5

Contact unsuccessful .................... 150 9.3

Internet locating unsuccessful ............... 131 8.2

Household found, screening pending........... 12 0.7

Household found, not adoptive............... 13 0.8

Household found, parent(s) deceased .......... 3 0.2

Household found, language ineligible........... 1 0.1

Household found, child 18 years or older ........ 3 0.2

Household found, child lives elsewhere ......... 29 1.8

Household found, incomplete interview ......... 52 3.2

Household found, partial interview ............ 1 0.1

Household found, full interview .............. 1,006 62.6

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs.
Table E. Number of completed interviews and unweighted interview completion rates, by

type of adoption as of the 2005–2006 NS-CSHCN

Foster

International care Private Overall

Total sample size .................. 318 717 572 1,607

Sample released1 .................. 312 705 559 1,576

Out of scope for interview2 ............ 3 25 21 49

Completed interviews ............... 229 438 340 1,007

Percent

Interview completion rate I

3 ............ 72.0 61.1 59.4 62.7

Interview completion rate II4 ........... 74.1 64.4 63.2 65.9

Series 1, No. 51 [ Page 11

the University of Chicago staff

conducted ongoing assessments and

modifications of the data collection

instrument, data collection procedures,

and calling rules. Integrated sample

management teams focused on NSCH,

NSAP, and NSAP-SN met frequently to

manage the sample in an effective and

efficient manner.

The NSAP-SN production

preparations did not involve a pretest as

1

Thirty-one cases were not released because it was known that the selected child would have been aged 18 years and over at the 

time of the NSAP-SN interview. The NSAP-SN interview was only completed when the selected child was under age 18 years at 

the time of NSAP-SN screening. 

2

Cases determined to be out of scope for interview during NSAP-SN screening. 

3

Interview completion rate I = Completed interviews / Total sample size. 

4

Interview completion rate II = Completed interviews / (Sample released - Out of scope). 

NOTE: NS-CSHCN is National Survey of Children with Special Health Care Needs; NSAP-SN is National Survey of Adoptive 

Parents of Children with Special Health Care Needs. 

Table F. Weighted interview completion rates, by type of adoption as of the 2005–2006

NS-CSHCN

International

Foster

care Private Overall

Weighted interview completion rate I

1 .....

Weighted interview completion rate II2 .....

72.5

76.7

60.7

63.6

62.4

67.0

63.6

67.3

1

Weighted interview completion rate I = Weighted count of completed interviews / Weighted count of total sample size. 

2

Weighted interview completion rate II = Weighted count of completed interviews / Weighted count of (Sample released - Out of 

scope). 

NOTE: NS-CSHCN is National Survey of Children with Special Health Care Needs. 

Table G. Unweighted and weighted NSAP-SN overall response rates

Unweighted Weighted

NS-CSHCN CASRO response rate .......

NSAP-SN interview completion rate I

1 .....

NSAP-SN interview completion rate II2 .....

NSAP-SN CASRO response rate3

........

Alternative NSAP-SN CASRO response

rate4 .......................... 

54.2

62.7

65.9

34.0

35.7

56.1

63.6

67.3

35.7

37.7

the survey contained minimal changes

from the previously fielded NSAP study.

After every quarter of data collection, a

list of potential changes to the

instrument was reviewed and

implemented if necessary. These

changes were based on analysis of

questionnaire breakoffs and reports from

interviewers of problem areas within the

questionnaire.

NSAP-SN monitored response rates

throughout the data collection period. In

response to findings of certain

nonresponse patterns in NSAP, the

NSAP-SN incentive model targeted

these nonresponsive subpopulations. All

NSAP-SN interviewers were trained

refusal converters and attempted to

convert nonrespondents by targeting the

case-specific source of the refusal based

on the case history. More detailed

descriptions of the incentive models, the

process by which cases were offered an

incentive, and important response rates

are included in Appendix V.

NSAP-SN maintained a toll-free

number and listed the number in all

letters to respondents. The toll-free

1

Interview completion rate I = Completed interviews / Total sample size. 

2

Interview completion rate II = Completed interviews / (Sample released - Out of scope). 

3

NSAP-SN CASRO response rate = (NS-CSHCN CASRO response rate) * (NSAP-SN interview completion rate I). 

4

Alternative NSAP-SN CASRO response rate = (NS-CSHCN CASRO response rate) * (NSAP-SN interview completion rate II). 

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs. 

the Council of American Survey

Research Organizations (CASRO)

guidelines, are available in the

NS-CSHCN design and operations

report (1). Table G provides the

unweighted and weighted overall

response rates using both interview

completion rate I and the alternative

interview completion rate II. The

weighted CASRO response rate for

NSAP-SN, excluding out-of-scope cases,

was 37.7%. Because of this low overall

CASRO response rate, an examination

of the potential for nonresponse bias is

presented in Appendix VI.

Efforts to Maximize

Response Rates

NSAP-SN worked to encourage

respondent participation by informing

respondents of the importance of the

survey, offering incentives, and allowing

respondents to call a toll-free number at

their convenience. NCHS and NORC at

number allowed respondents to

participate immediately, ask questions

regarding the survey, or obtain

additional survey-related information.

Locating Respondents

Numerous locating tactics were

explored as an essential part of data

collection due to the unpredictable

nature of the 3-year-old sample.

Locating efforts consisted of several

stages: a) identification of cases that

qualified for locating, b) generation of

leads using Accurint and Internet

databases, c) dialing leads in order to

identify the correct household, and d)

mailing ‘‘trying to reach you’’ letters to

nonresponsive households.
Page 12 [ Series 1, No. 51

Identifying cases qualified for

locating

NORC at the University of Chicago

began locating activities approximately

3 weeks into the data collection effort.

Initial call attempts yielded a number of

cases for which NORC at the University

of Chicago staff was unable to proceed

with the original phone number for

various reasons:

+	 Permanent noncontact households.

+	 Disconnected number.

+	 Fast busy.

+	 Fax or modem.

+	 Business or government.

+	 No adult in household.

+	 No such person in household.

+	 Number changed.

The submission of cases to Accurint

consisted of 217 cases identified as

‘‘locating needed’’ in the early weeks of

data collection and 698 persistent

noncontact cases (i.e., cases that resulted

in noncontact on repeated calls), for a

total of 915 cases.

Accurint database searches

Accurint is a locating vendor that

maintains a database of public records.

Two types of Accurint database searches

were conducted. The first was an

‘‘initial custom batch reverse search.’’

The locating effort on NSAP-SN was

hampered by the fact that minimum

information was available from the

2005–2006 NS-CSHCN:

+	 RDD phone number from the

2005–2006 NS-CSHCN.

+	 Respondent name only when an

incentive had been paid in

2005–2006.

+	 Adopted child’s age in months and

years at the time of the 2005–2006

interview.

+	 2005–2006 adopted child’s name

when provided.

+	 Adopted child’s gender.

Accurint was used to produce a

custom batch reverse search that yielded

names and addresses of individuals ever

associated with the phone numbers in

the sample. NORC at the University of

Chicago submitted the 915 cases to be

run through this batch reverse search. Of

the 915 cases submitted, 782 cases

(85%) received reverse search results.

The second type of Accurint

database used was a ‘‘current batch

search.’’ The name and address

information for 776 cases (782 minus 6

with an out-of-range date) retrieved

from the custom batch search were then

used in running a standard address batch

search to find the current name, address,

and telephone information for the

individuals listed.

Of the 217 cases identified for

locating, 69 cases (31.8%) received

current batch search results containing a

new phone number. All 69 cases were

updated in the CATI system to be

worked by the telephone interviewers

and 28 of these cases completed the

NSAP-SN interview. For the remaining

698 cases submitted, current batch

search results with a new phone number

were received for 69 cases (9.9%).

Thirty-one of these cases resulted in a

completed interview.

‘‘Trying to reach you’’ letters

A ‘‘trying to reach you’’ letter

(shown in Appendix IV) was mailed to

households when Accurint produced a

mailing address but no new telephone

number after unsuccessful contact using

the 2005–2006 NS-CSHCN sampled

telephone number. This letter explained

that attempts were made to contact the

household via telephone to complete the

NSAP-SN interview. It also briefly

described NSAP-SN and included an

FAQ section on the survey. In this way,

the letter served as an additional method

of locating the household. Of 84 cases

that were mailed a ‘‘trying to reach

you’’ letter, two respondents contacted

the 1–800 line and completed the

survey. An additional 14 completes were

achieved among these 84 cases through

Internet locating.

Locating protocol

Cases being located were updated

based on phone number information

returned from the locating batch searches.

Those cases were then delivered to the

telephone interviewers and dialed.

Appropriate status codes were assigned to

each case as it was dialed.

A separate group of cases was

identified for Internet locating. A special

team of seven locators was specially

trained to work through these cases

methodically and find the respondents’

most recent information.

Locators followed a protocol that

allowed them to work through the cases

efficiently and focus their efforts on

cases that were more attainable.

Locators used a combination of Web

searches and vendor batch searches. If

this information did not lead to the

2005–2006 respondent, the case was

designated ‘‘unlocatable.’’

While dialing leads, locators used

one of the following introductions:

‘‘Hello. My name is ___________,

and I’m calling from the National

Opinion Research Center at the

University of Chicago. I’m trying to

locate [2005–06 parent]. Does [he/she]

live here?’’

OR

‘‘Hello. My name is ___________,

and I’m calling from the National

Opinion Research Center at the

University of Chicago. In 2005, we may

have conducted a survey with an adult

in this household about the health care

of a child who was approximately

[AGE] years old. The child would now

be about [AGE PLUS 2 to AGE PLUS

3 years]. If possible, I’d like to speak

with that child’s [MOTHER/FATHER]

now. Is [he/she] AVAILABLE?’’

After the introduction, locators

followed a script that guided them

through the different scenarios

encountered during locating:

+	 If the respondent was confirmed and

available, the locator immediately

attempted to complete the interview.

+	 Appointments were scheduled to call

back households that were

confirmed to be the target household

but the respondent was unavailable.

+	 If the respondent did not live in the

household but the informant knew

the respondent, locators probed to

obtain new address and phone

information.

If the informant refused to give out

the information, the locator left the

project’s toll-free number and asked that

it be passed along to the respondent.
Series 1, No. 51 [ Page 13

Throughout the locating effort, locators

were careful not to mention adoption or

that the child was adopted until the

respondent was confirmed as the

adoptive parent of the child. This was

done to prevent the accidental disclosure

of adoptive status to any person in the

household unaware of the child’s

adoptive status.

Quality Control

Quality Control of

Interviewing

Telephone center supervisors were

available to the interviewing staff at all

times to resolve any questions or

concerns about a case. Supervisors

regularly observed the data collection

process to monitor interviewers

informally. In addition, supervisory staff

used remote telephone- and computermonitoring technology to evaluate

whether interviewers performed

according to project specifications. This

formal monitoring was conducted to

ensure that introductory materials were

properly read, that item wording and

sequence of the questionnaire were

followed correctly, that respondent

questions were answered properly, and

that any vague responses were properly

probed. Computer monitoring also

allowed supervisors to ascertain whether

answers were entered accurately into the

CATI system.

All supervisors attended an 8-hour

training session that introduced them to

the Monitoring Evaluation Form, the

Monitoring Database where forms are

filled out electronically, and the

Monitoring Selection Database where

telephone interviewers are prioritized

and selected for monitoring. In addition

to learning these basics of how to

monitor, supervisors participated in an

exercise to learn the basics of giving

effective feedback and coaching

interviewers. After this training session,

each new supervisor was scheduled for

1 week to conduct dual-monitoring

sessions with experienced staff. In these

sessions, the new monitors observed live

monitoring side by side with an

experienced monitor, and each

completed a Monitoring Evaluation

Form. At the end of each session, they

compared notes and discussed proper

scoring guidelines and strategies for

giving feedback. These strategies

ensured that all supervisors were

evaluating interviewers using the same

criteria.

To avoid bias in selecting whom to

monitor, the CATI monitoring system

automatically selected which

interviewers to monitor and gave newly

trained interviewers—those with the

fewest monitoring sessions or those with

the weakest performance reviews—the

highest priority for selection.

Experienced interviewers were

prioritized for monitoring based upon

the length of time since their last

monitoring session and recent

monitoring scores. Each interviewer was

typically monitored at least once a

week; however, some were monitored

more often.

Throughout, data collection

interviews were recorded (after gaining

agreement from respondents). These

recordings were valuable tools for

trainings, as well as for providing

feedback to interviewers on specific

case-related performance. The

recordings were kept for four quarters of

data collection and then deleted.

Data Quality Control

The CATI system was programmed

to help ensure complete and accurate

data collection using automated datachecking techniques such as responsevalue range checks and consistency edits

during the interview process. These

features enabled interviewers to obtain

needed clarifications while still on the

telephone with the respondent.

Throughout data collection, interview

data were reviewed for consistency

between fields, appropriate responsevalue ranges, skip logic patterns, and

missing information.

Weighting and

Estimation Procedures

This section provides a nontechnical

overview of the weighting procedures

for the NSAP-SN sample. A more

detailed and technical description can be

found in Appendix I.

Base Weight

Because the sample for NSAP-SN

was obtained by including all

English-speaking, adopted children aged

0–15 years as of the 2005–2006

NS-CSHCN, the base weights for

NSAP-SN are the final weights for the

2005–2006 NS-CSHCN. The final

NS-CSHCN weights were derived by

applying adjustments to account for

nonresponse, for households with

multiple telephone numbers, and for

noncoverage of children in households

without landline telephones, as well as

adjustments to known population control

estimates. For a detailed description of

the derivation of the NS-CSHCN final

weights, readers are referred to the

2005–2006 NS-CSHCN design and

operations report (1).

Adjustment for Incomplete

Interviews

To compensate for interview

nonresponse, an adjustment is made to

the base weights of the interviewcompleted cases. The adjustment factors

are computed by forming adjustment

cells using the following variables listed

in order of priority:

+	 Census region.

+	 Type of adoption.

+	 Age group (at the time of the

2005–2006 NS-CSHCN interview).

+	 Race/ethnicity.

Within each adjustment cell, the

adjustment factor is computed as the

ratio of the sum of base weights for all

cases in the adjustment cell to the sum

of base weights for all interviewcompleted cases in the adjustment cell.
Page 14 [ Series 1, No. 51

For interview-completed cases, the

interview weight is obtained by

multiplying the base weight and the

adjustment factor.

Raking Adjustment to

External Control Totals

There are no external control totals

available for NSAP-SN target children.

As the only source available is the

2005–2006 NS-CSHCN, the control

totals for NSAP-SN are obtained from

2005–2006 NS-CSHCN estimates.

The raking adjustment of the

weights is such that at the national level,

for the following margins, the sum of

the weights agrees with the control

totals for:

+	 Census region.

+	 Number of male and female children

within each of four age groups.

+	 Number of children in age group by

type of adoption.

+	 Race/ethnicity.

+	 Number of children in the household

by grouped highest reported

education in the household.

+	 Number of children in the household

by grouped household income.

For each interview-completed case,

the raking adjusted weight is the final

NSAP-SN weight.

Quality Control

Staff compared the formulas for the

weights and adjustments developed by

the sampling statistician with the actual

weights and adjustments constructed by

the statistical programmer. An

independent check was performed on

the programmer’s implementation of the

statistician’s weighting specifications.

Imputation of Relevant

Variables

Because NSAP-SN cases are a

subset of 2005–2006 NS-CSHCN cases,

for variables that need to be imputed in

the weighting process, imputed values

from the 2005–2006 NS-CSHCN were

used. Hence, no new imputation was

necessary.

Public-use Data File

One public-use data file was created

using SAS version 9.1. The file included

data from complete interviews (complete

through Section F: Adoption Agreement

and Post Adoption Services—Financial)

that were conducted in 2008. In order to

maintain confidentiality, certain

variables that could be used to identify

respondents were excluded from the file.

This file contains data on adopted

child and family characteristics, parent

and child well-being, adoption

agreement and postadoption financial

services, and postadoption nonfinancial

support. There is one record for each

child. Of the 1,007 records, 1,006 cases

completed the full interview, and 1 case

is a partially completed interview. Four

of the records represented CSHCN

whose parents were interviewed in

Louisiana prior to Hurricane Katrina in

August 2005 and were subsequently

dropped from the NS-CSHCN data so

that the Louisiana data for 2005–2006

would reflect the post-Katrina

population of CSHCN in the state [for

more information, see the 2005–2006

NS-CSHCN design and operations

report (1)]. Because these cases have a

NS-CSHCN final weight value of zero

and all weighting adjustments are

multiplicative, the final NSAP-SN

weight value for these cases is also zero.

With these four cases dropped from the

file, the final NSAP-SN data file

contains 1,003 records.

Editing

As discussed in the data quality

control section, the CATI system was

designed to perform edits as an

interviewer entered data into the

computer system. To prevent interviewer

error, the CATI system was developed

to include range and consistency checks.

If an interviewer entered a value that

was out of range, a warning screen

appeared, instructing the interviewer that

the value was not accepted and that he

or she had to reenter the response to the

question. For example, the acceptable

range for C1A, ‘‘How old was [S.C.]

when [his/her] adoption was finalized?’’

is from 0 to 17 years, 0 to 12 months,

and 0 to 52 weeks. If an interviewer

entered a value outside these ranges,

such as 13 months or greater, a warning

screen would appear saying ‘‘Please,

enter value between 0 and 12.’’ Another

consistency check also had to do with

the child’s age at adoption finalization.

For example, a respondent might

mistakenly report or the interviewer

might mistakenly enter the child’s age at

adoption as older than the child’s

current age. In that event, a consistency

check would appear indicating the

discrepancy: ‘‘[S.C.]’s age when

[his/her] adoption was finalized must be

less than or equal to child’s age.’’ Even

with many built-in CATI checks, data

cleaning was still necessary. Invalid

values were deleted and missing values

were investigated. On rare occasions,

certain data were not collected correctly,

but based on related questions, the

missing data could be determined. An

important part of data cleaning was

ensuring that the child identified for the

interview was the selected child from

the 2005–2006 NS-CSHCN interview

and that the child’s type of adoption

was correct. Finally, missing data had to

be determined to be the result of a

legitimate skip, a partially completed

interview, or data that actually were

missing in error. Questionnaire variables

in the public-use file that have been

altered in any way after data collection,

either due to cleaning or other editing

steps described below, had the letter

‘‘R’’ appended to the variable name to

denote ‘‘recode.’’

Missing Data

Missing data are not desirable when

doing analyses and are often ignored

completely by data analysts. However, it

is very helpful to know why data are

missing. The following codes have been

used in the interview file to give

analysts as much information as possible

on why certain data are missing.

(.A) Added question. Variable is

missing because this question was added

after the start of data collection and the

interview was conducted before the

question was added.

(.D) Deleted question. Variable is

missing because this question was
Series 1, No. 51 [ Page 15

removed after the start of data collection

and the interview was conducted after

the question was deleted.

(.L) Legitimate skip. Variable is

missing due to valid questionnaire paths

based on a previous answer to a root

question.

(.M) Missing in error. Variable is

missing due to interviewer or system

errors. In cases of interviewer error, the

interviewer may have deleted the data

by accident or simply may have not

answered the question. In cases of

system error, the data may not have

been collected or saved properly after

they were entered by the interviewer in

the CATI system.

(.P) Partially completed interview.

Variable is missing because the

respondent hung up after completing

Section F but before completing the full

interview.

Derived variables do not include the

detailed coding of missing data. Missing

values for derived variables received an

‘‘.M’’ code regardless of the reason for

the missing data.

Coding of Verbatim

Answers Into Question

Responses

For many questions in the

NSAP-SN interview, respondents

provided a response that did not match

any preexisting category. If this

occurred, the interviewer chose ‘‘other’’

and typed in the response provided by

the respondent. At the end of the data

collection period verbatim responses

were recoded into existing response

categories where appropriate.

There were three ways in which

verbatim responses were used to recode

or back-code data:

+	 Some verbatim responses were

back-coded to existing response

categories on the preceding question.

+	 Some verbatim responses were used

to create new response categories

for the preceding question, which

are indicated by new dummy

variables.

+	 Some verbatim responses were used

to create new variables to capture

the data because no root question

existed for which to create new

categories or back-code verbatim

responses into preexisting categories.

More detail about coding of

verbatim responses is provided in

Appendix VII.

Edits to Protect

Confidentiality

NCHS takes extraordinary measures

to assure that the identities of survey

subjects cannot be disclosed. The risk of

inadvertent disclosure of confidential

information regarding individual

respondents is higher with a publicly

released dataset having detailed

geography variables, a detailed and

extensive set of survey observations, and

a sizable proportion of the total

population of interest. Coarsening a

dataset by suppressing survey variables,

collapsing multiple variables into one,

collapsing response categories for other

variables, or introduction of noise in the

data are common techniques to reduce

the risk of inadvertent disclosure.

NSAP-SN data face a special

challenge in assuring the confidentiality

of respondents. The base survey data

from NS-CSHCN include state

identifiers on the public-use file.

NSAP-SN’s national sample size of

1,003 is too small to release state

identifiers, as the risk of disclosure

would be increased. This also means

that the public-use NSAP-SN data

cannot be linkable to the public-use

NS-CSHCN data, as such linkage would

allow the state identifiers to be attached

to the NSAP-SN data file.

To prevent the linkage of the

public-use files for NSAP-SN and

NS-CSHCN, the following steps were

taken: for all NS-CSHCN variables that

were included on the NSAP-SN

public-use file (n), and all common data

elements that exist on both public-use

files (m), (n + m)-way cross-tabulations

were examined to identify any

NSAP-SN case with a particular

combination of characteristics that could

be uniquely matched to an NS-CSHCN

case with the same combination of

characteristics. Whenever five or fewer

NS-CSHCN cases existed as potential

matches to a single NSAP-SN case, the

NS-CSHCN and NSAP-SN sampling

weights were examined to determine if

differences in the order of magnitude in

sampling weights could be used to

conclusively identify which of the five

or fewer cases was the exact match to

the NSAP-SN case (although the

NSAP-SN sampling weight does not

equal the NS-CSHCN sampling weight,

a hypothetical single NSAP-SN case

with an NSAP-SN weight of 65 that had

two potential matching NS-CSHCN

cases, with NS-CSHCN sampling

weights of 60 and 2,500, respectively,

could be deduced to match to the first

of those two NS-CSHCN cases).

To mask three cases in which the

child had not yet reached age 3 by

re-interview, the age of the child at

NSAP-SN interview was collapsed such

that children aged 2 were grouped with

children aged 3. To reduce the number

of (n + m)-common data elements that

could be used to match records between

the two public-use files, household

income relative to the federal poverty

level (FPL) was collapsed to five

categories (0%–100% of FPL; greater

than 100%–200%; greater than

200%–300%; greater than 300%–400%;

greater than 400%) in the NSAP-SN

file.

NSAP-SN variables C8A, C8C,

C9A, C9C, and C9E (which indicate the

exact number of children of various

types in the household) and variables

indicating the specific race and ethnicity

of both the respondent and the

respondent’s spouse or partner (N24,

N24A, N25, and N25A) were dropped

from the NSAP-SN public-use file to

prevent them being used to specifically

identify a household based on detailed

family structure. Variables indicating

whether the sample child had had any

biological children (C52) and the age of

the child when action to end the

adoption was taken (W20B) were

dropped from the NSAP-SN public-use

file because they were extremely rare,

and potentially observable. Additionally,

a few records were perturbed as

described below. These edits ensure that

no NSAP-SN case in the public-use file

can be matched to its respective

NS-CSHCN record in the NS-CSHCN

public-use file with certainty.
Page 16 [ Series 1, No. 51

Geography

NSAP-SN public-use data contains

no geographic identifiers of any kind.

Although the state is identified on the

NS-CSHCN public-use file, it is not

possible to match NSAP-SN respondents

to their respective NS-CSHCN records

using only the NSAP-SN and

NS-CSHCN public-use files.

Race

NS-CSHCN question CW10Q02

asked about the sample child’s race.

Respondents were permitted to identify

all possible categories that described the

child’s race. If a race other than one of

the seven existing categories was

indicated, then a verbatim response was

captured. Verbatim responses were

reviewed and matched against a

database of alternative race terminology

maintained by the U.S. Census Bureau.

Where possible, ‘‘other’’ race responses

were back-coded into one of the seven

existing categories. Once all possible

verbatim responses were back-coded, a

new race variable was created by

collapsing the seven categories into six

categories: White, Black or African

American, American Indian or Alaska

Native, Asian, Native Hawaiian or Other

Pacific Islander, and Multiple Race.

Multiple Race was reserved for those

cases where more than one of the other

five categories applied. If the respondent

did not know or refused to provide the

race, then race was coded as missing.

Cases where a verbatim response could

not be conclusively back-coded (e.g.,

American, Indian, Jewish) and no other

race was reported were also coded as

missing.

To reduce the number of common

data elements and prevent the matching

of NSAP-SN records to their respective

NS-CSHCN records, race was combined

with Hispanic ethnicity for the

NSAP-SN public-use file, as described

below for derived variable HISPRACE.

Top-coded and collapsed

variables

Several other variables were

top-coded to conceal the values of

outliers at the high end of the

distribution of responses or collapsed to

coarsen the detail of the measurement.

Due to their unusual characteristics,

records including this detail might have

been more readily identifiable.

+	 Age at NSAP interview

(AGEYRNSAP) had three cases

with age = 2 collapsed with age 3.

+	 The country of origin (S1_NR) was

collapsed such that countries other

than China, Russia, Guatemala, and

South Korea are grouped by

continent: Other: Asia, Other:

Europe, and Other.

+	 The time between when the child

was placed in the home and when

adoption became the case goal

(S11_MONTHS) was measured in

months, and 60 months or more was

the maximum reported.

+	 The child’s age when the adoption

was finalized (C1AR) was collapsed

into the following categories: 0

years, 1 year, 2 years, 3 years, 4–5

years, 6–7 years, 8–10 years, 11

years and over.

+	 The child’s age when first placed in

the home (C1BR) was collapsed into

the following categories: 0 years, 1

year, 2–3 years, 4–5 years, 6–8

years, 9 years and older.

+	 Responses of ‘‘another adoptive

family’’ and ‘‘a residential treatment

facility’’ for the place where the

child lived prior to placement

(C2_NR) were collapsed with

‘‘other.’’

+	 For respondents who were

themselves adopted as children, the

respondent’s age at adoption

(C15A_MONTHS) was measured in

months, and 120 months or more

was the maximum reported.

+	 For respondents’ spouses or partners

who were themselves adopted as

children, the respondent’s spouse’s

or partner’s age at adoption

(C15C_MONTHS) was measured in

months, and 48 months or more was

the maximum reported.

+	 For the number of postadoption

reports filed (C25AAR), 20 or more

was the maximum reported.

+	 For the first language the child

spoke (C53R), Korean and

Ukrainian were collapsed into

‘‘other.’’

+	 For the number of times the child

has lived outside the home for 2

weeks or more (W17AR), 10 or

more was the maximum reported.

+	 The adoption subsidy monthly dollar

amount (F4R) was collapsed into the

following categories: $0–$300,

$301–$400, $401–$500, $501–$600,

$601–$750, $751–$1,000, and

greater than $1,000.

+	 Respondent’s (N23R) and

respondent’s spouse’s or partner’s

(N23AAR) years of birth were

collapsed into the following

categories: before 1950, 1950–1954,

1955–1959, 1960–1964, 1965–1969,

and after 1969.

+	 The calculated year of adoption

(YR_ADOPT) was collapsed into

eight categories: 1990–1992,

1993–1995, 1996–1997, 1998–2000,

2001–2002, 2003–2004, 2005–2006,

and 2007–2008.

Data perturbations

Because there were no cases where

a single NSAP-SN case had five or

fewer potential NS-CSHCN matches

based on common data elements such

that it was possible to discern which of

the five was the correct match based on

examination of the sampling weights, it

was not necessary for additional data

perturbation to prevent the matching of

records.

Analysts interested in working with

data that were suppressed, coarsened, or

otherwise perturbed to protect

confidentiality may apply to access

unmodified data files through the NCHS

Research Data Centers (RDCs). These

facilities are located at NCHS

headquarters in Hyattsville, Maryland, a

Washington, D.C. suburb, and in

Atlanta, Georgia, CDC’s home base.

Data files housed in an RDC may also

be accessed remotely via e-mail or

through affiliated U.S. Census Bureau

RDCs, but the initial proposal to access

NSAP-SN data must be submitted to the

NCHS RDC. Analysts should visit their

website at http://www.cdc.gov/rdc/ for

more information.
Series 1, No. 51 [ Page 17

Derived Variables

A number of derived variables

appear on the public-use data file. The

definitions of these variables are

provided below. Derived variables from

the NS-CSHCN interview that were

appended to the NSAP-SN public-use

file are also included.

ADOPT_TYPE—Based on NS-CSHCN

variables C10Q04 and C10Q05 and

indicates the selected child’s type of

adoption (international, foster care, or

private domestic). While this

information was collected during the

2005–2006 NS-CSHCN interview, this

variable reflects any updates as of the

NSAP-SN interview (24 cases were

affected as described below).

AGEYRNSAP—Based on NSAP-SN

variable AGE and is a collapsed version

of child’s age at NSAP-SN interview in

categories of whole years of age: 2–3, 4,

5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16,

and 17.

ANYSIBS—Based on NS-CSHCN

variable TOTKIDSR, which gives the

total number of children under age 18

years in the household. ANYSIBS

indicates if there are any other children

in the household (= 1) or not (= 0).

C15A_MONTHS—Based on NSAP-SN

variables C15A_YEAR and

C15A_MONTH, which give the

respondent’s age at adoption, for cases

in which the adult respondent was also

adopted as a child. C15A_MONTHS is

measured in months, and top-coded at

120 months or more.

C15C_MONTHS—Based on NSAP-SN

variables C15C_YEAR and

C15C_MONTH, which give the

respondent’s spouse’s or partner’s age at

adoption, for cases in which the

respondent’s spouse or partner was also

adopted as a child. C15C_MONTHS is

measured in months, and top-coded at

48 months and over.

HISPRACE—Based on CW10Q01 and

C1002X01 through C1002X08 from

NS-CSHCN, including responses backcoded from the verbatim variable

CW10Q02A and indicates whether or

not the child is of Hispanic or Latino

origin, and if not, indicates the race of

the child. If the child is of Hispanic or

Latino origin, then HISPRACE = 1. If

the child is not of Hispanic or Latino

origin, then HISPRACE specifies the

race of the selected child as of one of

four categories: non-Hispanic white only

(= 2), non-Hispanic black only (= 3),

non-Hispanic Asian only (= 4), and

non-Hispanic other (= 5), including

American Indian only, Alaska Native

only, Native Hawaiian only, Pacific

Islander only, other unknown, or

multiple races. Twenty cases of ‘‘don’t

know’’ or ‘‘refused’’ responses were

replaced with imputed values for the

NSAP-SN public-use file.

POVLEVEL5—Is a collapsed version of

NS-CSHCN-derived variable

POVLEVEL, which is based on total

household members (C11Q01_A) and

the household income value. If data for

either of these two components are

missing, refused, or had a ‘‘don’t know’’

response, this variable is assigned a

missing value. Once an income-tohousehold-size measure is computed, it

is compared with HHS poverty

guidelines. Appendix VII of the

NS-CSHCN design and operations

report details the derivation of

POVLEVEL (1). POVLEVEL5, released

on the NSAP-SN public-use file,

collapses POVLEVEL into the following

five categories: 0%–100% of the FPL,

greater than 100%–200% FPL, greater

than 200%–300% FPL, greater than

300%–400% FPL, and greater than

400% FPL.

S11_MONTHS—Based on NSAP-SN

variables S11_Y and S11_M, which give

the span between the time the child was

placed in the home and when adoption

became the case goal. S11_MONTHS is

measured in months and top-coded at 60

months and over.

SEX—Based on NS-CSHCN variable

C2Q03 and specifies the gender of the

child. Three cases of ‘‘don’t know’’ or

‘‘refused’’ responses were replaced with

imputed values for the NSAP-SN

public-use file.

TRANSRACE—Based on NSAP-SN

variables C17_N and C17_A and

indicates whether or not the child’s

race/ethnicity differs from the

race/ethnicity of both parents or differs

from the race/ethnicity of the single

parent.

YR_ADOPT—Derived from the date of

NSAP-SN interview and the child’s

reported age at adoption and age in

months at interview. The number of

months between the date of adoption

and the date of interview were obtained

by comparison of the child’s age in

months at adoption and age in months at

interview, and was subtracted from the

century-month code (CMC) of the date

of interview to derive CMC of the date

of adoption. This variable was collapsed

as eight categories: 1990–1992,

1993–1995, 1996–1997, 1998–2000,

2001–2002, 2003–2004, 2005–2006, and

2007–2008.

Dummy Variables

When respondents were permitted

to provide multiple answers for the

same question, a variable was created

for each possible answer. The values for

these new dummy variables are ‘‘yes,

this answer was given’’ and ‘‘no, this

answer was not given.’’ When

respondents could not or did not provide

an answer to the question, a value of

‘‘don’t know’’ or ‘‘refused’’ was

reported for each of the dummy

variables.

Variable Dummy variable

C10_N C10_NX01 to C10_NX03

W20A W20AX01 to W20AX03

N1D N1DX01 to N1DX06

N2BA N2BAX01 to N2BAX08

N2D N2DX01 to N2DX05

N3B N3BX01 to N3BX07

N3D N3DX01 to N3DX05

N5D N5DX01 to N5DX09

N5F N5FX01 to N5FX05

N6B N6BX01 to N6BX09

N6D N6DX01 to N6DX07

N7B N7BX01 to N7BX07

N7D N7DX01 to N7DX07

N8B N8BX01 to N8BX08
Page 18 [ Series 1, No. 51

N8D N8DX01 to N8DX07

N9B N9BX01 to N9BX08

N9D N9DX01 to N9DX06

N10BB N10BBX01 to N10BBX08

N10D N10DX01 to N10DX07

N11B N11BX01 to N11BX07

N11D N11DX01 to N11DX07

N12B N12BX01 to N12BX07

N12D N12DX01 to N12DX07

N14BB N14BBX01 to N14BBX08

N14D N14DX01 to N14DX07

N18B N18BX01 to N18BX07

N18D N18DX01 to N18DX05

N24A N24AX01 to N24AX08

N25A N25AX01 to N25AX08

Additional Data Notes

There were 24 cases for which a

change was made to the case’s original

ADOPT_TYPE assignment because

information regarding the type of

adoption provided by the respondent

during the NSAP-SN interview

conflicted with similar information

provided during the NS-CSHCN

interview. Derived variable

ADOPT_TYPE reflects the later value

for these cases.

Values of the child’s age at the time

of NSAP-SN were updated for two

cases during data cleaning. Variables

were set to ‘‘missing in error’’ as

needed when updated age no longer

corresponded with age-based skip

patterns.

As the result of a system error,

eight cases have C9E set to ‘‘missing in

error.’’

During NSAP-SN data collection it

was discovered that the mental health

medication questions (F16A_A–

F16A_EA) were being asked if the child

had ever taken mental health

medications. However, the questions

should only have been asked if the child

had taken such medication in the

previous 12 months. Variable

F16_A_FLAG identifies cases where the

respondent indicated that the child had

not taken mental health medications in

the previous 12 months. There are 11

such cases.

Quality Control

A team of programmers and project

staff was responsible for cleaning data

at the end of data collection. The

cleaned data were also thoroughly

checked by other project staff. Below is

a brief description of the steps involved

in producing the final data file.

Using the questionnaire

specifications, project staff produced

several computer programs to review the

data and identify data items that

required cleaning. These programs were

also used during data collection to

monitor production. The programming

team developed cleaning programs so

that the resulting cleaned data file could

be replicated and reviewed by others.

These programs applied any final data

corrections based on data recovery,

checked that skip patterns were

followed, created derived variables from

questionnaire variables, and assigned

special codes to reflect various missing

data.

Project staff then ran several quality

control checks on the cleaned data file.

Project staff cross-checked the cleaned

file against an independently prepared

data file. Variable frequencies were

reviewed to confirm skip patterns,

missing code assignments, and expected

distributions. Derived variable

specifications and computations were

carefully reviewed. Variable labels were

compared against the questionnaire to

confirm accurate label assignments.

The cleaning programs were run on

each new version of the data file until

no problems were identified in the

quality control checks. The reviewer

then signed off on the data file. Finally,

senior project management reviewed the

data file and supporting documents.

Estimation and

Hypothesis Testing

The NSAP-SN data were obtained

through a complex sample design

involving the selection of a single child

with special health care needs per

household and stratification of

households within states. To produce

estimates that are nationally

representative of adopted CSHCN,

sampling weights must be used. These

sampling weights account for the

unequal probabilities of selection for

households and children, and they

include adjustments for multipletelephone households, unit nonresponse,

and noncoverage of nontelephone

households and households without

landline telephones, as well as

adjustments to known population control

estimates. As described earlier, the

sampling weights for NSAP-SN

respondents have further been adjusted

for nonresponse to NSAP-SN and

readjusted to population control

estimates for adopted CSHCN derived

from the 2005–2006 NS-CSHCN.

Estimates based on the sampling

weights generalize to the U.S.

population of adopted CSHCN who

were aged 0–15 years in 2005–2006 and

living in households where English is

spoken. These estimates do not

generalize to the population of adoptive

parents, or the population of adoptive

mothers, or the population of adopted

children’s health care providers.

Variables Used for

Variance Estimation

The sample design of NSAP-SN is

complex, and the interview records have

unequal weights, so statistical software

that assumes simple random sampling

will most often compute standard errors

that are too low. Tests of statistical

hypotheses may suggest statistically

significant differences or associations

that are misleading. Computer programs

are available that provide the capability

of variance estimation for complex

sample designs (e.g., SUDAAN, Stata,

WesVar). To provide the user with the

capability to estimate the complex

sample variances for the NSAP-SN data,

stratum and primary sampling unit

(PSU) identifiers have been provided on

the data file. These variables and the

sample weights are necessary to

properly calculate variances.

The stratum identifiers reported on

the dataset are not identical to the strata
Series 1, No. 51 [ Page 19

used to draw the main sample. In states

with multiple estimation areas,

independent samples were drawn from

each estimation area in proportion to the

total number of households with

children in each estimation area.

Therefore, these estimation areas should

be considered strata for variance

estimation. However, disclosure of the

specific estimation area for each child

could increase the risk of disclosure of a

respondent’s or child’s identity. In the

absence of estimation-area-specific

identifiers, the NS-CSHCN collapsed

stratum identifier is the state identifier.

By using the state identifier rather than

the suppressed estimation area identifier,

the standard errors for national and state

estimates with key variables are affected

only slightly and not in a consistent

direction.

The NSAP-SN sample size of 1,003

is considerably smaller than the

NS-CSHCN sample size of 40,723, and

the former is too small to allow for the

release of state identifier, as the risk of

disclosure of a respondent’s or child’s

identity would be increased. Therefore,

the NSAP-SN collapsed stratum

identifier (PSUID) collapses the 51

strata for the 50 states plus Washington,

D.C., into 10 categories. The categories

were determined by rank ordering the

51 strata by average sampling weight,

and dividing the 51 strata into 10 strata

by whole state. Nine categories contain

five strata and one category contains six

strata. By using this collapsed stratum

identifier rather than the suppressed

state identifier, the standard errors for

national estimates and for estimates by

adoption type with key variables are

affected only slightly and not in a

consistent direction. Households were

sampled within strata, and the unique

household identifier is called

NSAPSNID.

The overall number of persons in

this survey is sufficient for many

statistical inference purposes. However,

analyses of some rare responses and

analyses of subclasses can lead to

estimates that are unreliable. Small

sample sizes used in the variance

calculations may also produce unstable

estimates of the variances.

Consequently, these analyses require that

the user pay particular attention to the

variability of estimates of means,

proportions, and totals.

Variance Estimation Using

SUDAAN or Stata

Standard errors of estimates from

NSAP-SN can be obtained using the

Taylor Series approximation method,

available in software such as SUDAAN,

SAS, and Stata. The stratum should be

identified by the variable PSUID, and

the household should be identified by

the variable NSAPSNID.

The simplifying assumption that

households have been sampled with

replacement allows most complex

survey sample design computer

programs to calculate standard errors in

a straightforward way. This method

requires no recoding of design variables,

but it is statistically less efficient (and

therefore more conservative) than some

other methods. For SUDAAN, the data

file needs to be sorted by stratum

(PSUID) and household (NSAPSNID).

The following SUDAAN design

statements are used for analyses:

+ PROC ... DESIGN = WR;

+ NEST PSUID NSAPSNID;

+ WEIGHT NSAPSNWT;

For Stata, the following design

statements are used:

+ svyset strata PSUID.

+ svyset psu NSAPSNID.

+ svyset pweight NSAPSNWT.

+ svyset.

Other variance estimation

procedures are also applicable to

NSAP-SN. Specifically, the jackknife

method with replicate weights and the

bootstrap resampling method with

replicate weights can also be used (via

software such as WesVar) to obtain

standard errors that fully reflect the

impact of the weighting adjustments on

standard errors.

Variance Estimation for

Subsets of the Data

Many analyses of the NSAP-SN

data will focus on specific population

subgroups, such as CSHCN adopted

internationally or adopted CSHCN

living with a single parent. Some

analysts will therefore be tempted to

delete all records outside of the domain

of interest in order to work with smaller

data files and run computer jobs more

quickly. This procedure of keeping only

selected records and list-wise deleting

other records is called subsetting the

data. Subsetted data that are

appropriately weighted can be used to

generate correct point estimates (e.g.,

estimates of population subgroup

frequencies or means), but most

software packages that analyze complex

survey data will incorrectly compute

standard errors for subsetted data. When

complex survey data are subsetted, the

sample design structure is often

compromised because the complete

design information is not available.

Subsetting the data can delete important

design information needed for variance

estimation (e.g., deleting all records for

certain subgroups may result in entire

PSUs being removed from the design

structure). Typically, the standard errors

for subsetted data will be inflated,

resulting in a higher probability of

type-II error (i.e., failing to detect

significant differences that do in fact

exist). SUDAAN has a SUBPOPN

option that allows the user to target

specific subpopulations for analysis

while retaining the full unsubsetted

dataset that includes the full sample

design information. Analysts interested

in specific subpopulations must use

SUBPOPN with the full sample data

rather than subsetting the dataset.

Weighted Frequencies,

Prevalence Estimates, and

Standard Errors

Weighted frequencies of adopted

CSHCN by adoption type, with standard

errors calculated using the Taylor Series

approximation method in SUDAAN,

appear in Appendix VIII. Analysts may

wish to replicate this table to determine

if they are using the weights and sample

design variables correctly.
Page 20 [ Series 1, No. 51

Guidelines for Data

Use

With the goal of mutual benefit,

NCHS requests that users of data files

cooperate in certain actions related to their

use. Any published material derived from

the data should acknowledge NCHS as

the original source. The suggested citation,

‘‘SOURCE: CDC/NCHS, National Survey

of Adoptive Parents of Children with

Special Health Care Needs, 2008’’ should

appear at the bottom of all tables.

Published material derived from the data

should also include a disclaimer that

credits any analyses, interpretations, or

conclusions reached to the author and not

to NCHS, which is responsible only for

the initial data. Consumers who wish to

publish a technical description of the data

should make a reasonable effort to ensure

that the description is not inconsistent with

that published by NCHS.

CIPSEA and the Public Health

Service Act (section 308d) provide that

these data collected by NCHS may be

used only for the purpose of statistical

reporting and analysis. Any effort to

determine the identity of any reported

case is prohibited by these laws. NCHS

takes extraordinary measures to assure

that the identity of survey subjects

cannot be disclosed. All direct

identifiers, as well as any characteristics

that might lead to identification, have

been omitted from the dataset. Any

intentional identification or disclosure of

a person or establishment violates the

assurances of confidentiality given to

providers of the information. Therefore,

users must:

+	 Use the data in this dataset for

statistical reporting and analysis only.

+	 Make no use of the identity of any

person discovered, inadvertently or

otherwise, and advise the NCHS

Director of any such discovery

(301–458–4500).

+	 Not link this dataset with individually

identifiable data from any NCHS or

non-NCHS data sources.

+	 Use of the dataset signifies users’

agreement to comply with the

above-stated statutory-based

requirements.

Further Information

Data users can obtain the latest

information about SLAITS by

periodically checking the SLAITS

website at http://www.cdc.gov/nchs/

slaits.htm. This site features

downloadable data files and

documentation for SLAITS modules, as

well as important information about any

modifications and updates to data or

documentation. Data users will also find

current contact information if there are

any additional questions. Data users

with questions may also send e-mail to

slaits@cdc.gov.

Researchers may also wish to join

the SLAITS e-mail listserv. To subscribe

or unsubscribe, visit http://www.cdc.gov/

nchs/slaits/slaits_listserv.htm and follow

the directions listed. The listserv has

approximately 1,000 subscribers around

the world who use SLAITS data or are

interested in SLAITS. Subscribers

periodically receive e-mail containing

news about SLAITS surveys (e.g., new

releases or modifications to existing

data), publications, or related

conferences. The listserv is moderated

and listserv membership is private.

For more information on CDC, you

may contact CDC’s Information Contact

Center (CDC-INFO) in English or

Spanish by calling 800–CDC–INFO

(800–232–4636) or e-mailing

cdcinfo@cdc.gov. Persons with hearing

impairment may contact CDC-INFO

with a TTY machine at 888–232–6348.

The CDC-INFO fax machine line is

770–488–4760. Please note, however,

that CDC-INFO cannot respond to

questions about individual medical

cases, provide second opinions, or make

specific recommendations regarding

therapy. These issues should be

addressed directly with personal health

care providers.

References

1.Blumberg SJ, Welch EM, Chowdhury

SR, et al. Design and operation of the

National Survey of Children with

Special Health Care Needs, 2005–2006.

National Center for Health Statistics.

Vital Health Stat 1(45). 2008.

2.Blumberg SJ, Foster EB, Frasier AM,

et al. Design and operation of the

National Survey of Children’s Health,

2007. National Center for Health

Statistics. Vital Health Stat 1.

Forthcoming.

3.Bramlett MD, Foster EB, Frasier AM,

et al. Design and operation of the

National Survey of Adoptive Parents,

2007. National Center for Health

Statistics. Vital Health Stat 1(50). 2010.

4.Blumberg SJ, Olson L, Osborn L, et al.

Design and operation of the National

Survey of Early Childhood Health,

2000. National Center for Health

Statistics. Vital Health Stat 1(40). 2002.

5.Blumberg SJ, Olson L, Frankel M, et

al. Design and operation of the

National Survey of Children with

Special Health Care Needs, 2001.

National Center for Health Statistics.

Vital Health Stat 1(41). 2003.

6.Blumberg SJ, Olson L, Frankel MR, et

al. Design and operation of the

National Survey of Children’s Health,

2003. National Center for Health

Statistics. Vital Health Stat 1(43). 2005.

7.O’Connor KS, Osborn L, Olson L, et

al. Design and operation of the

National Asthma Survey. National

Center for Health Statistics. Vital

Health Stat 1(46). 2008.

8.McPherson M, Arango P, Fox H,

Lauver C, McManus M, Newacheck

PW, et al. A new definition of children

with special health care needs.

Pediatrics 102(1 Pt 1):137–40. 1998.

9.NORC at the University of Chicago.

2007 methodology report: National

Immunization Survey. Chicago, IL:

NORC. 2008.

10.Zell ER, Ezzati-Rice TM, Battaglia MP,

Wright RA. National Immunization

Survey: The methodology of a

vaccination surveillance system. Public

Health Rep 115(1):65–77. 2000.

11.Lepkowski JM. Telephone sampling

methods in the United States. In:

Groves RM, et al. (Eds.), Telephone

Survey Methodology. New York, NY:

John Wiley and Sons. 1988.

12.Blumberg SJ, Luke JV, Cynamon ML,

Frankel MR. Recent trends in

household telephone coverage in the

United States. In: Lepkowski JM, et al.

(Eds.), Advances in Telephone Survey

Methodology (Chapter 3). New York,

NY: John Wiley and Sons, Inc.

Forthcoming.
Series 1, No. 51 [ Page 21

Appendix I 

Weighting Technical

Summary

NSAP-SN weighting procedures

This appendix summarizes the

methodology used for weighting the

National Survey of Adoptive Parents of

Children with Special Health Care

Needs (NSAP-SN) sample. The

weighting scheme is a simplified version

of the weighting scheme for the

National Immunization Survey (NIS).

The weighting procedures for the

NSAP-SN sample involve the following

steps:

+	 Obtain base weights from

2005–2006 National Survey of

Children with Special Health Care

Needs (NS-CSHCN) final weights.

+	 Adjustment for nonresponse to the

NSAP-SN interview.

+	 Raking adjustment to available

control totals.

Step 1: Obtain base weight

The sample for NSAP-SN is

obtained by including all adopted

children in English-speaking households

in the target age range identified in the

2005–2006 NS-CSHCN sample. For

these identified cases, the weighting

process starts with the final weight from

the 2005–2006 NS-CSHCN. However, 4

out of 140 cases with CSHCN_AGE =

14 (age as of 2005–2006 NS-CSHCN)

and 27 out of 150 cases with

CSHCN_AGE = 15 were excluded from

the sample based on updated age (i.e.,

NSAP-SN age, 18 years and over).

The final NS-CSHCN weights were

derived by applying adjustments to

account for nonresponse, for households

with multiple telephone numbers, and

for noncoverage of children in

households without landline telephones,

as well as adjustments to known

population control estimates. For a

detailed description of the derivation of

the NS-CSHCN final weights, readers

are referred to the 2005–2006

NS-CSHCN design and operations

report (1).

The NSAP-SN base weight for each

child was defined as the 2005–2006

NS-CSHCN final weight for that child,

adjusted for children aged 14 and 15

years (as of 2005–2006 NS-CSHCN

interview) who were excluded from the

sample based on updated age by

proportionally increasing the weights of

the remaining children aged 14 and 15

in 2005–2006 to account for those

excluded. The proportional adjustments

were 140 / (140 { 4) and 150 / (150 {

27), respectively.

Step 2: Adjust for incomplete

interviews

Not all identified cases in the

NSAP-SN sample completed the

interview. To compensate for interview

nonresponse, the weights of the children

with complete interviews were adjusted.

The adjustment was made by forming

nonresponse adjustment cells. The

nonresponse-adjusted weight was

derived by dividing the base weight for

each child by the weighted NSAP-SN

interview completion rate for the

adjustment cell containing the child. The

interview nonresponse adjustment was

made separately within each census

region. The adjustment cells were

formed using the following variables

listed in order of priority:

+	 Census region.

+	 Type of adoption (as of 2005–2006

NS-CSHCN).

+	 2005–2006 NS-CSHCN age group.

+	 Race/ethnicity.

Any cell where the number of

responding cases was less than 20 was

collapsed with a neighboring cell.

Step 3: Raking adjustment to external

control totals

The interview nonresponse-adjusted

weight was further adjusted such that

the sum of the weights agreed with the

control totals. Since there are no

external control totals available on the

NSAP-SN target children, data from the

2005–2006 NS-CSHCN were used to

derive the control totals. That is, the

NS-CSHCN final weight was summed

for all English-speaking, adopted

children aged 0–15 years (age as of

2005–2006 NS-CSHCN), with the sums

to the appropriate levels serving as the

control totals. The raking adjustment

was done using various categories of the

following margins at the national level:

+	 Census region.

+	 Number of male and female children

within each of four 2005–2006

NS-CSHCN age groups.

+	 Number of children in age group by

type of adoption as assessed in

2005–2006 NS-CSHCN.

+	 Race/ethnicity.

+	 Number of children in households

by highest reported education in

household.

+	 Number of children in households

by household income.

Categories of these raking

dimensions with less than 20 cases were

collapsed with a neighboring category.

Raking took each variable in turn

and applied a proportional adjustment to

the interview nonresponse-adjusted

weights of the children who belonged to

the same category of the variables. After

a number of iterations over all raking

dimensions, the raked weights have

totals that match all the desired control

totals. The raked weight can be

expressed as the nonresponse-adjusted

weight for the child multiplied by the

raking adjustment factor for the child

derived through the iteration process.

At this point, the weights were

checked for extreme values. Similar to

the process for NIS, the weights that

exceeded the median weight plus six

times the inter-quartile range of the

weights were truncated to this cutoff.

The raking step was applied again after

the truncation of the weights, and the

weights were rechecked for extreme

weights and truncated as before. The

process was iterated until there was no

extreme weight after raking.

The raking and truncation process

produced a final weight for each child

with a completed NSAP-SN interview.
Page 22 [ Series 1, No. 51

National estimates and summary

statistics of weights

Descriptive statistics for the final

NSAP-SN weight are provided in

Table I. The final NSAP-SN weight is

used to obtain estimates at the national

level.

Table I. Summary statistics for the

NSAP-SN final weight

Statistic Value

Unweighted sample size ...... 1,007

Minimum weight. . . . . . . . . . . . 0.00

Maximum weight ........... 2,758.60

Mean weight .............. 401.45

Median weight. . . . . . . . . . . . . 219.70

Sum of weights ............ 404,261.85

NOTE: NSAP-SN is National Survey of Adoptive Parents of

Children with Special Health Care Needs.
Series 1, No. 51 [ Page 23

Appendix II

Questionnaire

This appendix contains the National

Survey of Adoptive Parents of Children

with Special Health Care Needs

questionnaire. The National Survey of

Children with Special Health Care

Needs (NS-CSHCN) questionnaire can

be found in the 2005–2006 NS-CSHCN

design and operations report (1) and on

the SLAITS website: http://

www.cdc.gov/nchs/slaits.htm.

National Survey of Adoptive Parents

of Children with Special Health Care Needs

NS-CSHCN 2005–2006 KEY QUESTIONS FOR SCREENING IN ADOPTIVE FAMILIES ............................ 24

PROGRAMMING KEY .................................................................................... 26

NSAP SCREENER (S) ..................................................................................... 28

CHARACTERISTICS (C) .................................................................................. 35

PARENT AND CHILD WELL-BEING (W) .................................................................... 58

ADOPTION AGREEMENT AND POST ADOPTION SERVICES – FINANCIAL (F).................................. 66

POST ADOPTION SUPPORTS – NON-FINANCIAL (NF) ....................................................... 76
Page 24 [ Series 1, No. 51

NS-CSHCN 2005–2006 KEY QUESTIONS FOR SCREENING IN ADOPTIVE FAMILIES

C10Q03	 IF S10Q00 = 04 OR 08 OR S10Q02X04 = 01 OR S10Q02X08 = 01, CONTINUE WITH C10Q03. ELSE, SKIP

TO C11Q01.

The next questions will help us better understand the health needs of adopted children.

How old was [S.C.] when the adoption was finalized? By ‘‘finalized,’’ I mean when the court papers were signed

that completed the adoption process.

C10Q03	 ___ ____ VALUE (MUST BE LESS THAN OR EQUAL TO AGE OF CHILD)

(6) DON’T KNOW

(7) REFUSED

INTERVIEWER INSTRUCTION: IF CHILD WAS LESS THAN 1 MONTH AT THE TIME OF ADOPTION,

ENTER ‘‘0 MONTHS.

C10Q03A	 Months (00–12)

Years (Range 00–17)

(CATI PROGRAMMING NOTE: 2 NUMERIC-CHARACTER FIELD FOR MONTHS

2 NUMERIC-CHARACTER FIELD FOR YEARS 

AGE SHOULD BE CONVERTED TO MONTHS) 

C10Q04	 Was [S.C.] adopted from another country?

IF RESPONDENT SEEMS UPSET BY THIS QUESTION, READ: We ask this question for all children with

adoptive parents.

(1) YES [SKIP TO C11Q01] [S.C.] Sorts as International Adoption]

(0) NO

(6) DON’T KNOW

(7) REFUSED

C10Q05	 Was [S.C.] residing in foster care prior to being placed for adoption? This includes children placed by private

agencies on behalf of a state or county child welfare agency.

IF THE CHILD WAS ADOPTED THROUGH A PRIVATE AGENCY AND THE PRIVATE AGENCY WAS

ACTIONG IN ASSOCIATION WITH OR IN COOPERATION WITH A STATE OR COUNTY WELFARE

AGENCY, THEN THIS QUESITON SHOULD BE ANSWERED ‘‘YES.’’

IF A FOSTER PARENT ADOPTED ONE OF THEIR OWN FOSTER CHILDREN, THEN THIS QUESTION

SHOULD BE ANSWERED ‘‘YES.’’

IF RESPONDENT SEEMS UPSET BY THIS QUESTION, READ: We ask this question for all children with

adoptive parents.

(1) YES	 [S.C.] Sorts as Foster Care Adoption]

(0) NO	 [S.C.] Sorts as Private Adoption]

(6) DON’T KNOW [S.C.] Sorts as Private Adoption]

(7) REFUSED [S.C.] Sorts as Private Adoption]

ELIGIBILITY FOR NSAP:

ADOPT_TYPE (Derived Variable):

ADOPT_TYPE = Null 

IF C10Q04 = 1 THEN ADOPT_TYPE = 1 

IF C10Q05 = 1 THEN ADOPT_TYPE = 2 

IF C10Q05 = NO, DON’T KNOW, or REFUSED THEN ADOPT_TYPE = 3 

AGE AT NSAP Derived Variables

c ELIGIBILITY DATE WAS SET WHEN FIRST CSHCN QUESTION WAS ANSWERED

c CALCULATE NUMBER OF MONTHS BETWEEN ELIGIBILITY DATE & NSAP START DATE

c ADD TO ‘‘AGE IN MONTHS’’ VARIABLE FROM CSHCN DATA FILE

o DERIVED VARIABLE ESTAGEMO = ESTIMATED AGE IN MONTHS AT NSAP START DATE
Series 1, No. 51 [ Page 25

o DERIVED VARIABLE ESTAGEYR = ESTIMATED AGE IN YEARS AT NSAP START DATE

o DERIVED VARIABLE AGEMONSAP = AGE IN MONTHS AS REPORTED AT AGE

o DERIVED VARIBLBE AGEYRNSAP = AGE IN YEARS AS REPORTED AT AGE

NOTE: ESTAGEMO AND ESTAGEYR WILL BE USED AT TO HELP IDENTIFY THE ELIGIBLE CHILD. AGEMONSAP

AND AGEYRNSAP WILL BE CALCULATED BASED ON THE CHILD’S CURRENT AGE AS REPORTED BY THE

PARENT DURING THE INTERVIEW.

IF (ADOPT_TYPE = 1, 2, OR 3) AND (AGEMONSAP<216) THEN CASE IS NSAP-ELIGIBLE AND SHOULD PROCEED

TO INTRO_1
c

Page 26 [ Series 1, No. 51

PROGRAMMING KEY

This key provides information about this instrument to facilitate programming.

c Skip instructions are contained within ‘‘<. . .>’’ symbols.

c When a skip instruction is not written next to a response option, this response goes to the next item.

c When skipping to an item, include any introductory text before that item. For example, when skipping to C1a, include the text

before this item: ‘‘Now I would like to ask you a few questions . . .’’

c Textfills are contained within ‘‘[. . .]’’ symbols.

‘‘Approximate Year of Adoption’’ (drives skip at Checkpoint before F19) is calculated as follows: Current Year minus

(AGEYRNSAP) plus ([S.C.]’s age at adoption from C1a) = approximate year of adoption

If approximate year of adoption = 1997 or later ask F19

Example: Current year = 2006, AGE = 10 years, C1a = years

2006 – 10 + 1 = 1997

The purpose of this calculation is to be sure to include all adoptions that occurred in 1998 or later – even though this will

include some in 1997, too. The cutoff is 1997 b/c a child could have been adopted in 1998 but appear to have been adopted

in 1997 if the adoption finalization happened earlier in the year than their birthday and the interview is taking place after the

child’s birthday for the current year.

Adoption group drives numerous skips throughout this instrument. Below are the definitions of the three adoption groups.

o	 NOTE: The 2005–06 CSHCN questionnaire did not include a question asking whether the adoption was finalized (it

assumed that the adoption was finalized as question C10Q03 asks how old [S.C.] was when the adoption was finalized).

The 2007 NSCH does include that question and makes finalization a requirement for being eligible for NSAP. For

CSHCN-NSAP, we’ll take an adoption case that falls into one of the following three categories.

IF C10Q04=YES: International Adoption

IF C10Q05=YES: Foster Care Adoption

IF C10Q05=NO OR DON’T KNOW OR REFUSED: Private Adoption
Series 1, No. 51 [ Page 27

QUESTIONNAIRE TEXTFILLS

There are several textfills that appear repeatedly throughout the instrument. To avoid cluttering the instrument with the same logic 

rules over and over, the textfill rules are provided here: 

[S.C.]’s Name: 

Textfill Child’s name for [S.C.] throughout instrument 

Gender:

IF C2Q03=1, [S.C.] IS MALE, use male pronouns (he, him, his, etc. . .)

IF C2Q03=2, [S.C.] IS FEMALE, use female pronouns (she, her, etc. . .)

Household Textfill:

Use ‘‘You’’ or ‘‘Your’’ . . . (do not use ‘‘spouse/partner’’ textfill) if there is only one adoptive parent in the HH. Specifically:

IF (S10Q00 = 04 OR 08) AND (S10Q01 = NO OR DON’T KNOW OR REFUSED) OR

IF (S10Q00 = 04 OR 08) AND (S10Q02 INDEX does not = 04 OR 08) OR

IF (S10Q00 does not = 04 OR 08) AND (S10Q02 INDEX = 04 OR 08) OR

IF (S3_N = 3 OR 4)

TEXTFILL = ‘‘You or/and your spouse’’ or ‘‘Your or/and your spouse’s’’ . . . if there are two adoptive parents in the HH and they

are spouses. Specifically:

IF (S10Q00 = 04 OR 08) AND (S10Q02 INDEX = 04 OR 08) AND (S3_N = 1) OR

IF (S10Q00 does not = 04 or 08) AND (S10Q02 INDEX = 04 and 08) AND (S3_N = 1)

TEXTFILL = ‘‘You or/and your partner’’ or ‘‘Your or/and your partner’s’’ . . . if there are two adoptive parents in the HH and they

are partners. Specifically:

IF (S10Q00 = 04 OR 08) AND (S10Q02 INDEX = 04 OR 08) AND (S3_N = 2) OR

IF (S10Q00 does not = 04 or 08) AND (S10Q02 INDEX = 04 and 08) AND (S3_N = 2)

TEXTFILL:

Use ‘‘My spouse and I were’’

IF (S10Q00 = 04 or 08) AND (S10Q02 = 04 or 08) AND (S3_N = 1) OR

IF (S10Q00 does not = 04 or 08) AND (S10Q02 INDEX = 04 and 08) AND (S3_N = 1)

Use ‘‘My partner and I were’’

IF (S10Q00 = 04 or 08) AND (S10Q02 = 04 or 08) AND (S3_N = 2) OR

IF (S10Q00 does not = 04 or 08) AND (S10Q02 INDEX = 04 and 08) AND (S3_N = 2)

Use ‘‘I was’’

IF S3_N = 3,4,6, OR 7

TEXTFILL:

Use ‘‘or your spouse’s’’

IF (S10Q00 = 04 or 08) AND (S10Q02 = 04 or 08) AND (S3_N = 1) OR

IF (S10Q00 does not = 04 or 08) AND (S10Q02 INDEX = 04 and 08) AND (S3_N = 1)

Use ‘‘or your partner’s’’

IF (S10Q00 = 04 or 08) AND (S10Q02 = 04 or 08) AND (S3_N = 2) OR

IF (S10Q00 does not = 04 or 08) AND (S10Q02 INDEX = 04 and 08) AND (S3_N = 2)

Time of Adoption Textfill:

IF (AGEYRNSAP) minus ([S.C.]’s age at adoption from C1a) = 1 or 0 use textfill: ‘‘Since the time of [S.C.]’s adoption’’.

IF (AGEYRNSAP) minus ([S.C.]’s age at adoption from C1a) = 2 or more use textfill: ‘‘During the last 12 months’’.
Page 28 [ Series 1, No. 51

NSAP SCREENER

TIMESTAMP_SECTION_S1 (all time stamps captured in the format yyyymmddhhmmss)

INTRO_1	 Hello, my name is _________________. I’m calling on behalf of the Centers for Disease Control and Prevention.

On [FILL INTDATE] we conducted a nationwide telephone survey on children’s health with an adult at this phone

number about a child who would now be about [FILL ESTAGEYR] years old. The CDC is interested in speaking

with this [FILL ESTAGEYR]-year old’s [FILL mother / father / mother or father] again.

NSAP_

INTRO IF ADOPTIVE MOTHER IN HH BUT NO ADOPTIVE FATHER

((S10Q00=04 OR S10Q02=04) AND (S10Q00 NE 08 AND S10Q02 NE 08)),

FILL ‘‘MOTHER’’ AND ‘‘SHE.’’ IF ADOPTIVE FATHER IN HH BUT NO ADOPTIVE MOTHER ((S10Q00=08

OR S10Q02=08) AND (S10Q00 NE 04 AND S10Q02 NE 04)), FILL ‘‘FATHER’’ AND ‘‘HE.’’ IF BOTH

ADOPTIVE MOTHER AND FATHER IN HH (((S10Q00=04 OR S10Q02=04) AND (S10Q00=08 OR

S10Q02=08)) OR ((S10Q00 NE 04 AND NE 08) AND S10Q02=04 AND 08)), FILL ‘‘MOTHER OR FATHER’’

AND ‘‘HE OR SHE.’’

Is [FILL: mother/father] available?

(1) Yes, speaking with that person	 <GO TO S1PRE>

(2) Yes, mother/father comes to phone	 <GO TO NSAP_INTRO2>

(3) No, not available now	 <GO TO S1PRE3>

(4) No, parent has moved <GO TO R_CONTACT>

(5) Do not know this person <GO TO NSAP_TERM> [set ITS=71]

(6) No, parent is deceased	 <IF TWO ADOPTIVE PARENTS IN HH, GO TO OTH_PAR ELSE GO

TO F1Q_PAR>

(7) No, youth is deceased <GO TO F1Q_CHLD> 

NOTE: IF NSAP_INTRO equals 5 (or 4 in some cases), the case would be eligible for locating via Accurint. If a 

new telephone number can be found via Accurint, it will be loaded and dialed.

ON-SCREEN INTERVIEWER LOCATING HELP & INSTRUCTION:

o CHILD’S NAME OR INITIALS:

o CHILD’S GENDER:

REMEMBER, YOU NEED TO FIND EITHER ONE OF [S.C.]’S ADOPTIVE PARENTS. THE ADOPTIVE PARENT MIGHT

NOT BE THE 2005 R.

OTH_PAR	 I’m sorry to hear that. Please accept my condolences.

Would the [TEX TFILL: ESTAGEYR]-year old’s [TEXT FILL: IF C2Q04=1 ‘father’ / ELSE IF C2Q04=2 ‘mother

/ ELSE ‘other parent]’ happen to be available?

(01) YES 

<GO TO NSAP_INTRO2 (ONCE PARENT COMES TO THE PHONE)> 

(02) NO 

<GO TO S1PRE3> 

F1Q_CHLD	 I’m sorry to hear that. I do not need to continue. Thank you, and please accept my condolences. Goodbye. <SET

AS INELIGIBLE=3>

F1Q_PAR	 I’m sorry to hear that. I do not need to continue. Thank you, and please accept my condolences. Goodbye. <SET

AS INELIGIBLE=3>

R_CONTACT	 Could you please tell me [him/her] new telephone number?

(1) YES <GO TO R_NPHONE>

(2) NO <GO TO R_NAME>

NOTE: If the case gets to R_CONTACT and a new telephone number is provided, CATI will dial that new

number on subsequent calls. If a name but no telephone number is provided, that information will be used to

conduct an Accurint search. If no name and no telephone number provided, an Accurint search on the original

number will be conducted.
Series 1, No. 51 [ Page 29

R_NPHONE_1 What is [him/her] telephone number?

___ ____ ____- ____ ____ ____- ____ ____ ____ ____

R_NPHONE_

TYPE Is that a landline or cellular telephone number?

(1) LANDLINE

(2) CELLULAR

R_NPHONE 

2 Does this person have another number that you would like to provide? 

(1) YES	 <GO TO R_PH_2>

(2) NO	 <GO to R NAME>

R_PH_2	 What is this telephone number?

___ ____ ____- ____ ____ ____- ____ ____ ____ ____

R_PH_TYPE2	 Is that a landline or cellular telephone number?

(1) LANDLINE

(2) CELLULAR

R_NPHONE 

3 Does this person have another number that you would like to provide? 

(1) YES	 <GO TO R_PH_3>

(2) NO	 <GO TO R NAME>

R_PH_3	 What is this telephone number?

___ ____ ____- ____ ____ ____- ____ ____ ____ ____

R_PH_TYPE3	 Is that a landline or cellular telephone number?

(1) LANDLINE

(2) CELLULAR

R_NAME	 Could you please tell me [him/her] name?

(1) YES <GO TO R_FIRSTNAME>

(2) NO <GO TO NSAP_TERM>

R_FIRST

NAME What is [his/her] first and last name?

FIRST NAME: ___________________________________

R_LAST

NAME What is [his/her] first and last name?

LAST NAME: ____________________________________ 

<GO TO NSAP_TERM> 

INTRO2	 Hello, my name is ________________. I’m calling on behalf of the Centers for Disease

Control and Prevention. On [FILL INTDATE] we conducted a nationwide

telephone survey on children’s health with an adult at this phone number about a

child who would now be about [FILL ESTAGEYR] years old.

[IF (01<S10Q00<=08), THEN READ: The person we spoke with told us [FILL:IF (01<S10Q00<=04): she/IF 

(05<=S10Q00<=08): he], was the child’s [FILL: IF (01<=S10Q00<=04: mother/ IF (05<=S10Q00<=08): father]. 

Are you this child’s parent?] 

[ELSE IF (S10Q00 LT 01 OR GT 08)], THEN READ: Are you this child’s parent?] 

(1) YES <GO TO NASAP_INTRO2A>

(2) NO <GO TO S1PRE3>
Page 30 [ Series 1, No. 51

NSAP_

INTRO2A We are interested in speaking with you again because we are doing a survey about the experiences of adoptive

parents and the person in this household who responded to the earlier survey told us that [FILL: IF S10Q00=4:

she was [S.C.]’s adoptive mother/ ELSE IF S10Q00=8: he was [S.C.]’s adoptive father/ ELSE IF (S10Q02 INDEX

= 04 AND NOT 08): [S.C.]’s adoptive mother lives in this household/ ELSE IF (S10Q02 INDEX = 08 AND NOT

04): [S.C.]’s adoptive father lives in this household/ ELSE IF (S10Q02 INDEX = 04 AND 08): [S.C.]’s adoptive

mother and father live in this household]. I have a few questions to ask to determine if you are eligible for the

survey.

Are you [S.C.]’s adoptive parent?

(1) YES <GO TO S1PREB>

(2) NO <GO TO S1PRE3>

S1PRE [IF NSAP_INTRO = 1, THEN READ: We are doing a survey about the experiences of adoptive parents and the

person in this household who responded to the earlier health survey told us that [FILL: IF S10Q00=4: she was

[S.C.]’s adoptive mother/ ELSE IF S10Q00=8: he was [S.C.]’s adoptive father/ ELSE IF (S10Q02 INDEX = 04

AND NOT 08): [S.C.]’s adoptive mother lives in this household/ ELSE IF (S10Q02 INDEX = 08 AND NOT 04):

[S.C.]’s adoptive father lives in this household/ ELSE IF (S10Q02 INDEX = 04 AND 08): [S.C.]’s adoptive

mother and father live in this household]. I have a few questions to ask to determine if you are eligible for the

survey.

Are you [S.C.]’s adoptive parent?

(1) YES <GO TO S1PREB>

(2) NO <GO TO S1PRE3>

INTERVIEWER: PLEASE VERIFY THAT RESPONDENT IS [S.C.]’s ADOPTIVE PARENT.

S1PRE3 When would be a good time to reach [S.C.]’s [IF NSAP_INTRO = 1 OR 2 READ: adoptive] parent?

(1) R IS AVAILABLE NOW <GO TO NSAP_INTRO2>

(2) SCHEDULE APPOINTMENT <GOTO CB1>

(3) THERE IS NO ADOPTIVE PARENT IN HOUSEHOLD <GO TO NSAP_TERM>

NSAP_

TERM Those are all the questions I have. I’d like to thank you on behalf of the Centers for Disease Control and

Prevention for the time and effort you’ve spent answering these questions.

S1PREB What is your relationship to [S.C.]?

(1) ADOPTIVE MOTHER

(2) ADOPTIVE FATHER

(6) DON’T KNOW

(7) REFUSED

INTERVIEWER INSTRUCTION: THIS QUESTION SHOULD ONLY BE ASKED IF YOU NEED TO CLARIFY

THE RESPONDENT’S GENDER.

AGE When we last spoke, [S.C.] was (CSHCN age in years/mos). How old is [he/she] now?

_______________

(6) DON’T KNOW

(7) REFUSED

AGEUNIT: SELECT UNIT

(1) YEARS

(2) MONTHS

PROGRAMMING NOTE: CALCULATE AGEMONSAP AND AGEYRNSAP HERE.

IF AGEMONSAP is ≥ 216 months old (i.e., child is 18 years old or older), case is not eligible for CSHCN-NSAP.

SET INELIGIBLE = 1 AND GO TO NSAP_TERM2
Series 1, No. 51 [ Page 31

INHOUSE: Is [S.C.] still living with you?

(1)

(2)

(6)

(7)

YES <GO TO CONSENT_INTRO>

NO <GO TO NSAP_TERM3 AND SET INELIGIBLE = 2>

DON’T KNOW

REFUSED

NSAP_

TERM2 We are only interviewing parents whose child is less than 18 years old. I’d like to thank you on behalf of the

Centers for Disease Control and Prevention for the time and effort you’ve spent answering these questions.

NSAP_

TERM3 We are only interviewing parents if the child still resides in their household. I’d like to thank you on behalf of the

Centers for Disease Control and Prevention for the time and effort you’ve spent answering these questions.

CONSENT_

INTRO Before we continue, I’d like you to know that taking part in this research is voluntary. You may choose not to

answer any question you don’t wish to answer or stop at any time. Whether or not you take part in this survey has

no effect on any benefits you may receive and there are no known risks. We are required by Federal law to

develop and follow strict procedures to protect your information and use your answers only for statistical research.

I can describe these laws if you wish. In appreciation for your time in taking the survey, we will send you $ [Text

Fill: IF NSAP_INCENT=, then use 25 / ELSE use NSAP_INCENT]. The survey will take about half an hour. In

order to review my work, my supervisor may record and listen as I ask the questions. I’d like to continue now

unless you have any questions.

READ IF NECESSARY: The Public Health Service Act is Volume 42 of the US Code, Section 242k. The

collection of information in this survey is authorized by Section 306 of this Act. The confidentiality of your

responses is assured by Section 308d of this Act and by the Confidential Information Protection and Statistical

Efficiency Act. Would you like me to read the Confidential Information Protection provisions to you?

IF RESPONDENT WOULD LIKE TO HEAR PROVISIONS, READ: The information you provide will be used

for statistical purposes only. In accordance with the Confidential Information Protection provisions of Title V,

Subtitle A, Public Law 107–347 and other applicable Federal laws, your responses will be kept confidential and

will not be disclosed in identifiable form to anyone other than employees or agents. By law, every employee of

the National Center for Health Statistics, the National Center for Immunization and Respiratory Diseases, and its

agent, the National Opinion Research Center who works on this survey has taken an oath and is subject to a jail

term of up to 5 years, a fine of up to $250,000, or both, if he or she willingly discloses ANY identifiable

information about you or your household members.

(1) CONTINUE, RECORDING ACCEPTABLE

(2) CONTINUE, DO NOT RECORD

<CHECKPOINT CPS1:

IF C10Q04=1 (International Adoption), GO TO S1_N; ELSE GO TO CPS3>

S1_N From what country was [S.C.] adopted?

DROP DOWN LIST FROM STATE DEPARTMENT

BRAZIL

CHINA (MAINLAND)

COLOMBIA

ETHIOPIA

GUATEMALA

HAITI

INDIA

JAMAICA

KAZAKHSTAN

LIBERIA

MEXICO

MOLDOVA

NEPAL

NIGERIA

PHILLIPINES
Page 32 [ Series 1, No. 51

POLAND 

RUSSIA 

SOUTH KOREA 

TAIWAN 

THAILAND 

UKRAINE 

OTHER <GO TO S1AA> 

(6) DON’T KNOW

(7) REFUSED 

<IF OTHER IS NOT SELECTED, GO TO S1B> 

S1AA	 ________________

(6) DON’T KNOW

(7) REFUSED

S1B	 In what country was [S.C.]’s adoption completed? Was it in the U.S., the child’s country of origin, or both?

(1) IN THE UNITED STATES

(2) THE CHILD’S COUNTRY OF ORIGIN

(3) BOTH THE U.S. AND THE COUNTRY OF ORIGIN

(4) ADOPTION IS NOT FINALIZED YET

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPS3:

IF (S10Q02=04 OR 08 AND S10Q00=04 OR 08) OR IF ((S10Q00 does not = 04 or 08) and (S10Q02 = 04 AND

S10Q02 =08)), GO TO S3_A; ELSE Go To CPS4

S3_A	 When we spoke to you for the previous survey, you and [S.C.]’s other adoptive parent lived in the same house. Is

this still correct?

(1) YES

(0) NO	 <SET S3_N TO 4 AND GO TO CPS4>

(6) DON’T KNOW <SET S3_N TO 4 AND GO TO CPS4>

(7) REFUSED <SET S3_N TO 4 AND GO TO CPS4>

S3_N	 What is your relationship to [S.C.]’s other adoptive parent who lives in this household?

(1) SPOUSE/HUSBAND/WIFE

(2) PARTNER/BOYFRIEND/GIRLFRIEND

(3) OTHER

(4) THERE IS NO OTHER ADOPTIVE PARENT IN THIS HOUSEHOLD

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPS4:

Ask S4_N if there are two adoptive parents in the household. Specifically: IF (S10Q02 = 04 OR 08) AND

(S10Q00 = 04 OR 08) GO TO S4_N; OR IF ((S10Q00 does not = 04 or 08) and (S10Q02 = 04 AND S10Q02 =

08)) GO TO S4_N; ELSE GO TO S6>

S4_N	 Were you married to [S.C.]’s other adoptive parent at the time of [S.C.]’s adoption?

(1) YES <IF S3_N=1 GO TO S6; ELSE GO TO S4A>

(0) NO <GO to S6>

(6) DON’T KNOW <GO TO S6>

(7) REFUSED <GO TO S6>

S4A	 Are you still married to this person?

(1) YES <GO TO S6>

(0) NO

(6) DON’T KNOW

(7) REFUSED
S6 Before you [TEXTFILL: and your spouse/partner] adopted [S.C.], were you [TEXTFILL: or your spouse/partner]

already related to him/her? For example, were you [TEXTFILL: or your spouse/partner] [S.C.]’s grandparent,

aunt/uncle, or other relative?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

S7 Did you [TEXTFILL: or your spouse/partner] know [S.C.] before [TEXTFILL: if S6=1: you considered adopting

[him/her]; if S6 ne 1: being matched with [him/her] for adoption]?

(1) YES <If ADOPT_TYPE = International or Private GO TO C41>

(0) NO <If ADOPT_TYPE = International or Private GO TO C41>

(6) DON’T KNOW <If ADOPT_TYPE = International or Private GO TO C41>

(7) REFUSED <If ADOPT_TYPE = International or Private GO TO C41>

S8 Were you [TEXTFILL: or your spouse/partner] [S.C.]’s foster parent at the time you began the adoption process?

(1) YES

(0) NO <GO TO S9>

(6) DON’T KNOW <GO TO S9>

(7) REFUSED <GO TO S9>

S8A Are you currently a licensed foster parent?

(1) YES <GO TO CPS10>

(0) NO <GO TO CPS10>

(6) DON’T KNOW <GO TO CPS10>

(7) REFUSED <GO TO CPS10>

S8B In the past three months have you cared for foster children in your home?

(1) YES <GO TO CPS10>

(0) NO <GO TO CPS10>

(6) DON’T KNOW <GO TO CPS10>

(7) REFUSED <GO TO CPS10>

S9 At any time before the adoption was finalized, were you [TEXTFILL: or your spouse/partner] [S.C.]’s foster

parent?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPS10:

IF S8= 1 OR S9= 1 GO TO S10; ELSE GO TO S14A>

S10 Did you [TEXTFILL: or your spouse/partner] become a foster parent with the intent to adopt a child from the

foster care system?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

S11 How long was [S.C.] living in your home before his/her case goal became adoption?

READ IF NECESSARY: How long was (child) living in your home before you decided you wanted to adopt

[him/her] from the foster care system?

S11_Y __ Years

S11_M __Months

Series 1, No. 51 [ Page 33
Page 34 [ Series 1, No. 51

(6) DON’T KNOW

(7) REFUSED

INTERVIEWER INSTRUCTION: ENTER 0 IF GOAL WAS ALWAYS ADOPTION

S12 Did you [TEXTFILL: or your spouse/partner] feel pressured by the child welfare agency to adopt [S.C.]?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

S13 When you [TEXTFILL: and your spouse/partner] were making your decision to adopt [S.C.] were other options

such as [TEXTFILL: IF S8=1: continuing as/ELSE: becoming] (his/her) foster parent or becoming (his/her) legal

guardian discussed with you?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

S14A. Were any of the following agencies involved in the adoption of [S.C.]: 

Public child welfare agency, that is, the state or county department of social services? 

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

S14B. Private agency under contract with public child welfare agency (for example, Catholic Charities, Lutheran Social

Services)?

<READ IF NECESSARY: Were any of the following agencies involved in the adoption of [S.C.]>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

S15. Was S.C.’s adoption an interstate adoption?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED 

<HELP SCREEN: PRIOR TO [S.C.] coming to live with you, did you and [S.C.] live in different states?> 
Series 1, No. 51 [ Page 35

CHARACTERISTICS

TIMESTAMP_SECTION_C1

C41.	 Now I would like to ask you a few questions about [S.C.] and the experience of adopting (him/her). Overall, was

your [TEXTFILL: and your spouse’s/partner’s] experience with your adoption agency or attorney very positive,

positive, mixed (positives and negatives about equal), negative, or very negative?

(1) VERY POSITIVE

(2) POSITIVE

(3) MIXED

(4) NEGATIVE

(5) VERY NEGATIVE

(6) THERE WAS NO ATTORNEY OR AGENCY

(96) DON’T KNOW

(97) REFUSED

C1A.	 How old was [S.C.] when his/her adoption was finalized?

<AGE CHECK: C1A MUST BE <OR = AGEYRNSAP>

[TI INSTRUCTION: ENTER 6 FOR DON’T KNOW AND 7 FOR REFUSED]

C1A_year: ___ years and

C1A_month: ___ months

[TI INSTRUCTION: IF LESS THAN ONE YEAR OLD, ENTER ‘‘0’’ FOR YEARS]

[TI INSTRUCTION: IF LESS THAN ONE MONTH OLD, ENTER ‘‘0’’ FOR MONTHS]

OR

C1A_week: ___ weeks [RANGE: 0–52]

(6) DON’T KNOW

(7) REFUSED

C1B.	 How old was [S.C.] when he/she was first placed in your home?

<AGE CHECK: C1B MUST BE < OR = AGEYRNSAP>

[TI INSTRUCTION: ENTER 77 FOR DON’T KNOW AND 99 FOR REFUSED]

C1B_year: ___ years and

C1B_month: ___ months 

[TI INSTRUCTION: IF LESS THAN ONE YEAR OLD, ENTER ‘‘0’’ FOR YEARS] 

[TI INSTRUCTION: IF LESS THAN ONE MONTH OLD, ENTER ‘‘0’’ FOR MONTHS] 

OR

C1B_week: ___ weeks [RANGE: 0–52]

(6) DON’T KNOW

(7) REFUSED

C1C. Has [S.C.] ever lived with his/her birth family?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C2_N. Just before being placed with you, where did [S.C.] live?

[TI INSTRUCTION: SELECT ONLY ONE.]

(1) A FOSTER FAMILY <GO TO C4_N>

(2) ANOTHER ADOPTIVE FAMILY <GO TO C4_N>

(3) BIRTH PARENTS <GO TO C4_N>
Page 36 [ Series 1, No. 51

(4) WITH MEMBERS OF HIS/HER BIRTH FAMILY 

OTHER THAN PARENTS <GO TO C4_N> 

(5) A GROUP HOME IN THE U.S. FOSTER CARE SYSTEM, 

THAT IS, A HOME WITH 4 FOSTER CHILDREN OR MORE <GO TO C4_N> 

(6) A RESIDENTIAL TREATMENT FACILITY IN THE U.S., 

THAT IS, A FACILITY WHERE LARGE NUMBERS OF 

CHILDREN AND YOUTH LIVE <GO TO C4_N> 

(7) AN INSTITUTION OR ORPHANAGE <GO TO C4_N> 

(8) A HOSPITAL OR HEALTH CLINIC <GO TO C4_N> 

(9) SOMEPLACE ELSE NOT MENTIONED <GO TO C4_N> 

(10) ADOPTED AT BIRTH <GO TO C4_N> 

(96) DON’T KNOW <GO TO C4_N> 

(97) REFUSED <GO TO C4_N> 

<HELP SCREEN: A HOSPITAL OR HEALTH CLINIC WOULD BE AN EXTENDED HOSPITAL OR

CLINIC STAY, NOT JUST THE COUPLE DAYS STAY WHILE MOTHER GAVE BIRTH.>

C2A. (specify) _________________________________

(6) DON’T KNOW

(7) REFUSED

C4_N. To your knowledge, does [S.C.] have birth siblings, that is, brothers or sisters of [S.C.], including half siblings?

(1) YES

(0) NO <GO TO C8_N>

(6) DON’T KNOW <GO TO C8_N>

(7) REFUSED <GO TO C8_N>

C5_N. Have any of [S.C.]’s birth siblings including half siblings ever been available for adoption?

(1) YES

(0) NO <GO TO C8_N>

(6) DON’T KNOW <GO TO C8_N>

(7) REFUSED <GO TO C8_N>

C6_N. Were you [TEXTFILL: or your spouse/parent] interested in adopting any of [S.C.]’s birth siblings?

(1) YES

(0) NO <GO TO C8_N>

(6) DON’T KNOW <GO TO C8_N>

(7) REFUSED <GO TO C8_N>

C7_N. Have you adopted any of [S.C.]’s birth siblings?

(1) YES

(0) NO

(3) NOT YET, BUT PLANNING TO OR IN THE PROCESS OF ADOPTING

(6) DON’T KNOW

(7) REFUSED

C8_N. Do you [TEXTFILL: or your spouse/partner] have biological children?

(1) YES

(0) NO <GO TO C9_N>

(6) DON’T KNOW <GO TO C9_N>

(7) REFUSED <GO TO C9_N>

C8A. How many? __________

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 37

C8B.	 TEXTFILL: IF C8A=1: Was this child/IF C8A>1: Were any of these children) born before S.C.’s adoption?

(1) YES <IF C8A=1, GO TO C9_N; ELSE GO TO C8C>

(0) NO <GO TO C9_N>

(6) DON’T KNOW <GO TO C9_N>

(7) REFUSED <GO TO C9_N>

C8C.	 How many? __________

(6) DON’T KNOW

(7) REFUSED

C9_N.	 Do you [TEXTFILL: or your spouse/partner] have adopted children other than [S.C.] [TEXTFILL IF C7_N=1: and

[S.C.]’s birth siblings]?

(1) YES

(0) NO <GO TO C12_INTRO>

(6) DON’T KNOW <GO TO C12_INTRO>

(7) REFUSED <GO TO C12_INTRO>

C9A.	 How many? __________

(6) DON’T KNOW

(7) REFUSED

C9B.	 [TEXTFILL: IF C9A=1: Was this child / IF C9A>1: Were any of these children] adopted before [S.C.]?

(1) YES <IF C9A=1, GO TO C10_N; ELSE GO TO C9C>

(2) NO <GO TO C9_D>

(6) DON’T KNOW <GO TO C9_D>

(7) REFUSED <GO TO C9_D>

C9C.	 How many? ________ 

<IF C9A=C9C, GO TO C10_N; If C9CA ne C9C, go to C9D> 

(6) DON’T KNOW <GO TO C10_N>

(7) REFUSED <GO TO C10_N>

C9D.	 [TEXTFILL: IF C9A=1: Was this child / IF C9a>1: Were any of these children] adopted at the same time as S.C.?

(1) YES	 <IF C9A=1 or C9A – C9C =1, GO TO C10_N; ELSE GO TO C9E>

(0) NO <GO TO C10_N>

(6) DON’T KNOW <GO TO C10_N>

(7) REFUSED <GO TO C10_N>

C9E.	 How many? ________

(6) DON’T KNOW

(7) REFUSED

C10_N.	 Did you [TEXTFILL: or your spouse/partner] adopt the other child or children through the United State foster care

system, through a private adoption in the United States, or through an international adoption? [SELECT ALL

THAT APPLY]

(1) UNITED STATES FOSTER CARE SYSTEM

(2) PRIVATE ADOPTION IN THE U.S.

(3) INTERNATIONAL ADOPTION

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC11: IF (C10Q04 = 1 (INTERNATIONAL ADOPTION) and C10_N = 3 (INTERNATIONAL ADOPTION):

GO TO C11_N; ELSE GO TO C12_INTRO>
Page 38 [ Series 1, No. 51

C11_N. Were the other children adopted from the same country as S.C.?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

C12_INTRO. There are many reasons why people decide to adopt a child. I am going to read a list of possible reasons why

people sometimes choose to adopt. For each reason, please tell me whether or not this was one of the reasons why

you [TEXTFILL: or your spouse/partner] chose adoption.

C12A. [TEXTFILL: My spouse/partner and I were/ I was] unable to have a biological child.

<READ IF NECESSARY: Please tell me whether or not this was one of the reasons that you [TEXTFILL: or your

spouse/partner] had for adopting [S.C.]>

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

C12B. [TEXTFILL: My spouse/partner and I / I] wanted to expand [TEXTFILL: S3_N=1 OR 2 ‘‘our’’/ S3_N=3,4,6,7

‘‘my’’] family.

<READ IF NECESSARY: Please tell me whether or not this was one of the reasons that you [TEXTFILL: or your

spouse/partner] had for adopting [S.C.]>

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<CHECKPOINT CPC12C: IF C7_N = 1 OR C8B = 1 OR C9B = 1 OR C9D =1, THEN ASK C12C. ELSE GO TO CPC12E>

C12C. [TEXTFILL: My spouse/partner and I / I] wanted a sibling for another child.

<READ IF NECESSARY: Please tell me whether or not this was one of the reasons that you [TEXTFILL: or your

spouse/partner] had for adopting [S.C.]>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC12E: IF C7_N = 1, THEN ASK C12E. ELSE GO TO CPC12F>

C12E. [TEXTFILL: I/we] already adopted S.C.’s sibling.

<READ IF NECESSARY: Please tell me whether or not this was one of the reasons that you [TEXTFILL: or your

spouse/partner] had for adopting [S.C.]>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C12F. [TEXTFILL: My spouse/partner and I / I] wanted to adopt a child in need of a permanent family

<READ IF NECESSARY: Please tell me whether or not this was one of the reasons that you [TEXTFILL: or your

spouse/partner] had for adopting [S.C.]>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 39

C12G. Was there another reason that I did not mention?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO C13_N>

<GO TO C13_N>

<GO TO C13_N>

C12GA. What was the other reason? (specify) ________________

(6)

(7)

DON’T KNOW

REFUSED

C13_N. Do any of your [TEXTFILL: or your spouse’s/partner’s] relatives have adopted children?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO C14>

<GO TO C14>

<GO TO C14>

C13A. Did any of your [TEXTFILL: or your spouse’s/partner’s] relatives adopt in the same manner as you did – that is,

were any of these children adopted through [TEXTFILL: IF C10Q05=1 a foster care/ ELSE IF C10Q04=1 an

international/ IF C10Q05=NO/DON’T KNOW/REFUSED a private] adoption?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

C14. Do any of your [TEXTFILL: or your spouse’s/partner’s] friends or close acquaintances have adopted children?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO C15_N>

<GO TO C15_N>

<GO TO C15_N>

C14A. Did any of your [TEXTFILL: or your spouse’s/partner’s] friends or acquaintances adopt in the same manner as

you did – that is, were any of these children adopted through a/an [TEXTFILL: foster care/international/private]

adoption?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

C15_N. Were you adopted as a child?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<IF S3_N=1 OR 2: GO TO C15b; ELSE GO TO C16_N>

<IF S3_N=1 OR 2: GO TO C15b; ELSE GO TO C16_N>

<IF S3_N=1 OR 2: GO TO C15b; ELSE GO TO C16_N>

C15A. How old were you when you were adopted?

[TI INSTRUCTION: ENTER 6 FOR DON’T KNOW AND 7 FOR REFUSED]

C15A_year: ___ years and

C15A_month: ___ months

[TI INSTRUCTION: IF LESS THAN ONE YEAR OLD, ENTER ‘‘0’’ FOR YEARS]

[TI INSTRUCTION: IF LESS THAN ONE MONTH OLD, ENTER ‘‘0’’ FOR MONTHS]

OR

C15A_week: ___ weeks [RANGE: 0–52]
Page 40 [ Series 1, No. 51

(6) DON’T KNOW <IF S3_N=1 OR 2: GO TO C15B; ELSE GO TO C16_N>

(7) REFUSED <IF S3_N=1 OR 2: GO TO C15B; ELSE GO TO C16_N>

C15B. Was your spouse/partner adopted as a child?

(1) YES

(0) NO <GO TO C16_N>

(6) DON’T KNOW <GO TO C16_N>

(7) REFUSED <GO TO C16_N>

C15C. How old was your spouse/partner when he/she was adopted?

C15C_year: ___ years and

C15C_month: ___ months

[IF LESS THAN ONE YEAR OLD, ENTER ‘‘0’’ FOR YEARS]

OR

C15C_week: ___ weeks

(6) DON’T KNOW

(7) REFUSED

C16_N. Do you [TEXTFILL: or your spouse/partner] have siblings who were adopted?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C17_N. Compared to yourself, is [S.C.] a different race or ethnicity or from a different culture?

(1) YES <IF S3_N=2 OR 1: GO TO C17A; ELSE GO TO C18A>

(0) NO <IF S3_N=2 OR 1: GO TO C17A; ELSE GO TO C21A>

(6) DON’T KNOW <IF S3_N=2 OR 1: GO TO C17A; ELSE GO TO C21A>

(7) REFUSED <IF S3_N=2 OR 1: GO TO C17A; ELSE GO TO C21A>

C17A. Is [S.C.] a different race or ethnicity or from a different culture than your spouse/partner?

(1) YES

(0) NO <IF C17_N=1 GO TO C18A; ELSE GO TO C21A>

(6) DON’T KNOW <IF C17_N=1 GO TO C18A; ELSE GO TO C21A>

(7) REFUSED <IF C17_N=1 GO TO C18A; ELSE GO TO C21A>

C18A. Since the time of the adoption, has your family done any of the following:

Lived in or moved to a racially or culturally diverse neighborhood

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18B. Lived or moved where [S.C.] can attend schools that are racially or culturally diverse?

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18C. Were involved in religious, social, tribal or recreational groups or activities that reflect [TEXTFILL: his/her] race

or ethnicity or culture

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following>

(1) YES
Series 1, No. 51 [ Page 41

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18D. Chosen multiracial or multicultural entertainment such as movies or plays that reflect [TEXTFILL: his/her] race or

ethnicity or culture

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following>

(1) YES

(2) NO

(6) DON’T KNOW

(7) REFUSED

C18E Chosen child care providers, teachers or other role models similar to [TEXTFILL: his/her] race or ethnicity

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18F Participated in racial/ethnic holidays that reflect [TEXTFILL: his/her]

race or ethnicity or culture

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18G Have friends who share [TEXTFILL: his/her] racial or ethnic or cultural background 

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following> 

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18H Prepared foods associated with [TEXTFILL: his/her] racial or ethnic or cultural background 

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following> 

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C18I Read books to your child about [TEXTFILL: his/her] racial or ethnic or cultural group or heritage

<READ IF NECESSARY: Since the time of the adoption, has your family done any of the following>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C19_N Would you [TEXTFILL: or your spouse/partner] encourage others to adopt transracially or transculturally?

(1) YES <GO TO C21A>

(0) NO <GO TO C20>

(6) DON’T KNOW <GO TO C20>

(7) REFUSED <GO TO C21A>
Page 42 [ Series 1, No. 51

C20 Why not? _________

(6) DON’T KNOW

(7) REFUSED

C21A	 At the time you began thinking about adopting a child which of the following types of adoption did you consider..

adoption from U.S. foster care

(1) YES

(2) NO

(6) DON’T KNOW

(7) REFUSED

C21B	 international adoption

<READ IF NECESSARY: At the time you began thinking about adopting a child which of the following types of

adoption did you consider..>

(1) YES

(2) NO

(6) DON’T KNOW

(7) REFUSED

C21C.	 private U.S. adoption

<READ IF NECESSARY: At the time you began thinking about adopting a child which of the following types of

adoption did you consider..>

(1) YES

(2) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC22:

IF C10Q05=NO, DON’T KNOW OR REFUSED and S6 does not = 1 and S7 does not = 1, GO TO C22; 

IF C10Q04=1 and S6 does not = 1 and S7 does not = 1, GO TO C23A_N; 

IF C10Q05=1 and S6 does not = 1 and S7 does not = 1, GO TO C24A; 

ELSE (i.e. Relative Adoptions) GO TO C36_INTRO> 

C22A.	 Earlier you indicated that you adopted [S.C.] through a domestic private adoption. I am going to read a list of

reasons to you for choosing this type of adoption. For each reason that I read to you please tell me whether or not

this was one of your [TEXTFILL: or your spouse’s/partner’s] reasons for choosing a domestic private adoption.

Thought [TEXTFILL: I/We] would get a child sooner

(READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic adoption )

(1) YES

(0) NO <GO TO C22B>

(6) DON’T KNOW <GO TO C22B>

(7) REFUSED <GO TO C22B>

C22AA	 Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22B	 (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Didn’t think [TEXTFILL: I/We] would qualify to adopt a child internationally.
Series 1, No. 51 [ Page 43

(1) YES

(0) NO <GO TO C22C>

(6) DON’T KNOW <GO TO C22C>

(7) REFUSED <GO TO C22C>

C22BA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22C (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Adoption workers or lawyer discouraged [TEXTFILL: me/us] from trying to adopt a child from the foster care

system.

(1) YES

(0) NO <GO TO C22D>

(6) DON’T KNOW <GO TO C22D>

(7) REFUSED <GO TO C22D>

C22CA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22D (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Wanted an infant.

(1) YES

(0) NO <GO TO C22E>

(6) DON’T KNOW <GO TO C22E>

(7) REFUSED <GO TO C22E>

C22DA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22E (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Wanted a healthy child

(1) YES

(0) NO <GO TO C22F>

(6) DON’T KNOW <GO TO C22F>

(7) REFUSED <GO TO C22F>

C22EA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED
Page 44 [ Series 1, No. 51

C22F (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Wanted a child the same race/ethnicity as our family

(1) YES

(0) NO <GO TO C22G>

(6) DON’T KNOW <GO TO C22G>

(7) REFUSED <GO TO C22G>

C22FA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22G (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Wanted a closed adoption, that is, no information exchange or contact with child’s birth family

(1) YES

(0) NO <GO TO C22H>

(6) DON’T KNOW <GO TO C22H>

(7) REFUSED <GO TO C22H>

C22GA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22H (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Previously adopted another child through a private, domestic adoption

(1) YES

(0) NO <GO TO C22I>

(6) DON’T KNOW <GO TO C22I>

(7) REFUSED <GO TO C22I>

C22HA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C22I (READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a domestic private adoption )

Did you have another reason for choosing a private, domestic adoption that I did not mention?

(1) YES

(0) NO <IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(6) DON’T KNOW <IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(7) REFUSED <IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

C22IA What was this reason that I did not mention? ____________
C22IAA Was this a very important reason, somewhat important reason, or not an important reason?

(1)	 VERY IMPORTANT REASON

<If S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(2)	 SOMEWHAT IMPORTANT

<If S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(3)	 NOT IMPORTANT

<If S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(6)	 DON’T KNOW

<If S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(7)	 REFUSED

<If S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

C23A_N. Earlier you indicated that you adopted [S.C.] through an international adoption. I am going to read a list of

reasons to you for choosing this type of adoption. For each reason that I read to you please tell me whether or not

this was one of your [TEXTFILL: or your spouse’s/partner’s] reasons for choosing an international adoption.

Interest in a particular culture

(1) YES

(0) NO <GO TO C23B>

(6) DON’T KNOW <GO TO C23B>

(7) REFUSED <GO TO C23B>

C23AA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23B Adoption workers or lawyer encouraged [TEXTFILL: IF (S3_N=3,4,6,7 ‘‘me’’ / IF S3_N= 1 OR 2 ‘‘us’’] to adopt

internationally

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23C>

(6) DON’T KNOW <GO TO C23C>

(7) REFUSED <GO TO C23C>

C23BA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23C Adoption workers or lawyer discouraged [TEXTFILL: me/us] from trying to adopt a child from the U.S.

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reason for choosing an international adoption>

(1) YES

(0) NO <GO TO C23D>

(6) DON’T KNOW <GO TO C23D>

(7) REFUSED <GO TO C23D>

C23CA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

Series 1, No. 51 [ Page 45
Page 46 [ Series 1, No. 51

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23D Wanted an infant

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23E>

(6) DON’T KNOW <GO TO C23E>

(7) REFUSED <GO TO C23E>

C23DA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23E Wanted a closed adoption, that is, no information exchange or contact with child’s birth family

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23F>

(6) DON’T KNOW <GO TO C23F>

(7) REFUSED <GO TO C23F>

C23EA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23F Thought it would be too difficult to adopt a child from the U.S.

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23G>

(6) DON’T KNOW <GO TO C23G>

(7) REFUSED <GO TO C23G>

C23FA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23G Didn’t think I would qualify to adopt a child from the U.S.

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23H>

(6) DON’T KNOW <GO TO C23H>

(7) REFUSED <GO TO C23H>
Series 1, No. 51 [ Page 47

C23GA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23H Thought I/we would get a child sooner

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23I>

(6) DON’T KNOW <GO TO C23I>

(7) REFUSED <GO TO C23I>

C23HA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23I Not interested in the children available for adoption in the U.S.

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23K>

(6) DON’T KNOW <GO TO C23K>

(7) REFUSED <GO TO C23K>

C23IA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

C23IAA. Why did you think that children available for adoption in the U.S. would not be the best option for you?

__________________________

(6) DON’T KNOW

(7) REFUSED

C23K. Previously adopted another child internationally

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing an international adoption>

(1) YES

(0) NO <GO TO C23L>

(6) DON’T KNOW <GO TO C23L>

(7) REFUSED <GO TO C23L>

C23KA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON

(2) SOMEWHAT IMPORTANT REASON

(3) NOT IMPORTANT
Page 48 [ Series 1, No. 51

C23L

C23LA

C23LB

C24A

C24AA

C24B

C24BA

(6)	 DON’T KNOW

(7)	 REFUSED

Did you have another reason for choosing an international adoption that I did not mention?

(1)	 YES

(0)	 NO <IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(6)	 DON’T KNOW <IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(7)	 REFUSED <IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

What was this reason that I did not mention? ____________

Was this a very important reason, somewhat important reason, or not an

important reason?

(1)	 VERY IMPORTANT REASON

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(2)	 SOMEWHAT IMPORTANT REASON

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(3)	 NOT IMPORTANT

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(6)	 DON’T KNOW

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(7)	 REFUSED

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

Earlier you indicated that you adopted [S.C.] through a foster care adoption. I am going to read a list of reasons to

you for choosing this type of adoption. For each reason that I read to you please tell me whether or not this was

one of your [TEXTFILL: or your spouse’s/partner’s] reasons for choosing a foster care adoption.

Thought [TEXTFILL: I/We] would get a child sooner

(1)	 YES

(0)	 NO <GO TO C24B>

(6)	 DON’T KNOW <GO TO C24B>

(7)	 REFUSED <GO TO C24B>

Was this a very important reason, somewhat important reason, or not an important reason?

(1)	 VERY IMPORTANT REASON

(2)	 SOMEWHAT IMPORTANT REASON

(3)	 NOT IMPORTANT

(6)	 DON’T KNOW

(7)	 REFUSED

(READ IF NECESSARY: Please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a foster care adoption )

Adopting from U.S. foster care was less costly than adopting internationally or privately

(1)	 YES

(0)	 NO <GO TO C24C>

(6)	 DON’T KNOW <GO TO C24C>

(7)	 REFUSED <GO TO C24C>

Was this a very important reason, somewhat important reason, or not an important reason?

(1)	 VERY IMPORTANT REASON

(2)	 SOMEWHAT IMPORTANT REASON

(3)	 NOT IMPORTANT

(6)	 DON’T KNOW

(7)	 REFUSED
Series 1, No. 51 [ Page 49

C24C Wanted an older child

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a foster care adoption>

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO C24D>

<GO TO C24D>

<GO TO C24D>

C24CA Was this a very important reason, somewhat important reason, or not an important reason?

(1)

(2)

(3)

(6)

(7)

VERY IMPORTANT REASON

SOMEWHAT IMPORTANT REASON

NOT IMPORTANT

DON’T KNOW

REFUSED

C24D Wanted a child with special needs

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a foster care adoption>

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO C24E>

<GO TO C24E>

<GO TO C24E>

C24DA Was this a very important reason, somewhat important reason, or not an important reason?

(1)

(2)

(3)

(6)

(7)

VERY IMPORTANT REASON

SOMEWHAT IMPORTANT REASON

NOT IMPORTANT

DON’T KNOW

REFUSED

C24E Previously adopted another child through the foster care system

<READ IF NECESSARY: please tell me whether or not this was one of your [TEXTFILL: or your spouse’s/

partner’s] reasons for choosing a foster care adoption>

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO C24F>

<GO TO C24F>

<GO TO C24F>

C24EA Was this a very important reason, somewhat important reason, or not an important reason?

(1)

(2)

(3)

(6)

(7)

VERY IMPORTANT REASON

SOMEWHAT IMPORTANT REASON

NOT IMPORTANT

DON’T KNOW

REFUSED

C24F Did you have another reason for choosing to adopt a child from foster care that I did not mention?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

C24FA What was this reason that I did not mention? ____________

C24FAA Was this a very important reason, somewhat important reason, or not an important reason?

(1) VERY IMPORTANT REASON
Page 50 [ Series 1, No. 51

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(2)	 SOMEWHAT IMPORTANT REASON

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(3)	 NOT IMPORTANT

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(6)	 DON’T KNOW

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

(7)	 REFUSED

<IF S6 ne 1, GO TO C25, ELSE go to C36_INTRO>

C25 At the time of the adoption, did the adoption agency or attorney offer any options for an open adoption?

<HELP SCREEN: By open adoption, we mean sharing written information such as letters or email, or in-person

visits between you [TEXTFILL: or your spouse/partner] and the birth family or between your child the the birth

family?>

(1)	 YES <If C10Q04=1, GO TO C25A; ELSE GO TO C26>

(0)	 NO <If C10Q04=1, GO TO C25A; ELSE GO TO C26>

(6)	 DON’T KNOW <If C10Q04=1, GO TO C25A; ELSE GO TO C26>

(7)	 REFUSED <If C10Q04=1, GO TO C25A; ELSE GO TO C26>

C25A Were you [TEXTFILL: or your spouse/partner] required to provide post-adoption reports to the child’s country of

origin?

<HELP SCREEN: These could be reports to either the government or to any other organization in the country of

origin.>

(1)	 YES

(0)	 NO <GO TO C26>

(6)	 DON’T KNOW <GO TO C26>

(7)	 REFUSED <GO TO C26>

C25AA How many post-adoption reports were filed?

___

(6)	 DON’T KNOW

(7)	 REFUSED

C25AB. Will you [TEXTFILL: or your spouse/partner] be providing post-adoption reports in the future?

(1)	 YES

(0)	 NO

(6)	 DON’T KNOW

(7)	 REFUSED

C26 Was there any kind of pre-adoption agreement in which you agreed to provide information about [S.C.] to one or

both of his/her birth parents or other birth family members?

(1)	 YES

(0)	 NO <GO TO C28>

(6)	 DON’T KNOW <GO TO C28>

(7)	 REFUSED <GO TO C28>

C26A Was this agreement written or verbal?

(1)	 WRITTEN

(2)	 VERBAL

(3)	 BOTH

(6)	 DON’T KNOW

(7)	 REFUSED

C27 Was information ever provided?

(1)	 YES

(0)	 NO
C28

C28A

C28B

C29

C29A

Series 1, No. 51 [ Page 51

<CHECKPOINT CPC29: If C4_N = NO, DON’T KNOW, or REFUSED GO TO C30/ ELSE go to C29>

(6) DON’T KNOW

(7) REFUSED

Since the time of [S.C.]’s adoption, have you, [TEXTFILL: SPOUSE OR PARTNER], or [S.C.] ever had contact

with his/her birth family members?

[INTERVIEWER INSTRUCTION: DEFINITION OF CONTACT SHOULD BE: LETTERS, EMAILS,

TELEPHONE CALLS OR IN-PERSON VISITS]:

(1) YES

(2) NO <GO TO C36_INTRO>

(6) DON’T KNOW <GO TO C36_INTRO>

(7) REFUSED <GO TO C36_INTRO>

Since the time of [S.C.]’s adoption, how often has [S.C.] had contact with his/her

Birthparent(s)

(1) NEVER <GO TO CPC29>

(2) ONCE A YEAR OR EVERY FEW YEARS

(3) A FEW TIMES A YEAR

(4) ABOUT EVERY MONTH OR MORE

(6) DON’T KNOW <GO TO CPC29>

(7) REFUSED <GO TO CPC29>

How comfortable are you [TEXTFILL: and your spouse/partner] with [S.C.] having contact with his/her birth

parents? Would you say very comfortable, somewhat comfortable, somewhat uncomfortable, or very

uncomfortable?

[INTERVIEWER INSTRUCTION: IF OPINIONS DIFFER BETWEEN RESPONDENT AND SPOUSE/

PARTNER, ASK FOR RESPONDENT’S OPINION]

(1) VERY COMFORTABLE

(2) SOMEWHAT COMFORTABLE

(3) SOMEWHAT UNCOMFORTABLE

(4) VERY UNCOMFORTABLE

(6) DON’T KNOW

(7) REFUSED

Since the time of S.C.’s adoption, how often has S.C. had contact with birth brothers or sisters who do not live in

your household

(1) NEVER <GO TO CPC30>

(2) ONCE A YEAR OR EVERY FEW YEARS

(3) A FEW TIMES A YEAR

(4) ABOUT EVERY MONTH OR MORE

(6) DON’T KNOW <GO TO CPC30>

(7) REFUSED <GO TO CPC30>

How comfortable are you [TEXTFILL: and your spouse/partner] with [S.C.] having contact with his/her birth

brothers or sisters who do not live in your household? Would you say very comfortable, somewhat comfortable,

somewhat uncomfortable, or very uncomfortable?

[INTERVIEWER INSTRUCTION: IF OPINIONS DIFFER BETWEEN RESPONDENT AND SPOUSE/

PARTNER, ASK FOR RESPONDENT’S OPINION]

(1) VERY COMFORTABLE

(2) SOMEWHAT COMFORTABLE

(3) SOMEWHAT UNCOMFORTABLE

(4) VERY UNCOMFORTABLE

(6) DON’T KNOW

(7) REFUSED
Page 52 [ Series 1, No. 51

C30	 Since the time of S.C.’s adoption, how often has S.C. had contact with other birth relatives such as birth

grandparents, birth aunts and uncles, etc...

(1) NEVER <GO TO CPC31>

(2) ONCE A YEAR OR EVERY FEW YEARS

(3) A FEW TIMES A YEAR

(4) ABOUT EVERY MONTH OR MORE

(6) DON’T KNOW <GO TO CPC31>

(7) REFUSED <GO TO CPC31>

C30A	 How comfortable are you [TEXTFILL: and your spouse/partner] with [S.C.] having contact with his/her other

birth relatives? Would you say very comfortable, somewhat comfortable, somewhat uncomfortable, or very

uncomfortable?

(1) VERY COMFORTABLE

(2) SOMEWHAT COMFORTABLE

(3) SOMEWHAT UNCOMFORTABLE

(4) VERY UNCOMFORTABLE

(6) DON’T KNOW

(7) REFUSED

C31	 These next questions are about any contact that you [or your spouse/partner] have had with [S.C.]’s birth family.

Since [S.C.]’s adoption was finalized, have you [or your spouse/partner] ever had planned contact with [S.C.]’s 

birth parents or other extended birth family? 

[INTERVIEWER DEFINITION OF CONTACT SHOULD BE: LETTERS, EMAILS, OR IN-PERSON VISITS] 

(1) YES

(0) NO <GO TO C36_INTRO>

(6) DON’T KNOW <GO TO C36_INTRO>

(7) REFUSED <GO TO C36_INTRO>

C32	 Was this contact with:

Birthparent(s)?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC33: If C4_N = NO, DON’T KNOW, or REFUSED then GO TO C34/ ELSE go to C33>

C33	 Brothers/sisters living elsewhere?

<READ IF NECESSARY: Was this contact with>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C34	 Other blood relatives (grandparents, aunts/uncles)?

<READ IF NECESSARY: Was this contact with>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C35	 Do you [TEXTFILL: or your spouse/partner] currently stay in contact with [S.C.]’s birth parents or other

extended birth family?

(1) YES
Series 1, No. 51 [ Page 53

(0) NO

(6) DON’T KNOW

(7) REFUSED

C36_INTRO These next questions are about information you may have received about [S.C.] before adopting [him/her].

C36 Prior to [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner]...

<CHECKPOINT CPC36A: IF ADOPT_TYPE not=FOSTER CARE go to C36B/ELSE Go to C36A>

C36A Receive or review the child’s case record

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

C36B Prior to [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner] Discuss the child’s past with an adoption

caseworker

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

C36C Discuss the child’s past with an adoption attorney

<READ IF NECESSARY: Prior to [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner]>

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<CHECKPOINT CPC36D: IF C1A<3 YEARS GO TO C36E

/ ELSE IF (C1A= 6 or 7) AND (AGEYRNSAP< 3), GO TO CPC36F

/ ELSE, go to C36D

C36D	 Receive or review a written psychological report

<READ IF NECESSARY: Prior to [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner]>

(1) YES <GO TO C36DA>

(0) NO <GO TO C36E>

(6) DON’T KNOW <GO TO C36E>

(7) REFUSED <GO TO C36E>

C36DA	 Did you [TEXTFILL: or your spouse/partner] consult with a professional of your

choosing regarding the contents of the psychological report?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C36E	 Receive or review information about [S.C.]’s medical history

<READ IF NECESSARY: Prior to [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner]>

(1) YES <GO TO C36EA>

(0) NO <GO TO C36>

(6) DON’T KNOW <GO TO C36>

(7) REFUSED <GO TO C36>
Page 54 [ Series 1, No. 51

C36EA	 Did you [or your spouse/partner] consult with a professional of your choosing regarding [S.C.]’s medical history?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC36F: IF C1A <5 YEARS, or IF (C1A= 6 or 7) AND (AGEYRNSAP< 5) , GO TO C38 / ELSE GO TO

C36F

C36F	 Receive or review records of [S.C.]’s school or educational history, such as grades or test scores

<READ IF NECESSARY: Prior to [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner]>

(1) YES <GO TO C36FA>

(0) NO <GO TO C38>

(6) DON’T KNOW <GO TO C38>

(7) REFUSED <GO TO C38>

C36FA	 Did you [TEXTFILL: or your spouse/partner] consult with a professional of your

choosing regarding [S.C.]’s school or educational records?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C38	 Do you believe that the agency knew important information about [S.C.] that they did not share with you

[TEXTFILL: or your spouse/partner] before [S.C.]’s adoption was finalized?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C3A	 These next questions are about problems your child may have experienced before being adopted by you. You may

not know the answers, but please answer to the best of your knowledge. We ask these questions to all parents.

Before [S.C.] first came to your home, how likely was it that he/she was...

Would you say very likely, likely, unlikely, or very unlikely?

CHILD

Very Very ADOPTED DON’T

likely Likely Unlikely unlikely AT BIRTH KNOW REFUSED

a. Physically abused 1 2 3 4 0 6 7

b. Sexually abused 1 2 3 4 0 6 7

c. Neglected 1 2 3 4 0 6 7

d. Exposed to drugs or alcohol before birth? 1 2 3 4 0 6 7

e. Emotionally abused 1 2 3 4 0 6 7

<CATI INSTRUCTIONS: FOR EACH SCREEN C3A-C3E, READ IF NECESSARY: Before [S.C.] first came to

your home, how likely was it that he/she was >

<HELP SCREEN: These questions may not apply to your child, but it is important that we ask these questions of

everyone.>

C42_INTRO	 The next few questions concern the child’s mental health and while these questions may sound similar to

previously asked questions, they ask about different conditions.

C44	 I am going to read you a list of conditions. For each condition, please tell me if a doctor or other health care

provider ever told you that [S.C.] had the condition, even if (he/she) does not have the condition now

Post-Traumatic Stress Disorder (PTSD)?

INTERVIEWER INSTRUCTION: IF THE RESPONDENT HAS NEVER HEARD OF THE MEDICAL

CONDITION OR DOES NOT KNOW WHAT THE CONDITION IS, THEN A DOCTOR OR OTHER HEALTH

CARE PROVIDER PROBABLY HAS NOT TOLD THE RESPONDENT THAT THE CHILD HAS THE

CONDITION.
Series 1, No. 51 [ Page 55

IF A DOCTOR OR OTHER HEALTH CARE PROVIDER HAS NOT TOLD THE RESPONDENT THAT THE

CHILD HAS THE CONDITION, BUT THE RESPONDENT INSISTS THAT THE CHILD HAS THE

CONDITION, WE STILL NEED TO CODE THE ANSWER AS ‘‘NO.’’

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C45	 Attachment disorder

<READ IF NECESSARY: Has a doctor or other health care provider ever told you that [S.C.] had the condition>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC46: IF AGEMONSAP < 24 MONTHS, SKIP TO CHECKPOINT CPC42

C46	 Oppositional Defiant Disorder (ODD)

<READ IF NECESSARY: Has a doctor or other health care provider ever told you that [S.C.] had the condition>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C47	 Conduct disorder

<READ IF NECESSARY: Has a doctor or other health care provider ever told you that [S.C.] had the condition>

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC42: If AGEMONSAP <36 months, skip to CPC53>

C42	 Mental health professionals include psychiatrists, psychologists, psychiatric nurses, and clinical social workers.

Since the time the adoption was finalized, has [S.C.] received any treatment or counseling from a mental health

professional?

(1) YES

(0) NO <GO TO CPC49>

(6) DON’T KNOW <GO TO CPC49>

(7) REFUSED <GO TO CPC49>

<CHECKPOINT CPC43: IF AGEMONSAP < 96 MONTHS, SKIP TO CPC53>

C43	 Since the time the adoption was finalized, has [S.C.] been placed in a psychiatric hospital, group home, or

residential treatment center?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC49: IF AGEYRNSAP <13 Years of age, GO TO C53_INTRO/ ELSE go to C49>
Page 56 [ Series 1, No. 51

C49	 Has [S.C.] ever had any alcohol or drug problems?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C50	 Has [S.C.] ever been arrested or in trouble with the police?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

C51	 Has [S.C.] ever (TEXTFILL: been pregnant /gotten someone pregnant)?

(1) YES

(0) NO <GO TO CPC53>

(6) DON’T KNOW <GO TO CPC53>

(7) REFUSED <GO TO CPC53>

C52	 Does [S.C.] have biological children of his/her own?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC53: IF AGEMONSAP < 12 MONTHS, Go to W1_INTRO/ ELSE Go TO C53_INTRO>

C53_INTRO	 The next few questions concern [S.C.]’s native language and education experiences.

C53	 What was the first language [S.C.] learned to speak?

Drop down list of languages

(1) ENGLISH <GO TO CPC55>

(2) CHINESE <GO TO CPC55>

(3) RUSSIAN <GO TO CPC55>

(4) SPANISH <GO TO CPC55>

(5) KOREAN <GO TO CPC55>

(6) UKRAINIAN <GO TO CPC55>

(7) OTHER <GO TO C53A>

(96) DON’T KNOW <GO TO CPC55>

(97) REFUSED <GO TO CPC55>

C53A SPECIFY ______________________

<CHECKPOINT CPC55: GO TO C55>

C55	 Does [S.C.] have any developmental problems for which (he/she) has a written intervention plan called an

[TEXTFILL:IF AGEMONSAP <36 MONTHS, INSERT: Individualized Family Services Plan or an IFSP?; IF

AGEMONSAP 36 MONTHS, INSERT: Individualized Education Program or IEP?]

HELP SCREEN (C55): Some young children have developmental delays or other problems for which they receive

services from a program called Early Intervention Services or Special Education. Children receiving these services

have a written intervention plan called an IFSP if the child is 3 or under, or an IEP if older than about 3 years.

Services on an IFSP or an IEP might include things such as special instruction; speech language therapy; vision

and hearing services; psychological services; health services; social work services; family counseling and support;

transportation; service coordination or other services needed to support the child’s development.

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 57

<CHECKPOINT CPC56: IF AGEYRNSAP IS <5 YEARS OF AGE, GO TO W1_INTRO; ELSE Go to C56>

C56. *NSAP	 Would you describe [S.C.]’s school performance in reading and language arts as excellent, very good, good,

fair or poor?

(1) EXCELLENT

(2) VERY GOOD

(3) GOOD

(4) FAIR

(5) POOR

(6) NOT IN SCHOOL <GO TO CPK7Q05>

(6) DON’T KNOW

(7) REFUSED

C56A. *NSAP	 Would you describe [S.C.]’s school performance in math as excellent, very good, good, fair or poor?

(1) EXCELLENT

(2) VERY GOOD

(3) GOOD

(4) FAIR

(5) POOR

(6) DON’T KNOW

(7) REFUSED

K7Q05	 Since starting kindergarten, has [he/she] repeated any grades?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPC57: Ask C57 and C58 only if AGEYRNSAP = OR > 10 years; ELSE GO TO W1_INTRO>

C57	 [TEXTFILL: IF (AGEYRNSAP - C1A) = 2 or more ‘‘During the past 12 months’’ / ELSE IF (AGEYRNSAP ­

C1A) = 1 or 0 ‘‘Since [S.C.]’s adoption was finalized’’ / ELSE IF C1A=6 or 7 ‘‘During the past 12 months.’’],

how many times has [S.C.] skipped school, cut classes without your permission, or refused to go to school?

Was it ...

(1) NEVER

(2) ONCE

(3) TWO OR MORE TIMES

(6) DON’T KNOW

(7) REFUSED

C58	 Including both in-school and out-of-school suspensions, [TEXTFILL: IF (AGEYRNSAP - C1A) = 2 or more

‘‘During the past 12 months’’ / ELSE IF (AGEYRNSAP - C1A) = 1 or 0 ‘‘Since [S.C.]’s adoption was finalized’’ /

ELSE IF C1A=6 or 7 ‘‘During the past 12 months.’’], has [S.C.] been suspended or expelled from school?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Page 58 [ Series 1, No. 51

PARENT AND CHILD WELL-BEING (W)

TIMESTAMP_SECTION_WB1

W1_INTRO	 The next series of questions are about how you, your child, and your family are doing. By family, we mean the

people in your family who live in your household.

K7Q70_INTRO I am going to read a list of items that sometimes describe children. For each item, please tell me how often this

was true for [S.C.] during the past month. Would you say never, rarely, sometimes, usually, or always?

QUESTION STEM: [Please tell me if this statement was never, rarely, sometimes, usually, or always true for

[S.C.] during the past month.]

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS

(6) DON’T KNOW

(7) REFUSED

[CATI: DISPLAY QUESTION STEM FOR EACH OF THE FOLLOWING SCREENS.]

K7Q70 [He/She] argues too much.

K7Q73 [He/She] gets along well with other children.

K7Q74 [He/She] is disobedient.

K7Q75 [He/She] is stubborn, sullen, or irritable.

K7Q76 [He/She] tries to understand other people’s feelings.

K7Q77 [He/She] tries to resolve conflicts with classmates, family, or friends.

K7Q79 [He/She] is unhappy, sad, or depressed.

W1 *NSAP How would you describe your relationship to [S.C.]? Would you say very warm and close, somewhat warm and

close, somewhat distant, or very distant?

<HELP SCREEN: Please describe your relationship as it exists now>

(1) VERY WARM AND CLOSE

(2) SOMEWHAT WARM AND CLOSE

(3) SOMEWHAT DISTANT

(4) VERY DISTANT

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW1A: IF(S3_N IS NOT 1 OR 2), SKIP W1A AND GO TO CPW2>

W1A How would you describe your [TEXTFILL: spouse’s/partner’s] relationship to [S.C.]? Would you say very warm

and close, somewhat warm and close, somewhat distant, or very distant? 

HELP SCREEN: Please describe their relationship as it exists now 

(1) VERY WARM AND CLOSE

(2) SOMEWHAT WARM AND CLOSE

(3) SOMEWHAT DISTANT

(4) VERY DISTANT

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW2: IF AGEMONSAP <6 months old, GO TO W7; ELSE GO TO W2>
Series 1, No. 51 [ Page 59

W2 *NSAP How often is [S.C.] affectionate or tender with you? Would you say never, rarely, sometimes, usually or always?

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS

(6) DON’T KNOW

(7) REFUSED

W3	 How satisfied are you with how affectionate or tender [S.C.] is with you? Would you say very satisfied, somewhat

satisfied, somewhat dissatisfied, or very dissatisfied?

(1) VERY SATISFIED

(2) SOMEWHAT SATISFIED

(3) SOMEWHAT DISSATISFIED

(4) VERY DISSATISFIED

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW4: IF AGEYRNSAP <13 YEARS OLD, GO TO CPW5/ ELSE Go to W4>

W4 *NSAP Do you feel that [S.C.] and you make decisions about (his/her) life together. Would you say never, rarely,

sometimes, usually or always?

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW5: IF AGEYRNSAP <5 YEAR OLDS, GO TO K8Q34/ ELSE go to W5>

W5 *NSAP During the past month, how often have you felt that you just did not understand (him/her). Would you say never,

rarely, sometimes, usually or always?

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS

(6) DON’T KNOW

(7) REFUSED

W6 *NSAP During the past month, how often have you felt that you can really trust (him/her). Would you say never, rarely,

sometimes, usually or always?

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS

(6) DON’T KNOW

(7) REFUSED

K8Q34	 During the past month, how often have you felt angry with [him/her]? [READ RESPONSES AS NECESSARY:

Would you say never, rarely, sometimes, usually, or always?]

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS
Page 60 [ Series 1, No. 51

(6) DON’T KNOW

(7) REFUSED

K8Q30	 CATI INSTRUCTION (K8Q30): IF C2Q04 = (1) Mother OR (2) Father FILL ‘‘parenthood’’. ELSE FILL

‘‘raising children’’.

In general, how well do you feel you are coping with the day to day demands of (parenthood/raising children)?

Would you say that you are coping very well, somewhat well, not very well, or not well at all?

(1) VERY WELL

(2) SOMEWHAT WELL

(3) NOT VERY WELL

(4) NOT WELL AT ALL

(6) DON’T KNOW

(7) REFUSED

W7	 Thinking about [S.C.]’s relationship with you, would you say things are better than you ever expected, about what

you expected, or more difficult than you ever expected?

(1) BETTER THAN YOU EVER EXPECTED

(2) ABOUT WHAT YOU EXPECTED

(3) MORE DIFFICULT THAN YOU EVER EXPECTED

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW8: IF (S3_N=1 OR 2) GO to W8/ ELSE Go to CPW9>

W8. Thinking about [S.C.]’s relationship with your [TEXTFILL: spouse/partner], would you say things are better than

you ever expected, about what you expected, or more difficult than you ever expected?

(1) BETTER THAN YOU EVER EXPECTED

(2) ABOUT WHAT YOU EXPECTED

(3) MORE DIFFICULT THAN YOU EVER EXPECTED

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW9: IF C8_N= NO/DON’T KNOW/REFUSED AND C9_N = NO/DON’T KNOW/REFUSED) OR 

AGEYRNSAP <1 YEAR GO TO W12 / ELSE GO TO W9_INTRO> 

W9_INTRO Now I would like to ask you to think about how [S.C.] gets along with other children in your family. 

W9 In general, how often does [S.C.] experience difficulty in getting along with other children in the household? 

Would you say never, rarely, sometimes, usually or always?

(1) NEVER

(2) RARELY

(3) SOMETIMES

(4) USUALLY

(5) ALWAYS

(6) DON’T KNOW

(7) REFUSED

[TI INSTRUCTION: BY ‘‘CHILDREN IN THE HOUSEHOLD’’ WE MEAN THOSE CHILDREN WHO LIVE

PERMANENTLY IN THIS HOUSEHOLD. DO NOT INCLUDE CHILDREN STAYING WITH THE

RESPONDENT TEMPORARILY.]

W12	 Overall, how has having [S.C.] in your life affected your family? By family, we mean your family who live in

your household. Would you say it has affected your family very positively, somewhat positively, somewhat

negatively, very negatively, or mixed?

(1) VERY POSITIVELY

(2) SOMEWHAT POSITIVELY

(3) MIXED

(4) SOMEWHAT NEGATIVELY
Series 1, No. 51 [ Page 61

(5) VERY NEGATIVELY

(6) DON’T KNOW

(7) REFUSED

W13 So far, how has having [S.C.] in your life compared with what you thought it would be like? Would you say it is

better than you expected, about what you expected, or more difficult than you expected?

(1) BETTER THAN YOU EVER EXPECTED

(2) ABOUT WHAT YOU EXPECTED

(3) MORE DIFFICULT THAN YOU EVER EXPECTED

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW14: IF AGEYRNSAP <5 YEARS Go to W15/ ELSE Go to W14>

W14 Overall, how do you think [S.C.] feels about being adopted? Would you say [S.C]... feels positive about it, feels

mostly positive about it, feels mostly negative about it, or feels negative about it?

(1) FEELS POSITIVE ABOUT IT

(2) FEELS MOSTLY POSITIVE ABOUT IT

(3) FEELS NEITHER POSITIVE NOR NEGATIVE ABOUT IT

(4) FEELS MOSTLY NEGATIVE ABOUT IT

(5) FEELS NEGATIVE ABOUT IT

(6) CHILD DOES NOT KNOW HE/SHE IS ADOPTED

(96) DON’T KNOW

(97) REFUSED

W15 If you [TEXTFILL: and your spouse/partner] knew everything about [S.C.] before the adoption that you now

know, how might that have affected your decision to accept him/her for adoption? Would you have....

Definitely accepted the child, probably accepted the child, probably not accepted the child, or definitely not

accepted the child.

(1) WOULD HAVE DEFINITELY ACCEPTED THE CHILD

(2) WOULD HAVE PROBABLY ACCEPTED THE CHILD

(3) WOULD HAVE PROBABLY NOT ACCEPTED THE CHILD

(4) WOULD HAVE DEFINITELY NOT ACCEPTED THE CHILD

(6) DON’T KNOW

(7) REFUSED

W16 Given your [TEXTFILL: and your spouse’s/partner’s] experience of adoption with this child, would you

recommend adoption to others?

(1) YES

(2) NO

(3) DEPENDS

(6) DON’T KNOW

(7) REFUSED

W17 Since the adoption was finalized, has [S.C.] ever lived outside of your home for two weeks or longer?

INTERVIEWER INSTRUCTION: DO NOT INCLUDE EXTENDED VACATIONS

(1) YES

(0) NO <GO TO CPW18>

(6) DON’T KNOW <GO TO CPW18>

(7) REFUSED <GO TO CPW18>

W17A How many times?

____

(6) DON’T KNOW

(7) REFUSED
Page 62 [ Series 1, No. 51

W17B	 Was [S.C.]’s time away from home related to problems or conflicts among family members?

(1)	 YES

(0)	 NO <GO TO CPW18>

(6)	 DON’T KNOW <GO TO CPW18>

(7) REFUSED <GO TO CPW18>

W17C As a result of [S.C.]’s time away from your home did the situation... improve, stay about the same, or get worse?

(1)	 IMPROVE

(2)	 STAY ABOUT THE SAME

(3)	 GET WORSE

(4)	 NOT APPLICABLE/STAY AWAY FROM HOME NOT RELATED TO PROBLEMS

(6)	 DON’T KNOW

(7) REFUSED

<CHECKPOINT CPW18: IF (W12 = 4 OR 5) OR (W15 = 3 OR 4) GO TO W18 / ELSE GO TO CPF1>

W18 Have you [TEXTFILL: or your spouse/partner] ever thought about ending this adoption?

(1)	 YES

(0)	 NO <GO TO CPF1>

(6)	 DON’T KNOW <GO TO CPF1>

(7) REFUSED <GO TO CPF1>

W19 Have you [TEXTFILL: or your spouse/partner] ever taken any action to end this adoption?

(1)	 YES

(0)	 NO <GO TO W23>

(6)	 DON’T KNOW <GO TO CPF1>

(7) REFUSED <GO TO CPF1>

W20A What actions have you [TEXTFILL: or your spouse/partner] taken?

(1)	 SPOKE TO CASEWORKER ABOUT IT 

<IF ‘‘OTHER’’ also selected, GO TO W20AA; ELSE GO TO W20B> 

(2)	 SPOKE WITH ATTORNEY ABOUT IT 

<IF ‘‘OTHER’’ also selected, GO TO W20AA; ELSE GO TO W20B> 

(3)	 OTHER <GO TO W20AA>

(6)	 DON’T KNOW 

<IF ‘‘OTHER’’ also selected, GO TO W20AA; ELSE GO TO W20B> 

(7)	 REFUSED 

<IF ‘‘OTHER’’ also selected, GO TO W20AA; ELSE GO TO W20B> 

W20AA. Specify:________________ 

W20B	 How old was [S.C.] when this action took place?

___years <GO TO W21A_INTRO>

(6)	 DON’T KNOW

(7)	 REFUSED

IF LESS THAN ONE YEAR, ENTER 0 FOR YEARS AND GO TO W20BA 

W20BA ___ months 

(6)	 DON’T KNOW

(7)	 REFUSED

W21A_INTRO I am going to read a list of reasons some parents may take this action. Please tell me if each was a very

important, somewhat important, or not important reason for you.
W21A

W21B

W21E

W21D

W21C

W21F

Series 1, No. 51 [ Page 63

Child behavioral or education problems.

<READ IF NECESSARY: Was this a very important, somewhat important, or not important reason for taking

action to end the adoption?>

(1) VERY IMPORTANT

(2) SOMEWHAT IMPORTANT

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

Child did not get along with siblings

<READ IF NECESSARY: Was this a very important, somewhat important, or not important reason for taking

action to end the adoption?>

(1) VERY IMPORTANT

(2) SOMEWHAT IMPORTANT

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

Child’s medical problems

<READ IF NECESSARY: Was this a very important, somewhat important, or not important reason for taking

action to end the adoption?>

(1) VERY IMPORTANT

(2) SOMEWHAT IMPORTANT

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

Financial reasons

<READ IF NECESSARY: Was this a very important, somewhat important, or not important reason for taking

action to end the adoption?>

(1) VERY IMPORTANT

(2) SOMEWHAT IMPORTANT

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

Other family problems not associated with child

<READ IF NECESSARY: Was this a very important, somewhat important, or not important reason for taking

action to end the adoption?>

(1) VERY IMPORTANT

(2) SOMEWHAT IMPORTANT

(3) NOT IMPORTANT

(6) DON’T KNOW

(7) REFUSED

Were there any other important reasons?

(1) YES

(0) NO <GO TO W22>

(6) DON’T KNOW <GO TO W22>

(7) REFUSED <GO TO W22>
Page 64 [ Series 1, No. 51

W21FA What were those reasons? ________________________

(6) DON’T KNOW

(7) REFUSED

W22 Are you [TEXTFILL: or your spouse/partner] currently trying to end the adoption?

(1) YES <GO TO CPF1>

(0) NO

(6) DON’T KNOW <GO TO CPF1>

(7) REFUSED <GO TO CPF1>

W23 I am going to read a list of reasons why you [TEXTFILL: or your spouse/partner] may have changed your mind

about ending it. Please tell me if each was a reason you are no longer trying to end the adoption.

W23A You resolved the problem(s) within family

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

W23B You discussed the situation with other relatives, neighbors, clergy.

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

W23C You discussed the situation with an adoption worker

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

W23D You discussed the situation with another adoptive family

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

W23E You received additional supportive services such as respite care, intensive family preservation, or day care

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 65

W23F You engaged in family or individual therapy

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

W23G You placed the child in a residential program

<READ IF NECESSARY: Please tell me if this was a reason you are no longer trying to end the adoption >

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

W23H Were there any other reasons?

(1)

(0)

(6)

(7)

YES

NO

DON’T KNOW

REFUSED

<GO TO CPF1>

<GO TO CPF1>

<GO TO CPF1>

W23HA What were those reasons? Specify: ________________

(6)

(7)

DON’T KNOW

REFUSED
Page 66 [ Series 1, No. 51

ADOPTION AGREEMENT AND POST ADOPTION SERVICES – FINANCIAL (F)

<CHECKPOINT CPF1: If C10Q04=1 or C1-Q05=NO, DON’T KNOW, OR REFUSED, GO TO F11>

F1.	 These next few questions are about financial services you may have received related to the adoption of [S.C.].

At the time of [S.C.]’s adoption, was an adoption agreement finalized between your family and the adoption

agency? By adoption agreement we mean an agreement made before the finalization of the adoption that may

include monthly maintenance payments from the agency, medical coverage, and other services such as therapy.

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F2. Do you currently receive a monthly subsidy payment to help you meet the needs of [S.C.]?

(1) YES <GO TO F3>

(0) NO <GO TO F2A>

(6) DON’T KNOW <GO TO F2A>

(7) REFUSED <GO TO F2A>

F2A.	 Have you ever received an adoption subsidy (payment every month) for [S.C.]?

<HELP SCREEN: An adoption subsidy is a monthly payment>

(1) YES <GO TO F3>

(0) NO <GO TO F10>

(6) DON’T KNOW <GO TO F10>

(7) REFUSED <GO TO F10>

<CHECKPOINT CPF3: IF F1=2 GO TO F4 / ELSE GO TO F3

F3. (If F2=1: Is/ If F2A=1: Was) this monthly subsidy payment written into your adoption agreement?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F4.	 What [TEXTFILL: IF F2=1: is; IF F2a=1: was] the amount per month of the adoption subsidy you [TEXTFILL:

IF F2=1: currently receive; IF F2a=1: received] for this child?

$____/month <IF S8=1 OR S9=1 GO TO F4a; ELSE GO TO F5>

(6) DON’T KNOW <IF S8=1 OR S9=1 GO TO F4a; ELSE GO TO F5>

(7) REFUSED <IF S8=1 OR S9=1 GO TO F4a; ELSE GO TO F5>

READ IF NECESSARY: We collect this information so we can compare support levels for different states,

racial/ethnic groups, or people with different income levels.

F4A.	 [TEXTFILL: IF F2=YES: Is; IF F2a=YES: Was] this monthly amount higher, lower, or the same as the amount

you received when you were [S.C.]’s foster parent?

(1) HIGHER

(2) LOWER

(3) SAME AS

(6) DON’T KNOW

(7) REFUSED

F5. Did you request the subsidy or was this subsidy given to you without requesting it?

(1) I/WE REQUESTED THIS SUBSIDY

(2) SUBSIDY GIVEN TO ME/US WITHOUT REQUESTING IT <GO TO F7>

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 67

F6A.	 Did you request a subsidy because...

[S.C.] needed additional services you could not afford?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F6B.	 The child welfare worker or adoption worker suggested that you request one?

<READ IF NECESSARY: Did you request a subsidy because >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F6C.	 Your attorney suggested you request one?

<READ IF NECESSARY: Did you requestion a subsidy because >

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F6D. Was there any other reason why a subsidy was requested?

(1) YES <GO TO F6DA>

(0) NO <IF F2=Yes, GO TO F7; ELSE GO TO F8>

(6) DON’T KNOW <IF F2=Yes, GO TO F7; ELSE GO TO F8>

(7) REFUSED <IF F2=Yes, GO TO F7; ELSE GO TO F8> 

F6DA. Specify: ________________ <IF F2=1, GO TO F7; ELSE GO TO F8> 

(6) DON’T KNOW

(7) REFUSED

F7. Do you feel that the subsidy received for [S.C.] helps to adequately meet [S.C.]’s needs?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F8.	 Without a subsidy would you say the likelihood of you having adopted [S.C.] would have been ...very likely,

likely, unlikely, or very unlikely?

(1) VERY LIKELY <IF F1=1, and F2=2, GO TO F9; ELSE GO TO F11>

(2) LIKELY <IF F1=1, and F2=2, GO TO F9; ELSE GO TO F11>

(3) UNLIKELY <IF F1=1, and F2=2, GO TO F9; ELSE GO TO F11>

(4) VERY UNLIKELY <IF F1=1, and F2=2, GO TO F9; ELSE GO TO F11>

(6) DON’T KNOW <IF F1=1, and F2=2, GO TO F9; ELSE GO TO F11>

(7) REFUSED <IF F1=1, and F2=2, GO TO F9; ELSE GO TO F11>
Page 68 [ Series 1, No. 51

F9. Why don’t you currently receive an adoption subsidy for [S.C.]? Is it because you no longer need the subsidy, no

longer qualify for the subsidy, or some other reason?

(1) NO LONGER NEEDED SUBSIDY <GO TO F11>

(2) NO LONGER QUALIFY FOR SUBSIDY <GO TO F11>

(3) SOME OTHER REASON <GO TO F11>

(6) DON’T KNOW <GO TO F11>

(7) REFUSED <GO TO F11>

F9A. What is the reason? ___________________ <GO TO F11>

(6) DON’T KNOW

(7) REFUSED 

F10. Why don’t you receive an adoption subsidy for [S.C.]? Is it because you 

<INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS ‘‘I WOULDN’T QUALIFY’’ OR ‘‘THEY WOULD 

HAVE TURNED US DOWN’’ CODE 1: DID NOT REQUEST A SUBSIDY> 

(1) DID NOT REQUEST A SUBSIDY <GO TO F11> 

(2) WERE TURNED DOWN <GO TO F11> 

(3) DECLINED THE OFFERED SUBSIDY <GO TO F11> 

(4) SOME OTHER REASON <GO TO F11> 

(6) DON’T KNOW <GO TO F11> 

(7) REFUSED <GO TO F11> 

F10A. What is the reason? ____________________ <GO TO F11> 

(6) DON’T KNOW 

(7) REFUSED 

F11. These next few questions are about costs you may have incurred related to the adoption of [S.C.]. 

Did you pay anything at the time of the adoption, for example, did you pay for a homestudy or pay an attorney? 

READ IF NECESSARY: A homestudy is the process by which an adoption social worker determines your 

suitability as adoptive parents. It usually includes applications, educational classes, interviews, and visits to the

home of the prospective parents.

(1) YES <IF C10Q04=1 OR C10Q05=NO, GO TO F11B, ELSE GO TO F11A>

(0) NO <GO TO CPF13>

(6) DON’T KNOW <GO TO CPF13>

(7) REFUSED <GO TO CPF13> 

F11A. Approximately how much did [S.C.]’s adoption cost? 

INTERVIEWER INSTRUCTION: DO NOT READ CATEGORIES 

(1) LESS THAN $5,000 <GO TO F12> 

(2) AT LEAST $5,000 BUT LESS THAN $10,000 <GO TO F12> 

(3) $10,000 OR MORE <GO TO F12> 

(6) DON’T KNOW <GO TO F12> 

(7) REFUSED <GO TO F12> 

F11B. Approximately how much did [S.C.]’s adoption cost (including [textfill if International: cost of travel to the child’s

country of origin/ if private: travel], legal fees, etc.)?

(1) Less than $5,000

(2) At least $5,000 but less than 10,000 <GO TO CPF13>

(3) At least $10,000 but less than $15,000 <GO TO CPF13>

(4) At least $15,000 but less than $20,000 <GO TO CPF13>

(5) At least $20,000 but less than $25,000 <GO TO CPF13>

(6) At least $25,000 but less than $30,000 <GO TO CPF13>

(7) At least $30,000 but less than $35,000 <GO TO CPF13>

(8) At least $35,000 but less than $40,000 <GO TO CPF13>

(9) $40,000 or more <GO TO CPF13>
Series 1, No. 51 [ Page 69

(96) DON’T KNOW

(97) REFUSED

F12. Did the adoption agency reimburse all, some, or none of these expenses?

(1) ALL

(2) SOME

(3) NONE

(6) DON’T KNOW

(7) REFUSED

F13_INTRO. These next questions are about your experiences with Medicaid. Some of these questions may seem similar to

other questions you have already answered, but they ask about different things.

<CHECKPOINT CPF13: IF F1=1: GO TO F13 / ELSE IF F1=null or missing, 2, 6, or 7: GO TO F14A>

F13. Was [S.C.]’s Medicaid or state-subsidized health insurance included in the adoption agreement?

(1) YES

(0) NO <GO TO F14A>

(6) DON’T KNOW

(7) REFUSED

F13A. Is any additional medical coverage included in the adoption agreement?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F14A. Have you ever used Medicaid to obtain mental health services for [S.C.]?

(1) YES

(0) NO <GO TO F14B>

(6) DON’T KNOW <GO TO F14B>

(7) REFUSED <GO TO F14B>

F14AA.	 How easy or difficult was it to use Medicaid to pay for these mental health services for [S.C.]? Would you say it

was very easy, somewhat easy, somewhat difficult, or very difficult?

(1) VERY EASY

(2) SOMEWHAT EASY

(3) SOMEWHAT DIFFICULT

(4) VERY DIFFICULT

(6) DON’T KNOW

(7) REFUSED

F14B. Have you ever used Medicaid to obtain dental or orthodontia care for [S.C.]?

(1) YES

(0) NO <GO TO F14C>

(6) DON’T KNOW <GO TO F14C>

(7) REFUSED <GO TO F14C>

F14BA.	 How easy or difficult was it to use Medicaid to pay for this dental or orthodontia care for [S.C.]? Would you say

it was very easy, somewhat easy, somewhat difficult, or very difficult?

(1) VERY EASY

(2) SOMEWHAT EASY

(3) SOMEWHAT DIFFICULT

(4) VERY DIFFICULT

(6) DON’T KNOW

(7) REFUSED
Page 70 [ Series 1, No. 51

F14C.	 Have you ever used Medicaid to obtain medical care for [S.C.]? Please include health care related to vision and

hearing.

(1) YES

(0) NO <GO TO F15>

(6) DON’T KNOW <GO TO F15>

(7) REFUSED <GO TO F15>

F14CA.	 How easy or difficult was it to use Medicaid to pay for these medical services for [S.C.]? Would you say it was

very easy, somewhat easy, somewhat difficult, or very difficult?

(1) VERY EASY

(2) SOMEWHAT EASY

(3) SOMEWHAT DIFFICULT

(4) VERY DIFFICULT

(6) DON’T KNOW

(7) REFUSED

F15. These next few questions are about mental health care [S.C.] may have received during the last 12 months.

Mental health professionals include psychiatrists, psychologists, psychiatric nurses, and clinical social workers.

During the past 12 months, has [S.C.] received any treatment or counseling from a mental health professional?

(1) YES <GO TO F16>

(0) NO <GO TO F17>

(6) DON’T KNOW <GO TO F17>

(7) REFUSED <GO TO F17>

F16. What portion of [S.C.]’s mental health services in the last 12 months was paid for by each of the following

sources: would you say none, some, almost all or all of [S.C.]’s mental health services were paid for by ...

<CHECKPOINT CPF16A: IF F14A=2 go to F16B/ ELSE Go to F16A >

F16A. Medicaid?

<READ IF NECESSARY: What portion of [S.C.]’s mental health services in the last 12 months was paid for by >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CPF14A_A>

(6) DON’T KNOW

(7) REFUSED

F16B.	 Insurance other than Medicaid?

<READ IF NECESSARY: What portion of [S.C.]’s mental health services in the last 12 months was paid for by >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CPF14A_A>

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPF16C: If [S.C.] is not FOSTER CARE (C10Q05 ne 1) GO TO F16d/ ELSE go to F16C>

F16C. Child Welfare or Adoption Agency?

<READ IF NECESSARY: What portion of [S.C.]’s mental health services in the last 12 months was paid for >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CPF14A_A>

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 71

F16D.	 You?

<READ IF NECESSARY: What portion of [S.C.]’s mental health services in the last 12 months was paid for by >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CPF14A_A>

(6) DON’T KNOW

(7) REFUSED

F16E Is there any other source helping pay for medical care?

(1) YES

(0) NO <GO TO F14A_A>

(6) DON’T KNOW <GO TO F14A_A>

(7) REFUSED <GO TO F14A_A> 

F16EA. What is that source? __________________________ 

(6) DON’T KNOW

(7) REFUSED

F14A_A.	 Mental health medications are used to treat difficulties with emotions, concentration, or behavior. Have you ever

used Medicaid to obtain mental health medications for [S.C.]?

(1) YES

(0) NO <GO TO F16_A>

(6) DON’T KNOW <GO TO F16_A>

(7) REFUSED <GO TO F16_A>

F14A_AA.	 How easy or difficult was it to use Medicaid to pay for these mental health medications for [S.C.]? Would you say

it was very easy, somewhat easy, somewhat difficult, or very difficult?

(1) VERY EASY

(2) SOMEWHAT EASY

(3) SOMEWHAT DIFFICULT

(4) VERY DIFFICULT

(6) DON’T KNOW

(7) REFUSED

F16_A. What portion of [S.C.]’s mental health medication needs in the last 12 months was paid for by each of the

following sources:

<CHECKPOINT CPF16A_A: IF F14A_A=2 SKIP F16A_A and go to F16A_B >

F16A_A.	 Medicaid?

<READ IF NECESSARY: What portion of [S.C.]’s mental health medication needs in the last 12 months was paid

for by each of the following sources>

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO F17>

(6) DON’T KNOW

(7) REFUSED
Page 72 [ Series 1, No. 51

F16A_B.	 Insurance other than Medicaid?

<READ IF NECESSARY: What portion of [S.C.]’s mental health medication needs in the last 12 months was paid

for by each of the following sources>

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO F17>

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPF16A_C: If [S.C.] is not FOSTER CARE (C10Q05 ne 1) SKIP F16A_C AND GO TO F16A_D>

F16A_C. Child Welfare or Adoption Agency?

<READ IF NECESSARY: What portion of [S.C.]’s mental health medication needs in the last 12 months was paid

for by each of the following sources >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO F17>

(6) DON’T KNOW

(7) REFUSED

F16A_D. You?

<READ IF NECESSARY: What portion of [S.C.]’s mental health medication needs in the last 12 months was paid

for by each of the following sources>

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO F17>

(6) DON’T KNOW

(7) REFUSED

F16A_E. Is there any other source helping pay for mental health medications?

<READ IF NECESSARY: What portion of [S.C.]’s mental health medication needs in the last 12 months was paid

for by each of the following sources>

(1) YES

(0) NO <GO TO F17>

(6) DON’T KNOW <GO TO F17>

(7) REFUSED <GO TO F17>

F16A_EA. What is that source? __________________________

(6) DON’T KNOW

(7) REFUSED

F17.	 These next few questions are about dental care [S.C.] may have received in the last 12 months.

In the last 12 months did [S.C.] receive any dental or orthodontia care?

(1) YES

(0) NO <GO TO F18>

(6) DON’T KNOW <GO TO F18>

(7) REFUSED <GO TO F18>

<CHECKPOINT CPF17A: IF F14B=2 GO TO F17B/ ELSE GO TO F17A >
F17A. What portion of [S.C.]’s dental or orthodontia care in the past 12 months was paid for by each of the following

sources:

Medicaid?

(1) NONE 

(2) SOME 

(3) ALMOST ALL 

(4) ALL <GO TO F18> 

(6) DON’T KNOW 

(7) REFUSED 

F17B. What portion of [S.C.]’s dental or orthodontia care in the past 12 months was paid for by each of the following 

sources: 

Insurance other than Medicaid? 

(1) NONE 

(2) SOME 

(3) ALMOST ALL 

(4) ALL <GO TO F18> 

(6) DON’T KNOW 

(7) REFUSED 

<CHECKPOINT CPF17C: IF [S.C.]’s is not FOSTER CARE (C10Q05 ne 1) GO TO F17D/ ELSE Go to F17C >

F17C. Child Welfare or Adoption Agency?

<READ IF NECESSARY: What portion of [S.C.]’s dental or orthodontia care in the past 12 months was paid for

by each of the following sources >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO F18>

(6) DON’T KNOW

(7) REFUSED 

F17D. You? 

<READ IF NECESSARY: What portion of [S.C.]’s dental or orthodontia care in the past 12 months was paid for 

by > 

(1) NONE 

(2) SOME 

(3) ALMOST ALL 

(4) ALL <GO TO F18> 

(6) DON’T KNOW 

(7) REFUSED 

F17E. Is there any other source helping pay for dental care? 

(1) YES 

(0) NO <GO TO F18> 

(6) DON’T KNOW <GO TO F18> 

(7) REFUSED <GO TO F18> 

Series 1, No. 51 [ Page 73
Page 74 [ Series 1, No. 51

F17EA.	 What is that source? __________________________

(6) DON’T KNOW

(7) REFUSED

F18. In the last 12 months has [S.C.] had any medical care including vision and hearing?

(1) YES

(0) NO <GO TO F19>

(6) DON’T KNOW <GO TO F19>

(7) REFUSED <GO TO F19>

<CHECKPOINT CPF18A: IF (F14C=2) SKIP F18A AND GO TO F18B/ ELSE Go to F18A >

F18A What portion of [S.C.]’s medical care in the past 12 months was paid for by each of the following sources:

Medicaid

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CHECKPOINT CPF19>

(6) DON’T KNOW

(7) REFUSED

F18B.	 Insurance other than Medicaid

<READ IF NECESSARY: What portion of [S.C.]’s medical care in the past 12 months was paid for by >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CHECKPOINT CPF19>

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPF18C: IF ADOPT_TYPE IS NOT=FOSTER CARE (C10Q05 ne 1) GO TO F18D/ ELSE Go to F18C >

F18C. Child Welfare or Adoption Agency

<READ IF NECESSARY: What portion of [S.C.]’s medical care in the past 12 months was paid for by >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CHECKPOINT CPF19>

(6) DON’T KNOW

(7) REFUSED

F18D.	 You?

<READ IF NECESSARY: What portion of [S.C.]’s medical care in the past 12 months was paid for by >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO CHECKPOINT CPF19>

(6) DON’T KNOW

(7) REFUSED

F18E. Is there any other source helping pay for medical care?

(1) YES

(0) NO <GO TO CPF19>

(6) DON’T KNOW <GO TO CPF19>

(7) REFUSED <GO TO CPF19>
Series 1, No. 51 [ Page 75

F18EA. What is that source? __________________________

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPF19: IF (AGEYRNSAP - C1A) < or = (CURRENT YEAR - 1997), GO TO F19/ ELSE GO TO F20 / IF

C1A = 6 or 7 GO TO F20>

F19.	 The next few questions are about other sources of financial support you may have received at the time of the

adoption.

At the time of [S.C.]’s adoption, were you [TEXTFILL: or your spouse/partner] aware of the federal adoption tax

credit?

INTERVIEWER INSTRUCTION: IF RESPONDENT ASKS ABOUT THE FEDERAL TAX CREDIT, TELL

THEM THEY SHOULD CONSULT A TAX SPECIALIST FOR MORE INFORMATION.

(1) YES

(0) NO <GO TO F20>

(6) DON’T KNOW

(7) REFUSED

F19A.	 Did you [TEXTFILL: or your spouse/partner] file for the adoption tax credit on your income tax return?

INTERVIEWER INSTRUCTION: IF RESPONDENT SAYS ‘‘WE WILL’’, CODE YES

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

F20.	 At the time of [S.C.]’s adoption, did your [TEXTFILL: or your spouse’s/partner’s] employer provide financial

assistance for the adoption?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Page 76 [ Series 1, No. 51

POST ADOPTION SUPPORTS – NON-FINANCIAL (NF)

TIMESTAMP_SECTION_NF1

SUPPORT 1

N1.	 For the next section, I’m going to ask you about different types of services that you may have received or wanted.

Did you [TEXTFILL: or your spouse/partner] ever meet with someone at an adoption agency or post-adoption

agency to discuss post-adoption services?

(1) YES

(0) NO <GO TO N1C>

(6) DON’T KNOW <GO TO N1C>

(7) REFUSED <GO TO N1C>

N1A. Was this someone you [TEXTFILL: or your spouse/partner] had contact with prior to [S.C.]’s adoption?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

N1B.	 Did you [TEXTFILL: or your spouse/partner] find this to be very helpful, somewhat helpful, or not very helpful to

you, your family, or [S.C.]?

(1) VERY HELPFUL <GO TO CPN2>

(2) SOMEWHAT HELPFUL <GO TO CPN2>

(3) NOT VERY HELPFUL <GO TO CPN2>

(6) DON’T KNOW <GO TO CPN2>

(7) REFUSED	 <GO TO CPN2>

N1C.	 Did you [TEXTFILL: or your spouse/partner] want to meet with someone at an adoption agency to discuss

post-adoption services and supports after the adoption was finalized?

<HELP SCREEN: At any time after the adoption was finalized>

(1) YES

(0) NO <GO TO CPN2>

(6) DON’T KNOW <GO TO CPN2>

(7) REFUSED <GO TO CPN2>

N1D.	 Why weren’t you [TEXTFILL: or your spouse/partner] able to meet with someone to discuss post-adoption

services and supports? [SELECT ALL THAT APPLY]

(1) NO SUCH WORKER AT MY AGENCY

(2) AGENCY DID NOT OFFER SERVICES REQUESTED

(3) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(4) SCHEDULES CONFLICTED

(5) NO TIME

(6) OTHER	 <GO TO N1DA>

(6) DON’T KNOW

(7) REFUSED

<IF ‘‘OTHER NOT SELECTED, GO TO Checkpoint before N2>

N1DA. Specify: ________________

(6) DON’T KNOW

(7) REFUSED

SUPPORT 2

TIMESTAMP_SECTION_NF2 

<CHECKPOINT CPN2: IF AGEYRNSAP > OR =5 years, GO TO N2; ELSE GO TO N3> 
N2. Has [S.C.] ever participated in an adoption support group for children or youth?

(1) YES

(0) NO <GO TO N2C>

(6) DON’T KNOW <GO TO N2C>

(7) REFUSED <GO TO N2C> 

N2A. Did you find this to be very helpful, somewhat helpful, or not very helpful? 

(1) VERY HELPFUL 

(2) SOMEWHAT HELPFUL 

(3) NOT VERY HELPFUL 

(6) DON’T KNOW 

(7) REFUSED 

N2B. Did S.C. find this to be very helpful, somewhat helpful, or not very helpful? 

(1) VERY HELPFUL 

(2) SOMEWHAT HELPFUL 

(3) NOT VERY HELPFUL 

(6) DON’T KNOW 

(7) REFUSED 

N2BA. How did you [TEXTFILL: or your spouse/partner] or [S.C.] hear about this support group? [SELECT ALL THAT

APPLY]

(1) CHILD’S SCHOOL

(2) ADOPTION WORKER

(3) ADOPTION AGENCY/CHILD WELFARE AGENCY

(4) ADOPTION ATTORNEY

(5) COMMUNITY OR LOCAL NEWSPAPER

(6) ADOPTION WEBSITE OR LISTSERV

(7) OTHER PARENTS

(8) OTHER <GO TO N2BAA>

(96) DON’T KNOW

(97) REFUSED

<GO TO N3 IF OTHER NOT SELECTED>

N2BAA. (specify) __________________________ <GO TO N3>

(6) DON’T KNOW <GO TO N3> 

(7) REFUSED <GO TO N3> 

N2C. Did you [TEXTFILL: or your spouse/partner] ever want [S.C.] to participate in an adoption support group? 

(1) YES <GO TO N2D> 

(2) NO <GO TO N3> 

(6) DON’T KNOW <GO TO N3> 

(7) REFUSED <GO TO N3> 

N2D. Why wasn’t [S.C.] able to participate in a group? [SELECT ALL THAT APPLY] 

(1) DID NOT KNOW WHERE ONE WAS 

(2) NONE CLOSE TO US 

(3) COST 

(4) CHILD REFUSED OR NOT INTERESTED 

(5) OTHER (specify:_________________) <GO TO N2DA> 

(6) DON’T KNOW 

(7) REFUSED 

<GO TO N3 IF OTHER NOT SELECTED> 

Series 1, No. 51 [ Page 77
Page 78 [ Series 1, No. 51

N2DA. Specify: ________________

(6) DON’T KNOW

(7) REFUSED

SUPPORT 3

TIMESTAMP_SECTION_NF3 

N3. Have you [TEXTFILL: or your spouse/partner] ever participated in an adoption support group? 

(1) YES <GO TO N3A>

(2) NO <GO TO N3C>

(6) DON’T KNOW <GO TO N3C>

(7) REFUSED <GO TO N3C>

N3A. Did you [TEXTFILL: or your spouse/partner] find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N3B.	 How did you [TEXTFILL: or your spouse/partner] hear about this support group(s)? [SELECT ALL THAT

APPLY]

(1) ADOPTION WORKER

(2) ADOPTION AGENCY OR CHILD WELFARE AGENCY

(3) ADOPTION ATTORNEY

(4) COMMUNITY OR LOCAL NEWSPAPER

(5) ADOPTION WEBSITE OR LISTSERV

(6) OTHER PARENTS

(7) OTHER <GO TO N3BA>

(6) DON’T KNOW

(7) REFUSED

<GO TO CP N5 IF OTHER NOT SELECTED> 

N3BA. Specify:________________ <GO TO CPN5> 

(6) DON’T KNOW <GO TO CPN5>

(7) REFUSED <GO TO CPN5>

N3C. Did you [TEXTFILL: or your spouse/partner] ever want to participate in an adoption support group?

(1) YES <GO TO N3D>

(0) NO <GO TO CPN5>

(6) DON’T KNOW <GO TO CPN5>

(7) REFUSED <GO TO CPN5>

N3D.	 Why weren’t you [TEXTFILL: or your spouse/partner] able to participate in a group? [SELECT ALL THAT

APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) COST

(3) DIDN’T KNOW WHERE TO FIND ONE

(4) NONE CLOSE TO US

(5) OTHER <GO TO N3DA>

(6) DON’T KNOW

(7) REFUSED 

<IF OTHER NOT SELECTED, GO TO CPN5> 
Series 1, No. 51 [ Page 79

N3DA.	 Specify:________________

(6) DON’T KNOW

(7)REFUSED

SUPPORT 5

TIMESTAMP_SECTION_NF5

<CHECKPOINT CPN5: IF AGEYRNSAP > OR =5 years GO TO N5; ELSE GO TO N6>

N5.	 Since the time of his/her adoption, Has [S.C.] ever received mental health care or counseling?

<HELP SCREEN: BY ‘‘counseling’’ we mean any mental health counseling, not just counseling related to being

adopted>

(1) YES <IF F1=Yes, GO TO N5A; ELSE GO TO N5B>

(0) NO <GO TO N5E>

(6) DON’T KNOW <GO TO N5E>

(7) REFUSED <GO TO N5E>

N5A. Was payment for counseling for [S.C.] written into your adoption agreement?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

N5B. Did you find this to be very helpful, somewhat helpful, or not very helpful for [S.C.]?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N5C. Did [S.C.] find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N5D. How did you hear about this mental health care or counseling? [SELECT ALL THAT APPLY]

(1) CHILD’S SCHOOL

(2) MEDICAL PROFESSIONAL

(3) ADOPTION WORKER

(4) ADOPTION AGENCY OR CHILD WELFARE AGENCY

(5) ADOPTION ATTORNEY

(6) COMMUNITY OR LOCAL NEWSPAPER

(7) ADOPTION WEBSITE OR LISTSERV

(8) OTHER PARENTS

(9) OTHER <GO TO N5DA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO N6> 

N5DA. Specify:________________ 

(6) DON’T KNOW <GO TO N6>

(7) REFUSED <GO TO N6>
Page 80 [ Series 1, No. 51

N5E. Did you ever want [S.C.] to receive mental health care or counseling?

(1) YES <GO TO N5F>

(0) NO <GO TO N6>

(6) DON’T KNOW <GO TO N6>

(7) REFUSED <GO TO N6>

N5F. Why didn’t [S.C.] receive the mental health care or counseling that he/she needed? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) COST

(3) DIDN’T KNOW WHERE TO FIND ONE

(4) NONE CLOSE TO US

(5) OTHER <GO TO N5FA>

(6) DON’T KNOW

(7) REFUSED 

<IF OTHER NOT SELECTED, GO TO N6> 

N5FA. Specify:________________

(6) DON’T KNOW

(7) REFUSED

SUPPORT 6

TIMESTAMP_SECTION_NF6

N6. Since [S.C.]’s adoption, did your family ever participate in family counseling?

<HELP SCREEN: BY ‘‘family counseling’’ we mean any counseling for family problems, not just counseling

related to be adopted>

(1) YES

(0) NO <GO TO N6C>

(6) DON’T KNOW <GO TO N6C>

(7) REFUSED <GO TO N6C>

N6A. Did you find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N6B. How did you hear about this service? [SELECT ALL THAT APPLY]

(1) CHILD’S SCHOOL

(2) MEDICAL PROFESSIONAL

(3) ADOPTION WORKER

(4) ADOPTION AGENCY

(5) ADOPTION ATTORNEY

(6) COMMUNITY OR LOCAL NEWSPAPER

(7) ADOPTION WEBSITE OR LISTSERV

(8) OTHER PARENTS

(9) OTHER <GO TO N6BA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED GO TO N7> 

N6BA. Specify: ________________ <GO TO N7>

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 81

N6C. Did you ever want your family to participate in family counseling since [S.C.]’s adoption?

(1) YES

(0) NO <GO TO N7>

(6) DON’T KNOW <GO TO N7>

(7) REFUSED <GO TO N7>

N6D. Why didn’t your family participate in the counseling that you wanted? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) WERE TOLD WE DID NOT QUALIFY FOR THIS SERVICE

(4) COST

(5) DIDN’T KNOW WHERE TO FIND SERVICES

(6) NO SERVICES CLOSE TO US

(7) OTHER <GO TO N6DA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO N7> 

N6DA. Specify: ________________

(6) DON’T KNOW

(7) REFUSED

SUPPORT 7

TIMESTAMP_SECTION_NF7

N7. After [S.C.]’s adoption, did your family ever receive crisis counseling?

(1) YES

(0) NO <GO TO N7C>

(6) DON’T KNOW <GO TO N7C>

(7) REFUSED <GO TO N7C>

N7A. Did you find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N7B. How did you hear about this service? [SELECT ALL THAT APPLY]

(1) ADOPTION WORKER

(2) ADOPTION AGENCY

(3) ADOPTION ATTORNEY

(4) COMMUNITY OR LOCAL NEWSPAPER

(5) ADOPTION WEBSITE OR LISTSERV

(6) OTHER PARENTS

(7) OTHER <GO TO N7BA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO CPN8> 

N7BA. Specify: ________________ <GO TO CPN8>

(6) DON’T KNOW <GO TO CPN8>

(7) REFUSED <GO TO CPN8>
Page 82 [ Series 1, No. 51

N7C.	 Did you ever want your family to receive crisis counseling since [S.C.]’s adoption?

(1) YES

(0) NO	 <GO TO CPN8>

(6) DON’T KNOW <GO TO CPN8>

(7) REFUSED <GO TO CPN8>

N7D.	 Why didn’t your family receive the crisis counseling that you needed? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(4) COST

(5) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(6) NO SUCH SERVICES CLOSE TO ME/US

(7) OTHER <GO TO N7DA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO CPN8> 

N7DA.	 Specify:________________

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPN8: IF AGEYRNSAP < 13 YEARS OLD GO TO N9; ELSE GO TO N8>

SUPPORT 8

TIMESTAMP_SECTION_NF8

N8.	 Since the time of his/her adoption, has [S.C.] ever received an alcohol or drug evaluation and/or treatment? Please

do not include routine SCREENing for purposes of employment or participation in school activities.

(1) YES

(2) NO	 <GO TO N8C>

(6) DON’T KNOW <GO TO N8C>

(7) REFUSED <GO TO N8C>

N8A.	 Did you find these services to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N8B.	 How did you hear about these services for [S.C.]? [SELECT ALL THAT APPLY]

(1) MEDICAL PROFESSIONAL

(2) ADOPTION WORKER

(3) ADOPTION AGENCY

(4) ADOPTION ATTORNEY

(5) COMMUNITY OR LOCAL NEWSPAPER

(6) ADOPTION WEBSITE OR LISTSERV

(7) OTHER PARENTS

(8) OTHER <GO TO N8BA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO N9> 
Series 1, No. 51 [ Page 83

N8BA. Specify: ________________ <GO TO CPN9>

(6) DON’T KNOW <GO TO CPN9>

(7) REFUSED <GO TO CPN9>

N8C. Did you ever want or need these services for [S.C.]?

(1) YES

(0) NO	 <GO TO CPN9>

(6) DON’T KNOW <GO TO CPN9>

(7) REFUSED <GO TO CPN9>

N8D.	 Why didn’t [S.C.] receive this service? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(4) COST

(5) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(6) NO SUCH SERVICES CLOSE TO ME/US

(7) OTHER <GO TO NDA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO CPN9> 

N8DA. Specify: ________________

(6) DON’T KNOW

(7) REFUSED

SUPPORT 9

TIMESTAMP_SECTION_NF9

<CHECKPOINT CPN9: IF AGEYRNSAP = OR > 5 years GO TO N9; ELSE GO TO N10>

N9.	 Next, I am going to ask you some questions about educational and child care services that you might have

received for [S.C.] following his/her adoption. Following his/her adoption, did [S.C.] ever have a mentor? By

mentor I mean an adult paired with your child through a school or community organization.

(1) YES

(0) NO	 <GO TO N9C>

(6) DON’T KNOW <GO TO N9C>

(7) REFUSED <GO TO N9C>

N9A.	 Did you find this to be very helpful, somewhat helpful, or not very helpful for [S.C.]?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N9AA.	 Did [S.C.] think this was very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED
Page 84 [ Series 1, No. 51

N9B. How did you hear about this service? [SELECT ALL THAT APPLY]

(1) CHILD’S SCHOOL

(2) ADOPTION WORKER

(3) ADOPTION AGENCY

(4) ADOPTION ATTORNEY

(5) COMMUNITY OR LOCAL NEWSPAPER

(6) ADOPTION WEBSITE OR LISTSERV

(7) OTHER PARENTS

(8) OTHER <GO TO N9BA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO CPN10> 

N9BA. Specify:________________ <GO TO CPN10>

(6) DON’T KNOW <GO TO CPN10>

(7) REFUSED <GO TO CPN10>

N9C. Did you [TEXTFILL: or your spouse/partner] ever want [S.C.] to have a mentor?

(1) YES

(0) NO <GO TO CPN10>

(6) DON’T KNOW <GO TO CPN10>

(7) REFUSED <GO TO CPN10>

N9D. Why didn’t [S.C.] receive a mentor? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(4) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(5) NO SUCH SERVICES CLOSE TO ME/US

(6) OTHER <GO TO N9DA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN10> 

N9DA. Specify: ________________ 

(6) DON’T KNOW

(7) REFUSED

SUPPORT 10

TIMESTAMP_SECTION_NF10

<CHECKPOINT CPN10: IF AGEYRNSAP = OR > 5 years GO TO N10; ELSE GO TO CPN11>

N10. At any time since he/she was adopted, has [S.C.] had an academic tutor?

(1) YES <IF F1=Yes, GO TO N10A; ELSE GO TO N10AA>

(0) NO <GO TO N10C>

(6) DON’T KNOW <GO TO N10C>

(7) REFUSED <GO TO N1OC>

N10A. Is the payment for tutoring for [S.C.] written into your adoption agreement?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 85

N10AA.	 Did you find this to be very helpful, somewhat helpful, or not very helpful for [S.C.]?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N10B.	 Did [S.C.] think that tutoring was very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N10BB.	 How did you hear about this tutoring? [SELECT ALL THAT APPLY]

(1) CHILD’S SCHOOL

(2) ADOPTION WORKER

(3) ADOPTION AGENCY

(4) ADOPTION ATTORNEY

(5) COMMUNITY OR LOCAL NEWSPAPER

(6) ADOPTION WEBSITE OR LISTSERV

(7) OTHER PARENTS

(8) OTHER <GO TO N10BA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN11> 

N10BA. (Specify) _________________ <GO TO CPN11> 

(6) DON’T KNOW <GO TO CPN11>

(7) REFUSED <GO TO CPN11>

N10C.	 Did you [TEXTFILL: or your spouse/partner] ever want tutoring for (S.C)?

(1) YES

(0) NO	 <GO TO CPN11>

(6) DON’T KNOW <GO TO CPN11>

(7) REFUSED <GO TO CPN11>

N10D.	 Why didn’t [S.C.] receive the tutoring that he/she needed? [SELECT ALL THAT

APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) COST

(4) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(5) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(6) NO SUCH SERVICES CLOSE TO ME/US

(7) OTHER <GO TO N10DA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN11> 

N10DA. (specify :________________) 

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPN11: IF C10Q05=1(FOSTER CARE ADOPTION) GO TO N11; ELSE GO TO CPN12>
Page 86 [ Series 1, No. 51

SUPPORT 11

TIMESTAMP_SECTION_NF11

N11.	 Following [S.C.]’s adoption, did you [TEXTFILL: or your spouse/partner] receive assistance paying for child care

for (S.C)?

(1) YES

(0) NO	 <GO TO N11C>

(6) DON’T KNOW <GO TO N11C>

(7) REFUSED <GO TO N11C>

N11A.	 Did you find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N11B.	 How did you hear about this child care assistance? [SELECT ALL THAT APPLY]

(1) ADOPTION WORKER

(2) ADOPTION AGENCY

(3) ADOPTION ATTORNEY

(4) COMMUNITY OR LOCAL NEWSPAPER

(5) ADOPTION WEBSITE OR LISTSERV

(6) OTHER PARENTS

(7) OTHER <GO TO N11BA>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED, GO TO CPN12> 

N11BA. (Specify) _________________ <GO TO CPN12>

(6) DON’T KNOW <GO TO CPN12>

(7) REFUSED <GO TO Checkpoint before N12>

N11C.	 Did you ever want or need help paying for child care for [S.C.]?

(1) YES

(0) NO	 <GO TO CPN12>

(6) DON’T KNOW <GO TO CPN12>

(7) REFUSED <GO TO CPN12>

N11D.	 Why didn’t you receive the assistance that you needed? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) COST

(4) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(5) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(6) NO SUCH SERVICES CLOSE TO ME/US

(7) OTHER, GO TO N11DA <GO TO N11DA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN12> 

N11DA. (specify :________________) 

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPN12: IF C10Q05=1, GO TO N12; ELSE GO TO CPN14>
Series 1, No. 51 [ Page 87

SUPPORT 12

TIMESTAMP_SECTION_NF12

N12.	 Did you [TEXTFILL: or your spouse/partner] receive any respite care following your adoption of [S.C.]?

READ IF NECESSARY: Respite care is care for the child so the family can have a break from ongoing care of

the child. Respite care can be thought of as child care or babysitting by someone trained to meet any special needs

the child may have. Both professional and non-professional respite care should be included.

(1) YES

(0) NO	 <GO TO N12c>

(6) DON’T KNOW <GO TO N12c>

(7) REFUSED <GO TO N12c>

N12A.	 Did you [TEXTFILL: or your spouse/partner] find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N12B. How did you [TEXTFILL: or your spouse/partner hear about this service? [SELECT ALL THAT APPLY]

(1) ADOPTION WORKER

(2) ADOPTION AGENCY

(3) ADOPTION ATTORNEY

(4) COMMUNITY OR LOCAL NEWSPAPER

(5) ADOPTION WEBSITE OR LISTSERV

(6) OTHER PARENTS

(7) OTHER <GO TO N12BA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN14> 

N12BA. (Specify) _________________ <GO TO CPN14> 

(6) DON’T KNOW <GO TO Checkpoint before N14>

(7) REFUSED <GO TO Checkpoint before N14>

N12C. Did you [TEXTFILL: or your spouse/partner] ever need this service since adopting [S.C.]?

(1) YES

(0) NO	 <GO TO CPN14>

(6) DON’T KNOW <GO TO CPN14>

(7) REFUSED <GO TO CPN14>

N12D.	 Why didn’t you receive this service that you needed? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) COST

(4) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(5) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(6) NO SUCH SERVICES CLOSE TO ME/US

(7) OTHER <GO TO N12DA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN14> 

N12DA. Specify: ________________ 

(6) DON’T KNOW

(7) REFUSED
Page 88 [ Series 1, No. 51

SUPPORT 14

TIMESTAMP_SECTION_NF14

<CHECKPOINT CPN14: CHECKPOINT: IF AGEMONSAP < 96 MONTHS, GO TO N18 / ELSE IF C43=1 GO TO

N14_INTRO / ELSE IF C42 or C43 = NULL GO TO N18 / ELSE GO TO N14C>

N14_INTRO.	 Earlier you told me that [S.C.] has spent time in a residential treatment or psychiatric facility since the time of

his/her adoption.

<CHECKPOINT CPN14A: <IF F1=1, GO TO N14A; ELSE GO TO N14AA>

N14A. Was the payment for residential treatment or psychiatric facility for [S.C.] written into your adoption agreement?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

N14AA. What portion of [S.C.]’s placement(s) in a group home or residential treatment facility or psychiatric facility was

paid for by each of the following sources:

N14AA1. Medicaid

<READ IF NECESSARY: What portion of [S.C.]’s placement (s) in a group home or residential treatment facility

or psychiatric facility was paid for by each of the following sources >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO N14B>

(6) DON’T KNOW

(7) REFUSED

N14AA2. Insurance other than Medicaid

<READ IF NECESSARY: What portion of [S.C.]’s placement (s) in a group home or residential treatment facility

or psychiatric facilty was paid for by each of the following sources >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO N14B>

(6) DON’T KNOW

(7) REFUSED

CHECKPOINT CPFN14AA3: <If C10Q05=1 then ask N14AA3, ELSE GO TO N14AA4>

N14AA3.	 Child welfare or adoption agency

<READ IF NECESSARY: What portion of [S.C.]’s placement (s) in a group home or residential treatment facility

or psychiatric facility was paid for by each of the following sources >

(1) NONE

(2) SOME

(3) ALMOST ALL

(4) ALL <GO TO N14B>

(6) DON’T KNOW

(7) REFUSED

N14AA4. You?

<READ IF NECESSARY: What portion of [S.C.]’s placement (s) in a group home or residential treatment facility

or psychiatric facility was paid for by each of the following sources >

(1) NONE

(2) SOME
Series 1, No. 51 [ Page 89

(3) ALMOST ALL

(4) ALL <GO TO N14B>

(6) DON’T KNOW

(7) REFUSED

N14AA5.	 Is there any other source helping pay for the placement?

(1) YES <GO TO N14AAB>

(2) NO <GO TO NF14B>

(6) DON’T KNOW <GO TO NF14B>

(7) REFUSED <GO TO NF14B> 

N14AAB. Other (specify :)________) 

(6) DON’T KNOW

(7) REFUSED

N14B.	 Did you find this to be very helpful, somewhat helpful, or not very helpful for [S.C.]?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N14BB.	 How did you hear about this facility? [SELECT ALL THAT APPLY]

(1) MEDICAL PROFESSIONAL

(2) ADOPTION WORKER

(3) ADOPTION AGENCY

(4) ADOPTION ATTORNEY

(5) COMMUNITY OR LOCAL NEWSPAPER

(6) ADOPTION WEBSITE OR LISTSERV

(7) OTHER PARENTS

(8) OTHER <GO TO N14BBA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO N18> 

N14BBA. (Specify) _________________ <GO TO N18> 

(6) DON’T KNOW <GO TO N18>

(7) REFUSED <GO TO N18>

N14C.	 IF C42=NO, ASK: Earlier you told me that [S.C.] has not received any treatment or counseling from a mental

health professional since the time of the adoption. Did you ever want [S.C.] to spend time in a residential

treatment or psychiatric facility? IF C42 = DON’T KNOW or REFUSED, ASK: Did you ever want [S.C.] to

spend time in a residential treatment or psychiatric facility? ELSE IF C43 = NO, DON’T KNOW OR REFUSED,

ASK: Earlier you told me that [S.C.] has not spent time in a residential treatment or psychiatric facility since the

time of the adoption. Did you ever want [S.C.] to spend time in a residential treatment or psychiatric facility?

(1) YES

(0) NO <GO TO N18>

(6) DON’T KNOW <GO TO N18>

(7) REFUSED <GO TO N18>
Page 90 [ Series 1, No. 51

N14D.	 Why didn’t [S.C.] spend time in a facility that you felt he/she needed? [SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) AGENCY DID NOT OFFER SERVICES

(3) COST

(4) WERE TOLD I/WE DID NOT QUALIFY FOR THIS SERVICE

(5) DIDN’T KNOW WHERE TO FIND THIS SERVICE

(6) NO SUCH SERVICES CLOSE TO ME/US

(7) OTHER <GO TO N14DA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO N18> 

N14DA. Specify: ________________ 

(6) DON’T KNOW

(7) REFUSED

SUPPORT 18

TIMESTAMP_SECTION_NF18

N18.	 Now I’d like to ask you about different types of information or education that you received about adoption after

you adopted [S.C.]. Following your adoption of [S.C.], did you [TEXTFILL: or your spouse/partner] attend any

classes, conferences, lectures or seminars about adoption?

<INTERVIEWER INSTRUCTION: IF RESPONDENT ASKS ABOUT CHILDREN ADOPTED BEFORE [S.C.],

THIS QUESTION REFERS TO [S.C.]. IF RESPONDENT ASKS ABOUT TIME FRAME, IT IS ‘‘AT ANY TIME

FOLLOWING YOUR ADOPTION OF [S.C.]’’>

(1) YES

(2) NO <GO TO N18C>

(6) DON’T KNOW <GO TO N18C>

(7) REFUSED <GO TO N18C>

N18A.	 Did you find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N18B.	 How did you [TEXTFILL: or your spouse/partner] hear about these classes, conferences, lectures or seminars?

[SELECT ALL THAT APPLY]

(1) ADOPTION WORKER

(2) ADOPTION AGENCY

(3) ADOPTION ATTORNEY

(4) COMMUNITY OR LOCAL NEWSPAPER

(5) ADOPTION WEBSITE OR LISTSERV

(6) OTHER PARENTS

(7) OTHER <GO TO N18BA>

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO N20> 

N18BA. Specify ________________ <GO TO N20> 

(6) DON’T KNOW <GO TO N20>

(7) REFUSED <GO TO N20>
Series 1, No. 51 [ Page 91

N18C.	 Did you [TEXTFILL: or your spouse/partner] ever wish you could attend classes,

conferences, lectures or seminars about adoption since adopting [S.C.]?

(1) YES

(2) NO <GO TO N20>

(6) DON’T KNOW <GO TO N20>

(7) REFUSED <GO TO N20>

N18D.	 Why were you [TEXTFILL: or your spouse/partner] not able to attend classes, lectures or seminars on adoption?

[SELECT ALL THAT APPLY]

(1) PROGRAM/SERVICE DID NOT HAVE ROOM

(2) COST

(3) DIDN’T KNOW WHERE TO FIND ONE

(4) NONE CLOSE TO US

(5) OTHER <GO TO N18DA>

(6) DON’T KNOW

(7) REFUSED

<IF OTHER NOT SELECTED, GO TO N20> 

N18DA. Specify ________________ <GO TO N20> 

(6) DON’T KNOW <GO TO N20>

(7) REFUSED <GO TO N20>

SUPPORT 20

TIMESTAMP_SECTION_NF20

N20.	 Following the adoption of [S.C.], have you [TEXTFILL: or your spouse/partner] utilized any web- or internetbased resources like websites, listservs, or chat rooms for information on adoption-related issues?

(1) YES

(0) NO <GO TO N21>

(6) DON’T KNOW <GO TO N21>

(7) REFUSED <GO TO N21>

N20A.	 Did you find this to be very helpful, somewhat helpful, or not very helpful?

(1) VERY HELPFUL

(2) SOMEWHAT HELPFUL

(3) NOT VERY HELPFUL

(6) DON’T KNOW

(7) REFUSED

N21.	 Now, I am going to ask you some questions about assistance that you might have provided to other adoptive

families. Have you [TEXTFILL: or your spouse/partner] ever been asked by anyone to assist in helping other

adoptive families?

(1) YES

(2) NO <GO TO N22>

(6) DON’T KNOW <GO TO N22>

(7) REFUSED <GO TO N22>

N21A.	 Who asked you to assist in helping other adoptive families?

(1) ADOPTION AGENCY

(2) FRIEND, RELATIVE OR NEIGHBOR

(3) CHURCH OR COMMUNITY GROUP

(4) OTHER ADOPTIVE PARENTS

(5) OTHER, <GO TO N21AA>

(6) DON’T KNOW

(7) REFUSED 

<IF OTHER NOT SELECTED, GO TO N21B> 
Page 92 [ Series 1, No. 51

N21AA. PLEASE SPECIFY ____________________________.

(6) DON’T KNOW

(7) REFUSED

N21B.	 Following the request, did you [TEXTFILL: or your spouse/partner] assist in helping other adoptive families?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

N22.	 Has anyone ever asked you [TEXTFILL: or your spouse/partner] to recruit other adoptive families?

(1) YES

(0) NO <GO TO N23>

(6) DON’T KNOW <GO TO N23>

(7) REFUSED <GO TO N23>

N22A.	 Who asked you to assist in recruiting other adoptive families?

(1) ADOPTION AGENCY

(2) FRIEND, RELATIVE OR NEIGHBOR

(3) CHURCH OR COMMUNITY GROUP

(4) OTHER ADOPTIVE PARENTS

(5) OTHER <GO TO N22AA>

(6) DON’T KNOW

(7) REFUSED

<IF OTHER NOT SELECTED, GO TO N22VB> 

N22AA. PLEASE SPECIFY ____________________________. 

(6) DON’T KNOW

(7) REFUSED

N22B.	 Following the request did you [TEXTFILL: or your spouse/partner] assist in recruiting other adoptive families?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

N23.	 Now I’m going to ask a few final questions about you [TEXTFILL: and your spouse/partner]. What year were you

born?

____________year [POSSIBLE FILL FROM NIS C10AMDY, C10B]

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPN23AA: IF (S3_N does not = 1 OR 2) GO TO N24>

N23AA.	 What year was [your spouse/partner] born?

____________year

(6) DON’T KNOW

(7) REFUSED

N24.	 Are you of Hispanic or Latino origin?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED
Series 1, No. 51 [ Page 93

N24A.	 Please choose one or more of the following categories to describe your race. Are you White, Black or African

American, American Indian, Alaska Native, Asian, or Native Hawaiian or other Pacific Islander? [SELECT ALL

THAT APPLY].

(1) WHITE

(2) BLACK/AFRICAN AMERICAN

(3) AMERICAN INDIAN

(4) ALASKA NATIVE

(5) ASIAN

(6) NATIVE HAWAIIAN

(7) PACIFIC ISLANDER

(8) OTHER <GO TO N24AA>

(96) DON’T KNOW

(97) REFUSED 

N24AA. OTHER (specify): _________________________ 

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPN25: IF (S3_N does not = 1 OR 2) GO TO N26>

N25.	 Is your [TEXTFILL: spouse/partner] of Hispanic or Latino origin?

(1) YES

(0) NO

(6) DON’T KNOW

(7) REFUSED

N25A.	 Please choose one or more of the following categories to describe your spouse/partner’s race. Is your spouse/

partner White, Black or African American, American Indian, Alaska Native, Asian, or Native Hawaiian or other

Pacific Islander? [SELECT ALL THAT APPLY].

(1) WHITE

(2) BLACK/AFRICAN AMERICAN

(3) AMERICAN INDIAN

(4) ALASKA NATIVE

(5) ASIAN

(6) NATIVE HAWAIIAN

(7) PACIFIC ISLANDER

(8) OTHER <GO TO N25AA>

(96) DON’T KNOW

(97) REFUSED 

N25AA. OTHER (specify). ___________________________ 

(6) DON’T KNOW

(7) REFUSED

N26.	 Last week were you working full time, working part time, temporarily not working, unemployed, retired, going to

school, keeping house, or something else?

(1) WORKING FULLTIME

(2) WORKING PART TIME

(3) TEMPORARILY NOT WORKING

(4) UNEMPLOYED

(5) RETIRED

(6) SCHOOL

(7) KEEPING HOUSE

(8) OTHER <GO TO N26A>

(9) DISABLED OR ON DISABILITY

(96) DON’T KNOW

(97) REFUSED

<IF OTHER NOT SELECTED, GO TO CPN27>
Page 94 [ Series 1, No. 51

N26A.	 ____________________

(6) DON’T KNOW

(7) REFUSED

<CHECKPOINT CPN27: IF (S3_N does not = 1 OR 2) GO TO END>

N27.	 Last week was your spouse/partner working full time, working part time, temporarily not working, unemployed,

retired, going to school, keeping house, or something else?

(1) WORKING FULLTIME

(2) WORKING PART TIME

(3) TEMPORARILY NOT WORKING

(4) UNEMPLOYED

(5) RETIRED

(6) SCHOOL

(7) KEEPING HOUSE

(8) OTHER <GO TO N27A>

(96) DON’T KNOW

(97) REFUSED 

<IF OTHER NOT SELECTED GO TO END> 

N27A. ____________________ <GO TO END>

(6) DON’T KNOW <GO TO END>

(7) REFUSED <GO TO END>

CELL_PAY

Did we conduct this survey on your cell phone?

(1) YES [GO TO CELL_SCRIPT]

(2) NO [GO TO END]

CELL_SCRIPT

You will receive an additional $10 to defer your costs for doing the interview on your cell phone.

END	 Those are all the questions I have. Before I go, I’ll need to confirm your mailing address so we can send you $25

as a token of our appreciation for taking the time to answer these questions.

<GET/CONFIRM ADDRESS and GO TO END_2>

END_2	 I’d like to thank you on behalf of the Centers for Disease Control and Prevention for the time and effort you’ve

spent answering these questions. If you have any questions about this survey, you may call my supervisor toll-free

at [TEXTFILL: 1-xxx-xxx-xxxx]. If you have questions about your rights as a survey participant, you may call the

chairman of the Research Ethics Review Board at 1-800-223-8118. Thank you again.

NSAP_END_TIME
Series 1, No. 51 [ Page 95

CALLBACK / REFUSAL CONVERSION SCRIPT

FOR RETURN PHONE CALLS/REFUSAL CONVERSION CALLS IN CSHCN

INTRO_1 Hello, my name is ____. I’m calling on behalf of the Centers for Disease Control and Prevention. Earlier, we

contacted your household to participate in a survey about the health of children and teenagers. I’m calling back to

continue the interview. In appreciation for your time, we will send you $25 for completing the interview. (IF

NAME WAS GIVEN FOR APPOINTMENT, ASK FOR THAT PERSON.)

BE SURE TO CONFIRM THAT YOU ARE SPEAKING WITH THE SAME PERSON WHO STARTED THE

INTERVIEW. THE PERSON WHO STARTED THE INTERVIEW MUST COMPLETE THIS INTERVIEW.

S1 Am I speaking to someone who lives in this household who is over 17 years old? IF NO, ASK ‘‘Is there someone

who lives in this household who is over 17 that I may speak with?’’

(01) YES, I AM THAT PERSON [IF [S.C.] IS SELECTED GO TO REMIND1/ ELSE CONTINUE

WITH INTERVIEW]

(02) THIS IS A BUSINESS [SKIP TO SALZ_BUS]

(03) NEW PERSON COMES TO PHONE [SKIP BACK TO INTRO_01]

(08) DOES NOT LIVE IN HOUSEHOLD [CALLBACK, SET DISP AND TERMINATE]

(09) NO PERSON AT HOME WHO IS OVER 17 [SKIP TO S2_B]

(7) REFUSED [GO TO REFUSAL CONVERSION,

SET DISP AND TERMINATE]

SALZ_BUS We are interviewing only private residences. Thank you very much. [ENTER DISPOSITION AND

TERMINATE INTERVIEW AND SET ITS=38]

S2_B Does anyone live in your household who is over 17 years old?

(01) YES > When would be a good time for me to call back and talk to that person?

[SCHEDULE APPOINTMENT]

(02) NO [TERMINATE INTERVIEW]

REMIND1 I want to remind you that we will be asking questions about (S.C) for the rest of this interview.

[CONTINUE WITH INTERVIEW AT POINT OF BREAKOFF]
Page 96 [ Series 1, No. 51

ANSWERING MACHINE MESSAGES

Answering Machine Message :

MSG_NSAP - Answering Machine Message: FOR ALL CASES IN THE NSAP INTERVIEW (PAST NSAP_1A)

(PLEASE READ SLOWLY AND CLEARLY.)

Hello. The Centers for Disease Control and Prevention is conducting a survey about the health and well-being of children and the

use of medical services. Your household participated in the survey about a year ago and now we would like to collect a little

additional information. Would you please call us, toll-free, at [TEXTFILL: 1-xxx-xxx-xxxx] ? We would be glad to answer any

questions you have. In appreciation for your time, we will send you $25 for completing the interview. The toll-free number again

is [TEXTFILL: 1-xxx-xxx-xxxx]. Thank you.

Answering machine message for appointments: 

MSG_Y_APPT_NSAP- Answering Machine Message: FOR APPOINTMENTS IN THE NSAP INTERVIEW (PAST 

NSAP_1A) 

(PLEASE READ SLOWLY AND CLEARLY.) 

Hello. I am calling on behalf of the Centers for Disease Control and Prevention regarding a nationwide study about the health of

children and the use of medical services. When we spoke previously about this important study, you requested that we call you

back at this time. I’m sorry that we’ve missed you. We’ll try to contact you again soon but please feel free to return our call

anytime at [TEXTFILL: 1-xxx-xxx-xxxx]. In appreciation for your time, we will send you $25 for completing the interview. If you

have any questions, that number again is [TEXTFILL: 1-xxx-xxx-xxxx]. Thank you.

MSG_NSAP_INCENT- Answering Machine Message: FOR ALL POST-REFUSAL CASES IN THE NSAP INTERVIEW 

(PAST NSAP_1A) 

(PLEASE READ SLOWLY AND CLEARLY.) 

Hello. The Centers for Disease Control and Prevention is conducting a survey about the health and well-being of children and the

use of medical services. Your household participated in the survey about a year ago and now we would like to collect a little

additional information. Would you please call us, toll-free, at 1-866-900-9601? We would be glad to answer any questions you

have. In appreciation for your time, we will send you $[Text Fill: IF NSAP_INCENT=<null>, then use 25 / ELSE use

NSAP_INCENT] for completing the interview. The toll-free number again is 1–866-900–9601. Thank you.
Series 1, No. 51 [ Page 97

Appendix III 

Summary of Questionnaire

Changes During Data

Collection

There were no questionnaire

changes during the National Survey of

Adoptive Parents of Children with

Special Health Care Needs (NSAP-SN)

data collection. However, NSAP-SN

staff did release additional interviewer

job aid text that provided respondents

with information pertaining to

postadoption services.

During data collection, interviewers

reported some confusion with questions

F14A_A and F16_A because the

questionnaire did not contain an

intermediate screening question between

these two questions. Respondents who

reported that they had used Medicaid to

obtain mental health medications for the

sample child in F14A_A were asked in

F16_A what portion of the sample

child’s mental health medications were

paid for by that source. The wording of

question F16_A assumed that the child

had used medications in the past 12

months when the interviewers had not

asked if the child had used medications

during that time frame.

The following procedure was

developed to work around this problem:

If the parent spontaneously indicated at

F16_A that the child had not used

mental health medications in the past 12

months, the interviewer entered ‘‘don’t

know’’ to questions F16A_A through

F16A_D without reading the text that

was presented on the screen. At F16A_E

(‘‘Is there any other source helping pay

for mental health medications?’’) the

interviewer entered ‘‘yes’’ and typed

‘‘CHILD HAS NOT USED MEDS IN

LAST 12 MOS’’ when prompted for the

verbatim entry at F16A_EA. When

NORC at the University of Chicago

cleaned the final data file, the answers

to F16A_A through F16A_EA were

blanked out as legitimate skips. There

are 11 such cases.

Changes that were made to the

National Survey of Adoptive Parents

(NSAP) questionnaire during the

administration of NSAP, but prior to the

beginning of NSAP-SN data collection,

are described in detail in the NSAP

design and operations report (3).
Page 98 [ Series 1, No. 51

Appendix IV

Letters Sent to Sampled

Households

This appendix contains the National

Survey of Adoptive Parents of Children

with Special Health Care Needs

(NSAP-SN)-specific complement of

letters sent to households during the

data collection period in 2008. The full

complement of advance letters,

follow-up letters, and thank you letters

used over the course of data collection

for the National Immunization Survey

and the National Survey of Children

with Special Health Care Needs

(NS-CSHCN) in 2005–2006 can be

found in the 2005–2006 NS-CSHCN

design and operations report (1).

The following six NSAP-SN letters

are included in this appendix:

+	 Advance letter sent prior to calling.

+	 Follow-up letter when incentives

were offered to households that had

refused twice or passively refused.

+	 Follow-up letter for households with

no telephone contact asking

respondents to call the toll-free

number.

+	 Thank you letter when incentive was

mailed ($25). Cases receiving this

thank you letter were either eligible

for $25 or eligible for $30 and

already received a $5 prepaid

incentive.

+	 Thank you letter when incentive was

mailed ($30). Cases receiving this

thank you letter were eligible for

$30 and did not receive a $5 prepaid

incentive.

+	 Thank you letter when incentive was

mailed ($35). Cases receiving this

thank you letter were either eligible

for $25 and received a $10

compensation for participating by

cellular telephone or eligible for

$30, already received a $5 prepaid

incentive, and received a $10

compensation for participating by

cellular telephone.
Series 1, No. 51 [ Page 99

NSAP-SN Advance Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road 

Hyattsville, Maryland 20782 

Dear Parent or Guardian, 

The Centers for Disease Control and Prevention (CDC) is conducting a nationwide survey and we need your help! In 

2005 or 2006, we spoke to someone in your household about children’s healthcare. We would like to interview you 

now to obtain additional information about children’s health, well-being, and use of services. The questions cover 

many broad topics including experiences with health care, child care, foster care, educational and counseling services, 

local support groups, adoption, and parent and child relationships. Not all topics will apply to all families. 

You can call the study’s toll-free telephone number, 1–866-900–9601, if you want to take part in the study now or to 

learn more about the study’s background and what you will be asked. You can also visit this website if you would like 

to learn more: http://www.cdc.gov/nchs/slaits.htm. 

We need your help to make this survey a success, and hope that you will agree to participate. It is your choice to 

participate. You will find answers to questions you might have about the study on the back of this letter. Please feel 

free to call us toll free at 1–866-900–9601 with any additional questions you may have. 

This study is authorized by the U.S. Public Health Service Act. It and other strict federal laws require us to treat your 

information as confidential. The information you report will be combined with answers from other families for 

statistical research only. 

Thank you in advance for your help with this important research. We look forward to speaking with you. 

Sincerely, 

/Edward J. Sondik/ 

Edward J. Sondik, Ph.D. 

Director, National Center for Health Statistics 

Centers for Disease Control and Prevention 

If you would like to contact us using a TTY, please call the AT&T Relay Service at 1–800–855–2880 and

request that 1–866–900–9601 be called.

CSHCN-NSAP ADV1 
Page 100 [ Series 1, No. 51

Frequently Asked Questions

Why are you doing this study?

The Centers for Disease Control and Prevention is committed to improving children’s health and well-being. State and

federal health agencies will use the results of this study to help them understand how best to meet the needs of all

types of children.

How will you use my answers?

A survey sponsor, the Administration for Children and Families (ACF) in the Department of Health and Human

Services (HHS), creates federal programs that promote the economic and social well-being of families, children,

individuals, and communities. The ACF will use the information we collect to determine where funding is needed for

state and local public health services which support children and their families. Federal, state, and local agencies (such

as the CDC and State Health and Welfare Departments) will use the information we collect to better understand the

special needs and circumstances of families. You may visit http://www.cdc.gov/nchs/slaits.htm to find general

information about the study.

Who sees my answers?

You will be called by a trained interviewer who enters your answers into a computer. Everyone who works on the

survey must sign an oath that promises they will never give out anyone’s personal information. Only a few people

who work on this survey ever see any personal information. Answers that could identify you or your family in any

way are separated from your other answers. Survey findings are put into summary reports that contain no names or

other information that identifies you.

How do you protect my information?

Your answers are used for health research purposes only. We conduct this survey under the Public Health Service Act.

It and other strict U.S. laws require that we protect your family’s information and keep it confidential. If you would

like to know more about how we protect your answers, these laws are described in detail at www.cdc.gov/nchs/about/

policy/confiden.htm.

If you want to know more about your rights as a study participant you may call 1–800–223–8118, toll free. This is the

number for the Research Ethics Review Board at CDC. You will be asked to leave a message. Say you are calling

about Protocol 2007–08. You may also contact the CDC’s general number at 1–800–CDC–INFO (1–800–232–4636) or

by e-mail at cdcinfo@cdc.gov

Participation in the study is your choice. You may choose not to answer any question that you do not wish to answer

or stop at any time.

Can I call you to participate?

Yes, call 1–866–900–9601 toll free to take part in the study right away, learn more about the study, and hear what you

will be asked.

CSHCN-NSAP ADV1 
Series 1, No. 51 [ Page 101

NSAP-SN Refusal Conversion Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road 

Hyattsville, Maryland 20782 

Dear Parent or Guardian,

The CDC needs your help!

We recently asked you to take part in a survey to help federal, state, and local agencies learn more about the special 

needs and concerns of families. The information we are asking for will help us assess the health and well-being of the 

nation’s children and their families. The questions cover many broad topics including experiences with health care, 

child care, foster care, educational and counseling services, local support groups, adoption, and parent and child 

relationships. 

We hope you will choose to take part in this important survey when an interviewer calls. You can call the study’s 

toll-free telephone number, 1–866-900–9601, if you want to take part now or to learn more about the study’s 

background and what you will be asked. 

The information you provide is confidential and protected by federal law. You will find answers to questions you 

might have about the study on the back of this letter. 

Thank you very much for your help with this important research. We look forward to speaking with you. 

Sincerely, 

/Edward J. Sondik/ 

Edward J. Sondik, Ph.D. 

Director, National Center for Health Statistics 

Centers for Disease Control and Prevention 

P.S. To thank you for your time and effort, we have enclosed $5. We will send an additional $25 in cash once you

participate in the interview.

If you would like to contact us using a TTY, please call the AT&T Relay Service at 1–800–855–2880 and

request that 1–866–900–9601 be called.

CSHCN-NSAP REF5 
Page 102 [ Series 1, No. 51

Frequently Asked Questions

Why are you doing this study?

The Centers for Disease Control and Prevention is committed to improving children’s health and well-being. State and

federal health agencies will use the results of this study to help them understand how best to meet the needs of all

types of children.

How will you use my answers?

A survey sponsor, the Administration for Children and Families (ACF) in the Department of Health and Human

Services (HHS), creates federal programs that promote the economic and social well-being of families, children,

individuals, and communities. The ACF will use the information we collect to determine where funding is needed for

state and local public health services which support children and their families. Federal, state, and local agencies (such

as the CDC and State Health and Welfare Departments) will use the information we collect to better understand the

special needs and circumstances of families. You may visit http://www.cdc.gov/nchs/slaits.htm to find general

information about the study.

Who sees my answers?

You will be called by a trained interviewer who enters your answers into a computer. Everyone who works on the

survey must sign an oath that promises they will never give out anyone’s personal information. Only a few people

who work on this survey ever see any personal information. Answers that could identify you or your family in any

way are separated from your other answers. Survey findings are put into summary reports that contain no names or

other information that identifies you.

How do you protect my information?

Your answers are used for health research purposes only. We conduct this survey under the Public Health Service Act.

It and other strict U.S. laws require that we protect your family’s information and keep it confidential. If you would

like to know more about how we protect your answers, these laws are described in detail at www.cdc.gov/nchs/about/

policy/confiden.htm.

If you want to know more about your rights as a study participant you may call 1–800–223–8118, toll free. This is the

number for the Research Ethics Review Board at CDC. You will be asked to leave a message. Say you are calling

about Protocol 2007–08. You may also contact the CDC’s general number at 1–800–CDC–INFO (1–800–232–4636) or

by e-mail at cdcinfo@cdc.gov.

Participation in the study is your choice. You may choose not to answer any question that you do not wish to answer

or stop at any time.

Can I call you to participate?

Yes, call 1–866–900–9601 toll free to take part in the study right away, learn more about the study, and hear what you

will be asked.

CSHCN-NSAP REF5 
Series 1, No. 51 [ Page 103

NSAP-SN ‘‘Trying to Reach You’’ Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES	 Public Health Service 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road 

Hyattsville, Maryland 20782 

Dear Parent or Guardian, 

The Centers for Disease Control and Prevention (CDC) has been trying to reach you for a very important survey on 

children’s health, well-being, and use of services! 

In 2005 or 2006, we called and spoke to someone in your household about children’s healthcare. We would very much 

like to speak to you again, but we have been unable to reach you. Please call us at 1–866–900–9601 to participate 

in the study now. When you call, please tell the interviewer that you are calling about the follow-up study. By 

calling us you can learn more about the study’s background and what you will be asked. You can also visit this 

website if you would like to learn more: http://www.cdc.gov/nchs/slaits.htm. You will find answers to questions you 

might have about the study on the back of this letter. 

The current study has questions covering many broad topics including experiences with health care, child care, foster 

care, educational and counseling services, local support groups, adoption, and parent and child relationships. Not all 

topics will apply to all families. 

It is your choice to participate. When we speak to you, we will ask a few questions to determine if you are eligible for 

the study. Families that qualify for the survey will be sent $25. 

This study is authorized by the U.S. Public Health Service Act. It and other strict federal laws require us to treat your 

information as confidential. The information you report will be combined with answers from other families for 

statistical research only. 

Thank you in advance for your help with this important research. We look forward to speaking with you. 

Sincerely, 

/Edward J. Sondik/ 

Edward J. Sondik, Ph.D. 

Director, National Center for Health Statistics 

Centers for Disease Control and Prevention 

If you would like to contact us using a TTY, please call the AT&T Relay Service at 1–800–855–2880 and

request that 1–866–900–9601 be called.
Page 104 [ Series 1, No. 51

Frequently Asked Questions

Why are you doing this study?

The Centers for Disease Control and Prevention is committed to improving children’s health and well-being. State and

federal health agencies will use the results of this study to help them understand how best to meet the needs of all

types of children.

How will you use my answers?

A survey sponsor, the Administration for Children and Families (ACF) in the Department of Health and Human

Services (HHS), creates federal programs that promote the economic and social well-being of families, children,

individuals, and communities. The ACF will use the information we collect to determine where funding is needed for

state and local public health services which support children and their families. Federal, state, and local agencies (such

as the CDC and State Health and Welfare Departments) will use the information we collect to better understand the

special needs and circumstances of families. You may visit http://www.cdc.gov/nchs/slaits.htm to find general

information about the study.

Who sees my answers?

You will be called by a trained interviewer who enters your answers into a computer. Everyone who works on the

survey must sign an oath that promises they will never give out anyone’s personal information. Only a few people

who work on this survey ever see any personal information. Answers that could identify you or your family in any

way are separated from your other answers. Survey findings are put into summary reports that contain no names or

other information that identifies you.

How do you protect my information?

Your answers are used for health research purposes only. We conduct this survey under the Public Health Service Act.

It and other strict U.S. laws require that we protect your family’s information and keep it confidential. If you would

like to know more about how we protect your answers, these laws are described in detail at www.cdc.gov/nchs/about/

policy/confiden.htm.

If you want to know more about your rights as a study participant you may call 1–800–223–8118, toll free. This is the

number for the Research Ethics Review Board at CDC. You will be asked to leave a message. Say you are calling

about Protocol 2007–08. You may also contact the CDC’s general number at 1–800–CDC–INFO (1–800–232–4636) or

by e-mail at cdcinfo@cdc.gov

Participation in the study is your choice. You may choose not to answer any question that you do not wish to answer

or stop at any time.

Can I call you to participate?

Yes, call 1–866–900–9601 toll free to take part in the study right away, learn more about the study, and hear what you

will be asked.
Series 1, No. 51 [ Page 105

NSAP-SN $25 Thank You Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road 

Hyattsville, Maryland 20782 

Dear Parent or Guardian, 

Thank you for taking part in the National Survey of Adoptive Parents. The information that you gave about your child 

will help the Centers for Disease Control and Prevention develop programs to promote adoption and examine the 

health of adopted children in your state and throughout the United States. 

In appreciation for your time and effort spent answering our questions, we have enclosed $25. 

If you would like more information about the National Survey of Adoptive Parents, you can visit the study’s web site 

at www.cdc.gov/nchs/slaits.htm or call the toll-free telephone number for the study at 1–866–900–9601. 

Thank you again for your help with this important research. 

Sincerely, 

/Edward J. Sondik/ 

Edward J. Sondik, Ph.D. 

Director, National Center for Health Statistics 

Centers for Disease Control and Prevention 

CSHCN-NSAP_TY25 
Page 106 [ Series 1, No. 51

NSAP-SN $30 Thank You Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES	 Public Health Service 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road 

Hyattsville, Maryland 20782 

Dear Parent or Guardian, 

Thank you for taking part in the National Survey of Adoptive Parents. The information that you gave about your child 

will help the Centers for Disease Control and Prevention develop programs to promote adoption and examine the 

health of adopted children in your state and throughout the United States. 

In appreciation for your time and effort spent answering our questions, we have enclosed $30. 

If you would like more information about the National Survey of Adoptive Parents, you can visit the study’s web site 

at www.cdc.gov/nchs/slaits.htm or call the toll-free telephone number for the study at 1–866–900–9601. 

Thank you again for your help with this important research. 

Sincerely, 

/Edward J. Sondik/ 

Edward J. Sondik, Ph.D. 

Director, National Center for Health Statistics 

Centers for Disease Control and Prevention 

CSHCN-NSAP_TY30 
Series 1, No. 51 [ Page 107

NSAP-SN $35 Thank You Letter

DEPARTMENT OF HEALTH & HUMAN SERVICES Public Health Service 

Centers for Disease Control and Prevention 

National Center for Health Statistics 

3311 Toledo Road 

Hyattsville, Maryland 20782 

Dear Parent or Guardian, 

Thank you for taking part in the National Survey of Adoptive Parents. The information that you gave about your child 

will help the Centers for Disease Control and Prevention develop programs to promote adoption and examine the 

health of adopted children in your state and throughout the United States. 

In appreciation for your time and effort spent answering our questions, we have enclosed $35. 

If you would like more information about the National Survey of Adoptive Parents, you can visit the study’s web site 

at www.cdc.gov/nchs/slaits.htm or call the toll-free telephone number for the study at 1–866–900–9601. 

Thank you again for your help with this important research. 

Sincerely, 

/Edward J. Sondik/ 

Edward J. Sondik, Ph.D. 

Director, National Center for Health Statistics 

Centers for Disease Control and Prevention 

CSHCN-NSAP_TY35 
Page 108 [ Series 1, No. 51

Appendix V 

Incentive Effort

The National Survey of Adoptive

Parents (NSAP) was the last of up to

three concurrent surveys [National

Immunization Survey (NIS), National

Survey of Children’s Health, and NSAP]

and nonresponse was a concern in

regards to respondent burden. The

National Survey of Adoptive Parents of

Children with Special Health Care

Needs (NSAP-SN), however, was a

stand-alone follow-back conducted years

after the original NIS and National

Survey of Children with Special Health

Care Needs (NS-CSHCN) interviews.

Nonresponse was a key issue because

NSAP-SN was a follow-back survey and

had the added challenge of finding

2005–2006 NS-CSHCN households. It

had been approximately 1–3 years since

households identified for NSAP-SN

were contacted as part of the 2005–2006

NS-CSHCN. While the reasons for the

likelihood of nonresponse on NSAP-SN

differed, it was recognized that

NSAP-SN would benefit from a similar

incentive model as used on NSAP to

address nonresponse.

Eligible cases

All households that completed the

NSAP-SN screener and screened as

in-scope for the interview were offered

$25 for completion of the survey.

Households became eligible for an

additional $5 incentive (total $30

incentive payment) based on their

interview status and calling history

characteristics.

Cases could become eligible for the

additional $5 incentive in one of two

ways. First, a case could qualify after

having refused participation verbally

(i.e., active refusal). After two refusals

in an NSAP-SN-eligible case’s call

history, the case became eligible for an

additional $5 incentive ($30 total

incentive payment). Second, a case

could qualify as a passive refusal based

on patterns of continued nonresponse.

Two groups of passive refusal cases

qualified for the additional $5 incentive:

NSAP-SN-eligible households that had

never verbally refused in their call

history, but had multiple calls placed to

the household over a period of time

without successful contact; and

NSAP-SN-eligible households that had

verbally refused once during their call

history, but since this refusal multiple

calls were placed to the household over

a period of time without successful

contact.

Procedures

Once NSAP-SN-eligible cases

became eligible for the additional $5

incentive ($30 total incentive), they

were offered the incentive either by mail

or on call back in the following manner.

After a second verbal refusal or

qualifying for a passive refusal

incentive, cases were temporarily

finalized, or removed from calling,

within the CATI system. For households

with an available address, a letter

(Appendix IV) was mailed with $5

enclosed. The letter explained that

attempts had been made to contact the

household via phone to complete the

NSAP-SN interview. It also briefly

described NSAP-SN, included an FAQ

section about the survey, and mentioned

that $25 would be mailed upon

continued participation in NSAP-SN. In

this way, the letter served as a

supplementary mode of refusal

conversion. After approximately 1–2

weeks from the time the case finalized,

the active refusal and passive refusal

incentive cases were reactivated and

offered $25 by phone. The incentive

offer was introduced in various

interview scripts (i.e., consent script,

callback script, answering machine

script) based on case progress within the

interview. For active refusal or passive

refusal incentive-eligible households

without an address, $30 was introduced

at similar points in the survey, again

based on the point at which the refusal

occurred.

After the incentive offer, cases

would be permanently finalized and not

called again based on refusal counts.

Active refusal cases (with two previous

refusals) and passive refusal cases (with

one previous refusal) were finalized

after one subsequent refusal. Passive

refusals with no previous refusals

finalized after the second refusal

postincentive offer. In addition, if any

case refused in a hostile manner or

requested to be removed from the

calling list, the case was finalized and

not called again.

If any passive refusal or active

refusal incentive-eligible household

completed NSAP-SN, or if a respondent

requested the incentive without

completing the interview, address

information for the household was either

confirmed or collected. The appropriate

$25 or $30 payment was mailed to the

household, along with a letter expressing

appreciation for the respondent’s time

and effort spent participating in the

interview. If a household completed

NSAP-SN without becoming eligible for

the $5 incentive, $25 was mailed to the

household enclosed in a letter

expressing appreciation for their

participation. Households that completed

the NSAP-SN interview, but declined to

confirm or provide address information

(36 cases), were not mailed the

incentive payment.

Results

The $5 additional incentive effort,

both for active and passive refusals,

helped achieve 15 additional NSAP-SN

interviews, as shown in Table II. Of the

active refusal incentive cases, six

(26.1%) completed the interview. Of the

passive incentive cases, nine (45.0%)

completed the interview.

Table II. Completion rates, by NSAP-SN incentive type

NSAP-SN- Completed Interview

eligible interview completion rate

$25 initial incentive, qualified for additional $5 active refusal

incentive ................................. 23 6 26.1

$25 initial incentive, qualified for additional $5 passive

refusal incentive ............................ 20 9 45.0

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs.
Series 1, No. 51

[ Page 109

The $5 additional incentive

increased the number of completed

interviews from 992 to 1,007. These

additional completes increased the

unweighted interview complete rate1

(ratio of completes to total sample) from

61.7% to 62.7% and the unweighted

interview complete rate2 (ratio of

completes to released sample excluding

out-of-scope cases) from 65.0% to

65.9%.
Page 110 [ Series 1, No. 51

Table III. Percentage of children, by demographic and health characteristics, for Appendix VI respondents and nonrespondents in NSAP-SN

Weighted percent (SE)

Nonresponse Bias Analysis

As previously described, the overall

response rate for the National Survey of

Adoptive Parents of Children with

Special Health Care Needs (NSAP-SN)

was 37.7%. Nonresponse to the

NSAP-SN occurred in two stages:

nonresponse to the 2005–2006 National

Survey of Children with Special Health

Care Needs (NS-CSHCN), and

nonresponse to the follow-up interview

for NSAP-SN. What is unusual in this

case is that all of the nonrespondents in

the second stage had already completed

NS-CSHCN, and as a result, a great

deal of information was known about

these nonrespondents; information that

is usually not available for

nonrespondents. This had two main

implications: first, it was possible to

conduct a more extensive and accurate

analysis of the potential for nonresponse

bias resulting from the second stage of

nonresponse than would normally be

possible, and second, it was possible to

adjust the weights very precisely to

correct for nonresponse bias (as

described in Appendix I). As a result of

the weighting adjustments, the overall

response rate for NS-CSHCN itself, i.e.,

the overall response rate for the first

stage of nonresponse, could be

considered the more accurate indicator

of potential nonresponse bias in

NSAP-SN.

Tables III, IV, and V present a

comparison of NSAP-SN respondents

and nonrespondents on selected

NS-CSHCN data elements. All cases

completed NS-CSHCN; they are

differentiated by whether they responded

or not in the second stage (i.e., whether

they responded to NSAP-SN or not).

Table III shows child-level demographic

and health characteristics, Table IV

shows household-level socioeconomic

and demographic characteristics, and

Table V shows NS-CSHCN data

elements that are topically similar to the

sorts of data collected in NSAP-SN.

These tables demonstrate that there are

significant differences between

respondents and nonrespondents on

NSAP-SN-eligible, NSAP-SN-eligible,

Child-level characteristic nonrespondents respondents

Adoption type 

International .......................... 

Foster care........................... 

Private domestic ....................... 

Age 

0–2 years ........................... 

3–5 years ........................... 

6–11 years ........................... 

12–17 years .......................... 

Sex 

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Race/ethnicity 

Hispanic ............................ 

Non-Hispanic white...................... 

Non-Hispanic black...................... 

Non-Hispanic Asian ..................... 

Non-Hispanic other...................... 

CSHCN screener criteria endorsed 

Prescription medications .................. 

Elevated service usage or need .............. 

Limitation in activity ..................... 

Physical, occupational, or speech therapy........ 

Behavioral, emotional, or developmental problem . . . 

Type of health insurance 

Private or employment-based only ............ 

Public only . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Private and public ...................... 

Other comprehensive insurance .............. 

Uninsured ........................... 

Ever uninsured previous 12 months 

Yes ............................... 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Sample size . . . . . . . . . . . . . . . . . . . . . . . . . . 

Weight ............................. 

†14.7 (2.60) †22.2 (2.01)

50.1 (3.38) 44.3 (2.66)

35.2 (3.08) 33.5 (2.74)

18.7 (2.96) 17.8 (1.94)

42.4 (3.33) 50.5 (2.73)

16.1 (2.25) 18.6 (2.60)

†22.9 (2.88) †13.1 (1.62)

55.0 (3.30) 57.0 (2.62)

45.0 (3.30) 43.0 (2.62)

10.0 (1.95) 11.1 (1.69)

†44.8 (3.18) †53.9 (2.68)

†28.4 (3.23) †16.8 (1.94)

7.9 (2.27) 12.4 (1.65)

8.9 (2.23) 5.9 (0.93)

75.4 (2.99) 77.3 (2.11)

52.7 (3.39) 53.7 (2.71)

28.8 (3.15) 27.9 (2.57)

24.3 (2.90) 26.8 (2.21)

48.8 (3.39) 50.6 (2.73)

†43.2 (3.29) †53.8 (2.71)

†38.2 (3.42) †29.2 (2.56)

14.6 (2.52) 14.0 (1.54)

1.6 (0.71) 1.7 (0.47)

2.4 (0.77) 1.3 (0.50)

†7.4 (1.50) †3.8 (0.90)

†92.7 (1.50) †96.2 (0.90)

598 1,003

NS-CSHCN NS-CSHCN

† Estimates for respondents and nonrespondents differ at the 0.05 level.

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs; SE is standard error;

CSHCN is children with special health care needs; NS-CSHCN is National Survey of Children with Special Health Care Needs.

SOURCE: CDC/NCHS, NS-CSHCN, 2005–2006.

many dimensions. Nonrespondents were

significantly less likely to represent

international adoptions, non-Hispanic

white children with special health care

needs (CSHCN), privately insured

CSHCN, and CSHCN with no insurance

coverage gaps, and significantly more

likely to represent older CSHCN,

non-Hispanic black CSHCN, publicly

insured CSHCN, and those with

insurance coverage gaps (Table III).

Nonrespondents were significantly less

likely to represent households in the

highest income or education categories,

households with two adults or two

children, and households in the

Midwest, and significantly more likely

to represent households in the south

(Table IV). Nonrespondents were

significantly less likely to represent

households with two adoptive parents,

CSHCN adopted at age 1 year, and

CSHCN not covered by Medicaid, and

significantly more likely to represent

households with one adoptive parent and

CSCHN covered by Medicaid (Table V).
Table IV. Percentage of children, by household socioeconomic and demographic

characteristics, for respondents and nonrespondents in NSAP-SN

Weighted percent (SE)

NSAP-SN-eligible, NSAP-SN-eligible,

Household-level characteristic nonrespondents respondents

Total household income 

Less than $10,000.................... 

$10,000–$19,999 .................... 

$20,000–$39,999 .................... 

$40,000–$59,000 .................... 

$60,000 or more ..................... 

Highest educational attainment 

Less than high school.................. 

High school or equivalent ............... 

More than high school ................. 

Number of adults 

1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

3 or more ......................... 

Number of children 

1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 

3 or more ......................... 

Primary language in the household 

English . . . . . . . . . . . . . . . . . . . . . . . . . . . 

Not English ........................ 

Census region 

Northeast ......................... 

Midwest .......................... 

South. . . . . . . . . . . . . . . . . . . . . . . . . . . . 

West ............................ 

MSA status 

In MSA. . . . . . . . . . . . . . . . . . . . . . . . . . . 

Not in MSA ........................ 

Sample size. . . . . . . . . . . . . . . . . . . . . . . . 

Weight . . . . . . . . . . . . . . . . . . . . . . . . . . . 

6.5 (1.69) 2.7 (0.98)

8.8 (1.73) 5.7 (1.25)

19.6 (2.82) 14.0 (1.75)

17.8 (2.63) 18.3 (1.93)

†47.3 (3.37) †59.2 (2.62)

5.5 (1.43) 3.2 (0.89)

17.7 (2.60) 12.5 (1.92)

†76.8 (2.82) †84.4 (2.06)

16.9 (2.49) 12.2 (1.65)

†61.4 (3.25) †69.9 (2.37)

21.7 (2.63) 17.9 (1.96)

40.7 (3.25) 38.6 (2.60)

†24.7 (2.74) †33.6 (2.47)

34.6 (3.47) 27.8 (2.69)

99.3 (0.34) 99.5 (0.36)

0.7 (0.34) 0.5 (0.36)

17.1 (2.25) 15.6 (1.33)

†20.5 (2.14) †29.5 (1.66)

†44.3 (2.87) †34.5 (1.96)

18.1 (2.29) 20.5 (2.13)

85.9 (1.97) 85.5 (1.55)

14.1 (1.97) 14.5 (1.55)

598 1,003

NS-CSHCN NS-CSHCN

† Estimates for respondents and nonrespondents differ at the 0.05 level.

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs; SE is standard error; MSA is

metropolitan statistical area; NS-CSHCN is National Survey of Children with Special Health Care Needs.

SOURCE: CDC/NCHS, NS-CSHCN, 2005–2006.

In addition to these statistically

significant differences, many other

characteristics showed differences

between respondents and

nonrespondents that are not statistically

significant, but are large enough to

prompt the question as to the magnitude

of the effect of second-stage

nonresponse on survey estimates.

Tables VI, VII, and VIII present

estimates for the final NSAP-SN

sample, weighted by the nonresponseadjusted sampling weights, compared

with estimates for the full pool of

NS-CSHCN cases that were eligible for

NSAP-SN (i.e., the NSAP-SN

respondents and nonrespondents

combined; the final NSAP-SN sample

that would have been attained if there

Series 1, No. 51 [ Page 111

were no second-stage nonresponse at

all). After the weighting adjustments

described in Appendix I, estimates for

NSAP-SN respondents are much closer

to the estimates for the full pool of

NSAP-SN-eligible cases, and in many,

comparisons are so close that the

remaining difference is negligible.

Although this is to be expected for the

characteristics that were used to adjust

the weights, such as age, it is also the

case for characteristics that were not

directly controlled in the adjustment of

the sampling weights, presumably

because they are related to the variables

that were controlled for in the weighting

adjustment.

The only characteristic that shows a

significant difference in Tables VI–VIII

is the percentage of households with

three or more children (the final

NSAP-SN sample underestimates the

proportion of adoptive households with

three or more children by 4 percentage

points). Other than the significant

difference found for three or more

children, only two other characteristics

in Tables VI–VIII showed a difference

between the final NSAP-SN sample and

the full pool of NSAP-SN-eligible cases

that was as high as 3 percentage points:

two children in the household

(3.6 percentage points, overestimated in

the final NSAP-SN file, Table VI) and

CSHCN adopted at age 0 (3 percentage

points, underestimated in the final

NSAP-SN file, Table VIII).

Of all the characteristics examined,

there is a second-stage nonresponse bias

of at least 3 percentage points for

categories of only two variables: the

number of children in the household and

the age at adoption. Although this

analysis does not necessarily

demonstrate that no nonresponse bias

derives from second-stage nonresponse,

it strongly suggests that the overall

first-stage response rate (56.1%) is very

likely a better indicator of the potential

nonresponse bias in NSAP-SN than the

final overall response rate of 37.7%.
Page 112 [ Series 1, No. 51

Table V. Percentage of children, by NS-CSHCN characteristics similar to NSAP-SN data

elements for respondents and nonrespondents in NSAP-SN

Weighted percent (SE)

NSAP-SN-eligible, NSAP-SN-eligible,

Household-level characteristic nonrespondents respondents

Number of adoptive parents in household

1 ................................. †51.9 (3.37) †40.5 (2.65)

2 ................................. †48.2 (3.37) †59.5 (2.65)

Age at adoption finalization

0 years ............................. 34.1 (3.22) 29.0 (2.48)

1 year .............................. †11.5 (1.90) †19.2 (2.46)

2–5 years ........................... 37.9 (3.33) 31.2 (2.33)

6 years and over ....................... 16.4 (2.26) 20.6 (2.29)

Child has difficulty with behavior problems

Yes ............................... 42.7 (3.38) 43.7 (2.66)

No ................................ 57.3 (3.38) 56.3 (2.66)

Child has received mental health treatment

Yes ............................... 39.1 (3.33) 45.1 (2.74)

No ................................ 60.9 (3.33) 54.9 (2.74)

Child has received substance abuse treatment ....

Yes ............................... 2.6 (0.91) 2.6 (0.90)

No ................................ 97.4 (0.91) 97.4 (0.90)

Child has Individualized Family

Service Plan or Individualized Education Plan

Yes ............................... 43.2 (3.35) 43.6 (2.61)

No ................................ 56.8 (3.35) 56.4 (2.61)

Child is covered by Medicaid or CHIP

Yes ............................... †52.8 (3.36) †43.1 (2.70)

No ................................ †47.3 (3.36) †56.9 (2.70)

Any difficulty using health care services

Yes ............................... 12.6 (2.12) 14.5 (1.73)

No ................................ 87.4 (2.12) 85.5 (1.73)

Reasons for difficulty using services

Lack of information ...................... 6.4 (1.60) 8.0 (1.25)

Cost ............................... 4.3 (1.10) 5.3 (1.23)

Transportation ......................... 2.0 (0.81) 2.4 (0.81)

Services not available when needed ........... 8.4 (1.89) 10.2 (1.52)

Language, communication, or culture problems .... 1.3 (0.60) 2.3 (0.89)

Not available in area ..................... 8.5 (1.92) 6.3 (1.26)

Child not eligible for services. . . . . . . . . . . . . . . . 4.2 (1.01) 6.1 (1.13)

Sample size .......................... 598 1,003

Weight ............................. NS-CSHCN NS-CSHCN

† Estimates for respondents and nonrespondents differ at the 0.05 level.

NOTE: NS-CSHCN is National Survey of Children with Special Health Care Needs; NSAP-SN is National Survey of Adoptive

Parents of Children with Special Health Care Needs; SE is standard error; CHIP is Children’s Health Insurance Program.

SOURCE: CDC/NCHS, NS-CSHCN, 2005–2006.
Series 1, No. 51 [ Page 113

Table VI. Percentage of children, by demographic and health characteristics in the final

NSAP-SN, and for all NSAP-SN-eligible cases

Weighted percent (95% CI)

All NSAP-SN- Final NSAP-SN

Child-level characteristic eligible cases data file

Adoption type

International .......................... 19.5 (16.5–22.8) 18.5 (15.4–22.1)

Foster care........................... 46.4 (42.3–50.6) 48.5 (43.5–53.5)

Private domestic ....................... 34.1 (30.1–38.3) 33.0 (28.5–37.9)

Age 

0–2 years ........................... 18.1 (15.1–21.6) 18.1 (14.7–22.1) 

3–5 years ........................... 47.6 (43.5–51.7) 47.6 (42.7–52.5) 

6–11 years ........................... 17.7 (14.3–21.7) 17.7 (14.2–21.9) 

12–17 years .......................... 16.7 (13.9–19.8) 16.7 (13.2–20.8) 

Sex

Male. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56.3 (52.2–60.3) 56.3 (51.3–61.1)

Female . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43.7 (39.7–47.8) 43.7 (38.9–48.7)

Race/ethnicity 

Hispanic ............................ 10.7 (8.4–13.4) 10.7 (8.0–14.1) 

Non-Hispanic white...................... 50.6 (46.5–54.7) 51.6 (46.6–56.5) 

Non-Hispanic black...................... 21.0 (17.8–24.6) 21.0 (16.9–25.8) 

Non-Hispanic Asian ..................... 10.8 (8.4–13.7) 10.8 (8.2–14.0) 

Non-Hispanic other...................... 7.0 (5.2–9.3) 6.0 (4.4–8.2) 

CSHCN screener criteria endorsed

Prescription medications .................. 76.6 (73.1–79.9) 76.9 (72.5–80.8)

Elevated service usage or need .............. 53.4 (49.2–57.5) 53.1 (48.2–58.0)

Limitation in activity ..................... 28.2 (24.4–32.3) 28.0 (23.7–32.8)

Physical, occupational, or speech therapy........ 25.9 (22.6–29.4) 27.4 (23.2–32.0)

Behavioral, emotional, or developmental problem . . . 50.0 (45.8–54.1) 50.9 (45.9–55.9)

Type of health insurance 

Private or employment based only ............ 49.9 (45.8–54.1) 49.1 (44.1–54.1) 

Public only . . . . . . . . . . . . . . . . . . . . . . . . . . . 32.5 (28.5–36.6) 32.7 (27.8–38.0) 

Private and public ...................... 14.2 (11.8–17.0) 14.4 (11.5–17.9) 

Other comprehensive insurance .............. 1.7 (1.1–2.7) 1.9 (1.1–3.3) 

Uninsured ........................... 1.7 (1.1–2.8) 2.0 (0.9–4.3) 

Ever uninsured previous 12 months

Yes ............................... 5.1 (3.8–6.9) 4.6 (2.8–7.2) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 94.9 (93.1–96.2) 95.5 (92.8–97.2) 

Sample size . . . . . . . . . . . . . . . . . . . . . . . . . . 1,601 1,003 

Weight ............................. NS-CSHCN NSAP-SN 

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs; CI is confidence interval; 

CSHCN is children with special health care needs; NS-CSHCN is National Survey of Children with Special Health Care Needs. 

SOURCES: CDC/NCHS, NS-CSHCN, 2005–2006 and NSAP-SN, 2008.
Page 114 [ Series 1, No. 51

Table VII. Percentage of children, by household socioeconomic and demographic

characteristics in the final NSAP-SN, and for all NSAP-SN-eligible cases

Weighted percent (95% CI)

Final

All NSAP-SN- NSAP-SN

Household-level characteristic eligible cases data file

Total household income 

Less than $10,000 ........................... 4.1 (2.7–6.2) 3.7 (1.9–7.1) 

$10,000-$19,999 ............................ 6.9 (5.1–9.1) 7.2 (4.8–10.6) 

$20,000-$39,999 ............................ 16.1 (13.3–19.2) 16.1 (12.6–20.2) 

$40,000-$59,000 ............................ 18.1 (15.3–21.4) 18.1 (14.8–22.0) 

$60,000 or more ............................ 54.9 (50.8–58.9) 54.9 (49.8–59.8) 

Highest educational attainment

Less than high school ......................... 4.0 (2.7–5.8) 4.3 (2.4–7.4)

High school or equivalent....................... 14.4 (11.6–17.7) 14.1 (10.5–18.8)

More than high school......................... 81.6 (78.2–84.7) 81.6 (76.7–85.7)

Number of adults

1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13.9 (11.4–16.9) 14.0 (10.7–18.0)

2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 66.8 (62.9–70.5) 67.0 (62.1–71.6)

3 or more ................................ 19.3 (16.4–22.5) 19.0 (15.3–23.4)

Number of children

1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 39.4 (35.5–43.4) 39.8 (35.1–44.7)

2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 30.4 (26.9–34.1) 34.0 (29.3–38.9)

3 or more ................................ †30.3 (26.3–34.6) †26.3 (21.9–31.1)

Primary language in the household

English . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 99.4 (98.6–99.8) 99.5 (98.3–99.8)

Not English ............................... 0.6 (0.2–1.4) 0.5 (0.2–1.8)

Census region 

Northeast ................................ 16.2 (14.6–17.9) 16.2 (14.2–18.4) 

Midwest ................................. 26.2 (24.4–28.0) 26.2 (24.0–28.5) 

South . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 38.1 (35.8–40.3) 38.1 (35.3–40.8) 

West ................................... 19.6 (17.2–22.3) 19.6 (17.6–21.8) 

MSA status

In MSA . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 85.7 (83.2–87.9) 84.9 (81.4–87.9) 

Not in MSA ............................... 14.3 (12.1–16.8) 15.1 (12.1–18.6) 

Sample size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,601 1,003 

Weight .................................. NS-CSHCN NSAP-SN 

† Estimates for NSAP-SN final data and NSAP-SN-eligible cases differ at the 0.05 level. 

NOTE: NSAP-SN is National Survey of Adoptive Parents of Children with Special Health Care Needs; CI is confidence interval; 

MSA is metropolitan statistical area; NS-CSHCN is National Survey of Children with Special Health Care Needs. 

SOURCES: CDC/NCHS, NS-CSHCN, 2005–2006 and NSAP-SN, 2008. 
Series 1, No. 51 [ Page 115

Table VIII. Percentage of children, by NS-CSHCN characteristics similar to NSAP-SN data

elements in the final NSAP-SN, and for all NSAP-SN-eligible cases

Weighted percent (95% CI)

Final

All NSAP-SN- NSAP-SN

Characteristic eligible cases data file

Number of adoptive parents in household

1. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 44.6 (40.6–48.8) 44.4 (39.4–49.5) 

2. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 55.4 (51.2–59.4) 55.6 (50.5–60.6) 

Age at adoption finalization

0 years .................................. 30.9 (27.1–34.8) 27.9 (23.8–32.5) 

1 year................................... 16.5 (13.3–20.1) 18.3 (14.6–22.5) 

2–5 years ................................ 33.6 (29.9–37.5) 31.9 (27.6–36.5) 

6 years and over ............................ 19.1 (16.0–22.6) 22.0 (17.7–27.0) 

Child has difficulty with behavior problems

Yes .................................... 43.3 (39.3–47.5) 45.6 (40.6–50.7) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56.7 (52.5–60.7) 54.4 (49.3–59.4) 

Child has received mental health treatment

Yes .................................... 42.9 (38.8–47.1) 45.3 (40.4–50.4) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57.1 (52.9–61.2) 54.7 (49.6–59.7) 

Child has received substance abuse treatment

Yes .................................... 2.6 (1.6–4.3) 3.4 (1.7–6.8) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 97.4 (95.7–98.4) 96.6 (93.2–98.4) 

Child has Individualized Family 

Service Plan or Individualized Education Plan 

Yes .................................... 43.4 (39.5–47.5) 44.1 (39.2–49.1) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56.6 (52.6–60.5) 55.9 (51.0–60.8) 

Child is covered by Medicaid or CHIP

Yes .................................... 46.6 (42.5–50.8) 47.0 (42.0–52.1) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53.4 (49.2–57.5) 53.0 (47.9–58.1) 

Any difficulty using health care services

Yes .................................... 13.8 (11.4–16.7) 15.4 (12.0–19.5) 

No . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 86.2 (83.4–88.6) 84.6 (80.5–88.0) 

Reasons for difficulty using services

Lack of information........................... 7.4 (5.7–9.6) 8.7 (6.2–12.0) 

Cost. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 4.9 (3.4–6.9) 6.2 (3.9–9.9) 

Transportation.............................. 2.3 (1.4–3.8) 2.8 (1.4–5.6) 

Services not available when needed ................ 9.6 (7.5–12.1) 11.2 (8.3–15.1) 

Language, communication, or culture problems ......... 1.9 (1.0–3.5) 2.8 (1.3–5.9) 

Not available in area. . . . . . . . . . . . . . . . . . . . . . . . . . 7.1 (5.3–9.5) 7.1 (4.7–10.4) 

Child not eligible for services .................... 5.4 (4.0–7.2) 6.7 (4.6–9.9) 

Sample size . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,601 1,003 

Weight .................................. NS-CSHCN NSAP-SN 

NOTE: NS-CSHCN is National Survey of Children with Special Health Care Needs; NSAP-SN is National Survey of Adoptive 

Parents of Children with Special Health Care Needs; CI is confidence interval; CHIP is Children’s Health Insurance Program. 

SOURCES: CDC/NCHS, NS-CSHCN, 2005–2006 and NSAP-SN, 2008.
Page 116 [ Series 1, No. 51

Appendix VII 

Coding of Verbatim

Answers Into Question

Responses

For many questions in the

NSAP-SN interview, respondents

provided a response that did not match

any preexisting category. If this

occurred, the interviewer chose ‘‘other’’

and typed in the response provided by

the respondent. After the end of the data

collection period verbatim responses

were recoded into existing response

categories where appropriate.

There were three ways in which

verbatim responses were used to recode

or back-code data:

+	 Some verbatim responses were

back-coded to existing response

categories on preceding questions.

+	 Some verbatim responses were used

to create new response categories

for preceding questions, which are

indicated by new dummy variables.

+	 Some verbatim responses were used

to create new variables to capture

the data because no root question

existed for which to create new

categories or back-code verbatim

responses into preexisting categories.

Any questionnaire variable that was

recoded or back-coded based on

verbatim responses had the letter ‘‘R’’

appended to the variable name to denote

‘‘recoded version’’ of the variable.

Verbatim responses were used to

back-code ‘‘other’’ into preexisting

categories for the following variables:

+	 C2_N asked where the child lived

prior to placement with the family

and ‘‘other’’ responses were

recorded verbatim in C2A. Verbatim

responses were used to change a

few cases of ‘‘other’’ to one of the

preexisting codes on C2_NR.

+	 C12A–C12F asked if a list of items

were reasons why the respondent

chose to adopt, C12G asked if there

were any other reasons, and C12GA

recorded the verbatim reason.

Verbatim responses were used to

change ‘‘no’’ to ‘‘yes’’ for a few

cases each on C12AR, C12BR,

C12CR, C12ER, and C12FR.

+	 C22A–C22H asked if a list of items

were reasons why the respondent

chose to adopt via a private

domestic adoption and C22I asked if

there were any other reasons and

C22IA recorded the verbatim reason.

C22A–C22H and C22IA were each

followed by a question that asked if

the reason was very important,

somewhat important, or not

important. Verbatim responses were

used to change ‘‘no’’ to ‘‘yes’’ for a

few cases each on C22AR, C22ER,

and C22HR, and in each case, the

value for the importance follow-up

C22IA was assigned as appropriate

to C22AAR, C22EAR, and

C22HAR.

+	 C23A_N–C23K asked if a list of

items were reasons why the

respondent chose to adopt via an

international adoption, C23L asked

if there were any other reasons, and

C23LA recorded the verbatim

reason. C23A_N–C23K and C23LA

were each followed by a question

that asked if the reason was very

important, somewhat important, or

not important. Verbatim responses

were used to change ‘‘no’’ to ‘‘yes’’

for a few cases each on C23A_NR,

C23DR, C23ER, C23FR, C23GR,

and C23HR and in each case, the

value for the importance follow-up

C23LB was assigned as appropriate

to C23AAR, C23DAR, C23EAR,

C23FAR, C23GAR, and C23HAR.

+	 F6A–F6C asked if a list of items

were reasons why the respondent

requested a subsidy, F6D asked if

there were any other reasons, and

F6DA recorded the verbatim reason.

Verbatim responses were used to

change ‘‘no’’ to ‘‘yes’’ for a few

cases on F6AR.

+	 N1D, N2D, N3D, N5F, N6D, N7D,

N9D, N10D, N11D, N12D, N14D,

and N18D are items that asked why

the respondent or respondent’s child

did not receive a particular

postadoption support or service;

multiple answers were possible and

the answers were recorded in

dummy variables. Verbatim

responses were used to change

‘‘other’’ to one of the preexisting

codes for a few cases on each of the

following dummy variables:

N1DX01R, N1DX02R, N1DX04R,

N2DX01R, N2DX02R, N3DX03R,

N3DX04R, N5FX01R, N5FX02R,

N6DX02R, N7DX02R, N9DX01R,

N9DX02R, N9DX03R, N10DX01R,

N10DX02R, N10DX04R,

N10DX05R, N10DX06R,

N11DX02R, N11DX04R,

N11DX05R, N12DX01R,

N12DX02R, N12DX04R,

N12DX05R, N14DX04R, and

N18DX03R.

+	 N3B, N5D, N6B, N10BB, N11B,

and N12B are items that asked how

the respondent heard about

particular postadoption support and

services; multiple answers were

possible and the answers were

recorded in dummy variables.

Verbatim responses were used to

change ‘‘other’’ to one of the

preexisting codes for a few cases on

each the following dummy

variables: N3BX02R, N5DX01R,

N5DX02R, N6BX03R,

N10BBX01R, N10BBX02R,

N11BX01R, and N12BX01R.

+	 N21A and N22A asked the

respondent who helped them assist

or recruit other adoptive families.

Verbatim responses were used to

change ‘‘other’’ to one of the

preexisting codes for a few cases on

N21AR and N22AR.

+	 N26 and N27 are items that asked

the respondent’s and respondent’s

spouse’s or partner’s employment

status the previous week. Verbatim

responses were used to change

‘‘other’’ to one of the preexisting

codes for a few cases on N26R and

N27R.

Verbatim responses were used to

create new response categories for the

following variables:

+	 F10A asked for other reasons why

the family didn’t receive an

adoption subsidy. Some ‘‘other’’

responses were put into a new

category on F10R indicating the

subsidy was not available.

+	 N1DA, N2DA, N3DA, N5FA,

N6DA, N7DA, N9DA, N10DA,

N11DA, N12DA, N14DA, and
Series 1, No. 51 [ Page 117

N18DA are items that asked for

other reasons why the respondent or

respondent’s child did not receive a

particular postadoption support or

service. For each, some ‘‘other:

verbatim’’ responses have been

back-coded into new categories: one

that combines responses such as

‘‘distance’’ and ‘‘transportation

issues,’’ another that combines

responses such as ‘‘time’’ and

‘‘scheduling difficulties,’’ another

that combines responses that

indicate the child’s condition or

behavior prevented the family from

receiving the service, and another

that combined responses such as ‘‘it

wasn’t needed,’’ ‘‘a family member

refused,’’ and ‘‘we didn’t follow

through with it.’’ All of these

variables got the new code ‘‘no

need/someone refused/no

follow-through’’ and none of these

variables got more than two new

codes in total. The new response

categories were captured by the

dummy variables N1DA_1,

N1DA_2, N2DA_1, N2DA_2,

N3DA_1, N3DA_2, N5FA_1,

N6DA_1, N7DA_1, N9DA_1,

N10DA_1, N11DA_1, N12DA_1,

N14DA_1, N18DA_1, and

N18DA_2.

+	 N2BAA, N3BA, N5DA, N6BA,

N7BA, N8BA, N9BA, N10BA,

N11BA, N12BA, N14BBA, and

N18BA are items that asked for

other sources from whom the

respondent heard about particular

postadoption support and services.

For each, some ‘‘other: verbatim’’

responses have been back-coded into

two new categories: one that

combines responses such as

‘‘friends,’’ ‘‘acquaintances,’’

‘‘church,’’ and ‘‘word of mouth,’’

and another that combines responses

such as ‘‘clinic,’’ ‘‘hospital,’’ and

others as ‘‘other service providers.’’

The new response categories are

captured by the dummy variables

N2BAA_1, N2BAA_2, N3BA_1,

N3BA_2, N5DA_1, N5DA_2,

N6BA_1, N6BA_2, N7BA_1,

N7BA_2, N8BA_1, N9BA_1,

N9BA_2, N10BA_1, N10BA_2,

N11BA_2, N12BA_1, N12BA_2,

N14BBA_1, N14BBA_2, N18BA_1,

and N18BA_2.

+	 N21AA and N22AA asked the

respondent for other sources that

helped them assist or recruit other

adoptive families. A new category

has been created for these variables

that groups together responses such

as ‘‘social services,’’ ‘‘other public

agency,’’ and ‘‘non-governmental

organization.’’ The new response

categories were captured by the

dummy variables N21AA_1 and

N22AA_1.

Verbatim responses were used to

create new variables for the following

situations:

+	 C12GA asked for other reasons why

the respondent chose to adopt. New

variable C12GA_1 indicates that the

respondent had formed a bond or

already loved the child prior to

adoption, C12GA_2 indicates that

the child was a relative’s or friend’s

child prior to the adoption,

C12GA_3 indicates a general

statement such as ‘‘I love children,’’

and C12GA_4 indicates that the

respondent wanted to help the child

avoid going to foster care.

+	 C22IA, C23LA, and C24FA asked

for other reasons why the

respondent chose the specific type

of adoption he or she did (private

domestic, international, or foster

care). New variable C22IA_1

indicates responses such as

convenience or a desire to help

American children, C22IA_2

indicates responses such as lower

cost or less risk, C22IA_3 indicates

responses such as wanting an open

adoption or knowing the child prior

to adoption, and C22IA_4 indicates

responses such as familiarity with

that agency. C23LA_1 indicates

responses such as wanting a Chinese

girl, C23LA_2 indicates responses

such as wanting to bring a child to

the United States, C23LA_3

indicates responses such as seeing a

great need in that country, C23LA_4

indicates responses such as not

qualifying for a U.S. adoption

because of single-parent status,

C23LA_5 indicates responses such

as having friends that adopted that

way, and C23LA_6 indicates

responses such as the child having

the same race/ethnicity or national

origin as the family. C24FA_1

indicates responses such as wanting

to give a home to a child who really

needed one.

+	 C23IAA asked why the respondent

felt that a U.S. adoption would not

be the best option. New variable

C23IAAR has three categories

created from the verbatim responses:

‘‘legal issues/fear of birth parents

changing their minds,’’ ‘‘race or age

considerations,’’ and ‘‘drug

abuse/special needs considerations.’’

+	 F6DA asked the respondent for

other reasons why he or she

requested an adoption subsidy. New

variable F6DA_1 indicates one

category created from the verbatim

responses: because they could

always use extra income or because

it was available.

+	 F16EA, F17EA, and F18EA asked if

there was any other source helping

to pay for services. New variables

F16EA_1 and F16EA_2 indicate

answers of ‘‘insurance (other than

Medicaid)’’ and ‘‘school,’’ F17EA_1

and F17EA_2 indicate answers of

‘‘insurance’’ and ‘‘Medicaid,’’ and

F18EA_1 and F18EA_2 indicate

answers of ‘‘insurance’’ and

‘‘Medicaid.’’
Page 118 [ Series 1, No. 51

Appendix VIII

Prevalence Estimates and

Weighted Frequencies

Table IX. Unweighted and weighted estimates of the frequency and prevalence of type of adoption for adopted CSHCN

Type of adoption

Total

unweighted

number of

children

Total

weighted

estimate of

number of

children

Standard

error of

weighted

estimate

of number

of children

Percent of

children

Standard

error of

percent of

children

Total. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1,003 404,262 11,612.7 100.0 . . .

International ...............................

Foster care ...............................

Private domestic ............................

225

457

321

74,855

196,027

133,379

6,822.4

12,339.7

10,627.4

18.5

48.5

33.0

1.74

2.53

2.42

. . . Category not applicable. 

NOTE: CSHCN is children with special health care needs. 
Vital and Health Statistics

Series Descriptions

ACTIVE SERIES

Series 1.	 Programs and Collection Procedures—This type of report

describes the data collection programs of the National Center

for Health Statistics. Series 1 includes descriptions of the

methods used to collect and process the data, definitions, and

other material necessary for understanding the data.

Series 2.	 Data Evaluation and Methods Research—This type of

report concerns statistical methods and includes analytical

techniques, objective evaluations of reliability of collected

data, and contributions to statistical theory. Also included are

experimental tests of new survey methods, comparisons of

U.S. methodologies with those of other countries, and as of

2009, studies of cognition and survey measurement, and final

reports of major committees concerning vital and health

statistics measurement and methods.

Series 3.	 Analytical and Epidemiological Studies—This type of

report presents analytical or interpretive studies based on vital

and health statistics. As of 2009, Series 3 also includes

studies based on surveys that are not part of continuing data

systems of the National Center for Health Statistics and

international vital and health statistics reports.

Series 10.	 Data From the National Health Interview Survey—This

type of report contains statistics on illness; unintentional

injuries; disability; use of hospital, medical, and other health

services; and a wide range of special current health topics

covering many aspects of health behaviors, health status, and

health care utilization. Series 10 is based on data collected in

this continuing national household interview survey.

Series 11.	 Data From the National Health Examination Survey, the

National Health and Nutrition Examination Surveys, and

the Hispanic Health and Nutrition Examination Survey—

In this type of report, data from direct examination, testing,

and measurement on representative samples of the civilian

noninstitutionalized population provide the basis for (1)

medically defined total prevalence of specific diseases or

conditions in the United States and the distributions of the

population with respect to physical, physiological, and

psychological characteristics, and (2) analyses of trends and

relationships among various measurements and between

survey periods.

Series 13.	 Data From the National Health Care Survey—This type of

report contains statistics on health resources and the public’s

use of health care resources including ambulatory, hospital,

and long-term care services based on data collected directly

from health care providers and provider records.

Series 20.	 Data on Mortality—This type of report contains statistics on

mortality that are not included in regular, annual, or monthly

reports. Special analyses by cause of death, age, other

demographic variables, and geographic and trend analyses

are included.

Series 21.	 Data on Natality, Marriage, and Divorce—This type of

report contains statistics on natality, marriage, and divorce

that are not included in regular, annual, or monthly reports.

Special analyses by health and demographic variables and

geographic and trend analyses are included.

Series 23.	 Data From the National Survey of Family Growth—These

reports contain statistics on factors that affect birth rates,

including contraception and infertility; factors affecting the

formation and dissolution of families, including cohabitation,

marriage, divorce, and remarriage; and behavior related to

the risk of HIV and other sexually transmitted diseases.

These statistics are based on national surveys of women and

men of childbearing age.

DISCONTINUED SERIES

Series 4.	 Documents and Committee Reports—These are final

reports of major committees concerned with vital and health

statistics and documents. The last Series 4 report was

published in 2002. As of 2009, this type of report is included

in Series 2 or another appropriate series, depending on the

report topic.

Series 5.	 International Vital and Health Statistics Reports—This

type of report compares U.S. vital and health statistics with

those of other countries or presents other international data of

relevance to the health statistics system of the United States.

The last Series 5 report was published in 2003. As of 2009,

this type of report is included in Series 3 or another series,

depending on the report topic.

Series 6.	 Cognition and Survey Measurement—This type of report

uses methods of cognitive science to design, evaluate, and

test survey instruments. The last Series 6 report was

published in 1999. As of 2009, this type of report is included

in Series 2.

Series 12.	 Data From the Institutionalized Population Surveys— The

last Series 12 report was published in 1974. Reports from

these surveys are included in Series 13.

Series 14.	 Data on Health Resources: Manpower and Facilities—

The last Series 14 report was published in 1989. Reports on

health resources are included in Series 13.

Series 15.	 Data From Special Surveys— This type of report contains

statistics on health and health-related topics collected in

special surveys that are not part of the continuing data

systems of the National Center for Health Statistics. The last

Series 15 report was published in 2002. As of 2009, reports

based on these surveys are included in Series 3.

Series 16.	 Compilations of Advance Data From Vital and Health

Statistics— The last Series 16 report was published in 1996.

All reports are available online, and so compilations of

Advance Data reports are no longer needed.

Series 22.	 Data From the National Mortality and Natality Surveys—

The last Series 22 report was published in 1973. Reports

from these sample surveys, based on vital records, are

published in Series 20 or 21.

Series 24.	 Compilations of Data on Natality, Mortality, Marriage, and

Divorce—The last Series 24 report was published in 1996.

All reports are available online, and so compilations of reports

are no longer needed.

For answers to questions about this report or for a list of reports published

in these series, contact:

Information Dissemination Staff

National Center for Health Statistics

Centers for Disease Control and Prevention

3311 Toledo Road, Room 5412

Hyattsville, MD 20782

1–800–232–4636

E-mail: cdcinfo@cdc.gov

Internet: http://www.cdc.gov/nchs
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