APPENDIX C

FOURTH-GRADE

TEACHER-LEVEL QUESTIONNAIRE (TQ)

Early Childhood Longitudinal Study, Kindergarten Class of 2010-11 

(ECLS-K:2011)

Spring Fourth-Grade National Data Collection

and Fifth-Grade Recruitment

OMB Clearance Package

#1850-0750 v.16
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Rockville, Maryland

Spring 2015

Teacher Questionnaire

Use a black or blue ball point pen to complete this questionnaire.

National Center for Education Statistics by:

Prepared for the U.S. Department of Education

Westat

RETURN THIS COMPLETED QUESTIONNAIRE IN THE SEALED

TYVEK® ENVELOPE DIRECTLY TO YOUR SCHOOL COORDINATOR

OR AN ECLS‐K:2011 STAFF MEMBER. DO NOT MAIL THIS

QUESTIONNAIRE UNLESS YOU ARE ASKED TO DO SO BY STUDY

STAFF AND ARE PROVIDED WITH AN ENVELOPE FOR MAILING.

S_ID T_ID T

According to the Paperwork Reduction Act of 1995, no persons are required 

to respond to a collection of information unless it displays a valid OMB 

control number. The valid OMB control number for this voluntary survey is 

1850‐XXXX. Approval expires XX/XX/XXXX. The time required to complete this 

survey is estimated to average 13 minutes per response, including the time to 

review instructions, search existing data resources, gather the data needed, 

and complete and review the survey. If you have any comments concerning 

the accuracy of the time estimate or suggestions for improving this survey, or 

any comments or concerns regarding the status of your individual submission 

of this survey, please write to: Early Childhood Longitudinal Study, National 

Center for Education Statistics, 1990 K Street, N.W., Washington, D.C. 20006‐

5574.

The collection of information in this survey is authorized by 20 U.S. 

Code, Section 9543. Participation is voluntary. You may skip questions 

you do not wish to answer; however, we hope that you will answer as 

many questions as you can. Your responses are protected from 

disclosure by federal statute ﴾20 U.S. Code, Section 9573﴿. All 

responses that relate to or describe identifiable characteristics of 

individuals may be used only for statistical purposes and may not be 

disclosed, or used, in identifiable form for any other purpose except as 

required by law. Data will be combined to produce statistical reports. 

No individual data that links your name, address, telephone number, 

or identification number with your responses will be included in the 

statistical reports. 

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Dear Teacher, 

This questionnaire is an important part of a major longitudinal study of children’s early educational 

experiences beginning with kindergarten and continuing through grade 5. You have received this 

questionnaire because you teach one or more of the children who are participants in this study. 

The Early Childhood Longitudinal Study, Kindergarten Class of 2010‐2011 ﴾ECLS‐K:2011﴿ is 

collecting information from teachers of children who are in the study to investigate the relationship 

between children’s academic progress and various school, classroom, teacher, and home characteristics. 

Taking part in the study is voluntary. You may stop at any time or choose not to answer a question you do 

not want to answer. However, only you can provide this information. Although we realize you are very 

busy, we urge you to complete this questionnaire as completely and accurately as possible. The 

information you provide is being collected for research purposes only and will be protected from 

disclosure to the fullest extent allowable by law ﴾Education Sciences Reform Act of 2002, 20 U.S.C. § 9573﴿. 

Information from multiple individuals will be combined to produce statistical reports; no information that 

identifies you will be included in any reports or provided to students, their parents, or other school staff. 

Please record your answers directly on the questionnaire by marking the appropriate answer ﴾as 

instructed on page 4﴿ or by writing your responses in the space provided. Your best estimates are 

acceptable answers. 

THANK YOU VERY MUCH FOR YOUR HELP. 

Dear Teacher, 

This questionnaire is an important part of a major longitudinal study of children’s early educational 

experiences beginning with kindergarten and continuing through grade 5. You have received this 

questionnaire because you teach one or more of the children who are participants in this study. 

The Early Childhood Longitudinal Study, Kindergarten Class of 2010‐2011 ﴾ECLS‐K:2011﴿ is 

collecting information from teachers of children who are in the study to investigate the relationship 

between children’s academic progress and various school, classroom, teacher, and home characteristics. 

Taking part in the study is voluntary. You may stop at any time or choose not to answer a question you do 

not want to answer. However, only you can provide this information. Although we realize you are very 

busy, we urge you to complete this questionnaire as completely and accurately as possible. The 

information you provide is being collected for research purposes only and will be protected from 

disclosure to the fullest extent allowable by law ﴾Education Sciences Reform Act of 2002, 20 U.S.C. § 9573﴿. 

Information from multiple individuals will be combined to produce statistical reports; no information that 

identifies you will be included in any reports or provided to students, their parents, or other school staff. 

Please record your answers directly on the questionnaire by marking the appropriate answer ﴾as 

instructed on page 4﴿ or by writing your responses in the space provided. Your best estimates are 

acceptable answers. 

THANK YOU VERY MUCH FOR YOUR HELP. 

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SECTION A. STUDENT, SCHOOL, AND STAFF ACTIVITIES

A1. Which of the following subjects do you teach during this school year? MARK ONE RESPONSE ON

EACH ROW.

A2. How often does the typical child in your class﴾es﴿ usually work on lessons or projects in the

following general subject areas, whether as a whole class, in small groups, or in individualized

arrangements? MARK ONE RESPONSE ON EACH ROW.

e. Music

a. Reading and language arts

b. Mathematics

c. Social studies

d. Science

4 days

 a week

3 days

a week

2 days

a week

1 day a

week

5 days

a week

Less than

once a

Never week

f. Art

g. Physical education

h. Dance/creative movement

i. Theater/creative dramatics

j. Foreign language ﴾excluding

English for ELL students﴿

a. Reading/language arts 

b. Mathematics

c. Science 

d. Social studies

Yes No

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A4. How many days a week do children have recess? MARK ONE RESPONSE.

Zero ﴾no recess on any day﴿﴾SKIP TO Q A6﴿

One

Two

Three

Four

Five

Other/Varies by week

A3. On the days children work in these areas, how much time does the typical child in your class﴾es﴿

usually work on lessons or projects in the following general subject areas? MARK ONE RESPONSE ON

EACH ROW.

 Not

applicable/

never

2 1⁄2 to

less

than 3

hours

2 to less

than 2

1⁄2 hours

1 1⁄2 to

less

than 2

hours

1 to less

than 1

1⁄2 hours

3 hours

or more

1⁄2 hour

to less

than 1

hour

Less

than 1⁄2

hour a

day

a. Reading and

language arts

e. Music

b. Mathematics

c. Social studies

d. Science

f. Art

g. Physical education

h. Dance/creative

movement

i. Theater/creative

dramatics

j. Foreign language

﴾excluding English

for ELL students﴿

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A7. How important is each of the following in evaluating the children in your class﴾es﴿ for reporting 

to parents? MARK ONE RESPONSE ON EACH ROW.

Not

important

Somewhat

important

Very

important

Extremely

important

a. Individual child's achievement relative

to the rest of the class

b. Individual child's achievement relative

to local, state, or professional standards

c. Individual improvement or progress

over past performance

d. Effort

e. Class participation

f. Daily attendance

g. Classroom behavior or conduct

h. Cooperativeness with other children

i. Ability to follow directions

0% 1‐25% 26‐50% 51‐75%

76% or

more

c. Attend open houses or parties

d. Attend art/music events or demonstrations

a. Attend teacher‐parent conferences

b. Volunteer regularly to help in your

classroom or another part of the school

A6. What percentage of children in your class﴾es﴿ have parents who participate in the following 

activities? MARK ONE RESPONSE ON EACH ROW.

One

Two

Three

Four

Five

Other/Varies by day

A5. On days when children have recess, between the school day starting time and the dismissal time,

how many times a day do children have recess? MARK ONE RESPONSE.

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SECTION B. VIEWS ON SCHOOL CLIMATE AND SCHOOL ENVIRONMENT

B1. Please indicate the extent to which you agree or disagree with each of the following statements

about your school. MARK ONE RESPONSE ON EACH ROW.

B2. To what extent do you agree or disagree with each of the following statements? MARK ONE

RESPONSE ON EACH ROW.

a. The level of child misbehavior ﴾for

example, noise, horseplay, or fighting

in the halls or cafeteria﴿ in this school

interferes with my teaching.

b. Many of the children I teach are not

capable of learning the material I am

supposed to teach them.

d. There is a great deal of cooperative

effort among the staff members.

g. The school administrator sets priorities,

makes plans, and sees that they are

carried out.

h. The school administration's behavior

toward the staff is supportive and

encouraging.

f. The academic standards at this school

are too low.

c. Parents are supportive of school staff.

e. There is a consensus among

administrators and teachers on goals 

and expectations.

Strongly

disagree Disagree

Neither

agree nor

disagree Agree

Strongly

agree

a. The attitudes and habits students bring

to my class﴾es﴿ greatly reduce their

chances for academic success.

b. My success or failure in teaching is due

primarily to factors beyond my control

rather than to my own effort or ability.

c. The amount a student can learn is

primarily related to family background.

d. I really enjoy my present teaching job.

e. If I could start over, I would choose

teaching again as my career.

Strongly

disagree Disagree

Neither

agree nor

disagree Agree

Strongly

agree

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SECTION C. TEACHER BACKGROUND

Male

Female

YEAR

Yes

No

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

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C1. What is your gender? MARK ONE RESPONSE.

C2. In what year were you born? WRITE IN YEAR BELOW.

C3. Are you Hispanic or Latino? MARK ONE RESPONSE.

C4. Which best describes your race? MARK ONE OR MORE RESPONSES TO INDICATE WHAT YOU CONSIDER

YOURSELF TO BE.

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Year﴾s﴿

Yes

No

C7. Is this school year the first year you have taught in this school? MARK ONE RESPONSE.

C6. Counting this school year, how many total years have you been a schoolteacher, including years in

which you taught part time? WRITE THE NUMBER OF YEARS TO THE NEAREST FULL SCHOOL YEAR. IF

THIS IS YOUR FIRST YEAR, WRITE "1."

C5. Counting this school year, how many years have you taught each of the following grades and

programs, including years in which you taught part time?

WRITE THE NUMBER OF YEARS TO THE NEAREST FULL SCHOOL YEAR. IF THIS IS YOUR FIRST YEAR

TEACHING, WRITE "1." WRITE "0" IF YOU HAVE NEVER TAUGHT THE GRADE OR PROGRAM LISTED.

Total years

grade or program taught

a. Preschool or kindergarten

b. First grade

Second grade

Third grade

c.

d.

Fourth grade

Fifth grade

g. Sixth grade or higher

English as a Second Language ﴾ESL﴿, bilingual

education, and/or dual language program

h.

e.

f.

i. Special education program

j. Program for gifted children

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C9. If you have an associate's or bachelor's degree, indicate your undergraduate major field of study.

MARK YES OR NO ON EACH ROW.

C8. What is the highest level of education you have completed? MARK ONE RESPONSE.

Did not complete high school

High school diploma or equivalent/GED

Some college or technical or vocational school

Associate's degree

Bachelor's degree

Master's degree

An advanced professional degree beyond a master's degree ﴾for example, Ph.D., MD﴿

﴾SKIP TO Q C11﴿

﴾SKIP TO Q C11﴿

﴾SKIP TO Q C11﴿

Early childhood education

Elementary education

English

Curriculum and instruction

a.

b.

c.

d.

e.

Reading and/or language arts

Mathematics education

Mathematics

Life science

f.

g.

h.

i.

Science education

Physical science

Earth science

Other education‐related major ﴾for example, secondary education,

educational psychology, administration, music education, etc.﴿

j.

k.

l.

m.

Special education

n. Non‐education major ﴾for example, history, etc.﴿

Yes No

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C10. If you have a graduate degree, indicate the major field of study of your highest level graduate

degree. MARK YES OR NO ON EACH ROW.

C11. Have you ever taken a college course that addressed issues related to the following? MARK YES OR

NO ON EACH ROW.

Using published research evidence to identify and select effective

interventions and supports for students

Using formal assessment data to inform the choice of READING

interventions and supports for students

Using formal assessment data to inform the choice of MATH

interventions and supports for students

Using data to inform the choice of behavioral interventions and

supports for students

a.

b.

c.

d.

Yes No

Early childhood education

Elementary education

English

Curriculum and instruction

a.

b.

c.

d.

e.

Reading and/or language arts

Mathematics education

Mathematics

Life science

f.

g.

h.

i.

Science education

Physical science

Earth science

Other education‐related major ﴾for example, secondary education,

educational psychology, administration, music education, etc.﴿

j.

k.

l.

m.

Special education

n. Non‐education major ﴾for example, history, etc.﴿

Yes No

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C12. Which of the following describes the teaching certificate you currently hold in THIS state? MARK

ONE RESPONSE.

C13. Date Questionnaire Completed:

THANK YOU FOR YOUR COOPERATION!

MONTH DAY YEAR

2015

Regular or standard state certificate or advanced professional certificate

Certificate issued after satisfying all requirements except the completion of a probationary

Certificate that requires some additional coursework, student teaching, or passage of a test

Certificate issued to persons who must complete a certification program in order to continue

I do not hold any of the above certifications in THIS state.

period

before regular certification can be obtained

teaching

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For Office Use Only

C ‐ No DR C ‐ DR Comp

 C ‐ DR Ref Ref

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