att_lic teacher report ii ssrs-t form

7/23/2019 Att_LIC Teacher Report II SSRS-T Form

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Teacher Report -- Part II

SSRS-T Form



Teacher Report (Part II)

LESSONS IN CHARACTER STUDY

Social Skills Questionnaire - TEACHER FORMGrades 1-5

Thank you in ad!ance "or res#ondin$ to the "ollo%in$ &uestions' This instru(ent is )ein$ ad(inistered as#art o" a lon$-ter( research #ro*ect )y +estEd to e,a(ine the i(#act o" the Lessons in Character Program ./C0 an En$lish lan$ua$e arts-)ased character education #ro$ra( on student acade(ic #er"or(anceattendance school (oti!ation and endorse(ent o" uni!ersal !alues consistent %ith character education'+estEd a research de!elo#(ent and ser!ice a$ency %orks %ith education and other co((unities to#ro(ote e,cellence achie!e e&uity and i(#ro!e learnin$ "or children youth and adults'

This sur!ey is desi$ned "or you to rate the social skills 2art A0 and acade(ic co(#etence 2art 30 o" s#eci"icchildren in your classroo(' Accordin$ to the 2a#er%ork Reduction Act o" 1445 no #ersons are re&uired tores#ond to a collection o" in"or(ation unless such collection dis#lays a !alid OM3 control nu()er' The !alidOM3 control nu()er "or this in"or(ation collection is 156-678' The ti(e re&uired to co(#lete thisin"or(ation collection is esti(ated to a!era$e 15 (inutes #er res#onse includin$ the ti(e to re!ie%

instructions search e,istin$ data resources $ather the data needed and co(#lete and re!ie% thein"or(ation collection' /" you ha!e any co((ents concernin$ the accuracy o" the ti(e esti(ates0 orsu$$estions "or i(#ro!in$ this "or( #lease %rite to9 :'S' ;e#art(ent o" Education +ashin$ton ;'C' 76767-<851' /" you ha!e co((ents or concerns re$ardin$ the status o" your indi!idual su)(ission o" this "or(%rite directly to9 Ra"ael =aldi!ieso :'S' ;e#art(ent o" Education 555 >e% ?ersey A!enue >+ Roo(568E +ashin$ton ;'C' 7676'

Res#onses to this data collection %ill )e used only "or statistical #ur#oses' The re#orts #re#ared "or thisstudy %ill su((ari@e "indin$s across the sa(#le and %ill not associate res#onses %ith a s#eci"ic district orindi!idual' +e %ill not #ro!ide in"or(ation that identi"ies you or your district to anyone outside the study tea(e,ce#t as re&uired )y la%'

2lease contact ;r' 3ar)ara ;ietsch %ith any &uestions at 587'44'5178 or )y e(ail at )dietscB%ested'or$'

mailto:[email protected]





Part A.

For ite(s 1-< read each ite( and think a)out this students )eha!ior durin$ the #ast (onth or t%o' ;ecidehow often the student does the )eha!ior descri)ed'

/" the student never does this )eha!ior (ark the 11

/" the student sometimes does this )eha!ior (ark the 2/" the student very often does this )eha!ior (ark the 3

Here are t%o e,a(#les9

Ho% O"tenD

>e!er So(eti(es =ery O"ten

Sho%s e(#athy "or #eers' 1 7

Asks &uestions o" you %hen unsure o" %hat to do in school%ork' 1 7

This student very often shows empathy for classmates. Also, this student sometimes asks questionswhen unsure of schoolwork.

Please do not sip any items.

/n so(e cases you (ay not ha!e o)ser!ed the student #er"or( a #articular )eha!ior' Make anesti(ate o" the de$ree to %hich you think the student %ould #ro)a)ly #er"or( that )eha!ior'

Social Skills Ho% O"tenD


1' Controls te(#er in con"lict situations %ith #eers' 1 7

7' /ntroduces hersel" or hi(sel" to ne% #eo#le %ithout )ein$ told' 1 7

' A##ro#riately &uestions rules that (ay )e un"air' 1 7

<' Co(#ro(ises in con"lict situations )y chan$in$ o%n ideas to reacha$ree(ent'

1 7

5' Res#onds a##ro#riately to #eer #ressure' 1 7

8' Says nice thin$s a)out hi(sel" or hersel" %hen a##ro#riate' 1 7

' /n!ites others to *oin in acti!ities' 1 7

' :ses "ree ti(e in an acce#ta)le %ay' 1 7

4' Finishes class assi$n(ents %ithin ti(e li(its' 1 7

16' Makes "riends easily' 1 7

11' Res#onds a##ro#riately to teasin$ )y #eers' 1 7

17' Controls te(#er in con"lict situations %ith adults' 1 7

1' Recei!es criticis( %ell' 1 7 1<' /nitiates con!ersations %ith #eers' 1 7

15' :ses ti(e a##ro#riately %hile %aitin$ "or hel#' 1 7

18' 2roduces correct school%ork' 1 7

1' A##ro#riately tells you %hen he or she thinks you ha!e treated hi(or her un"airly'

1 7

1 If bubble font is used in this survey administration, “mark” ill be replaced ith “bubble in”!



Social Skills Ho% O"tenD


1' Acce#ts #eers ideas "or $rou# acti!ities' 1 7

14' Gi!es co(#li(ents to #eers' 1 7

76' Follo%s your directions' 1 7

71' 2uts %ork (aterials or school #ro#erty a%ay' 1 7

77' Coo#erates %ith #eers %ithout #ro(#tin$' 1 7 7' =olunteers to hel# #eers %ith classroo( tasks' 1 7

7<' ?oins on$oin$ acti!ity or $rou# %ithout )ein$ told' 1 7

75' Res#onds a##ro#riately %hen #ushed or hit )y other children' 1 7

78' /$nores #eer distractions %hen doin$ class %ork' 1 7

7' ee#s desk clean and neat %ithout )ein$ re(inded' 1 7

7' Attends to your instructions' 1 7

74' Easily (akes transition "ro( one classroo( acti!ity to another' 1 7

6' Gets alon$ %ith #eo#le %ho are di""erent' 1 7

Problem Behaviors Ho% O"tenD>e!er So(eti(es =ery O"ten

1' Fi$hts %ith others' 1 7

7' Has lo% sel"-estee(' 1 7

' Threatens or )ullies others' 1 7

<' A##ears lonely' 1 7

5' /s easily distracted' 1 7

8' /nterru#ts con!ersations o" others' 1 7

' ;istur)s on$oin$ acti!ities' 1 7

' Sho%s an,iety a)out )ein$ %ith a $rou# o" children' 1 7

4' /s easily e()arrassed' 1 7

<6' ;oesnt listen to %hat others say' 1 7

<1' Ar$ues %ith others' 1 7

<7' Talks )ack to adults %hen corrected' 1 7

<' Gets an$ry easily' 1 7

<<' Has te(#er tantru(s' 1 7

<5' .ikes to )e alone' 1 7

<8' Acts sad or de#ressed' 1 7

<' Acts i(#ulsi!ely' 1 7

<' Fid$ets or (o!es e,cessi!ely' 1 7



Part !.

The ne,t nine ite(s <4-50 re&uire your *ud$(ents o" this students acade(ic or learnin$ )eha!iorsas o)ser!ed in your classroo(' Co(#are the student %ith other children %ho are in the sa(eclassroo('

Rate all ite(s usin$ a scale o" 1 to 5' Mark the nu()er that )est re#resents your *ud$(ent' The

nu()er 1 indicates the lo%est or least "a!ora)le #er"or(ance #lacin$ the student in the lo%est 16o" the class' >u()er " indicates the hi$hest or (ost "a!ora)le #er"or(ance #lacin$ the student inthe hi$hest 16 co(#ared %ith other students in the classroo('

.o%est16

>e,t .o%est76

Middle<6

>e,t Hi$hest76

Hi$hest16

<4' Co(#ared %ith other children in (y classroo( theoverall academic performance o" this child is9

1 7 < 5

56' /n readin# ho% does this child co(#are %ith otherstudentsD

1 7 < 5

51' /n mathematics ho% does this child co(#are %ith

other studentsD 1

7

<

5

57' /n ter(s o" $rade-le!el e,#ectations this childs skills inreadin# are9

1 7 < 5

5' /n ter(s o" $rade-le!el e,#ectations this childs skills inmathematics are9

1 7 < 5

5<' This childs overall motivation to succeedacade(ically isD

1 7 < 5

55' This childs parental enco$ra#ement to succeedacade(ically isD

1 7 < 5

58' Co(#ared %ith other children in (y classroo( thischilds intellect$al f$nctionin# is9

1 7 < 5

5' Co(#ared %ith other children in (y classroo( thischilds overall classroom %ehavior is9 1 7 < 5

<Repeated for each child in the SSRS sample>

att_lic teacher report ii ssrs-t form

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