TOOLS, INSTRUMENTS, AND SURVEYS

 For additional questions on instruments, surveys, or other tools, please contact NECTC Research for a complete copy of the NECTC Multi-State Study Data Collection Manual.

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Family Interview | Flow Charts | Forms | Instruments | Surveys

Family Interview

English Version

Title
Family Interview Cover Page
Section 1-Adult
Section 1- Adult Addendum
Section 2-Child
Section 2-Child Addendum
Section 3-Foster Care
Section 4-Child's Health
Section 5-Child Care Arrangements
Section 5-Child Care Provider Addendum
Section 6- About Child and Family Needs
Section 7-Income and Public Support
Section 8 - Evolving Section - Study 1
Section 8 - Evolving Section - Study 2
Section 8 - Evolving Section - Study 3
Section 8 - Evolving Section - Study 4
Family Interview Extension Post - 3
Family Interview Extension Post - 5

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Spanish Version

Title
Spanish Family Interview Introduction
Spanish Section 1
Spanish Adult Addendum
Spanish Section 2
Spanish Child Addendum
Spanish Section 3
Spanish Section 4
Spanish Section 5
Spanish Provider Addendum
Spanish Section 6
Spanish Section 7
Spanish Section 8 - Evolving Section

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Flow Charts

Title
Sample Selection
Initial Reliability
Initial Contact (Page 1)
Initial Contact (Page 2)
Meeting with the Provider
After the Data are Collected
Prior To The Next Data Collection Point
When Families Move
Ongoing Reliability

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Forms

Title
Child Assessment Coversheet - DCP 1
Child Assessment Coversheet - DCP2
Document Retrieval Form
Family Assessment Coversheet
Release of IFSP Information
Release of IEP Information

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Instruments

English Versions

Behavioral Assessment Scale for Children-Parent (BASC PRS-p)
Behavioral Assessment Scale for Children-Teacher (BASC TRS-p)

Published tools can be found at: http://ags.pearsonassessments.com

Individual Growth and Development Indicator (IGDI): Picture Naming
Individual Growth and Development Indicator (IGDI): Rhyming
Individual Growth and Development Indicator (IGDI): Alliteration

Published tools can be found at: http://www.igdi.ku.edu/

Early Math Skills 
Zill, N. (2003). Early Math Skills Test. Rockville, MD: Westat, Inc. Copyright 2003 Westat, Inc.  All rights reserved.

Published tool can be found at: https://www.peels.org/Assessments.asp

DIBELS Letter Naming Fluency
Published tool can be found at: https://dibels.uoregon.edu/

Title
Ecomap Script & Directions
Ecomap Sample
Additional Ecomap Samples 1
Additional Ecomap Samples 2
Additional Ecomap Samples 3

Emergent Literacy Measure (ELM)
Head Start Family and Child Experiences Survey (FACES). (1998). U.S. Department of Health and Human Services.

Center for Epidemiological Studies Depression Scale (CES-D)
(Radloff, 1977)

Dismensions of Temperament-Revised (DOTS-R, Child)
Dismensions of Temperament-Revised (DOTS-R, Parent)
(Windle & Lerner, 1999)

Early Intervention Services Assessment Scale (EISAS), Assessment (Parent)
Early Intervention Services Assessment Scale (EISAS), Program Practices (Provider)
Early Intervention Services Assessment Scale (EISAS), Transition (Provider)
(Aytch, Cryer, Castro & Selz-Campbell, 2003)

Family Empowerment Scale
(Koren, DeChillo & Friesen, 1992)

Family Support Scale
(Dunst, Jenkins & Trivette, 1984)

Pediatric Evaluation of Disability Inventory (PEDI version 1.0)
Haley, Stephen M., Coster, Wendy J., Ludlow, Larry H., Haltiwanger, Jane T., Andrellos, Peter J.(1992). Peditatric Evaluation of Disability Inventory (PEDI): Development, Standardization and Administration Manual. Boston University.

Peabody Picture Vocabulary Test-Third Edition (PPVT-III Form A)
Peabody Picture Vocabulary Test-Third Edition (PPVT-III Form B)

Published tools can be found at: http://ags.pearsonassessments.com

MP-R Cognitive
MP-R Expressive Language Evaluator Report
MP-R Expressive Language Parent Form
Revised MP-R Expressive Language Parent Form
MP-R Gross Motor Measure
Revised MP-R Gross Motor Measure
MP-R Developmental Scale Social Emotional
MP-R Self-Help
Revised MP-R Self-Help
MP-R Social-Emotional Behavior Styles
MP-R Social-Emotional Problem Indicators

Published tools can be found at: 
http://www.stoeltingco.com/tests/store/viewlevel3.asp?keyword1=33&keyword3=1532

Transition Perception of Providers
Transition Perception of Parents
Innocenti, M. S., Judd, D. R., & Taylor M. J. (1998).  Transition Perspectives of Parents.  Logan, UT:  Early Intervention Research Institute, Utah State University.

Spanish Versions

Encuesta Revisiada Sobre Dimensiones De La Disposicion-Nino
(Windle & Lerner, 1999)

Only published instruments are included in Appendix D

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Surveys

End of Early Intervention

Title
EI Provider Survey A
EI Provider Survey B
Provider Survey A, Center-based Care
Provider Survey B, Center-based Care
Service Coordinator Survey A
Service Coordinator Survey B

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Beginning of Preschool

Title
Provider Survey A, Center-Based Care
Provider Survey B, Center-Based Care
Special Needs Provider Survey A
Special Needs Provider Survey B
Transition Perception of Parents
Transition Perception of Providers

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End of Pre-Kindergarten

Title
Teacher-Provider Survey A
Teacher-Provider Survey B
Administrator Survey - Public Preschool Program Pre-Transition to K
Administrator Survey - Non-Public Preschool Program Pre-Transition to K

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Beginning of Kindergarten

Title
Teacher-Provider Survey A
Teacher-Provider Survey B
Administrator Survey - Public Preschool Program Post-Transition to K
Administrator Survey - Non-Public Preschool Program Post-Transition to K
Transition Perception of Parents
Transition Perception of Providers

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