Student UH Questionnaire – English

Instructions

In this questionnaire you will find questions about the following topics:

  • You, your family, and your home
  • Your science learning

Please read each question carefully and answer as accurately as you can.

In this questionnaire, there are no right or wrong answers. Your answers should be the ones that are right for yourself.

You may ask for help if you do not understand something or are not sure how to answer a question.

Some questions relate to science. Please think of all the different subjects and courses in your school that teach content related to science. Your school might teach science in different subjects such as physics, chemistry, biology, Earth and geology, space and astronomy, applied sciences and technology (e.g., engineering, robotics), or your school teaches a general, integrated, or comprehensive science course (e.g., anatomy and physiology, biological and physical science).

Please note that the forward button used to proceed to the next question is located at the bottom right hand corner of your screen. In some instances you may need to scroll down to the bottom of your screen to access this forward button.

Your answers will be combined with answers from other students to calculate totals and averages. All information (or responses) you provide may only be used for statistical purposes and may not be disclosed, or used, in identifiable form for any other purpose except as required by law [Education Science Reform Act of 2002 (ESRA 2002), 20 U.S. Code, Section 9573].

According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless such collection displays a valid OMB control number. The valid OMB control number for this voluntary information collection is 1850-0755. The time required to complete this information collection is estimated to average 30 minutes per response, including the time to review instructions, search existing data resources, gather the data needed, and complete and review the information collection. If you have any suggestions for improving the form, or comments or concerns regarding the accuracy of the time estimate(s) or the status of your individual submission of this form, please write to: Program for International Student Assessment (PISA), National Center for Education Statistics, U.S. Department of Education, 1990 K Street, N.W., Room 8122, Washington, D.C. 20006. O.M.B. No. 1850-0755, Approval Expires 08/31/2016

You, Your Family, and Your Home

ST001

What grade are you in?

(Please select from the drop-down menu to answer the question.)

Grade (7 – 12)

ST003

When were you born?

(Please select the month, day, and year from the drop-down menus to answer the question.)

Month (January – December)

Day (1 – 31)

Year (1998 –2001)

ST004

Are you female or male?

(Please select one response.)

radio button unchecked Female

radio button unchecked Male

ST801

Which best describes you?

(Please select one response.)

radio button unchecked I am Hispanic or Latino

radio button unchecked I am not Hispanic or Latino

ST802

Which of these categories best describes your race?

(Please select one or more responses.)

checkbox unchecked White

checkbox unchecked Black or African American

checkbox unchecked Asian

checkbox unchecked American Indian or Alaska Native

checkbox unchecked Native Hawaiian or Other Pacific Islander

ST005

What is the highest level of schooling (not including college) completed by your mother?

If you are not sure which circle to choose, please ask the test administrator for help.

(Please select one response.)

radio button unchecked She completed grade 12 (high school diploma or GED).

radio button unchecked She completed grade 9.

radio button unchecked She completed grade 6.

radio button unchecked She did not complete grade 6.

ST006

Does your mother have any of the following degrees, certificates, or diplomas?

If you are not sure how to answer this question, please ask the test administrator for help.

(Please select one response in each row.)

  Yes No
Master’s, doctoral, or professional degree such as medicine or law radio button unchecked radio button unchecked
Bachelor’s degree (4-year college degree) radio button unchecked radio button unchecked
Associate’s degree (2-year degree from a community college) radio button unchecked radio button unchecked
Vocational or technical certificate/diploma after high school (such as cosmetology or auto mechanics) radio button unchecked radio button unchecked

ST014

The following two questions concern your mother’s job:

(If she is not working now, please tell us her last main job.)

text entry areaWhat is your mother’s main job? (e.g., school teacher, cook, sales manager)
Please type in the job title.

text entry areaWhat does your mother do in her main job? (e.g., teaches high school students, helps prepare meals in a restaurant, manages a sales team)
Please use a sentence to describe the kind of work she does or did in that job.

ST007

What is the highest level of schooling (not including college) completed by your father?

If you are not sure which circle to choose, please ask the test administrator for help.

(Please select one response.)

radio button unchecked He completed grade 12 (high school diploma or GED).

radio button unchecked He completed grade 9.

radio button unchecked He completed grade 6.

radio button unchecked He did not complete grade 6.

ST008

Does your father have any of the following degrees, certificates, or diplomas?

If you are not sure how to answer this question, please ask the test administrator for help.

(Please select one response in each row.)

  Yes No
Master’s, doctoral, or professional degree such as medicine or law radio button unchecked radio button unchecked
Bachelor’s degree (4-year college degree) radio button unchecked radio button unchecked
Associate’s degree (2-year degree from a community college) radio button unchecked radio button unchecked
Vocational or technical certificate/diploma after high school (such as cosmetology or auto mechanics) radio button unchecked radio button unchecked

ST015

The following two questions concern your father’s job:

(If he is not working now, please tell us his last main job.)

text entry areaWhat is your father’s main job? (e.g., school teacher, cook, sales manager)
Please type in the job title.

text entry areaWhat does your father do in his main job? (e.g., teaches high school students, helps prepare meals in a restaurant, manages a sales team)
Please use a sentence to describe the kind of work she does or did in that job.

ST011

Which of the following are in your home?

(Please select one response in each row.)

  Yes No
A desk to study at radio button unchecked radio button unchecked
A room of your own radio button unchecked radio button unchecked
A quiet place to study radio button unchecked radio button unchecked
A computer you can use for school work radio button unchecked radio button unchecked
Educational software radio button unchecked radio button unchecked
A link to the Internet radio button unchecked radio button unchecked
Classic literature (e.g., Shakespeare) radio button unchecked radio button unchecked
Books of poetry radio button unchecked radio button unchecked
Works of art (e.g., paintings) radio button unchecked radio button unchecked
Books to help with your school work radio button unchecked radio button unchecked
Technical reference books or manuals radio button unchecked radio button unchecked
A dictionary radio button unchecked radio button unchecked
Books on art, music, or design radio button unchecked radio button unchecked
A guest room radio button unchecked radio button unchecked
A high-speed Internet connection radio button unchecked radio button unchecked
A musical instrument radio button unchecked radio button unchecked

ST012

How many of these are there at your home?

(Please select one response in each row.)

  None One Two Three or more
Televisions radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Cars radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Bathrooms with a bathtub or shower radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Cell phones with Internet access (e.g., smartphones) radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Computers (desktop computer, portable laptop, or notebook) radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Tablet computers (e.g., iPad®, Samsung Galaxy®) radio button unchecked radio button unchecked radio button unchecked radio button unchecked
E-book readers (e.g., Kindle™, Nook) radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Musical instruments (e.g., guitar, piano) radio button unchecked radio button unchecked radio button unchecked radio button unchecked

ST013

How many books are there in your home?

There are usually about 15 books per foot of shelving. Do not include magazines, newspapers, or your schoolbooks.

(Please select one response.)

radio button unchecked 0-10 books

radio button unchecked 11-25 books

radio button unchecked 26-100 books

radio button unchecked 101-200 books

radio button unchecked 201-500 books

radio button unchecked More than 500 books

ST019

In what country were you and your parents born?

(Please select one response in each column.)

  You Mother Father
United States* radio button unchecked radio button unchecked radio button unchecked
Other country radio button unchecked radio button unchecked radio button unchecked

* NOTE: The “United States” refers to the 50 states, District of Columbia, and U.S. military bases abroad.

ST022

What language do you speak at home most of the time?

(Please select one response.)

radio button unchecked English

radio button unchecked Spanish

radio button unchecked Other language

ST125

How old were you when you started pre-school?

(Please choose from the drop-down menu to answer the question.)

Years

ST126

How old were you when you started first grade?

(Please choose from the drop-down menu to answer the question.)

Years old

Your Science Learning

ST094

How much do you disagree or agree with the statements about yourself below?

(Please select one response in each row.)

  Strongly Disagree Disagree Agree Strongly Agree
I generally have fun when I am learning science topics. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
I like reading about science. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
I am happy working on science topics. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
I enjoy acquiring new knowledge in science. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
I am interested in learning about science. radio button unchecked radio button unchecked radio button unchecked radio button unchecked

ST097

How often do these things happen in your science classes?

(Please select one response in each row.)

  Every class Most classes Some classes Never or hardly ever
Students don’t listen to what the teacher says. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
There is noise and disorder. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
The teacher has to wait a long time for students to quiet down. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Students cannot work well. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
Students don’t start working for a long time after the lesson begins. radio button unchecked radio button unchecked radio button unchecked radio button unchecked

ST100

How often do these things happen in your science classes?

(Please select one response in each row.)

  Every class Most classes Some classes Never or hardly ever
The teacher shows an interest in every student’s learning. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
The teacher gives extra help when students need it. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
The teacher helps students with their learning. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
The teacher continues teaching until the students understand. radio button unchecked radio button unchecked radio button unchecked radio button unchecked
The teacher gives students an opportunity to express opinions. radio button unchecked radio button unchecked radio button unchecked radio button unchecked

Thank you very much for your cooperation in completing this questionnaire!

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