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ELEMENTARY TOPICS (Grade 3-5)
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Student Engagement
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How much effort are you
putting into your classes
right now?
Almost no effortA little bit of effortSome effortQuite a bit bit of effortA great deal of effort
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How difficult or easy is it for
you to try hard on your
schoolwork right now?
Very
difficult
Somewhat difficult
Slightly
difficult
Neither
difficult nor
easy
Slightly
easy
Somewhat easyVery easy
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How difficult or easy is it for
you to stay focused on your
schoolwork right now?
Very
difficult
Somewhat difficult
Slightly
difficult
Neither
difficult nor
easy
Slightly
easy
Somewhat easyVery easy
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If you have missed online
classes recently, why did
you miss class? You can pick
more than one.
I was sick
A family
member
was sick
I did not
have a
computer
to use
My internet
wasn’t
working
I didn’t feel
like
attending
I was
helping my
family with
something
Other
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Sense of Belonging (3-5)
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How well do people at your school understand you as a person?Do not understand
at all
Understand a
little
Understand somewhatUnderstand
quite a bit
Completely
understand
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How much support do the adults at your school give you?No support at allA little bit of
support
Some support Quite a bit of
support
A tremendous
amount of
support
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How much respect do students at your school show you?No respect at allA little bit of
respect
Some respectQuite a bit of respectA temendous amount of respect
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Overall, how much do you feel like you belong at your school?Do not belong
at all
Belong a little
bit
Belong
somewhat
Belong quite
a bit
Completely
belong
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ANXIETY
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anxiety: school
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(social) How stressed do you get about other students at school liking you?Not at all stressedSlightly stressedSomewhat StressedQuite stressedExtremely stressed
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How often do you worry about what other students think of you?Almost neverOnce in a whileSometimesFrequentlyAlmost always
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(academic) How stressed do you get about doing well in school?Not at all stressedSlightly stressedSomewhat StressedQuite stressedExtremely stressed
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How often do you worry about grades?Almost neverOnce in a whileSometimesFrequentlyAlmost always
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anxiety: general
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How stressed do you get about things outside of school?Not at all stressedSlightly stressedSomewhat StressedQuite stressedExtremely stressed
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How often do you worry about things outside of school?Almost neverOnce in a whileSometimesFrequentlyAlmost always
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JOY
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joy: school
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At school, how often do you laugh?Almost neverOnce in a whileSometimesFrequentlyAlmost always
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How happy do you feel in school?Not at all happySlightly happySomewhat happyQuite happyExtremely happy
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joy: general
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Outside of school, how often do you laugh?Almost neverOnce in a whileSometimesFrequentlyAlmost always
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How happy do you feel outside of school?Not at all happySlightly happySomewhat happyQuite happyExtremely happy
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SOCIAL AWARENESS---During the past 30 days…
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How carefully did you listen to other people's points of view?Not carefully at allSlightly carefullySomewhat
carefully
Quite carefullyExtremely
carefully
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How much did you care about other people's feelings?Did not care at all Cared a little bitCared
somewhat
Cared quite
a bit
Cared a tremendous amount
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How often did you compliment others' accomplishments?Almost neverOnce in a whileSometimesFrequentlyAlmost always
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How well did you get along with students who are different from you?Did not get along
at all
Got along a little
bit
Got along
somewhat
Got along
pretty well
Got along
extremely well
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How clearly were you able to describe your feelings?Not at all clearlySlightly clearlySomewhat clearlyQuite clearlyExtremely clearly
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When others disagreed with you, how respectful were you of their views?Not at all respectfulSlightly respectfulSomewhat respectfulQuite respectfulExtremely respectful
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To what extent were you able to stand up for yourself without putting others down?Not at allA little bitSomewhatQuite a bitA tremendous amount
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To what extent were you able to disagree with others without starting an argument?Not at allA little bitSomewhatQuite a bitA tremendous amount
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SCHOOL CLIMATE
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How often do your teachers seem excited to be teaching your classes?Almost neverOnce in a
while
SometimesFrequentlyAlmost always
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How fair or unfair are the rules for the students at this school?Very unfair Somewhat
unfair
Slightly
unfair
Neither unfair
nor fair
Slightly fairSomewhat
fair
Very fair
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How positive or negative is the energy of the school?Very negative Somewhat
negative
Slightly
negative
Neither
negative nor
positive
Slightly
positive
Somewhat
positive
Very
positive
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At your school, how much does the behavior of other students hurt or help your learning?Hurts my
learning a
tremendous
amount
Hurts my learning some
Hurts my learning a little bit
Neither helps
nor hurts my
learning
Helps my learning a little bitHelps my learning someHelps my learning a tremendous amount
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