Parent/family Survey questions – for parents, grandparents, family members in Montana who have children receiving services through the infant/toddler program(Part C) and/or school-based special education services (Part B).
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1. Greetings families in Montana,
Please complete and submit the following survey if you have children who receive or have received infant and toddler and/or special education services.
- Skip any questions you are not comfortable with or are not sure about. - If there are check boxes, check as many as you need. - If you have more than one child who has received services, you may choose to do multiple surveys or to enter all information on one survey. - Spouses/other family members are encouraged to complete surveys also. - All information shared is ANONYMOUS. Individual results will remain CONFIDENTIAL. Only summary information will be published.
Plan on about 15 minutes to do the survey. There are about 50 questions. |
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2. Section 1 – Your Household |
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3. I reside in this area of MT. (check all that apply) |
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4. I would describe myself as a: (check all that apply) |
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5. My ethnicity: (check all that apply) |
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| 7. Annual Household Income(approximate): | | |
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8. Section 2 - Your Child |
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9. I have a child/children within these age ranges: |
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| 10. Number of children included on this survey: | | |
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11. I would describe my child’s ethnicity as (check as many as needed): |
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| 12. Enter the year your child graduated or left school. | | |
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| 13. Describe briefly the services your child receives – home-based, school, medical, social, insurance, private therapies (PT, OT, SLA, ABA), other | | |
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14. Child’s disability. (check all that apply) |
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15. My child has received services through: (check all that apply) |
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16. Children’s Insurance/benefits: (check all that apply) |
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17. Section 3 – Where Do You Get Information? |
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18. How would you rate the quality of information you have received regarding your child via:
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| 19. Describe other ways you get information that benefits you and your child. | | |
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20. Do you feel that the information you have received has helped to improve your child’s development/education? |
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21. Do you feel the information you have received has allowed you to make more informed/better decisions regarding your child’s services/care/education? |
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22. How would you like to obtain information: |
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23. If you would like to receive information/training via workshops, please tell us when and how you would be able to participate: |
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| 24. Describe training topics you would like: | | |
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| 25. What else would you like to see in place that would help you with your information and support needs regarding your child? | | |
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26. Section 4 - Questions on infant toddler programs (Part C) (if your child ever received services through the infant/toddler programs). |
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27. I have been informed of my parental rights under the Early Intervention program and been given a copy of procedural safeguards at least once per year in my native language. |
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28. How was your child referred for early intervention services? |
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29. Were you made aware that there were other Early Intervention providers besides the agency you were referred to? |
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| 30. What year did your child begin receiving services: | | |
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| 31. How long did it take from evaluation to receiving services? | | |
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| 32. In what year did your child transition from infant/toddler programs to Preschool Special Education | | |
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33. How strongly do you agree with the following statements:
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| 34. If you strongly disagree with any statement above – why? | | |
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35. Rate the level of improvement you believe is needed in each of the following areas (leave blank if you don’t know or are not sure):
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| 36. Any other areas of improvement you would like to add? | | |
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37. In the last year I have had to resolve a dispute with the agency providing services for my child: |
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| 38. If so, describe briefly the type of dispute and how it was resolved? (Mediation, complaint, due process) | | |
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39. Where do you go to get information on Early Intervention Services: |
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40. I believe the early intervention system in Montana is providing the services and family supports that my child and family needs: |
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41. Are you aware of Montana’s annual Performance Report? |
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42. Are you aware of the US Department of Education’s evaluation of Montana’s compliance? |
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43. Section 5 - Special Education Services in School (includes preschool) - Part B Questions: |
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44. I have been informed of my parental rights under the Federal Special Education Law (Individuals with Disabilities Education Act) and been given a copy of procedural safeguards at least once per year in my native language. |
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| 45. How was your child referred for Special education services? | | |
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| 46. In what year did your child begin receiving services. | | |
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| 47. If you requested an evaluation in writing, estimate the time (number of days) between the request and when the evaluation was completed. | | |
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48. How strongly do you agree with these statements?
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| 49. If you strongly disagree with any of the statements above – why? | | |
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50. The IEP team placed my child in a private school at district expense: |
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51. Please rate the need for improvement in these special education areas in Montana (leave blank if you don’t know or are not sure):
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| 52. Any other areas needing improvement not listed above? | | |
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53. If your child is 16 or older, have you participated in development of your child’s Transition Plan on the IEP? |
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54. If you have developed a Transition plan, how do you rate it in meeting your child’s post school goals?
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55. Within the last year I have requested: (check all that apply) |
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| 56. If you requested any of the above, what was the result? | | |
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57. Where do you get data on State and local performance in special education? |
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58. How would you rate the following statement:
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59. I know the results of the US Department of Education’s evaluation of my state’s compliance with special education law and regulations and have read the determination letter:
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60. Are you aware of the state’s Annual Performance Report? |
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61. Additional Questions/Comments |
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62. Did you fill out a parent involvement questionnaire from the state in the last year?
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| 63. If you received and did not fill out a parent involvement questionnaire, why not? | | |
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64. For those of you in the Billings or Bozeman area that have participated in the Informative Pointing workshops with Heather Clare, please indicate if you would like to participate in additional workshops this fall: |
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65. How would you rate this survey?
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| 66. Get it off your chest – Any comments you wish to add? | | |
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