PISA-D Student Questionnaire
Student Questionnaire
What grade are you in? *
On what date were you born? *
Are you female or male? *
Required
What language do you speak at home most of the time? (Please check only on box) *
Required
In what country were you and your parents born? (Please check only one box in each column) *
You
Mother
Father
Jamaica
USA
Canada
China
Other country
Overall, how satisfied are you with your life as a whole these days? (Please check only one box)
Not at all satisfied
Completely satisfied
Clear selection
The next five statements are about your health. (Please check one box in each row.) *
Yes
No
I can see what is written on the board without difficulty
I can hear the teacher's voice clearly when he or she is giving a lesson.
I have a physical disabilty that makes it difficult for me to walk or use stairs.
I have a physical disability that makes it difficult for me to grasp small objects like a pencil or scissors.
I often get so sick i cannot play, work or go to school.
We would like to know about certain feelings you may have at home or at school. For each statement below, please tell us how often you feel this way. (Please check one box in each row.) *
Never or almost never
About once a week
2 to 3 times a week
Almost every day
I am fearful or nervous
I am afraid that other students think i am stupid.
I worry about a teacher asking me a question.
i worry about what other students think of me
I cry without a good reason
I feel lonely
Other students seem to have more fun than me
I feel sad or depressed
I have trouble falling asleep at night
A lot of things seem to bother me
In general, would you say your health is (Please check only one box) *
Poor
Excellent
During the past year, have you had any of the following health problems? (Please check one box in each row) *
Yes
No
A chronic disease (e.g. heart disease, lung or other respiratory problems, cancer, diabetes)
An infectious disease (e.g. cholera, malaria, tuberculosis)
Gastrointestinal problems (e.g. heartburn, stomach pain, constipation, diarrhea)
A cold or flu
An injury that needed treatment
Pain that was long-lasting or recurring
Depression
Panic and anxiety attacks
Insomnia
Fatigue that was long-lasting or recurring
Did you attend primary school? (Please check only one box) *
Required
What language did most of your teachers use for instruction in primary school? *
Required
When did you begin learning English Language (Please check only one box *
Required
Which language did you first learn to read? (Please check only one box)
Have you ever repeated a grade? *
No, never
Yes, once
Yes, twice or more
At primary school
At lower secondary school
At upper secondary school
Have you ever missed school for more than three months in a row? (Please check only one box) *
Required
Why did you miss school for more than three months in a row? (Please check one box in each row) *
Yes
No
I was bored
I was suspended for something i did (e.g. violence, aggression, use of drugs, drug dealing)
I was suspended
I could not reach school because of transportation problems
I did not have a teacher
I could not understand the language in which the lessons were given
I had to take care of a family member
I had to help with work at home or on the family land
I had to get work to bring money home
I was sick
I did not feel safe at school
I had to take care of sick parents or relatives
I was no longer interested in school
I could not pay school fees
School was closed because of a natural disaster (e.g. flood, earthquake)
Thinking about your school: to what extent do you agree with the following statements? (Please check one box in each row) *
Strongly agree
Agree
Disagree
Strongly disagree
School has helped my confidence to make decisions
School has taught me things which could be useful in a job
Trying hard at school will help me get into a good college
I enjoy receiving good grades
Trying hard at school is important
Thinking about your school: to what extent do you agree with the following statements? (Please check one box in each row) *
Strongly agree
Agree
Disagree
Strongly disagree
I feel like an outsider ( or left out of things) at school
I make friends easily at school
I feel like i belong at school
I feel awkward and out of place in my school
Other students seem to like me
I feel lonely at school
Thinking about your school: to what extent do you agree with the following statements? (Please check one box in each row) *
Strongly agree
Agree
Disagree
Strongly disagree
I feel safe at our school
I feel safe on my way to school.
I feel safe on my way home from school
*
Yes
No
I was in a physical fight on school property
I stayed home from school because i felt unsafe
Our school was vandalized
I gave money to someone at school because they have threatened to hurt me
I witnessed a fight on school property in which someone got hurt
I saw gangs in and around the school
I heard a student threaten to hurt another student
Someone stole something of mine at school
I saw a student carrying a gun or a knife at school
Thinking about the teachers at your school: to what extent do you agree or disagree with the following statements? (Please choose one box in each row) *
Strongly agree
Agree
Disagree
Strongly disagree
I get along well with most of my teachers
Most of my teachers are interested in my well-being
Most of my teachers listen to what i have to say
If i need extra help, i will receive it from my teachers
Most of my teachers treat me fairly
The teachers show an interest in every student's learning
The teachers give students an opportunity to express opinions
Our teachers expect us to do our homework on time
Our teachers expect us to work hard
Our teachers encourage students to do their best work
Students understand what is expected of them for their courses
Sexual harassment is any unwanted or inappropriate language or touching of a sexual nature that makes you feel upset, hurt or angry.It can be verbal, such as comments about your body, sexual remarks, or the spreading of rumours about a person. It can be physical, such as touching, rubbing, pinching or hugging in a sexual way. It can be a request for a sexual favour in return for something else. It can happen to both boys and girls.
Please check one box in each row *
Yes
No
In the past 4 weeks, have you felt sexually harassed at school by a student
In the past 4 weeks, have you felt sexually harassed at school by a teacher or other staff member?
How often do these thing happen in your classroom? (Please check one box in each row) *
Every lesson
Most lessons
Some lessons
Never or hardly ever
Students don't listen to what the teacher says.
There is noise and disorder
The teacher has to wait a long time for students to quiet down.
Students cannot work well
Students don't get start working for a long time after the lesson begins
How often do these things happen in your lessons in mathematics. (Please check one box in each row.) *
Every lesson
Most lessons
Some lessons
Never or hardly ever
The teacher explains the purpose of the lesson
The teacher reviews what we learned in previous lessons
The teacher shows us how to solve problems.
The teacher provides examples of successful work
The teachers gives clear answers to students' questions
The teacher gives a formal lecture on the topic
The teacher explains mathematical concepts
The teacher gives us work to do at our desk
The teacher talks with students about their work
The teacher summarizes what we have done that day.
The teacher gives us homework to practice what we have learned.
In the last two weeks at school, how often did the following things occur? (Please check one box in each row.) *
Never
One or two times
Three or four times
Five or more times
i skipped a whole school day
i skipped some classes
i arrived late for school
How long does it usually take you to get from your home to school. (Please check only one box) *
Required
In the last two weeks at school, did any of these happen? (Please check one box in each row.) *
Yes
No
One or more classes were cancelled.
School was cancelled.
One of my teachers was late for class.
One of my teachers did not come for class.
There was a teacher strike.
My teacher worked at the computer during class time.
My teacher answered personal calls during class time.
My teacher attended a meeting during class time.
In general, how often do your parents or someone in your family do the following things with you? ( Please check one box in each row.) *
Never or hardly ever
A few times a year
About once a month
Several times a month
Several times a year
Discuss how well you are doing at school
Eat dinner with you
Spend time just talking with you
Talk to you about any problems you might have at school.
Ask you about how well you are getting along with kids at school
Encourage you to get good grades.
Take an interest in what you are learning at school.
Talk to you about your future education.
Ask you what you did in school that day.
Think of the work you did in the past week. (Please check one box in each row.) *
Yes
No
I worked for payment for someone who is not a member of my household.
I fetched water for household use.
I collected firewood for household use.
I worked on our family farm, in our family business, or selling goods on the street.
I helped in the care of children, or an elderly or sick person.
I helped with other household chores such as shopping, cleaning, washing clothes, or cooking.
Who do you live with at home? (Please check one box in each row.) *
Yes
No
Your mother
Your father
Your grand-mother
Your grand-father
Your siblings (including step-sisters or step-brothers)
Other relatives (e.g. aunts, uncles, cousins)
Your child/children
Which of the following are in your home? (Please check one box in each row.) *
Yes
No
A desk to study
A room of your own
A quiet place to study
A computer you can use for school work
Educational software
A link to the internet
Books to help with your school work
A dictionary
A table to have meals
A washer
A refrigerator or freezer
A stove or burner for cooking
How many of thee are there in your home? (Please check one box in each row.) *
None
One
Two
Three or more
Televisions
Cars, vans or trucks
Rooms with a bath or shower
Cell phones with internet access (e.g. smartphones)
Computers (Desktop computer, portable laptop or notebook)
Musical instruments (e.g. guitar, piano, drum)
How many books are there in your home? Do not include magazines, newspaper or your schoolbooks. (Please check only one box) *
Required
Do you share a toilet facility with others who are not your family? *
Required
What is the floor of your home mostly made of? (Please check only one box.) *
Required
Do you have a flush toilet at your house? *
Required
Does any member of your household have a bank account? *
Required
In the past 30 days, how often were you hungry because there was not enough food? (Please check only one box) *
Required
What is the highest level of schooling completed by your mother?  (Please check only one box.) *
Required
Can your mother read and write? (Please check only one box.) *
Required
Does your mother have any of the following qualifications? (Please tick one box in each row.) *
Yes
No
Doctorate
Diploma
Degree
CSEC
What kind of job does your mother have? (Please check only one box.) *
Required
The following two questions concern your mother’s job.
(If she is not working now, please tell us her last main job.)What is your mother’s main job? (e.g., school teacher, kitchen-hand, sales manager) *
What does your mother do in her main job? (e.g., teaches high school students, helps the cook 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. *
What is the highest level of schooling completed by your father? (Please check only one box.) *
Required
 Can your father read and write? (Please check only one box.) *
Required
Does your father have any of the following qualifications? (Please check one box in each row.) *
Yes
No
Doctorate
Diploma
Degree
CSEC
What kind of job does your father have? (Please check only one box.) *
Required
The following two questions concern your father’s job.
(If he is not working now, please tell us his last main job.) What is your father’s main job? (e.g., school teacher, kitchen-hand, sales manager) *
What does your father do in his main job? (e.g., teaches high school students, helps the cook prepare meals in a restaurant, manages a sales team) Please use a sentence to describe the kind of work he does or did in that job. *
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