Start
nshd_59_ts
STRICTLY CONFIDENTIAL
MAY 1959
TEACHER'S QUESTIONNAIRE*
NATIONAL SURVEY OF THE HEALTH AND DEVELOPMENT OF CHILDREN
Under the joint auspices of
Institute of Child Health (University of London); Society of Medical Officers of Health; Population Investigation Committee
and National Foundation for Educational Research in England and Wales

Ref. No.

Generic text

Name

Generic text

Address

Generic text

School

Generic text
FOR THOSE WHO HAVE MOVED

New Address

Generic text

L.E.A.

Generic text

New School

Generic text
If a child has moved to another school this form should be returned to the Director of Education and not sent directly to the new school.
EXPLANATORY NOTE
This child was enrolled at birth in a national survey of the health, growth and development of children. With the help of his parents and of health visitors, school nurses and teachers, a detailed account has been obtained of his health and development during the past 13 years. The survey children come from all types of home and are attending all types of school both independent and Local Authority. During the past 13 years only 6 per cent have been lost and the value of this inquiry depends on our continuing to obtain information for every possible survey child.
Some of the most valuable information obtained during the primary school period was given by the teachers, and the present questions are modelled on those that were particularly successful in the past. A large number relate to behaviour, and in these the object is to find out how well the child is adjusted to school and work. We are just as interested in those who are doing very well as in those who are doing badly.
All information given will be regarded as strictly confidential and there is no possibility that the name of any child or school will appear in any report.
CHILDREN'S QUESTIONNAIRE
You will find inside this questionnaire another one (on yellow paper) for the child himself to fill in. This should be administered in the same way as an intelligence test ; after making sure the child fully understands the instructions get him to move rapidly through the items. When he has finished please make sure he has answered all the questions and then return both questionnaires, folded one inside the other, to the Director of Education.
HOW TO FILL IN THIS FORM
Please put a circle round the number opposite the answer which most nearly describes your views. If you feel that further comment is called for, please do not hesitate to give it.
*This form should be filled in by the teacher that knows this child best.
I SCHOOL WORK

Please give the following details about this child's present class:- Number of children on the roll of the class. ... children.

How many

Please give the following details about this child's present class:- Sex of children in the class.

1
Boys only
2
Girls only
3
Mixed

Please give the following details about this child's present class:- What is the average age of the children in this class? ... years ... months

Age
months

Please give the following details about this child's present class:- How many children in the class are under 13 years of age? ... children.

How many

Please give the following details about this child's present class:- How many children in the class are over 14 years of age? ... children.

How many

Are the children in this school streamed for ability within each year?

1
Yes
0
No
IF "YES"
qc_2 == 1

How many streams are there?

How many

In which stream is this child?

Generic text
If in Special Class or Stream for backward children,

please give details:

Generic text

Please give this child's position in his/her class at the time of the last placing. (If the children in this class are not usually placed, please give an estimate.)

1
In top quarter
2
In the middle half
3
In the bottom quarter

Is there any general school subject(s) in which this child's performance is OUTSTANDINGLY GOOD?

1
Yes
0
No
IF "YES"
qc_4 == 1

In which subject(s) is he/she outstandingly good?

Generic text

Is there any general school subject(s) in which this child's performance is OUTSTANDINGLY BAD?

1
Yes
0
No
IF "YES"
qc_5 == 1

In which subject(s) is he/she outstandingly bad?

Generic text

Has this child been punctual in attending school during the last year?

0
Never late unless with good reason
1
Sometimes late
2
Persistently late

Has this child played truant during the last year?

2
Yes, frequently
1
Yes, occasionally
0
Never

Do you consider that this child's school work is adversely affected by any physical disability?

1
Yes
0
No
IF "YES,"
qc_8 == 1

please give details.

Generic text

Do you consider that this child's school work is adversely affected by any factors outside the school (e.g. home circumstances, out of school activities, etc.)?

1
Yes
0
No
IF "YES,"
qc_9 == 1

please give details.

Generic text

Are there any out of school activities in which this pupil shows exceptional ability?

1
Yes
0
No
IF "YES,"
qc_10 == 1

please give details.

Generic text

Please assess this child's ability at games in relation to the other children in the class.

1
Above average
2
Average
3
Below average

Do you regard this child as:-

1
Extremely energetic, never tired?
2
Normally energetic?
3
Always tired and "washed out"?

Have you discussed this child's education with either of his/her parents during the past year?

1
Yes, both
2
Yes, mother only
3
Yes, father only
0
Neither

To what extent do this child's parents show interest in his/her progress at school?

1
Very interested
2
Average interest
3
Little or no interest
II CHILD'S ATTITUDE TO SCHOOL WORK

Which statement in each group best describes this child?

1
A very hard worker
2
Average-works moderately well
3
A poor worker or lazy

Which statement in each group best describes this child?

1
One with high power of concentration
2
Average-concentrates moderately well
3
Little or no power of sustained concentration

Which statement in each group best describes this child?

1
Extremely neat and tidy in class work
2
Average-moderately neat and tidy
3
Very untidy in class work

Which statement in each group best describes this child?

1
Seldom or never disobedient
2
Sometimes disobedient
3
Frequently disobedient

Which statement in each group best describes this child?

1
Seldom or never difficult to discipline
2
Sometimes difficult to discipline
3
Frequently difficult to discipline

Which statement in each group best describes this child?

1
Seldom or never restless in class
2
Sometimes restless in class
3
Frequently restless in class

Which statement in each group best describes this child?

1
Seldom or never daydreams in class
2
Sometimes daydreams in class
3
Frequently daydreams in class

Which statement in each group best describes this child?

1
Seldom or never cribs
2
Sometimes cribs
3
Frequently cribs

Which statement in each group best describes this child?

1
Seldom or never evades the truth to keep out of trouble
2
Sometimes evades the truth to keep out of trouble
3
Frequently evades the truth to keep out of trouble
III BEHAVIOUR

Which statement in each group best describes this child?

1
Very popular with other children
2
Of average popularity
3
Tends to be ignored by other children

Which statement in each group best describes this child?

1
Liable to get unduly rough during playtime
2
Takes a normal part in rough games
3
Rather frightened of rough games

Which statement in each group best describes this child?

1
Avoids attention, hates being in the limelight
2
Does not unduly avoid or seek attention
3
Shows off; seeks attention

Which statement in each group best describes this child?

1
A dare-devil
2
As cautious as the average child
3
Extremely fearful

Which statement in each group best describes this child?

1
Over-competitive with other children
2
Normally competitive
3
Diffident about competing with other children

Which statement in each group best describes this child?

1
Unusually happy and contented child
2
Generally cheerful and in good humour
3
Usually gloomy and sad

Which statement in each group best describes this child?

1
A quarrelsome and aggressive child
2
Average-not particularly quarrelsome
3
A timid child

Which statement in each group best describes this child?

1
Makes friends extremely easily
2
Takes usual amount of time to make friends
3
Does not seem able to make friends
IV HABITS
Has this child frequently shown any of the following habits or mannerisms?
-

1 - Yes

0 - No

Nail biting
Nose picking
Thumb or finger sucking
Picking sores
Stammering
Nervous twitches or grimaces

Please comment if any of these habits are shown to an extreme degree.

Generic text

Has this child, to your knowledge, any puzzling or inexplicable habits; or are there ritualistic acts which he finds it essential to perform without knowing why, such as touching every desk or person passed, or smelling every object come across?

1
Yes
0
No
IF "YES,"
qc_17 == 1

what are these habits?

Generic text

Has this child, to your knowledge, an obsession about cleanliness or a morbid pre-occupation with any other idea or condition?

1
Yes
0
No
IF "YES,"
qc_18 == 1

please specify

Generic text

Has this child, to your knowledge, any phobias-i.e. is there any object, person or situation of which he is unreasonably afraid?

1
Yes
0
No
IF "YES,"
qc_19 == 1

please specify

Generic text

Would you describe this child as an anxious child-i.e. apprehensive, worrying and fearful?

0
Not at all anxious
1
Somewhat anxious
2
Very anxious

Does this child show extreme changes of mood, swinging between periods of elation and great activity and periods of gloominess and lethargy?

1
Yes
0
No

How does this child react to criticism or punishment?

1
Tends to become unduly resentful
2
Tends to become unduly miserable or worried
0
Normal attitude to criticism and punishment
Taking this child's behaviour and relationships with other children as a whole. would you say he/she is-
-

0 - Not at all

1 - Somewhat

2 - Very

Sensitive or highly strung
Shy or withdrawn
Aggressive

Taking this child's behaviour and relationships with other children as a whole. would you say he/she is- Other, namely

1
Somewhat
2
Very
Other

Please comment on any problems of adjustment or conduct which are or might be a cause of concern.

Generic text
V SCHOOL ATTENDANCE
Please give the following details of this child's school attendance during the past year.
Attendances made by this child (1/2 days) Attendances that could have been made (1/2 days)
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
Winter term-1958
Spring term-1959
Summer term-1959

Teacher's Name (Mr, Mrs, Miss)

Generic text

How well do you know this child?

1
Very well
2
Moderately well
3
Not very well

Date

Generic date
End

nshd_59_ts

STRICTLY CONFIDENTIAL
MAY 1959
TEACHER'S QUESTIONNAIRE*
NATIONAL SURVEY OF THE HEALTH AND DEVELOPMENT OF CHILDREN
Under the joint auspices of
Institute of Child Health (University of London); Society of Medical Officers of Health; Population Investigation Committee
and National Foundation for Educational Research in England and Wales
Ref. No.
Generic text
Name
Generic text
Address
Generic text
School
Generic text

FOR THOSE WHO HAVE MOVED

New Address
Generic text
L.E.A.
Generic text
New School
Generic text
If a child has moved to another school this form should be returned to the Director of Education and not sent directly to the new school.
EXPLANATORY NOTE
This child was enrolled at birth in a national survey of the health, growth and development of children. With the help of his parents and of health visitors, school nurses and teachers, a detailed account has been obtained of his health and development during the past 13 years. The survey children come from all types of home and are attending all types of school both independent and Local Authority. During the past 13 years only 6 per cent have been lost and the value of this inquiry depends on our continuing to obtain information for every possible survey child.
Some of the most valuable information obtained during the primary school period was given by the teachers, and the present questions are modelled on those that were particularly successful in the past. A large number relate to behaviour, and in these the object is to find out how well the child is adjusted to school and work. We are just as interested in those who are doing very well as in those who are doing badly.
All information given will be regarded as strictly confidential and there is no possibility that the name of any child or school will appear in any report.
CHILDREN'S QUESTIONNAIRE
You will find inside this questionnaire another one (on yellow paper) for the child himself to fill in. This should be administered in the same way as an intelligence test ; after making sure the child fully understands the instructions get him to move rapidly through the items. When he has finished please make sure he has answered all the questions and then return both questionnaires, folded one inside the other, to the Director of Education.
HOW TO FILL IN THIS FORM
Please put a circle round the number opposite the answer which most nearly describes your views. If you feel that further comment is called for, please do not hesitate to give it.
*This form should be filled in by the teacher that knows this child best.

I SCHOOL WORK

Please give the following details about this child's present class:- Number of children on the roll of the class. ... children.
How many
Please give the following details about this child's present class:- Sex of children in the class.
1
Boys only
2
Girls only
3
Mixed
Please give the following details about this child's present class:- What is the average age of the children in this class? ... years ... months
Age
months
Please give the following details about this child's present class:- How many children in the class are under 13 years of age? ... children.
How many
Please give the following details about this child's present class:- How many children in the class are over 14 years of age? ... children.
How many
Are the children in this school streamed for ability within each year?
1
Yes
0
No
How many streams are there?
How many
In which stream is this child?
Generic text
please give details:
Generic text
Please give this child's position in his/her class at the time of the last placing. (If the children in this class are not usually placed, please give an estimate.)
1
In top quarter
2
In the middle half
3
In the bottom quarter
Is there any general school subject(s) in which this child's performance is OUTSTANDINGLY GOOD?
1
Yes
0
No
In which subject(s) is he/she outstandingly good?
Generic text
Is there any general school subject(s) in which this child's performance is OUTSTANDINGLY BAD?
1
Yes
0
No
In which subject(s) is he/she outstandingly bad?
Generic text
Has this child been punctual in attending school during the last year?
0
Never late unless with good reason
1
Sometimes late
2
Persistently late
Has this child played truant during the last year?
2
Yes, frequently
1
Yes, occasionally
0
Never
Do you consider that this child's school work is adversely affected by any physical disability?
1
Yes
0
No
please give details.
Generic text
Do you consider that this child's school work is adversely affected by any factors outside the school (e.g. home circumstances, out of school activities, etc.)?
1
Yes
0
No
please give details.
Generic text
Are there any out of school activities in which this pupil shows exceptional ability?
1
Yes
0
No
please give details.
Generic text
Please assess this child's ability at games in relation to the other children in the class.
1
Above average
2
Average
3
Below average
Do you regard this child as:-
1
Extremely energetic, never tired?
2
Normally energetic?
3
Always tired and "washed out"?
Have you discussed this child's education with either of his/her parents during the past year?
1
Yes, both
2
Yes, mother only
3
Yes, father only
0
Neither
To what extent do this child's parents show interest in his/her progress at school?
1
Very interested
2
Average interest
3
Little or no interest

II CHILD'S ATTITUDE TO SCHOOL WORK

Which statement in each group best describes this child?
1
A very hard worker
2
Average-works moderately well
3
A poor worker or lazy
Which statement in each group best describes this child?
1
One with high power of concentration
2
Average-concentrates moderately well
3
Little or no power of sustained concentration
Which statement in each group best describes this child?
1
Extremely neat and tidy in class work
2
Average-moderately neat and tidy
3
Very untidy in class work
Which statement in each group best describes this child?
1
Seldom or never disobedient
2
Sometimes disobedient
3
Frequently disobedient
Which statement in each group best describes this child?
1
Seldom or never difficult to discipline
2
Sometimes difficult to discipline
3
Frequently difficult to discipline
Which statement in each group best describes this child?
1
Seldom or never restless in class
2
Sometimes restless in class
3
Frequently restless in class
Which statement in each group best describes this child?
1
Seldom or never daydreams in class
2
Sometimes daydreams in class
3
Frequently daydreams in class
Which statement in each group best describes this child?
1
Seldom or never cribs
2
Sometimes cribs
3
Frequently cribs
Which statement in each group best describes this child?
1
Seldom or never evades the truth to keep out of trouble
2
Sometimes evades the truth to keep out of trouble
3
Frequently evades the truth to keep out of trouble

III BEHAVIOUR

Which statement in each group best describes this child?
1
Very popular with other children
2
Of average popularity
3
Tends to be ignored by other children
Which statement in each group best describes this child?
1
Liable to get unduly rough during playtime
2
Takes a normal part in rough games
3
Rather frightened of rough games
Which statement in each group best describes this child?
1
Avoids attention, hates being in the limelight
2
Does not unduly avoid or seek attention
3
Shows off; seeks attention
Which statement in each group best describes this child?
1
A dare-devil
2
As cautious as the average child
3
Extremely fearful
Which statement in each group best describes this child?
1
Over-competitive with other children
2
Normally competitive
3
Diffident about competing with other children
Which statement in each group best describes this child?
1
Unusually happy and contented child
2
Generally cheerful and in good humour
3
Usually gloomy and sad
Which statement in each group best describes this child?
1
A quarrelsome and aggressive child
2
Average-not particularly quarrelsome
3
A timid child
Which statement in each group best describes this child?
1
Makes friends extremely easily
2
Takes usual amount of time to make friends
3
Does not seem able to make friends

IV HABITS

Has this child frequently shown any of the following habits or mannerisms?

-

1 - Yes

0 - No

Nail biting
Nose picking
Thumb or finger sucking
Picking sores
Stammering
Nervous twitches or grimaces
Please comment if any of these habits are shown to an extreme degree.
Generic text
Has this child, to your knowledge, any puzzling or inexplicable habits; or are there ritualistic acts which he finds it essential to perform without knowing why, such as touching every desk or person passed, or smelling every object come across?
1
Yes
0
No
what are these habits?
Generic text
Has this child, to your knowledge, an obsession about cleanliness or a morbid pre-occupation with any other idea or condition?
1
Yes
0
No
please specify
Generic text
Has this child, to your knowledge, any phobias-i.e. is there any object, person or situation of which he is unreasonably afraid?
1
Yes
0
No
please specify
Generic text
Would you describe this child as an anxious child-i.e. apprehensive, worrying and fearful?
0
Not at all anxious
1
Somewhat anxious
2
Very anxious
Does this child show extreme changes of mood, swinging between periods of elation and great activity and periods of gloominess and lethargy?
1
Yes
0
No
How does this child react to criticism or punishment?
1
Tends to become unduly resentful
2
Tends to become unduly miserable or worried
0
Normal attitude to criticism and punishment

Taking this child's behaviour and relationships with other children as a whole. would you say he/she is-

-

0 - Not at all

1 - Somewhat

2 - Very

Sensitive or highly strung
Shy or withdrawn
Aggressive
Taking this child's behaviour and relationships with other children as a whole. would you say he/she is- Other, namely
1
Somewhat
2
Very
Other
Please comment on any problems of adjustment or conduct which are or might be a cause of concern.
Generic text

V SCHOOL ATTENDANCE

Please give the following details of this child's school attendance during the past year.

Attendances made by this child (1/2 days) Attendances that could have been made (1/2 days)
How manyHow manyHow manyHow many How manyHow manyHow manyHow many
Winter term-1958
Spring term-1959
Summer term-1959
Teacher's Name (Mr, Mrs, Miss)
Generic text
How well do you know this child?
1
Very well
2
Moderately well
3
Not very well
Date
Generic date
Name

1959 Teacher's Questionnaire