Student Sample Questionnaire

Welcome to your PISA-D Student Questionnaire

What grade are you in?

On what date were you born?

(Please write in the day, month and year you were born.)

Are you female or male?

Male

Female

What language do you speak at home most of the time?
(Please tick only one box.)

English Language

Spanish

Chinese

Other

In what country were you and your parents born?

(Please tick only one box in each column.)

Overall, how satisfied are you with your life as a whole these days?

0 = Not at all satisfied
10 = Completely

0 1 2 3 4 5 6 7 8 9 10

The next five statements are about your health.

(Choose all that applies.)

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 disability 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.

In general, would you say your health is:

0-3 = Poor
4-6 = Fair
7-8 = Very Good
9-10 = Excellent

0 1 2 3 4 5 6 7 8 9 10

During the past year, have you had any of the following health problems?

(Choose all that applies.)

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?

No

Yes, for one year or less

Yes, for more than one year

When did you begin learning English Language?

At home before i started school

In basic school

When i started primary school

When i started high school

Which language did you first learn to read?

English Language

Spanish

Chinese

Other language

Have you ever missed school for more than three months in a row?
(Please tick only one box.)

No (Please go to Question 13)

Yes, once (Please go to Question 12)

Yes, twice or more (Please go to Question 12)

Why did you miss school for more than three months in a row?

(Choose all that applies.)

I was bored.

I was suspended for something I did (e.g., violence, aggression, use of drugs, drug dealing).

I was pregnant.

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).

During the past four weeks, did any of the following events occur?

(Choose all that applies.)

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.

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.

(Choose all that applies.)

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 long does it usually take you to get from your home to school?

15 minutes or less

More than 15 minutes but less than 30 minutes

30 minutes or more, but less than 60 minutes

60 minutes or more, but less than 90 minutes

More than 90 minutes

In the last two weeks at school, did any of these happen?

(Choose all that applies.)

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.

Think of the work you did in the past week

(Choose all that applies.)

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.

Other relatives (e.g. aunts,uncles,cousins)

I helped with other household chores such as shopping, cleaning, washing clothes, or cooking.

Who do you live with at home?

(Choose all that applies.)

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?

(Choose all that applies.)

A desk to study at

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 books are there in your home?

Do not include magazines, newspapers, or your schoolbooks. (Please tick only one box.)

There are no books.

There are fewer than 10 books.

There are 10 - 50 books.

There are more than 50 books.

Do you share a toilet facility with others who are not members of your family?

Yes

No

What is the floor of your home mostly made of?
(Please tick only one box.)

Earth, sand or dung

Wood planks, palm, or bamboo

Parquet, polished wood

Vinyl or asphalt strips

Ceramic tiles

Cement

Stone

Do you have a flush toilet at your house?

Yes

No

Does any member of your household have a bank account?

Yes

No

In the past 30 days, how often were you hungry because there was not enough food?

(Please tick only one box.)

Never or almost never

About once a week

2 to 3 times a week

Almost every day

What is the highest level of schooling completed by your mother?

If you are not sure which box to choose, please ask the test

Administrator for help.

(Please tick only one box.)

Secondary

Upper secondary

Lower secondary

Primary school

She did not complete

Can your mother read and write?

My mother cannot read or write.

My mother can read but not write.

My mother can read and write well.

I do not know.

Does your mother have any of the following qualifications? If you are not sure how to answer this question, please ask the for help.

Doctorate

Diploma

Degree

CSEC

What kind of job does your mother have?

(Please tick only one box.)

No Job (i.e., she is not working for pay)

Armed forces (e.g., captain, lieutenant, sergeant, corporal, private)

Labourer (e.g., hotel or office cleaner, farm labourer, mining labourer, factory labourer, kitchen helper, newspaper vendor, mail carrier)

Machine Operator (e.g., miner, paper products machine operator, sewing machine operator, dry-cleaning machine operator)

Craft and Trades Worker (e.g., house builder, bricklayer, carpenter, building painter, mechanic, handicraft worker)

Skilled Worker (e.g., cattle or dairy farmer, fisher, gardener)

Services and Sales Worker (e.g., cook, waiter, hairdresser, street food vendor, grocer, store cashier, hospital orderly)

Clerical Worker (e.g., secretary, data entry clerk, bank teller, hotel receptionist)

Technical Worker (e.g., building inspector, nursing aide, bookkeeper, chef)

Professional (e.g., engineer, nurse, doctor, school teacher, accountant, computer programmer, lawyer)

Manager (e.g., government official, sales manager, building construction supervisor, hotel or restaurant manager)

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)

Please write the job title._____________________________

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?

If you are not sure which box to choose, please ask the test

Secondary

Upper secondary

Lower secondary

Primary school

He did not complete primary school

Can your father read and write?

My father cannot read or write.

My father can read but not write.

My father can read and write well.

I do not know.

Does your father have any of the following qualifications? If you are not sure how to answer this question, please ask the <test administrator> for help.

Doctorate

Diploma

Degree

CSEC

What kind of job does your father have?

(Please tick only one box.)

No Job (i.e., he is not working for pay)