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survey title:
Family Patterns and Student Achievement  Edit Title
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1. Introduction

The purpose of this survey is to collect data about family patterns and student achievement.

1. I live with (check all that apply)


2. My parents have clear expectations about and monitor my

 AlwaysOftenSometimesRarelyNeverDoes not apply
homework and study time
meals and snacks
wake up time
household chores
TV watching
Internet usage
cell phone usage
social networking
after-school "latch key" time
video games
music choices
movie choices
friend choices

3. On average, how much out-of-school time do you spend on each of the following activities?

homework & study time
meals & snacks
involved in after school sports/activites
household chores
watching TV
using the Internet
on the phone
using social networking
playing video games
listening to music
playing outside

4. My parents

ask me about my school day
ask me about my homework
encourage high, but realistic goals
know who my friends are
know what my interests are
expect me to do my best
support my interests
are available for me to talk to
help me with my homework when needed
are too busy working to keep up with my activities
are too busy with their own interests to keep up with me
generally know who I am with and what I am doing

5. Regarding my sleeping patterns, I generally...

 everyday5-6 times a week4-5 times a week3-4 times a week2-3 times a week1-2 times a week0 times a week
go to bed at about the same time every night
get up at about the same time every day
use an alarm or manage to get myself up each morning
need someone to help me wake up, or I would never make it
get 5 or fewer hours of sleep each night
get about 6 hours of sleep each night
get about 7 hours of sleep each night
get about 8 hours of sleep each night
get 9 or more hours of sleep each night
have my sleep interrupted by a cell phone or text message
turn off my cell phone before going to bed
feel well-rested when I wake up
have to fight to stay awake
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