Understanding Choices Surrounding Separating or Keeping Together Multiples in Elementary School

Purpose: To understand the choices surrounding keeping together or separating multiples when in grade school and its impact on academic achievement and school adjustment

Audience: This survey is to be completed by parents who have multiples in elementary school (K-5). If you have more than one set of twins, complete this survey separately for each set.

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* 1. What type of multiples do you have?

Twins

Triples

Quadruplets

Quintuplets

More than one set [branching-other set of multiples]

Other (please specify)

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* 2. Are your multiples:

Identical

Fraternal

Unknown

Other (please specify)

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* 3. What is the gender of your multiples:

B/B

G/G

B/G

Other [higher order]

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* 4. What is the age of your multiples?

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* 5. What grade are your multiples in?

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* 6. Are your multiples:

In the same class

In difference classes

In some classes together and not others

Other (please specify)

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* 7. What were your multiples end of year grades for the most current grading report card [branching for Kindergarteners], please specify for each multiple

Science

English

Math

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* 8. Do you plan to______________ in elementary school?

Separate

Keep together

Be flexible

Follow school policy

Other (please specify)

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* 9. If your multiples are older than Kindergarten, do you plan to ____________ this year?

Separate

Keep together

Be flexible

Follow school policy

Other (please specify)

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* 10. Does the school administration have a policy regarding classroom placement of multiples?

Yes

Other (please specify)

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* 11. Did you (the parent or guardian) have any input into the classroom placement?

Yes

Other (please specify)

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* 12. Was the classroom placement the choice of the:

Parents

Multiples

Administration

Other (please specify)

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* 13. What type of school do your multiples attend?

Private

Public

Public Charter

Public Magnet

Homeschool

Other (please specify)

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* 14. Parents’ rating of social adaptation (Multiple A)

	Never	Sometimes	Very Often
Make friends easily	Make friends easily Never	Make friends easily Sometimes	Make friends easily Very Often
Avoid situations that are likely to result in trouble	Avoid situations that are likely to result in trouble Never	Avoid situations that are likely to result in trouble Sometimes	Avoid situations that are likely to result in trouble Very Often
Speak in appropriate tone of voice at home	Speak in appropriate tone of voice at home Never	Speak in appropriate tone of voice at home Sometimes	Speak in appropriate tone of voice at home Very Often
Start conversations rather than waiting for others to start	Start conversations rather than waiting for others to start Never	Start conversations rather than waiting for others to start Sometimes	Start conversations rather than waiting for others to start Very Often
Seem confident in social situations, such as parties or group outings	Seem confident in social situations, such as parties or group outings Never	Seem confident in social situations, such as parties or group outings Sometimes	Seem confident in social situations, such as parties or group outings Very Often
Cooperate with family members without being told to do so	Cooperate with family members without being told to do so Never	Cooperate with family members without being told to do so Sometimes	Cooperate with family members without being told to do so Very Often
Control his or her temper when arguing with other children	Control his or her temper when arguing with other children Never	Control his or her temper when arguing with other children Sometimes	Control his or her temper when arguing with other children Very Often
End disagreements with parent calmly	End disagreements with parent calmly Never	End disagreements with parent calmly Sometimes	End disagreements with parent calmly Very Often
Join group activities, such as a group having lunch together, without being told to do so	Join group activities, such as a group having lunch together, without being told to do so Never	Join group activities, such as a group having lunch together, without being told to do so Sometimes	Join group activities, such as a group having lunch together, without being told to do so Very Often
Receive criticism well	Receive criticism well Never	Receive criticism well Sometimes	Receive criticism well Very Often

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* 15. Parents’ rating of social adaptation (Multiple B)

	Never	Sometimes	Very Often
Make friends easily	Make friends easily Never	Make friends easily Sometimes	Make friends easily Very Often
Avoid situations that are likely to result in trouble	Avoid situations that are likely to result in trouble Never	Avoid situations that are likely to result in trouble Sometimes	Avoid situations that are likely to result in trouble Very Often
Speak in appropriate tone of voice at home	Speak in appropriate tone of voice at home Never	Speak in appropriate tone of voice at home Sometimes	Speak in appropriate tone of voice at home Very Often
Start conversations rather than waiting for others to start	Start conversations rather than waiting for others to start Never	Start conversations rather than waiting for others to start Sometimes	Start conversations rather than waiting for others to start Very Often
Seem confident in social situations, such as parties or group outings	Seem confident in social situations, such as parties or group outings Never	Seem confident in social situations, such as parties or group outings Sometimes	Seem confident in social situations, such as parties or group outings Very Often
Cooperate with family members without being told to do so	Cooperate with family members without being told to do so Never	Cooperate with family members without being told to do so Sometimes	Cooperate with family members without being told to do so Very Often
Control his or her temper when arguing with other children	Control his or her temper when arguing with other children Never	Control his or her temper when arguing with other children Sometimes	Control his or her temper when arguing with other children Very Often
End disagreements with parent calmly	End disagreements with parent calmly Never	End disagreements with parent calmly Sometimes	End disagreements with parent calmly Very Often
Join group activities, such as a group having lunch together, without being told to do so	Join group activities, such as a group having lunch together, without being told to do so Never	Join group activities, such as a group having lunch together, without being told to do so Sometimes	Join group activities, such as a group having lunch together, without being told to do so Very Often
Receive criticism well	Receive criticism well Never	Receive criticism well Sometimes	Receive criticism well Very Often

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* 16. Parents’ rating of social adaptation (Multiple C)

	Never	Sometimes	Very Often
Make friends easily	Make friends easily Never	Make friends easily Sometimes	Make friends easily Very Often
Avoid situations that are likely to result in trouble	Avoid situations that are likely to result in trouble Never	Avoid situations that are likely to result in trouble Sometimes	Avoid situations that are likely to result in trouble Very Often
Speak in appropriate tone of voice at home	Speak in appropriate tone of voice at home Never	Speak in appropriate tone of voice at home Sometimes	Speak in appropriate tone of voice at home Very Often
Start conversations rather than waiting for others to start	Start conversations rather than waiting for others to start Never	Start conversations rather than waiting for others to start Sometimes	Start conversations rather than waiting for others to start Very Often
Seem confident in social situations, such as parties or group outings	Seem confident in social situations, such as parties or group outings Never	Seem confident in social situations, such as parties or group outings Sometimes	Seem confident in social situations, such as parties or group outings Very Often
Cooperate with family members without being told to do so	Cooperate with family members without being told to do so Never	Cooperate with family members without being told to do so Sometimes	Cooperate with family members without being told to do so Very Often
Control his or her temper when arguing with other children	Control his or her temper when arguing with other children Never	Control his or her temper when arguing with other children Sometimes	Control his or her temper when arguing with other children Very Often
End disagreements with parent calmly	End disagreements with parent calmly Never	End disagreements with parent calmly Sometimes	End disagreements with parent calmly Very Often
Join group activities, such as a group having lunch together, without being told to do so	Join group activities, such as a group having lunch together, without being told to do so Never	Join group activities, such as a group having lunch together, without being told to do so Sometimes	Join group activities, such as a group having lunch together, without being told to do so Very Often
Receive criticism well	Receive criticism well Never	Receive criticism well Sometimes	Receive criticism well Very Often

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* 17. Social Adjustment at school Rate to the best of your knowledge (Multiple A)

	Never	Sometimes	Very Often
Easily transitions between classroom activities	Easily transitions between classroom activities Never	Easily transitions between classroom activities Sometimes	Easily transitions between classroom activities Very Often
Follows teacher directions	Follows teacher directions Never	Follows teacher directions Sometimes	Follows teacher directions Very Often
Controls temper in conflict situations with peers	Controls temper in conflict situations with peers Never	Controls temper in conflict situations with peers Sometimes	Controls temper in conflict situations with peers Very Often
Cooperates with peers without prompting	Cooperates with peers without prompting Never	Cooperates with peers without prompting Sometimes	Cooperates with peers without prompting Very Often
Acts sad or depressed	Acts sad or depressed Never	Acts sad or depressed Sometimes	Acts sad or depressed Very Often
Fights with others	Fights with others Never	Fights with others Sometimes	Fights with others Very Often
Gets easily distracted	Gets easily distracted Never	Gets easily distracted Sometimes	Gets easily distracted Very Often

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* 18. Social Adjustment at school Rate to the best of your knowledge (Multiple B)

	Never	Sometimes	Very Often
Easily transitions between classroom activities	Easily transitions between classroom activities Never	Easily transitions between classroom activities Sometimes	Easily transitions between classroom activities Very Often
Follows teacher directions	Follows teacher directions Never	Follows teacher directions Sometimes	Follows teacher directions Very Often
Controls temper in conflict situations with peers	Controls temper in conflict situations with peers Never	Controls temper in conflict situations with peers Sometimes	Controls temper in conflict situations with peers Very Often
Cooperates with peers without prompting	Cooperates with peers without prompting Never	Cooperates with peers without prompting Sometimes	Cooperates with peers without prompting Very Often
Acts sad or depressed	Acts sad or depressed Never	Acts sad or depressed Sometimes	Acts sad or depressed Very Often
Fights with others	Fights with others Never	Fights with others Sometimes	Fights with others Very Often
Gets easily distracted	Gets easily distracted Never	Gets easily distracted Sometimes	Gets easily distracted Very Often

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* 19. Social Adjustment at school Rate to the best of your knowledge (Multiple C)

	Never	Sometimes	Very Often
Easily transitions between classroom activities	Easily transitions between classroom activities Never	Easily transitions between classroom activities Sometimes	Easily transitions between classroom activities Very Often
Follows teacher directions	Follows teacher directions Never	Follows teacher directions Sometimes	Follows teacher directions Very Often
Controls temper in conflict situations with peers	Controls temper in conflict situations with peers Never	Controls temper in conflict situations with peers Sometimes	Controls temper in conflict situations with peers Very Often
Cooperates with peers without prompting	Cooperates with peers without prompting Never	Cooperates with peers without prompting Sometimes	Cooperates with peers without prompting Very Often
Acts sad or depressed	Acts sad or depressed Never	Acts sad or depressed Sometimes	Acts sad or depressed Very Often
Fights with others	Fights with others Never	Fights with others Sometimes	Fights with others Very Often
Gets easily distracted	Gets easily distracted Never	Gets easily distracted Sometimes	Gets easily distracted Very Often

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* 1. What type of multiples do you have?

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* 2. Are your multiples:

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* 3. What is the gender of your multiples:

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* 4. What is the age of your multiples?

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* 5. What grade are your multiples in?

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* 6. Are your multiples:

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* 7. What were your multiples end of year grades for the most current grading report card [branching for Kindergarteners], please specify for each multiple

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* 8. Do you plan to______________ in elementary school?

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* 9. If your multiples are older than Kindergarten, do you plan to ____________ this year?

Question Title

* 10. Does the school administration have a policy regarding classroom placement of multiples?

Question Title

* 11. Did you (the parent or guardian) have any input into the classroom placement?

Question Title

* 12. Was the classroom placement the choice of the:

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* 13. What type of school do your multiples attend?

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* 14. Parents’ rating of social adaptation (Multiple A)

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* 15. Parents’ rating of social adaptation (Multiple B)

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* 16. Parents’ rating of social adaptation (Multiple C)

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* 17. Social Adjustment at school Rate to the best of your knowledge (Multiple A)

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* 18. Social Adjustment at school Rate to the best of your knowledge (Multiple B)

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* 19. Social Adjustment at school Rate to the best of your knowledge (Multiple C)

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* 20. Do you have any other comments on this subject?