BSE CYCLICAL MONITORING PARENT SURVEY Question Title * 1. My child attends Elementary School Middle School High School Question Title * 2. My child's disability is Traumatic Brain Injury Hearing Impairment including Deafness Specific Learning Disability Orthopedic Impairment Emotional Disturbance Speech or Language Impairment Visual Impairment including Blindness Deaf-Blindness Multiple Disabilities Autism Other Heather Impairment Developmental Delay (aged 3-6 in Early Intervention Program) Don't Know Question Title * 3. I think the overall severity of my child's disability is: Mild Moderate Severe Don't Know Question Title * 4. My child's school placement is best described as: Inside the regular class 80% or more of the day Inside the regular class 40-79% of the day Inside the regular class less than 40% of the day Public Separate Facility (Non-Residential) Approved Private School (Non-Residential) Other Private Separate Facility (Non-Residential) Hospital/Home Bound (including partial hospitalization) Public Separate Facility - Residential Approved Private School - Residential Other Private Facility - Residential Out of State Facility Instruction in the Home Correctional Facility Don't Know Question Title * 5. My child's main type of special education support in school is: Learning Support Life Skills Support Multi-Disabilities Support Emotional Support Deaf or Hearing Impaired Support Speech and Language Support Physical Support Blind or Visually Impaired Support Autistic Support Other-Not described above Don't Know Question Title * 6. Support services for my child are provided: Inside the general education classroom Outside the general education classroom Both Don't Know Question Title * 7. Did the school district/charter school your child is attending inform you that your child cannot be removed from the general education classroom merely because of the severity of his or her disability? Yes No Don't Know Question Title * 8. Did the school district/charter school your child is attending inform you that it must consider the full range of supplemental aids and services in the general education classroom, including modification or curriculum content, before recommending a more restrictive setting: Yes No Don't Know NA Question Title * 9. Did you understand the information from the school personnel about educating your child in general education classes with supplementary aids and services? Yes No Don't Know Question Title * 10. If your child is educated in regular class for 80% of the day or more, please describe how the placement decision was made: I was offered this inclusive placement by the school I requested the placement and the school agreed I requested the placement and the school agreed only after vigorous advocacy on my part I went to mediation I went to a due process hearing Other Don't know NA Question Title * 11. If your child is not educated in the regular class for 80% of the day or more, what are the reason? Please check all that apply (if not applicable skip this question and go to 12.) I am satisfied that a less inclusive placement is appropriate for my child I am concerned that the school district/charter school my child is attending could not meet my child's educational needs in a more inclusive setting because of the lack of appropriate staff training and experience. I am concerned that the school district/charter school my child is attending could not meet my child needs in a more inclusive setting because the school district/charter school would not provide the needed support in regular class. I am concerned that my child would not be safe in a more inclusive setting. I requested a more inclusive placement, but the school district/charter school my child is attending would not agree, and dispute resolution is not an option for my family. I tried to obtain a more inclusive placement through mediation but did not succeed. I tried to obtain a more inclusive placement through a due process hearing but did not succeed. Other Don't Know Question Title * 12. Please read the following questions carefully and check the box that best describes your opinion.My child spends the right amount of each school day in general education classrooms. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 13. My child is making progress on his/her IEP goals. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 14. My child's teachers have the supports they need to implement the IEP. Strongly agree Agree In Between Disagreed Strongly disagree Don't Know NA Question Title * 15. The supports identified in my child's IEP are implemented. Strongly agree Agree in Between Disagree Strongly disagree Don't Know NA Question Title * 16. My child's needs for support in extra-curricular activities are addressed in the IEP. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 17. My school provides and uses equipment or technology that is required in my child's IEP. Strongly Agree Agree In Between Disagree Strongly Disagree Don't Know NA Question Title * 18. All supports I think my child needs are in the IEP. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 19. I am respected as a member of the IEP team. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 20. My suggestions about teaching my child are welcomed. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 21. I am invited to trainings that provide information about my child's disability and educational programs. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 22. I am invited to trainings that provide information for parents regarding educational practices, e.g. inclusive practices, assistive technology, behavior support and parent rights. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 23. My school openly supports inclusion of students with disabilities. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 24. The school answers questions about my rights. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Question Title * 25. I think my child is getting a good education. Strongly agree Agree In Between Disagree Strongly disagree Don't Know NA Done