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TEIS to Preschool Family Survey (3 to 5 Years Old)

TEIS to Preschool Family Survey (3 to 5 Years Old)

If you have a child ages 3 - 5 who RECENTLY (in the past 3 years), moved from TEIS (Tennessee Early Intervention Services) to preschool or an early education program, we would love your feedback to learn what helped you and your child feel prepared during this time of transition, as well as any challenges you experienced.

The information you provide by completing this brief 8-minute survey will be used to assist the Tennessee Department of Education and STEP, Inc. to improve early education services for children with disabilities and provided needed information to families.

All answers are confidential.
1.In your child's final year receiving TEIS services, where were those services provided? Please check all that apply
2.In your child's final year receiving TEIS services, what types of services did your child receive? Please check all that apply
3.DId you participate in a meeting to discuss your child’s transition from early intervention services to preschool?
4.Each family has areas that they believe are most important to help prepare their child for the preschool experience. What skills are/were most important for your child to prepare for transition to preschool? (Please choose FIVE)
5.For this group of questions, think about how confident you are/were that the services your child received from the early intervention providers through TEIS prepared your child for preschool in these academic areas:
Extremely Confident
Very Confident
Somwhat Confident
Not Confident
Not Applicable
Early Reading Skills (turn book the correct way, turning pages, repeat parts of a story)
Early Writing Skills (holds crayon in palm of hand, scribbles, draws a circle, imitates a line)
Early Math Skills (points to and counts objects, beginning to understand short/tall, full/empty)
Listening Skills (responds to name, responds to sounds like bell or horn, push button to hear sound)
Problem Solving (try to push steps to sink to wash hands, change position of shape to fit in sorter)
Engages and Interacts (imitate play of another child, pretend play - uses pots and pans to "cook")
Communication/Language (begins an interaction, responds to question, asks why, where, what questions)
6.Please indicate how confident you are/were that your child’s early intervention providers prepared your child for preschool in the these personal, social, and adaptive areas:
Extremely Confident
Very Confident
Somwhat Confident
Not Confident
Not Applicable
Ability to pay attention to a task
Social/Behavioral (cooperation, self-control, expresses feelings: "I want" "mine"
Fine Motor Skills (picking up small objects, pull down zipper, poking and building with play dough)
Self-Help and Functional Skills (washing hands, toileting, feeding self, wiping face)
Physical Movement (Gross Motor) (hopping, climb steps on slide, fling a ball, jump with both feet)
7.If your child required adaptive equipment, such as a standing board, special spoon, communication device, or weighted vest; please tell us how prepared you are/were to use the adaptive equipment at home with your child as they exited TEIS services?
Extremely Prepared
Very Prepared
Somewhat Prepared
Not Prepared
N/A
8.Was your child provided a way to express their thoughts and ideas, engage socially, and participate meaningfully in their school, home, and community?
9.For this group of questions, think about how confident you are/were that your child’s early intervention providers equipped you to work with your child in the following academic
Extremely Confident
Very Confident
Somwhat Confident
Not Confident
Not Applicable
Early Reading Skills (turn book the correct way, turning pages, repeat parts of a story)
Early Writing Skills (holds crayon in palm of hand, scribbles, draws a circle, imitates a line)
Early Math Skills (points to and counts objects, beginning to understand short/tall, full/empty)
Listening Skills (responds to name, responds to sounds like bell or horn, push button to hear sound)
Problem Solving (try to push steps to sink to wash hands, change position of shape to fit in sorter)
Engages and Interacts (imitate play of another child, pretend play - uses pots and pans to "cook")
Communication/Language (begins an interaction, responds to question, asks why, where, what questions
Creativity (pretend games/play, exploring objects, building with blocks and variety of materials)
10.Please indicate if your early childhood provider provided you information in these areas:
YES
NO
How to select books to read with your child
How to work with your child on their specific goals
How to implement behavior techniques at home and in the community
11.Based on the information you received from your child’s early intervention provider, how prepared are/were you for your child’s transition from early intervention services to preschool?
Extremely Prepared
Very Prepared
Somwhat Prepared
Not Prepared
12.Please tell us about your information and training needs.
As you think of your child being in a preschool setting, what information and resources would be most useful to you?
13.As you think about the transition from TEIS to preschool, what information do you feel would be most useful to help families prepare for that transition? 
14.Child Information (If you have more than one child, please complete individual surveys for each child)
15.Relationship to the child who has/had an Individual Family Service Plan (IFSP):
16.What is your county of residence?
Thank you for completing this survey. This information will be used to assist the TN Department of Education State Personnel Development Grant and their family partner, STEP, Inc. (Support & Training for Exceptional Parents) to continue to improve early education processes and services for children with disabilities and assist families to better understand and participate in their child's education.
Current Progress,
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