About You
1. I am the child’s:
· Mother/Stepmother a Father/Stepfather
· Grandparent
· Other Relative
· Foster Parent
· Other
About Your Child and Family
2. My child is a:
· Boy
· Girl
3. My child’s race/ethnicity best described as:
· Native American or Alaskan Native
· Asian
· Native Hawaiian or Other Pacific Islander
· Black/African American
· Hispanic/Latino
· White
· Multiracial
· Other
4. My child is:
· 6 years old or younger
· 7 years old
· 8 years old
· 9 year sold
· 10 years old
· 11 years old
· 12 years old or older
5. Are you currently married?
· No
· Yes
6. How many people age 17 or younger live in your home (including the child taking the ESSP)?
· None
· One
· Two
· Three
· 4 or more
7. How many people age 18 or older live in your home (including yourself)?
· None
· One
· Two
· Three
· 4 or more
8. How far in school did you go?
· Did not complete high school
· Received a high school diploma or equivalent
· Received some College or vocational training
· Completed 2-year college degree
· Completed a 4-year college degree
· Completed a graduate degree
9. If there is a second parent or other adult in your child’s home who helps take care of the child‚ how far in school did he or she go?
· There is no second caregiver in the home
· Did not complete high school
· Received a high school diploma or equivalent
· Received some college or vocational training
· Completed a 2-year college degree
· Completed a 4-year college degree
· Completed a graduate degree
About Your Child and Family
10. Did any of your child’s brothers or sisters (Including step- or half-siblings) drop out of school before graduating from high school?
· No
· Yes
· My child has no brothers or sisters
11. How would you describe the financial situation of your household?
· Very comfortable and secure
· Able to make ends meet every month
· Some months it’s hard to make ends meet
· Most months it’s hard to make ends meet
· Every month it’s hard to make ends meet
12. What is the zip code of your home address? (Write the numbers in the boxes‚ then fill in the right circle below each box.)
13. Do any of the adults (people 18 and Older) in the child’s home currently work for pay?
· No
· Yes
14. Does your child receive free or reduced price lunches at school?
· No
· Yes
15. Do you have a way to get to your child’s school if needed?
Never‚ Sometimes‚ Often‚ Always
16. Has a doctor suggested your child take medication this year for any of the following reasons? NO‚ YES
· Anxiety or depression
· Attention Deficit Disorder (ADD) or Attention Deficit Hyperactivity Disorder (ADHD)
· Physical or medical disorders (for example‚ eating or sleeping disorders‚ asthma‚ allergies‚ diabetes or seizures)
About Your Neighborhood
Think about the part of town where you live‚ This is what we mean by “neighborhood” in the next sentences. If you live in a rural area‚ think of the people who live closest to you.
17. Do people move in and out of your neighborhood a lot?
· No
· Yes
· I don’t know
18. How many times have you moved in the past year?
· No moves
· 1 move
· 2 moves
· 3 or more moves
About Your Neighborhood
19. How much time per week does your child usually spend on neighborhood or community activities run by adults‚ such as team sports‚ the scouts‚ or programs at a community center or park?
· None
· Less than 1 hour
· 1 to less than 2 hours
· 2 to less than 4 hours
· 4 or more hours
20. How big of a problem are drugs in your neighborhood?
· Not a problem
· Somewhat of a problem
· A big problem
21. In the past 30days did any of the following things happen in your neighborhood? No‚ Yes
a. Someone was mugged.
b. A home or business was broken into.
c. You heard gunshots
d. You saw someone selling illegal drugs.
e. A person was murdered.
f. A fight broke out between two groups or gangs.
g. Someone was beaten up.
h. A child was removed from a home because of abuse of neglect.
22. Do you agree or disagree with the following statements?
Strongly Agree‚ Disagree‚ Agree‚ Strongly agree
Adults in my neighborhood:
a. Show an interest in what children in the neighborhood are doing.
b. Would tell me if my child misbehaved or did something dangerous
c. look out for my child.
d. Help one another in times of need.
e. Look out for one another.
f. Work together to improve the neighborhood.
g. Would take care of my child(ren) in an emergency.
23. Do you agree or disagree with the following statements?
Strongly Agree‚ Disagree‚ Agree‚ Strongly agree
a. My child is safe from crime and violence in our neighborhood.
b. People in our neighborhood can be trusted.
c. I like living In our neighborhood
d. I feel safe from crime and violence in our neighborhood.
About Your Neighborhood
24. Do you agree or disagree with the following statements?
Strongly Agree‚ Disagree‚ Agree‚ Strongly agree
Most teenagers in my neighborhood:
a. Make good grades in school
b. Get in trouble with the police.
c. C. Drink alcohol
d. Use drugs
e. Belong to gangs.
f. Graduate from l high school
g. Carry a weapon such as a knife‚ gun‚ or club
h. Find a job after high school
i. Will go to college
j. Show respect to adults
About Your Child and the School
25. Does your child receive after-school care at the school?
No‚ Yes‚ Not available at the school
26. Does your child take part in any school clubs or activities that take place after school (such as team sports‚ band‚ drama‚ or science club)? No‚ Yes‚ Not available at the school
27. How often are you afraid that someone will hurt or bother your child at school? Never‚ Sometimes‚ Often‚ Always
28. My child’s teacher cares about my child. Strongly disagree‚ Disagree‚ Agree‚ Strongly agree
29. My child’s teacher wants my child to do well in school. Strongly disagree‚ Disagree‚ Agree‚ Strongly agree
About Your Child and the School
30. My child’s teacher or other school staff would contact me if they had a concern or question about my child’s school behavior or progress. Strongly disagree‚ Disagree‚ Agree‚ Strongly agree
31. How much influence do you think parents like You can have in making schools a better place for students to learn and grow?
· No influence
· A little influence
· Some influence
· A lot of influence
32. How good of an education do you think your child is getting at his or her school? Poor‚ Fair‚ Good‚ Excellent
33. My work schedule makes it hard for me to be involved at my child’s school.
· I don’t work outside the home
· Never
· Sometimes
· Often
· Always
34. How often do you do the following?
Never‚ Sometimes‚ Often‚ Always
· Go to your child’s school for parent-teacher conferences
· Volunteer at your child’s school or in the classroom
· Go to the school when parents are invited to fun events
· Contact your child’s teacher or other school staff about your child’s school progress or behavior
· Go to the school for information sessions (such as workshops on behavior‚ testing‚ special programs‚ or homework help)
· Go to parent-teacher association (PTA) meetings
About You and Your Child at Home
35. How often do you do the following?
Never‚ Sometimes‚ Often‚ Always
a. Talk to your child about things he or she is learning at school
b. Talk to your child about things that happened during the school day
c. Talk to you child about homework
d. Check on whether your child does his or her homework
e. Praise or reward your child for working hard on school work
f. Help your child gel books or supplies for doing homework
36. How often do you do the following?
a. Limit the amount of time your child spends watching TV
b. Limit the amount of time your child spends playing on school nights
c. Make sure your child spends time reading (apart from homework)
d. Make sure your child spends time on learning Activities (such as hobbies‚ talking to adults‚ going to the library or museum)
37. For the following statements‚ choose the response that best describes your child within the past 30 days.
Never‚ Rarely‚ Sometimes‚ Often‚ Very Often‚ Always
My child:
a. Is liked by playmates.
b. Is friendly
c. Initiates interactions with others
d. Plays with others
e. Plays with friendly‚ well behaved children
f. Is accepted by friendly‚ well behaved children
About You and Your Child at Home
38. For the following statements‚ choose the response that best describes your child within the past30 days.
Never‚ Rarely‚ Sometimes‚ Often‚ Very Often‚ Always
My child:
a. Thinks before acting.
b. Can give suggestions and opinions without being bossy.
c. Can calm down when excited or all wound up.
d. Is helpful to others.
e. Controls temper when there is a disagreement.
f. Has trouble accepting authority.
g. Is very good at understanding other people’s feelings.
h. Breaks rules.
i. Is stubborn.
39. For the following statements. Choose the response that best describes your child within the past 30 days.
Never‚ Rarely‚ Sometimes‚ Often‚ Very Often‚ Always
My child:
a. Physically fights.
b. Harms others.
c. Plays aggressively (rough).
d. Hits others on purpose.
40. How much time does your child spend on homework on most school nights?
None
· less than15 minutes
· 15 to less than 30 minutes
· 30 to less than 45 minutes
· 45 minutes to less than 1 hour
· 1 hour or more
41. How much time does your child spend watching TV on most school nights?
· 0 Hours
· less than 1 hour
· 1 to less than 2 hours
· 2 to less than 4 hours
· 4 or more hours
About You and Your Child at Home
42. How much time does your child spend playing non-educational computer or video games on most school nights?
· 0 hours
· Less than 1/2 hour
· 1/2 to 1 hour
· More than 1 but less than 2 hours
· 2or more hours
43. How much time does your child spend using educational programs or doing homework on the computer on most school nights?
· 0 hours
· Less than 1/2 hour
· 1/2 to 1 hour
· More than 1 but less than 2 hours
· 2 or more hours
44. How much time each week does your child spend on chores (such as helping with meals‚ pets‚ or cleaning)?
· 0 hours
· Less than 112 hour
· 1/2 to 1 hour
· More than 1 but less than 2 hours
· 2 or more hours
45. How many of your child’s friends do you know?
· Almost none
· Some
· Most
· Almost all
46. How many of the parents of your child’s friends do you know?
· Almost none
· Some
· Most
· Almost all
47. How far in school do you think your child will go?
· Will not complete high school
· Will receive a high school diploma or equivalent
· Will receive some college or vocational training
· Will complete a 2-year college degree
· Will complete a 4-year college degree
· Will complete a graduate degree
48. How often do you do the following?
Never‚ Sometimes‚ Often‚ Always
a. Give your child encouragement
b. Tell your child you love him or her
c. Tell your child he or she did a good job
d. Make your child feel special
e. Spend free time with your child
About You and Your Child at Home
49. How often are the following statements true for your family?
Never‚ Sometimes‚ Often‚ Always
The people in my home:
a. Support one another during difficult times
b. Give each other plenty of time and attention
c. Talk openly and listen to one another
d. Feel loved and cared for by one another.
e. Play and laugh together‚
f. Work together to Solve problems.
50. How often does your child do the following?
Never‚ Sometimes‚ Often‚ Always‚ No other children in home
a. Get along with the other children in our home
b. Help or comfort the other children in our home
c. Share things with the other children in our home
51. How often do you do the following?
Never‚ Sometimes‚ Often‚ Always
a. Reward or praise your child’s good behavior
a. b. Punish misbehavior even if your child gets upset with the punishment
b. Listen to your child’s side before deciding whether to punish your child
c. Explain to your child why he or she is being punished
d. Use “time out” as a punishment
e. Take away a desired activity or object as punishment for misbehavior
f. Stay calm but firm when your child doesn’t listen
About You and Your Child at Home
52. Has your child experienced the death of a parent‚ brother‚ sister‚ grandparent‚ or other close family member in the last year? No‚ Yes
53. Have you talked to your child about drugs‚ cigarettes‚ or alcohol?
· No‚ not yet
· Yes‚ once
· Yes‚ a few times
· Yes‚ I do this often
54. Many young people get Involved with alcohol and drugs. How likely do you think it is that your child will do each of the following as he/she gets older?
Unlikely‚ Somewhat likely‚ Very likely
a. Drink alcohol (beer‚ wine‚ liquor)
b. Smoke cigarettes
C. Smoke marijuana
d. Use other illegal drugs (e.g. cocaine‚ heroin‚ LSD)
This instrument can be found at: https://www.schoolsuccessonline.com/ & Fischer‚ Joel.‚ Corcoran‚ Kevin J. (2007). Measures for Clinical Practice and research: A sourcebook. (4th ed.). NY. Oxford University Pr. Vol. 1‚ Page (s): 510-528.
Bowen‚ G. L.‚ Richman‚ J.M.‚ Bowen‚ N. K. The School Success Profile: A results management approach to assessment and intervention planning. In: Roberts‚ AR.; Greene‚ GJ.‚ editors. Social workers’ desk reference. New York: Oxford University Press; 2002. p. 787-793.
Bowen‚ N.K.‚ Bowen‚ G. L.‚ (2004). Woolley‚ M. E. Constructing and validating assessment tools for school based practitioners: The Elementary School Success Profile. In: Roberts‚ AR.; Yeager‚ KR.‚ editors. Evidence-based practice manual: Research and outcome measures in health and human services. New York: Oxford University Press;. p. 509-517.
Bowen‚ G. L.‚ Rose‚ R‚ A.‚ Bowen‚ N. K. The reliability and validity of the School Success Profile. Philadelphia: Xlibris; 2005.
Bowen‚ N.K.‚ Powers‚ J. D. (2005). Knowledge gaps among school staff and the role of high quality ecological assessments in schools. Research on Social Work Practice‚ 15‚ 491–500.
Bowen‚ N.K. (2006). Psychometric properties of the Elementary School Success Profile for Children. Social Work Research.; 30(1)‚ 51–63.
Bowen‚ G. L.‚ Rose‚ R. A.‚ Powers‚ J. D.‚ & Glennie‚ E. J. (2008). The joint effects of neighborhoods‚ schools‚ peers‚ and families on changes in the school success of middle school students. Family Relations‚ 57 ‚ 504–516.
Bowen‚ N. K. (2005). Elementary School Success Profile (ESSP). In Fischer‚ Joel.‚ Corcoran‚ Kevin J. (2007). Measures for Clinical Practice and research: A sourcebook. (4th ed.). NY. Oxford University Pr. Vol. 1‚ Page (s): 510-528.
Bowen‚ N.K. (2008). Psychometric properties of the Elementary School Success Profile for Parents. Unpublished paper presented at the Society for Social Work Research; Washington‚ DC. 2008 January.
Bowen‚ N.K. (2008). Cognitive Testing and the Validity of Child-Report Data from the Elementary School Success Profile. for Social Work Research‚ 32(1):
Wegmann‚ Kate M.‚ Thompson‚ Aaron M. and Bowen‚ Natasha K. (2011). A Confirmatory Factor Analysis of Home Environment and Home Social Behavior Data from the Elementary School Success Profile for Families. Social Work Research‚ 35(2)‚ 117-127.