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Participate in the Service Providers Survey

Your Path: Circle of Inclusion Home Page --> Service Providers Survey
If you are a staff member of an early childhood setting please complete the survey below. (See Privacy Statement)Then a link will be provided so you may view the aggregated results that you and your colleagues have submitted. If you are not a staff member or have already filled out the survey please view the survey results here. The purpose of this survey is to gain a better understanding of the people who staff early childhood settings. The information you provide will only be presented in aggregate and will never be used to invade your privacy or the privacy of your workplace. Thank you for your participation.

Information About You: (OPTIONAL)
Name       E-mail

1. What is the highest level of education that you have completed?
      High School
      Certificate Program
      AA
      BS/BA
      Masters
      EdS/PhD
      None of the above

2. What is your role in the early childhood or elementary school program? (check all that apply)
     Administrators:
           Community Program Director
           Special Education Administrator
           Regular Education Administrator
           Disabilities Coordinator
     Teachers:
           Early Childhood/Primary Grades Teacher
           Early Childhood/Primary Grades Special Education Teacher
           Assistant Teacher
           Paraprofessional
           Teacher Educator
     Support Personnel
           Occupational Therapist or Occupational Therapist Assistant
           Physical Therapist or Physical Therapist Assistant
           School Psychologist
           Speech Language Pathologist or Speech Language Paraprofessional
           Health Services
           Family Services Coordinator
           Transition Facilitator
           Social Worker
           Music Therapist
           Art Therapist
           Teacher of Students with Visual Impairments
           Teacher of Students with Hearing Impairments
           Audiologist
           General Support Personnel
           Preservice Support Personnel
           Other
     None of these roles fit me

3. If you are a teacher, which model best describes your role in teaching? (check all that apply)
      Single lead teacher in classroom
      Team teaching in a classroom
      Consulting, itinerant, resource teacher
      Home-based teacher
      Family Services Coordinator

4. Your primary employer is a:
      Private program/agency
      Public school program
      Head Start
      I don't know.
      None of the above.

5. How many years have you participated in inclusive programs?
      I have not participated in an inclusive program.
      less than 1 year
      1 year
      2 years
      3 years
      4 years
      5 years or more

6. Which curriculums/approaches/features best describe your program? (check all that apply)
      Creative Curriculum
      Direct Instruction
      High Scope
      Project Approach
      Waldorf
      Kamii-Deveries Constructivist Perspective
      Montessori
      Multi-Age Classrooms
      Thematic
      AEPS
      Carolina
      Insite
      DISTAR
      HELP
      TEACH
      PREP
      NAEYC Accreditation
      Other
      I don't know.

7. What is the program's location?
      Urban
      Suburban
      Rural

8. Which age groups are served by your program? (check all that apply)
      0-2 years
      3-5 years
      6-8 years
      9 years and/or older

9. What is the approximate percentage of children with disabilities in your program?
      0%
      1% to 10%
      11% to 25%
      26% to 50%
      More than 50%

10. Which roles are utilized in your early childhood or elementary school program? (check all that apply)
     Administrators:
           Community Program Director
           Special Education Administrator
           Regular Education Administrator
           Disabilities Coordinator
     Teachers:
           Early Childhood/Primary Grades Teacher
           Early Childhood/Primary Grades Special Education Teacher
           Assistant Teacher
           Paraprofessional
           Teacher Educator
     Support Personnel:
           Occupational Therapist or Occupational Therapist Assistant
           Physical Therapist or Physical Therapist Assistant
           School Psychologist
           Speech Language Pathologist or Speech Language Paraprofessional
           Health Services
           Family Services Coordinator
           Transition Facilitator
           Social Worker
           Music Therapist
           Art Therapist
           Teacher of Students with Visual Impairments
           Teacher of Students with Hearing Impairments
           Audiologist
           General Support Personnel
           Preservice Support Personnel

11. Where do you access the Internet? (check all that apply)
      Home
      Work
      Public library
      School
      Other

Please be sure that you have correctly filled out the survey.


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