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Parent/family Survey questions – for parents, grandparents, family members in Montana who have children receiving services through the infant/toddler program(Part C) and/or school-based special education services (Part B).
1. 
Greetings families in Montana,

Please complete and submit the following survey if you have children who receive or have received infant and toddler and/or special education services.

- Skip any questions you are not comfortable with or are not sure about.
- If there are check boxes, check as many as you need.
- If you have more than one child who has received services, you may choose to do multiple surveys or to enter all information on one survey.
- Spouses/other family members are encouraged to complete surveys also.
- All information shared is ANONYMOUS. Individual results will remain CONFIDENTIAL. Only summary information will be published.

Plan on about 15 minutes to do the survey. There are about 50 questions.
 
 
 
2. Section 1 – Your Household
 
 
 
3. I reside in this area of MT. (check all that apply)
 
Northern
 
Eastern
 
Western
 
Southern
 
Central
 
Other
 

 
 
 
4. I would describe myself as a: (check all that apply)
 
Parent
 
Grandparent
 
Family member
 
Educator
 
Professional
 
Service provider
 
Other
 

 
 
 
5. My ethnicity: (check all that apply)
 
American Indian
 
Hispanic
 
African American
 
Asian
 
Pacific Islander
 
Caucasian
 
Other
 

 
 
 
6. Household:
 
Single parent
 
Two parent
 
Other
 
 
 
 
7. Annual Household Income(approximate):
   
 
 
 
8. Section 2 - Your Child
 
 
 
9. I have a child/children within these age ranges:
 
Birth to age 3 years
 
3 through 5 years
 
6 to 16 years
 
Over 16 years
 
Adult
 
Deceased

 
 
 
10. Number of children included on this survey:
   
 
 
 
11. I would describe my child’s ethnicity as (check as many as needed):
 
American Indian
 
Hispanic
 
African American
 
Asian
 
Pacific Islander
 
Caucasian
 
Other
 

 
 
 
12. Enter the year your child graduated or left school.
   
 
 
 
13. Describe briefly the services your child receives – home-based, school, medical, social, insurance, private therapies (PT, OT, SLA, ABA), other
   
 
 
 
14. Child’s disability. (check all that apply)
 
Unknown
 
Evaluation in process
 
At risk
 
Autism
 
Cognitive delay
 
Deaf-blindness
 
Deafness
 
Developmental delay
 
Emotional disturbance
 
Hearing impairment
 
Orthopedic impairment
 
Learning disability
 
Speech impairment
 
Traumatic brain injury
 
Visual impairment
 
Other delays
 
Other diagnosed physical or mental condition.
 
Other
 

 
 
 
15. My child has received services through: (check all that apply)
 
IFSP
 
IEP
 
504
 
Health plan
 
Title I
 
DD services
 
Autism waiver
 
Children’s Special Health Services
 
Rural Health clinic
 
Indian Health Service
 
Easter Seals
 
Private therapist
 
Mental health
 
Other

 
 
 
16. Children’s Insurance/benefits: (check all that apply)
 
Medicaid
 
CHIP
 
Private
 
SSI
 
Public Assistance
 
Medicare
 
Other
 

 
 
 
17. Section 3 – Where Do You Get Information?
 
 
18. How would you rate the quality of information you have received regarding your child via:
Poor Below Average Average Good Excellent N/A
Internet
Friends
Other parents
Pediatrician
Other professionals
School
PLUK
Workshops
Conferences
Public Library
PTA
Support Group
Online course
 
 
 
19. Describe other ways you get information that benefits you and your child.
   
 
 
 
20. Do you feel that the information you have received has helped to improve your child’s development/education?
 
Yes
 
No
 
Not sure
 
Other
 
 
 
 
21. Do you feel the information you have received has allowed you to make more informed/better decisions regarding your child’s services/care/education?
 
Yes
 
No
 
Not sure
 
Other
 
 
 
 
22. How would you like to obtain information:
 
Internet/websites
 
Texting
 
Newsletter
 
Phone
 
Connection with other parents
 
Workshops
 
Other

 
 
 
23. If you would like to receive information/training via workshops, please tell us when and how you would be able to participate:
 
Morning
 
Noon
 
Evening
 
30 minute Session
 
1 hour session
 
In-person
 
Telephone conference call
 
Webinar
 
Archived training (that you can view anytime online or on DVD).
 
Other

 
 
 
24. Describe training topics you would like:
   
 
 
 
25. What else would you like to see in place that would help you with your information and support needs regarding your child?
   
 
 
 
26. Section 4 - Questions on infant toddler programs (Part C) (if your child ever received services through the infant/toddler programs).
 
 
 
27. I have been informed of my parental rights under the Early Intervention program and been given a copy of procedural safeguards at least once per year in my native language.
 
Yes
 
No
 
Other
 
 
 
 
28. How was your child referred for early intervention services?
 
Hospital
 
Childfind
 
Professional
 
Not sure
 
Other
 
 
 
 
29. Were you made aware that there were other Early Intervention providers besides the agency you were referred to?
 
Yes
 
No
 
 
 
30. What year did your child begin receiving services:
   
 
 
 
31. How long did it take from evaluation to receiving services?
   
 
 
 
32. In what year did your child transition from infant/toddler programs to Preschool Special Education
   
 
 
33. How strongly do you agree with the following statements:
Strongly Disagree Disagree Undecided Agree Strongly Agree
I was encouraged and facilitated to be an equal partner in the development of my child’s IFSP and this has made a difference in my child’s progress.
My child has made progress on their IFSP because of the supports/services received.
My child receives the services needed in order to progress.
 
 
 
34. If you strongly disagree with any statement above – why?
   
 
 
35. Rate the level of improvement you believe is needed in each of the following areas (leave blank if you don’t know or are not sure):
Doesn't need 2 3 4 Needs improvement
Evaluation/assessment
Implementing IFSP
Transition from the infant/toddler program to preschool special education (Part C to Part B)
Appropriate services that meet my child’s and family’s needs
Quality service providers
Timely early intervention services
Child find/referral (the process for finding children who qualify for services)
Receiving services in natural environments
 
 
 
36. Any other areas of improvement you would like to add?
   
 
 
 
37. In the last year I have had to resolve a dispute with the agency providing services for my child:
 
Yes
 
No
 
 
 
38. If so, describe briefly the type of dispute and how it was resolved? (Mediation, complaint, due process)
   
 
 
 
39. Where do you go to get information on Early Intervention Services:
 
State Website
 
Early Intervention agency staff
 
State or district staff
 
Other parents
 
PLUK
 
Other
 

 
 
 
40. I believe the early intervention system in Montana is providing the services and family supports that my child and family needs:
 
Yes
 
No
 
Not sure
 
Other
 
 
 
 
41. Are you aware of Montana’s annual Performance Report?
 
Yes
 
No
 
 
 
42. Are you aware of the US Department of Education’s evaluation of Montana’s compliance?
 
Yes
 
No
 
 
 
43. Section 5 - Special Education Services in School (includes preschool) - Part B Questions:
 
 
 
44. I have been informed of my parental rights under the Federal Special Education Law (Individuals with Disabilities Education Act) and been given a copy of procedural safeguards at least once per year in my native language.
 
Yes
 
No
 
Other
 
 
 
 
45. How was your child referred for Special education services?
   
 
 
 
46. In what year did your child begin receiving services.
   
 
 
 
47. If you requested an evaluation in writing, estimate the time (number of days) between the request and when the evaluation was completed.
   
 
 
48. How strongly do you agree with these statements?
Strongly Disagree Disagree Undecided Agree Strongly Agree
At my child’s IEP meetings, there is a complete IEP team present – general education teacher, special education provider or supervisor, someone who can interpret evaluation results (if evaluation results were being discussed), and a district representative with authority to make commitments for services for my child. If a member was not present, I gave informed written consent for their absence in advance of the meeting and any information they would have provided was given to me in advance.
My child has made progress towards the goals on the IEP because of supports/services received.
The school district encouraged and facilitated my involvement in my child’s IEP (held the meeting at a convenient time, asked about my child’s strengths, talked about goals I have for my child, etc.) and this has made a difference in my child’s educational progress.
My child has the supports/services in place needed to progress.
 
 
 
49. If you strongly disagree with any of the statements above – why?
   
 
 
 
50. The IEP team placed my child in a private school at district expense:
 
Yes
 
No
 
Other
 
 
 
51. Please rate the need for improvement in these special education areas in Montana (leave blank if you don’t know or are not sure):
Doesn't need 2 3 4 Needs improvement
Modifications and accommodations in the general education classroom (students with disabilities being given meaningful access to the general education classroom and curriculum.
Teacher training or quality
Assistive technology
Supplemental services (OT, speech, counseling, etc.)
Writing effective IEPs
Implementing effective IEPs
Evaluation
Dispute resolution (disagreements, complaints, due process)
Transportation
Transition
 
 
 
52. Any other areas needing improvement not listed above?
   
 
 
 
53. If your child is 16 or older, have you participated in development of your child’s Transition Plan on the IEP?
 
Yes
 
No
 
Not sure
 
Other
 
 
 
54. If you have developed a Transition plan, how do you rate it in meeting your child’s post school goals?
Poor Below Average Average Good Excellent N/A
 
 
 
 
55. Within the last year I have requested: (check all that apply)
 
An additional IEP to discuss my child’s progress and discuss disagreements or resolve a dispute.
 
Early assistance to resolve a disagreement
 
A formal complaint to the state
 
A mediation session
 
A due process hearing
 
Other
 

 
 
 
56. If you requested any of the above, what was the result?
   
 
 
 
57. Where do you get data on State and local performance in special education?
 
Website
 
State or district staff
 
Not sure
 
Other
 

 
 
58. How would you rate the following statement:
Strongly Disagree Disagree Undecided Agree Strongly Agree
Montana is doing a good job educating students with disabilities.
 
 
 
59. I know the results of the US Department of Education’s evaluation of my state’s compliance with special education law and regulations and have read the determination letter:
 
Yes
 
No
 
Other
 
 
 
 
60. Are you aware of the state’s Annual Performance Report?
 
Yes
 
No
 
 
 
61. Additional Questions/Comments
 
 
 
62. Did you fill out a parent involvement questionnaire from the state in the last year?

 
Yes
 
No
 
 
 
63. If you received and did not fill out a parent involvement questionnaire, why not?
   
 
 
 
64. For those of you in the Billings or Bozeman area that have participated in the Informative Pointing workshops with Heather Clare, please indicate if you would like to participate in additional workshops this fall:
 
Yes
 
No
 
 
65. How would you rate this survey?
Poor Below Average Average Good Excellent
 
 
 
 
66. Get it off your chest – Any comments you wish to add?
   
 

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Thank you for providing your input.

Please contact [email protected] if you have any questions regarding this survey.
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