2013-2014 Parent Survey
Instructions:
● Please darken the circles completely and clearly using a pen or pencil.
● If you are using a pencil, make clean erasures.
● Select only one response for each item.
Return the survey in the postage-paid envelope provided.
This survey is for parents of Alabama students who receive services through an Individualized Education
Program (IEP). In this survey, special education refers to special services provided to students through an IEP.
1. School System Name: (Please circle the city or county school system where your child attends school.)
Andalusia City
Arab City
Athens City
Autauga County
Bibb County
Clay County
Cleburne County
Colbert County
Escambia County
Etowah County
Fayette County
Geneva City
Geneva County
Huntsville City
Lamar County
Lawrence County
Linden City
Mobile County
2. My Child’s Gender
Female
Montgomery County
Muscle Shoals City
Oneonta City
Phenix City
Pickens County
Roanoke City
Russellville City
Scottsboro City
Shelby County
Sylacauga City
Talladega County
Tallapoosa County
Tarrant City
Trussville City
Winfield City
Winston Count
Male
3. My Child’s Race:
Hispanic/Latino
American Indian or Alaska Native
Asian
Black or African American
Native Hawaiian or Other Pacific Islander
White
Multi Race—Two or more races
4. My child receives IEP services because of his/her:
Autism
Deaf-Blindness
Developmental Delay
Emotional Disability
Hearing Impairment
Intellectual Disability
Orthopedic Impairment
Other Health Impairment
Specific Learning Disability
Speech or Language Impairment
Traumatic Brain Injury
Visual Impairment
Multiple Disabilities
5. My Child’s Grade:
Preschool
Grades K-6
1
Grades 7-8
Grades 9-12
6. My Child’s Special Education Program:
For each of the following statements, select your
level of agreement
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
strongly
agree
agree
no
opinion
disagree
strongly
disagree
▼
▼
▼
▼
▼
The school offers parent training about
special education issues.
The school sends me information about
activities and workshops for parents.
Teachers and administrators ensure that I
have fully understood the Procedural
Safeguards (the rules in the federal law that
protect the rights of parents).
The school offers me a variety of ways to
communicate with teachers.
Teachers show a willingness to learn more
about my child's needs.
IEP meetings are scheduled at a time and
place that are convenient for me.
Teachers and administrators encourage me to
participate in the decision-making process.
I am considered an equal partner with
teachers and other professionals in planning
my child's program.
The school communicates regularly with me
regarding my child’s progress on IEP goals
and other important issues.
Written information I receive is provided to
me in an understandable way.
The principal sets a positive and welcoming
tone in the school.
The next two items should be ONLY answered by parents of pre-school (age 3 to 5)
children:
My child transitioned from early intervention
12. (birth to 3 program) to preschool special
education without a break in services.
My child receives his/her preschool special
13. education services with children without
disabilities to the maximum extent possible.
The next two items should be ONLY answered by parents of students with a secondary
transition plan: (usually age 16 and older, but may be younger).
11.
14.
The school encourages student involvement
in IEP meetings.
2
15.
7.
Services are provided to help students
become self-sufficient after high school.
My Additional Comments: (please write on the lines below)
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
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Thank you for your participation.
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