ࡱ> ]_\` Ebjbj 4H $,,,,T\$%<`$$$$$$$$R&h(%Q%V%.$$VS!@" ДZ h,"! [#l%0%!xX)?X)"X)"D%% %$$$ d$$$ $$$ STUDENT-ASSISTED INTERVIEW  Student s Name:  FORMTEXT      SSN:  FORMTEXT      Grade:  FORMTEXT      Teacher:  FORMTEXT      School:  FORMTEXT      Date:  FORMTEXT      Interviewer:  FORMTEXT       Always Sometimes Never1. In general, is your work hard?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 2. In general, is your work easy?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 3. When you ask for help appropriately, do you get it?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 4. Do you think work periods for each assignment are too long?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 5. Do you think work periods for each assignment are too short?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 6. When you do seatwork, do you do better when someone works with you?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 7. Do you think people notice when you do a good job?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 8. Do you think you get the rewards you deserve when you do well?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 9. Do you think you would do better in school if you received more rewards?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX 10. Are there things in the classroom that distract you?   FORMCHECKBOX   FORMCHECKBOX   FORMCHECKBOX  11. Do you like to go to school?  FORMTEXT       12. Do you have problems, or get into trouble at school?  FORMTEXT       13. When do you have problems at school?  FORMTEXT       14. Why do you have problems at that time?  FORMTEXT       15. When are your best times at school?  FORMTEXT       16. Why do you have no problems during those times?  FORMTEXT       17. What changes could be made so you would have fewer problems at school?  FORMTEXT       18. What kind of rewards would you like to earn for good beha 468:XZ\prt~ºº{thcº[WLjh@aUhAjhAU hA5h?h5CJaJ hbUhjhbUhQ^U jhbUh?UmHnHuj6hbUhQ^U hbUh?jhbUh?UhbUh?5hbUh5h5CJ aJ jh?h?5CJ UaJ hx5CJ aJ hA5CJ aJ hhR5CJ aJ 6:& mkd4$$IfTl0)5 t0J*644 laT $Ifgd$a$gdE    " $ & ( 4 8 : N P R \ ^ ` h l n ɾⲭtlh]lj6hkUhkjhkU jhbUhkUmHnHujhbUhkU hbUhkjhbUhkUhbUhk5 hk5h?h5CJaJj|h@aUhAhbUh?5hbUh5 hA5 hbUhjhAUmHnHujhAU& ( ` ~uu $Ifgdkkd$$IfTl;0)5 t0J*644 laT 9 : H I J Z [ i j k z { ɾײҨҘҨ҈ҨxҨhҨjp hhRhhR5Uj\ hhRh_)5Uj hhRh_)5Ujt hhRh_)5UjhhR5U hX5 hkhkjhkUhk hk5 hhR5h?hk5CJaJ hbUhkjhkUjhkUmHnHu' ~uu $Ifgdkd$$IfTl,0)5 t0J*644 laT  ~ypp $IfgdhRgdkd$$IfTl,0)5 t0J*644 laT  4  F= $Ifgd_)Xkd $$IfTs^0&P t`'44 saT $IfgdhRXkd$$IfTsy0&P t`'44 saT    F G U V W g h v w x     ! / 0 1 y z qjPhhRhhR5UjhhRhhR5UjhhhRhhR5UjThhRhhR5Uj hhRhhR5Ujl hhRhhR5UjX hhRhhR5U hhR5jhhR5Uj hhRhhR5U( A 2 =Xkd$$IfTs^0&P t`'44 saT $Ifgd_) $IfgdhRXkd $$IfTs^0&P t`'44 saT2 3 t  m =Xkd$$IfTs^0&P t`'44 saT $Ifgd_) $IfgdhRXkd$$IfTs^0&P t`'44 saT   ) * + ; < J K L [ \ j k l qjhhRhhR5Uj\hhRhhR5UjHhhRhhR5UjhhRhhR5Uj`hhRhhR5UjLhhRhhR5UjhhRhhR5U hhR5jhhR5UjdhhRhhR5U(m n A=Xkd$$IfTs^0&P t`'44 saT $Ifgd_) $IfgdhRXkd$$IfTs^0&P t`'44 saT FGUVWghvwx -.<=>ᬢrbjPhhRht5Uj<hhRht5UjhhRht5UjThhRht5Ujht5U ht5j@hhRhhR5UjhhRhhR5UjXhhRhhR5U hhR5jhhR5UjDhhRhhR5U&?@z=Xkd$$IfTs^0&P t`'44 saT $Ifgd_) $IfgdhRXkd$$IfTs^0&P t`'44 saT  ",.yg#j8hkVh_)CJUaJ#jhkVh_)CJUaJ(jhkVhtCJUaJmHnHu#jLhkVh_)CJUaJhkVhtCJaJjhkVhtCJUaJhtj8hhRht5UjhhRht5Ujht5U ht5$02.0 ^`gdt0^0gdtXkd$$IfTs^0&P t`'44 saT *,\^rtv<6<8<L<N<P<Z<\<<<<޹޹޹ā޹o޹#j hkVh_)CJUaJU#j hkVh_)CJUaJ#jhkVh_)CJUaJ#j$hkVh_)CJUaJhkVhtCJaJ ht5(jhkVhtCJUaJmHnHujhkVhtCJUaJ#jhkVh_)CJUaJ%vior or good school work?  FORMTEXT       19. Who encourages you to do your best in behavior and classwork?  FORMTEXT       20. What are your favorite activities at school?  FORMTEXT       At home?  FORMTEXT       21. If you had the^<`<====DDDEEEEEgd_) ^`gdt<<= = =t=v=============>DDDDDDDDDEEEEE޹޹ē޹|w|h]hkVh_)CJaJjhkVh_)CJUaJ h_)6 h_)5#j^"hkVh_)CJUaJU#j!hkVh_)CJUaJ#jr!hkVh_)CJUaJhkVhtCJaJ ht5(jhkVhtCJUaJmHnHujhkVhtCJUaJ#j hkVh_)CJUaJ! chance, what activites would you like to do that you don t have the opportunity to do now?  FORMTEXT       Interviewer comments: Please state attitude of student, willingness to complete this task,etc..  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