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Appendix 1.3: Language Decision Form
To the best of your knowledge,
| 1. | What language does the child speak most often at home? | ||
| ENGLISH | 01 | ||
| SPANISH | 02 | ||
| OTHER (SPECIFY) | 03 | ||
| ________________________________ | |||
| 2. | What language does the child speak most often at this care settings? | ||
| ENGLISH | 01 | ||
| SPANISH | 02 | ||
| OTHER (SPECIFY) | 03 | ||
| ________________________________ | |||
| 3. | What language does it appear this child prefers to speak? | ||
| ENGLISH | 01 | ||
| SPANISH | 02 | ||
| OTHER (SPECIFY) | 03 | ||
| ________________________________ | |||
Language in which at least two of three responses are the same:
|
||
| ________________________________ LANGUAGE |
| 4. | If language is other than English or Spanish, ask main care provider: Can child understand and answer questions in English? (IF YES, PROCEED WITH ENGLISH TESTING. OTHERWISE FOLLOW INSTRUCTIONS FOR CHILDREN BEING TESTED IN OTHER LANGUAGE) | ||
| YES | 1 | ||
| NO | 2 | ||
| 5. | Language in which at least two of three responses are the same:
|
|
| ________________________________ LANGUAGE |
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