Fillable Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health (Comprehensive Center Network)

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Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health (Comprehensive Center Network)

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Return-to-School Survey: Supporting Mental, Behavioral, and
Socioemotional Health
[For Teachers]
As we plan the return to virtual or hybrid classrooms this fall, we would like to know how best to
support you in your work.
Please read through the questions below and answer to the best of your ability. The survey should
take about 10 minutes to complete.
www.compcenternetwork.org 1
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
Section I.
The first section asks questions about your experiences teaching in 2019–20 and concerns
for teaching in 2020–21.
1. Below is a list of challenges some staff may have experienced with online teaching
during the school closures. Please indicate if you experienced any of these issues. (Check
all that apply.)
I was anxious at home under the safer-at-home order.
I had trouble focusing in the online environment.
Problems with technology (e.g., lack of internet access, reliable device, issues with log in)
stressed me out.
I had trouble communicating with colleagues and administrators.
I had trouble communicating with parents/caregivers.
I had problems integrating instructional plans and materials into online teaching.
Facilitating student participation online.
Student absenteeism during online classes.
I found that the quality or format of my work wasn’t effective.
I wasn’t sure what I was supposed to do.
I wasn’t given proper directions from my administrators.
I didn’t have a quiet place to complete my work.
I had other responsibilities or needs to attend to.
I did not experience any specific issues.
2. From what sources did you receive the most support/resources while teaching remotely
through the end of the 2019–2020 school year? (Check up to two.)
School-based guidance/resources
District guidance/resources
State resources and toolkits
Resources from colleagues from my school
Other educators who I personally know from outside my school
General online resources that I sought out myself (e.g., Khan Academy, Coursera, iTunesU)
Resources from professional associations or national organizations like the Collaborative
for Academic, Social, and Emotional Learning (CASEL) and others
www.compcenternetwork.org 2
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
3. How concerned are you about supporting the social emotional well-being of your family
and friends after school starts? (Check one.)
Not at all concerned
Slightly concerned
Moderately concerned
Extremely concerned
4. In what specific ways do you think the psychological effects of COVID-19 and school
closures on students might manifest themselves once schools re-open? (Open ended)
5. What do you think the primary effects of COVID-19 and school closures on teacher’s
mental, behavioral, or social and emotional well-being are, and how might they affect
their teaching? (Open ended)
www.compcenternetwork.org 3
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
6. What additional supports or material resources do you think teachers will need, to deal
with the effects of COVID-19 and school closures on students’ mental, behavioral, or
social and emotional well-being? (Open ended)
7. Are there specific groups of students for whom you are most concerned about the effects
of the pandemic and school closures? If yes, which student groups? (Check all that apply.)
I am equally concerned about all groups of students
Experiencing homelessness
With disabilities
With special needs
In foster care
From low income households
From rural communities
English learners
Experienced serious trauma
Other (Please specify): _______________________________________________________________________________
8. To what extent do you have concerns about your students being sufficiently focused,
engaged, and ready to learn during the first few months transitioning back to the
physical classroom setting? (Check one.)
Not at all concerned
Slightly concerned
Moderately concerned
Extremely concerned
www.compcenternetwork.org 4
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
9. What concerns do you have, if any, about student engagement in the upcoming school
year if instruction is all virtual or a hybrid model? Students might… (Check all that apply.)
have sporadic attendance.
miss crucial services/supports if schools remain closed for in-person instruction
(free/reduced meals, counseling, etc.).
be unable to access online schooling consistently (e.g., lack of internet access, needing to
focus on other responsibilities).
have trouble focusing on learning.
miss non-core academic school instruction such as art, music, and physical education.
drop out of school.
I have no concerns about student engagement.
www.compcenternetwork.org 5
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
Section II.
The next few questions pertain to virtual instruction.
10. How confident are you in your ability to teach remotely, if needed, in 2020–21? (Check
one.)
Very confident
Moderately confident
Minimally confident
Not at all confident
11. In a virtual learning setting, how confident are you that you can meet the needs of your
students who need the most academic support? (Check one.)
Very confident
Moderately confident
Minimally confident
Not at all confident
12. In a virtual learning setting, how confident are you that you can meet the needs of your
students who are academically advanced? (Check one.)
Very confident
Moderately confident
Minimally confident
Not at all confident
13. What are the benefits, if any, for students to learn through online classes as compared to
in-person instruction? (Open-ended)
www.compcenternetwork.org 6
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
14. Please indicate your level of agreement with the following statements about virtual
instruction. (Check a response for each statement.)
Strongly
agree Agree Disagree
Strongly
disagree
There is a shared vision across my school
and/or [district/network] for effective remote
learning.
I am receiving support in implementing
effective remote learning.
I have received clear communication from
schools/districts regarding what to expect when
schools reopen.
I understand how to support my students’
learning in a remote learning environment.
I know how to handle students who are
disruptive during online instruction.
I know how to handle students who have
experienced family loss.
My school will have adequate staff (e.g., school
counselors, school psychologists) to support the
mental health needs of students virtually.
I know what to do when students don’t attend
online classes regularly.
www.compcenternetwork.org 7
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
Section III.
The next few questions pertain to in-person/hybrid instruction.
15. How confident are you in your ability to teach in-person, if needed, in 2020–21? (Check
one.)
Very confident
Moderately confident
Minimally confident
Not at all confident
16. In an in-person learning setting, how confident are you that you can meet the needs of
your students who need the most academic support? (Check one.)
Very confident
Moderately confident
Minimally confident
Not at all confident
17. In an in-person learning setting, how confident are you that you can meet the needs of
your most academically advanced students? (Check one.)
Very confident
Moderately confident
Minimally confident
Not at all confident
www.compcenternetwork.org 8
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
18. Please indicate your level of agreement with the following statements about in-person
instruction. (Check a response for each statement.)
Strongly
agree
Agree Disagree
Strongly
disagree
There is a shared vision across my school
and/or [district/network] for effective
in-person learning.
I am receiving support in implementing
effective in-person learning.
I know how to handle students who are
disruptive in an in-person setting.
I know how to handle students who have
experienced family loss in an in-person learning
setting.
My school will have adequate staff (e.g., school
counselors, school psychologists) to support the
mental health needs of students in-person.
I know how to address attendance issues in an
in-person learning setting.
www.compcenternetwork.org 9
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
Section IV.
The next set of questions pertains to your needs for training, support, or material resources
19. What additional professional development supports do you need to prepare for the
upcoming school year (whether classrooms are virtual or hybrid)? (Open ended)
20. Please list any material resources you recommend the school or district provide to
students and their families to support their mental, behavioral, and social and
emotional well-being (e.g., brochures on youth mental health during COVID-19, self-
care,
1
mental health resources in the community). (Open ended)
1
Self-care is the practice of taking an active role in protecting one's own well-being, especially during periods of stress
(e.g., activities such as meditation, going for walks, talking to friends/family).
www.compcenternetwork.org 10
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Teachers
21. How can the school counselors, social workers, or school mental health professionals
help make the 2020–21 school year more successful? (Check all that apply.)
Explain how to refer a student to the school counselor for additional services or support.
Check-in with teachers on a regular basis.
Provide teachers with additional mental health resources.
I Work with students who are experiencing grief or trauma.
Assist with classroom management.
Other (Please specify): _______________________________________________________________________________
22. For fall 2020, which of the following would be the preferred scenario to you for
reopening schools? (Check one.)
All online
All in-person
Hybrid
Unsure
23. As background for understanding your answers, which grade levels will you be teaching
in 2020–21? (Check all that apply.)
Pre-K
K
1
2
3
4
5
6
7
8
9
10
11
12
Sources
Questions in this survey are based on:
Surveys from the British Council, UK
The New Teacher Project, NY.
Educator Research Alliance, TN
Information for School Districts, Department of Public Instruction, WI.
The content of this survey was developed under a grant from the Department of Education. However, the contents do not necessarily
represent the policy of the Department of Education, and you should not assume endorsement by the Federal government.
www.compcenternetwork.org 11
Return-to-School Survey: Supporting Mental, Behavioral, and
Socioemotional Health
[For school counselors/social workers/school psychologists/school nurses/other student
support services staff]
As we plan the return to virtual or hybrid classrooms in Fall 2020, we would like to know how best
to support you in your work.
Please read through the questions below and answer to the best of your ability. The survey should
take about 15 minutes to complete.
Section I.
This section asks questions about challenges in supporting the mental, behavioral, and
socioemotional health needs of students for the upcoming school year.
1. Below is a list of problems some staff may have experienced with online learning during
the coronavirus pandemic. Please indicate if you experienced any of these issues. (Check
all that apply.)
I was anxious while at home during the safer-at-home order.
I had trouble focusing in the online environment.
Problems with technology (e.g., lack of internet access, reliable device, issues with log in)
stressed me out.
I had trouble communicating with colleagues and administrators.
I had trouble communicating with parents/caregivers.
I found that the quality or format of my work wasn’t effective.
I wasn’t sure what I was supposed to do.
I wasn’t given proper directions from my administrators.
I didn’t have a quiet place to complete my work.
I had other responsibilities or needs to attend to.
I did not experience any specific issues.
www.compcenternetwork.org 1
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 2
2. In what specific ways do you think the psychological effects of COVID-19 and school
closures on students might manifest themselves once schools re-open? (Open ended)
3. How prepared do you fe
el for supporting students in the upcoming school year if schools
reopen for virtual instruction? (Check one.)
Completely prepared
Mostly prepared
Somewhat prepared
Not prepared at all
4. How prepared do you feel for supporting students in the upcoming school year if schools
reopen for hybrid classrooms? (Check one.)
Completely prepared
Mostly prepared
Somewhat prepared
Not prepared at all
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 3
5. Which of the following work-related issues concern you most about the upcoming school
year? (Please pick a maximum of three responses.)
Managing my home and work responsibilities.
Feeling unprepared to do my job in this pandemic context.
Not being able to support students as much as before.
Not having the training to support students with trauma.
Conducting online counseling/support services.
Being able to ensure confidentiality during online counseling.
Getting the support and guidance from the school/school district.
Communicating with parents/guardians.
Other (Please specify:) _______________________________________________________________________________
6. Do you anticipate an increas
ed demand for counseling in the upcoming school year, and
if so, how much? (Check one.)
No increase
Slight increase
Moderate increase
Large increase
7. Are there specific groups of students for whom you are most concerned about the effects
of the pandemic and school closures? (Check one.)
Yes
No
If Yes, which of the following student groups are you most concerned about? (Check all
that apply.)
Experiencing homelessness
In foster care
With disabilities
With special needs
From low income households
From rural communities
English learners
Experienced serious trauma
Other (Please specify:) _______________________________________________________________________________
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 4
8. What do you think the primary effects of COVID-19 and school closures on teacher’s
mental, behavioral, or socia
l and emotional well-being are, and how might they affect
their teaching? (Open ended)
9. What a
dditional supports or material resources do you think teachers will need to
address the effects of COVID-19 and school closures on students’ mental, behavioral, or
social and emotional well-being? (Open ended)
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 5
Section II.
This set of questions pertains to your needs for training or material resources.
10. Which of the following self-
care support/resources do you have access to? (Check all that
apply.)
EAP (Employees Assistance Program)
Online health and wellness resources
School self-care supports/resources
District self-care supports/resources
State education department self-care supports/resources
Other (Please describe in the space below):
None of the above
11. What types of additional training, if any, do you need to support students when schools
reopen? (Check all that apply.)
Trauma-specific training
Training on how to provide online counseling
Training on how to engage students
Training on how to deal with confidentiality issues
Training for supporting specific groups of students (such as students with disabilities,
students who experienced domestic violence, had other trauma, or lost a family member)
Other training (Please specify): _____________________________________________________________________
No additional training required
12. What technical training would be useful for working virtually or in a hybrid model?
(Check all that apply.)
How to use online platforms/software
Using virtual environments for social and emotional learning
Creating student assessments that can be administered virtually
Engaging students in a virtual environment
Other (Please specify): _______________________________________________________________________________
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 6
13. What specific resources or guidance can the schools/district/state provide to you that
would help you support your students and teachers better? (Open ended)
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 7
Section III.
Finally, the last questions ask about plans for the school year.
14. What sources have been most helpful in planning for the upcoming school year in terms
of strategies or ideas? (Check all that apply.)
School
District
State education department
Regional centers (e.g., Regional Educational Laboratory [REL], Regional Comprehensive
Center [RC])
Professional associations/organizations
Peers
Other (Please specify): _______________________________________________________________________________
15. Does your school
or district have a communication plan to inform students/families
about counseling services? (Check one.)
Yes
No
Unsure
If yes, please describe.
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 8
16. Are there specific counseling centers and other resources in the community that you
will be using to support students’ needs? (Check one.)
Yes
No
Unsure
If yes, please briefly describe.
1
7. Please list any material resources you recommend that the school or district provide to
students and their families to support their mental, behavioral, and social and
emotional well-being (e.g., brochures on youth mental health during COVID-19, self-
care,
1
mental health resources in the community). (Open ended)
1
Self-care is the practice of taking an active role in protecting one's own well-being, especially during periods of stress (e.g., activities
such as meditation, going for walks, talking to friends/family).
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
www.compcenternetwork.org 9
18. Are there any changes you are planning to make to engage students once the schools
reopen? (Check all that apply.)
More outreach to students to increase their awareness and utilization of counseling
services.
More outreach to parents/caregivers on how they can support their children.
Developing school-specific resources that address mental health in the current situation.
Classroom visits to talk about the effects of COVID-19 and school closures.
Including more content on mental health in family health curriculum.
More online resources on mental health on school website.
Putting up posters around the schools (if your school reopens for hybrid classes).
Holding office hours (virtual or in-person) or other changes in scheduling students.
Referrals to hotline options.
Partnering with other mental health organizations to help support students.
19. Do you plan to assess the effect of COVID-19 and school closures on the mental,
behavioral, and social and emotional well-being of the students, and if so, using what
measures? (Check one.)
Yes
No
Unsure
If yes, briefly describe measures.
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For School Counselors/Social Workers/Other School-Related MH Professionals
10
20. As background for understanding your answers, what grade level will you serve in your
role as counselor, social worker, or school psychologist in 2020–21. (Check all that apply.)
Preschool, including Pre-K
Elementary School
Middle School
High School
Other (Please specify): _______________________________________________________________________________
Sources
Questions in this survey are based on:
Educator Research Alliance, TN
Montgomery County Public Schools, MD
The content of this survey was developed under a grant from the Department of Education. However, the contents do not necessarily
represent the policy of the Department of Education, and you should not assume endorsement by the Federal government.
www.compcenternetwork.org
1
Return-to-School Survey: Supporting Mental, Behavioral, and
Socioemotional Health
[For Parents/Caregivers/Guardians]
As we plan the return to virtual or hybrid classrooms this fall, we would like to know how best to
support your child’s mental, social, and emotional needs.
Please read through the questions below and answer to the best of your ability. If you have more
than one child enrolled in school, please answer these questions about your oldest child or
complete one survey for each child.
The survey should take about 10 minutes to complete.
Section I.
The first set of questions asks about your child’s experiences at the end of the 2019–20
school year, when schools closed or switched to virtual classes.
1. What has been the overall impact, positive or negative, of the extended school closures
on your child’s mental and behavioral health? Please describe. (Open ended)
www.compcenternetwork.org
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Parents
www.compcenternetwork.org 2
2. Below is a list of challenges students may have experienced with online teaching during
the school closures. Please indicate if your child experienced any of these issues. (Check
all that apply.)
My child did not have any problems with virtual learning.
My child had problems with technology (e.g., lack of internet access, reliable device, issues
with log in) that stressed him/her out.
It was hard for me to communicate with my child's teacher(s).
I could not support my child’s schoolwork.
My child was anxious and lacked supports (i.e., counselors).
My child had trouble adjusting to distance learning.
My child was not able to focus during online classes.
My child missed seeing their teacher(s) in-person.
My child missed socializing with other students.
My child did not have a quiet place at home for online classes.
My child had other family obligations and responsibilities while at home.
My child had other basic needs that were not being met (e.g., nutrition, housing).
Other (Please specify): _______________________________________________________________________________
3. To what extent do you agree with the following statements about your school or
district’s communication with families at the end of the 2019–20 school year? (Check a
response for each statement).
Strongly
agree Agree Disagree
Strongly
disagree
Does not
apply
I received consistent messaging
about the district’s response to
COVID-19.
The information I received was in a
language I could easily understand.
I was receiving too much
information
The information I received was too
confusing for me to understand.
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Parents
www.compcenternetwork.org 3
Section II. General Concerns
The next few questions ask about your family’s social and emotional well-being.
4. How concerned are you about supporting the social emotional well-being of people in
your life after school starts (children, other family members, or friends)? (Check one.)
Not at all concerned
Slightly concerned
Moderately concerned
Extremely concerned
5. Do y
ou agree with the following statements? (Check all that apply.)
Having my child enrolled in online classes makes my day-to-day life significantly more
stressful.
Online learning has a negative effect on my child’s social and emotional well-being.
The online learning program is requiring too much of the students.
I am finding it easy to manage my child’s online learning program.
If online learning continues in the fall, I feel well prepared to manage my child’s remote
learning program.
My child misses having in-person interactions with his/her teachers.
My child has an easier time keeping up with homework when classes are in-person.
It is harder for my child to participate when classes are online.
My child will be able to seek help from school mental health staff, if needed.
6. To what extent do you foresee your child having to miss in-person school days because
of COVID-19 related personal or family hardships? (Check one.)
Will not miss any days
Will miss a few days
Will miss many days
Will miss a lot of days
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Parents
www.compcenternetwork.org 4
Section III. Child Adjustment to Online Learning
The next few questions ask about how your child’s adjustment if schools were to reopen for
online classes only.
7. How engaged and ready to learn do you think your child will be during the first few
months of school if it’s online or a hybrid (some days in-person, some online)? (Check
one.)
Very ready
Somewhat ready
Not at all ready
8. In a remote (online) learning setting, how confident are you that your child’s
learning/academic needs will be met? (Check one.)
Very Confident
Somewhat confident
Not at all confident
9. In a remote (online) learning setting, how confident are you that your child’s social-
emotional needs will be met? (Check one.)
Very Confident
Somewhat confident
Not at all confident
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Parents
www.compcenternetwork.org 5
Section IV. Child Adjustment to In-Person Learning
The next few questions ask about how your child’s adjustment if schools were to reopen for
hybrid/in-person classes.
10. How engaged and ready to learn do you think your child will be during the first few
months of school if it’s in-person? (Check one.)
Very ready
Somewhat ready
Not at all ready
11. In an in-person learning setting, how confident are you that your child’s learning/
academic needs will be/are being met? (Check one.)
Very Confident
Somewhat confident
Not at all confident
12. In an in-person learning setting, how confident are you that your child’s social-
emotional needs will be/are being met? (Check one.)
Very Confident
Somewhat confident
Not at all confident
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Parents
www.compcenternetwork.org 6
Section V. Supports Needed
The next set of questions are about the resources and support the schools can provide.
13. What can your school or district do to support your family’s social emotional well-being
during the pandemic? (Check all that apply.)
Increase access to online or in-person counseling services
Train school mental health staff to deal with the current situation
Offer additional mental health resources for students (e.g., brochures, online information)
Offer additional mental health resources for parents/caregivers (e.g., brochures, online
information)
Provide more information on COVID-19 to students
Provide a forum or other medium for students to discuss personal challenges.
Other (Please specify): _______________________________________________________________________________
14. Are there other resources that you would like your school/district to provide to
students and families? If so, please explain. (Open-ended)
15. As background for understanding your answers, how many children do you have?
Number of children _______________________
Sources
Questions in this survey are based on:
School2Home Parent Readiness Survey
Everyschool.org COVID-19 Parent Survey
Zero To Three
Scientificmommy.com Parent Support Survey: COVID-19
Polling American K–12 School Parents About COVID-19. EdChoice.
The content of this survey was developed under a grant from the Department of Education. However, the contents do not necessarily
represent the policy of the Department of Education, and you should not assume endorsement by the Federal government.
Return-to-School Survey: Supporting Mental, Behavioral, and
Socioemotional Health
[For Students Grades 6–12]
As we end the school year and start thinking about returning to virtual or in-person classrooms this
fall (2020–21 school year) we would like to know what your needs and concerns are so we can plan
accordingly for school reopening.
Please read through the questions below and answer honestly and to the best of your ability. The
survey should take about 10 minutes to complete.
www.compcenternetwork.org 1
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
Section I.
This section is about how to support the mental health needs of students for the upcoming
school year.
1. Below is a list of challenges some students may have experienced with online learning
during the school closures. Please indicate if you experienced any of these issues. (Check
all that apply.)
I did not have any problems with online learning.
I was anxious while at home during the safer-at-home order.
I had problems with technology (e.g., lack of internet access, sharing computers, issues
with logging on).
I had trouble reaching out to my teacher(s).
I wasn’t able to reach the school counselor/social worker/nurse when I wanted to.
I wasn’t sure what I was supposed to do.
I had trouble paying attention in online class.
I wasn’t given proper directions by my teachers.
I missed hanging out with other students at school.
I experienced bullying online.
I felt lonely.
I didn’t have a quiet place to complete my work.
I had difficulty completing work.
I had other responsibilities in the house (e.g., taking care of a family member).
I could not access basic needs (e.g., meals, housing).
www.compcenternetwork.org 2
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
2. Was there anything good about staying at home and taking online classes when schools
were closed due to COVID-19? (Check all that apply.)
I had more free time.
I didn’t have to wake up early for school.
I didn’t have to socialize with my peers.
I experienced less bullying.
I had less homework.
I enjoyed being at home.
My parents/caregivers/siblings helped me with homework.
I was able to learn better than I did with in-person classes.
I was not tired from having to travel to and from school.
No, there was nothing good about staying at home.
www.compcenternetwork.org 3
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
Section II.
For the next two questions, think about schools reopening for online classes only.
3. How ready are you to learn online this fall? (Check one.)
Very ready
Somewhat ready
Not ready at all
4. If you need to, how likely are you to reach out to the school counselor/social worker
when schools reopen (online)? (Check one.)
Very likely
Somewhat likely
Unlikely
I definitely will not
www.compcenternetwork.org 4
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
Section III.
For the next four questions, think about schools reopening for in-person instruction.
5. How ready are you to learn in-person this fall? (Check one.)
Very ready
Somewhat ready
Not ready at all
6. If you need to, how likely are you to reach out to the school counselor/social worker in-
person? (Check one.)
Very likely
Somewhat likely
Unlikely
I definitely will not
7. If schools reopen for in-person instruction, what are your biggest concerns? (Check all
that apply.)
Not being able to focus in class.
Having to talk to teachers.
Being too distracted by fears and anxieties over COVID-19.
Having been disengaged for a long time (COVID-19 and summer).
Getting distracted by social distancing protocols.
Worried about how close I’m sitting to other kids.
Kids not following social-distancing protocol.
Sitting with others on buses.
Having a changed schedule.
Anxiety about catching COVID-19.
Having other family obligations and responsibilities while at home.
Adjusting to school while my family is experiencing significant problems (illness, lack of
money or food, changes in housing).
Building and maintaining friendships with my peers.
Getting back into a routine.
Other (Please specify): ______________________________________________________________________________
I have no particular concerns.
www.compcenternetwork.org 5
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
8. What do you want your teacher(s) to do differently when you go back? (Check up to three.)
Talk about COVID-19 and their experiences with it.
Ask the class about their experiences and challenges with staying at home.
Explain what the new school/classroom procedures and schedules are.
Explain what the social distancing procedures are.
Encourage students to social distance and wear masks.
Not assign in-person group work/projects.
Support students who had a hard time during COVID-19 with death in the family or other
negative events.
Have talking sessions with students (e.g., community circles, welcome new students,
provide an orientation to the new procedures).
Provide information to students on where they can receive mental health support.
Introduce students to the school counselor or social worker (if they are unfamiliar).
Nothing. I would like my teachers to do the same things that they did before COVID-19.
www.compcenternetwork.org 6
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
Section IV.
The next set of questions are about the suggestions you may have for the schools.
9. Can you think of something your school can do that would help students transition back
to school this fall? (Open-ended)
10. Are there any resources or information from school counselors that you would like to
get to help you adjust back to school? (Open-ended)
11. A
s background for understanding your answers, what grade level will you be in this fall
(2020)?
Grade level __________________________________
www.compcenternetwork.org 7
Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health
For Students Grade 6–12
Sources
Questions in this survey are based on:
Department of Population Health and Biostatistics at The University of Texas Rio Grande Valley
School of Medicine.
Panorama Social-Emotional Learning: Student Competency Measures for Pittsburgh Public Schools.
Grades 6-12.
The content of this survey was developed under a grant from the Department of Education. However, the contents do not necessarily
represent the policy of the Department of Education, and you should not assume endorsement by the Federal government.
8 www.compcenternetwork.org
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Return-to-School Survey: Supporting Mental, Behavioral, and Socioemotional Health (Comprehensive Center Network)

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Completed 13 July 2021

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