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Supplemental Series 2 – Low Cost Supplemental Modules

Safety & Violence Module

This module consists largely of additional items from the California Student Survey (CSS) relating to safety and violence-related items were derived from the Youth Risk Behavior Survey (YRBS).

Less school-specific than the Core, it can help provide a better understanding of these issues and offers greater comparability to state norms.

Download High School Survey

Download Middle School Survey

Resilience & Youth Development Module

The Supplemental Resilience & Youth Development Module contains additional questions designed to measure environmental and individual protective factors in the lives of youth that help promote success. It assesses the three key developmental supports (caring adult relationships, high expectations, and meaningful participation) in the home and peer groups, for comparison with the data on the school and community environment provided by the Core Module. It also assesses six personal social-emotional skills or resilience strengths (Communication and Collaboration, Empathy, Self-efficacy, Self-awareness, Problem-solving, and Goals and Aspirations).

Download Middle School / High School Survey

For more information about what the resilience questions on the CHKS measure and resilience theory, visit the Resilience and Youth Development section of this site.

You may also download a full version (pdf) of the Resilience and Youth Development Module (RYDM) that includes all External Protective Factor and Internal Protective Factor questions.

Social Emotional Health Module

The Social Emotional Health Module (SEHM) greatly enhances the value of the CHKS as a strength-based assessment of positive emotions, engagement, ability to build and maintain relationships, and other social-emotional capacities linked to not only student mental health and well-being but also academic success and career and college readiness. Building on some of the scales in the existing CHKS Resilience and Youth Development Module (RYDM), it includes scales assessing youth empathy, self-efficacy, self-awareness, persistence, emotional self-regulation, behavioral self-control, gratitude, zest, and optimism. The SEHM was developed by researchers at UC Santa Barbara led by Dr. Michael Furlong.

Download Middle School / High School Survey

Physical Health and Nutrition Module

This module provides detailed information on physical activity in and out of school, body image, and behaviors related to weight loss or maintenance, physical risks associated with sports and motor vehicles, and general health, including doctor visits.

The majority of the items have been derived from the Youth Risk Behavior Survey (YRBS).

To fully assess and understand substance use and violence, and to promote positive youth development, it is essential to examine overall physical and mental health. Many of the behaviors assessed by this module have also been linked to school performance.

Download High School Survey

Download Middle School Survey

Sexual Behavior Module

When using this module the following wording must be included on the Active Parent Consent Form:

"This module includes questions about sexual behavior and practices leading to HIV/AIDS, sexually transmitted diseases, and pregnancy” (Ed Code 51513).

The items in this module, the majority derived from the Youth Risk Behavior Survey (YRBS), assess sexual experience, patterns and attitudes, pregnancy history, and HIV-related risk behaviors.

They cover number of partners (a main HIV risk factor), perception of peer behavioral norms, use of contraception, AOD use before sexual intercourse, family discussion, and exposure to HIV/AIDS education.

Download High School Survey

Download Middle School Survey

District After-School Module (DASM)

District After-School Module for districts with After-School Programs (ASPs)

The items in this module are for schools and districts that have students attending an after-school program. This may be a program run in conjunction with the school or as a separate entity. The questions assess how students spend their time after school, if they attend an ASP and issues related to safety.

Note: This module is part of the regular CHKS given in school. It is not the After-School Program Survey, which is administered in after-school programs.

Download High School Survey

Download Middle School Survey

Download Elementary School Survey

Gang Risk Awareness Module

Developed in conjunction with Sonoma County and the City of Santa Rosa, the Gang Risk Assessment Module (GRAM) gathers information on gang involvement, perceptions, knowledge, attitudes, and risk factors, as well as related, and alternative activities among youth grades 5 and up. The GRAM includes questions recommended by the US Office of Juvenile Justice and Delinquency Prevention.

Download Middle School / High School Survey

Download Elementary School Survey

To sign up please go to Sign Up or call (888) 841.7536.

For more information about this module contact Leslie Poynor at lpoynor@wested.org or (510) 302.4241.

Closing the Achievement Gap (CTAG) Module

For the CHKS, a short 10-question supplementary CTAG Module was developed that assesses student perceptions concerning extra help with school work, academic rigor, the cultural relevance of lessons, equity in opportunities, and fair and respectful treatment of all students. These questions align with new CTAG-related questions on the California School Staff Survey (CSSS), so that staff and student perceptions can be compared. These new questions greatly enhance the value of both the CHKS and the CSSS as tools to guide school-improvement efforts for all students.

Download Middle School / High School Survey

Gender & Sex-Based Harassment Module

The Gender and Sex-Based Harassment Module addresses students’ perceptions of harassment experiences on school campus. It targets students who identify as, or are perceived to be, lesbian, gay, bisexual, transgender, questioning, or gender nonconforming. Items include bullying frequency, negative attitudes and language expressed by peers and school staff, pro-bullying attitudes, peer and staff intervening behaviors, willingness to seek help, and availability of school-based prevention and intervention supports.

Download Middle School / High School Survey

Military Connected School Module

The military module will allow schools to gather anonymously the views of students about their schools and their educational needs. The voices of students will be used to establish sustainable military-friendly school climates that improve social, behavioral, and academic outcomes.

Download Middle School / High School Survey

Download Elementary School Survey

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