Name: _______________________
Age: _______
Sex: ☐ Male ☐ Female
Grade and Section: _______________________
School: _______________________
Directions:
Please read each statement carefully. Put a check (✔) on the option that
best shows your answer. There are no right or wrong answers. Be honest.
Scale:
1 – Never
2 – Rarely
3 – Sometimes
4 – Often
5 – Always
Part I. Home Environment and Parental Support
1. My parents or guardians encourage me to read at home.
☐1☐2☐3☐4☐5
2. I have enough time at home to study or read.
☐1☐2☐3☐4☐5
3. My parents help me understand difficult words or sentences when I
read.
☐1☐2☐3☐4☐5
4. I feel tired or distracted when I try to read at home.
☐1☐2☐3☐4☐5
5. My parents ask me about what I have read.
☐1☐2☐3☐4☐5
6. My parents provide reading materials (books, stories, online
articles).
☐1☐2☐3☐4☐5
7. My parents remind me to practice reading regularly.
☐1☐2☐3☐4☐5
Part II. School-Based Academic Support
8. My English teacher gives clear explanations during reading lessons.
☐1☐2☐3☐4☐5
9. My teacher provides activities that help me understand stories
better.
☐1☐2☐3☐4☐5
10. I receive feedback from my teacher to improve my reading
comprehension.
☐1☐2☐3☐4☐5
11. The school provides enough time for reading activities.
☐1☐2☐3☐4☐5
12. I receive help from my classmates during reading activities.
☐1☐2☐3☐4☐5
Part III. Learning Resources and Programs
13. Our school provides reading materials that are interesting and
easy to understand.
☐1☐2☐3☐4☐5
14. I use digital tools (e.g., Canva, videos, online stories) to help
me understand what I read.
☐1☐2☐3☐4☐5
15. Reading activities at school motivate me to read more.
☐1☐2☐3☐4☐5
16. The academic support I receive helps me improve my reading
skills.
☐1☐2☐3☐4☐5
Interview
1. How do you feel about reading in English? Can you describe your
experience?
2. Can you tell me what usually happens at home when you try to read
or study?
3. Do you have enough time to read at home? Why or why not?
4. What things at home make reading easy or difficult for you?
5. Is there a place at home where you can read quietly? Please explain.
6. What reading materials do you usually use at home or in school?
7. Do you have access to books, modules, or digital reading materials?
Please explain.
8. How do digital tools (like Canva, videos, or online stories) help you
understand what you read?
9. What do you find most difficult when reading?
10. Do problems at home ever affect your focus in reading? Can
you explain?