语言背景问卷（一二语）
欢迎参加本次语言背景调查，请根据您的实际语言经历和水平作答。题目无对错之分，您的反馈将用于研究。
1. 您的姓名：
Full Name:
2. 实验编号:
Subject ID:
3. 日期：
Today's Date
4. 您的年龄：
Age:
5. 您的出生年月日：
Date of Birth:
6. 您的性别：
Gender:
男 Male
女 Female
7. 您的惯用手是？Dominant Hand
左手 Left
右手 Right
8. 您通过的最高的汉语水平（HSK）等级是？
What is the highest HSK level you have passed?
HSK1
HSK2
HSK3
HSK4
HSK5
HSK6
HSK7
HSK8
HSK9
还没有考。您感觉自己多少级？
9. 您获得该HSK成绩的时间（年份和月份）：
When did you obtain this HSK score? (Year and month):
10. 您一共掌握、运用以及长时间学习几种语言？
How many languages do you know, use, or have studied for an extended period?
1种
2种
3种及以上 3 or more languages
11. 请按
主次顺序
列出你所学过或用过的语言（最常用的在前，包括第一语言）：
Please list the languages you have studied or used in order of proficiency (most frequently used first, including your first language):
1. ___ 2. ___ 3. ___ 4. ___ 5. ___
12. 请按
习得顺序
列出你所学过或用过的语言（第一语言（母语）在先）：
Please list all the languages you know in order of acquistion(your native language first) :
1. ___ 2. ___ 3. ___ 4. ___ 5. ___
13. 以下4个题目，请按
习得顺序
填写：
Please complete the following four questions in the order of language acquisition：
我明白了。I understand.
我不明白，请询问主试。I do not understand. Please ask the experimenter.
14. 请您列出
目前
您所接触每种语言
时间
的百分比。（例如：汉语80%，
各项百分比之和应为100%
）
Please list what percentage of the time you are currently and on average exposed to each language.
(your percentages should add up to 100%)
第一语言 the First Language
第二语言 the Second Language
第三语言 the Third Language
第四语言 the Forth Language
第五语言 the Fifth Language
15.
如果一篇文章有你会的多种语言版本，您通常会选择用哪种语言来阅读？
（各项百分比之和应为100%）
When choosing to read a text available in all your languages,in what percentage of cases would you choose to read it in each of your languages?Assume that the original was wirtten in another language,which is unknown to you
(your percentage should add up to 100%)
第一语言 the First Language
第二语言 the Second Language
第三语言 the Third Language
第四语言 the Forth Language
第五语言 the Fifth Language
16. 当您和所有语言能力都与你相同的人交流时，让您选择语言与他沟通，您使用各语言的百分比是怎样的？
（各项百分比之和应为100%）
When choosing a language to speak with a person who is equally fluent in all your languages,what percentage of time would you choose to speak each language?
(your percentage should add up to 100%)
第一语言 the First Language
第二语言 the Second language
第三语言 The Third Language
第四语言 the Forth Language
第五语言 the Fifth Language
17. 请列出您所认同的各种文化名称。并在0-10的数值范围内，标出您对每一种文化认同感。
（您所使用的语言（
国家层面
）对应一种文化。例如：英语-西方文化；普通话-中国文化。根据第一语言...第三语言所对应的文化顺序填写）
Please name the cultures with which you identify.
On a scale from zero to ten, please rate the extent to which you identify with each culture. (Examples of
possible cultures include US-American, Chinese, Jewish-Orthodox, etc):
文化1 Culture 1
0
10
文化2 Culture 2
0
10
文化3 Culture 3
0
10
文化4 Culture 4
0
10
文化5 Culture 5
0
10
18. 您的最高教育程度：
Please check your highest education level
低于高中 Less than High School
高中 High School
职高 Professional Training
本科未毕业 Bachelor's degree (not completed)
本科已毕业 Bachelor's degree completed
研究生未毕业 Graduate studies (not completed)
研究生已毕业 Master's degree completed
哲学博士/医学博士/法学博士 Ph.D./MLD./J.D.
其他 Other
19. 是否有移居别国的经历（大于3个月）：
Have you ever lived in another country for more than 3 months?
是 Yes
否 No
20. 如若移居过其它国家，请填写移居日期和该国名称：
If you have lived in another country, please indicate the date you moved there and the name of the country.
21. 您是否有过以下障碍？
Have you ever had:
视力障碍 Vision Problem
听力障碍 Hearing Problem
语言障碍 Language Disability
学习障碍 Learning Disability
无以上障碍 None of the above
22. 如果有障碍，请说明（包括校正）：
If yes, please explain (including any corrections):
23. 在学习
第一语言
时，以下节点出现的
年龄
。
Age at which the following milestones were reached in first language acquisition:
第一语言是 What is your first language?
开始说话年龄 Age started speaking 请填数字 Please enter the number.
说得流畅年龄 Age became fluent in speaking 请填数字 Please enter the number.
开始阅读年龄 Age started reading 请填数字 Please enter the number.
读得流畅年龄 Age became fluent in reading 请填数字 Please enter the number.
24.
在以下
第一语言
环境中度过的时间
（x年或x月）：
Please list the number of years and months you spent in the first language environment:
在使用第一语言国家的时间 The time you live in the country where the first language is spoken
在使用第一语言家庭的时间 The time you live in the family where the first language is spoken
在使用第一语言学校或工作单位的时间 The time you study/work at the school and/or working environment where the first language is spoken
25. 在以下方面，
第一语言
的熟练程度：
Select your level of proficiency in speaking,understanding and reading in your first language...
0
1
2
3
4
5
6
7
8
9
10
口语 Speaking
理解他人语言 Understanding
阅读 Reading
写作 Writing
词汇 Vocabulary
语法 Grammar
发音 Pronunciaton
26. 下列因素，对您学习
第一语言
的影响程度：
Please select how much the following factors contributed to you learning of the first language:
0
1
2
3
4
5
6
7
8
9
10
与朋友互动 Interacting with friends
与家庭互动 Interacting with family
阅读 Reading
语言磁带/自学 Language tapes/ Self instruction
看电视 Watching TV
听收音机 Listening to the radio
27.
当前
，在以下情景接触
第一语言
的程度：
Please rate to what extent you are currently exposed to the first language in the following contexts.
0
1
2
3
4
5
6
7
8
9
10
与朋友互动 Interacting with friends
与家庭互动 Interacting with family
阅读 Reading
语言磁带/自学 Language tapes/Self instruction
看电视 Watching TV
听收音机 /音乐 Listening to radio/music
28. 您感觉自己讲
第一语言
时
口音
有多重？
How much of a foreign accent do you have in the first language
0
0
1
2
3
4
5
6
7
8
9
10
10
29. 他人根据你的“第一语言口音”判断你的“母语”
不是
“第一语言”的频率：
How frequently others identify you as a non-native speaker based on your accent in your first language
他人根据你的“第一语言口音”判断你的“母语”“第一语言”的频率：别人根据你母语中的口音认定你为非母语者的情况
0
0
1
2
3
4
5
6
7
8
9
10
10
30. 在学习
普通话
时，以下节点出现的
年龄
:
Age at which the following milestones were reached in Mandarin learning:
开始说话年龄 Age started speaking 请填数字 Please enter the number.
说得流畅年龄 Age became fluent in speaking 请填数字 Please enter the number.
开始阅读年龄 Age started reading 请填数字 Please enter the number.
读得流畅年龄 Age became fluent in reading 请填数字 Please enter the number.
31. 在以下
普通话
环境中所度过的时间（x年或x月）：
Please list the number of years and months you spent in Mandarin environment:
使用普通话的国家 A country where Mandarin is spoken
使用普通话的家庭 A family where Mandarin is spoken
使用普通话的学校或工作单位 A school and/or working environment where Mandarin is spoken
32. 在以下方面，
普通话
的熟练程度：
Select your Mandarin level of proficiency in speaking,understanding and reading...
0
1
2
3
4
5
6
7
8
9
10
口语 Speaking
理解他人语言 Understanding
阅读 Reading
写作 Writing
词汇 Vocabulary
语法 Grammar
发音 Pronunciaton
33. 下列因素，对您学习
普通话
的影响程度：
Please select how much the following factors contributed to you learning of Mandarin:
0
1
2
3
4
5
6
7
8
9
10
与朋友互动 Interacting with friends
与家庭互动 Interacting with family
阅读 Reading
语言磁带/自学 Language tapes/ Self instruction
看电视 Watching TV
听收音机 Listening to the radio
34.
当前
，在以下情景接触
普通话
的程度：
Please rate to what extent you are currently exposed to Mandarin in the following contexts.
0
1
2
3
4
5
6
7
8
9
10
与朋友互动 Interacting with friends
与家庭互动 Interacting with family
阅读 Reading
语言磁带/自学 Language tapes/Self instruction
看电视 Watching TV
听收音机 /音乐 Listening to radio/music
35. 您感觉自己讲
普通话
时
口音
有多重？
How much of a foreign accent do you have in
Mandarin
?
0
0
1
2
3
4
5
6
7
8
9
10
10
36. 他人根据你的“普通话口音”判断你的“母语”
不是
“普通话”的频率：
How frequently others identify you as a non-native speaker based on your accent in Mandarin：
0
0
1
2
3
4
5
6
7
8
9
10
10
关闭
更多问卷
复制此问卷