Information:
Error:
ID
19509
Description
Study part: Household Screener National Survey of Childrens Health, NSCH, 2016. A study by the U.S. Department of Health and Human Services to better understand the health issues faced by children in the United States today. Child and Adolescent Health Measurement Initiative, Data Resource Center on Child and Adolescent Health website. Retrieved on 07/12/2016 from http://childhealthdata.org/learn/NSCH/resources/survey-instruments. OMB No. 0607-0990: Approval Expires 04/30/2019.
Link
http://childhealthdata.org/learn/NSCH/resources/survey-instruments
Keywords
Versions (1)
- 1/6/17 1/6/17 -
Uploaded on
January 6, 2017
DOI
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License
Creative Commons BY-NC 3.0
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NSCH 2016 Household Screener
Similar models
Household Screener
- StudyEvent: ODM
Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item
Are there any children 0-17 years old who usually live or stay at this address?
text
C2347958 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Code List
Are there any children 0-17 years old who usually live or stay at this address?
CL Item
NoIf No, STOP HERE after marking “No” and return this survey to us in the enclosed envelope. It is important that we receive a response from every household selected for this study (1)
CL Item
Yes (2)
number of children Resident
Item
How many children 0-17 years old usually live or stay at this address?
integer
C2229974 (UMLS CUI [1,1])
C2347958 (UMLS CUI [1,2])
C2347958 (UMLS CUI [1,2])
Item
What is the primary language spoken in the household?
text
C1717991 (UMLS CUI [1])
CL Item
English (1)
CL Item
Spanish (2)
CL Item
Other (3)
Other
Item
If other, please mention
text
C0205394 (UMLS CUI [1])
first name
Item
First name, initials, or nickname of the youngest child
text
C1443235 (UMLS CUI [1])
Item
1. Is this child of Hispanic, Latino, or Spanish origin?
text
C0079946 (UMLS CUI [1])
CL Item
No, not of Hispanic, Latino, or Spanish origin (1)
CL Item
Yes, Mexican, Mexican American, Chicano (2)
CL Item
Yes, Puerto Rican (3)
CL Item
Yes, Cuban (4)
CL Item
Yes, another Hispanic, Latino, or Spanish origin (5)
Caucasoid Race child
Item
2. What is this child’s race? White?
boolean
C0007457 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child African American
Item
2. What is this child’s race?Black or African American?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
race child American Indian
Item
2. What is this child’s race? American Indian or Alaska Native?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
race child Asian Indian
Item
2. What is this child’s race?Asian Indian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
race child Chinese
Item
2. What is this child’s race? Chinese?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
Filipino child
Item
2. What is this child’s race? Filipino ?
boolean
C1556093 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Japanese child
Item
2. What is this child’s race? Japanese ?
boolean
C1556094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Korean child
Item
2. What is this child’s race? Korean?
boolean
C1556095 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Vietnamese child
Item
2. What is this child’s race? Vietnamese?
boolean
C1561452 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Asian
Item
2. What is this child’s race? Other Asian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
race child Native Hawaiian
Item
2. What is this child’s race? Native Hawaiian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
Guamanian child
Item
2. What is this child’s race? Guamanian or Chamorro?
boolean
C1553342 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Samoan child
Item
2. What is this child’s race? Samoan?
boolean
C1556103 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Pacific Islander
Item
2. What is this child’s race? Other Pacific Islander?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
Other Race child
Item
2. What is this child’s race? Some other race?
boolean
C0425379 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
age
Item
3. How old is this child? If the child is less than one month old, round age in months to 1.
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
Item
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
text
C0376245 (UMLS CUI [1])
Code List
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
CL Item
Very well (1)
CL Item
Not well (2)
CL Item
Well (3)
CL Item
Not at all (4)
drugs; supplements
Item
6. Does this child CURRENTLY need or use medicine prescribed by a doctor, other than vitamins?
boolean
C0013227 (UMLS CUI [1])
C0242295 (UMLS CUI [2])
C0242295 (UMLS CUI [2])
medical condition; drugs; supplements
Item
6. If yes, is this child’s need for prescription medicine because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
Duration medical condition; drugs; supplements
Item
6. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
medical care; educational services; mental health
Item
7. Does this child need or use more medical care, mental health, or educational services than is usual for most children of the same age?
boolean
C0496675 (UMLS CUI [1])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
medical condition; medical care; educational services; mental health
Item
7. If yes, is this child’s need for medical care, mental health, or educational services because of ANY medical, behavioral, or health condition?
boolean
C0012634 (UMLS CUI [1])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
Duration medical condition; medical care; educational services; mental health
Item
7. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
ability limited
Item
8. Is this child limited or prevented in any way in his or her ability to do the things most children of the same age can do?
boolean
C0085732 (UMLS CUI [1,1])
C0439801 (UMLS CUI [1,2])
C0439801 (UMLS CUI [1,2])
medical condition; ability limited
Item
8. If yes, is this child’s limitation in abilities because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
Duration medical condition; ability limited
Item
8. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
physical therapy; speech therapy; occupational therapy
Item
9. Does this child need or get special therapy, such as physical, occupational, or speech therapy?
boolean
C0949766 (UMLS CUI [1])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
Duration medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. Does this child have any kind of emotional, developmental, or behavioral problem for which he or she needs treatment or counseling?
boolean
C0087111 (UMLS CUI [1,1])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
duration treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. If yes, has his or her emotional, developmental, or behavioral problem lasted or is it expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
first name
Item
First name, initials, or nickname of the next oldest child
text
C1443235 (UMLS CUI [1])
Item
1. Is this child of Hispanic, Latino, or Spanish origin?
text
C0079946 (UMLS CUI [1])
CL Item
No, not of Hispanic, Latino, or Spanish origin (1)
CL Item
Yes, Mexican, Mexican American, Chicano (2)
CL Item
Yes, Puerto Rican (3)
CL Item
Yes, Cuban (4)
CL Item
Yes, another Hispanic, Latino, or Spanish origin (5)
Caucasoid Race child
Item
2. What is this child’s race? White?
boolean
C0007457 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child African American
Item
2. What is this child’s race?Black or African American?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
race child American Indian
Item
2. What is this child’s race? American Indian or Alaska Native?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
race child Asian Indian
Item
2. What is this child’s race?Asian Indian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
race child Chinese
Item
2. What is this child’s race? Chinese?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
Filipino child
Item
2. What is this child’s race? Filipino ?
boolean
C1556093 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Japanese child
Item
2. What is this child’s race? Japanese ?
boolean
C1556094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Korean child
Item
2. What is this child’s race? Korean?
boolean
C1556095 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Vietnamese child
Item
2. What is this child’s race? Vietnamese?
boolean
C1561452 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Asian
Item
2. What is this child’s race? Other Asian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
race child Native Hawaiian
Item
2. What is this child’s race? Native Hawaiian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
Guamanian child
Item
2. What is this child’s race? Guamanian or Chamorro?
boolean
C1553342 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Samoan child
Item
2. What is this child’s race? Samoan?
boolean
C1556103 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Pacific Islander
Item
2. What is this child’s race? Other Pacific Islander?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
Other Race child
Item
2. What is this child’s race? Some other race?
boolean
C0425379 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
age
Item
3. How old is this child? If the child is less than one month old, round age in months to 1.
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
Item
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
text
C0376245 (UMLS CUI [1])
Code List
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
CL Item
Very well (1)
CL Item
Not well (2)
CL Item
Well (3)
CL Item
Not at all (4)
drugs; supplements
Item
6. Does this child CURRENTLY need or use medicine prescribed by a doctor, other than vitamins?
boolean
C0013227 (UMLS CUI [1])
C0242295 (UMLS CUI [2])
C0242295 (UMLS CUI [2])
medical condition; drugs; supplements
Item
6. If yes, is this child’s need for prescription medicine because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
Duration medical condition; drugs; supplements
Item
6. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
medical care; educational services; mental health
Item
7. Does this child need or use more medical care, mental health, or educational services than is usual for most children of the same age?
boolean
C0496675 (UMLS CUI [1])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
medical condition; medical care; educational services; mental health
Item
7. If yes, is this child’s need for medical care, mental health, or educational services because of ANY medical, behavioral, or health condition?
boolean
C0012634 (UMLS CUI [1])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
Duration medical condition; medical care; educational services; mental health
Item
7. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
ability limited
Item
8. Is this child limited or prevented in any way in his or her ability to do the things most children of the same age can do?
boolean
C0085732 (UMLS CUI [1,1])
C0439801 (UMLS CUI [1,2])
C0439801 (UMLS CUI [1,2])
medical condition; ability limited
Item
8. If yes, is this child’s limitation in abilities because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
Duration medical condition; ability limited
Item
8. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
physical therapy; speech therapy; occupational therapy
Item
9. Does this child need or get special therapy, such as physical, occupational, or speech therapy?
boolean
C0949766 (UMLS CUI [1])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
Duration medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. Does this child have any kind of emotional, developmental, or behavioral problem for which he or she needs treatment or counseling?
boolean
C0087111 (UMLS CUI [1,1])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
duration treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. If yes, has his or her emotional, developmental, or behavioral problem lasted or is it expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
first name
Item
First name, initials, or nickname of the next oldest child
text
C1443235 (UMLS CUI [1])
Item
1. Is this child of Hispanic, Latino, or Spanish origin?
text
C0079946 (UMLS CUI [1])
CL Item
No, not of Hispanic, Latino, or Spanish origin (1)
CL Item
Yes, Mexican, Mexican American, Chicano (2)
CL Item
Yes, Puerto Rican (3)
CL Item
Yes, Cuban (4)
CL Item
Yes, another Hispanic, Latino, or Spanish origin (5)
Caucasoid Race child
Item
2. What is this child’s race? White?
boolean
C0007457 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child African American
Item
2. What is this child’s race?Black or African American?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
race child American Indian
Item
2. What is this child’s race? American Indian or Alaska Native?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
race child Asian Indian
Item
2. What is this child’s race?Asian Indian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
race child Chinese
Item
2. What is this child’s race? Chinese?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
Filipino child
Item
2. What is this child’s race? Filipino ?
boolean
C1556093 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Japanese child
Item
2. What is this child’s race? Japanese ?
boolean
C1556094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Korean child
Item
2. What is this child’s race? Korean?
boolean
C1556095 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Vietnamese child
Item
2. What is this child’s race? Vietnamese?
boolean
C1561452 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Asian
Item
2. What is this child’s race? Other Asian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
race child Native Hawaiian
Item
2. What is this child’s race? Native Hawaiian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
Guamanian child
Item
2. What is this child’s race? Guamanian or Chamorro?
boolean
C1553342 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Samoan child
Item
2. What is this child’s race? Samoan?
boolean
C1556103 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Pacific Islander
Item
2. What is this child’s race? Other Pacific Islander?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
Other Race child
Item
2. What is this child’s race? Some other race?
boolean
C0425379 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
age
Item
3. How old is this child? If the child is less than one month old, round age in months to 1.
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
Item
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
text
C0376245 (UMLS CUI [1])
Code List
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
CL Item
Very well (1)
CL Item
Not well (2)
CL Item
Well (3)
CL Item
Not at all (4)
drugs; supplements
Item
6. Does this child CURRENTLY need or use medicine prescribed by a doctor, other than vitamins?
boolean
C0013227 (UMLS CUI [1])
C0242295 (UMLS CUI [2])
C0242295 (UMLS CUI [2])
medical condition; drugs; supplements
Item
6. If yes, is this child’s need for prescription medicine because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
Duration medical condition; drugs; supplements
Item
6. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
medical care; educational services; mental health
Item
7. Does this child need or use more medical care, mental health, or educational services than is usual for most children of the same age?
boolean
C0496675 (UMLS CUI [1])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
medical condition; medical care; educational services; mental health
Item
7. If yes, is this child’s need for medical care, mental health, or educational services because of ANY medical, behavioral, or health condition?
boolean
C0012634 (UMLS CUI [1])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
Duration medical condition; medical care; educational services; mental health
Item
7. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
ability limited
Item
8. Is this child limited or prevented in any way in his or her ability to do the things most children of the same age can do?
boolean
C0085732 (UMLS CUI [1,1])
C0439801 (UMLS CUI [1,2])
C0439801 (UMLS CUI [1,2])
medical condition; ability limited
Item
8. If yes, is this child’s limitation in abilities because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
Duration medical condition; ability limited
Item
8. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
physical therapy; speech therapy; occupational therapy
Item
9. Does this child need or get special therapy, such as physical, occupational, or speech therapy?
boolean
C0949766 (UMLS CUI [1])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
Duration medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. Does this child have any kind of emotional, developmental, or behavioral problem for which he or she needs treatment or counseling?
boolean
C0087111 (UMLS CUI [1,1])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
duration treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. If yes, has his or her emotional, developmental, or behavioral problem lasted or is it expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
first name
Item
First name, initials, or nickname of the next oldest child
text
C1443235 (UMLS CUI [1])
Item
1. Is this child of Hispanic, Latino, or Spanish origin?
text
C0079946 (UMLS CUI [1])
CL Item
No, not of Hispanic, Latino, or Spanish origin (1)
CL Item
Yes, Mexican, Mexican American, Chicano (2)
CL Item
Yes, Puerto Rican (3)
CL Item
Yes, Cuban (4)
CL Item
Yes, another Hispanic, Latino, or Spanish origin (5)
Caucasoid Race child
Item
2. What is this child’s race? White?
boolean
C0007457 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child African American
Item
2. What is this child’s race?Black or African American?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0085756 (UMLS CUI [1,3])
race child American Indian
Item
2. What is this child’s race? American Indian or Alaska Native?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0002460 (UMLS CUI [1,3])
race child Asian Indian
Item
2. What is this child’s race?Asian Indian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C1524069 (UMLS CUI [1,3])
race child Chinese
Item
2. What is this child’s race? Chinese?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0008121 (UMLS CUI [1,3])
Filipino child
Item
2. What is this child’s race? Filipino ?
boolean
C1556093 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Japanese child
Item
2. What is this child’s race? Japanese ?
boolean
C1556094 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Korean child
Item
2. What is this child’s race? Korean?
boolean
C1556095 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Vietnamese child
Item
2. What is this child’s race? Vietnamese?
boolean
C1561452 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Asian
Item
2. What is this child’s race? Other Asian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0078988 (UMLS CUI [1,3])
race child Native Hawaiian
Item
2. What is this child’s race? Native Hawaiian?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0337920 (UMLS CUI [1,3])
Guamanian child
Item
2. What is this child’s race? Guamanian or Chamorro?
boolean
C1553342 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
Samoan child
Item
2. What is this child’s race? Samoan?
boolean
C1556103 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
race child Pacific Islander
Item
2. What is this child’s race? Other Pacific Islander?
boolean
C0034510 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
C0008059 (UMLS CUI [1,2])
C0242191 (UMLS CUI [1,3])
Other Race child
Item
2. What is this child’s race? Some other race?
boolean
C0425379 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
C0008059 (UMLS CUI [1,2])
age
Item
3. How old is this child? If the child is less than one month old, round age in months to 1.
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
Item
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
text
Code List
5. If this child is YOUNGER THAN 4 YEARS OLD, please SKIP to question 6. How well does this child speak English?
CL Item
Very well (1)
CL Item
Not well (2)
CL Item
Well (3)
CL Item
Not at all (4)
drugs; supplements
Item
6. Does this child CURRENTLY need or use medicine prescribed by a doctor, other than vitamins?
boolean
C0013227 (UMLS CUI [1])
C0242295 (UMLS CUI [2])
C0242295 (UMLS CUI [2])
medical condition; drugs; supplements
Item
6. If yes, is this child’s need for prescription medicine because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
Duration medical condition; drugs; supplements
Item
6. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
C0012634 (UMLS CUI [1,2])
C0013227 (UMLS CUI [2])
C0242295 (UMLS CUI [3])
medical care; educational services; mental health
Item
7. Does this child need or use more medical care, mental health, or educational services than is usual for most children of the same age?
boolean
C0496675 (UMLS CUI [1])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
C0587721 (UMLS CUI [2])
C0025353 (UMLS CUI [3])
medical condition; medical care; educational services; mental health
Item
7. If yes, is this child’s need for medical care, mental health, or educational services because of ANY medical, behavioral, or health condition?
boolean
C0012634 (UMLS CUI [1])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
Duration medical condition; medical care; educational services; mental health
Item
7. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0496675 (UMLS CUI [2])
C0587721 (UMLS CUI [3])
C0025353 (UMLS CUI [4])
ability limited
Item
8. Is this child limited or prevented in any way in his or her ability to do the things most children of the same age can do?
boolean
C0085732 (UMLS CUI [1,1])
C0439801 (UMLS CUI [1,2])
C0439801 (UMLS CUI [1,2])
medical condition; ability limited
Item
8. If yes, is this child’s limitation in abilities because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
Duration medical condition; ability limited
Item
8. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
C0012634 (UMLS CUI [1,2])
C0085732 (UMLS CUI [2,1])
C0439801 (UMLS CUI [2,2])
physical therapy; speech therapy; occupational therapy
Item
9. Does this child need or get special therapy, such as physical, occupational, or speech therapy?
boolean
C0949766 (UMLS CUI [1])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
C0037831 (UMLS CUI [2])
C1318464 (UMLS CUI [3])
medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this because of ANY medical, behavioral, or other health condition?
boolean
C0012634 (UMLS CUI [1])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
Duration medical condition; physical therapy; speech therapy; occupational therapy
Item
9. If yes, is this a condition that has lasted or is expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
C0012634 (UMLS CUI [1,2])
C0949766 (UMLS CUI [2])
C0037831 (UMLS CUI [3])
C1318464 (UMLS CUI [4])
treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. Does this child have any kind of emotional, developmental, or behavioral problem for which he or she needs treatment or counseling?
boolean
C0087111 (UMLS CUI [1,1])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
C0010210 (UMLS CUI [1,2])
C0008073 (UMLS CUI [1,3])
C0004930 (UMLS CUI [1,4])
C0233459 (UMLS CUI [1,5])
duration treatment counseling Developmental Disabilities Behavior Disorders Emotional disorder
Item
10. If yes, has his or her emotional, developmental, or behavioral problem lasted or is it expected to last 12 months or longer?
boolean
C0449238 (UMLS CUI [1,1])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
C0087111 (UMLS CUI [1,2])
C0010210 (UMLS CUI [1,3])
C0008073 (UMLS CUI [1,4])
C0004930 (UMLS CUI [1,5])
C0233459 (UMLS CUI [1,6])
Item Group
If there are more than four children 0-17 years old who usually live or stay at this address, list the age and sex for each. Do not repeat information for children already included for Child 1 through Child 4.
C0037047 (UMLS CUI-1)
C1533716 (UMLS CUI-2)
C1533716 (UMLS CUI-2)
First name
Item
Child 5 (Next oldest) First name, initials, or nickname
text
C1443235 (UMLS CUI [1])
Age
Item
Child 5 (Next oldest) Age
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
First name
Item
Child 6 (Next oldest) First name, initials, or nickname
text
C1443235 (UMLS CUI [1])
Age
Item
Child 6 (Next oldest) Age
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
First name
Item
Child 7 (Next oldest) First name, initials, or nickname
text
C1443235 (UMLS CUI [1])
Age
Item
Child 7 (Next oldest) Age
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
First name
Item
Child 8 (Next oldest) First name, initials, or nickname
text
C1443235 (UMLS CUI [1])
Age
Item
Child 8 (Next oldest) Age
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
First name
Item
Child 9 (Next oldest) First name, initials, or nickname
text
C1443235 (UMLS CUI [1])
Age
Item
Child 9 (Next oldest) Age
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
First name
Item
Child 10 (Next oldest) First name, initials, or nickname
text
C1443235 (UMLS CUI [1])
Age
Item
Child 10 (Next oldest) Age
integer
C0001779 (UMLS CUI [1])
CL Item
Male (1)
CL Item
Female (2)
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