Item
1.In general, how would you describe this child’s health (the one named above)?
text
C0018759 (UMLS CUI [1,1])
C0008059 (UMLS CUI [1,2])
Code List
1.In general, how would you describe this child’s health (the one named above)?
Item
2. How would you describe the condition of this child’s teeth?
text
C0018759 (UMLS CUI [1,1])
C0040426 (UMLS CUI [1,2])
Code List
2. How would you describe the condition of this child’s teeth?
CL Item
This child does not have any teeth (1)
Item
3a. How well do each of the following phrases describe this child? This child shows interest and curiosity in learning new things
text
C0870265 (UMLS CUI [1,1])
C0564588 (UMLS CUI [1,2])
Code List
3a. How well do each of the following phrases describe this child? This child shows interest and curiosity in learning new things
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3b. How well do each of the following phrases describe this child? This child works to finish tasks he or she starts
text
C0870265 (UMLS CUI [1,1])
C0205197 (UMLS CUI [1,2])
C3540678 (UMLS CUI [1,3])
Code List
3b. How well do each of the following phrases describe this child? This child works to finish tasks he or she starts
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3c. How well do each of the following phrases describe this child? This child stays calm and in control when faced with a challenge
text
C0870265 (UMLS CUI [1,1])
C0564528 (UMLS CUI [1,2])
Code List
3c. How well do each of the following phrases describe this child? This child stays calm and in control when faced with a challenge
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3d. How well do each of the following phrases describe this child? This child cares about doing well in school
text
C0870265 (UMLS CUI [1,1])
C0036373 (UMLS CUI [1,2])
Code List
3d. How well do each of the following phrases describe this child? This child cares about doing well in school
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3e. How well do each of the following phrases describe this child? This child does all required homework
text
C0870265 (UMLS CUI [1,1])
C4274630 (UMLS CUI [1,2])
Code List
3e. How well do each of the following phrases describe this child? This child does all required homework
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3f. How well do each of the following phrases describe this child? This child is bullied, picked on, or excluded by other children
text
C0870265 (UMLS CUI [1,1])
C0562379 (UMLS CUI [1,2])
Code List
3f. How well do each of the following phrases describe this child? This child is bullied, picked on, or excluded by other children
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3g. How well do each of the following phrases describe this child? This child bullies others, picks on them, or excludes them
text
C0870265 (UMLS CUI [1,1])
C0424318 (UMLS CUI [1,2])
Code List
3g. How well do each of the following phrases describe this child? This child bullies others, picks on them, or excludes them
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
Item
3h. How well do each of the following phrases describe this child? This child argues too much
text
C0870265 (UMLS CUI [1,1])
C0848421 (UMLS CUI [1,2])
Code List
3h. How well do each of the following phrases describe this child? This child argues too much
CL Item
Definitely true (1)
CL Item
Somewhat true (2)
chronic disease Respiration Disorders wheezing
Item
4a. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following?Breathing or other respiratory problems (such as wheezing or shortness of breath)
boolean
C0008679 (UMLS CUI [1,1])
C0035204 (UMLS CUI [1,2])
C0043144 (UMLS CUI [1,3])
chronic disease Eating Disorders Deglutition Disorders
Item
4b. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following? Eating or swallowing because of health condition
boolean
C0008679 (UMLS CUI [1,1])
C0013473 (UMLS CUI [1,2])
C0011168 (UMLS CUI [1,3])
chronic disease Gastrointestinal problem constipation diarrhea
Item
4c. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following?Digesting food, including stomach/ intestinal problems, constipation, or diarrhea
boolean
C0008679 (UMLS CUI [1,1])
C0017187 (UMLS CUI [1,2])
C0009806 (UMLS CUI [1,3])
C0011991 (UMLS CUI [1,4])
chronic disease Headache BODY ACHE
Item
4d. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following? Repeated or chronic physical pain, including headaches or other back or body pain
boolean
C0008679 (UMLS CUI [1,1])
C0018681 (UMLS CUI [1,2])
C0741585 (UMLS CUI [1,3])
chronic disease Toothache
Item
4e. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following? Toothaches
boolean
C0008679 (UMLS CUI [1,1])
C0040460 (UMLS CUI [1,2])
chronic disease Gingival Hemorrhage
Item
4f. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following?Bleeding gums
boolean
C0008679 (UMLS CUI [1,1])
C0017565 (UMLS CUI [1,2])
chronic disease Dental caries
Item
4g. DURING THE PAST 12 MONTHS, has this child had FREQUENT or CHRONIC difficulty with any of the following? Decayed teeth or cavities
boolean
C0008679 (UMLS CUI [1,1])
C0011334 (UMLS CUI [1,2])
difficulty concentrating; Mental condition
Item
5a. Does this child have any of the following? Serious difficulty concentrating, remembering, or making decisions because of a physical, mental, or emotional condition
boolean
C0947509 (UMLS CUI [1])
C3840291 (UMLS CUI [2])
difficulty walking; Difficulty walking up stairs
Item
5b. Does this child have any of the following? Serious difficulty walking or climbing stairs
boolean
C0311394 (UMLS CUI [1])
C0239067 (UMLS CUI [2])
Difficulty dressing; difficulty bathing
Item
5c. Does this child have any of the following? Difficulty dressing or bathing
boolean
C0562886 (UMLS CUI [1])
C1948100 (UMLS CUI [2])
Difficulty doing errands
Item
5d. Does this child have any of the following? Difficulty doing errands alone, such as visiting a doctor’s office or shopping, because of a physical, mental, or emotional condition
boolean
C3481922 (UMLS CUI [1])
hearing problem Deafness
Item
5e. Does this child have any of the following? Deafness or problems with hearing
boolean
C0260662 (UMLS CUI [1,1])
C0011053 (UMLS CUI [1,2])
visual impairment Blindness
Item
5f. Does this child have any of the following? Blindness or problems with seeing, even when wearing glasses
boolean
C3665347 (UMLS CUI [1,1])
C0456909 (UMLS CUI [1,2])
Hypersensitivity
Item
6. Has a doctor or other health care provider EVER told you that this child has Allergies (including food, drug, insect, or other)?
boolean
C0020517 (UMLS CUI [1])
Hypersensitivity
Item
6. If yes, does this child CURRENTLY have the condition?
boolean
C0020517 (UMLS CUI [1])
Item
6. If yes, is it:
text
C0020517 (UMLS CUI [1])
Code List
6. If yes, is it:
Arthritis
Item
7. Has a doctor or other health care provider EVER told you that this child has Arthritis?
boolean
C0003864 (UMLS CUI [1])
Arthritis
Item
7. If yes, does this child CURRENTLY have the condition?
boolean
C0003864 (UMLS CUI [1])
Item
7. If yes, is it:
text
C0003864 (UMLS CUI [1])
Code List
7. If yes, is it:
Asthma
Item
8. Has a doctor or other health care provider EVER told you that this child has Asthma?
boolean
C0004096 (UMLS CUI [1])
Asthma
Item
8. If yes, does this child CURRENTLY have the condition?
boolean
C0004096 (UMLS CUI [1])
Item
8. If yes, is it:
text
C0004096 (UMLS CUI [1])
Code List
8. If yes, is it:
Hematological Disease Sickle Cell Disease Thalassemia Hemophilia
Item
9. Has a doctor or other health care provider EVER told you that this child has Blood Disorders (such as Sickle Cell Disease, Thalassemia, or Hemophilia)?
boolean
C0018939 (UMLS CUI [1,1])
C0002895 (UMLS CUI [1,2])
C0039730 (UMLS CUI [1,3])
C0684275 (UMLS CUI [1,4])
Hematological Disease Sickle Cell Disease Thalassemia Hemophilia
Item
9. If yes, does this child CURRENTLY have the condition?
boolean
C0018939 (UMLS CUI [1,1])
C0002895 (UMLS CUI [1,2])
C0039730 (UMLS CUI [1,3])
C0684275 (UMLS CUI [1,4])
Item
9. f yes, is it:
text
C0018939 (UMLS CUI [1,1])
C0002895 (UMLS CUI [1,2])
C0039730 (UMLS CUI [1,3])
C0684275 (UMLS CUI [1,4])
Code List
9. f yes, is it:
Brain Injury Concussion head injury
Item
10. Has a doctor or other health care provider EVER told you that this child has Brain Injury, Concussion or head injury?
boolean
C0270611 (UMLS CUI [1,1])
C0006107 (UMLS CUI [1,2])
C0018674 (UMLS CUI [1,3])
Brain Injury Concussion head injury
Item
10. If yes, does this child CURRENTLY have the condition?
boolean
C0270611 (UMLS CUI [1,1])
C0006107 (UMLS CUI [1,2])
C0018674 (UMLS CUI [1,3])
Item
10. f yes, is it:
text
C0270611 (UMLS CUI [1,1])
C0006107 (UMLS CUI [1,2])
C0018674 (UMLS CUI [1,3])
Code List
10. f yes, is it:
Cerebral Palsy
Item
11. Has a doctor or other health care provider EVER told you that this child has Cerebral Palsy?
boolean
C0007789 (UMLS CUI [1])
Cerebral Palsy
Item
11. If yes, does this child CURRENTLY have the condition?
boolean
C0007789 (UMLS CUI [1])
Item
11. If yes, is it:
text
C0007789 (UMLS CUI [1])
Code List
11. If yes, is it:
Cystic Fibrosis
Item
12. Has a doctor or other health care provider EVER told you that this child has Cystic Fibrosis?
boolean
C0010674 (UMLS CUI [1])
Cystic Fibrosis
Item
12. If yes, does this child CURRENTLY have the condition?
boolean
C0010674 (UMLS CUI [1])
Item
12. If yes, is it:
text
C0010674 (UMLS CUI [1])
Code List
12. If yes, is it:
Diabetes
Item
13. Has a doctor or other health care provider EVER told you that this child has Diabetes?
boolean
C0011847 (UMLS CUI [1])
Diabetes
Item
13. If yes, does this child CURRENTLY have the condition?
boolean
C0011847 (UMLS CUI [1])
Item
13. If yes, is it:
text
C0011847 (UMLS CUI [1])
Code List
13. If yes, is it:
Down Syndrome
Item
14. Has a doctor or other health care provider EVER told you that this child has Down Syndrome?
boolean
C0013080 (UMLS CUI [1])
Down Syndrome
Item
14. If yes, does this child CURRENTLY have the condition?
boolean
C0013080 (UMLS CUI [1])
Item
14. If yes, is it:
text
C0013080 (UMLS CUI [1])
Code List
14. If yes, is it:
Epilepsy Seizure Disorder
Item
15. Has a doctor or other health care provider EVER told you that this child has Epilepsy or Seizure Disorder?
boolean
C0014544 (UMLS CUI [1,1])
C0036572 (UMLS CUI [1,2])
Epilepsy Seizure Disorder
Item
15. If yes, does this child CURRENTLY have the condition?
boolean
C0014544 (UMLS CUI [1,1])
C0036572 (UMLS CUI [1,2])
Item
15. If yes, is it:
text
C0014544 (UMLS CUI [1,1])
C0036572 (UMLS CUI [1,2])
Code List
15. If yes, is it:
Heart Condition
Item
16. Has a doctor or other health care provider EVER told you that this child has Heart Condition?
boolean
C3842523 (UMLS CUI [1])
Heart Condition
Item
16. If yes, does this child CURRENTLY have the condition?
boolean
C3842523 (UMLS CUI [1])
Item
16. If yes, is it:
text
C3842523 (UMLS CUI [1])
Code List
16. If yes, is it:
Severe Headaches Migraine
Item
17. Has a doctor or other health care provider EVER told you that this child has Frequent or Severe Headaches, including Migraine?
boolean
C2957106 (UMLS CUI [1,1])
C0149931 (UMLS CUI [1,2])
Severe Headaches Migraine
Item
17. If yes, does this child CURRENTLY have the condition?
boolean
C2957106 (UMLS CUI [1,1])
C0149931 (UMLS CUI [1,2])
Item
17. If yes, is it:
text
C2957106 (UMLS CUI [1,1])
C0149931 (UMLS CUI [1,2])
Code List
17. If yes, is it:
Tourette Syndrome
Item
18. Has a doctor or other health care provider EVER told you that this child has Tourette Syndrome?
boolean
C0040517 (UMLS CUI [1])
Tourette Syndrome
Item
18. If yes, does this child CURRENTLY have the condition?
boolean
C0040517 (UMLS CUI [1])
Item
18. If yes, is it:
text
C0040517 (UMLS CUI [1])
Code List
18. If yes, is it:
Anxiety Problem
Item
19. Has a doctor or other health care provider EVER told you that this child has Anxiety Problems?
boolean
C1387808 (UMLS CUI [1])
Anxiety Problem
Item
19. If yes, does this child CURRENTLY have the condition?
boolean
C1387808 (UMLS CUI [1])
Item
19. If yes, is it:
text
C1387808 (UMLS CUI [1])
Code List
19. If yes, is it:
Depression
Item
20. Has a doctor or other health care provider EVER told you that this child has Depression?
boolean
C0011581 (UMLS CUI [1])
Depression
Item
20. If yes, does this child CURRENTLY have the condition?
boolean
C0011581 (UMLS CUI [1])
Item
20. If yes, is it:
text
C0011581 (UMLS CUI [1])
Code List
20. If yes, is it:
Hereditary Diseases
Item
21. Has a doctor or other health care provider EVER told you that this child has Other Genetic or Inherited Condition?
boolean
C0019247 (UMLS CUI [1])
Hereditary Diseases
Item
21. If yes, does this child CURRENTLY have the condition?
boolean
C0019247 (UMLS CUI [1])
Item
21. If yes, is it:
text
C0019247 (UMLS CUI [1])
Code List
21. If yes, is it:
Behavioral disorder
Item
22. Has a doctor, other health care provider, or educator EVER told you that this child has Behavioral or Conduct Problems?
boolean
C0004930 (UMLS CUI [1])
Behavioral disorder
Item
22. If yes, does this child CURRENTLY have the condition?
boolean
C0004930 (UMLS CUI [1])
Item
22. If yes, is it:
text
C0004930 (UMLS CUI [1])
Code List
22. If yes, is it:
Substance Abuse Disorder
Item
23. Has a doctor, other health care provider, or educator EVER told you that this child has: Substance Abuse Disorder?
boolean
C0038586 (UMLS CUI [1])
Substance Abuse Disorder
Item
23. If yes, does this child CURRENTLY have the condition?
boolean
C0038586 (UMLS CUI [1])
Item
23. If yes, is it:
text
C0038586 (UMLS CUI [1])
Code List
23. If yes, is it:
Developmental Delay
Item
24. Has a doctor, other health care provider, or educator EVER told you that this child has Developmental Delay?
boolean
C0424605 (UMLS CUI [1])
Developmental Delay
Item
24. If yes, does this child CURRENTLY have the condition?
boolean
C0424605 (UMLS CUI [1])
Item
24. If yes, is it:
text
C0424605 (UMLS CUI [1])
Code List
24. If yes, is it:
Intellectual Disability Mental Retardation
Item
25. Has a doctor, other health care provider, or educator EVER told you that this child has Intellectual Disability (also known as Mental Retardation)?
boolean
C3714756 (UMLS CUI [1,1])
C0025362 (UMLS CUI [1,2])
Intellectual Disability Mental Retardation
Item
25. If yes, does this child CURRENTLY have the condition?
boolean
C3714756 (UMLS CUI [1,1])
C0025362 (UMLS CUI [1,2])
Item
25. If yes, is it:
text
C3714756 (UMLS CUI [1,1])
C0025362 (UMLS CUI [1,2])
Code List
25. If yes, is it:
Speech disorder
Item
26. Has a doctor, other health care provider, or educator EVER told you that this child has Speech or Other Language Disorder?
boolean
C0037822 (UMLS CUI [1])
Speech disorder
Item
26. If yes, does this child CURRENTLY have the condition?
boolean
C0037822 (UMLS CUI [1])
Item
26. If yes, is it:
text
C0037822 (UMLS CUI [1])
Code List
26. If yes, is it:
Learning Disability
Item
27. Has a doctor, other health care provider, or educator EVER told you that this child has Learning Disability?
boolean
C0751265 (UMLS CUI [1])
Learning Disability
Item
27. If yes, does this child CURRENTLY have the condition?
boolean
C0751265 (UMLS CUI [1])
Item
27. If yes, is it:
text
C0751265 (UMLS CUI [1])
Code List
27. If yes, is it:
mental condition
Item
28. Has a doctor or other health care provider EVER told you that this child has any other Mental Health Condition?
boolean
C3840291 (UMLS CUI [1])
mental condition
Item
28. If yes, specify:
text
C3840291 (UMLS CUI [1])
mental condition
Item
28. If yes, does this child CURRENTLY have the condition?
boolean
C3840291 (UMLS CUI [1])
Item
28.If yes, is it:
text
C3840291 (UMLS CUI [1])
Code List
28.If yes, is it:
Autism Spectrum Disorder
Item
29. Has a doctor or other health care provider EVER told you that this child has Autism or Autism Spectrum Disorder (ASD)? Include diagnoses of Asperger’s Disorder or Pervasive Developmental Disorder (PDD).
boolean
C1510586 (UMLS CUI [1])
Autism Spectrum Disorder
Item
29. If yes, does this child CURRENTLY have the condition?
boolean
C1510586 (UMLS CUI [1])
Item
29. If yes, is it:
text
C1510586 (UMLS CUI [1])
Code List
29. If yes, is it:
age
Item
30. How old was this child when a doctor or other health care provider FIRST told you that he or she had Autism, ASD, Asperger’s Disorder or PDD?
integer
C0001779 (UMLS CUI [1])
Item
31. What type of doctor or other health care provider was the FIRST to tell you that this child had Autism, ASD, Asperger’s Disorder or PDD?
text
C0031831 (UMLS CUI [1])
Code List
31. What type of doctor or other health care provider was the FIRST to tell you that this child had Autism, ASD, Asperger’s Disorder or PDD?
CL Item
Primary Care Provider (1)
CL Item
School Psychologist/ Counselor (3)
CL Item
Other Psychologist (Non-School) (4)
CL Item
Other, specify (6)
other physician
Item
31. If other, specify:
text
C0205394 (UMLS CUI [1,1])
C0031831 (UMLS CUI [1,2])
medication Autism Spectrum Disorder
Item
32. Is this child CURRENTLY taking medication for Autism, ASD, Asperger’s Disorder or PDD?
boolean
C0013227 (UMLS CUI [1,1])
C1510586 (UMLS CUI [1,2])
Behavior Therapy Autism Spectrum Disorder
Item
33. At any time DURING THE PAST 12 MONTHS, did this child receive behavioral treatment for Autism, ASD, Asperger’s Disorder or PDD, such as training or an intervention that you or this child received to help with his or her behavior?
boolean
C0004933 (UMLS CUI [1,1])
C1510586 (UMLS CUI [1,2])
Attention deficit hyperactivity disorder
Item
34. Has a doctor or other health care provider EVER told you that this child has Attention Deficit Disorder or Attention Deficit/Hyperactivity Disorder, that is, ADD or ADHD?
boolean
C1263846 (UMLS CUI [1])
Attention deficit hyperactivity disorder
Item
34. If yes, does this child CURRENTLY have the condition?
boolean
C1263846 (UMLS CUI [1])
Item
34. If yes, is it:
text
C1263846 (UMLS CUI [1])
Code List
34. If yes, is it:
medication Attention deficit hyperactivity disorder
Item
35. Is this child currently taking medication for ADD or ADHD?
boolean
C0013227 (UMLS CUI [1,1])
C1263846 (UMLS CUI [1,2])
Behavior Therapy Attention deficit hyperactivity disorder
Item
36. At any time DURING THE PAST 12 MONTHS, did this child receive behavioral treatment for ADD or ADHD, such as training or an intervention that you or this child received to help with his or her behavior?
boolean
C0004933 (UMLS CUI [1,1])
C1263846 (UMLS CUI [1,2])
Item
37. DURING THE PAST 12 MONTHS, how often have this child’s health conditions or problems affected his or her ability to do things other children his or her age do?
text
C2707304 (UMLS CUI [1,1])
C0001721 (UMLS CUI [1,2])
C0085732 (UMLS CUI [1,3])
Code List
37. DURING THE PAST 12 MONTHS, how often have this child’s health conditions or problems affected his or her ability to do things other children his or her age do?
CL Item
This child does not have any conditions ➔ SKIP to question B1 (1)
Item
38. To what extent do this child’s health conditions or problems affect his or her ability to do things?
text
C2707304 (UMLS CUI [1,1])
C0001721 (UMLS CUI [1,2])
C0085732 (UMLS CUI [1,3])
Code List
38. To what extent do this child’s health conditions or problems affect his or her ability to do things?