ID

40382

Description

Silva, L. M. T., & Schalock, M. . (2012) . Sense and Self-Regulation Checklist (SSC) . Measurement Instrument Database for the Social Science. Retrieved 06.03.2020 from www.midss.ie Key references: Silva, L. M. T., & Schalock, M. (2012). Sense and self-regulation checklist, a measure of comorbid autism symptoms: Initial psychometric evidence. The American Journal of Occupational Therapy, 66, 177-186. Primary use / Purpose: This instrument was designed as a parent/caregiver measure of comorbid symptoms in autism. Background: Comorbid symptoms are common in autism spectrum disorder are associated with increased autism severity. Comorbid symptoms include abnormal sensory responses, sleep disruption, gastrointestinal problems, self-injurious behaviours, aggression, and irritability. It is recommended that comorbid symptoms are identified and treated from the time of autism diagnosis. The SSC was developed following extensive interviews of parents of children with autism about their child's sensory and self-regulatory responses to ordinary, daily-life situations. It contains six sensory subdomains (touch-pain, auditory, visual, taste-smell, hyperreactive to noninjurious stimuli, and hyporeactive to injurious stimuli). Items are rated never (0), rarely (1), sometimes (2), or often (3). Domain scores are obtained by summing the individual items. The SSC has been shown to be a valid measure of sensory and self-regulatory difficulties for children under 6 years of age. It can be used as a treatment outcome measure for children with autism. It can also be used to identify patterns of sensory and self-regulatory of sensory and self-regulatory difficulties in young children with other disabilities. The SSC caregiver report is suitable for use by caregivers who have an elementary school education and is available in English, Spanish, and Chinese. Psychometrics: Acceptable internal consistency and test-retest reliability has been demonstrated (Silva & Schalock, 2012). Instructions: 1. Write the date, name of your child, and who is completing the checklist. (It is very important that the same parent/caretaker complete the form each time the form is used.) 2. Circle the response for each item that most accurately describes your child. 3. Add all of the numbers circled. 4. Write total into the space provided

Link

www.midss.ie

Keywords

  1. 3/30/20 3/30/20 -
  2. 4/16/20 4/16/20 -
Copyright Holder

Silva, L. M. T., & Schalock, M.

Uploaded on

April 16, 2020

DOI

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License

Creative Commons BY-NC 4.0

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Measurement Instrument Database for the Social Science (MIDSS)

Sense and Self-Regulation Checklist (SSC)

TOUCH/PAIN
Description

TOUCH/PAIN

Alias
UMLS CUI-1
C0030193
UMLS CUI-2
C0702221
Does not cry tears when hurt.
Description

Crying negative

Data type

integer

Alias
UMLS CUI [1,1]
C0010399
UMLS CUI [1,2]
C0030193
UMLS CUI [1,3]
C0205160
Doesn’t notice if the diaper is wet or dirty.
Description

Diaper

Data type

integer

Alias
UMLS CUI [1,1]
C0426371
UMLS CUI [1,2]
C0180416
UMLS CUI [2,1]
C0474499
UMLS CUI [2,2]
C0180416
UMLS CUI [3,1]
C0426371
UMLS CUI [3,2]
C0474499
UMLS CUI [3,3]
C0205430
UMLS CUI [3,4]
C0180416
Face washing is difficult.
Description

Face washing

Data type

integer

Alias
UMLS CUI [1,1]
C0015450
UMLS CUI [1,2]
C0441648
UMLS CUI [1,3]
C0332218
Haircuts are difficult
Description

Haircuts

Data type

integer

Alias
UMLS CUI [1,1]
C0332218
UMLS CUI [1,2]
C3697748
Refuses to wear a hat.
Description

Refuses hats

Data type

integer

Alias
UMLS CUI [1,1]
C1705116
UMLS CUI [1,2]
C0444765
Prefers to wear a hat.
Description

Prefers hats

Data type

integer

Alias
UMLS CUI [1,1]
C0444765
UMLS CUI [1,2]
C0558295
Cutting fingernails is difficult.
Description

Cutting fingernails

Data type

integer

Alias
UMLS CUI [1,1]
C0332218
UMLS CUI [1,2]
C3496294
UMLS CUI [1,3]
C0222001
Prefers to wear one or two gloves.
Description

Prefers gloves

Data type

integer

Alias
UMLS CUI [1,1]
C0558295
UMLS CUI [1,2]
C0441051
UMLS CUI [1,3]
C0205448
UMLS CUI [2,1]
C0558295
UMLS CUI [2,2]
C0441051
UMLS CUI [2,3]
C0205447
Avoids wearing gloves
Description

Avoids gloves

Data type

integer

Alias
UMLS CUI [1,1]
C0441051
UMLS CUI [1,2]
C0870186
Cutting toenails is difficult.
Description

Cutting toenails

Data type

integer

Alias
UMLS CUI [1,1]
C0332218
UMLS CUI [1,2]
C3496294
UMLS CUI [1,3]
C0222007
Will only wear certain footwear (e.g. loose shoes, no socks).
Description

Footwear

Data type

integer

Alias
UMLS CUI [1,1]
C0336894
UMLS CUI [1,2]
C0205369
UMLS CUI [1,3]
C1548966
Prefers to wear the same clothes day after day.
Description

Prefers the same clothes

Data type

integer

Alias
UMLS CUI [1,1]
C0558295
UMLS CUI [1,2]
C0009072
UMLS CUI [1,3]
C0445247
UMLS CUI [1,4]
C0332173
Will only wear certain clothes (e.g. no elastic, not tight, no tags, long or short sleeves)
Description

Certain clothes

Data type

integer

Alias
UMLS CUI [1,1]
C0009072
UMLS CUI [1,2]
C0205369
UMLS CUI [1,3]
C1548966
Cries tears when falls, scrapes skin, or gets hurt.
Description

(scale is reversed on purpose)

Data type

integer

Alias
UMLS CUI [1,1]
C0010399
UMLS CUI [1,2]
C0030193
UMLS CUI [1,3]
C1446409
Head bangs on a hard surface
Description

Head bangs on a hard surface

Data type

integer

Alias
UMLS CUI [1,1]
C0018672
UMLS CUI [1,2]
C0205148
UMLS CUI [1,3]
C0018599
Head bangs on a soft surface
Description

Head bangs on a soft surface

Data type

integer

Alias
UMLS CUI [1,1]
C0018672
UMLS CUI [1,2]
C0205148
UMLS CUI [1,3]
C0205358
Self-regulation – Orientation/Attention/Self-soothing/Sleep
Description

Self-regulation – Orientation/Attention/Self-soothing/Sleep

Alias
UMLS CUI-1
C0684274
UMLS CUI-2
C0029266
UMLS CUI-3
C0004268
UMLS CUI-4
C0517080
UMLS CUI-5
C0037313
Has to be prompted to make eye contact when spoken to
Description

Eye contact upon beeing spoken to

Data type

integer

Alias
UMLS CUI [1,1]
C0870532
UMLS CUI [1,2]
C0871157
UMLS CUI [1,3]
C2370895
Seems not to notice when spoken to in a normal voice
Description

Seems not to notice when spoken to in a normal voice

Data type

integer

Alias
UMLS CUI [1,1]
C2370895
UMLS CUI [1,2]
C0004448
UMLS CUI [1,3]
C0205160
UMLS CUI [1,4]
C0234759
Does not respond to name
Description

Does not respond to name

Data type

integer

Alias
UMLS CUI [1]
C2317765
Does not notice or react when tapped on the back
Description

Does not notice or react when tapped on the back

Data type

integer

Alias
UMLS CUI [1,1]
C0004448
UMLS CUI [1,2]
C0205160
UMLS CUI [1,3]
C0004600
UMLS CUI [1,4]
C0702221
UMLS CUI [2,1]
C0442740
UMLS CUI [2,2]
C0004600
UMLS CUI [2,3]
C0702221
Does not roll over onto the back when asked
Description

Does not roll over onto the back when asked

Data type

integer

Alias
UMLS CUI [1,1]
C0560482
UMLS CUI [1,2]
C0004600
UMLS CUI [1,3]
C1705178
Stares off into space
Description

Stares off into space

Data type

integer

Alias
UMLS CUI [1,1]
C0011018
UMLS CUI [1,2]
C0423086
Seems unaware when others are hurt
Description

Seems unaware when others are hurt

Data type

integer

Alias
UMLS CUI [1,1]
C0004448
UMLS CUI [1,2]
C0205160
UMLS CUI [1,3]
C4061918
UMLS CUI [1,4]
C0021797
Has difficulty calming him/herself when upset
Description

Has difficulty calming him/herself when upset

Data type

integer

Alias
UMLS CUI [1,1]
C0517080
UMLS CUI [1,2]
C1299586
UMLS CUI [1,3]
C3887804
Gets upset or tantrums when asked to make a transition
Description

Gets upset or tantrums when asked to make a transition

Data type

integer

Alias
UMLS CUI [1,1]
C3887804
UMLS CUI [1,2]
C1705178
UMLS CUI [1,3]
C2700061
UMLS CUI [2,1]
C0233558
UMLS CUI [2,2]
C1705178
UMLS CUI [2,3]
C2700061
Has difficulty falling asleep at bedtime
Description

Has difficulty falling asleep at bedtime

Data type

integer

Alias
UMLS CUI [1,1]
C0393760
UMLS CUI [1,2]
C0521112
Has difficulty falling back asleep when awakens during the night
Description

Has difficulty falling back asleep when awakens during the night

Data type

integer

Alias
UMLS CUI [1]
C0393761
Awakens very early and stays awake
Description

Awakens very early and stays awake

Data type

integer

Alias
UMLS CUI [1]
C0541798
Has difficulty awakening in morning
Description

Has difficulty awakening in morning

Data type

integer

Alias
UMLS CUI [1]
C4065477
Makes little jokes
Description

(Answer only if your child has language.) (scale is reversed on purpose)

Data type

integer

Alias
UMLS CUI [1,1]
C0871981
UMLS CUI [1,2]
C2937276
VISION
Description

VISION

Alias
UMLS CUI-1
C0042789
Looks at objects out of sides of eyes
Description

Looks at objects out of sides of eyes

Data type

integer

Alias
UMLS CUI [1,1]
C0016183
UMLS CUI [1,2]
C0347997
UMLS CUI [1,3]
C0015392
UMLS CUI [1,4]
C0441987
Is bothered by certain lights
Description

Is bothered by certain lights

Data type

integer

Alias
UMLS CUI [1]
C1698258
Self-regulation – Behavior: Irritability, Aggression, Selfinjurious
Description

Self-regulation – Behavior: Irritability, Aggression, Selfinjurious

Alias
UMLS CUI-1
C0684274
UMLS CUI-2
C0004927
UMLS CUI-3
C0022107
UMLS CUI-4
C0178360
UMLS CUI-5
C0424323
Tantrums or meltdowns
Description

Tantrums or meltdowns

Data type

integer

Alias
UMLS CUI [1,1]
C0004927
UMLS CUI [1,2]
C0233558
UMLS CUI [2,1]
C0004927
UMLS CUI [2,2]
C0221508
Tantrums last ______ minutes
Description

Tantrums duration

Data type

integer

Alias
UMLS CUI [1,1]
C0233558
UMLS CUI [1,2]
C0449238
UMLS CUI [1,3]
C0439232
Tantrums occur _____ times/day
Description

Tantrums frequency

Data type

integer

Alias
UMLS CUI [1,1]
C0439603
UMLS CUI [1,2]
C0439511
UMLS CUI [1,3]
C0233558
Cries easily when frustrated
Description

Cries easily when frustrated

Data type

integer

Alias
UMLS CUI [1,1]
C0424110
UMLS CUI [1,2]
C0016770
Hits or kicks others
Description

Hits or kicks others

Data type

integer

Alias
UMLS CUI [1,1]
C0424323
UMLS CUI [1,2]
C0562583
UMLS CUI [2,1]
C0424323
UMLS CUI [2,2]
C3662012
Scratches or pulls other’s hair
Description

Scratches or pulls other’s hair

Data type

integer

Alias
UMLS CUI [1,1]
C0424323
UMLS CUI [1,2]
C0562594
UMLS CUI [2,1]
C0424323
UMLS CUI [2,2]
C0562591
Bites others
Description

Bites others

Data type

integer

Alias
UMLS CUI [1,1]
C0424323
UMLS CUI [1,2]
C0562590
Throws things at others
Description

Throws things at others

Data type

integer

Alias
UMLS CUI [1,1]
C0424323
UMLS CUI [1,2]
C0565696
UMLS CUI [1,3]
C0037420
Pulls own hair
Description

Pulls own hair

Data type

integer

Alias
UMLS CUI [1,1]
C0178360
UMLS CUI [1,2]
C0563036
Pulls own hair: Where on the head?
Description

Pulls own hair: where

Data type

text

Alias
UMLS CUI [1,1]
C0178360
UMLS CUI [1,2]
C0563036
UMLS CUI [1,3]
C1515974
Bites self
Description

Bites self

Data type

integer

Alias
UMLS CUI [1,1]
C0178360
UMLS CUI [1,2]
C0424375
Bites self: Which part of the body (e.g. left thumb)?
Description

Bites self: where

Data type

text

Alias
UMLS CUI [1,1]
C0178360
UMLS CUI [1,2]
C0424375
UMLS CUI [1,3]
C1515974
Hits self
Description

Hits self

Data type

integer

Alias
UMLS CUI [1,1]
C0178360
UMLS CUI [1,2]
C0562716
Hits self: Which part of the body?
Description

Hits self: where

Data type

text

Alias
UMLS CUI [1,1]
C0178360
UMLS CUI [1,2]
C0562716
UMLS CUI [1,3]
C1515974
Gets aggressive or ‘hyper’ with exposure to certain smells
Description

Gets aggressive or ‘hyper’ with exposure to certain smells

Data type

integer

Alias
UMLS CUI [1,1]
C0001807
UMLS CUI [1,2]
C0037361
UMLS CUI [1,3]
C0205369
HEARING
Description

HEARING

Alias
UMLS CUI-1
C0018767
Reacts poorly to certain everyday noises
Description

Reacts poorly to certain everyday noises

Data type

integer

Alias
UMLS CUI [1,1]
C0443286
UMLS CUI [1,2]
C0205169
UMLS CUI [1,3]
C0028263
UMLS CUI [1,4]
C0205369
UMLS CUI [1,5]
C0205214
Covers ears with certain sounds
Description

Covers ears with certain sounds

Data type

integer

Alias
UMLS CUI [1,1]
C1545588
UMLS CUI [1,2]
C0013443
UMLS CUI [1,3]
C0205369
UMLS CUI [1,4]
C0037709
Reacts strongly when others cry loudly or scream
Description

Reacts strongly when others cry loudly or scream

Data type

integer

Alias
UMLS CUI [1,1]
C0443286
UMLS CUI [1,2]
C0442821
UMLS CUI [1,3]
C0021797
UMLS CUI [1,4]
C2185952
UMLS CUI [2,1]
C0443286
UMLS CUI [2,2]
C0442821
UMLS CUI [2,3]
C0021797
UMLS CUI [2,4]
C0521008
Is startled by sudden noises
Description

Is startled by sudden noises

Data type

integer

Alias
UMLS CUI [1,1]
C0015726
UMLS CUI [1,2]
C1276802
UMLS CUI [1,3]
C0028263
Self-regulation – Toilet Training
Description

Self-regulation – Toilet Training

Alias
UMLS CUI-1
C0684274
UMLS CUI-2
C0040365
Is dry at night
Description

(scale is reversed on purpose)

Data type

integer

Alias
UMLS CUI [1,1]
C0040365
UMLS CUI [1,2]
C0876938
UMLS CUI [1,3]
C0240526
Diaper is wet in the morning
Description

Diaper is wet in the morning

Data type

integer

Alias
UMLS CUI [1,1]
C0180416
UMLS CUI [1,2]
C0042036
UMLS CUI [1,3]
C0332170
Wears a diaper during the day
Description

Wears a diaper during the day

Data type

integer

Alias
UMLS CUI [1,1]
C2203007
UMLS CUI [1,2]
C0585022
Is toilet trained
Description

(scale is reversed on purpose)

Data type

integer

Alias
UMLS CUI [1]
C0700127
TASTE/SMELL
Description

TASTE/SMELL

Alias
UMLS CUI-1
C0039336
UMLS CUI-2
C0037361
Gags with certain smells
Description

Gags with certain smells

Data type

integer

Alias
UMLS CUI [1,1]
C0016927
UMLS CUI [1,2]
C0205369
UMLS CUI [1,3]
C0037361
Avoids foods with certain textures
Description

Avoids foods with certain textures

Data type

integer

Alias
UMLS CUI [1,1]
C0870186
UMLS CUI [1,2]
C0016452
UMLS CUI [1,3]
C0205369
UMLS CUI [1,4]
C0449582
Tooth brushing is difficult
Description

Tooth brushing is difficult

Data type

integer

Alias
UMLS CUI [1]
C2135846
Mouths or chews objects
Description

Mouths or chews objects

Data type

integer

Alias
UMLS CUI [1]
C2584309
UMLS CUI [2,1]
C0024888
UMLS CUI [2,2]
C0347997
Self-regulation - Digestion
Description

Self-regulation - Digestion

Alias
UMLS CUI-1
C0684274
UMLS CUI-2
C0012238
Will only eat familiar foods
Description

Will only eat familiar foods

Data type

integer

Alias
UMLS CUI [1,1]
C0016468
UMLS CUI [1,2]
C0453817
UMLS CUI [1,3]
C0205171
Does not seem to be interested in food
Description

Does not seem to be interested in food

Data type

integer

Alias
UMLS CUI [1,1]
C2183819
UMLS CUI [1,2]
C0016452
Eats very few foods (five to ten items)
Description

Eats very few foods (five to ten items)

Data type

integer

Alias
UMLS CUI [1,1]
C0013470
UMLS CUI [1,2]
C0205388
UMLS CUI [1,3]
C0016452
Bowels are loose
Description

Bowels are loose

Data type

integer

Alias
UMLS CUI [1]
C2129214
Bowel movements (“poops”) are frequent (more than 3 per day)
Description

Bowel movements (“poops”) are frequent (more than 3 per day)

Data type

integer

Alias
UMLS CUI [1]
C4288986
Requires regular use of laxative to avoid constipation
Description

Requires regular use of laxative to avoid constipation

Data type

integer

Alias
UMLS CUI [1,1]
C0199176
UMLS CUI [1,2]
C0009806
UMLS CUI [1,3]
C0240170
UMLS CUI [1,4]
C1514873
UMLS CUI [1,5]
C0332183
Bowel movement (“poop”) is hard and dry
Description

Bowel movement (“poop”) is hard and dry

Data type

integer

Alias
UMLS CUI [1,1]
C0278016
UMLS CUI [1,2]
C0474605
Has a bowel movement every other day
Description

Has a bowel movement every other day

Data type

integer

Alias
UMLS CUI [1,1]
C0426642
UMLS CUI [1,2]
C0558287
Has a bowel movement twice a week
Description

Has a bowel movement twice a week

Data type

integer

Alias
UMLS CUI [1,1]
C0556985
UMLS CUI [1,2]
C0426642
Has a bowel movement once a week
Description

Has a bowel movement once a week

Data type

integer

Alias
UMLS CUI [1,1]
C0426642
UMLS CUI [1,2]
C0558293
Bowel movements are often green
Description

Bowel movements are often green

Data type

integer

Alias
UMLS CUI [1,1]
C0474583
UMLS CUI [1,2]
C0332183

Similar models

Sense and Self-Regulation Checklist (SSC)

Name
Type
Description | Question | Decode (Coded Value)
Data type
Alias
Item Group
TOUCH/PAIN
C0030193 (UMLS CUI-1)
C0702221 (UMLS CUI-2)
Item
Does not cry tears when hurt.
integer
C0010399 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
C0205160 (UMLS CUI [1,3])
Code List
Does not cry tears when hurt.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Doesn’t notice if the diaper is wet or dirty.
integer
C0426371 (UMLS CUI [1,1])
C0180416 (UMLS CUI [1,2])
C0474499 (UMLS CUI [2,1])
C0180416 (UMLS CUI [2,2])
C0426371 (UMLS CUI [3,1])
C0474499 (UMLS CUI [3,2])
C0205430 (UMLS CUI [3,3])
C0180416 (UMLS CUI [3,4])
Code List
Doesn’t notice if the diaper is wet or dirty.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Face washing is difficult.
integer
C0015450 (UMLS CUI [1,1])
C0441648 (UMLS CUI [1,2])
C0332218 (UMLS CUI [1,3])
Code List
Face washing is difficult.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Haircuts are difficult
integer
C0332218 (UMLS CUI [1,1])
C3697748 (UMLS CUI [1,2])
Code List
Haircuts are difficult
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Refuses to wear a hat.
integer
C1705116 (UMLS CUI [1,1])
C0444765 (UMLS CUI [1,2])
Code List
Refuses to wear a hat.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Prefers to wear a hat.
integer
C0444765 (UMLS CUI [1,1])
C0558295 (UMLS CUI [1,2])
Code List
Prefers to wear a hat.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Cutting fingernails is difficult.
integer
C0332218 (UMLS CUI [1,1])
C3496294 (UMLS CUI [1,2])
C0222001 (UMLS CUI [1,3])
Code List
Cutting fingernails is difficult.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Prefers to wear one or two gloves.
integer
C0558295 (UMLS CUI [1,1])
C0441051 (UMLS CUI [1,2])
C0205448 (UMLS CUI [1,3])
C0558295 (UMLS CUI [2,1])
C0441051 (UMLS CUI [2,2])
C0205447 (UMLS CUI [2,3])
Code List
Prefers to wear one or two gloves.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Avoids wearing gloves
integer
C0441051 (UMLS CUI [1,1])
C0870186 (UMLS CUI [1,2])
Code List
Avoids wearing gloves
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Cutting toenails is difficult.
integer
C0332218 (UMLS CUI [1,1])
C3496294 (UMLS CUI [1,2])
C0222007 (UMLS CUI [1,3])
Code List
Cutting toenails is difficult.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Will only wear certain footwear (e.g. loose shoes, no socks).
integer
C0336894 (UMLS CUI [1,1])
C0205369 (UMLS CUI [1,2])
C1548966 (UMLS CUI [1,3])
Code List
Will only wear certain footwear (e.g. loose shoes, no socks).
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Prefers to wear the same clothes day after day.
integer
C0558295 (UMLS CUI [1,1])
C0009072 (UMLS CUI [1,2])
C0445247 (UMLS CUI [1,3])
C0332173 (UMLS CUI [1,4])
Code List
Prefers to wear the same clothes day after day.
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Will only wear certain clothes (e.g. no elastic, not tight, no tags, long or short sleeves)
integer
C0009072 (UMLS CUI [1,1])
C0205369 (UMLS CUI [1,2])
C1548966 (UMLS CUI [1,3])
Code List
Will only wear certain clothes (e.g. no elastic, not tight, no tags, long or short sleeves)
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Cries tears when falls, scrapes skin, or gets hurt.
integer
C0010399 (UMLS CUI [1,1])
C0030193 (UMLS CUI [1,2])
C1446409 (UMLS CUI [1,3])
Code List
Cries tears when falls, scrapes skin, or gets hurt.
CL Item
Often (0)
CL Item
Sometimes (1)
CL Item
Rarely (2)
CL Item
Never (3)
Item
Head bangs on a hard surface
integer
C0018672 (UMLS CUI [1,1])
C0205148 (UMLS CUI [1,2])
C0018599 (UMLS CUI [1,3])
Code List
Head bangs on a hard surface
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Head bangs on a soft surface
integer
C0018672 (UMLS CUI [1,1])
C0205148 (UMLS CUI [1,2])
C0205358 (UMLS CUI [1,3])
Code List
Head bangs on a soft surface
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item Group
Self-regulation – Orientation/Attention/Self-soothing/Sleep
C0684274 (UMLS CUI-1)
C0029266 (UMLS CUI-2)
C0004268 (UMLS CUI-3)
C0517080 (UMLS CUI-4)
C0037313 (UMLS CUI-5)
Item
Has to be prompted to make eye contact when spoken to
integer
C0870532 (UMLS CUI [1,1])
C0871157 (UMLS CUI [1,2])
C2370895 (UMLS CUI [1,3])
Code List
Has to be prompted to make eye contact when spoken to
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Seems not to notice when spoken to in a normal voice
integer
C2370895 (UMLS CUI [1,1])
C0004448 (UMLS CUI [1,2])
C0205160 (UMLS CUI [1,3])
C0234759 (UMLS CUI [1,4])
Code List
Seems not to notice when spoken to in a normal voice
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Does not respond to name
integer
C2317765 (UMLS CUI [1])
Code List
Does not respond to name
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Does not notice or react when tapped on the back
integer
C0004448 (UMLS CUI [1,1])
C0205160 (UMLS CUI [1,2])
C0004600 (UMLS CUI [1,3])
C0702221 (UMLS CUI [1,4])
C0442740 (UMLS CUI [2,1])
C0004600 (UMLS CUI [2,2])
C0702221 (UMLS CUI [2,3])
Code List
Does not notice or react when tapped on the back
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Does not roll over onto the back when asked
integer
C0560482 (UMLS CUI [1,1])
C0004600 (UMLS CUI [1,2])
C1705178 (UMLS CUI [1,3])
Code List
Does not roll over onto the back when asked
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Stares off into space
integer
C0011018 (UMLS CUI [1,1])
C0423086 (UMLS CUI [1,2])
Code List
Stares off into space
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Seems unaware when others are hurt
integer
C0004448 (UMLS CUI [1,1])
C0205160 (UMLS CUI [1,2])
C4061918 (UMLS CUI [1,3])
C0021797 (UMLS CUI [1,4])
Code List
Seems unaware when others are hurt
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has difficulty calming him/herself when upset
integer
C0517080 (UMLS CUI [1,1])
C1299586 (UMLS CUI [1,2])
C3887804 (UMLS CUI [1,3])
Code List
Has difficulty calming him/herself when upset
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Gets upset or tantrums when asked to make a transition
integer
C3887804 (UMLS CUI [1,1])
C1705178 (UMLS CUI [1,2])
C2700061 (UMLS CUI [1,3])
C0233558 (UMLS CUI [2,1])
C1705178 (UMLS CUI [2,2])
C2700061 (UMLS CUI [2,3])
Code List
Gets upset or tantrums when asked to make a transition
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has difficulty falling asleep at bedtime
integer
C0393760 (UMLS CUI [1,1])
C0521112 (UMLS CUI [1,2])
Code List
Has difficulty falling asleep at bedtime
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has difficulty falling back asleep when awakens during the night
integer
C0393761 (UMLS CUI [1])
Code List
Has difficulty falling back asleep when awakens during the night
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Awakens very early and stays awake
integer
C0541798 (UMLS CUI [1])
Code List
Awakens very early and stays awake
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has difficulty awakening in morning
integer
C4065477 (UMLS CUI [1])
Code List
Has difficulty awakening in morning
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Makes little jokes
integer
C0871981 (UMLS CUI [1,1])
C2937276 (UMLS CUI [1,2])
Code List
Makes little jokes
CL Item
Often (0)
CL Item
Sometimes (1)
CL Item
Rarely (2)
CL Item
Never (3)
Item Group
VISION
C0042789 (UMLS CUI-1)
Item
Looks at objects out of sides of eyes
integer
C0016183 (UMLS CUI [1,1])
C0347997 (UMLS CUI [1,2])
C0015392 (UMLS CUI [1,3])
C0441987 (UMLS CUI [1,4])
Code List
Looks at objects out of sides of eyes
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Is bothered by certain lights
integer
C1698258 (UMLS CUI [1])
Code List
Is bothered by certain lights
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item Group
Self-regulation – Behavior: Irritability, Aggression, Selfinjurious
C0684274 (UMLS CUI-1)
C0004927 (UMLS CUI-2)
C0022107 (UMLS CUI-3)
C0178360 (UMLS CUI-4)
C0424323 (UMLS CUI-5)
Item
Tantrums or meltdowns
integer
C0004927 (UMLS CUI [1,1])
C0233558 (UMLS CUI [1,2])
C0004927 (UMLS CUI [2,1])
C0221508 (UMLS CUI [2,2])
Code List
Tantrums or meltdowns
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Tantrums duration
Item
Tantrums last ______ minutes
integer
C0233558 (UMLS CUI [1,1])
C0449238 (UMLS CUI [1,2])
C0439232 (UMLS CUI [1,3])
Tantrums frequency
Item
Tantrums occur _____ times/day
integer
C0439603 (UMLS CUI [1,1])
C0439511 (UMLS CUI [1,2])
C0233558 (UMLS CUI [1,3])
Item
Cries easily when frustrated
integer
C0424110 (UMLS CUI [1,1])
C0016770 (UMLS CUI [1,2])
Code List
Cries easily when frustrated
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Hits or kicks others
integer
C0424323 (UMLS CUI [1,1])
C0562583 (UMLS CUI [1,2])
C0424323 (UMLS CUI [2,1])
C3662012 (UMLS CUI [2,2])
Code List
Hits or kicks others
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Scratches or pulls other’s hair
integer
C0424323 (UMLS CUI [1,1])
C0562594 (UMLS CUI [1,2])
C0424323 (UMLS CUI [2,1])
C0562591 (UMLS CUI [2,2])
Code List
Scratches or pulls other’s hair
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Bites others
integer
C0424323 (UMLS CUI [1,1])
C0562590 (UMLS CUI [1,2])
Code List
Bites others
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Throws things at others
integer
C0424323 (UMLS CUI [1,1])
C0565696 (UMLS CUI [1,2])
C0037420 (UMLS CUI [1,3])
Code List
Throws things at others
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Pulls own hair
integer
C0178360 (UMLS CUI [1,1])
C0563036 (UMLS CUI [1,2])
Code List
Pulls own hair
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Pulls own hair: where
Item
Pulls own hair: Where on the head?
text
C0178360 (UMLS CUI [1,1])
C0563036 (UMLS CUI [1,2])
C1515974 (UMLS CUI [1,3])
Item
Bites self
integer
C0178360 (UMLS CUI [1,1])
C0424375 (UMLS CUI [1,2])
Code List
Bites self
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Bites self: where
Item
Bites self: Which part of the body (e.g. left thumb)?
text
C0178360 (UMLS CUI [1,1])
C0424375 (UMLS CUI [1,2])
C1515974 (UMLS CUI [1,3])
Item
Hits self
integer
C0178360 (UMLS CUI [1,1])
C0562716 (UMLS CUI [1,2])
Code List
Hits self
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Hits self: where
Item
Hits self: Which part of the body?
text
C0178360 (UMLS CUI [1,1])
C0562716 (UMLS CUI [1,2])
C1515974 (UMLS CUI [1,3])
Item
Gets aggressive or ‘hyper’ with exposure to certain smells
integer
C0001807 (UMLS CUI [1,1])
C0037361 (UMLS CUI [1,2])
C0205369 (UMLS CUI [1,3])
Code List
Gets aggressive or ‘hyper’ with exposure to certain smells
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item Group
HEARING
C0018767 (UMLS CUI-1)
Item
Reacts poorly to certain everyday noises
integer
C0443286 (UMLS CUI [1,1])
C0205169 (UMLS CUI [1,2])
C0028263 (UMLS CUI [1,3])
C0205369 (UMLS CUI [1,4])
C0205214 (UMLS CUI [1,5])
Code List
Reacts poorly to certain everyday noises
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Covers ears with certain sounds
integer
C1545588 (UMLS CUI [1,1])
C0013443 (UMLS CUI [1,2])
C0205369 (UMLS CUI [1,3])
C0037709 (UMLS CUI [1,4])
Code List
Covers ears with certain sounds
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Reacts strongly when others cry loudly or scream
integer
C0443286 (UMLS CUI [1,1])
C0442821 (UMLS CUI [1,2])
C0021797 (UMLS CUI [1,3])
C2185952 (UMLS CUI [1,4])
C0443286 (UMLS CUI [2,1])
C0442821 (UMLS CUI [2,2])
C0021797 (UMLS CUI [2,3])
C0521008 (UMLS CUI [2,4])
Code List
Reacts strongly when others cry loudly or scream
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Is startled by sudden noises
integer
C0015726 (UMLS CUI [1,1])
C1276802 (UMLS CUI [1,2])
C0028263 (UMLS CUI [1,3])
Code List
Is startled by sudden noises
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item Group
Self-regulation – Toilet Training
C0684274 (UMLS CUI-1)
C0040365 (UMLS CUI-2)
Item
Is dry at night
integer
C0040365 (UMLS CUI [1,1])
C0876938 (UMLS CUI [1,2])
C0240526 (UMLS CUI [1,3])
Code List
Is dry at night
CL Item
Often (0)
CL Item
Sometimes (1)
CL Item
Rarely (2)
CL Item
Never (3)
Item
Diaper is wet in the morning
integer
C0180416 (UMLS CUI [1,1])
C0042036 (UMLS CUI [1,2])
C0332170 (UMLS CUI [1,3])
Code List
Diaper is wet in the morning
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Wears a diaper during the day
integer
C2203007 (UMLS CUI [1,1])
C0585022 (UMLS CUI [1,2])
Code List
Wears a diaper during the day
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Is toilet trained
integer
C0700127 (UMLS CUI [1])
Code List
Is toilet trained
CL Item
Often (0)
CL Item
Sometimes (1)
CL Item
Rarely (2)
CL Item
Never (3)
Item Group
TASTE/SMELL
C0039336 (UMLS CUI-1)
C0037361 (UMLS CUI-2)
Item
Gags with certain smells
integer
C0016927 (UMLS CUI [1,1])
C0205369 (UMLS CUI [1,2])
C0037361 (UMLS CUI [1,3])
Code List
Gags with certain smells
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Avoids foods with certain textures
integer
C0870186 (UMLS CUI [1,1])
C0016452 (UMLS CUI [1,2])
C0205369 (UMLS CUI [1,3])
C0449582 (UMLS CUI [1,4])
Code List
Avoids foods with certain textures
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Tooth brushing is difficult
integer
C2135846 (UMLS CUI [1])
Code List
Tooth brushing is difficult
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Mouths or chews objects
integer
C2584309 (UMLS CUI [1])
C0024888 (UMLS CUI [2,1])
C0347997 (UMLS CUI [2,2])
Code List
Mouths or chews objects
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item Group
Self-regulation - Digestion
C0684274 (UMLS CUI-1)
C0012238 (UMLS CUI-2)
Item
Will only eat familiar foods
integer
C0016468 (UMLS CUI [1,1])
C0453817 (UMLS CUI [1,2])
C0205171 (UMLS CUI [1,3])
Code List
Will only eat familiar foods
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Does not seem to be interested in food
integer
C2183819 (UMLS CUI [1,1])
C0016452 (UMLS CUI [1,2])
Code List
Does not seem to be interested in food
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Eats very few foods (five to ten items)
integer
C0013470 (UMLS CUI [1,1])
C0205388 (UMLS CUI [1,2])
C0016452 (UMLS CUI [1,3])
Code List
Eats very few foods (five to ten items)
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Bowels are loose
integer
C2129214 (UMLS CUI [1])
Code List
Bowels are loose
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Bowel movements (“poops”) are frequent (more than 3 per day)
integer
C4288986 (UMLS CUI [1])
Code List
Bowel movements (“poops”) are frequent (more than 3 per day)
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Requires regular use of laxative to avoid constipation
integer
C0199176 (UMLS CUI [1,1])
C0009806 (UMLS CUI [1,2])
C0240170 (UMLS CUI [1,3])
C1514873 (UMLS CUI [1,4])
C0332183 (UMLS CUI [1,5])
Code List
Requires regular use of laxative to avoid constipation
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Bowel movement (“poop”) is hard and dry
integer
C0278016 (UMLS CUI [1,1])
C0474605 (UMLS CUI [1,2])
Code List
Bowel movement (“poop”) is hard and dry
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has a bowel movement every other day
integer
C0426642 (UMLS CUI [1,1])
C0558287 (UMLS CUI [1,2])
Code List
Has a bowel movement every other day
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has a bowel movement twice a week
integer
C0556985 (UMLS CUI [1,1])
C0426642 (UMLS CUI [1,2])
Code List
Has a bowel movement twice a week
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Has a bowel movement once a week
integer
C0426642 (UMLS CUI [1,1])
C0558293 (UMLS CUI [1,2])
Code List
Has a bowel movement once a week
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)
Item
Bowel movements are often green
integer
C0474583 (UMLS CUI [1,1])
C0332183 (UMLS CUI [1,2])
Code List
Bowel movements are often green
CL Item
Rarely (1)
CL Item
Sometimes (2)
CL Item
Often (3)
CL Item
Never (0)

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