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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

Child Information Sheet

617 Shared Subjects

Child Information Sheet as defined by Sally Rogers' lab at the University of California, Davis
Clinical Assessments
Demographics
05/24/2012
child_info_sheet01
05/24/2012
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY Addate
interview_age Integer Required Age in months at the time of the interview/test/sampling/imaging. 0::1440 Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month. ADagemos
Query interview_chrono_age Integer Recommended Interview Chronological Age 0 :: 1200
Query interview_adj_age Integer Recommended Interview Adjusted Age 0 :: 1200
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported SEX, gender
comments_misc String 4,000 Recommended Miscellaneous comments on study, interview, methodology relevant to this form data
Query respondent String 20 Recommended Respondent
Mother;Father;Parent;Guardian;Teacher;Child;Self;Caregiver;Partner;Other
Query african String 5 Recommended Ethnicity: African to American
Yes;No
Query asian String 5 Recommended Ethnicity: Asian
Yes;No; 999
999= missing
Query pacific String 5 Recommended Ethnicity: Pacific
Yes;No; 999
999= missing
Query caucasian String 5 Recommended Ethnicity: Caucasian
Yes;No
Query amindian String 5 Recommended Ethnicity: American Indian
Yes;No
Query indian String 5 Recommended Ethnicity: Indian
Yes;No
Query hispanic Integer Recommended Is subject of Hispanic, Latino, or Spanish origin? 0; 1; 999 0 = No; 1 = Yes; 999= missing
otherrace String 100 Recommended specify other race The following questions are about you or the child's family.
Query multiplerace String 5 Recommended multiple ethnicity
Yes;No
Query primaryrace String 50 Recommended primary ethnic identification
Query liveswith String 100 Recommended child lives with
Both biological mother and father;Biological mother only;Biological father only;Biological mother and stepfather;Biological father and stepmother;Adoptive parents;Foster parents;Relatives;Other
Query liveswithother String 50 Recommended Child lives with other, specify
Query familystatus String 100 Recommended family status Married;Separated;Divorced;Widow/widower;Divorced and remarried;Widow/widower and remarried;Living with a partner without marriage;Single
Query momedu Integer Recommended mother's education 1::12; 999 1=some elementary school; 2=completed elementary school; 3=some junior-high school; 4=completed junior-high school; 5=some high school; 6=high school diploma; 7=trade or vocational school; 8=some college; 9=college degree; 10=some graduate school; 11=graduate school degree;other; 999=missing/NA; 12=less than 8th grade
Query momeduo String 50 Recommended mother's education, specify other
Query momoccu String 100 Recommended mother's occupation unemployed; employed part-time; employed full-time; employed full-time and a second job; N/A; missing
momoccuc String 100 Recommended mother's current occupation
Query spsedu String 100 Recommended spouse's education less than 8th grade;some high school;high school diploma;some college;college degree;some graduate school;graduate school degree;other;missing;N/A
Query spseduo String 50 Recommended spouse's education, specify other
Query spsoccu String 100 Recommended spouse's occupation unemployed; employed part-time; employed full-time; employed full-time and a second job; N/A; missing
spsoccuc String 50 Recommended spouse's current occupation
Query fmincome String 100 Recommended family income under 10,000; under 25,000; between 10,000 and 25,000;25,000 to 49,999;50,000 to 74,999;75,000 to 99,999; above 100,000; 100,000 to 124,999;125,000 and above;not provided
Query refnewsl String 5 Recommended Referral source: newsletter
Yes;No
Query refweb String 5 Recommended Referral source: website
Yes;No
Query refclinic String 5 Recommended Referral source: clinic
Yes;No
Query refmd String 5 Recommended Referral source: doctor
Yes;No
Query refmdname String 50 Recommended Referral source: doctor, specify name
Query refcharge String 5 Recommended Referral source: CHARGE
Yes;No
Query refstudy String 5 Recommended Referral source: another study
Yes;No
Query refstudyname String 50 Recommended Referral source: another study, specify
Query refbroch String 5 Recommended Referral source: brochure
Yes;No
Query refword String 5 Recommended Referral source: word of mouth
Yes;No
Query refcall String 5 Recommended Referral source: a call from researchers
Yes;No
Query refother String 1,000 Recommended Referral source: other referral source
Yes;No
refothers String 50 Recommended Referral source: specify
Query fhxbirdefect String 5 Required Family medical History: Family Med Hx: birth defect
Yes;No;999
999=NA/missing
Query fhxcp String 5 Required Cerebral Palsy
Yes;No; NK
NK = Not known
Query fhxkidney String 5 Recommended Family medical History: kidney disease
Yes;No
Query fhxhandicap String 5 Recommended Family medical History: physical handicap
Yes;No
Query fhxscleroderma String 5 Recommended Family medical History: scleroderma
Yes;No
Query fhxhuntington String 5 Recommended Family medical History: Huntington's chorea
Yes;No
Query fhxsickle String 5 Recommended Family medical History: sickle to cell anemia
Yes;No
Query fhxdm String 5 Required Family medical History: diabetes
Yes;No;999
999=NA/missing
Query fhxallergy String 5 Required Family medical History: other allergies
Yes;No;999
999=NA/missing
Query fhxasthma String 5 Required Family medical History: asthma
Yes;No;999
999=NA/missing
Query fhxamyotrophic String 5 Recommended Family medical History: amyotrophic lateral sclerosis
Yes;No
Query fhxhyperthyroid String 5 Recommended Family medical History: hyperthyrodism
Yes;No
Query fhxrheumatoid String 5 Recommended Family medical History: rheumatoid arthritis
Yes;No
Query fhxspondylitis String 5 Recommended Family medical History: ankylosing spondylitis
Yes;No
Query fhxtaysachs String 5 Recommended Family medical History: Tay to Sachs Disease
Yes;No
Query fhxheadinjury String 5 Required Family medical History: severe head injury Yes;No;999 999=NA/missing
Query fhxmigraine String 5 Recommended Family medical History: migraine headache
Yes;No
Query fhxlupus String 5 Required Family medical History: lupus
Yes;No;999
999=NA/missing
Query fhxalzheimer String 5 Recommended Family medical History: Alzheimer's disease
Yes;No;DK
Query fhxmusdys String 5 Recommended Family medical History: muscular dystrophy Yes;No
Query fhxcancer String 5 Recommended Family medical History: cancer
Yes;No
Query fhxseasonal String 5 Required Family medical History: seasonal allergy
Yes;No;999
999=NA/missing
Query fhxheart String 5 Required Family medical History: heart disease
Yes;No;999
999=NA/missing
Query fhxceliac String 5 Required Family medical History: Celiac disease
Yes;No;999
999=NA/missing
Query fhxhemolytic String 5 Recommended Family medical History: aplastic or hemolytic anemia
Yes;No
Query fhxaddison String 5 Recommended Family medical History: Addison's disease Yes;No
Query fhximmdis String 5 Recommended Family medical History: immune dysfunction/disorder
Yes;No
Query fhxraynaud String 5 Recommended Family medical History: Raynaud's syndrome
Yes;No
Query fhxcystic String 5 Recommended Family medical History: Cystic fibrosis Yes;No
Query fhxhbp String 5 Recommended Family medical History: high blood pressure
Yes;No
Query fhxms String 5 Recommended Family medical History: multiple sclerosis
Yes;No
Query fhxstroke String 5 Recommended Family medical History: stroke Yes;No
Query fhxhemophilia String 5 Recommended Family medical History: hemophilia
Yes;No
Query fhxparkinson String 5 Recommended Family medical History: Parkinson's disease
Yes;No;DK
Query fhxseizure String 5 Required Family medical History: seizure or epilepsy Yes;No;999 999=NA/missing
Query fhxfood String 5 Recommended Family medical History: food allergy
Yes;No
Query fhxmyasthenia String 5 Recommended Family medical History: Myasthenia Gravis
Yes;No
Query fhxcrohn String 5 Required Family medical History: Crohn's Disease Yes;No;999 999=NA/missing
Query fhxhypothyroid String 5 Recommended Family medical History: hypothyroidism
Yes;No
Query fhxguillain String 5 Recommended Family medical History: Guillain to barre syndrome
Yes;No
Query fhxsydenham String 5 Recommended Family medical History: Sydenham's chorea
Yes;No
Query fhxother String 5 Recommended Family medical History: other
Yes;No
Query fhxothers String 255 Recommended Family medical History: other, specify
fhxfamily String 150 Recommended Family medical History: if yes, specify which family member, maternal/paternal, has each condition
Query momconcern String 5 Recommended do you have concerns about your child's development?
Yes;No
momconcerns String 255 Recommended specify concerns about your child's development
Query anyconcern String 5 Recommended does anyone else have concerns about your child's development? Yes;No
anyconcerns String 255 Recommended specify else's concerns about your child's development
Query momcomment String 255 Recommended specify anything else about your child you would like us to know
Query referral_by Integer Recommended Who made your child's referral to the developmental clinic? 1::4 1=Self-referral; 2=Pediatrician; 3=Recommendation by friend or family member; 4=Other
Query ref_other String 200 Recommended If other, please specify:
Query why_referred Integer Recommended Why was your child referred to the developmental clinic? 1::5 1=Autism (ASD); 2=Speech/Communication delay; 3=Developmental Delay; 4=Motor delay concerns; 5=Other
Query referred_other String 200 Recommended If other, please specify:
Query prior_da1 Integer Recommended Has your child ever been referred for a developmental assessment before? 1::3 1=Yes, but he/she did not complete the assessment; 2=Yes, an assessment was completed with normal results; 3=No, this is his/her first referral for a development assessment
other_appts String 200 Recommended What other appointments, if any, has your child had that are associated with the developmental assessment process? (For example, your child's pediatrician may have referred him/her to audiology, neurology, or other specialists for different types of assessments.)
Query da_difficulty Integer Recommended Knowing that the developmental assessment involves multiple appointments, and considering things that might affect your ability to complete this process such as transportation, time off of work, and childcare, on a scale of 0-10, how hard do you think it will be to complete the developmental assessment process on your own in the next 3 months?
Query da_confidence Integer Recommended On a scale of 0-10, how confident are you that you will be able to complete the developmental assessment process on your own in the next 3 months?
Query da_worried Integer Recommended On a scale of 0-10, how worried are you about how your child is developing?
worried_why String 200 Recommended Explain worried: Can you tell me why you answered a [insert number from previous answer]? ei_pt
Query da_important Integer Recommended On a scale of 0-10, how important is it for your child to complete the developmental assessment?
Query home_with_child Integer Recommended Are you home with your child full-time during the work week? 0;1 0=No; 1=Yes
Query who_watches_child Integer Recommended If no, who watches your child during the work week? 1::4 1=In home care from family member or babysitter; 2=Out of home care from family member or babysitter; 3=Out of home care at childcare center; 4=Other
who_watches_child_other String 100 Recommended If other, please specify:
Query childcare_how_often Integer Recommended During the work week, how frequently is your child cared for by someone other than yourself? 0;1 0=Fulltime (>30 hours); 1=Part-time (<30 hours)
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

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