|
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 |
|
|
Subject_ID |
Query
|
timepoint_label |
String |
50
|
Recommended |
Timepoint/visit label |
|
|
|
Query
|
age_in_days_dot_to_edc |
Integer |
|
Recommended |
Age in days obtained by subtracting the Expected Date of Confinement (EDC/Due Date) from the date of test |
|
|
Exclusion_Age_in_Days_DOT_to_EDC |
Query
|
admin_status |
String |
20
|
Recommended |
Instrument administration status |
Complete;Partial;Not Administered;Not Applicable
|
|
Exclusion_Administration_Status |
Query
|
ex_ia_demo_parents_uncom_engl |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IA Both biological mother and father of the Child of Interest (COI) are uncomfortable reading English documents (One parent uncomfortable with reading English is not exclusionary) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IA_Demographic_COI_Parents_Uncomfortable_English |
Query
|
ex_ib_demo_adopted_or_osd |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IB Child of Interest (COI) adopted or product of ovum/sperm donation (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IB_Demographic_COI_Adopted_or_Ovum_Sperm_Donation |
Query
|
ex_ic_demo_bio_parent_unkwn_hx |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IC Biological father or mother of Child of Interest (COI) has unknown history (ex. Medical) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IC_Demographic_COI_Biol_Parent_with_Unknown_History |
Query
|
ex_iia1_preg_mom_age_coi_birth |
Integer |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIA1 Maternal age at Child of Interest (COI) birth |
|
|
Exclusion_IIA1_Pregnancy_Maternal_Age_at_COIs_Birth_in_Years |
Query
|
ex_iia2_preg_mom_age_ran_birth |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIA2 Maternal age at Child of Interest (COI) birth <16 years or >44 years (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIA2_Pregnancy_Maternal_Age_Range_at_COI_Birth |
Query
|
ex_iib1_preg_mom_smoking |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIB1 Maternal Smoking >10 cigarettes/week during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIB1_Pregnancy_COI_Maternal_Smoking |
Query
|
ex_iib2_preg_mom_alc_intake |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIB2 Maternal Alcohol intake >2 drinks/week during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIB2_Pregnancy_COI_Maternal_Alcohol_Intake |
Query
|
ex_iib3a_preg_mom_ex_meds_used |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIB3a Maternal exclusionary medications used during pregnancy with Child of Interest (COI) from Appendix A (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIB3a_Pregnancy_COI_Maternal_Exclusionary_Meds_Used |
Query
|
ex_iib4_preg_mom_drugs_abuse |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIB4 Maternal drugs of abuse used during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIB4_Pregnancy_COI_Maternal_Drugs_of_Abuse |
Query
|
ex_iic1_preg_mom_plac_abrupt |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC1 Maternal placental abruption during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC1_Pregnancy_COI_Maternal_Placental_Abruption |
Query
|
ex_iic2_preg_mom_preeclampsia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC2 Maternal preeclampsia with treatment during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC2_Pregnancy_COI_Maternal_Preeclampsia_Treatment |
Query
|
ex_iic3_preg_mom_strct_bedrest |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC3 Maternal strict bed rest >6 weeks duration during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC3_Pregnancy_COI_Maternal_Strict_Bedrest |
Query
|
ex_iic4_preg_mom_hospital_ad |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC4 Maternal pre-delivery hospital admissions related to pregnancy, during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC4_Pregnancy_COI_Maternal_Hospital_Admissions |
Query
|
ex_iic5_preg_mom_a_hemorrhage |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC5 Maternal antepartum hemorrhage during pregnacy with Child of Interest (COI) (spotting is not exclusionary) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC5_Pregnancy_COI_Maternal_Antepartum_Hemorrhage |
Query
|
ex_iic6_preg_mom_premature_rup |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC6 Maternal premature rupture of membranes >24 hours prior to delivery of Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC6_Pregnancy_COI_Maternal_Premature_Rupture |
Query
|
ex_iic7_preg_mom_general_anes |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC7 Maternal general anesthesia during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC7_Pregnancy_COI_Maternal_General_Anesthesia |
Query
|
ex_iic8_preg_mom_medical_cond |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC8 Maternal medical conditions during pregnancy with Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC8_Pregnancy_COI_Maternal_Medical_Conditions |
Query
|
ex_iic9_preg_mom_infection_del |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIC9 Maternal infections around time of delivery of Child of Interest (COI) (e.g., HIV, sepsis, toxoplasmosis, rubella, CMV, herpes, syphilis [ToRCHeS], hepatitis, positive culture (fever) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIC9_Pregnancy_COI_Maternal_Infection_Around_Delivery |
Query
|
ex_iiia_del_c_section_distress |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIIA C-section performed secondary to Child of Interest (COI) or maternal medical distress (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIIA_Delivery_C_Section_Maternal_COI_Distress |
Query
|
ex_iiib_del_multiple_births |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIIB Multiple Births (e.g., Child of Interest (COI) a twin, triplet, etc.) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIIB_Delivery_COI_Multiple_Births |
Query
|
ex_iiic_del_high_forceps |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIIC High Forceps used during delivery of the Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIIC_Delivery_COI_High_Forceps |
Query
|
ex_iiid_del_vacuum_extraction |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIID Vacuum Extraction used during delivery of the Child of Interest (COI) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIID_Delivery_COI_Vacuum_Extraction |
Query
|
ex_iiie_del_breech_malpresent |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IIIE Breech or malpresentation during delivery of the Child of Interest (COI) (not exclusionary with planned c-section) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IIIE_Delivery_COI_Breech_Malpresentation |
Query
|
ex_iva5a_bn_born_early_or_late |
String |
10
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVA5a Was the Child of Interest (COI) born early or late? (Early, Late, NA=Not Available) |
Early;Late;NA
|
NA = Not available
|
Exclusion_IVA5a_Birth_Neonatal_COI_Born_Early_or_Late |
Query
|
ex_iva6_bn_37wks4day_42wks3day |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVA6 Child of Interest (COI) born born at <37 weeks 4 days or >42 weeks 3 days (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVA6_Birth_Neonatal_COI_37weeks4days_42weeks3days |
Query
|
ex_ivb1a_bn_birth_body_wt_gram |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB1a Child of Interest (COI) birth body weight in grams |
|
|
Exclusion_IVB1a_Birth_Neonatal_COI_Birth_Body_Weight_Grams |
Query
|
ex_ivb1b_bn_birth_body_wt_perc |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB1b Child of Interest (COI) birth body weight percentile |
|
|
Exclusion_IVB1b_Birth_Neonatal_COI_Birth_Body_Weight_Perc |
Query
|
ex_ivb1c_bn_body_wt_less_5_pct |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB1c Was the Child of Interest (COI) birth body weight less than the 5th percentile? (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVB1c_Birth_Neonatal_COI_Body_Wgt_Less_Than_5th_Perc |
Query
|
ex_ivb2a_bn_birth_body_lgth_cm |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB2a Child of Interest (COI) birth body length in centimeters |
|
|
Exclusion_IVB2a_Birth_Neonatal_COI_Birth_Body_Length_cm |
Query
|
ex_ivb2b_bn_birth_bdy_lgth_pct |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB2b Child of Interest (COI) birth body length percentile |
|
|
Exclusion_IVB2b_Birth_Neonatal_COI_Birth_Body_Length_Perc |
Query
|
ex_ivb2c_bn_bdy_lgth_less_5pct |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB2c Was the Child of Interest (COI) birth body length less than the 5th percentile? (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVB2c_Birth_Neonatal_COI_Body_Lgth_Less_Than_5th_Perc |
Query
|
ex_ivb3a_bn_birth_ofc_cm |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB3a Child of Interest (COI) birth Head Circumference (OFC) in centimeters |
|
|
Exclusion_IVB3a_Birth_Neonatal_COI_Birth_OFC_cm |
Query
|
ex_ivb3b_bn_birth_ofc_perc |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB3b Child of Interest (COI) birth Head Circumference (OFC) percentile |
|
|
Exclusion_IVB3b_Birth_Neonatal_COI_Birth_OFC_Perc |
Query
|
ex_ivb3c_bn_brth_ofc_less_5pct |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB3c Was the Child of Interest (COI) Head Circumference OFC less than the 5th percentile at Birth? (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVB3c_Birth_Neonatal_COI_Birth_OFC_Less_Than_5th_Perc |
Query
|
ex_ivb4a_bn_weight_length_pct |
Float |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB4a Child of Interest (COI) birth body weight-for-length or stature percentile |
|
|
Exclusion_IVB4a_Birth_Neonatal_COI_Weight_for_Length_Perc |
Query
|
ex_ivb4b_bn_wt_lgth_less_5_pct |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB4b Was the Child of Interest (COI) weight-for-length or stature at birth less than the 5th percentile? (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVB4b_Birth_Neonatal_COI_Wgt_for_Lgth_Less_5th_Perc |
Query
|
ex_ivb5a_bn_apgar_at_1_minute |
Integer |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB5a Child of Interest (COI) Apgar score at 1 minute (0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10) |
|
|
Exclusion_IVB5a_Birth_Neonatal_COI_Apgar_at_1_Minute |
Query
|
ex_ivb5b_bn_apgar_at_5_minutes |
Integer |
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB5b Child of Interest (COI) Apgar score at 5 minutes (0, 1, 2, 3, 4, 5, 6, 7, 8, 9, 10) |
|
|
Exclusion_IVB5b_Birth_Neonatal_COI_Apgar_at_5_Minutes |
Query
|
ex_ivb5c_bn_apgar_less_8at5min |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVB5c Was the Child of Interest (COI) Apgar score less than 8 at 5 minutes? (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVB5c_Birth_Neonatal_COI_Apgar_Less_Than_8_at_5_Min |
Query
|
ex_ivc1_bn_seizures |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC1 Child of Interest (COI) seizures (all, including febrile seizures) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC1_Birth_Neonatal_COI_Seizures |
Query
|
ex_ivc2_bn_hyperbilirubinemia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC2 Child of Interest (COI) hyperbilirubinemia requiring transfusion, phototherapy, or bili-blanket >48 hours, or, hospital re-admission with treatment (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC2_Birth_Neonatal_COI_Hyperbilirubinemia |
Query
|
ex_ivc3_bn_structural_abnormal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC3 Child of Interest (COI) structural abnormalities of body (limbs, head or face) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC3_Birth_Neonatal_COI_Structural_Abnormalities |
Query
|
ex_ivc4_bn_medical_conditions |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC4 Child of Interest (COI) medical conditions (e.g., PKU, hypothyroidism, hyperthyroidism, anemia) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC4_Birth_Neonatal_COI_Medical_Conditions |
Query
|
ex_ivc5_bn_resp_distress |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC5 Child of Interest (COI) respiratory distress (e.g., chest compression, intubation, ventilator, supplemental oxygen, meconium, pneumonia) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC5_Birth_Neonatal_COI_Respiratory_Distress |
Query
|
ex_ivc6a_bn_admitted_neonatal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC6a Child of Interest (COI) admitted to specialized neonatal care unit (ex. NICU) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC6a_Birth_Neonatal_COI_Admitted_to_Neonatal_Care |
Query
|
ex_ivc7_bn_heart_disease_surg |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC7 Child of Interest (COI) heart disease or heart surgery (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC7_Birth_Neonatal_COI_Heart_Disease_Surgery |
Query
|
ex_ivc8_bn_chromosomal_anomal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC8 Child of Interest (COI) chromosomal/congenital anomalies (Downs, Turners, Klinefelters, Cleft lip) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC8_Birth_Neonatal_COI_Chromosomal_Anomalies |
Query
|
ex_ivc9_bn_infections |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC9 Child of Interest (COI) infections (e.g., HIV, sepsis, toxoplasmosis, rubella, CMV, herpes, syphilis [ToRCHeS], hepatitis, meningitis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC9_Birth_Neonatal_COI_Infections |
Query
|
ex_ivc10_bn_abn_brain_scan_eeg |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC10 Child of Interest (COI) abnormal brain scan or EEG (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC10_Birth_Neonatal_COI_Abnormal_Brain_Scan_EEG |
Query
|
ex_ivc11_bn_vision_hear_impair |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC11 Child of Interest (COI) vision or hearing impairment (e.g., abnormal BAER or Autoacoustic, Retinopathy, Ophthalmia) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC11_Birth_Neonatal_COI_Vision_Hearing_Impairment |
Query
|
ex_ivc12_bn_tumors_diap_hernia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question IVC12 Child of Interest (COI) tumors or diaphragmatic hernia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_IVC12_Birth_Neonatal_COI_Tumors_Diaphragmatic_Hernia |
Query
|
ex_va1_dev_non_fluent_english |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VA1 Child of Interest (COI) non-fluent in English, if age appropriate (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VA1_Development_COI_Non_Fluent_in_English |
Query
|
ex_va2a_dev_mom_drug_breastfed |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VA2a If Child of Interest (COI) breastfed: Exclusionary maternal medications and drugs of abuse from Appendix A (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VA2a_Development_COI_Maternal_Drugs_Breastfeeding |
Query
|
ex_vc1_dev_chronic_med_cond |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC1 Child of Interest (COI) chronic medical conditions (e.g., diabetes, kidney, or liver problems) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC1_Development_COI_Chronic_Medical_Conditions |
Query
|
ex_vc2_dev_metal_implants |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC2 Child of Interest (COI) metal implants (e.g., pacemaker, electronic medical implants, teeth braces, pins) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC2_Development_COI_Metal_Implants |
Query
|
ex_vc3_dev_metal_frag_eye_face |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC3 Child of Interest (COI) metal fragments in the eye or face (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC3_Development_COI_Metal_Fragments_Eye_Face |
Query
|
ex_vc4_dev_nr_piercings |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC4 Child of Interest (COI) non-removable body piercings (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC4_Development_COI_Non_Removable_Piercings |
Query
|
ex_vc5_dev_system_rheum_ill |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC5 Child of Interest (COI) systematic rheumatologic illness or disorder (e.g., arthritis) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC5_Development_COI_Systematic_Rheumatologic_Illness |
Query
|
ex_vc6_dev_malignancy_cancer |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC6 Child of Interest (COI) malignancy or cancer (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC6_Development_COI_Malignancy_Cancer |
Query
|
ex_vc7_dev_sign_heart_disease |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC7 Child of Interest (COI) significant heart disease (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC7_Development_COI_Significant_Heart_Disease |
Query
|
ex_vc8_dev_major_surgery |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC8 Child of Interest (COI) major surgery (e.g., neuro, heart) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC8_Development_COI_Major_Surgery |
Query
|
ex_vc9_dev_chemo_rad_therapy |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC9 Child of Interest (COI) chemotherapy or radiation therapy (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC9_Development_COI_Chemo_Radiation_Therapy |
Query
|
ex_vc10_dev_nr_dental_work |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC10 Child of Interest (COI) non-removable metal dental work (e.g., braces, retainer [tooth fillings are not exclusionary]) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC10_Development_COI_Non_Removable_Dental_Work |
Query
|
ex_vc11_dev_congenital_abnorm |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC11 Child of Interest (COI) congenital abnormalities of face, head, or limbs (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC11_Development_COI_Congenital_Abnormalities |
Query
|
ex_vc12a_dev_exclusionary_meds |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VC12a Child of Interest (COI) exclusionary medications used during past year from Appendix A (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VC12a_Development_COI_Exclusionary_Medications |
Query
|
ex_vd1_dev_seizures |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD1 Child of Interest (COI) seizures (all, including febrile seizures) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD1_Development_COI_Seizures |
Query
|
ex_vd2_dev_muscular_dystrophy |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD2 Child of Interest (COI) Muscular Dystrophy (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD2_Development_COI_Muscular_Dystrophy |
Query
|
ex_vd3_dev_myotonic_dystrophy |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD3 Child of Interest (COI) Myotonic Dystrophy (e.g., muscle disease) (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD3_Development_COI_Myotonic_Dystrophy |
Query
|
ex_vd4_dev_cns_infection |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD4 Child of Interest (COI) CNS Infection (e.g., meningitis, encephalitis) (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD4_Development_COI_CNS_Infection |
Query
|
ex_vd5_dev_closed_head_injury |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD5 Child of Interest (COI) closed head injury (e.g., >5 minutes loss of consciousness, overnight hospital stay) (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD5_Development_COI_Closed_Head_Injury |
Query
|
ex_vd6_dev_hearing_impairment |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD6 Child of Interest (COI) hearing impairment requiring treatment/intervention (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD6_Development_COI_Hearing_Impairment |
Query
|
ex_vd7_dev_visual_impairment |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD7 Child of Interest (COI) visual impairment (e.g., strabismus, visual disability [conventional glasses correction to 20/40 or better is not exclusionary]) (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD7_Development_COI_Visual_Impairment |
Query
|
ex_vd8_dev_tuberous_sclerosis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD8 Child of Interest (COI) Tuberous Sclerosis (e.g., brain lesion causing seizures, skin lesions) (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD8_Development_COI_Tuberous_Sclerosis |
Query
|
ex_vd9_dev_neurofibromatosis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD9 Child of Interest (COI) Neurofibromatosis (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD9_Development_COI_Neurofibromatosis |
Query
|
ex_vd10_dev_cns_radiotherapy |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD10 Child of Interest (COI) CNS Radiotherapy (e.g., radiation treatment for cancer) (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD10_Development_COI_CNS_Radiotherapy |
Query
|
ex_vd11a_dev_other_neuro_cond |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VD11a Child of Interest (COI) Other diagnosed/treated neurological conditions (Y=Yes, N=No) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VD11a_Development_COI_Other_Neurological_Conditions |
Query
|
ex_ve1_dev_lang_learning_dis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VE1 Child of Interest (COI) Significant language or learning disorder program or treatment (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VE1_Development_COI_Language_Learning_Disorder |
Query
|
ex_ve2_dev_special_educ_pl |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VE2 Child of Interest (COI) Special types of educational placement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VE2_Development_COI_Special_Educational_Placement |
Query
|
ex_ve3_dev_occupational_therap |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VE3 Child of Interest (COI) Occupational therapy related to medical or neurological exclusion (current or past) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VE3_Development_COI_Occupational_Therapy |
Query
|
ex_ve4_dev_physical_therapy |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VE4 Child of Interest (COI) Physical therapy related to medical or neurological exclusion (current or past) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VE4_Development_COI_Physical_Therapy |
Query
|
ex_ve5_dev_lead |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VE5 Child of Interest (COI) Tested for lead and clinic treatment or intervention (e.g., hospitalization, medications, chelation, change in diet or environment) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VE5_Development_COI_Lead |
Query
|
ex_vf1_dev_mood |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF1 Child of Interest (COI) diagnosed with a Mood Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF1_Development_COI_Mood |
Query
|
ex_vf2_dev_separation_anxiety |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF2 Child of Interest (COI) diagnosed with Separation Anxiety (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF2_Development_COI_Separation_Anxiety |
Query
|
ex_vf3_dev_conduct_disorder |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF3 Child of Interest (COI) diagnosed with Conduct Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF3_Development_COI_Conduct_Disorder |
Query
|
ex_vf4_dev_adhd |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF4 Child of Interest (COI) diagnosed with Attention Deficit-Hyperactivity Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF4_Development_COI_ADHD |
Query
|
ex_vf5_dev_ocd |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF5 Child of Interest (COI) diagnosed with Obsessive Compulsive Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF5_Development_COI_OCD |
Query
|
ex_vf6_dev_pdd |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF6 Child of Interest (COI) diagnosed with Pervasive Developmental Disorder (PDD) (e.g. Autism, Asperger Syndrome, etc.) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF6_Development_COI_PDD |
Query
|
ex_vf7_dev_tic_disorder |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF7 Child of Interest (COI) diagnosed with Tic Disorder (e.g., motor and vocal) (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF7_Development_COI_Tic_Disorder |
Query
|
ex_vf8_dev_child_disintegr_dis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF8 Child of Interest (COI) diagnosed with Childhood Disintegration Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF8_Development_COI_Childhood_Disintegration_Disorder |
Query
|
ex_vf9_dev_retts_disorder |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF9 Child of Interest (COI) diagnosed with Retts Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF9_Development_COI_Retts_Disorder |
Query
|
ex_vf10_dev_reactive_attch_dis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF10 Child of Interest (COI) diagnosed with Reactive Attachment Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF10_Development_COI_Reactive_Attachment_Disorder |
Query
|
ex_vf11_dev_feed_dis_infancy |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF11 Child of Interest (COI) diagnosed with Feeding Disorder of Infancy (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF11_Development_COI_Feeding_Disorder_of_Infancy |
Query
|
ex_vf12_dev_pica |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF12 Child of Interest (COI) diagnosed with Pica (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF12_Development_COI_Pica |
Query
|
ex_vf13_dev_rumination_dis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF13 Child of Interest (COI) diagnosed with Rumination Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF13_Development_COI_Rumination_Disorder |
Query
|
ex_vf14_dev_selective_mutism |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF14 Child of Interest (COI) diagnosed with Selective Mutism (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF14_Development_COI_Selective_Mutism |
Query
|
ex_vf15_dev_tourettes_syndrome |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF15 Child of Interest (COI) diagnosed with Tourettes Syndrome (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF15_Development_COI_Tourettes_Syndrome |
Query
|
ex_vf16_dev_stereo_move_dis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VF16 Child of Interest (COI) diagnosed with Stereotypic Movement Disorder (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VF16_Development_COI_Stereotypic_Movement_Disorder |
Query
|
ex_viiia_n_admin_status |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA Neurological Exam 0:0 to 0:1 Was this exam administered to the Child of Interest (COI)? |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA_NEURO_COI_0y0m_to_0y1m_Administration_Status |
Query
|
ex_viiia1_n_dysmorphisms |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA1 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Facial Dysmorphisms (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA1_NEURO_COI_0y0m_to_0y1m_Dysmorphisms |
Query
|
ex_viiia1a_n_dysmorph_palatal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA1a Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired palatal cleft |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiia1b_n_dysmorph_labial |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA1b Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired labial cleft |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiia1c_n_dysmorph_sturge |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA1c Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of Sturge Weber disease |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiia1d_n_dysmorph_tuberous |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA1d Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of tuberous sclerosis |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiia2_n_hypertonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA2 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypertonia (Y=Yes, N=No, NA=NotAvailable) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA2_NEURO_COI_0y0m_to_0y1m_Hypertonia |
Query
|
ex_viiia3_n_hypotonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA3 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypotonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA3_NEURO_COI_0y0m_to_0y1m_Hypotonia |
Query
|
ex_viiia4_n_strength |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA4 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Strength <4/5 (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA4_NEURO_COI_0y0m_to_0y1m_Strength |
Query
|
ex_viiia5_n_clonus_ankle |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA5 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with >10 beats of Clonus at ankles (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA5_NEURO_COI_0y0m_to_0y1m_Clonus_Ankle |
Query
|
ex_viiia6_n_clonus_other |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA6 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Clonus at site other than ankle (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA6_NEURO_COI_0y0m_to_0y1m_Clonus_Other |
Query
|
ex_viiia7_n_dystonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA7 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Dystonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA7_NEURO_COI_0y0m_to_0y1m_Dystonia |
Query
|
ex_viiia8_n_choreoathetosis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA8 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Choreoathetosis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA8_NEURO_COI_0y0m_to_0y1m_Choreoathetosis |
Query
|
ex_viiia9_n_tremor |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA9 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Tremor (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA9_NEURO_COI_0y0m_to_0y1m_Tremor |
Query
|
ex_viiia10_n_tics |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA10 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Tics (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA10_NEURO_COI_0y0m_to_0y1m_Tics |
Query
|
ex_viiia11_n_exo_esotropia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA11 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with any clearly noticeable Exo- or Esotropia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA11_NEURO_COI_0y0m_to_0y1m_Exo_Esotropia |
Query
|
ex_viiia12_n_nystagmus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA12 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with jerk, pendular, rotatory, or monocular Nystagmus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA12_NEURO_COI_0y0m_to_0y1m_Nystagmus |
Query
|
ex_viiia13_n_asym_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA13 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Asymmetry of Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA13_NEURO_COI_0y0m_to_0y1m_Asymmetry_Facial_Move |
Query
|
ex_viiia14_n_abn_visual_fields |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA14 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Abnormal Visual Fields (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA14_NEURO_COI_0y0m_to_0y1m_Abnormal_Visual_Fields |
Query
|
ex_viiia15_n_ocular_motility |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA15 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Ocular Motility Disturbance (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA15_NEURO_COI_0y0m_to_0y1m_Ocular_Motility |
Query
|
ex_viiia16_n_strabismus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA16 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Strabismus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA16_NEURO_COI_0y0m_to_0y1m_Strabismus |
Query
|
ex_viiia17_n_abn_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIA17 Neurological Exam 0:0 to 0:1 Child of Interest (COI) diagnosed with Markedly Abnormal Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIA17_NEURO_COI_0y0m_to_0y1m_Abnormal_Facial_Move |
Query
|
ex_viiib_n_admin_status |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB Neurological Exam 0:2 to 0:11 Was this exam administered to the Child of Interest (COI) (Y=Yes, N=No, NA=Not Available)? |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB_NEURO_COI_0y2m_to_0y11m_Administration_Status |
Query
|
ex_viiib1_n_dysmorphisms |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB1 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB1_NEURO_COI_0y2m_to_0y11m_Dysmorphisms |
Query
|
ex_viiib1a_n_dysmorph_palatal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB1a Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired palatal cleft |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiib1b_n_dysmorph_labial |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB1b Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired labial cleft |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiib1c_n_dysmorph_sturge |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB1c Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of Sturge Weber disease |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiib1d_n_dysmorph_tuberous |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB1d Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of tuberous sclerosis |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiib2_n_hypertonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB2 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypertonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB2_NEURO_COI_0y2m_to_0y11m_Hypertonia |
Query
|
ex_viiib20_n_cannot_sit_indep |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB20 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with inability to sit independently by 8 months (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB20_NEURO_COI_0y2m_to_0y11m_Cannot_Sit_Indep |
Query
|
ex_viiib21_n_cannot_roll |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB21 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with inability to roll from front to back or back to front by 6 months (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB21_NEURO_COI_0y2m_to_0y11m_Cannot_Roll |
Query
|
ex_viiib22_n_tonic_neck_reflex |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB22 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with present tonic neck reflex after 7 months (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB22_NEURO_COI_0y2m_to_0y11m_Tonic_Neck_Reflex |
Query
|
ex_viiib3_n_hypotonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB3 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypotonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB3_NEURO_COI_0y2m_to_0y11m_Hypotonia |
Query
|
ex_viiib4_n_strength |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB4 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Strength <4/5 (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB4_NEURO_COI_0y2m_to_0y11m_Strength |
Query
|
ex_viiib5_n_clonus_ankle |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB5 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with >5 beats of Clonus at ankles for children 2-4 months of age; any ankle Clonus in children >4 months of age |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB5_NEURO_COI_0y2m_to_0y11m_Clonus_Ankle |
Query
|
ex_viiib6_n_clonus_other |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB6 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Clonus at site other than ankle (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB6_NEURO_COI_0y2m_to_0y11m_Clonus_Other |
Query
|
ex_viiib7_n_dystonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB7 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Dystonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB7_NEURO_COI_0y2m_to_0y11m_Dystonia |
Query
|
ex_viiib8_n_choreoathetosis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB8 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Choreoathetosis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB8_NEURO_COI_0y2m_to_0y11m_Choreoathetosis |
Query
|
ex_viiib9_n_tremor |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB9 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Tremor (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB9_NEURO_COI_0y2m_to_0y11m_Tremor |
Query
|
ex_viiib10_n_tics |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB10 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Tics (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB10_NEURO_COI_0y2m_to_0y11m_Tics |
Query
|
ex_viiib11_n_dysmetria |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB11 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Dysmetria (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB11_NEURO_COI_0y2m_to_0y11m_Dysmetria |
Query
|
ex_viiib12_n_ataxia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB12 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Ataxia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB12_NEURO_COI_0y2m_to_0y11m_Ataxia |
Query
|
ex_viiib13_n_exo_esotropia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB13 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with any clearly noticeable Exo- or Esotropia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB13_NEURO_COI_0y2m_to_0y11m_Exo_Esotropia |
Query
|
ex_viiib14_n_nystagmus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB14 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with jerk, pendular, rotatory, or monocular Nystagmus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB14_NEURO_COI_0y2m_to_0y11m_Nystagmus |
Query
|
ex_viiib15_n_asym_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB15 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Asymmetry of Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB15_NEURO_COI_0y2m_to_0y11m_Asymmetry_Facial_Move |
Query
|
ex_viiib16_n_abn_visual_field |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB16 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Abnormal Visual Fields (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB16_NEURO_COI_0y2m_to_0y11m_Abnormal_Visual_Field |
Query
|
ex_viiib17_n_ocular_motility |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB17 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Ocular Motility Disturbance (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB17_NEURO_COI_0y2m_to_0y11m_Ocular_Motility |
Query
|
ex_viiib18_n_strabismus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB18 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Strabismus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB18_NEURO_COI_0y2m_to_0y11m_Strabismus |
Query
|
ex_viiib19_n_abnfacial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIB19 Neurological Exam 0:2 to 0:11 Child of Interest (COI) diagnosed with Markedly Abnormal Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIB19_NEURO_COI_0y2m_to_0y11m_Abnormal_Facial_Move |
Query
|
ex_viiic_n_admin_status |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC Neurological Exam 1:0 to 2:11 Was this exam administered to the Child of Interest (COI) (Y=Yes, N=No, NA=Not Available)? |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC_NEURO_COI_1y0m_to_2y11m_Administration_Status |
Query
|
ex_viiic1_n_dysmorphisms |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC1 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC1_NEURO_COI_1y0m_to_2y11m_Dysmorphisms |
Query
|
ex_viiic1a_n_dysmorph_palatal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC1a Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired palatal cleft (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiic1b_n_dysmorph_labial |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC1b Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired labial cleft (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiic1c_n_dysmorph_sturge |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC1c Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of Sturge Weber disease (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiic1d_n_dysmorph_tuberous |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC1d Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of tuberous sclerosis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiic2_n_hypertonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC2 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypertonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC2_NEURO_COI_1y0m_to_2y11m_Hypertonia |
Query
|
ex_viiic3_n_hypotonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC3 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypotonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC3_NEURO_COI_1y0m_to_2y11m_Hypotonia |
Query
|
ex_viiic4_n_strength |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC4 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Strength <4/5 (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC4_NEURO_COI_1y0m_to_2y11m_Strength |
Query
|
ex_viiic5_n_clonus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC5 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Clonus at any site (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC5_NEURO_COI_1y0m_to_2y11m_Clonus |
Query
|
ex_viiic6_n_dystonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC6 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Dystonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC6_NEURO_COI_1y0m_to_2y11m_Dystonia |
Query
|
ex_viiic7_n_choreoathetosis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC7 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Choreoathetosis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC7_NEURO_COI_1y0m_to_2y11m_Choreoathetosis |
Query
|
ex_viiic8_n_tremor |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC8 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Tremor (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC8_NEURO_COI_1y0m_to_2y11m_Tremor |
Query
|
ex_viiic9_n_tics |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC9 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Tics (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC9_NEURO_COI_1y0m_to_2y11m_Tics |
Query
|
ex_viiic10_n_dysmetria |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC10 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Dysmetria (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC10_NEURO_COI_1y0m_to_2y11m_Dysmetria |
Query
|
ex_viiic11_n_ataxia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC11 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Ataxia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC11_NEURO_COI_1y0m_to_2y11m_Ataxia |
Query
|
ex_viiic12_n_exo_esotropia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC12 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with any clearly noticeable Exo- or Esotropia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC12_NEURO_COI_1y0m_to_2y11m_Exo_Esotropia |
Query
|
ex_viiic13_n_nystagmus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC13 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with jerk, pendular, rotatory, or monocular Nystagmus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC13_NEURO_COI_1y0m_to_2y11m_Nystagmus |
Query
|
ex_viiic14_n_asym_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC14 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Asymmetry of Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC14_NEURO_COI_1y0m_to_2y11m_Asymmetry_Facial_Move |
Query
|
ex_viiic15_n_abn_visual_field |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC15 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Abnormal Visual Fields (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC15_NEURO_COI_1y0m_to_2y11m_Abnormal_Visual_Field |
Query
|
ex_viiic16_n_ocular_motility |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC16 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Ocular Motility Disturbance (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC16_NEURO_COI_1y0m_to_2y11m_Ocular_Motility |
Query
|
ex_viiic17_n_strabismus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC17 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Strabismus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC17_NEURO_COI_1y0m_to_2y11m_Strabismus |
Query
|
ex_viiic18_n_abn_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC18 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with Markedly Abnormal Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC18_NEURO_COI_1y0m_to_2y11m_Abnormal_Facial_Move |
Query
|
ex_viiic19_n_babbling |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC19 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with inability to babble by 12 months (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC19_NEURO_COI_1y0m_to_2y11m_Babbling |
Query
|
ex_viiic20_n_expressive_lang |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIIC20 Neurological Exam 1:0 to 2:11 Child of Interest (COI) diagnosed with no Expressive Language (word expression) by 24 months (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIIC20_NEURO_COI_1y0m_to_2y11m_Expressive_Language |
Query
|
ex_viiid_n_admin_status |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID Neurological Exam 3:0 to 4:5 Was this exam administered to the Child of Interest (COI) (Y=Yes, N=No, NA=Not Available)? |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID_NEURO_COI_3y0m_to_4y5m_Administration_Status |
Query
|
ex_viiid1_n_dysmorphisms |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID1 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Facial Dysmorphisms (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID1_NEURO_COI_3y0m_to_4y5m_Dysmorphisms |
Query
|
ex_viiid1a_n_dysmorph_palatal |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID1a Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired palatal cleft (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiid1b_n_dysmorph_labial |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID1b Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Facial Dysmorphisms - repaired or unrepaired labial cleft (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiid1c_n_dysmorph_sturge |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID1c Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of Sturge Weber disease (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiid1d_n_dysmorph_tuberous |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID1d Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Facial Dysmorphisms - facial stigmata of tuberous sclerosis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
|
Query
|
ex_viiid2_n_hypertonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID2 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypertonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID2_NEURO_COI_3y0m_to_4y5m_Hypertonia |
Query
|
ex_viiid3_n_hypotonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID3 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with mild, moderate, or severe Hypotonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID3_NEURO_COI_3y0m_to_4y5m_Hypotonia |
Query
|
ex_viiid4_n_strength |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID4 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Strength <4/5 (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID4_NEURO_COI_3y0m_to_4y5m_Strength |
Query
|
ex_viiid5_n_clonus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID5 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Clonus at any site (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID5_NEURO_COI_3y0m_to_4y5m_Clonus |
Query
|
ex_viiid6_n_dystonia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID6 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Dystonia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID6_NEURO_COI_3y0m_to_4y5m_Dystonia |
Query
|
ex_viiid7_n_choreoathetosis |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID7 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Choreoathetosis (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID7_NEURO_COI_3y0m_to_4y5m_Choreoathetosis |
Query
|
ex_viiid8_n_tremor |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID8 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Tremor (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID8_NEURO_COI_3y0m_to_4y5m_Tremor |
Query
|
ex_viiid9_n_tics |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID9 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Tics (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID9_NEURO_COI_3y0m_to_4y5m_Tics |
Query
|
ex_viiid10_n_dysmetria |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID10 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Dysmetria (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID10_NEURO_COI_3y0m_to_4y5m_Dysmetria |
Query
|
ex_viiid11_n_ataxia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID11 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Ataxia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID11_NEURO_COI_3y0m_to_4y5m_Ataxia |
Query
|
ex_viiid12_n_exo_esotropia |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID12 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with any clearly noticeable Exo- or Esotropia (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID12_NEURO_COI_3y0m_to_4y5m_Exo_Esotropia |
Query
|
ex_viiid13_n_nystagmus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID13 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with jerk, pendular, rotatory, or monocular Nystagmus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID13_NEURO_COI_3y0m_to_4y5m_Nystagmus |
Query
|
ex_viiid14_n_asym_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID14 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Asymmetry of Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID14_NEURO_COI_3y0m_to_4y5m_Asymmetry_Facial_Move |
Query
|
ex_viiid15_n_abn_visual_fields |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID15 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Abnormal Visual Fields (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID15_NEURO_COI_3y0m_to_4y5m_Abnormal_Visual_Fields |
Query
|
ex_viiid16_n_ocular_motility |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID16 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Ocular Motility Disturbance (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID16_NEURO_COI_3y0m_to_4y5m_Ocular_Motility |
Query
|
ex_viiid17_n_strabismus |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID17 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Strabismus (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID17_NEURO_COI_3y0m_to_4y5m_Strabismus |
Query
|
ex_viiid18_n_abn_facial_move |
String |
2
|
Recommended |
Screening and Exclusion Form (0:0 to 4:5 y:m) Question VIIID18 Neurological Exam 3:0 to 4:5 Child of Interest (COI) diagnosed with Markedly Abnormal Facial Movement (Y=Yes, N=No, NA=Not Available) |
|
Y = Yes; N = No; NA = Not available
|
Exclusion_VIIID18_NEURO_COI_3y0m_to_4y5m_Abnormal_Facial_Move |