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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

BSRC Intervention History Form

624 Shared Subjects

Baby Sibling Research Consortium Intervention History Form
Clinical Assessments
Treatment
01/03/2014
bsrc_intervention01
01/03/2014
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_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.
interview_date Date Required Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported gender
date_last_visit Date Recommended Date of last visit
Query prof_refer Integer Recommended Did a professional refer your child to an "early intervention" or "birth-to-three" program? 0;1 0 = No; 1 = Yes refer_birth_to_three
Query early_therapy Integer Recommended Did your child receive any "early intervention" or "birth to three" program service? 0;1 0 = No; 1 = Yes receive_birth_to_three
Query community_class Integer Recommended Did a professional recommend that your child attend any community based classes/activities? 0;1 0 = No; 1 = Yes recommend_community_classes
Query participate_class Integer Recommended Did your child participate in any classes/activities whether or not recommended by a professional? 0;1 0 = No; 1 = Yes
Query dev_services Integer Recommended Did your child receive services for developmental delays of any kind or concerns about delay? 0;1 0 = No; 1 = Yes receive_services_dev_delays
Query txhx1occtx1 Integer Recommended Did child participate in occupational therapy
0;1
0 = No; 1 = Yes occupational_therapy
txhxocctx1start Date Recommended occupational therapy start date date_started_occupational_therapy
Query txhxocctx1ong Integer Recommended occupational therapy ongoing?
0;1
0 = No; 1 = Yes still_receiving_occupational_therapy
txhxocctx1end Date Recommended occupational therapy end date if_no_date_stopped_occupational_therapy
Query txhxocctx1type String 10 Recommended occupational therapy type Individual; Group individual_or_group_occupational_therapy
Query ot_setting String 200 Recommended setting of OT setting_occupational_therapy
ot_other String 25 Recommended Other setting of Occupational Therapy other_setting_occupational_therapy
Query ot1_week_hrs Float Recommended Occupational Therapy Occurrence 1:For the following intervention, how many hours per week were provided? hours_per_week_occupational_therapy
Query service_physical String 5 Recommended Physical Therapy Yes; No physical_therapy
pt_start Date Recommended Date started Physical Therapy: date_started_physical_therapy
Query pt_ongoing Integer Recommended Still receiving Physical Therapy? 0;1 0 = No; 1 = Yes still_receiving_physical_therapy
pt_end Date Recommended date subject ended PT date_stopped_physical_therapy
Query pt_type Integer Recommended Individual or Group Physical Therapy? 0;1 0 = Group; 1 = Individual individual_group_physical_therapy
Query pt_setting String 200 Recommended setting of PT setting_physical_therapy
pt_other String 25 Recommended Other setting of Physical Therapy: other_setting_physical_therapy
Query pt_week_hrs Float Recommended Average hours per week at Physical Therapy: hours_per_week_physical_therapy
Query txhx1speechtx1 Integer Recommended Did child participate in speech therapy
0;1
0 = No; 1 = Yes speech_language_therapy
txhxspeechtx1start Date Recommended speech therapy start date date_started_speech_language
Query txhxspeechtx1ong Integer Recommended speech therapy ongoing?
0;1
0 = No; 1 = Yes still_receiving_speech_language_therapy
txhxspeechtx1end Date Recommended speech therapy end date date_stopped_speech_language
Query txhxspeechtx1type String 10 Recommended speech therapy type Individual; Group individual_or_group_speech_language
Query speech_setting Integer Recommended Setting of Speech-Lanugage Therapy: 0::3 0 = Daycare/preschool; 1 = Home; 2 = Office/Clinic; 3= Other setting_speech_lanugage_therapy
speech_other String 25 Recommended Other setting of Speech-Lanugage Therapy other_setting_speech_lanugage_therapy
Query speech_week_hrs Float Recommended Average hours per week at Speech-Language Therapy: hours_per_week_speech_language
Query cbe_interv Integer Recommended Comprehensive Behavioral/Educational Interventions 0;1 0 = No; 1 = Yes comp_behavioral_educational_interventions
cbe_start Date Recommended Date Started Comprehensive Behavioral/Educational Interventions date_started_comprehensive_behavioral
Query cbe_ongoing Integer Recommended Still receiving Comprehensive Behavioral/Educational Interventions? 0;1 0 = No; 1 = Yes still_receiving_comprehensive_behavioral
cbe_end Date Recommended If, No, date stopped Comprehensive Behavioral/Educational Interventions date_stopped_comprehensive
Query sbe_type Integer Recommended Individual or Group Comprehensive Behavioral/Educational Interventions? 0;1 0 = Group; 1 = Individual individual_or_group_comprehensive_behavioral
Query cbe_setting Integer Recommended Setting of Comprehensive Behavioral/Educational Interventions 0::3 0 = Daycare/preschool; 1 = Home; 2 = Office/Clinic; 3= Other setting_comprehensive_behavioral
cbe_other String 25 Recommended Other setting of Comprehensive Behavioral/Educational Interventions other_setting_comprehensive_behavioral
Query cbe_week_hrs Float Recommended Average hours per week at Comprehensive Behavioral/Educational Interventions: average_hours_per_week_comp_behavioral
Query other_intervention Integer Recommended Other Intervention 0;1 0 = No; 1 = Yes
other_start Date Recommended date subject began other therapy date_started_other_intervention
Query other_ongoing Integer Recommended Still receiving Other Intervention? 0;1 0 = No; 1 = Yes still_receiving_other_intervention
other_end Date Recommended date subject ended other therapy if_no_date_stopped_other_intervention
Query othertherapy1_group_ind String 50 Recommended Other Therapy Occurrence 1: For the following intervention, how was it provided? Individual;Group;Both individual_or_group_other_intervention
other_setting String 200 Recommended setting of other therapy setting_other_intervention
other_other String 50 Recommended Other Setting of Other Intervention: other_setting_other_intervention
Query othertherapy1_week_hrs Float Recommended Other Therapy Occurrence 1:For the following intervention, how many hours per week were provided? average_hours_per_week_other_intervention
Query intervention_average Float Recommended On average, how many hours per week has your child been in intervention since your last visit to our research program? hours_per_week_since_last_visit
Query intervention_average_year Float Recommended On average, how many hours per week has your child been in intervention in the past year? hours_per_week_in_past_year
Query alternative_therapies Integer Recommended Did your child receive complementory or alternative therapies used to treat symptoms of autism? 0;1 0 = No; 1 = Yes receive_alternative_therapies
Query alternative_specify String 50 Recommended If Yes, please specify: please_specify_alternative_therapy
Query pharma_int Integer Recommended 8. Did your child receive medical or pharmacological interventions? 0;1 0 = No; 1 = Yes medical_pharmacological_intervention
pharma_specify String 50 Recommended If, Yes, please specify: specify_pharm_intervention
Query assess_36m Integer Recommended Is this your child's 36-month assessment? 0;1 0 = No; 1 = Yes this_your_childs_36_month_assessment
Query intervention_plan Integer Recommended Do you plan to continue your child's enrollment in intervention during the next year? 0;1 0 = No; 1 = Yes plan_continue_childs_enrollment_intervention
future_intervention String 100 Recommended Plan to continue following interventions
Query program_week_hrs Float Recommended Average hours per week (of early intervention or birth to three programs). average_hours_per_week
Query total_hrs Float Recommended Total hours since last visit (of early intervention or birth to three programs). total_hours_since_last_visit
comments_misc String 4,000 Recommended Miscellaneous comments on study, interview, methodology relevant to this form data anything_tell_us_about_services
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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