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NDAR provides a single access to de-identified autism research data. For permission to download data, you will need an NDAR account with approved access to NDAR or a connected repository (AGRE, IAN, or the ATP). For NDAR access, you need to be a research investigator sponsored by an NIH recognized institution with federal wide assurance. See Request Access for more information.

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Clinical Assessment Form

caform

01

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Element NameData TypeSizeRequiredDescriptionValue RangeNotesAliases
subjectkeyGUIDRequiredThe NDAR Global Unique Identifier (GUID) for research subjectNDAR*
src_subject_idString20RequiredSubject ID how it's defined in lab/project
interview_dateDateRequiredDate on which the interview/genetic test/sampling/imaging was completed. MM/DD/YYYYRequired field
interview_ageIntegerRequiredAge in months at the time of the interview/test/sampling/imaging.0 :: 1260Age 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.
genderString20RequiredSex of the subjectM;FM = Male; F = Female
abdomdistentionIntegerRecommendedAbdominal distention0::50=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
abdomenabnormalString50RecommendedAbdomen If abnormal briefly describe abnormalities
abdomenlistIntegerRecommendedAbdomen0::31=Normal; 2=G-tube present and normal; 3=Abnormal (not including distention; recorded elsewhere); 0=Not done
actionposttremorIntegerRecommendedAction or postural tremor0::40=Not present; 1=1 cm to <3 cm maximal amplitude; 2=3 cm to 10 cm maximal amplitude; 3=>10 cm maximal amplitude;4= <1 cm maximal amplitude
aggressivebehaviorsIntegerRecommendedAggressive behaviors towards others1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
airswallowingIntegerRecommendedAirswallowing1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
alertness_dxIntegerRecommendedAlertness0::40=Not alert; 1=~25%;2= ~50%; 3=~75%;4= Alert entire visit (>90%)alertness
appendicrigidityIntegerRecommendedAppendicular Rigidity nonvelocity dependent stiffness0::50=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
appendictoneIntegerRecommendedOverall tone choose one option onlyAppendicular1::41=Normal; 2=Hypotonic; 3=Hypertonic;4= Mixed
ataxiaapraxiaIntegerRecommendedAtaxiaapraxia of gait1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
axialrigidityIntegerRecommendedAxial Rigidity nonvelocity dependent stiffness0::50=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
axialtoneIntegerRecommendedOverall tone choose one option onlyAxial1::41=Normal; 2=Hypotonic; 3=Hypertonic;4= Mixed
bmicategorycssIntegerRecommendedBMI category for CSS1::51=26%-50% or higher; 2=11-25%; 3=5-10%; 4=<5%; 5=<<5%
babinskinotpresentIntegerRecommendedBabinskiNotpresent0;10 = unchecked box; 1 = checked box
birthmarkslocationsizeIntegerRecommendedBirth marks location and size
bradykinesiaIntegerRecommendedBradykinesia0::40=Not present; 1=Deliberate movements with minimal slowness (<10% of time); 2=Mild paucity of movement or mild slowness (<50% of time); 3=Moderate paucity of movement with moderate slowness (50-90% of time); 4=Rarely moves or movements extremely slow (95-100% of time)
breasttannerstageIntegerRecommendedBreast Tanner stage for males indicate not done0::51=I - no glandular tissue; areola follows the skin contours of the chest; 2=II - breast bud forms, with small area of surrounding glandular tissue; areola begins to widen; 3=III - breast more elevated, extends beyond areola border, areola continues to widen (in contour with breast); 4=IV - increased breast size and elevation; areola and papilla form a secondary mound; 5=V - breast final adult size; areola returns to contour of surrounding breast; projecting central papilla; 0=not done
breathholdingIntegerRecommendedBreathholding of time of visit Hyperventilation and Breathholding cannot be 1001::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
breathholdingcyanosisIntegerRecommendedIf breathholding present level of cyanosis0::30=No cyanosis; 1=Mild, peri-oral or acrocyanosis; 2=Moderate cyanosis; 3=Severe cyanosis with alteration of consciousness
breathholdingdisruptIntegerRecommendedIf breathholding present level of disruption0::50=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
bruxism_dxIntegerRecommendedBruxism1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%bruxism
cardiacabcommentString100RecommendedCardiac soundsComments if abnormal
cardiacsoundsIntegerRecommendedCardiac sounds0::21=Normal; 2=Abnormal; 0=Not Done
choreaIntegerRecommendedChorea0::40=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
comestositIntegerRecommendedComes to sitting0::31=On own; 2=With minimal assistance; 3=With maximal assistance; 0=No attempt
comestostandIntegerRecommendedComes to standing0::31=On own; 2=With minimal assistance; 3=With maximal assistance; 0=No attempt
commgenexamString250RecommendedOptional comments on general exam
commnonverblangString150RecommendedOptional comments on expressive nonverbal language
commentsreflexString150RecommendedOptional comments on reflexes or pathological reflexes present
contractures_ankleIntegerRecommendedContractures: Ankle0;10 = unchecked box; 1 = checked box
contractures_elbowIntegerRecommendedContractures: Elbow0;10 = unchecked box; 1 = checked box
contractures_fingersIntegerRecommendedContractures: Fingers0;10 = unchecked box; 1 = checked box
contractures_hipIntegerRecommendedContractures: Hip0;10 = unchecked box; 1 = checked box
contractures_kneeIntegerRecommendedContractures: Knee0;10 = unchecked box; 1 = checked box
contractures_noneIntegerRecommendedContractures: None0;10 = unchecked box; 1 = checked box
contractures_wristIntegerRecommendedContractures: Wrist0;10 = unchecked box; 1 = checked box
pe_9IntegerRecommendedCranial Nerves0::21=Normal;2=Abnormal; 0=Not donecranialnerves
degreehyperreflexiaIntegerRecommendedDegree of Hyperreflexia1::51=4+ with spread or clonus; 2=4+ with spread and clonus; 3=Normal; 4=4+ ankles or knees; 5=4+ ankles and knees
descriptabnormalotherString50RecommendedDescription of abnormalityIf other please specify
da_doesnotalerttosIntegerRecommendedDescriptAbnormal: Does not alert to sounds0;10 = unchecked box; 1 = checked boxdescriptabnormal_doesnotalerttos
da_doesnotfixvisuaIntegerRecommendedDescriptAbnormal: Does not fix visually0;10 = unchecked box; 1 = checked boxdescriptabnormal_doesnotfixvisua
da_doesnotfollowokIntegerRecommendedDescriptAbnormal: Does not follow OKN tape/test0;10 = unchecked box; 1 = checked boxdescriptabnormal_doesnotfollowok
da_doesnotfollowviIntegerRecommendedDescriptAbnormal: Does not follow visually0;10 = unchecked box; 1 = checked boxdescriptabnormal_doesnotfollowvi
da_dysconjugategazIntegerRecommendedDescriptAbnormal: Dysconjugate gaze0;10 = unchecked box; 1 = checked boxdescriptabnormal_dysconjugategaz
da_facialnervepalsIntegerRecommendedDescriptAbnormal: Facial nerve palsy, peripheral or central0;10 = unchecked box; 1 = checked boxdescriptabnormal_facialnervepals
da_lateralgazepalsIntegerRecommendedDescriptAbnormal: Lateral gaze palsy0;10 = unchecked box; 1 = checked boxdescriptabnormal_lateralgazepals
da_nystagmusIntegerRecommendedDescriptAbnormal: Nystagmus0;10 = unchecked box; 1 = checked boxdescriptabnormal_nystagmus
da_otherIntegerRecommendedDescriptAbnormal: Other0;10 = unchecked box; 1 = checked boxdescriptabnormal_other
da_sialorrheaIntegerRecommendedDescriptAbnormal: Sialorrhea0;10 = unchecked box; 1 = checked boxdescriptabnormal_sialorrhea
da_verticalgazepalIntegerRecommendedDescriptAbnormal: Vertical gaze palsy0;10 = unchecked box; 1 = checked boxdescriptabnormal_verticalgazepal
da_appearsanxiousorfIntegerRecommendedDescript Affect: Appears anxious or fearful0;10 = unchecked box; 1 = checked boxdescriptaffect_appearsanxiousorf
descriptaffect_calmIntegerRecommendedDescript Affect: Calm0;10 = unchecked box; 1 = checked box
descriptaffect_cryingIntegerRecommendedDescript Affect: Crying0;10 = unchecked box; 1 = checked box
descriptaffect_frowningorsadIntegerRecommendedDescript Affect: Frowning or sad0;10 = unchecked box; 1 = checked box
descriptaffect_irritableIntegerRecommendedDescript Affect: Irritable0;10 = unchecked box; 1 = checked box
da_laughingorgigglinIntegerRecommendedDescript Affect: Laughing or giggling0;10 = unchecked box; 1 = checked boxdescriptaffect_laughingorgigglin
descriptaffect_screamingIntegerRecommendedDescript Affect: Screaming0;10 = unchecked box; 1 = checked box
descriptaffect_smilingIntegerRecommendedDescript Affect: Smiling0;10 = unchecked box; 1 = checked box
drooling_dxIntegerRecommendedDrooling of time of visit Drooling and PuffingBlowing Raspberries cant be 1001::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%drooling
durationeyecontIntegerRecommendedDuration of eye contact0::41=Preserved and propositive; 2=Good eye contact (>30 seconds); 3=Intermittent eye contact (5 to <30 seconds); 4=Infrequent eye contact (<5 seconds); 0=None
dysmextremotherString100RecommendedDysmorphic features of extremitiesIf other please specify
d_abnormalnailbedsIntegerRecommendedDysmExtrem: abnormal nail beds0;10 = unchecked box; 1 = checked boxdysmextrem_abnormalnailbeds
de_noneIntegerRecommendedDysmExtrem: none0;10 = unchecked box; 1 = checked boxdysmextrem_none
de_otherIntegerRecommendedDysmExtrem: other0;10 = unchecked box; 1 = checked boxdysmextrem_other
d_polydactylyIntegerRecommendedDysmExtrem: polydactyly0;10 = unchecked box; 1 = checked boxdysmextrem_polydactyly
d_syndactylyIntegerRecommendedDysmExtrem: syndactyly0;10 = unchecked box; 1 = checked boxdysmextrem_syndactyly
d_antevertednaresIntegerRecommendedDysmorphicCB: anteverted nares0;10 = unchecked box; 1 = checked boxdysmorphiccb_antevertednares
d_archedeyebrowsIntegerRecommendedDysmorphicCB: arched eyebrows0;10 = unchecked box; 1 = checked boxdysmorphiccb_archedeyebrows
d_broadforeheadIntegerRecommendedDysmorphicCB: broad forehead0;10 = unchecked box; 1 = checked boxdysmorphiccb_broadforehead
d_broadnasalbridgeIntegerRecommendedDysmorphicCB: broad nasal bridge0;10 = unchecked box; 1 = checked boxdysmorphiccb_broadnasalbridge
d_bulbousnoseIntegerRecommendedDysmorphicCB: bulbous nose0;10 = unchecked box; 1 = checked boxdysmorphiccb_bulbousnose
d_deepseteyesIntegerRecommendedDysmorphicCB: deep-set eyes0;10 = unchecked box; 1 = checked boxdysmorphiccb_deepseteyes
d_depressednasalbridgIntegerRecommendedDysmorphicCB: depressed nasal bridge0;10 = unchecked box; 1 = checked boxdysmorphiccb_depressednasalbridg
d_downslantingpalpebrIntegerRecommendedDysmorphicCB: downslanting palpebral fissues0;10 = unchecked box; 1 = checked boxdysmorphiccb_downslantingpalpebr
d_epicanthalfoldsIntegerRecommendedDysmorphicCB: epicanthal folds0;10 = unchecked box; 1 = checked boxdysmorphiccb_epicanthalfolds
d_higharchedpalateIntegerRecommendedDysmorphicCB: high arched palate0;10 = unchecked box; 1 = checked boxdysmorphiccb_higharchedpalate
d_highforeheadIntegerRecommendedDysmorphicCB: high forehead0;10 = unchecked box; 1 = checked boxdysmorphiccb_highforehead
d_highfrontalhairlineIntegerRecommendedDysmorphicCB: high frontal hairline0;10 = unchecked box; 1 = checked boxdysmorphiccb_highfrontalhairline
d_hypertelorismIntegerRecommendedDysmorphicCB: hypertelorism0;10 = unchecked box; 1 = checked boxdysmorphiccb_hypertelorism
d_hypotelorismIntegerRecommendedDysmorphicCB: hypotelorism0;10 = unchecked box; 1 = checked boxdysmorphiccb_hypotelorism
d_largemouthIntegerRecommendedDysmorphicCB: large mouth0;10 = unchecked box; 1 = checked boxdysmorphiccb_largemouth
d_longeyelashesIntegerRecommendedDysmorphicCB: long eyelashes0;10 = unchecked box; 1 = checked boxdysmorphiccb_longeyelashes
d_lowsetearsIntegerRecommendedDysmorphicCB: low set ears0;10 = unchecked box; 1 = checked boxdysmorphiccb_lowsetears
d_micrognathiaIntegerRecommendedDysmorphicCB: micrognathia0;10 = unchecked box; 1 = checked boxdysmorphiccb_micrognathia
dy_noneIntegerRecommendedDysmorphicCB: none0;10 = unchecked box; 1 = checked boxdysmorphiccb_none
dy_otherIntegerRecommendedDysmorphicCB: other0;10 = unchecked box; 1 = checked boxdysmorphiccb_other
d_pointedchinIntegerRecommendedDysmorphicCB: pointed chin0;10 = unchecked box; 1 = checked boxdysmorphiccb_pointedchin
d_posteriorlyrotatedeIntegerRecommendedDysmorphicCB: posteriorly rotated ears0;10 = unchecked box; 1 = checked boxdysmorphiccb_posteriorlyrotatede
d_retrognathiaIntegerRecommendedDysmorphicCB: retrognathia0;10 = unchecked box; 1 = checked boxdysmorphiccb_retrognathia
d_smoothphiltrumIntegerRecommendedDysmorphicCB: smooth philtrum0;10 = unchecked box; 1 = checked boxdysmorphiccb_smoothphiltrum
d_synophrysIntegerRecommendedDysmorphicCB: synophrys0;10 = unchecked box; 1 = checked boxdysmorphiccb_synophrys
d_thinupperlipIntegerRecommendedDysmorphicCB: thin upper lip0;10 = unchecked box; 1 = checked boxdysmorphiccb_thinupperlip
d_triangularfaceIntegerRecommendedDysmorphicCB: triangular face0;10 = unchecked box; 1 = checked boxdysmorphiccb_triangularface
d_upslantingpalpebralIntegerRecommendedDysmorphicCB: upslanting palpebral fissures0;10 = unchecked box; 1 = checked boxdysmorphiccb_upslantingpalpebral
d_widelyspacedteethIntegerRecommendedDysmorphicCB: widely spaced teeth0;10 = unchecked box; 1 = checked boxdysmorphiccb_widelyspacedteeth
dysmorphicotherIntegerRecommendedDysmorphic featuresIf other please specify
dystoniaIntegerRecommendedDystonia0::50=None; 1=Focal dystonia (more than one joint); 2=Segmental dystonia (two extremities); 3=Generalized dystonia (>2 extremities); 4=None; 5=Focal dystonia (one joint)
facialflushIntegerRecommendedFacial flushing0;10=Absent; 1=Present
fathercircumnotdoneIntegerRecommendedBirth Fathers head circumference not done0;10 = unchecked box; 1 = checked box
pda_s2q3_percentile_head_faIntegerRecommendedBio father head circumference percentilefathercircumpercent
pda_s2q3_head_circumference_faString50RecommendedBio father head circumference (cm)fatherheadcircum
feetcbIntegerRecommendedFeet choose one from each column1::41=Pink; 2=Mottled; 3=Cyanotic; 4=Red
freqhandmouthingIntegerRecommendedFrequency of hand mouthing hands or objects1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
freqhandstereotypiesIntegerRecommendedFrequency of hand stereotypies1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
gp_broadbasedIntegerRecommendedGaitPattern: Broad based0;10 = unchecked box; 1 = checked boxgaitpattern_broadbased
gp_dyspraxicIntegerRecommendedGaitPattern: Dyspraxic0;10 = unchecked box; 1 = checked boxgaitpattern_dyspraxic
gp_normalIntegerRecommendedGaitPattern: Normal0;10 = unchecked box; 1 = checked boxgaitpattern_normal
gp_retropulsionIntegerRecommendedGaitPattern: Retropulsion0;10 = unchecked box; 1 = checked boxgaitpattern_retropulsion
gp_rockingsidetosideIntegerRecommendedGaitPattern: Rocking side-to-side0;10 = unchecked box; 1 = checked boxgaitpattern_rockingsidetoside
gp_toewalkingIntegerRecommendedGaitPattern: Toe walking0;10 = unchecked box; 1 = checked boxgaitpattern_toewalking
gesturevisualcueIntegerRecommendedPlace toyfood on table and after participant is distracted using only a gesture or visual cue eg pointing and looking at item indicate the toy food and record response0::51=Looks at item immediately; 2=After a delay of greater than 5 seconds, looks at item; 3=Turns and looks somewhere else; 4=Regards examiner but does not perform any action; 5=Ignores examiner completely; 0=Unable to perform
gaotherString150RecommendedIf participant cannot walk independently describe some of the ways heshe gets aroundIf other specifygetsaroundother
ga_crawlsIntegerRecommendedGetsAround: Crawls0;10 = unchecked box; 1 = checked boxgetsaround_crawls
ga_creepsonbellypullsselIntegerRecommendedGetsAround: Creeps on belly (pulls self)0;10 = unchecked box; 1 = checked boxgetsaround_creepsonbellypullssel
ga_otherIntegerRecommendedGetsAround: Other0;10 = unchecked box; 1 = checked boxgetsaround_other
ga_rollsIntegerRecommendedGetsAround: Rolls0;10 = unchecked box; 1 = checked boxgetsaround_rolls
ga_scootsonbottomIntegerRecommendedGetsAround: Scoots on bottom0;10 = unchecked box; 1 = checked boxgetsaround_scootsonbottom
ga_unabletogetaroundIntegerRecommendedGetsAround: Unable to get around0;10 = unchecked box; 1 = checked boxgetsaround_unabletogetaround
ga_walkswithassistanceIntegerRecommendedGetsAround: Walks with assistance0;10 = unchecked box; 1 = checked boxgetsaround_walkswithassistance
grimaceIntegerRecommendedGrimace or sharp contortion of face1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
handdominanceIntegerRecommendedHand Dominance1::41=Left; 2=Variable; 3=Right; 4=Unable to determine
handuseimpressionIntegerRecommendedHand use Impression1::61=Holds object when placed in hand; 2=Normal; 3=Plays with toys or activates switches purposefully; 4=Uses utensils; 5=Finger feeds only or picks up toys; 6=No purposeful hand use
handscbIntegerRecommendedHands choose one from each column1::41=Pink; 2=Mottled; 3=Cyanotic; 4=Red
headcircumnotdoneIntegerRecommendedHead circumference not done0;10 = unchecked box; 1 = checked box
pda_s3q4_headcirc_percentileIntegerRecommendedHead circumference percentileheadcircumpercent
head_circumFloatRecommendedHead Circumference (in cm)-1 = Not knownheadcircumference
heightmeasurementIntegerRecommendedHeight measurement way1::41=Standing; 2=Recumbent; 3=Segmental; 4=Calculated
heightnotdoneIntegerRecommendedHeight not done0;10 = unchecked box; 1 = checked box
neuro_007_height_cmFloatRecommendedNeurological Exam (4:6+ y:m): Measured height (cm)heighttextbox
hyperactivityIntegerRecommendedHyperactivity of time of visit Hypo and Hyperactivity cant be 1001::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
hyperventleveldisruptIntegerRecommendedIf hyperventilation present level of disruption0::50=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
hyperventilationIntegerRecommendedHyperventilation of time of visit Hyperventilation and Breathholding cannot be 1001::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
hypoactivityIntegerRecommendedHypoactivity of time of visit Hypo and Hyperactivity cant be 1001::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
interactionIntegerRecommendedInteraction with examiner1::51=~25%; 2=Not interactive; 3=Interactive entire visit (>90%); 4=~75%; 5=~50%
irritability_dxIntegerRecommendedIrritability0::40=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of timeirritability
lefthandotherString100RecommendedHand use mark all observedLeft hand if other specify
lh_copiescircleIntegerRecommendedLeftHandUse: Copies circle0;10 = unchecked box; 1 = checked boxlefthanduse_copiescircle
lh_copiesdrawnlinevertiIntegerRecommendedLeftHandUse: Copies drawn line vertically0;10 = unchecked box; 1 = checked boxlefthanduse_copiesdrawnlineverti
lh_copieslinedrawnhorizIntegerRecommendedLeftHandUse: Copies line drawn horizontally0;10 = unchecked box; 1 = checked boxlefthanduse_copieslinedrawnhoriz
lh_drawsonpaperwithoutcIntegerRecommendedLeftHandUse: Draws on paper without copying0;10 = unchecked box; 1 = checked boxlefthanduse_drawsonpaperwithoutc
lh_foldspaperinhalfIntegerRecommendedLeftHandUse: Folds paper in half0;10 = unchecked box; 1 = checked boxlefthanduse_foldspaperinhalf
lh_graspstoyfoodwpincheIntegerRecommendedLeftHandUse: Grasps toy/food w/pincher0;10 = unchecked box; 1 = checked boxlefthanduse_graspstoyfoodwpinche
lh_holdscupIntegerRecommendedLeftHandUse: Holds cup0;10 = unchecked box; 1 = checked boxlefthanduse_holdscup
lh_holdsobjectIntegerRecommendedLeftHandUse: Holds object0;10 = unchecked box; 1 = checked boxlefthanduse_holdsobject
lh_manipulatesobjectIntegerRecommendedLeftHandUse: Manipulates object0;10 = unchecked box; 1 = checked boxlefthanduse_manipulatesobject
lh_noneobservedIntegerRecommendedLeftHandUse: None observed0;10 = unchecked box; 1 = checked boxlefthanduse_noneobserved
lh_otherIntegerRecommendedLeftHandUse: Other0;10 = unchecked box; 1 = checked boxlefthanduse_other
lh_reachesfortoyfoodIntegerRecommendedLeftHandUse: Reaches for toy/food0;10 = unchecked box; 1 = checked boxlefthanduse_reachesfortoyfood
lh_throwsobjectIntegerRecommendedLeftHandUse: Throws object0;10 = unchecked box; 1 = checked boxlefthanduse_throwsobject
lh_transfersobjectIntegerRecommendedLeftHandUse: Transfers object0;10 = unchecked box; 1 = checked boxlefthanduse_transfersobject
lh_turnspageinbookIntegerRecommendedLeftHandUse: Turns page in book0;10 = unchecked box; 1 = checked boxlefthanduse_turnspageinbook
lh_usesutensilmaybeadapIntegerRecommendedLeftHandUse: Uses utensil (may be adaptive)0;10 = unchecked box; 1 = checked boxlefthanduse_usesutensilmaybeadap
lh_writeslettersIntegerRecommendedLeftHandUse: Writes letters0;10 = unchecked box; 1 = checked boxlefthanduse_writesletters
lighttouchIntegerRecommendedLight touch1::31=Normal or apparently normal; 2=No clear response to light touch in specific region; 3=No clear response to light touch throughout
lsa_bangingheadIntegerRecommendedListSelfAbusive: Banging head0;10 = unchecked box; 1 = checked boxlistselfabusive_banginghead
lsa_bitingchewingselIntegerRecommendedListSelfAbusive: Biting/chewing self0;10 = unchecked box; 1 = checked boxlistselfabusive_bitingchewingsel
lsa_hittingslapping1IntegerRecommendedListSelfAbusive: Hitting/slapping other parts of head0;10 = unchecked box; 1 = checked boxlistselfabusive_hittingslapping1
lsa_hittingslapping2IntegerRecommendedListSelfAbusive: Hitting/slapping other body parts0;10 = unchecked box; 1 = checked boxlistselfabusive_hittingslapping2
lsa_noneIntegerRecommendedListSelfAbusive: None0;10 = unchecked box; 1 = checked boxlistselfabusive_none
lsa_pickingselfIntegerRecommendedListSelfAbusive: Picking self0;10 = unchecked box; 1 = checked boxlistselfabusive_pickingself
lsa_pullinghairIntegerRecommendedListSelfAbusive: Pulling hair0;10 = unchecked box; 1 = checked boxlistselfabusive_pullinghair
lsa_rubbingorpinchinIntegerRecommendedListSelfAbusive: Rubbing or pinching self0;10 = unchecked box; 1 = checked boxlistselfabusive_rubbingorpinchin
lsa_scratchingdigginIntegerRecommendedListSelfAbusive: Scratching/digging self0;10 = unchecked box; 1 = checked boxlistselfabusive_scratchingdiggin
lsa_slappingfaceIntegerRecommendedListSelfAbusive: Slapping face0;10 = unchecked box; 1 = checked boxlistselfabusive_slappingface
miduppercircnotdoneIntegerRecommendedMidupper arm circ not done0;10 = unchecked box; 1 = checked box
mothercircumnotdoneIntegerRecommendedBirth Mothers head circumference not done0;10 = unchecked box; 1 = checked box
pda_s2q2_head_circumferenceString50RecommendedBio mother Head circumference (cm)motherheadcircum
pda_s2q2_percentile_head_mthrString50RecommendedBio mother Head circumference percentilemothercircumpercent
musclemassIntegerRecommendedMuscle mass1;21=Normal to increased; 2=Decreased
neuroexamcommString300RecommendedOptional comments on general neurological exam
nonvclearmeaningIntegerRecommendedWhen using nonverbal communication how clear is meaning without coaching1::61=Meaning is always clear; 2=Meaning is clear most of the time (>90%);3= Meaning is clear more than half the time (50-90%); 4=Meaning is clear less than half the time (10-<50%); 5=Meaning is rarely clear (<10% of time); 6=No communication (0%)
nonverbattemptsgestString100RecommendedList all nonverbal ways child attempts to communicateIf hand gestures example
nonverbattemptsotherString150RecommendedList all nonverbal ways child attempts to communicateIf other example
nonverbattemptssignString50RecommendedList all nonverbal ways child attempts to communicateIf sign language example
nva_expressionofangeIntegerRecommendedNonverbAttempts: Expression of anger0;10 = unchecked box; 1 = checked boxnonverbattempts_expressionofange
nva_expressionoffearIntegerRecommendedNonverbAttempts: Expression of fear or anxiety0;10 = unchecked box; 1 = checked boxnonverbattempts_expressionoffear
nva_expressionofsadnIntegerRecommendedNonverbAttempts: Expression of sadness0;10 = unchecked box; 1 = checked boxnonverbattempts_expressionofsadn
nva_expressionofsurpIntegerRecommendedNonverbAttempts: Expression of surprise0;10 = unchecked box; 1 = checked boxnonverbattempts_expressionofsurp
nva_frowningIntegerRecommendedNonverbAttempts: Frowning0;10 = unchecked box; 1 = checked boxnonverbattempts_frowning
nva_handgesturesIntegerRecommendedNonverbAttempts: Hand gestures0;10 = unchecked box; 1 = checked boxnonverbattempts_handgestures
nva_noattemptIntegerRecommendedNonverbAttempts: No attempt0;10 = unchecked box; 1 = checked boxnonverbattempts_noattempt
nva_othercuesIntegerRecommendedNonverbAttempts: Other cues0;10 = unchecked box; 1 = checked boxnonverbattempts_othercues
nva_pointingIntegerRecommendedNonverbAttempts: Pointing0;10 = unchecked box; 1 = checked boxnonverbattempts_pointing
nva_signlanguageIntegerRecommendedNonverbAttempts: Sign Language0;10 = unchecked box; 1 = checked boxnonverbattempts_signlanguage
nva_smilingsociallyIntegerRecommendedNonverbAttempts: Smiling (socially)0;10 = unchecked box; 1 = checked boxnonverbattempts_smilingsocially
nva_wavingIntegerRecommendedNonverbAttempts: Waving0;10 = unchecked box; 1 = checked boxnonverbattempts_waving
nonverbchoiceIntegerRecommendedWhen shown 2 items use favorite toys if present or food items how does participant choose nonverbally If participant indicated want clearly verbally to provoke nonverbal response ask participant to show me which one0::51=Points with a single finger to the item she/he wants; 2=Gestures with several fingers or hand to the item she/he wants; 3=Indicates want using other gesture; 4=Turns towards the item she/he wants but does not gesture; 5=Does not indicate want nonverbally; 0=Unable to perform
nystagmustypeIntegerRecommendedDescription of abnormalityIf Nystagmus what type1::31=Vertical; 2=Horizontal; 3=Rotator
oromotordyskinesiaIntegerRecommendedOromotor dyskinesia tongue protrusion smacking lips sidetoside jaw movements1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
othermovementsIntegerRecommendedOther movements mark all that apply0::40=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
or_babinskipresentIntegerRecommendedOtherReflexes: Babinski present0;10 = unchecked box; 1 = checked boxotherreflexes_babinskipresent
otherreflexes_noneIntegerRecommendedOtherReflexes: None0;10 = unchecked box; 1 = checked box
or_palmomentalpresentIntegerRecommendedOtherReflexes: Palmomental present0;10 = unchecked box; 1 = checked boxotherreflexes_palmomentalpresent
ors_snoutpresentIntegerRecommendedOtherReflexes: Snout present0;10 = unchecked box; 1 = checked boxotherreflexes_snoutpresent
overallhypertoniaIntegerRecommendedOverall hypertonia choose one option only0::40=None; 1=Ankle hypertonia; 2=Upper or lower limb hypertonia; 3=Generalized no contractures; 4=Generalized with contractures
overallreflexesIntegerRecommendedOverall reflexes choose one option only1::31=Normal throughout (include hyporeflexia); 2=Some Hyperreflexia; 3=Global Hyperreflexia
painfulstimulationIntegerRecommendedPainful stimulation apply firm pressure to base of finger nail bed using pen or examiners nail for 5 seconds0::31=Immediate withdrawal and change in facial expression; 2=Immediate withdrawal without grimace or clear recognition; 3=Delayed withdrawal; 0=No response during 5 seconds of pressure
palmomentalnotpresentIntegerRecommendedPalmomental Not present0;10 = unchecked box; 1 = checked box
predominantaffectIntegerRecommendedDescription of affect Choose all that apply and choose one predominant affect1::81=Calm; 2=Smiling; 3=Laughing or giggling; 4=Appears anxious or fearful; 5=Frowning or sad; 6=Crying; 7=Irritable; 8=Screaming
pubictannerstageIntegerRecommendedPubic Tanner stage0::51=I - No pubic hair; 2=II - Females: small amount of long, downy hair, slight pigmentation on labia majora; 3=III - Hair becomes more coarse and curly, and begins to extend laterally; 4=IV - Adult-like hair quality, extending across pubis but sparing medial thighs; 5=V - Hair extends to medial surface of the thighs; 0=Not done
puffblowraspIntegerRecommendedPuffingblowing raspberries of time of visit Drooling and PuffingBlowing Raspberries cant be 1001::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
pulmexamIntegerRecommendedPulmonary exam0::21=Normal; 2=Abnormal; 0=Not Done
pulmexamabcomString100RecommendedPulmonary examComments if abnormal
rm_chewinglickiIntegerRecommendedRepetitiveMovements: Chewing/licking0;10 = unchecked box; 1 = checked boxrepetitivemovements_chewinglicki
rm_clappingIntegerRecommendedRepetitiveMovements: Clapping0;10 = unchecked box; 1 = checked boxrepetitivemovements_clapping
rm_claspingIntegerRecommendedRepetitiveMovements: Clasping0;10 = unchecked box; 1 = checked boxrepetitivemovements_clasping
rm_fingerrubbinIntegerRecommendedRepetitiveMovements: Finger rubbing0;10 = unchecked box; 1 = checked boxrepetitivemovements_fingerrubbin
rm_flappinginfrIntegerRecommendedRepetitiveMovements: Flapping in front of body0;10 = unchecked box; 1 = checked boxrepetitivemovements_flappinginfr
rm_flappingnextIntegerRecommendedRepetitiveMovements: Flapping next to body0;10 = unchecked box; 1 = checked boxrepetitivemovements_flappingnext
rm_flickingfingIntegerRecommendedRepetitiveMovements: Flicking (fingers, lips, etc.)0;10 = unchecked box; 1 = checked boxrepetitivemovements_flickingfing
rm_flippingpageIntegerRecommendedRepetitiveMovements: Flipping (pages, hands, objects)0;10 = unchecked box; 1 = checked boxrepetitivemovements_flippingpage
rm_hairtwirlingIntegerRecommendedRepetitiveMovements: Hair twirling/pulling0;10 = unchecked box; 1 = checked boxrepetitivemovements_hairtwirling
rm_handmouthingIntegerRecommendedRepetitiveMovements: Hand mouthing0;10 = unchecked box; 1 = checked boxrepetitivemovements_handmouthing
rm_handwringingIntegerRecommendedRepetitiveMovements: Hand wringing/washing0;10 = unchecked box; 1 = checked boxrepetitivemovements_handwringing
rm_knittingtwisIntegerRecommendedRepetitiveMovements: Knitting/twisting fingers0;10 = unchecked box; 1 = checked boxrepetitivemovements_knittingtwis
rm_noneIntegerRecommendedRepetitiveMovements: None0;10 = unchecked box; 1 = checked boxrepetitivemovements_none
rm_pickingclothIntegerRecommendedRepetitiveMovements: Picking (clothes, body, arms, etc.)0;10 = unchecked box; 1 = checked boxrepetitivemovements_pickingcloth
rm_pullinghairIntegerRecommendedRepetitiveMovements: Pulling hair0;10 = unchecked box; 1 = checked boxrepetitivemovements_pullinghair
rm_rubbingIntegerRecommendedRepetitiveMovements: Rubbing0;10 = unchecked box; 1 = checked boxrepetitivemovements_rubbing
rm_scratchingIntegerRecommendedRepetitiveMovements: Scratching0;10 = unchecked box; 1 = checked boxrepetitivemovements_scratching
rm_squeezinghanIntegerRecommendedRepetitiveMovements: Squeezing (hands, body, object)0;10 = unchecked box; 1 = checked boxrepetitivemovements_squeezinghan
rm_tappinghittiIntegerRecommendedRepetitiveMovements: Tapping/hitting (hands, surfaces)0;10 = unchecked box; 1 = checked boxrepetitivemovements_tappinghitti
resptospokenIntegerRecommendedResponse to spoken word0::40=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
restingtremorIntegerRecommendedResting tremor0::40=Not present; 1=<1 cm maximal amplitude; 2=1 cm to <2 cm maximal amplitude; 3=2 cm to 3 cm maximal amplitude;4= >3 cm maximal amplitude
righthandotherString100RecommendedHand use mark all observedRight hand if other specify
rh_copiescircleIntegerRecommendedRightHandUse: Copies circle0;10 = unchecked box; 1 = checked boxrighthanduse_copiescircle
rh_copiesdrawnlinevertIntegerRecommendedRightHandUse: Copies drawn line vertically0;10 = unchecked box; 1 = checked boxrighthanduse_copiesdrawnlinevert
rh_copieslinedrawnhoriIntegerRecommendedRightHandUse: Copies line drawn horizontally0;10 = unchecked box; 1 = checked boxrighthanduse_copieslinedrawnhori
rh_drawsonpaperwithoutIntegerRecommendedRightHandUse: Draws on paper without copying0;10 = unchecked box; 1 = checked boxrighthanduse_drawsonpaperwithout
rh_foldspaperinhalfIntegerRecommendedRightHandUse: Folds paper in half0;10 = unchecked box; 1 = checked boxrighthanduse_foldspaperinhalf
rh_graspstoyfoodwpinchIntegerRecommendedRightHandUse: Grasps toy/food w/pincher0;10 = unchecked box; 1 = checked boxrighthanduse_graspstoyfoodwpinch
rh_holdscupIntegerRecommendedRightHandUse: Holds cup0;10 = unchecked box; 1 = checked boxrighthanduse_holdscup
rh_holdsobjectIntegerRecommendedRightHandUse: Holds object0;10 = unchecked box; 1 = checked boxrighthanduse_holdsobject
rh_manipulatesobjectIntegerRecommendedRightHandUse: Manipulates object0;10 = unchecked box; 1 = checked boxrighthanduse_manipulatesobject
rh_noneobservedIntegerRecommendedRightHandUse: None observed0;10 = unchecked box; 1 = checked boxrighthanduse_noneobserved
rh_otherIntegerRecommendedRightHandUse: Other0;10 = unchecked box; 1 = checked boxrighthanduse_other
rh_reachesfortoyfoodIntegerRecommendedRightHandUse: Reaches for toy/food0;10 = unchecked box; 1 = checked boxrighthanduse_reachesfortoyfood
rh_throwsobjectIntegerRecommendedRightHandUse: Throws object0;10 = unchecked box; 1 = checked boxrighthanduse_throwsobject
rh_transfersobjectIntegerRecommendedRightHandUse: Transfers object0;10 = unchecked box; 1 = checked boxrighthanduse_transfersobject
rh_turnspageinbookIntegerRecommendedRightHandUse: Turns page in book0;10 = unchecked box; 1 = checked boxrighthanduse_turnspageinbook
rh_usesutensilmaybeadaIntegerRecommendedRightHandUse: Uses utensil (may be adaptive)0;10 = unchecked box; 1 = checked boxrighthanduse_usesutensilmaybeada
rh_writeslettersIntegerRecommendedRightHandUse: Writes letters0;10 = unchecked box; 1 = checked boxrighthanduse_writesletters
scoliosis_dxIntegerRecommendedScoliosis choose only one option0::50=None; 1=< 10 degrees; 2=10-<20 degrees; 3=20-<40 degrees; 4=40-<60 degrees; 5=60 degrees or greaterscoliosis
scoliosissurgynIntegerRecommendedScoliosis surgery performed0;11=Yes; 0=No
selfabusiveIntegerRecommendedSelfabusive behaviors1::51=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
sittingIntegerRecommendedSitting1::41=Sits unaided; 2=Sits with minimal support; 3=Sits with maximal support; 4=Unable to sit
sittingdurationIntegerRecommendedSittingIf sits unaided duration1::31=5-30 seconds; 2=>5 seconds; 3=>30 seconds
sea_birthmarksIntegerRecommendedSkinExamAbnormal: Birth marks0;10 = unchecked box; 1 = checked boxskinexamabnormal_birthmarks
sea_cracksanderytheIntegerRecommendedSkinExamAbnormal: Cracks and erythema on hands0;10 = unchecked box; 1 = checked boxskinexamabnormal_cracksanderythe
sea_erythemaonhandsIntegerRecommendedSkinExamAbnormal: Erythema on hands0;10 = unchecked box; 1 = checked boxskinexamabnormal_erythemaonhands
sea_otherIntegerRecommendedSkinExamAbnormal: Other0;10 = unchecked box; 1 = checked boxskinexamabnormal_other
sea_skinbreakdownonIntegerRecommendedSkinExamAbnormal: Skin breakdown on hands0;10 = unchecked box; 1 = checked boxskinexamabnormal_skinbreakdownon
skinIntegerRecommendedSkin exam0::51=Wide range of normal variability; 2=Abnormal by exam; 3=Abnormal by history only; 0=Not done; 4=Normal; 5=Abnormalskinexamlist
skinexamotherString300RecommendedSkin examIf other please specify
snoutnotpresentIntegerRecommendedSnout Not present0;10 = unchecked box; 1 = checked box
socialreactionIntegerRecommendedSocial reaction when examiner engages with them mark single most characteristic1::51=Responds normally (100%); 2=Regards examiner for most of the time (75%); 3=Regards examiner for some of the time (50%); 4=Regards examiner for a little of the time (25%); 5=Ignores examiner completely (0%)
standingIntegerRecommendedStanding1::41=Stands unaided; 2=Stands (minimal support); 3=Stands (maximal support); 4=Unable to stand
standingdurationIntegerRecommendedStandingIf stands unaided duration1::31=5-30 seconds; 2=>5 seconds; 3=>30 seconds
strengthIntegerRecommendedStrength1;21=Normal throughout; 2=Any weakness
totalclinicexpIntegerRecommendedConsidering your total clinical experience with this population how impaired is participant now USE CGIS SCALE BELOW1::71=Normal, not at all impaired; 2=Borderline impaired; 3=Mildly impaired; 4=Moderately impaired; 5=Markedly impaired; 6=Severely impaired; 7=The most impaired
tricepfoldcircumnotdoneIntegerRecommendedTricep skin fold not done0;10 = unchecked box; 1 = checked box
truncalrockingIntegerRecommendedTruncal rocking voluntary0::40=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
truncaltitubationIntegerRecommendedTruncal titubation0::40=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
verbclearmeaningIntegerRecommendedWhen using vocal or verbal communication how clear is meaning without coaching from parents1::61=Meaning is always clear; 2=Meaning is clear most of the time (>90%); 3=Meaning is clear more than half the time (>50%); 4=Meaning is clear less than half the time (<50%); 5=Vocalizes or verbalizes, but meaning is never clear; 6=Never vocalizes or verbalizes
verblangnumbsentIntegerRecommendedVerbal language output during visitIf uses complete sentences estimate total number of sentences used during visit1::61; 2; 3; 4; 5; 6=>6
verblangnumbwordsIntegerRecommendedVerbal language output during visitIf uses single words estimate total number of words used during visit1::61=1; 2=2; 3=3 to 5; 4=6-10; 5=11-20; 6=>20
verblangoutputIntegerRecommendedVerbal language output during visit best function0::80=None, except crying, screaming; 1=Babbles/vocalizes; 2=Uses sounds that have meaning ( I need the bathroom ); 3 =;Echoes words; 4=Uses single words that have meaning 5=; Use phrases (>2 words, but not complete sentence); 6=Uses isolated sentences (>2 words; subject and verb are present); 7=Uses complete sentences linked together in context; 8=Fluent, normal speech (may include occasional errors.)
verbalchoiceIntegerRecommendedWhen shown 2 items use favorite toys if present or food how does participant choose vocally or verbally If participant indicated want clearly nonverbally to provoke verbal response ask participant to tell me which one1::41=Names the item she/he wants; 2=Indicates want using words ('that') but does not name item; 3=Indicates want using non-specific verbalization; 4=Does not indicate want verbally
c_waistFloatRecommendedWaist (cm)waistcircum
waistcircumnotdoneIntegerRecommendedWaist circumference not done0;10 = unchecked box; 1 = checked box
walkstaminaIntegerRecommendedWalking stamina1::51=Walks distance from waiting room to interview room (>10 feet) easily; 2=Walks distance from waiting room to interview room (>10 feet) with difficulty; 3=Walks across room; 4=Takes a few steps; 5=Stands but does not walk
walkingIntegerRecommendedWalking1::51=Walks unaided at normal pace for age; 2=Walks unaided at reduced pace for age; 3=Walks with minimal support; 4=Walks with maximum support; 5=Unable to walk
weightnotdoneIntegerRecommendedWeight not done0;10 = unchecked box; 1 = checked box
weight_metFloatRecommendedWeight - Metric Unitweighttextbox
wristcircumnotdoneIntegerRecommendedWrist circumference not done0;10 = unchecked box; 1 = checked box
u5211cababinskinottestedIntegerRecommendedBabinski not tested0;10 = unchecked box; 1 = checked box
u5211cafeetgroup2IntegerRecommendedFeet Column 21::41=Warm; 2=Cool; 3=Cold; 4=Hot
u5211cafeetgroup3IntegerRecommendedFeet Column 31;21=Dry;2= Sweaty
u5211cahandsgroup2IntegerRecommendedHands Column 21::41=Warm; 2=Cool; 3=Cold; 4=Hot
u5211cahandsgroup3IntegerRecommendedHands Column 31;21=Dry;2= Sweaty
u5211capalmomentalintIntegerRecommendedPalmomentali Not Tested0;10 = unchecked box; 1 = checked boxu5211capalmomentalinottested
u5211caresponsetltString50RecommendedSpecify response to light touchu5211caresponsetolighttouch
u5211casnoutnottestedIntegerRecommendedSnout Not Tested0;10 = unchecked box; 1 = checked box
mostsevereabusiveIntegerRecommendedList all selfabusive behaviors and fill in O next to the single most severeproblematic of these movements0::91=Slapping face; 2=Biting/chewing self; 3=Banging head; 4=Pulling hair; 5=Picking self; 6=Hitting/slapping other parts of head; 7=Hitting/slapping other body parts; 8=Scratching/digging self;9= Rubbing or pinching self; 0=None
mostsevererepmoveIntegerRecommendedList all repetitive movements and fill in O next to the single most severeproblematic of these movements0::181=Clasping; 2=Hand wringing/washing; 3=Clapping; 4=Tapping/hitting (hands, surfaces); 5=Squeezing (hands, body, object); 6=Flicking (fingers, lips, etc.); 7=Scratching; 8=Hand mouthing; 9=Pulling hair; 10=Finger rubbing; 11=Picking (clothes, body, arms, etc.); 12=Hair twirling/pulling;13= Knitting/twisting fingers;14= Flipping (pages, hands, objects); 15=Rubbing; 16=Chewing/licking;17= Flapping next to body; 18=Flapping in front of body; 0=None
u5211caemaffectprIntegerRecommendedD1 Description of Affect Predominant1::81=Calm; 2=Smiling; 3=Laughing or giggling; 4=Appears anxious or fearful; 5=Frowning or sad; 6=Crying; 7=Irritable; 8=Screamingu5211caemotionalaffectpredomin
midupperarmcircumFloatRecommendedMidupper arm circ cm
tricepfoldcircumFloatRecommendedTricep skin fold mm
wristcircumFloatRecommendedWrist circumference cm
bmibycalcFloatRecommendedBMI by calculation
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
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  • 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)
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Distribution for DataStructure: caform01 and Element:
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