|
subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
|
|
|
|
src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
|
|
|
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
|
|
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.
|
|
|
sex |
String |
20
|
Required |
Sex of subject at birth |
M;F; O; NR
|
M = Male; F = Female; O=Other; NR = Not reported
|
gender |
Query
|
version_form |
String |
121
|
Required |
Form used/assessment name |
|
|
|
Query
|
t1serva |
Integer |
|
Recommended |
Speech or lanugage therapy, or communication services |
0;1
|
0=No; 1=Yes
|
sixmo_services2speech |
Query
|
t1serva1 |
Integer |
|
Recommended |
Speech or lanugage therapy, or communication services. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2speech_a |
Query
|
t1serva2 |
Integer |
|
Recommended |
Speech or lanugage therapy, or communication services. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2speech_b |
Query
|
t1serva3 |
Integer |
|
Recommended |
Speech or lanugage therapy, or communication services. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_service2s_speech_d |
Query
|
t1serva4 |
Integer |
|
Recommended |
Speech or lanugage therapy, or communication services. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1serva4m |
String |
15
|
Recommended |
Speech or lanugage therapy, or communication services. How many months on wait list? |
|
|
|
Query
|
sixmo_services2speech_c |
Integer |
|
Recommended |
Speech or lanugage therapy, or communication services. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servb |
Integer |
|
Recommended |
Audiology services for hearing problems |
0;1
|
0=No; 1=Yes
|
sixmo_services2audiol |
Query
|
t1servb1 |
Integer |
|
Recommended |
Audiology services for hearing problems. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2audiol_a |
Query
|
t1servb2 |
Integer |
|
Recommended |
Audiology services for hearing problems. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2audiol_b |
Query
|
t1servb3 |
Integer |
|
Recommended |
Audiology services for hearing problems. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2audiol_d |
Query
|
t1servb4 |
Integer |
|
Recommended |
Audiology services for hearing problems. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servb4m |
String |
15
|
Recommended |
Audiology services for hearing problems. How many months on wait list? |
|
|
|
Query
|
sixmo_services2audiol_c |
Integer |
|
Recommended |
Audiology services for hearing problems. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servk |
Integer |
|
Recommended |
Reader or interpreter, including sign language |
0;1
|
0=No; 1=Yes
|
sixmo_services2read |
Query
|
t1servk1 |
Integer |
|
Recommended |
Reader or interpreter, including sign language. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2read_a |
Query
|
t1servk2 |
Integer |
|
Recommended |
Reader or interpreter, including sign language. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2read_b |
Query
|
t1servk3 |
Integer |
|
Recommended |
Reader or interpreter, including sign language. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2read_d |
Query
|
t1servk4 |
Integer |
|
Recommended |
Reader or interpreter, including sign language. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servk4m |
String |
15
|
Recommended |
Reader or interpreter, including sign language. How many months on wait list? |
|
|
|
Query
|
sixmo_services2read_c |
Integer |
|
Recommended |
Reader or interpreter, including sign language. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servm |
Integer |
|
Recommended |
Assistive technology services/devices, such as help getting /using any kind of equipment that helps people with a disability, like a tape recorder or reading machine |
0;1
|
0=No; 1=Yes
|
sixmo_services2at |
Query
|
t1servmd |
String |
50
|
Recommended |
Specify assistive technology: |
|
|
sixmo_services2at_1 |
Query
|
t1servm1 |
Integer |
|
Recommended |
Assistive technology services/devices. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2at_a |
Query
|
t1servm2 |
Integer |
|
Recommended |
Assistive technology services/devices. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2at_b |
Query
|
t1servm3 |
Integer |
|
Recommended |
Assistive technology services/devices. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2_at_d |
Query
|
t1servm4 |
Integer |
|
Recommended |
Assistive technology services/devices. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servm4m |
String |
15
|
Recommended |
Assistive technology services/devices. How many months on wait list? |
|
|
|
Query
|
sixmo_services2at_c |
Integer |
|
Recommended |
Assistive technology services/devices. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servg |
Integer |
|
Recommended |
Orientation and mobility services |
0;1
|
0=No; 1=Yes
|
sixmo_services2orien |
Query
|
t1servg1 |
Integer |
|
Recommended |
Orientation and mobility services. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2orien_a |
Query
|
t1servg2 |
Integer |
|
Recommended |
Orientation and mobility services. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2orien_b |
Query
|
t1servg3 |
Integer |
|
Recommended |
Orientation and mobility services. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2orien_d |
Query
|
t1servg4 |
Integer |
|
Recommended |
Orientation and mobility services. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servg4m |
String |
15
|
Recommended |
Orientation and mobility services. How many months on wait list? |
|
|
|
Query
|
sixmo_services2orien_c |
Integer |
|
Recommended |
Orientation and mobility services. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servd |
Integer |
|
Recommended |
Physical therapy |
0;1
|
0=No; 1=Yes
|
sixmo_services2pt |
Query
|
t1servd1 |
Integer |
|
Recommended |
Physical therapy. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2pt_a |
Query
|
t1servd2 |
Integer |
|
Recommended |
Physical therapy. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2pt_b |
Query
|
t1servd3 |
Integer |
|
Recommended |
Physical therapy. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2pt_d |
Query
|
t1servd4 |
Integer |
|
Recommended |
Physical therapy. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servd4m |
String |
15
|
Recommended |
Physical therapy. How many months on wait list? |
|
|
|
Query
|
sixmo_services2pt_c |
Integer |
|
Recommended |
Physical therapy. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servn |
Integer |
|
Recommended |
Transportation because of his/her special needs |
0;1
|
0=No; 1=Yes
|
sixmo_services2transp |
Query
|
t1servn1 |
Integer |
|
Recommended |
Transportation. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2transp_a |
Query
|
t1servn2 |
Integer |
|
Recommended |
Transportation. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2transp_b |
Query
|
t1servn3 |
Integer |
|
Recommended |
Transportation. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2transp_d |
Query
|
t1servn4 |
Integer |
|
Recommended |
Transportation. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servn4m |
String |
15
|
Recommended |
Transportation. How many months on wait list? |
|
|
|
Query
|
sixmo_services2trasnp_c |
Integer |
|
Recommended |
Transportation. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servl |
Integer |
|
Recommended |
Nursing care |
0;1
|
0=No; 1=Yes
|
sixmo_services2nc |
Query
|
t1servl1 |
Integer |
|
Recommended |
Nursing care. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2nc_a |
Query
|
t1servl2 |
Integer |
|
Recommended |
Nursing care. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2nc_b |
Query
|
t1servl3 |
Integer |
|
Recommended |
Nursing care. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2nc_d |
Query
|
t1servl4 |
Integer |
|
Recommended |
Nursing care. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servl4m |
String |
15
|
Recommended |
Nursing care. How many months on wait list? |
|
|
|
Query
|
sixmo_services2nc_c |
Integer |
|
Recommended |
Nursing care. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servi |
Integer |
|
Recommended |
Personal assistant or an in-the-home aide |
0;1
|
0=No; 1=Yes
|
sixmo_services2pa |
Query
|
t1servi1 |
Integer |
|
Recommended |
Personal assistant or an in-the-home aide. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2pa_a |
Query
|
t1servi2 |
Integer |
|
Recommended |
Personal assistant or an in-the-home aide. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2pa_b |
Query
|
t1servi3 |
Integer |
|
Recommended |
Personal assistant or an in-the-home aide. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2pa_d |
Query
|
t1servi4 |
Integer |
|
Recommended |
Personal assistant or an in-the-home aide. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servi4m |
String |
15
|
Recommended |
Personal assistant or an in-the-home aide. How many months on wait list? |
|
|
|
Query
|
sixmo_services2pa_c |
Integer |
|
Recommended |
Personal assistant or an in-the-home aide. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servo |
Integer |
|
Recommended |
Respite care |
0;1
|
0=No; 1=Yes
|
sixmo_services2rc |
Query
|
t1servo1 |
Integer |
|
Recommended |
Respite care. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2rc_a |
Query
|
t1servo2 |
Integer |
|
Recommended |
Respite care. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2rc_b |
Query
|
t1servo3 |
Integer |
|
Recommended |
Respite care. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2rc_d |
Query
|
t1servo4 |
Integer |
|
Recommended |
Respite care. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servo4m |
String |
15
|
Recommended |
Respite care. How many months on wait list? |
|
|
|
Query
|
sixmo_services2rc_c |
Integer |
|
Recommended |
Respite care. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1serve |
Integer |
|
Recommended |
Social work services |
0;1
|
0=No; 1=Yes
|
sixmo_services2sw |
Query
|
t1serve1 |
Integer |
|
Recommended |
Social work services. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2sw_a |
Query
|
t1serve2 |
Integer |
|
Recommended |
Social work services. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2sw_b |
Query
|
t1serve3 |
Integer |
|
Recommended |
Social work services. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2sw_d |
Query
|
t1serve4 |
Integer |
|
Recommended |
Social work services. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1serve4m |
String |
15
|
Recommended |
Social work services. How many months on wait list? |
|
|
|
Query
|
sixmo_services2sw_c |
Integer |
|
Recommended |
Social work services. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servc |
Integer |
|
Recommended |
Psychological or mental health services or counseling |
0;1
|
0=No; 1=Yes
|
sixmo_services2psyc |
Query
|
t1servc1 |
Integer |
|
Recommended |
Psychological or mental health services or counseling. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2psyc_a |
Query
|
t1servc2 |
Integer |
|
Recommended |
Psychological or mental health services or counseling. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2psyc_b |
Query
|
t1servc3 |
Integer |
|
Recommended |
Psychological or mental health services or counseling. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2psyc_d |
Query
|
t1servc4 |
Integer |
|
Recommended |
Psychological or mental health services or counseling. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servc4m |
String |
15
|
Recommended |
Psychological or mental health services or counseling. How many months on wait list? |
|
|
|
Query
|
sixmo_services2psyc_c |
Integer |
|
Recommended |
Psychological or mental health services or counseling. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servh |
Integer |
|
Recommended |
Medical services for diagnosis or evaluation related to his/her special needs |
0;1
|
0=No; 1=Yes
|
sixmo_services2med |
Query
|
t1servh1 |
Integer |
|
Recommended |
Medical services. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2med_a |
Query
|
t1servh2 |
Integer |
|
Recommended |
Medical services. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2med_b |
Query
|
t1servh3 |
Integer |
|
Recommended |
Medical services. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2med_d |
Query
|
t1servh4 |
Integer |
|
Recommended |
Medical services. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servh4m |
String |
15
|
Recommended |
Medical services. How many months on wait list? |
|
|
|
Query
|
sixmo_services2med_c |
Integer |
|
Recommended |
Medical services. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servf |
Integer |
|
Recommended |
Training in independent living skills or occupational therapy |
0;1
|
0=No; 1=Yes
|
sixmo_services2ind |
Query
|
t1servfd |
String |
50
|
Recommended |
Specify training/ occupational therapy: |
|
|
sixmo_services2ind_1 |
Query
|
t1servf1 |
Integer |
|
Recommended |
Training/ occupational therapy. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2ind_a |
Query
|
t1servf2 |
Integer |
|
Recommended |
Training/ occupational therapy. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2ind_b |
Query
|
t1servf3 |
Integer |
|
Recommended |
Training/ occupational therapy. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2ind_d |
Query
|
t1servf4 |
Integer |
|
Recommended |
Training/ occupational therapy. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servf4m |
String |
15
|
Recommended |
Training/ occupational therapy. How many months on wait list? |
|
|
|
Query
|
sixmo_services2ind_c |
Integer |
|
Recommended |
Training/ occupational therapy. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servr |
Integer |
|
Recommended |
Housing assistance or services such as a supervised group home |
0;1
|
0=No; 1=Yes
|
sixmo_services2hous |
Query
|
t1servrd |
String |
50
|
Recommended |
Specify housing service: |
|
|
sixmo_services2hous_1 |
Query
|
t1servr1 |
Integer |
|
Recommended |
Housing service. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2hous_a |
Query
|
t1servr2 |
Integer |
|
Recommended |
Housing service. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2hous_b |
Query
|
t1servr3 |
Integer |
|
Recommended |
Housing service. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2hous_d |
Query
|
t1servr4 |
Integer |
|
Recommended |
Housing service. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servr4m |
String |
15
|
Recommended |
Housing service. How many months on wait list? |
|
|
|
Query
|
sixmo_services2hous_c |
Integer |
|
Recommended |
Housing service. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servp |
Integer |
|
Recommended |
Vocational services like job training, basic work skills training, career counseling, job shadowing, internships, help in finding a job |
0;1
|
0=No; 1=Yes
|
sixmo_services2voc |
Query
|
t1servpd |
String |
50
|
Recommended |
Specify job services: |
|
|
sixmo_services2voc_1 |
Query
|
t1servp1 |
Integer |
|
Recommended |
Job services. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2voc_a |
Query
|
t1servp2 |
Integer |
|
Recommended |
Job services. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2voc_b |
Query
|
t1servp3 |
Integer |
|
Recommended |
Job services. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2voc_d |
Query
|
t1servp4 |
Integer |
|
Recommended |
Job services. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servp4m |
String |
15
|
Recommended |
Job services. How many months on wait list? |
|
|
|
Query
|
sixmo_services2voc_c |
Integer |
|
Recommended |
Job services. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
t1servq |
Integer |
|
Recommended |
Other services because of his or her special needs |
0;1
|
0=No; 1=Yes
|
sixmo_services2other |
|
t1servqd |
String |
50
|
Recommended |
Specify other services: |
|
|
sixmo_services2other_a |
Query
|
t1servq1 |
Integer |
|
Recommended |
Other services. Do you pay for |
1::3
|
1=all of service; 2=some; 3=none
|
sixmo_services2other_b |
Query
|
t1servq2 |
Integer |
|
Recommended |
Other services. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
sixmo_services2other_c |
Query
|
t1servq3 |
Integer |
|
Recommended |
Other services. Currently needed? |
0;1
|
0=No; 1=Yes
|
sixmo_services2other_e |
Query
|
t1servq4 |
Integer |
|
Recommended |
Other services. On the wait list? |
0;1
|
0=No; 1=Yes
|
|
|
t1servq4m |
String |
15
|
Recommended |
Other services. How many months on wait list? |
|
|
|
Query
|
sixmo_services2other_d |
Integer |
|
Recommended |
Other services. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services1 |
Integer |
|
Recommended |
Is your son/daughter currently receiving SSI (supplemental security income)? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2 |
Integer |
|
Recommended |
SSI. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services3 |
Integer |
|
Recommended |
SSI. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
Query
|
sixmo_services3_other |
String |
50
|
Recommended |
SSI. Please specify: |
|
|
|
Query
|
sixmo_services4 |
Integer |
|
Recommended |
Is your son or daughter currently receiving SSDI? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services5 |
Integer |
|
Recommended |
SSDI. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services6 |
Integer |
|
Recommended |
SSDI. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
Query
|
sixmo_services6_other |
String |
50
|
Recommended |
SSDI. Please specify: |
|
|
|
Query
|
sixmo_services7 |
Integer |
|
Recommended |
Is your son/daughter currently receiving Vocational Rehabilitative (VR) Services? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services8 |
Integer |
|
Recommended |
VR. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services9 |
Integer |
|
Recommended |
VR. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
Query
|
sixmo_services9_other |
String |
50
|
Recommended |
VR. Please specify: |
|
|
|
Query
|
sixmo_services10 |
Integer |
|
Recommended |
Is your son/daughter currently receiving Medicaid Waiver Services? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services11 |
Integer |
|
Recommended |
Medicaid Waiver Services. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services12 |
Integer |
|
Recommended |
Medicaid Waiver Services. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
Query
|
sixmo_services12_other |
String |
50
|
Recommended |
Medicaid Waiver Services. Please specify: |
|
|
|
Query
|
sixmo_services13 |
Integer |
|
Recommended |
Is your son/daughter currently receiving conservatorship (including conservatorship, power of attorney, health care surrogate)? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services14 |
Integer |
|
Recommended |
Conservatorship. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services15 |
Integer |
|
Recommended |
Conservatorship. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
Query
|
sixmo_services15_other |
String |
50
|
Recommended |
Conservatorship. Please specify: |
|
|
|
Query
|
sixmo_services16 |
Integer |
|
Recommended |
Is your son/daughter currently receiving Special Needs Trust? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services17 |
Integer |
|
Recommended |
Special Needs Trust. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services18 |
Integer |
|
Recommended |
Special Needs Trust. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
Query
|
sixmo_services18_other |
String |
50
|
Recommended |
Special Needs Trust. Please specify: |
|
|
|
Query
|
sixmo_services19 |
Integer |
|
Recommended |
Is your son/daughter currently receiving Section 8 Housing? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services20 |
Integer |
|
Recommended |
Section 8 Housing. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services21 |
Integer |
|
Recommended |
Section 8 Housing. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
|
sixmo_services21_other |
String |
50
|
Recommended |
Section 8 Housing. Please specify: |
|
|
|
Query
|
sixmo_services22 |
Integer |
|
Recommended |
Is your son currently receiving Ticket to Work? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services23 |
Integer |
|
Recommended |
Ticket to Work. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services24 |
Integer |
|
Recommended |
Ticket to Work. Why not receiving? |
1::3
|
1=Started to apply; 2=Applied and is waiting for approval; 3=Has not applied
|
|
|
sixmo_services24_other |
String |
50
|
Recommended |
Ticket to Work. Please specify: |
|
|
|
Query
|
sixmo_services2fin |
Integer |
|
Recommended |
Is your son or daughter currently receiving financial aid? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2fin_a |
Integer |
|
Recommended |
Financial aid. Do you pay for...? |
1::3
|
1=all of service; 2=some; 3=none
|
|
Query
|
sixmo_services2fin_b |
Integer |
|
Recommended |
Financial aid. How satisfied with service are you? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
|
Query
|
sixmo_services2fin_c |
Integer |
|
Recommended |
Financial aid. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2fin_d |
Integer |
|
Recommended |
Financial aid. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2educ |
Integer |
|
Recommended |
Is your son or daughter currently receiving education assistance or tutoring? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2educ_1 |
String |
50
|
Recommended |
Education assistance or tutoring. Please specify type of service: |
|
|
|
Query
|
sixmo_services2educ_a |
Integer |
|
Recommended |
Education assistance or tutoring. Do you pay for...? |
1::3
|
1=all of service; 2=some; 3=none
|
|
Query
|
sixmo_services2educ_b |
Integer |
|
Recommended |
Education assistance or tutoring. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
|
Query
|
sixmo_services2educ_c |
Integer |
|
Recommended |
Education assistance or tutoring. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2educ_d |
Integer |
|
Recommended |
Education assistance or tutoring. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2child |
Integer |
|
Recommended |
Is your son or daughter currently receiving childcare services or parenting skills training? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2child_a |
Integer |
|
Recommended |
Childcare services or parenting skills training. Do you pay for...? |
1::3
|
1=all of service; 2=some; 3=none
|
|
Query
|
sixmo_services2child_b |
Integer |
|
Recommended |
Childcare services or parenting skills training. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
|
Query
|
sixmo_services2child_c |
Integer |
|
Recommended |
Childcare services or parenting skills training. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2child_d |
Integer |
|
Recommended |
Childcare services or parenting skills training. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2adult |
Integer |
|
Recommended |
Is your son or daughter currently receiving adult day care? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2adult_a |
Integer |
|
Recommended |
Adult day care. Do you pay for...? |
1::3
|
1=all of service; 2=some; 3=none
|
|
Query
|
sixmo_services2adult_b |
Integer |
|
Recommended |
Adult day care. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
|
Query
|
sixmo_services2adult_c |
Integer |
|
Recommended |
Adult day care. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2adult_d |
Integer |
|
Recommended |
Adult day care. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2case |
Integer |
|
Recommended |
Is your son or daughter currently receiving services from a case manager or someone who coordinates the services he/she receives? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2case_a |
Integer |
|
Recommended |
Services from a case manager. Do you pay for...? |
1::3
|
1=all of service; 2=some; 3=none
|
|
Query
|
sixmo_services2case_b |
Integer |
|
Recommended |
Services from a case manager. How satisfied are you with service? |
1::3
|
1=not at all; 2=somewhat; 3=very
|
|
Query
|
sixmo_services2case_c |
Integer |
|
Recommended |
Services from a case manager. Received in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2case_d |
Integer |
|
Recommended |
Services from a case manager. Currently needed? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2waitlist |
Integer |
|
Recommended |
Is your son or daughter currently on a wait list for any services? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_b |
String |
50
|
Recommended |
On a wait list. Please specify type of service: |
|
|
|
Query
|
sixmo_famrole |
Integer |
|
Recommended |
Did you begin receiving any new services in 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole1 |
Integer |
|
Recommended |
Have you attempted to get services for your son or daughter since January 1, 2016? |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole2 |
Integer |
|
Recommended |
Overall, how much effort did you or your family expend to get new services for your son or daughter? |
1::4; -9
|
4= A great deal of effort; 3= Some effort; 2=A little effort; 1=Almost no effort; -9=No new services
|
|
Query
|
sixmo_famrole_4 |
String |
50
|
Recommended |
Please specify type of problem: |
|
|
|
Query
|
sixmo_famrole5 |
Integer |
|
Recommended |
Who coordinates the services your son or daughter receives? |
1::6
|
1= social worker or other professional; 2= you or another family member; 3= teacher; 4= no one; 5= someone else; 6= N/A= doesn't receive any services
|
|
Query
|
sixmo_famrole6 |
String |
50
|
Recommended |
Please specify coordination: |
|
|
|
Query
|
notes |
String |
200
|
Recommended |
Any additional notes |
|
|
sixmo_famrole5_comments |
Query
|
sixmo_services2wait_a___1 |
Integer |
|
Recommended |
On a wait list. Please specify services: Audiology |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___2 |
Integer |
|
Recommended |
On a wait list. Please specify services: Speech or language therapy |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___3 |
Integer |
|
Recommended |
On a wait list. Please specify services: Reader or interpreter |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___4 |
Integer |
|
Recommended |
On a wait list. Please specify services: Assistive technology |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___5 |
Integer |
|
Recommended |
On a wait list. Please specify services: Orientation and mobility |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___6 |
Integer |
|
Recommended |
On a wait list. Please specify services: Social work |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___7 |
Integer |
|
Recommended |
On a wait list. Please specify services: Independent living skills training |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___8 |
Integer |
|
Recommended |
On a wait list. Please specify services: Educational Assistance |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___9 |
Integer |
|
Recommended |
On a wait list. Please specify services: Personal assistant |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___10 |
Integer |
|
Recommended |
On a wait list. Please specify services: Case manager |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___11 |
Integer |
|
Recommended |
On a wait list. Please specify services: Medical services related to special needs |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___12 |
Integer |
|
Recommended |
On a wait list. Please specify services: Transportation |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___13 |
Integer |
|
Recommended |
On a wait list. Please specify services: Housing services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___14 |
Integer |
|
Recommended |
On a wait list. Please specify services: Vocational services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___15 |
Integer |
|
Recommended |
On a wait list. Please specify services: Nursing care |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___16 |
Integer |
|
Recommended |
On a wait list. Please specify services: Parenting skills training |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___17 |
Integer |
|
Recommended |
On a wait list. Please specify services: Physical therapy |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___18 |
Integer |
|
Recommended |
On a wait list. Please specify services: Mental health services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___19 |
Integer |
|
Recommended |
On a wait list. Please specify services: Occupational therapy |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___20 |
Integer |
|
Recommended |
On a wait list. Please specify services: Respite care |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___21 |
Integer |
|
Recommended |
On a wait list. Please specify services: Childcare services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___22 |
Integer |
|
Recommended |
On a wait list. Please specify services: Adult day care |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___23 |
Integer |
|
Recommended |
On a wait list. Please specify services: Financial aid |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_services2wait_a___24 |
Integer |
|
Recommended |
On a wait list. Please specify services: Other |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___1 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? cost of services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___2 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? where services are provided |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___3 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? services not being available |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___4 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? physical accessibility of services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___5 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? poor service quality |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___6 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? scheduling conflicts |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___7 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? language problems |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___8 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? lack of time for services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___9 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? Transportation |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___10 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? son or daughter not being eligible for the service |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___11 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? lack of information about services |
0;1
|
0=No; 1=Yes
|
|
Query
|
sixmo_famrole3___12 |
Integer |
|
Recommended |
Have any of the following been a problem in getting or dealing with services? anything else |
0;1
|
0=No; 1=Yes
|
|
|
avsev08p |
Integer |
|
Recommended |
How many times in the past 30 days have you received a session devoted to helping you with relapse triggers or other specific methods to help you avoid relapse? (?Cuantas veces en los ultimos 30 dias usted ha recibido una sesion dedicada a ayudarle con los factores de recaida u otros metodos espec?ficos para ayudarle a evitar la recaida?) |
|
(Number of times)
|
|
|
avsev09p |
Integer |
|
Recommended |
How many times in the past 30 days have you attended an AA/NA/CA or any other 12-Step or Self-Help session? (?Cuantas veces en los ultimos 30 dias usted ha atendido a una sesion de AA/NA/CA o a cualquier otra sesion de 12 pasos o autoayuda?) |
|
(Number of times)
|
|
|
avsev10p |
Integer |
|
Recommended |
How many days in the past 30 days have you seen a case manager, social worker or educational/training specialist regarding your education or training needs? (?Cuantas veces en los ultimos 30 dias usted ha visto a un administrador de casos, trabajador social o especialista en educacion/formacion con respecto a sus necesidades de educacion o formacion?) |
|
(Number of days)
|
|
|
avsev11p |
Integer |
|
Recommended |
In the past 30 days have you seen a housing agency or service to obtain adequate, safe, housing or to get assistance with your housing expenses (e.g. rent assistance)? (?Cuantas veces en los ultimos 30 dias usted ha visto una agencia o servicio de vivienda para obtener una vivienda adecuada y segura o para obtener ayuda con sus gastos de vivienda (por ejemplo, asistencia de alquiler)? |
0;1
|
0 = No; 1 = Yes (Si)
|
|
|
avsev12p |
Integer |
|
Recommended |
In the past 30 days have you seen an individual, agency or service to improve your transportation problem, including getting your driver''s license? (?Cuantas veces en los ultimos 30 dias usted ha visto a un individuo, agencia, o servicio para mejorar su problema de transporte, incluyendo obtener su licencia de conducir?) |
0;1
|
0 = No; 1 = Yes (Si)
|
|
|
avsev01p |
Integer |
|
Recommended |
How many times in the past 30 days have you had a physical examination or a visit to a medical professional for medical care? (?Cuantas veces en los ultimos 30 dias usted ha tenido un examen fisico o ha visitado a un profesional medico para recibir atencion medica?) |
|
(Number of times)
|
|
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avsev02p |
Integer |
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Recommended |
How many times in the past 30 days have you had a session by a specialist focused on helping you get housing, food, clothing or shelter? (?Cuantas veces en los ultimos 30 dias usted ha tenido una sesion con un especialista centrada en ayudarle a conseguir vivienda, comida, ropa o refugio?) |
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(Number of times)
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avsev03p |
Integer |
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Recommended |
How many times in the past 30 days have you had a session by a specialist focused on helping you get SSI, Welfare, disability or other benefits? (?Cuantas veces en los ultimos 30 dias usted ha tenido una sesion con un especialista enfocada en ayudarle a obtener SSI, asistencia social, discapacidad u otros beneficios?) |
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(Number of times)
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avsev04p |
Integer |
|
Recommended |
How many times in the past 30 days have you had a session with a specialist focused on helping you get employment? (?Cuantas veces en los ultimos 30 dias usted ha tenido una sesion con un especialista centrada en ayudarle a conseguir empleo?) |
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(Number of times)
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avsev05p |
Integer |
|
Recommended |
How many times in the past 30 days have you actually taken a medication to help you detoxify from alcohol or drugs? (?Cuantas veces en los ultimos 30 dias usted ha realmente tomado un medicamento para ayudarle a desintoxicarse del alcohol o las drogas?) |
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(Number of times)
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avsev06p |
Integer |
|
Recommended |
How many times in the past 30 days have you actually taken a medication to prevent you from drinking or taking drugs? (?Cuantas veces en los ultimos 30 dias usted ha realmente tomado un medicamento para prevenir que bebas o tomes drogas?) |
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(Number of times)
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avsev07p |
Integer |
|
Recommended |
How many times in the past 30 days have you received acupuncture to stop or reduce your drinking or drug use? (?Cuantas veces en los ultimos 30 dias usted ha recibido acupuntura para detener o reducir su consumo de alcohol o drogas?) |
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(Number of times)
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