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Developmental Assessment of Children from Spanish Speaking Families

141 Shared Subjects

Developmental Assessment of Children from Spanish Speaking Families
Clinical Assessments
Questionnaire
08/21/2014
dacssf01
11/29/2018
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*
srcsubjectid String 20 Required The site or study's subject identification
Query interviewage Integer Required Age in months at the time of the interview/test/sampling/imaging. 0 :: 1200 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.
interviewdate Date Required Date on which the interview/genetic test/sampling/imaging was completed MM/DD/YYYY Required field
sex String 20 Required Sex of subject at birth M;F; O; NR M = Male; F = Female; O=Other; NR = Not reported gender, sex
comments_misc String 4,000 Recommended Miscellaneous comments on study, interview, methodology relevant to this form data
Query early_therapy Integer Recommended Did your child receive any "early intervention" or "birth to three" program service? 0;1 0 = No; 1 = Yes
Query interv_earlyint_age Integer Recommended Treatment/Intervention - Early Intervention - Age at start of treatment 0 :: 1200
Query psserv Integer Recommended Did your child receive services between the ages of 3 and 5? 0;1 0=No; 1=Yes
Query service_35 String 100 Recommended What services did/does your son/daughter receive from the Early Childhood Education Program
Query service_not String 100 Recommended Why doesn't/didn't your son/daughter receive services from the Early Childhood Education Program
Query service_hbst Integer Recommended Has your child ever been referred to the Children's Home-Based Support Program 0::2 0=No; 1=Yes; 2=Don't know
Query hbst_ever Integer Recommended Has your child ever received services from the Children's Home-Based Support Program 0::2 0=No; 1=Yes; 2=Don't know
Query hbst_ref Integer Recommended Who referred you to this program 1=Physician; 2=Teacher; 3=Other professional; 4=Other parents; 5=Advocacy group; 6=Birth to Three program; 7=Other
Query hbst_refsp String 150 Recommended Who referred you to this program. Specify
Query ita_aba Integer Recommended Has your child ever received Intensive Autism Therapy 0::2 0=No; 1=Yes; 2=Don't know
Query ita_aba_hours Integer Recommended If yes, how many hours a week did or does your child receive intensive autism therapy
Query ita_aba_months Integer Recommended If yes, for how many months has your child receive intensive autism therapy
Query hurt_6m Integer Recommended Does this problem occur withing past 6 month: Is your son/daughter hurtful to him/herself; injures own body by hitting, banging head or scratching 0;1 0=No, 1= Yes
Query hurt_freq Integer Recommended Hurtful to him/herself. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query hurt_sever Integer Recommended Hurtful to him/herself. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query dest_6m Integer Recommended Does this problem occur withing past 6 month: Is your son/daughter destructive or hurtful to others; causes physical pain to other people or to animals 0;1 0=No, 1= Yes
Query dest_freq Integer Recommended Destructive to others. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query dest_sever Integer Recommended Destructive to others. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query destruct_6m Integer Recommended Does this problem occur withing past 6 month: Is your son/daughter destructive to property; deliberately defaces or destroys things 0;1 0=No, 1= Yes
Query destruct_freq Integer Recommended Destructive to property. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query destruct_sever Integer Recommended Destructive to property. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query disr_6m Integer Recommended Does this problem occur withing past 6 month: Does your son/daughter have disruptive behavior; interferes with the activity of others by clinging, pestering or teasing 0;1 0=No, 1= Yes
Query disr_freq Integer Recommended Disraptive behavior. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query disr_sever Integer Recommended Disraptive behavior. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query repet_6m Integer Recommended Does this problem occur withing past 6 month: Does your son/daughter have any unusual or repetitive habits; unusual behavior done over and over like pacing, rocking, twirling fingers, or talking to him/herself 0;1 0=No, 1= Yes
Query repet_freq Integer Recommended Repetitive behavior. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query repet_sever Integer Recommended Repetitive behavior. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query socof_6m Integer Recommended Does this problem occur withing past 6 month: Does your son/daughter have any socially offensive behavior; such has talking too loud, swearing, touching others too much, or belching 0;1 0=No, 1= Yes
Query socof_freq Integer Recommended Socially offencive. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query socofsever Integer Recommended Socially offencive. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query withdr_6m Integer Recommended Does this problem occur withing past 6 month: Does your son/daughter have withdrawn or inattentive behavior; difficulty being around others or paying attention 0;1 0=No, 1= Yes
Query withdr_freq Integer Recommended Withdrawn. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query withdr_sever Integer Recommended Withdrawn. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query uncoop_6m Integer Recommended Does this problem occur withing past 6 month: Does your son/daughter have uncooperative behavior; refusing to obey or refusing to go to work or school 0;1 0=No, 1= Yes
Query uncoop_freq Integer Recommended Uncooperative. Frequency rating 1::5 1 = less than once a month; 2 = 1-3 times a month; 3 = 1-6 times a week; 4 = 1-10 times a day; 5 = 1 or more times/hour
Query uncoop_sever Integer Recommended Uncooperative. Severity rating 1::5 1 = not serious; 2 = slightly serious; 3 = moderately serious; 4 = very serious; 5 = extremely serious
Query ethnic_group String 255 Recommended Ethnic group
Query respondent String 20 Recommended Respondent
Mother;Father;Parent;Guardian;Teacher;Child;Self;Caregiver;Partner;Other
Query birthlocation Integer Recommended Where was your son or daughter born? 1::3 1=Latin America Country or Puerto Rico; 2= United States; 3= Other
birthlocationsp String 50 Recommended Birth location specify
Query resp_race String 150 Recommended Respondent's race American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported
Query resplocation Integer Recommended Where you were born? 1::3 1=Latin America Country or Puerto Rico; 2= United States; 3= Other
Query resplocationsp String 25 Recommended Respondend birth location specify imm_country_subj
Query ustime String 100 Recommended How long you lived in US, years
Query fatherlocation Integer Recommended Where respondent's father were born 1::3 1=Latin America Country or Puerto Rico; 2= United States; 3= Other
Query fatherlocationsp String 25 Recommended Where respondent's father were born. Specify imm_country_father
Query motherlocation Integer Recommended Where respondent's mother were born 1::3 1=Latin America Country or Puerto Rico; 2= United States; 3= Other
Query motherlocationsp String 25 Recommended Where respondent's mother were born. Specify imm_country_mother
Query resp_age Integer Recommended Respondent's age 0::1200; -777 -777=Not applicable
Query resp_education Integer Recommended Respondent's education 1::9 1 = Less than 8th grade; 2 = 9th-11th grade; 3 = High school or GED; 4 = Trade or vocational; 5 = Associate's degree or 2 years; 6 = Courses towards college; 7 = Bachelor's degree; 8 = Master's degree; 9 = Professional degree (MD, PhD, JD)
Query resp_employmentstatus Integer Recommended Respondent's employment status 1::6 1 = Working at a full-time paid job (35 or more hours a week); 2 = Working at a part-time paid job (less than 35 hours a week); 3 = A full-time student (3 or more class/semester); 4 = A part-time student (1 or 2 classes/semester); 5 = Not currently working; 6 = Other
Query resp_occupation String 255 Recommended Respondent's occupation
Query respstrain Integer Recommended If you are currently working outside of the home, do you feel any strain between your employment situation and your family responsibilities? 0::2 0=no strain; 1=some strain; 2=a great deal of strain
Query resphealth Integer Recommended How would you rate your overall health at the present time? 1::4 1=poor; 2=fair; 3=good; 4=excellent
Query resphealth5 Integer Recommended Is your physical health now worse, about the same, or better than it was five years ago? 0::2 0=worse; 1=about the same; 2= better
Query resplivewith String 50 Recommended Besides your son or daughter with autism, with whom do you currently live?
Query incomely Integer Recommended Which category is appropriate for your household income last year 1::13 1=$0 - 4,999; 2=$5,000 - 9,999;3=$10,000 - 14,999;4=$15,000 - 19,999; 5=$20,000 - 24,999; 6=$25,000 - 29,999; 7=$30,000 - 34,999; 8=$35,000 - 39,999;9=$40,000 - 44,999; 10=$45,000 - 49,999; 11=$50,000 - 59,999;12=$60,000 - 69,999; 13=$70,000 +
Query marital Integer Recommended What is your current marital status 1::9 1= never married; 2= living with someone; 3= married; 4= separated; 5=divorced; 6=widowed; 7= engaged; 8= lived with, but now single; 9= other
Query curmar Integer Recommended Are you currently married to biological father/mother 0;1 0=No; 1=Yes
Query contact_bio Integer Recommended Does your son or daughter currently have contact with his/her biogical father/mother 0;1 0=No; 1=Yes
Query talk_bio Integer Recommended How often does your son or daughter see or talk to his/her biological father/mother, including over the telephone 0::7 0=never; 1=once a year or less; 2=several times a year; 3=monthly; 4=several times a month; 5=weekly; 6=several times a week; 7=daily
Query parent_et Integer Recommended What is your child's father's/mother's ethnicity 1::6 1=Mexican/Mexican-American/Chicano; 2=Puerto Rican; 3=Cuban/Cuban-American; 4=Other Latino; 5=Latino and non-Latino ethnicity; 6=Non-Latino
parent_et_sp String 50 Recommended Specify ethnicity
Query parent_born Integer Recommended Where was your child's father/mother born 1::3 1=Latin America Country; 2= United States; 3= Other
Query parent_born_sp String 50 Recommended Where was your child's father/mother born. Specify
Query parent_us Integer Recommended How long has your child's father/mother lived in the US? specify # of years)
Query grand_born Integer Recommended Where was your child's paternal/maternal grandfather born 1::3 1=Latin America Country; 2= United States; 3= Other
Query grand_born_sp String 50 Recommended Where was your child's paternal/maternal grandfather born. Specify
Query country_often Integer Recommended How often do you return to the country of origin of your parents)? 0::3 0=Never; 1= Rarely; 2= Sometimes; 3= Often
Query country_times Integer Recommended How many times have you returned to the country of origin of your parents/your country of origin in the last year?
Query stay_days Integer Recommended Approximately how long did you stay in the country of origin of your parents/your country of origin in the last year? number of days
Query residence Integer Recommended Which is your primary residence, your country of origin or the United States 1::4 1=Country of Origin; 2=United States; 3=Both; 4=Don't Know
Query speak_span Integer Recommended How well do you speak Spanish 0::3; 8; 9 0 = Poor; 1 = Fair; 2 = Good; 3 = Excellent; 8 = Don¿t know; 9 = Refused
Query read_span Integer Recommended How well do you read Spanish 0::3; 8; 9 0 = Poor; 1 = Fair; 2 = Good; 3 = Excellent; 8 = Don¿t know; 9 = Refused
Query write_span Integer Recommended How well do you write in Spanish 0::3; 8; 9 0 = Poor; 1 = Fair; 2 = Good; 3 = Excellent; 8 = Don¿t know; 9 = Refused
Query speak_eng Integer Recommended How well do you speak English? ¿Qué tan bien habla usted el inglés? 0::3; 8; 9 0 = Poor/Mal; 1 = Fair/Regular; 2 = Good/Bien; 3 = Excellent/Excelente; 8 = Don't Know/No se; 9 = Refused/Niego contestar
Query read_eng Integer Recommended How well do you read English 0::3; 8; 9 0 = Poor; 1 = Fair; 2 = Good; 3 = Excellent; 8 = Don¿t know; 9 = Refused
Query write_eng Integer Recommended How well do you write in English 0::3; 8; 9 0 = Poor; 1 = Fair; 2 = Good; 3 = Excellent; 8 = Don¿t know; 9 = Refused
Query friend_speak Integer Recommended What language do you speak with most of your friends? ¿En qué idioma habla con la mayoría de sus amistades? 0::4; 8; 9 0 = (Other language) all the time/(Otro idioma) todo el tiempo; 1 = (Other language) most of the time /(Otro idioma) la mayor parte del tiempo; 2 = (Other language) and English equally /(Otro idioma) e inglés igualmente; 3 = English most of the time /Inglés la mayor parte del tiempo; 4 = English all the time/ Inglés todo el tiempo; 8 = Don't Know /No se; 9 = Refused/ Niego contestar
Query family_speak Integer Recommended What language do you speak with most of your family? ¿En qué idioma habla con la mayoría de su familia? 0::4; 8; 9 0 = (Other language) all the time/(Otro idioma) todo el tiempo; 1 = (Other language) most of the time /(Otro idioma) la mayor parte del tiempo; 2 = (Other language) and English equally /(Otro idioma) e inglés igualmente; 3 = English most of the time /Inglés la mayor parte del tiempo; 4 = English all the time/ Inglés todo el tiempo; 8 = Don't Know /No se; 9 = Refused/ Niego contestar
Query lang_think Integer Recommended In what language do you think 0::4; 8; 9 0 = Spanish all the time; 1 = Spanish most of the time; 2 = Spanish and English equally; 3 = English most of the time; 4 = English all the time; 8 = Don¿t know; 9 = Refused
Query q32_1 Integer Recommended Do you feel guilty for leaving family or friends in your country of origin 0::2 0=Nol 1=Yes; 2=N/A
Query q32_2 Integer Recommended Do you feel that in the United States you have the respect you had in your country of origin 0::2 0=Nol 1=Yes; 2=N/A
Query q32_3 Integer Recommended Do you feel that living out of your country of origin has limited your contact with family or friends 0::2 0=Nol 1=Yes; 2=N/A
Query q32_4 Integer Recommended Do you find it hard interacting with others because of difficulties you have with the English language 0::2 0=Nol 1=Yes; 2=N/A
Query q32_5 Integer Recommended Do people treat you badly because they think you do not speak English well or speak with an accent 0::2 0=Nol 1=Yes; 2=N/A
Query q32_6 Integer Recommended Do you find it difficult to find the work you want because you are of Latino descent 0::2 0=Nol 1=Yes; 2=N/A
Query q32_7 Integer Recommended Have you ever been questioned about your legal status 0::2 0=Nol 1=Yes; 2=N/A
Query q32_8 Integer Recommended Do you think you will be deported if you go to a social or government agency 0::2 0=Nol 1=Yes; 2=N/A
Query q32_9 Integer Recommended Do you avoid seeking health insurance due to fear of immigration officials 0::2 0=Nol 1=Yes; 2=N/A
Query spouse_grade Integer Recommended What is the highest grade of school your spouse completed 0::7 0=less than 8th grade; 1=8th - 11th grade; 2=high school grad/GED; 3=1-3 years of college but not an Associate Degree; 4= Associate degree; 5=Bachelor's degree; 6=Post BA/BS but no graduate degree; 7=Graduate degree
Query spouse_grade_sp String 50 Recommended What is the highest grade of school your spouse completed. Specify
Query spouse_empl Integer Recommended Is your spouse currently employed 0::2; 7 0=No; 1=Yes part-time; 2=Yes full-time; 7=Retired
spouse_occup String 50 Recommended What is his occupation
Query spouse_health Integer Recommended How would you rate your spouse's health at the present time 1::4 1 = Poor; 2 = Fair; 3 = Good; 4 = Excellent
Query spouse_health_pr Integer Recommended Is your spouse's physical health now worse, about the same, or better than it was five years ago 0::2 0=worse; 1=about the same; 2= better
Query childgen String 2 Recommended Child gender M;F M=Male; F= Female
Query accult_q1_y Integer Recommended How well do you speak English? 1 ; 2 ; 3 ; 4 1 = Poor; 2 = Fair; 3 = Good; 4 = Excellent imm_language_1
Query span_level Integer Recommended How well do you feel you speak Spanish 1::4 1=poor; 2=fair; 3=good; 4= excellent imm_langugae_7
Query imm_uscitizen Integer Recommended Are you a citizen of the United States? 0;1 0=no; 1=yes
Query imm_bornuscitizen Integer Recommended Were you born a United States citizen? 0;1 0=no; 1=yes
immcountry_paternalgrandfather String 100 Recommended In what country, - was your father's father (paternal grandfather) born? - Country
immcountry_paternalgrandmother String 100 Recommended In what country, - was your father's mother (paternal grandmother) born? - Country
immcountry_maternalgrandfather String 100 Recommended In what country, - was your mother's father (maternal grandfather) born? - Country
immcountry_maternalgrandmother String 100 Recommended In what country, - was your mother's mother (maternal grandmother) born? - Country
Query imm_language_2 Integer Recommended How well do you read in English? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_language_3 Integer Recommended How well do you understand television programs in English? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_language_4 Integer Recommended How well do you understand radio programs in English? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_language_5 Integer Recommended How well do you write in English? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_language_6 Integer Recommended How well do you understand music in English? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_langugae_8 Integer Recommended How well do you read Spanish? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_langugae_9 Integer Recommended How well do you understand television programs in Spanish? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_langugae_10 Integer Recommended How well do you understand radio programs in Spanish? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_langugae_11 Integer Recommended How well do you write in Spanish? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_langugae_12 Integer Recommended How well do you understand music in Spanish? 1 :: 4 1=very poorly; 2=poorly; 3=well; 4=very well
Query imm_language_english_total Integer Recommended Immigration Language: English Total items 1-6 6 :: 24
Query imm_language_english_mean Float Recommended Immigration Language: English Mean items 1-6 1 :: 4
Query imm_language_spanish_total Integer Recommended Immigration Language: Spanish Total items 7-12 6 :: 24
Query imm_language_spanish_mean Float Recommended Immigration Language: Spanish Mean items 7-12 1 :: 4
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