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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

Family Economic Impact Inventory

0 Shared Subjects

N/A
Clinical Assessments
Treatment
05/02/2017
famei01
05/11/2017
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
subjectkey GUID Required The NDAR Global Unique Identifier (GUID) for research subject NDAR*
src_subject_id String 20 Required Subject ID how it's defined in lab/project
interview_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
chcname1 String 50 Recommended Chronic health condition name 1
chcname2 String 50 Recommended Chronic health condition name 2
chcname3 String 50 Recommended Chronic health condition name 3
chcname4 String 50 Recommended Chronic health condition name 4
chcname5 String 50 Recommended Chronic health condition name 5
servicename1 String 50 Recommended First "sevice with a medical or other professional provider" used
servicename2 String 50 Recommended Second "sevice with a medical or other professional provider" used
servicename3 String 50 Recommended Third "sevice with a medical or other professional provider" used
servicename4 String 50 Recommended Fourth "sevice with a medical or other professional provider" used
servicename5 String 50 Recommended Fifth "sevice with a medical or other professional provider" used
servicecondition1 String 50 Recommended If not related to chronic health condition, what was it for?
servicecondition2 String 50 Recommended If not related to chronic health condition, what was it for?
servicecondition3 String 50 Recommended If not related to chronic health condition, what was it for?
servicecondition4 String 50 Recommended If not related to chronic health condition, what was it for?
servicecondition5 String 50 Recommended If not related to chronic health condition, what was it for?
serviceusage1 Integer Recommended Has [name of child] ever used the following service? Service 1 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
serviceusage2 Integer Recommended Has [name of child] ever used the following service? Service 2 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
serviceusage3 Integer Recommended Has [name of child] ever used the following service? Service 3 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
serviceusage4 Integer Recommended Has [name of child] ever used the following service? Service 4 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
serviceusage5 Integer Recommended Has [name of child] ever used the following service? Service 5 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
service_recent1 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 1
service_recent2 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 2
service_recent3 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 3
service_recent4 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 4
service_recent5 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 5
service_pay1 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 1
service_pay2 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 2
service_pay3 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 3
service_pay4 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 4
service_pay5 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 5
service_helpful1 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
service_helpful2 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
service_helpful3 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
service_helpful4 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
service_helpful5 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdservicename1 String 50 Recommended First "ASD specific service" used
asdservicename2 String 50 Recommended Second "ASD specific service" used
asdservicename3 String 50 Recommended Third "ASD specific service" used
asdservicename4 String 50 Recommended Fourth "ASD specific service" used
asdservicename5 String 50 Recommended Fifth "ASD specific service" used
asdserviceusage1 Integer Recommended Has [name of child] ever used the following service? Service 1 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
asdserviceusage2 Integer Recommended Has [name of child] ever used the following service? Service 2 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
asdserviceusage3 Integer Recommended Has [name of child] ever used the following service? Service 3 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
asdserviceusage4 Integer Recommended Has [name of child] ever used the following service? Service 4 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
asdserviceusage5 Integer Recommended Has [name of child] ever used the following service? Service 5 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
asdservice_recent1 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 1
asdservice_recent2 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 2
asdservice_recent3 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 3
asdservice_recent4 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 4
asdservice_recent5 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 5
asdservice_pay1 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 1
asdservice_pay2 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 2
asdservice_pay3 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 3
asdservice_pay4 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 4
asdservice_pay5 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 5
asdservice_helpful1 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdservice_helpful2 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdservice_helpful3 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdservice_helpful4 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdservice_helpful5 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
camservicename1 String 50 Recommended First "Complementary and Alternative Medicine Service" used
camservicename2 String 50 Recommended Second "Complementary and Alternative Medicine Service" used
camservicename3 String 50 Recommended Third "Complementary and Alternative Medicine Service" used
camservicename4 String 50 Recommended Fourth "Complementary and Alternative Medicine Service" used
camservicename5 String 50 Recommended Fifth "Complementary and Alternative Medicine Service" used
camservicecondition1 String 50 Recommended If not related to chronic health condition, what was it for?
camservicecondition2 String 50 Recommended If not related to chronic health condition, what was it for?
camservicecondition3 String 50 Recommended If not related to chronic health condition, what was it for?
camservicecondition4 String 50 Recommended If not related to chronic health condition, what was it for?
camservicecondition5 String 50 Recommended If not related to chronic health condition, what was it for?
camserviceusage1 Integer Recommended Has [name of child] ever used the following service? Service 1 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
camserviceusage2 Integer Recommended Has [name of child] ever used the following service? Service 2 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
camserviceusage3 Integer Recommended Has [name of child] ever used the following service? Service 3 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
camserviceusage4 Integer Recommended Has [name of child] ever used the following service? Service 4 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
camserviceusage5 Integer Recommended Has [name of child] ever used the following service? Service 5 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
camservice_recent1 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 1
camservice_recent2 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 2
camservice_recent3 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 3
camservice_recent4 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 4
camservice_recent5 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 5
camservice_pay1 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 1
camservice_pay2 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 2
camservice_pay3 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 3
camservice_pay4 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 4
camservice_pay5 Integer Recommended About how much did your family pay for this service IN THE LAST 4 MONTHS? Service 5
camservice_helpful1 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
camservice_helpful2 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
camservice_helpful3 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
camservice_helpful4 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
camservice_helpful5 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childs ASD: Service 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
educational_setting String 50 Recommended Which of the following best describes [name of child]s most recent school or educational setting? Public school; Charter school; Private school; Home school program; Early childhood intervention program; Other (specify); Does not currently attend school; Don't Know
classroom_setting Integer Recommended Within that school or educational program, which of the following best describes your childs most recent classroom setting 1::7 1= Regular classroom all day; 2= Regular classroom all day with an aide or assistant; 3= Regular classroom most of the day, special education classroom some of the time; 4= Regular classroom most of the day, pulled out for support services such as speech; 5= Same amount of time in regular classroom and in special education classroom; 6= Special education classroom most of the day, regular classroom some of the time; 7= Special education classroom all day
schoolservicename1 String 50 Recommended First "School Service" used
schoolservicename2 String 50 Recommended Second "School Service" used
schoolservicename3 String 50 Recommended Third "School Service" used
schoolservicename4 String 50 Recommended Fourth "School Service" used
schoolservicename5 String 50 Recommended Fifth "School Service" used
schoolservicecondition1 String 50 Recommended If not related to chronic health condition, what was it for?
schoolservicecondition2 String 50 Recommended If not related to chronic health condition, what was it for?
schoolservicecondition3 String 50 Recommended If not related to chronic health condition, what was it for?
schoolservicecondition4 String 50 Recommended If not related to chronic health condition, what was it for?
schoolservicecondition5 String 50 Recommended If not related to chronic health condition, what was it for?
schoolserviceusage1 Integer Recommended Has [name of child] ever used the following service? Service 1 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
schoolserviceusage2 Integer Recommended Has [name of child] ever used the following service? Service 2 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
schoolserviceusage3 Integer Recommended Has [name of child] ever used the following service? Service 3 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
schoolserviceusage4 Integer Recommended Has [name of child] ever used the following service? Service 4 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
schoolserviceusage5 Integer Recommended Has [name of child] ever used the following service? Service 5 1::3 1= Never used this service/ Don't Know; 2= Ever used this service in child's lifetime; 3= Used this service in the last 4 months
schoolservice_recent1 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 1
schoolservice_recent2 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 2
schoolservice_recent3 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 3
schoolservice_recent4 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 4
schoolservice_recent5 Integer Recommended About how many times did you use this service IN THE LAST 4 MONTHS? Service 5
schoolservice_helpful1 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childshealth or chronic health conditions: Service 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
schoolservice_helpful2 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childshealth or chronic health conditions: Service 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
schoolservice_helpful3 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childshealth or chronic health conditions: Service 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
schoolservice_helpful4 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childshealth or chronic health conditions: Service 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
schoolservice_helpful5 Integer Recommended SERVICE you indicated your child or family has EVER used to help with your childshealth or chronic health conditions: Service 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
medication_name String 255 Recommended Name of medication
medication2_name String 500 Recommended Name second medication that the participant has taken 0 = No medication; 999= Legitimately skipped
medication3_name String 500 Recommended Name third medication that the participant has taken 0 = No medication; 999= Legitimately skipped
medication4_name String 500 Recommended Name fourth medication that the participant has taken 0 = No medication; 999= Legitimately skipped
medication5_name String 500 Recommended Name fifth medication that the participant has taken 0 = No medication; 999= Legitimately skipped
drugusage1 Integer Recommended Has [name of child] ever used medication1? 1::3 1= Never used this medicine/ Don't Know; 2= Ever used this medicine in child's lifetime; 3= Used this medicine in the last 4 months
drugusage2 Integer Recommended Has [name of child] ever used medication2? 1::3 1= Never used this medicine/ Don't Know; 2= Ever used this medicine in child's lifetime; 3= Used this medicine in the last 4 months
drugusage3 Integer Recommended Has [name of child] ever used medication3? 1::3 1= Never used this medicine/ Don't Know; 2= Ever used this medicine in child's lifetime; 3= Used this medicine in the last 4 months
drugusage4 Integer Recommended Has [name of child] ever used medication4? 1::3 1= Never used this medicine/ Don't Know; 2= Ever used this medicine in child's lifetime; 3= Used this medicine in the last 4 months
drugusage5 Integer Recommended Has [name of child] ever used medication5? 1::3 1= Never used this medicine/ Don't Know; 2= Ever used this medicine in child's lifetime; 3= Used this medicine in the last 4 months
drug_pay1 Integer Recommended About how much did your family pay for medication1 IN THE LAST 4 MONTHS?
drug_pay2 Integer Recommended About how much did your family pay for medication2 IN THE LAST 4 MONTHS?
drug_pay3 Integer Recommended About how much did your family pay for medication3 IN THE LAST 4 MONTHS?
drug_pay4 Integer Recommended About how much did your family pay for medication4 IN THE LAST 4 MONTHS?
drug_pay5 Integer Recommended About how much did your family pay for medication5 IN THE LAST 4 MONTHS?
drug_helpful1 Integer Recommended MEDICATION you indicated your child or family has EVER used to help with your childs ASD: medication1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
drug_helpful2 Integer Recommended MEDICATION you indicated your child or family has EVER used to help with your childs ASD: medication2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
drug_helpful3 Integer Recommended MEDICATION you indicated your child or family has EVER used to help with your childs ASD: medication3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
drug_helpful4 Integer Recommended MEDICATION you indicated your child or family has EVER used to help with your childs ASD: medication4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
drug_helpful5 Integer Recommended MEDICATION you indicated your child or family has EVER used to help with your childs ASD: medication5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
vitaminname1 String 50 Recommended First "Vitamins, Supplements, and Herbs" used
vitaminname2 String 50 Recommended Second "Vitamins, Supplements, and Herbs" used
vitaminname3 String 50 Recommended Third "Vitamins, Supplements, and Herbs" used
vitaminname4 String 50 Recommended Fourth "Vitamins, Supplements, and Herbs" used
vitaminname5 String 50 Recommended Fifth "Vitamins, Supplements, and Herbs" used
vitaminusage1 Integer Recommended Has [name of child] ever used vitamin1? 1::3 1= Never used this vitamin/ Don't Know; 2= Ever used this vitamin in child's lifetime; 3= Used this vitamin in the last 4 months
vitaminusage2 Integer Recommended Has [name of child] ever used vitamin2? 1::3 1= Never used this vitamin/ Don't Know; 2= Ever used this vitamin in child's lifetime; 3= Used this vitamin in the last 4 months
vitaminusage3 Integer Recommended Has [name of child] ever used vitamin3? 1::3 1= Never used this vitamin/ Don't Know; 2= Ever used this vitamin in child's lifetime; 3= Used this vitamin in the last 4 months
vitaminusage4 Integer Recommended Has [name of child] ever used vitamin4? 1::3 1= Never used this vitamin/ Don't Know; 2= Ever used this vitamin in child's lifetime; 3= Used this vitamin in the last 4 months
vitaminusage5 Integer Recommended Has [name of child] ever used vitamin5? 1::3 1= Never used this vitamin/ Don't Know; 2= Ever used this vitamin in child's lifetime; 3= Used this vitamin in the last 4 months
vitamin_pay1 Integer Recommended About how much did your family pay for this vitamin IN THE LAST 4 MONTHS? vitamin 1
vitamin_pay2 Integer Recommended About how much did your family pay for this vitamin IN THE LAST 4 MONTHS? vitamin 2
vitamin_pay3 Integer Recommended About how much did your family pay for this vitamin IN THE LAST 4 MONTHS? vitamin 3
vitamin_pay4 Integer Recommended About how much did your family pay for this vitamin IN THE LAST 4 MONTHS? vitamin 4
vitamin_pay5 Integer Recommended About how much did your family pay for this vitamin IN THE LAST 4 MONTHS? vitamin 5
vitamin_helpful1 Integer Recommended Vitamin you indicated your child or family has EVER used to help with your childs ASD: vitamin 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
vitamin_helpful2 Integer Recommended Vitamin you indicated your child or family has EVER used to help with your childs ASD: vitamin 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
vitamin_helpful3 Integer Recommended Vitamin you indicated your child or family has EVER used to help with your childs ASD: vitamin 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
vitamin_helpful4 Integer Recommended Vitamin you indicated your child or family has EVER used to help with your childs ASD: vitamin 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
vitamin_helpful5 Integer Recommended Vitamin you indicated your child or family has EVER used to help with your childs ASD: vitamin 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
homepathicname String 50 Recommended You answered "Homeopathic remedy" to the question about vitamins or supplements to help manage s ASD. Please tell us the name of the remedy
herbname String 50 Recommended You answered "Chinese herb" to the question about vitamins or supplements to help manage s ASD. Please tell us the name of the herb
childcare_satisfaction Integer Recommended Now I am going to ask you how satisfied you are with the childcare arrangement or combination of arrangements for this child. I would like to use these categories: 1::5 1= Very satisfied; 2= Satisfied; 3= Mixed feelings; 4= Dissatisfied; 5= Very dissatisfied
childcare_pastchanges Integer Recommended How frequently have you changed child care arrangements in the past year? 0::7 0= Does not apply; 1= Never; 2= Yearly; 3= Once every six months; 4= Every few months; 5= Monthly; 6= Weekly; 7= On a daily basis
childcare_future Integer Recommended Do you plan to change your child care arrangements in the near future? 0; 1 0= No; 1= Yes
dietname1 String 50 Recommended First "Special Diet" used
dietname2 String 50 Recommended Second "Special Diet" used
dietname3 String 50 Recommended Third "Special Diet" used
dietname4 String 50 Recommended Fourth "Special Diet" used
dietname5 String 50 Recommended Fifth "Special Diet" used
dietusage1 Integer Recommended Has [name of child] ever used the following diet? diet 1 1::3 1= Never used this diet/ Don't Know; 2= Ever used this diet in child's lifetime; 3= Used this diet in the last 4 months
dietusage2 Integer Recommended Has [name of child] ever used the following diet? diet 2 1::3 1= Never used this diet/ Don't Know; 2= Ever used this diet in child's lifetime; 3= Used this diet in the last 4 months
dietusage3 Integer Recommended Has [name of child] ever used the following diet? diet 3 1::3 1= Never used this diet/ Don't Know; 2= Ever used this diet in child's lifetime; 3= Used this diet in the last 4 months
dietusage4 Integer Recommended Has [name of child] ever used the following diet? diet 4 1::3 1= Never used this diet/ Don't Know; 2= Ever used this diet in child's lifetime; 3= Used this diet in the last 4 months
dietusage5 Integer Recommended Has [name of child] ever used the following diet? diet 5 1::3 1= Never used this diet/ Don't Know; 2= Ever used this diet in child's lifetime; 3= Used this diet in the last 4 months
diet_recent1 Integer Recommended IF YOU HAVE USED THIS DIET IN THE LAST THREE MONTHS: Please indicate how often, in the last 4 months, you used this diet with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
diet_recent2 Integer Recommended IF YOU HAVE USED THIS DIET IN THE LAST THREE MONTHS: Please indicate how often, in the last 4 months, you used this diet with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
diet_recent3 Integer Recommended IF YOU HAVE USED THIS DIET IN THE LAST THREE MONTHS: Please indicate how often, in the last 4 months, you used this diet with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
diet_recent4 Integer Recommended IF YOU HAVE USED THIS DIET IN THE LAST THREE MONTHS: Please indicate how often, in the last 4 months, you used this diet with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
diet_recent5 Integer Recommended IF YOU HAVE USED THIS DIET IN THE LAST THREE MONTHS: Please indicate how often, in the last 4 months, you used this diet with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
diet_helpful1 Integer Recommended Diet you indicated your child or family has EVER used to help with your childs ASD: diet 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
diet_helpful2 Integer Recommended Diet you indicated your child or family has EVER used to help with your childs ASD: diet 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
diet_helpful3 Integer Recommended Diet you indicated your child or family has EVER used to help with your childs ASD: diet 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
diet_helpful4 Integer Recommended Diet you indicated your child or family has EVER used to help with your childs ASD: diet 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
diet_helpful5 Integer Recommended Diet you indicated your child or family has EVER used to help with your childs ASD: diet 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdprogramname1 String 50 Recommended First "ASD Programs" used
asdprogramname2 String 50 Recommended Second "ASD Programs" used
asdprogramname3 String 50 Recommended Third "ASD Programs" used
asdprogramname4 String 50 Recommended Fourth "ASD Programs" used
asdprogramname5 String 50 Recommended Fifth "ASD Programs" used
asdprogramusage1 Integer Recommended Has [name of child] ever used the following ASD program 1? 1::3 1= Never used this program/ Don't Know; 2= Ever used this program in child's lifetime; 3= Used this program in the last 4 months
asdprogramusage2 Integer Recommended Has [name of child] ever used the following ASD program 2? 1::3 1= Never used this program/ Don't Know; 2= Ever used this program in child's lifetime; 3= Used this program in the last 4 months
asdprogramusage3 Integer Recommended Has [name of child] ever used the following ASD program 3? 1::3 1= Never used this program/ Don't Know; 2= Ever used this program in child's lifetime; 3= Used this program in the last 4 months
asdprogramusage4 Integer Recommended Has [name of child] ever used the following ASD program 4? 1::3 1= Never used this program/ Don't Know; 2= Ever used this program in child's lifetime; 3= Used this program in the last 4 months
asdprogramusage5 Integer Recommended Has [name of child] ever used the following ASD program 5? 1::3 1= Never used this program/ Don't Know; 2= Ever used this program in child's lifetime; 3= Used this program in the last 4 months
asdprogram_recent1 Integer Recommended IF YOU HAVE USED THIS PROGRAM IN THE LAST THREE MONTHS: please indicate how often, in the last 4 months, you have used this program with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
asdprogram_recent2 Integer Recommended IF YOU HAVE USED THIS PROGRAM IN THE LAST THREE MONTHS: please indicate how often, in the last 4 months, you have used this program with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
asdprogram_recent3 Integer Recommended IF YOU HAVE USED THIS PROGRAM IN THE LAST THREE MONTHS: please indicate how often, in the last 4 months, you have used this program with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
asdprogram_recent4 Integer Recommended IF YOU HAVE USED THIS PROGRAM IN THE LAST THREE MONTHS: please indicate how often, in the last 4 months, you have used this program with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
asdprogram_recent5 Integer Recommended IF YOU HAVE USED THIS PROGRAM IN THE LAST THREE MONTHS: please indicate how often, in the last 4 months, you have used this program with your child. 1::3 1= Often; 2= Sometimes (at least 1 time per week); 3= Once in awhile (less than 1 time per week)
asdprogram_helpful1 Integer Recommended PROGRAM you indicated your child or family has EVER used to help with your childs ASD: ASD Program 1 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdprogram_helpful2 Integer Recommended PROGRAM you indicated your child or family has EVER used to help with your childs ASD: ASD Program 2 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdprogram_helpful3 Integer Recommended PROGRAM you indicated your child or family has EVER used to help with your childs ASD: ASD Program 3 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdprogram_helpful4 Integer Recommended PROGRAM you indicated your child or family has EVER used to help with your childs ASD: ASD Program 4 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
asdprogram_helpful5 Integer Recommended PROGRAM you indicated your child or family has EVER used to help with your childs ASD: ASD Program 5 1::5 1= Very Harmful; 2= Moderately Harmful; 3= No Effect; 4= Moderately Helpful; 5= Very Helpful
chc_needmed Integer Recommended In the LAST 44 MONTHS, was subject supposed to be taking medication for his/her health or chronic health condition? 0; 1 0= No; 1= Yes
med_genhealth Integer Recommended Was the medication for general health? 0; 1 0= No; 1= Yes
med_forchc Integer Recommended Was the medication for your childs chronic health condition? 0; 1 0= No; 1= Yes
medicated_condition String 50 Recommended Name condition for which subject is taking medication
famcost1 Integer Recommended Did you spend extra time helping, reminding, or urging [name of child] to take his/her medication? 0; 1 0= No; 1= Yes
famcost2 Integer Recommended In the LAST 44 MONTHS, have you spent time educating or explaining to [name of child], other family members, or other people abour your childs chronic health condition? (This could include discussing the diagnosis, symptoms, treatment, or any other aspects of [name of child]s condition. 0; 1 0= No; 1= Yes
famcost3 Integer Recommended In the LAST 44 MONTHS, have you spent time at the library, bookstores, or on the Internet (or anywhere else) doing general research about [name of child]s ASD? (This might include talking to people on the phone about [name of child]s ASD, but DOES NOT INCLUDE discussions with treatment providers, school, or child care staff.) 0; 1 0= No; 1= Yes
famcost4 Integer Recommended In the LAST 4 MONTHS, have you gotten help from or hired a person to provide help to advocate for [name of child] in court or in other situations? (This might include a lawyer, an advocate with the school regarding an individual education plan, or other special advocate for [name of child] related to his/her HEALTH OR CHRONIC HEALTH CONDITION.) 0; 1 0= No; 1= Yes
famcost5 Integer Recommended In the LAST 4 MONTHS, have you spent time doing paperwork or other administrative tasks (such as talking with insurance companies about insurance coverage or payments, or filline out legal documents) related to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost6 Integer Recommended In the LAST 4 MONTHS, have you spent time planning for [name of childs FUTURE care or planning for FUTURE expenses related to his/her HEALTH OR CHRONIC HEALTH CONDITION? (Examples might include discussions about saving or budgeting for services, schools, or long-term care for your child, planning for more immediate issues like next year�s medical bills or school fees, creating wills and trusts, or planning for college, adulthood, or changes in medical coverage or life insurance.) 0; 1 0= No; 1= Yes
famcost7 Integer Recommended In the LAST 4 MONTHS, have you had extra expenses for safety modividations or changes in your home due to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost8 Integer Recommended In the LAST 4 MONTHS, have you spent time or money on any other activities related to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION or behavior problems, such as extra laundry, higher utilities, or phone charges? 0; 1 0= No; 1= Yes
famcost9 Integer Recommended IN THE LAST 4 MONTHS, did you work either full time or part time, for pay?
famcost10 String 50 Recommended What best describes your current job status?
famcost11 String 200 Recommended Describe the job in which you received the most earnings IN THE LAST 4 MONTHS?
famcost12 Integer Recommended IN THE LAST 4 MONTHS, did you have to use paid time off, vacation time, or sick leave due to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost13 Integer Recommended IN THE LAST 4 MONTHS, do you think [name of child]s HEALTH OR CHRONIC HEALTH CONDITION affected how you spent your time or how well you focused or performed tasks while at work? 0; 1 0= No; 1= Yes
famcost14 Integer Recommended About how much did [name of child]s HEALTH OR CHRONIC HEALTH CONDITION affect your work performance? 0::4 0= Don't Know; 1= I almost could not work at all (affected me 75-100% of the time); 2= My work was greatly affected (affected me 50-75% of the time); 3= Regularly (affected me 25-50% of the time); 4= Only a little (affected me less than 25% of the time)
famcost15 Integer Recommended IN THE LAST 4 MONTHS, were you in school full or part time related to career development? 0; 1 0= No; 1= Yes
famcost16 Integer Recommended IN THE LAST 4 MONTHS, did you take time off of work or school related to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost17 Integer Recommended IN THE LAST 4 MONTHS, how many hours did you miss from work or school because of these activities?
famcost18 Integer Recommended Has [name of child]s HEALTH OR CHRONIC HEALTH CONDITION EVER affected your ability to go to school or work or perform your regular tasks at work or school? 0; 1 0= No; 1= Yes
famcost19 Integer Recommended In the LAST 4 MONTHS, has [name of child]s HEALTH OR CHRONIC HEALTH CONDITION affected your ability to go to school or work, or perform your regular tasks at work or school? 0; 1 0= No; 1= Yes
famcost20 Integer Recommended Have you EVER changed jobs, work schedule, or number of hours worked due to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost21 String 100 Recommended Describe job-related change
famcost22 Integer Recommended Have you EVER chosen NOT to work or attend school due to [name of child]s HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost23 Integer Recommended Have you EVER been prevented from pursuing a career or advancing a job because of caring for [name of child] or because of his/her HEALTH OR CHRONIC HEALTH CONDITION? 0; 1 0= No; 1= Yes
famcost24 Integer Recommended Have you EVER been unable to work because of problems finding or keeping childcare for [name of child]? 0; 1 0= No; 1= Yes
famcost25 String 100 Recommended Describe problems working or finding work
child_caretaker String 50 Recommended Who cares for this child?
child_nursery_location String 110 Recommended Where is this child cared for?
comments_misc String 4,000 Recommended Miscellaneous comments on study, interview, methodology relevant to this form data
pregia_c String 100 Recommended Who else has been a primary caretaker?
resp_householdincome Integer Recommended Respondent's total household income in the last year before taxes 1::11 1 = $20,000 or less; 2 = $20,000-$40,000; 3 = $40,000-$60,000; 4 = $60,000-$100,000; 5 = $100,000-$125,000; 6 = $125,000-$150,000; 7 = $125,000-$150,000; 8 = $150,000-$200,000; 9 = $200,000 or higher; 10 = I don't know; 11 = I prefer not to answer
das1ms String 200 Recommended Marital status
grade_highed String 50 Recommended Grade/Highest education 1= Less than 6th grade; 2= Some high school; 3= High school diploma or GED; 4= Some college, no degree; 5= Associates degree; 6= Bachelors degree; 7= Some graduate school; 8= Masters degree and above; 9= Some post-graduate training, no degree; 10= Completed 8th grade, no high school; 11= High school; 12= College or University; 13= Graduate school; 14= Other; 15= Less than high school; 99= Information not available
primary_language String 255 Recommended Subject's Primary Language
ethnicity String 30 Recommended Ethnicity of participant Hispanic or Latino; Not Hispanic or Latino; Unknown
race String 30 Recommended Race of study subject American Indian/Alaska Native; Asian; Hawaiian or Pacific Islander; Black or African American; White; More than one race; Unknown or not reported; Other Non-White; Other
relationship Integer Recommended Relationship of respondent to individual 1::94;-999 1 = Biological mom; 2 = Biological dad; 3 = Grandparent; 4 = Special education (sped) teacher; 5 = General education teacher; 6 = Occupational therapist; 7 = Speech and language therapist; 8 = Behavioral therapist; 9 = Paraprofessional; 10 = Aide; 11 = Principal; 12 = Administrator; 14 = Content teacher; 15 = Parent center director; 16 = Self; 17=Adoptive mother; 18=Adoptive father; 19=Foster mother; 20 = Foster father; 21=Grandmother; 22=Grandfather; 23=Step-mother; 24 = Step-father; 25=Aunt; 26=Uncle; 28=Both parents;31= Grandmother from mother side; 32= Grandfather from mother side; 33= Grandmother from father side; 34= Grandfather from father side; 36= Brother; 37= Sister; 38= Cousin; 39= female caregiver; 40=male caregiver; 41=Female child; 42=Male child; 43=Spouse/Mate; 44=Friend; 45=Parent; 46=Significant other; 47=Sibling; 48=Son/Daughter; 49=Son-in-law/Daughter-in law; 50=Other Relative; 51=Paid caregiver; 52=Friends; 53=Roommate; 54=Supervisor; 55=mother's boyfriend; 56=other parental figure; 57=Summary; 58=counselor ; 59 = other female relative; 60 = other male relative; 61 = non-relative ; 62=Maternal Aunt; 63=Maternal Uncle; 64=Maternal Cousin; 65 = Paternal Aunt; 66=Paternal Uncle; 67=Paternal Cousin ; 68=Biological/Adoptive Mother and Grandmother; 69=Biological/Adoptive Mother and Stepmother and Grandmother; 70=Biological/Adoptive Mother and Grandmother and Foster Father; 71=Biological/Adoptive Mother and Stepmother and Foster Mother; 72=Biological/Adoptive Mother and Foster Mother; 73=Biological/Adoptive Mother and Biological/Adoptive Father; 74=Biological/Adoptive Mother and Stepmother and Biological/Adoptive Father; 75=Biological/Adoptive Mother and Other; 76=Biological/Adoptive Mother and Stepmother and Stepfather; 77=Biological/Adoptive Mother and Stepfather; 78=Biological/Adoptive Mother and Grandfather; 79=Biological/Adoptive Mother and Stepmother and Foster Father; 80=Biological/Adoptive Mother and Stepmother; 81=Guardian, female; 82=Other female; 83=Guardian, male; 84=Other male; 85=Other/Grandparent/Nanny; 86 = Mother, Father, Guardian; 87 = Daughter, son, grandchild; 88 = Professional (e.g., social worker, nurse, therapist, psychiatrist, or group home staff); -999=Missing; 89 = Biological parent; 90=Other; 91 = Stepparent; 92 = Adoptive parent; 93 = Foster parent; 94 = Co-worker
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

Please email the The NDA Help Desk with any questions.

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