|
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 |
|
|
id |
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
tdate |
|
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
|
early_therapy |
Integer |
|
Recommended |
Did your child receive any "early intervention" or "birth to three" program service? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
community_class |
Integer |
|
Recommended |
Did a professional recommend that your child attend any community based classes/activities? |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
participate_class |
Integer |
|
Recommended |
Did your child participate in any classes/activities whether or not recommended by a professional? |
0;1
|
0 = No; 1 = Yes
|
|
|
txhxearlyint1start |
Date |
|
Recommended |
early intervention 1 start date |
|
|
|
Query
|
still_attend |
Integer |
|
Recommended |
Still attending class/activity? |
0;1
|
0 = No; 1 = Yes
|
|
|
date_stop |
Date |
|
Recommended |
Date stopped |
|
|
|
Query
|
program_week_hrs |
Float |
|
Recommended |
Average hours per week (of early intervention or birth to three programs). |
|
|
|
Query
|
abatrain |
Integer |
|
Recommended |
Received training for Applied Behavior Analysis (ABA) |
0; 1
|
0 = No; 1 = Yes
|
|
|
aba_start |
Date |
|
Recommended |
date subject began Applied Behavioural Analysis (ABA) |
|
|
|
Query
|
ihcfi_aba_receive |
Integer |
|
Recommended |
ABA therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
|
aba_end |
Date |
|
Recommended |
date subject ended Applied Behavioural Analysis (ABA) |
|
|
|
Query
|
ihcfi_aba_size |
Integer |
|
Recommended |
ABA therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_aba_setting |
Integer |
|
Recommended |
ABA therapy Setting |
1::6
|
1= Office; 2= Home; 3= Daycare/Preschool; 4= Special Class; 5=Other; 6=Clinic
|
|
Query
|
ihcfi_aba_avg_hour |
Float |
|
Recommended |
ABA therapy Average hours per week |
|
|
|
Query
|
non_aba |
Integer |
|
Recommended |
Did your child participate in any Non-ABA comprehensive Intervention program |
0;1
|
0 = No; 1 = Yes
|
|
|
nonaba_start |
Date |
|
Recommended |
Non-ABA start date |
|
|
|
Query
|
ihcfi_naba_receive |
Integer |
|
Recommended |
Non-ABA (N-ABA) therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
|
nonaba_end |
Date |
|
Recommended |
Non-ABA stop date |
|
|
|
Query
|
ihcfi_naba_size |
Integer |
|
Recommended |
Non-ABA (N-ABA) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_naba_setting |
Integer |
|
Recommended |
Non-ABA (N-ABA) therapy Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
ihcfi_naba_avg_hour |
Integer |
|
Recommended |
Non-ABA (N-ABA) therapy Average hours per week |
|
|
|
Query
|
rel_ther |
Integer |
|
Recommended |
Did your child participate in any Relationship based therapy (eg, Floortime, DIR, RDI) |
0;1
|
0=No; 1=Yes
|
|
|
relther_start |
Date |
|
Recommended |
Relationship therapy start date |
|
|
|
Query
|
ihcfi_rb_receive |
Integer |
|
Recommended |
Relationship-based (RB) therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
|
relther_end |
Date |
|
Recommended |
Relationship therapy stop date |
|
|
|
Query
|
ihcfi_rb_size |
Integer |
|
Recommended |
Relationship-based (RB) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_rb_setting |
Integer |
|
Recommended |
Relationship-based (RB) therapy Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
ihcfi_rb_avg_hour |
Integer |
|
Recommended |
Relationship-based (RB) therapy Average hours per week |
|
|
|
Query
|
gei_ther |
Integer |
|
Recommended |
Did child participate in General Early Intervention services |
|
|
|
Query
|
ihcfi_gei_size |
Integer |
|
Recommended |
General early Intervention (GEI) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_gei_setting |
Integer |
|
Recommended |
General early Intervention (GEI) therapy Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
ihcfi_gei_avg_hour |
Integer |
|
Recommended |
General early Intervention (GEI) therapy Average hours per week |
|
|
|
Query
|
ihcfi_gei_receive |
Integer |
|
Recommended |
General early Intervention (GEI) therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
|
gei_start |
Date |
|
Recommended |
General Early Intervention services start date |
|
|
|
|
gei_end |
Date |
|
Recommended |
General Early Intervention services end date |
|
|
|
Query
|
sensint_ther |
Integer |
|
Recommended |
Did child participate in Sensory Integration Therapy |
0;1
|
0=No; 1=Yes
|
|
Query
|
sensint_size |
Integer |
|
Recommended |
Sensory Integration Therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
sensint_setting |
Integer |
|
Recommended |
Sensory Integration Therapy Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
sensint_avg_hour |
Float |
|
Recommended |
Sensory Integration Therapy Average hours per week |
|
|
|
Query
|
sensint_receive |
Integer |
|
Recommended |
Sensory Integration Therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
|
sensint_start |
Date |
|
Recommended |
Sensory Integration Therapy start date |
|
|
|
|
sensint_end |
Date |
|
Recommended |
Sensory Integration Therapy end date |
|
|
|
Query
|
q14_4f |
Integer |
|
Recommended |
Other service: Occupational therapy |
0; 1
|
0 = No; 1 = Yes
|
|
|
occuther_start |
Date |
|
Recommended |
Occupational Therapy start day |
|
|
|
Query
|
q45_4f |
Integer |
|
Recommended |
Occupational Therapy OT Ongoing |
0;1
|
0=No; 1=Yes
|
|
|
occuther_end |
Date |
|
Recommended |
Occupational Therapy end day |
|
|
|
Query
|
ihcfi_ot_size |
Integer |
|
Recommended |
Occupational Therapy (OT) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_ot_setting |
Integer |
|
Recommended |
Occupational Therapy (OT) therapy Setting |
1::6
|
1= Office; 2= Home; 3= Daycare/Preschool; 4= Special Class; 5=Other; 6=Clinic
|
|
Query
|
ihcfi_ot_avg_hour |
Float |
|
Recommended |
Occupational Therapy (OT) therapy Average hours per week |
|
|
|
Query
|
service_physical |
String |
5
|
Recommended |
Physical Therapy |
Yes; No
|
|
|
|
pt_start |
Date |
|
Recommended |
Date started Physical Therapy: |
|
|
|
Query
|
ihcfi_pt_receive |
Integer |
|
Recommended |
Physical Therapy (PT) therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
Query
|
ihcfi_pt_size |
Integer |
|
Recommended |
Physical Therapy (PT) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_pt_setting |
Integer |
|
Recommended |
Physical Therapy (PT) therapy Setting |
1::6
|
1= Office; 2= Home; 3= Daycare/Preschool; 4= Special Class; 5=Other; 6=Clinic
|
|
Query
|
ihcfi_pt_avg_hour |
Float |
|
Recommended |
Physical Therapy (PT) therapy Average hours per week |
|
|
|
|
pt_end |
Date |
|
Recommended |
date subject ended PT |
|
|
|
Query
|
socskiltr |
String |
20
|
Recommended |
Social Skills Training |
0;1; 999
|
0=No; 1=Yes; 999=missing
|
|
|
socskiltr_start |
Date |
|
Recommended |
Date started Social Skills Training |
|
|
|
Query
|
socskiltr_receive |
Integer |
|
Recommended |
Social Skills Training Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
Query
|
socskiltr_size |
Integer |
|
Recommended |
Social Skills Training size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
socskiltr_setting |
Integer |
|
Recommended |
Social Skills Training Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
socskiltr_avg_hour |
Float |
|
Recommended |
Social Skills Training Average hours per week |
|
|
|
|
socskiltr_end |
Date |
|
Recommended |
Social Skills Training end date |
|
|
|
Query
|
txhx1speechtx1 |
Integer |
|
Recommended |
Did child participate in speech therapy |
|
0 = No; 1 = Yes
|
|
|
speech_therapy_start |
Date |
|
Recommended |
date subject began Speech Therapy (ST) |
|
|
|
Query
|
txhxspeechtx1ong |
Integer |
|
Recommended |
speech therapy ongoing? |
|
0 = No; 1 = Yes
|
|
Query
|
speechther_size |
Integer |
|
Recommended |
Speech Therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
speechther_setting |
Integer |
|
Recommended |
Speech Therapy Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
cspeechhrs |
Float |
|
Recommended |
Speech therapy (hrs/week) |
0::168
|
|
|
|
st_end |
Date |
|
Recommended |
date subject ended Speech Therapy (ST) |
|
|
|
Query
|
otherther1 |
Integer |
|
Recommended |
Did child participate in other therapy 1 |
0;1
|
0=No; 1=Yes
|
|
|
ihcfi_o1_comment |
String |
250
|
Recommended |
Other 1 (O1) therapy comments |
|
|
spec1 |
|
otherther1_start |
Date |
|
Recommended |
Date started other therapy 1 |
|
|
|
Query
|
ihcfi_o1_receive |
Integer |
|
Recommended |
Other 1 (O1) therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
Query
|
ihcfi_o1_size |
Integer |
|
Recommended |
Other 1 (O1) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_o1_setting |
Integer |
|
Recommended |
Other 1 (O1) therapy Setting |
1::6
|
1= Office; 2= Home; 3= Daycare/Preschool; 4= Special Class; 5=Other; 6=Clinic
|
|
Query
|
ihcfi_o1_avg_hour |
Integer |
|
Recommended |
Other 1 (O1) therapy Average hours per week |
|
|
w1t9 |
|
other1_end |
Date |
|
Recommended |
date subject ended other therapy 1 |
|
|
|
Query
|
otherther2 |
Integer |
|
Recommended |
Did child participate in other therapy 2 |
0;1
|
0=No; 1=Yes
|
|
|
ihcfi_o2_comment |
String |
250
|
Recommended |
Other 2 (O2) therapy comments |
|
|
spec2 |
|
otherther2_start |
Date |
|
Recommended |
Date started other therapy 2 |
|
|
|
Query
|
ihcfi_o2_receive |
Integer |
|
Recommended |
Other 2 (O2) therapy Still receiving intervention? |
0;1
|
0=No; 1=Yes
|
|
Query
|
ihcfi_o2_size |
Integer |
|
Recommended |
Other 2 (O2) therapy size |
1;2
|
1 Individual = 1; 2 Group = 2;
|
|
Query
|
ihcfi_o2_setting |
Integer |
|
Recommended |
Other 2 (O2) therapy Setting |
1::5
|
Office = 1; Home = 2; Daycare/Preschool = 3; Special Class = 4; Other = 5
|
|
Query
|
ihcfi_o2_avg_hour |
Integer |
|
Recommended |
Other 2 (O2) therapy Average hours per week |
|
|
w1t10 |
|
other2_end |
Date |
|
Recommended |
date subject ended other therapy 2 |
|
|
|
Query
|
aamt_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Antibiotics or antiviral medications or therapies (AAMT) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
aamt_age |
Integer |
|
Recommended |
AAMT. Age at first service date, months |
|
|
|
|
aamt_type |
String |
50
|
Recommended |
AAMT. Specify type of therapy |
|
|
|
Query
|
aamt_endage |
Integer |
|
Recommended |
AAMT. Age at last service date, months |
|
|
|
Query
|
chelation_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Chelation |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
chelation_age |
Integer |
|
Recommended |
Chelation. Age at first service date, months |
|
|
|
|
chelation_type |
String |
50
|
Recommended |
Chelation. Specify type of therapy |
|
|
|
Query
|
chelation_endage |
Integer |
|
Recommended |
Chelation. Age at last service date, months |
|
|
|
Query
|
ccmt_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Chiropractic Care or massage therapy (CCMT) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
ccmt_age |
Integer |
|
Recommended |
CCMT. Age at first service date, months |
|
|
|
|
ccmt_type |
String |
50
|
Recommended |
CCMT. Specify type of therapy |
|
|
|
Query
|
ccmt_endage |
Integer |
|
Recommended |
CCMT. Age at last service date, months |
|
|
|
Query
|
dgcf_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Diet: Gluten and/or Casein Free (DGCF) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
dgcf_age |
Integer |
|
Recommended |
DGCF. Age at first service date, months |
|
|
|
|
dgcf_type |
String |
50
|
Recommended |
DGCF. Specify type of therapy |
|
|
|
Query
|
dgcf_endage |
Integer |
|
Recommended |
DGCF. Age at last service date, months |
|
|
|
Query
|
dyfd_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Diet: Yeast free Diet(DYFD) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
dyfd_age |
Integer |
|
Recommended |
DYFD. Age at first service date, months |
|
|
|
|
dyfd_type |
String |
50
|
Recommended |
DYFD. Specify type of therapy |
|
|
|
Query
|
dyfd_endage |
Integer |
|
Recommended |
DYFD. Age at last service date, months |
|
|
|
Query
|
do_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Diet other (DO) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
do_age |
Integer |
|
Recommended |
DO. Age at first service date, months |
|
|
|
|
do_type |
String |
50
|
Recommended |
DO. Specify type of therapy |
|
|
|
Query
|
do_endage |
Integer |
|
Recommended |
DO. Age at last service date, months |
|
|
|
Query
|
dvs_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Dietary or Vitamin Supplements (DVS) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
dvs_age |
Integer |
|
Recommended |
DVS. Age at first service date, months |
|
|
|
|
dvs_type |
String |
50
|
Recommended |
DVS. Specify type of therapy |
|
|
|
Query
|
dvs_endage |
Integer |
|
Recommended |
DVS. Age at last service date, months |
|
|
|
Query
|
hsmt_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Herbal supplements, medication or tea (HSMT) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
hsmt_age |
Integer |
|
Recommended |
HSMT. Age at first service date, months |
|
|
|
|
hsmt_type |
String |
50
|
Recommended |
HSMT. Specify type of therapy |
|
|
|
Query
|
hsmt_endage |
Integer |
|
Recommended |
HSMT. Age at last service date, months |
|
|
|
Query
|
hbot_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Hyperbaric Oxygen Therapy (HBOT) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
hbot_age |
Integer |
|
Recommended |
HBOT. Age at first service date, months |
|
|
|
|
hbot_type |
String |
50
|
Recommended |
HBOT. Specify type of therapy |
|
|
|
Query
|
hbot_endage |
Integer |
|
Recommended |
HBOT. Age at last service date, months |
|
|
|
Query
|
itsc_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Immune treatments (e.g. stem cell transplants (ITSC) |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
itsc_age |
Integer |
|
Recommended |
ITSC. Age at first service date, months |
|
|
|
|
itsc_type |
String |
50
|
Recommended |
ITSC. Specify type of therapy |
|
|
|
Query
|
itsc_endage |
Integer |
|
Recommended |
ITSC. Age at last service date, months |
|
|
|
Query
|
other_ther |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive complementary or alternative therapies used to treat symptoms of autism: Other |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
other_age |
Integer |
|
Recommended |
Other. Age at first service date, months |
|
|
|
|
other_type |
String |
50
|
Recommended |
Other. Specify type of therapy |
|
|
|
Query
|
other_endage |
Integer |
|
Recommended |
Other. Age at last service date, months |
|
|
|
Query
|
aaos_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Antidepressants, anti-anxiety, or obsessive-compulsive (AAOS) medications |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
aaos_age |
Integer |
|
Recommended |
AAOS. Age at first prescription, months |
|
|
|
|
aaos_type |
String |
50
|
Recommended |
AAOS. Specific type of medication |
|
|
|
Query
|
atantip_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Atypical Antipsychotics medications |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
atantip_age |
Integer |
|
Recommended |
Atypical Antipsychotics. Age at first prescription, months |
|
|
|
|
atantip_type |
String |
50
|
Recommended |
Atypical Antipsychotics. Specific type of medication |
|
|
|
Query
|
hyperag_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Hypertension agents medications |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
hyperag_age |
Integer |
|
Recommended |
Hypertension agents. Age at first prescription, months |
|
|
|
|
hyperag_type |
String |
50
|
Recommended |
Hypertension agents. Specific type of medication |
|
|
|
Query
|
mtseiz_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Medications used to treat seizures, which are also used to stabilize mood |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
mtseiz_age |
Integer |
|
Recommended |
Medications used to treat seizures, which are also used to stabilize mood. Age at first prescription, months |
|
|
|
|
mtseiz_type |
String |
50
|
Recommended |
Medications used to treat seizures, which are also used to stabilize mood. Specific type of medication |
|
|
|
Query
|
stimul_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Stimulants |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
stimul_age |
Integer |
|
Recommended |
Stimulants. Age at first prescription, months |
|
|
|
|
stimul_type |
String |
50
|
Recommended |
Stimulants. Specific type of medication |
|
|
|
Query
|
other1_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Other medications 1 |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
other1_age |
Integer |
|
Recommended |
Other 1. Age at first prescription, months |
|
|
|
|
other1_type |
String |
50
|
Recommended |
Other 1. Specific type of medication |
|
|
|
Query
|
other2_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Other medications 2 |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
other2_age |
Integer |
|
Recommended |
Other 2. Age at first prescription, months |
|
|
|
|
other2_type |
String |
50
|
Recommended |
Other 2. Specific type of medication |
|
|
|
Query
|
other3_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Other medications 3 |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
other3_age |
Integer |
|
Recommended |
Other 3. Age at first prescription, months |
|
|
|
|
other3_type |
String |
50
|
Recommended |
Other 3. Specific type of medication |
|
|
|
Query
|
other4_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Other medications 4 |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
other4_age |
Integer |
|
Recommended |
Other 4. Age at first prescription, months |
|
|
|
|
other4_type |
String |
50
|
Recommended |
Other 4. Specific type of medication |
|
|
|
Query
|
other5_meds |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive medical or pharmacological interventions used to treat symptoms of autism? Other medications 5 |
0;1; 9
|
0=No; 1=Yes; 9=DK
|
|
Query
|
other5_age |
Integer |
|
Recommended |
Other 5. Age at first prescription, months |
|
|
|
|
other5_type |
String |
50
|
Recommended |
Other 5. Specific type of medication |
|
|
|
|
comments_misc |
String |
4,000
|
Recommended |
Miscellaneous comments on study, interview, methodology relevant to this form data |
|
|
|
Query
|
social_tr |
Integer |
|
Recommended |
At any point during the past six months did your toddler participate in any classes/activities designed to increase socialization (eg. MommyandMe, Gymboree, etc.) |
0;1
|
0=No; 1=Yes
|
|
Query
|
develop_tr |
Integer |
|
Recommended |
At any point during the past six months did your toddler receive any intervention or service for developmental delays or concerns? |
0;1
|
0=No; 1=Yes
|
|
Query
|
notreat |
Integer |
|
Recommended |
If subject did not receive treatment during this rating period, please check here |
0;1;999
|
0 = Not checked, receiving treatment; 1 = Checked, not receiveing treatment; 999 = missing
|
|
Query
|
w1t2 |
Integer |
|
Recommended |
Group sessions per week |
|
0 = Not Applicable
|
|
Query
|
w1t3 |
Integer |
|
Recommended |
Family sessions per week |
|
0 = Not Applicable
|
|
Query
|
w1t4 |
Integer |
|
Recommended |
Med Session sessions per week |
|
0 = Not Applicable
|
|
Query
|
w1t5 |
Integer |
|
Recommended |
Self-help sessions per week |
|
0 = Not Applicable
|
|
Query
|
w1t6 |
Integer |
|
Recommended |
Inpatient treatment days per week |
|
0 = Not Applicable
|
|
Query
|
w1t7 |
Integer |
|
Recommended |
Partial hospitalization treatment days per week |
|
0 = Not Applicable
|
|
Query
|
timeunit1 |
Integer |
|
Recommended |
Other therapy modality 1 Ratings are listed as |
1::3
|
1 = Days/week; 2 = Hours/week; 3 = Sessions/week
|
time1 |
Query
|
timeunit2 |
Integer |
|
Recommended |
Other therapy modality 2 Ratings are listed as |
1::3
|
1 = Days/week; 2 = Hours/week; 3 = Sessions/week
|
time2 |
Query
|
timeunit3 |
Integer |
|
Recommended |
Other therapy modality 3 Ratings are listed as |
1::3
|
1 = Days/week; 2 = Hours/week; 3 = Sessions/week
|
time3 |
Query
|
timeunit4 |
Integer |
|
Recommended |
Other therapy modality 4 Ratings are listed as |
1::3
|
1 = Days/week; 2 = Hours/week; 3 = Sessions/week
|
time4 |
|
site |
String |
101
|
Recommended |
Site |
|
Study Site
|
|
Query
|
page |
Integer |
|
Recommended |
Page of form |
|
|
pg |
Query
|
respond |
Integer |
|
Recommended |
Respondent |
1::7;999
|
1 = Parent; 2 = Teacher; 3=Self; 4= Other; 5= Significant other; 6 = Parent 1; 7 = Parent 2; 999 = Not available
|
aorc |
Query
|
days_baseline |
Integer |
|
Recommended |
Days since baseline |
|
|
|
Query
|
bsit0 |
Float |
|
Recommended |
Weeks from Time 0/baseline to assessment |
|
|
w1 |
Query
|
txhxindiv1sess |
Integer |
|
Recommended |
individual therapy number of sessions per week |
|
|
w1t1 |
Query
|
care_private |
Integer |
|
Recommended |
No. of hours per week child in care of Private Provider in Home |
|
Enter '0' for NA
|
w1t8 |
Query
|
ihcfi_oc_avg_hour |
Integer |
|
Recommended |
Other Comprehensive (OC) therapy Average hours per week |
|
|
w1t11 |
Query
|
cothhrs |
Float |
|
Recommended |
Other interventions (hrs/week) |
0::168
|
|
w1t12 |
|
ihcfi_oc_comment |
String |
250
|
Recommended |
Other Comprehensive (OC) therapy comments |
|
|
spec3 |
|
mhcomm |
String |
100
|
Recommended |
Mental Health Other/Comments |
|
|
spec4 |
|
intstart |
Date |
|
Recommended |
intake start date |
|
|
intake |
Query
|
aescode |
Integer |
|
Recommended |
Staff code number of person completing this form |
|
999= Missing Data
|
|
Query
|
bsimo |
Float |
|
Recommended |
Months from Time 0 to assessment |
|
|
monfol |
Query
|
daysrz |
Integer |
|
Recommended |
days since randomization |
|
|
|
Query
|
visnum |
Float |
|
Recommended |
Numeric Visit Number |
|
-1.5 = Pre-Screening; -1 = Screening; 0 = Baseline; ## = Visit ## (from 1 to 10); Whole numbers = standard monthly visits; #.001 - #.009 = Unscheduled; #.1 = End of Phase 1; #.2 = End of Phase 2; #.3 = End of Phase 3; #.4 = End of Open Choice Phase; #.5 = End of Study; #.6 = Genetic Analysis; 1000=all visits
|
|
Query
|
school_hours |
Float |
|
Recommended |
How many hours per week does your child spend in school? |
|
|
|
Query
|
q14_4c |
Integer |
|
Recommended |
Other service: Adaptive PE |
0; 1; -7; -8; -9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
|
Query
|
q14_4c1 |
Float |
|
Recommended |
Adaptive PE: # Hours per week |
0.0 :: 99.99; -7; -8; -9
|
-7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
|
Query
|
suq02 |
Integer |
|
Recommended |
Special education for behavioral or emotional support? |
0; 1
|
0 = No; 1 = Yes
|
|
Query
|
q14_4d |
Integer |
|
Recommended |
Other service: Crisis management |
0; 1; -7; -8; -9
|
0 = No; 1 = Yes; -7 = Don't know; -8 = Refused to answer; -9 = Does not apply
|
|
|
q14_4_s13 |
String |
100
|
Recommended |
Other service: Other Specify |
|
|
|
Query
|
othertherapy1_week_hrs |
Float |
|
Recommended |
Other Therapy Occurrence 1:For the following intervention, how many hours per week were provided? |
|
|
|
|
s2_1o |
String |
150
|
Recommended |
Spcify other services |
|
|
|
Query
|
q14_4m1 |
Float |
|
Recommended |
Other: # Hours per week |
0.0 :: 99.99; -7; -8; -9; 999
|
-7 = Don't know; -8 = Refused to answer; -9 = Does not apply; 999 = Missing value
|
|
Query
|
q45_38c |
Float |
|
Recommended |
Crisis Management Hours or Week |
-7;-8;-9;0.0 :: 999.9
|
Complete only if "Type of Intervention Changed since last visit" = 1
|
|
|
schoolotr_school_otr |
String |
100
|
Recommended |
Other specify Type of school or day program Other specify |
|
|
|
Query
|
ieisq1 |
Integer |
|
Recommended |
What percentage (range) of the typical school day does this child spend in special education? (select one response) |
1::5
|
1 = 0-10%; 2 = 11-30%; 3 = 31-50%; 4 = 51-70%; 5 = > 70%
|
|
Query
|
ieisq2 |
Integer |
|
Recommended |
What percentage (range) of the typical school day does this child spend in regular education? (select one response) |
1::5
|
1 = 0-10%; 2 = 11-30%; 3 = 31-50%; 4 = 51-70%; 5 = > 70%
|
|
Query
|
ieisq3 |
Integer |
|
Recommended |
What type of specialized program this child is in: (check the most appropriate) |
1::9
|
1 = Full-time Reg Ed Classroom without aide; 2 = Reg Ed full-time w/one-to-one aide; 3 = Reg Ed with pullout for certain areas; 4 = Special Ed w/minimal inclusion (e.g., lunch); 5 = Full-time special ed with no inclusion; 6 = Special (MR/DD) school; 7 = Not in school; 8 = Home-school; 9 = Other (please describe)
|
|
Query
|
ieisq5 |
Float |
|
Recommended |
What percentage/% of the student's time is spent with typically developing peers? |
0::100
|
|
|
Query
|
q6ack |
Integer |
|
Recommended |
Speech Therapy: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6bck |
Integer |
|
Recommended |
Occupational Therapy: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6cck |
Integer |
|
Recommended |
Physical Therapy: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6dck |
Integer |
|
Recommended |
Sensory Integration: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6eck |
Integer |
|
Recommended |
Social Skills Training: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6fck |
Integer |
|
Recommended |
Adaptive PE: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6gck |
Integer |
|
Recommended |
Behavior Support Plan (or other management plan): converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6hck |
Integer |
|
Recommended |
Crisis Management Plan: converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6ick |
Integer |
|
Recommended |
Other 1 (O1): converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6jck |
Integer |
|
Recommended |
Other 2 (O2): converted percent of week to hours per week |
0;1
|
0 = No; 1 = Yes
|
|
Query
|
q6apcnt |
Float |
|
Recommended |
Speech Therapy: percent per week |
0::100
|
|
|
Query
|
q6bpcnt |
Float |
|
Recommended |
Occupational Therapy: percent per week |
0::100
|
|
|
Query
|
q6cpcnt |
Float |
|
Recommended |
Physical Therapy: percent per week |
0::100
|
|
|
Query
|
q6dpcnt |
Float |
|
Recommended |
Sensory Integration: percent per week |
0::100
|
|
|
Query
|
q6epcnt |
Float |
|
Recommended |
Social Skills Training: percent per week |
0::100
|
|
|
Query
|
q6fpcnt |
Float |
|
Recommended |
Adaptive PE: percent per week |
0::100
|
|
|
Query
|
q6gpcnt |
Float |
|
Recommended |
Behavior Support Plan (or other management plan): percent per week |
0::100
|
|
|
Query
|
q6hpcnt |
Float |
|
Recommended |
Crisis Management Plan: percent per week |
0::100
|
|
|
Query
|
q6ipcnt |
Float |
|
Recommended |
Other 1 (O1): percent per week |
0::100
|
|
|
Query
|
q6jpcnt |
Float |
|
Recommended |
Other 2 (O2): percent per week |
0::100
|
|
|
Query
|
q6ghrwk |
Float |
|
Recommended |
Behavior support plan (or other management plan) hours per week |
|
|
|