MS-STARTSCREEN [] | Section: MS-Preliminaries |
NATIONAL LONGITUDINAL SURVEY OF YOUTH
MOTHER SUPPLEMENT
ENGLISH
VERSION: [MS VERSION STAMP]
MS-CONFIRM-CASE [] | Section: MS-Preliminaries |
INTERVIEWER: THIS INSTRUMENT IS DATE SENSITIVE -- PLEASE DO NOT PROCEED BEYOND THIS POINT UNLESS YOU ARE READY TO CONDUCT THE INTERVIEW.
YOU HAVE OPENED THE CASE SHOWN BELOW. IF THIS IS THE DESIRED CASE, AND YOU ARE READY TO COMPLETE THE INSTRUMENT, CLICK ON THE APPROPRIATE BUTTON TO PROCEED.
CASE ID: [MSCASEIDTXT]
NAME: [Child Full Name]
DATE OF BIRTH: [CHILDBDAY~X]
UPDATES TO DATE OF BIRTH MAY BE MADE LATER IN THE INSTRUMENT IF NECESSARY.
MS-CONF-SYSDATE [M00007.00] | Section: MS-Preliminaries |
INTERVIEWER: THE COMPUTER SYSTEM DATE IS SET TO:
DATE: [MSDATENOW~X]
TIME: [SYSTEM TIME STAMP]
ARE THE DATE AND TIME SHOWN CORRECT?
MS-SYSDATE-RESET [] | Section: MS-Preliminaries |
INTERVIEWER: YOU INDICATED THE COMPUTER DATE INFORMATION IS INCORRECT.
PLEASE EXIT THE INSTRUMENT, RESET THE SYSTEM DATE AND TIME, AND RESTART THE CASE. ON RESTART, BE SURE TO BACKUP TO THE BEGINNING SCREEN.
MS-PRELIM-TITLE [] | Section: MS-Preliminaries |
**** PRELIMINARIES ****
MS-CKNAME [M00008.00] | Section: MS-Preliminaries |
ISVAREMPTY([Child First Name])
COMMENT: Check if first name is empty on spawned infosheet. If so, prompt for name entry.
If Answer = 1 Then Go To MS-ENTERNAME
MS-ENTERNAME [] | Section: MS-Preliminaries |
INTERVIEWER: ENTER CHILD'S FIRST NAME:
MS-CKFULLNAME [M00009.00] | Section: MS-Preliminaries |
ISVAREMPTY([Child Full Name])
COMMENT: Check if first name is empty on spawned infosheet. If so, prompt for name entry.
If Answer = 1 Then Go To MS-ENTERFULLNAME
MS-ENTERFULLNAME [] | Section: MS-Preliminaries |
INTERVIEWER: ENTER CHILD'S FULL NAME:
MS-INT-MODE [M00012.00] | Section: MS-Preliminaries |
INTERVIEWER: SELECT INTERVIEW MODE.
MS-INTRO-1A [] | Section: MS-Preliminaries |
In the past years, NLS has gathered information about the work, education, and family life of your generation. Since you have children of your own, and because they are your children, they are important people to us. The purpose of this study is to better understand how children learn and develop.
The U.S. Department of Labor and the National Institute of Child Health and Human Development sponsor this study of the children of the NLS respondents. For each child who participates, you will receive [MSRESPFEE] in appreciation for the time spent answering the questionnaire.
MS-INTRO-1B [] | Section: MS-Preliminaries |
We would like to ask you some questions about [Child Full Name].
MS-QUEXSTAT [M00019.00] | Section: MS-Preliminaries |
INTERVIEWER: VERIFY - WILL THE MOTHER SUPPLEMENT BE COMPLETED?
| 1 MOTHER WILL COMPLETE MOTHER SUPPLEMENT INTERVIEW |
| 2 MOTHER REFUSES THE MOTHER SUPPLEMENT QUESTIONNAIRE ...(Go To MSIR-TITLE) |
MS-CKFULLDOB1 [M00020.00] | Section: MS-Preliminaries |
{MSDOBCOMPLETE}==1
If Answer = 1 Then Go To MS-AGE-VRFY1
MS-AGE-VRFY1 [M00021.00] | Section: MS-Preliminaries |
(VERIFY CHILD'S AGE WITH MOTHER:) [Child First Name] is [CHILD AGE (YEARS)] years and [MONTHS] months old. Is that correct?
MS-ENTR-DOB [M00022.00] | Section: MS-Preliminaries |
INTERVIEWER: ENTER CORRECT BIRTH DATE FOR [Child First Name].
MS-FULLDOBCK2A [M00023.00] | Section: MS-Preliminaries |
ISCOMPLETE ([MS_CHILDDOB])
COMMENT: check birthdate to see if it has don't know or refusal
If Answer = 1 Then Go To MS-DOB-VRFY2A
MS-DOB-VRFY2A [] | Section: MS-Preliminaries |
INTERVIEWER: VERIFY CHILD'S D.O.B. ENTRY -
YOU ENTERED [ms_childdob~x].
IF CHILD'S DATE OF BIRTH IS INCORRECT, PRESS THE BACK/LEFT ARROW ICON TO RETURN TO THE PREVIOUS QUESTION AND ENTER THE CORRECT BIRTH DATE. OTHERWISE, CLICK " Submit and Continue" TO PROCEED....
MS-DOB-VRFY2B [] | Section: MS-Preliminaries |
INTERVIEWER:
THE DATE YOU ENTERED IS AN [ms_childdob~x].
CONFIRM: REFUSAL AND DON'T KNOW ENTRIES WILL SHOW IN THE DATE FIELDS BELOW....
IF THIS IS THE TRUE RESPONSE, THEN CLICK "Submit and Continue" TO PROCEED.
OTHERWISE, ENTER THE CORRECT BIRTH DATE THEN CLICK "Submit and Continue" TO PROCEED.
MS-FULLDOBCK2B [] | Section: MS-Preliminaries |
ISCOMPLETE ([MS_CHILDDOB])
COMMENT: Check birthdate to see if it has don't know or refusal one last time. If so, get age numerically.
If Answer = 1 Then Go To MS-AGE-VRFY2
MS-AGE-VRFY2 [] | Section: MS-Preliminaries |
(VERIFY CHILD'S AGE WITH MOTHER:)
[Child First Name] is [CHILD AGE (YEARS)] year(s) and [MONTHS] month(s) old. Is that correct?
INTERVIEWER: IF CHILD'S AGE IS INCORRECT, PRESS THE BACK/LEFT ARROW ICON TO BACK UP AND ENTER THE CORRECT BIRTH DATE.
OTHERWISE, CLICK "Submit and Continue" TO PROCEED....
MS-FILLYRS [] | Section: MS-Preliminaries |
How old was [Child First Name] on [his/her] last birthday?
INTERVIEWER: ENTER AGE IN YEARS. CODE 00 IF LESS THAN 1 YEAR OLD.
MONTHS APPEAR ON NEXT SCREEN....
If Answer >= -2 AND Answer <= -1 Then Go To MS-FILLEXIT
MS-FILLMOS [] | Section: MS-Preliminaries |
(How many months has it been since [Child First Name] was born/since [Child First Name]'s birthday?)
INTERVIEWER: ENTER MONTHS PORTION OF AGE (IN YEARS AND MONTHS)
If Answer = -2 Then Go To MS-OVERAGE-CK
If Answer = -1 Then Go To MS-FILLEXIT
MS-FILLEXIT [] | Section: MS-Preliminaries |
INTERVIEWER: NO ACCURATE AGE OR BIRTH DATE COULD BE DETERMINED FOR [Child First Name] . THE CASE WILL BE TERMINATED AS A REFUSAL.
USE THE SURVEY SCREEN BACK ARROW ICON TO RETURN TO EITHER THE BIRTH DATE OR AGE ENTRY QUESTIONS IF A BIRTH DATE OR AGE HAS BEEN INCORRECTLY ENTERED.
MS-OVERAGE-CK [M00029.00] | Section: MS-Preliminaries |
([CHILD AGE IN MONTHS] >= 180) || ([MSDOBCOMPLETE]==1 && ([MS_CHILDDOB~Y] < [MSDOBFLOOR~Y]))
COMMENT: additional age check
If Answer = 1 Then Go To MS-OVERAGE-NOTE
MS-OVERAGE-NOTE [] | Section: MS-Preliminaries |
STOP!
INTERVIEWER: THIS CHILD, [Child First Name], IS 15 YEARS OR OLDER AS OF 12/31/2004 AND THE MOTHER SUPPLEMENT SHOULD NOT BE ADMINISTERED.
PLEASE VERIFY DOB AND AGE OF THIS CHILD WITH MOTHER. IF CHILD IS STILL FOUND TO BE 15 OR OLDER BY 12/31/2004, PREPARE TO TERMINATE CASE. NOTIFY YOUR FM FOR REASSIGNMENT OF THIS CASE.
MS-OVERAGE-EXIT [] | Section: MS-Preliminaries |
INTERVIEWER: PLEASE RECORD ANY ADDITIONAL COMMENTS REGARDING THIS CASE.
RECORD PROJECT ID ON NEXT SCREEN AND TERMINATE CASE.
BKGN-AGECHK [M00047.00] | Section: CHILD BACKGROUND |
([CHILD AGE (YEARS)] < 3)
COMMENT: NO BACKGROUND ITEMS ASKED FOR CHILDREN UNDER 3
If Answer = 1 Then Go To HLTH-TITLE
BKGN-TITLE [] | Section: CHILD BACKGROUND |
**** BEGIN SECTION: CHILD BACKGROUND *****
BKGN-1 [M00051.00] | Section: CHILD BACKGROUND |
Please think about the [2003-2004] regular school year. [Is/Was] [Child First Name] attending or enrolled in regular school or preschool?
(If [Child First Name] is between the spring and fall school sessions, please tell us about the LAST school year.)
BKGN-2 [M00052.00] | Section: CHILD BACKGROUND |
Has [he/she] ever attended regular school, nursery school, or preschool?
BKGN-3 [M00053.00] | Section: CHILD BACKGROUND |
What grade [is currently attending/did last attend]?
(IF R SAYS 'PRE-FIRST GRADE', CODE KINDERGARTEN.)
| 90 Nursery/preschool |
| 0 Kindergarten |
| 1 1st grade |
| 2 2nd grade |
| 3 3rd grade |
| 4 4th grade |
| 5 5th grade |
| 6 6th grade |
| 7 7th grade |
| 8 8th grade |
| 9 9th grade |
| 10 10th grade |
| 11 11th grade |
| 12 12th grade |
| 13 1st year in college |
| 14 2nd year in college |
| 15 3rd year in college |
| 16 4th year in college |
| 95 Ungraded ...(Go To BKGN-4) |
If Answer = -2 Then Go To BKGN-4
BKGN-4 [M00054.00] | Section: CHILD BACKGROUND |
If [Child First Name] were in a graded class, what grade would [he/she] be enrolled in?
(IF R SAYS 'PRE-FIRST GRADE', CODE KINDERGARTEN.)
| 90 Nursery/preschool |
| 0 Kindergarten |
| 1 1st grade |
| 2 2nd grade |
| 3 3rd grade |
| 4 4th grade |
| 5 5th grade |
| 6 6th grade |
| 7 7th grade |
| 8 8th grade |
| 9 9th grade |
| 10 10th grade |
| 11 11th grade |
| 12 12th grade |
| 95 Other (SPECIFY) |
BKGN-5-DATECHK [M00055.00] | Section: CHILD BACKGROUND |
([SUMMER TERM FLAG])
COMMENT: Is interview date near or after the end of the school year?
If Answer = 1 Then Go To BKGN-5A
BKGN-5A [M00056.00] | Section: CHILD BACKGROUND |
Is/Was [Child First Name] (currently) attending or enrolled in summer school?
BKGN-5B [M00057.00] | Section: CHILD BACKGROUND |
Has [he/she] ever attended summer school?
BKGN-6-DATECHK [M00058.00] | Section: CHILD BACKGROUND |
([FALL TERM FLAG])
COMMENT: Is interview date after or near the beginning of the new school year?
If Answer = 1 Then Go To BKGN-6A
BKGN-6A [M00059.00] | Section: CHILD BACKGROUND |
Now please think about the [2004-2005] regular school year.
Has [Child First Name] been attending regular school or preschool for at least four weeks (of the [2004-2005] school year)?
| 1 Yes ...(Go To BKGN-6B) |
| 0 No |
| 2 IF VOLUNTEERED: Home Schooling ...(Go To BKGN-6C) |
BKGN-6B [M00060.00] | Section: CHILD BACKGROUND |
What grade is [Child First Name] currently attending?
(IF R SAYS 'PRE-FIRST GRADE', CODE KINDERGARTEN.)
| 90 Nursery/preschool |
| 0 Kindergarten |
| 1 1st grade |
| 2 2nd grade |
| 3 3rd grade |
| 4 4th grade |
| 5 5th grade |
| 6 6th grade |
| 7 7th grade |
| 8 8th grade |
| 9 9th grade |
| 10 10th grade |
| 11 11th grade |
| 12 12th grade |
| 13 1st year in college |
| 14 2nd year in college |
| 15 3rd year in college |
| 16 4th year in college |
| 95 Ungraded |
BKGN-6C [M00061.00] | Section: CHILD BACKGROUND |
If [Child First Name] were in a graded class, what grade would [he/she] be enrolled in?
(IF R SAYS 'PRE-FIRST GRADE', CODE KINDERGARTEN.)
| 90 Nursery/preschool |
| 0 Kindergarten |
| 1 1st grade |
| 2 2nd grade |
| 3 3rd grade |
| 4 4th grade |
| 5 5th grade |
| 6 6th grade |
| 7 7th grade |
| 8 8th grade |
| 9 9th grade |
| 10 10th grade |
| 11 11th grade |
| 12 12th grade |
| 95 Other (SPECIFY) |
BKGN-AGECK-PRESCHL [M00063.00] | Section: CHILD BACKGROUND |
([CHILD AGE (YEARS)] < 8)
If Answer = 1 Then Go To BKGN-GRDCHK-PRESCHL
BKGN-GRDCHK-PRESCHL [M00064.00] | Section: CHILD BACKGROUND |
([CHILD GRADE (OR EQUIVALENT)])
COMMENT: Is CHILD currently attending nursery or preschool (i.e., Child's GRADE coded 90)?
If Answer = 90 Then Go To BKGN-8
BKGN-7 [M00065.00] | Section: CHILD BACKGROUND |
Has [Child First Name] ever been enrolled in a preschool program (not including kindergarten)?
BKGN-8 [M00066.00] | Section: CHILD BACKGROUND |
Has [Child First Name] ever been enrolled in day care?
BKGN-11 [M00068.00] | Section: CHILD BACKGROUND |
([BYPASS HEADSTART FLAG - INFO EXISTS] == 1)
COMMENT: Does complete information on Head Start participation already exist for child ?
If Answer = 1 Then Go To BKGN-17
BKGN-12 [M00069.00] | Section: CHILD BACKGROUND |
Has [Child First Name] ever been enrolled in the Head Start Program?
BKGN-13 [M00070.00] | Section: CHILD BACKGROUND |
How old was [Child First Name] when [he/she] first attended Head Start?
(INTERVIEWER: ENTER AGE IN YEARS. CODE 00 = LESS THAN 1 YEAR OLD.)
BKGN-14 [M00071.00] | Section: CHILD BACKGROUND |
In total, how long (has [Child First Name] attended/did [Child First Name] attend) Head Start?
| 1 Less than 3 months |
| 2 3 - 11 months |
| 3 1 year - 23 months |
| 4 2 years or more |
| 5 Still enrolled |
BKGN-15 [M00072.00] | Section: CHILD BACKGROUND |
How satisfied are you with what Head Start has done for [Child First Name]?
| 1 Very satisfied |
| 2 Somewhat satisfied |
| 3 Somewhat dissatisfied |
| 4 Very dissatisfied |
BKGN-16 [M00073.00] | Section: CHILD BACKGROUND |
How satisfied are you with what [Child First Name]'s Head Start program has done for you?
| 1 Very satisfied |
| 2 Somewhat satisfied |
| 3 Somewhat dissatisfied |
| 4 Very dissatisfied |
BKGN-17 [M00074.00] | Section: CHILD BACKGROUND |
([CHILD AGE (YEARS)] < 5 )
COMMENT: If child age is less than 5 YRS , jump to BKGN-END
If Answer = 1 Then Go To HLTH-TITLE
BKGN-18 [M00075.00] | Section: CHILD BACKGROUND |
([IN SCHOOL] == 1)
If Answer = 1 Then Go To BKGN-20
BKGN-19 [M00076.00] | Section: CHILD BACKGROUND |
If [Child First Name] does not attend school at all, what is the reason?
| 1 Unable to attend due to physical, emotional, or mental condition |
| 2 Expelled or suspended |
| 3 School closed because of strike, physical damage, etc. |
| 4 Child's father, stepfather, father-figure won't let child attend |
| 7 Home schooled |
| 5 Other reasons (SPECIFY) |
BKGN-20 [M00077.00] | Section: CHILD BACKGROUND |
Which of the following describes the school [Child First Name] attends:
| 1 Public school ...(Go To BKGN-23) |
| 2 Charter school |
| 3 Catholic school |
| 4 Other religious or church-sponsored school |
| 5 Non-religious private school ...(Go To BKGN-23) |
| 6 Indian reservation school |
| 7 Military academy |
| 8 Home-schooled ...(Go To BKGN-23) |
| 9 Other (SPECIFY) |
BKGN-21 [M00078.00] | Section: CHILD BACKGROUND |
Is the school [he/she] attends public or private?
| 1 Public |
| 2 Private |
| 3 Other (SPECIFY) |
| 4 Does not attend school at all |
BKGN-23 [M00079.00] | Section: CHILD BACKGROUND |
([EVER IN SCHOOL] == 0) && ([IN SCHOOL] == 0)
If Answer = 1 Then Go To BKGN-32
BKGN-24 [M00080.00] | Section: CHILD BACKGROUND |
How many different schools has your child ever attended? Please include the school [he/she] is currently attending.
If Answer >= -2 AND Answer <= -1 Then Go To BKGN-FIRSTLANG
BKGN-25 [M00081.00] | Section: CHILD BACKGROUND |
How many of these were elementary schools?
BKGN-FIRSTLANG [M00082.00] | Section: CHILD BACKGROUND |
What language did [Child First Name] speak when [he/she] first started regular school?
| 1 ENGLISH (OR MOSTLY ENGLISH) |
| 2 SPANISH (OR MOSTLY SPANISH) |
| 3 ENGLISH AND SPANISH EQUALLY |
| 4 ENGLISH AND ANOTHER LANGUAGE EQUALLY (SPECIFY) |
| 5 CHILD DOES NOT SPEAK |
| 6 ANOTHER LANGUAGE (SPECIFY) |
BKGN-CURRLANG [M00083.00] | Section: CHILD BACKGROUND |
What language does [Child First Name] speak most now?
COMMENT:
| 1 ENGLISH (OR MOSTLY ENGLISH) |
| 2 SPANISH (OR MOSTLY SPANISH) |
| 3 ENGLISH AND SPANISH EQUALLY |
| 4 ENGLISH AND ANOTHER LANGUAGE EQUALLY (SPECIFY) |
| 5 CHILD DOES NOT SPEAK |
| 6 ANOTHER LANGUAGE (SPECIFY) |
BKGN-26 [M00084.00] | Section: CHILD BACKGROUND |
In a typical school week, how much time does [Child First Name] usually spend after school working on math problems or math homework?
ENTER HOURS PER WEEK. ROUND TO NEAREST 1/2 HR.
BKGN-27 [M00085.00] | Section: CHILD BACKGROUND |
In a typical school week, how much time does [Child First Name] usually spend after school writing up reports, papers, book-reports, or stories?
ENTER HOURS PER WEEK. ROUND TO NEAREST 1/2 HR.
BKGN-28 [M00086.00] | Section: CHILD BACKGROUND |
([EVER IN SCHOOL] == 0) && ([IN SCHOOL] == 0)
If Answer = 1 Then Go To BKGN-32
BKGN-29A [M00087.00] | Section: CHILD BACKGROUND |
{msschlyr}, did/has {cfname} participate(d) in a remedial math program?
BKGN-29B [M00088.00] | Section: CHILD BACKGROUND |
{msschlyr}, did/has {heshe} participate(d) in a remedial reading, remedial English, or remedial language arts program?
BKGN-29C [M00089.00] | Section: CHILD BACKGROUND |
{msschlyr}, did/has {heshe} participate(d) in a gifted and talented program, or a special class for advanced work?
BKGN-29D [M00090.00] | Section: CHILD BACKGROUND |
{msschlyr}, did/has {heshe} participate(d) in special education or a program for handicapped children?
BKGN-29E [M00091.00] | Section: CHILD BACKGROUND |
{msschlyr}, did/has {heshe} participate(d) in a program that teaches English as a second language (ESL)?
BKGN-30 [M00092.00] | Section: CHILD BACKGROUND |
([IN SCHOOL] == 1)
If Answer = 1 Then Go To BKGN-31A
BKGN-31A [M00093.00] | Section: CHILD BACKGROUND |
Do you or your (spouse/partner) participate in a parent-teacher organization at [Child First Name]'s school?
BKGN-31B [M00094.00] | Section: CHILD BACKGROUND |
Do you or your (spouse/partner) volunteer in the classroom at [his/her] school?
BKGN-31C [M00095.00] | Section: CHILD BACKGROUND |
Do you or your (spouse/partner) do volunteer work such as supervising lunch, or chaperoning a field trip at [Child First Name]'s school?
BKGN-31D [M00096.00] | Section: CHILD BACKGROUND |
Do you or your (spouse/partner) attend parent-teacher conferences at [his/her] school?
BKGN-32 [M00097.00] | Section: CHILD BACKGROUND |
How many of [Child First Name]'s close friends do you know by sight and by first and last name?
Do you know . . .
| 1 All of them |
| 2 Most of them |
| 3 About half |
| 4 Only a few |
| 5 None of them |
| 6 CHILD HAS NO CLOSE FRIENDS |
BKGN-33 [M00098.00] | Section: CHILD BACKGROUND |
About how often do you know who [Child First Name] is with when [he/she] is not at home?
Would you say you know who [he/she] is with . . .
| 1 All of the time |
| 2 Most of the time |
| 3 Some of the time, or |
| 4 Rarely? |
BKGN-34 [M00099.00] | Section: CHILD BACKGROUND |
In the past year, how often has [Child First Name] attended religious services (including Sunday School, or other religious classes)?
| 1 About once a week |
| 2 At least once a month |
| 3 A few times a year |
| 4 Never |
BKGN-35 [M00100.00] | Section: CHILD BACKGROUND |
Aside from attending religious services, how important is it to you to provide religious training for [him/her]?
| 1 Very important |
| 2 Fairly important |
| 3 Not at all important |
HLTH-TITLE [] | Section: HEALTH |
**** BEGIN SECTION: CHILD HEALTH *****
HLTH-INTRO [] | Section: HEALTH |
(READ TO MOTHER/GUARDIAN)
Now I'd like to ask you some questions about [Child First Name]'s general state of health and [his/her] physical characteristics.
HLTH-1A [M00104.00] | Section: HEALTH |
{RESN-NOSCHL} == 1
COMMENT: If reason for not attending school is health related, skip directly to HEALTH-5 LOOP begin
If Answer = 1 Then Go To HLTH-5-LOOP-BEGIN
HLTH-1B [M00105.00] | Section: HEALTH |
([CHILD AGE (YEARS)] >= 4) || ([IN SCHOOL] == 1) || ([EVER IN SCHOOL] == 1)
If Answer = 1 Then Go To HLTH-2A
HLTH-2A [M00106.00] | Section: HEALTH |
Does [Child First Name] have any physical, emotional, or mental condition that limits or prevents [his/her] ability to...
...attend school regularly?
HLTH-2B [M00107.00] | Section: HEALTH |
Does [he/she] have any physical, emotional, or mental condition that limits or prevents [his/her] ability to...
...do regular school work?
HLTH-2C [M00108.00] | Section: HEALTH |
Does [Child First Name] have any physical, emotional, or mental condition that limits or prevents [his/her] ability to...
...do usual childhood activities such as play, or participate in games or sports?
HLTH-3A [M00109.00] | Section: HEALTH |
Does [he/she] have any physical, emotional, or mental condition that requires...
...frequent attention or treatment from a doctor or other health professional?
HLTH-3B [M00110.00] | Section: HEALTH |
Does [Child First Name] have any physical, emotional, or mental condition that requires...
...regular use of any medicine or drug (other than vitamins)?
HLTH-3C [M00111.00] | Section: HEALTH |
Does [he/she] have any physical, emotional, or mental condition that requires...
... use of any special equipment, such as a brace, crutches, a wheelchair, special shoes, a helmet, a special bed, a breathing mask, an air filter, or a catheter and so on?
HLTH-5-LOOP-BEGIN [] | Section: HEALTH |
REPEAT
COMMENT: Begin loop about limiting conditions
HLTH-5A_VERBATIM [M00116.00] | Section: HEALTH |
What is [Child First Name]'s (next) health condition or limitation?
INTERVIEWER: PROBE AS NECESSARY: (What is it called?)
HLTH-5A [M00119.00] | Section: HEALTH |
CODE ONLY ONE
| 1 Learning disability |
| 2 Minimal brain dysfunction, minimal cerebral dysfunction, attention deficit disorder |
| 3 Hyperkinesis, hyperactivity |
| 4 Asthma |
| 5 Respiratory disorder or sinus infection |
| 6 Speech impairment |
| 7 Serious hearing difficulty or deafness |
| 8 Serious difficulty in seeing or blindness |
| 9 Serious emotional disturbance |
| 10 Allergic condition(s) |
| 11 Orthopedic handicap |
| 12 Mental retardation |
| 13 Heart trouble |
| 14 Chronic nervous disorder |
| 16 Chronic ear problems or infections |
| 17 Blood disorder or immune deficiency (e.g. sickle cell anemia) |
| 18 Epilepsy/Seizures |
| 95 Health condition not listed (SPECIFY) |
HLTH-5C-AGECK [M00122.00] | Section: HEALTH |
{msagemo}<=11
COMMENT: Don't ask how long had condition if less than 1 yr old
If Answer = 1 Then Go To HLTH-5-CNT
HLTH-5C [M00125.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
How old was [Child First Name] when [he/she] first developed this condition?
INTERVIEWER: ENTER AGE IN YEARS (SINCE BIRTH=0)
HLTH-5-CNT [M00128.00] | Section: HEALTH |
{HLTH-LOOP5COUNTER}
COMMENT: IF loop=1 goto HLTH-5-1STQ2A, else skip to HLTH-5-SCHLCHK
If Answer = 1 Then Go To HLTH-5-1STQ2A
HLTH-5-1STQ2A [M00131.00] | Section: HEALTH |
([LIMITS TO ATTENDING SCHL?] == 1) || ([RESN-NOSCHL] == 1)
COMMENT: jump to NEXT appropriate effect of limit to ask about
If Answer = 1 Then Go To HLTH-5E
HLTH-5-1STQ2B [M00132.00] | Section: HEALTH |
{lim-schlwk} == 1
COMMENT: jump to NEXT appropriate effect of limit to ask about
If Answer = 1 Then Go To HLTH-5F
HLTH-5-1STQ2C [M00133.00] | Section: HEALTH |
{lim-play} == 1
COMMENT: jump to NEXT appropriate effect of limit to ask about
If Answer = 1 Then Go To HLTH-5G
HLTH-5-1STQ3A [M00134.00] | Section: HEALTH |
{lim-dr-oftn} ==1
COMMENT: jump to NEXT appropriate effect of limit to ask about
If Answer = 1 Then Go To HLTH-5H
HLTH-5-1STQ3B [M00135.00] | Section: HEALTH |
{lim-meds} == 1
COMMENT: jump to NEXT appropriate effect of limit to ask about
If Answer = 1 Then Go To HLTH-5I
HLTH-5-1STQ3C [M00136.00] | Section: HEALTH |
{lim-eqmt} == 1
COMMENT: jump to NEXT effect of limit to ask about
If Answer = 1 Then Go To HLTH-5J
HLTH-5-SCHLCK [M00137.00] | Section: HEALTH |
([CHILD AGE (YEARS)] >=4) || ([IN SCHOOL] == 1) || ([EVER IN SCHOOL] == 1)
If Answer = 1 Then Go To HLTH-5D
HLTH-5D [M00139.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
Does this condition limit or prevent [his/her] ability to...
...attend school regularly?
HLTH-5E [M00141.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
Does this condition limit or prevent [his/her] ability to...
...do regular schoolwork?
HLTH-5F [M00144.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
Does this condition limit or prevent [his/her] ability to...
...do usual childhood activities such as play, or participate in games or sports?
HLTH-5G [M00147.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
Does this condition require...
...frequent attention or treatment from a doctor or other health professional?
HLTH-5H [M00150.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
Does this condition require...
...regular use of any medicine or drug (other than vitamins)?
HLTH-5I [M00153.00] | Section: HEALTH |
IN REFERENCE TO VERBATIM: [HEALTH CONDITION]
Does this condition require...
... use of any special equipment, such as a brace, crutches, a wheelchair, special shoes, a helmet, a special bed, a breathing mask, an air filter, or a catheter and so on?
HLTH-5J [M00156.00] | Section: HEALTH |
Does [Child First Name] have any other health conditions (that we haven't talked about)?
HLTH-5-LOOP-END [] | Section: HEALTH |
UNTIL([ANYMORECONDITIONS]==0)
COMMENT: loop until there are no more conditions to ask about
HLTH-6 [M00162.00] | Section: HEALTH |
{HLTH-SUB3}, has {cfname} had any accidents or injuries that required medical attention?
HLTH-6-LOOP-BEGIN [] | Section: HEALTH |
REPEAT
COMMENT: Begin loop about accidents requiring medical attention
HLTH-6B [M00167.00] | Section: HEALTH |
Thinking of the [most recent accident or injury/accident or injury that occurred before the one you just described], in what month and year did it occur?
HLTH-6C_VERBATIM [M00170.00] | Section: HEALTH |
What was the cause of that accident or injury?
HLTH-6C [M00173.00] | Section: HEALTH |
CODE ONLY ONE
| 1 Motor vehicle accident as occupant |
2 Motor vehicle accident as pedestrian |
| 3 Cycling |
4 Fall unrelated to athletics or sports activity |
| 5 Fall/contact related to athletics/sports activity |
6 Fire or smoke |
| 7 Hot liquid |
8 Toy or item intended for child use |
| 9 Equipment or device not intended for a child |
10 Poisoning |
| 11 Smashed body part: car/door/window bruise/contusion |
12 Adult injured child accidentally (pull/lift injury) |
| 13 Intentional violent injury |
14 "Rough housing", impact injury: wrestling, etc. |
| 16 Fighting: broke bone/nose, hit in face, shot, stabbed, etc. |
17 Struck by object from other person (intent unknown) |
| 18 Insect sting or bite |
19 Stepped on sharp object, i.e. glass/nails/metal |
| 20 Ran into stationary object (not in home environment) |
22 Ran into stationary object (home environment) |
| 21 Animal bite |
23 Cut by sharp object, i.e. knife/glass/tool |
| 24 Burn, i.e. from heater/cigarette/oven/stove |
25 Jump/fall accident, i.e. off furniture/other object |
| 26 "Temper" injuries, i.e. fell, kicked furniture, etc. |
15 Other (SPECIFY) |
HLTH-6D [M00176.00] | Section: HEALTH |
What specific injury or conditions resulted from the accident just mentioned?
(CODE ALL THAT APPLY)
| 1 Broken or dislocated bones |
| 2 Sprain, strain, or pulled muscle |
| 3 Wound: cuts, scrapes, puncture |
| 4 Head injury, concussion |
| 5 Bruise, contusion, or internal bleeding |
| 6 Burn, scald |
| 7 Illness or effect from poisons, medicines (drugs), etc |
| 15 Other (SPECIFY) |
HLTH-6E [M00179.00] | Section: HEALTH |
Where did the accident or injury happen?
| 1 At home (any, not necessarily the child's) |
| 2 School (including grounds and athletic areas) |
| 3 Day care location (preschool/nursery) |
| 4 Street or highway |
| 5 Public building or space (other than streets or schools) |
| 6 Place of recreation and sports, except school |
| 7 Farm or agricultural area, except farm house |
| 8 Other (SPECIFY) |
HLTH-6G [M00182.00] | Section: HEALTH |
Has [Child First Name] had any other accidents or injuries requiring medical attention [HLTH-SUB3B]?
HLTH-6-LOOP-END [] | Section: HEALTH |
UNTIL([ANY MORE HURTS?]==0)
COMMENT: loop until there are no more accidents or injuries
HLTH-7 [M00188.00] | Section: HEALTH |
Now we're going to talk about any time [Child First Name] may have been hospitalized since [ was born/we last interviewed you on ]. (This may include an injury that you have already mentioned here.)
Has [Child First Name] had any accidents or injuries that required hospitalization since [ was born/we last interviewed you on ]?
HLTH-7-LOOP-BEGIN [] | Section: HEALTH |
REPEAT
HLTH-7B [M00192.00] | Section: HEALTH |
Thinking of the [most recent accident or injury that/accident or injury that occurred before the one you just described that also] required hospitalization, in what month and year did it occur?
HLTH-7C_VERBATIM [M00194.00] | Section: HEALTH |
What was the cause of this accident or injury?
HLTH-7C [M00196.00] | Section: HEALTH |
CODE ONLY ONE
| 1 Motor vehicle accident as occupant |
2 Motor vehicle accident as pedestrian |
| 3 Cycling |
4 Fall unrelated to athletics or sports activity |
| 5 Fall/contact related to athletics/sports activity |
6 Fire or smoke |
| 7 Hot liquid |
8 Toy or item intended for child use |
| 9 Equipment or device not intended for a child |
10 Poisoning |
| 11 Smashed body part: car/door/window bruise/contusion |
12 Adult injured child accidentally (pull/lift injury) |
| 13 Intentional violent injury |
14 "Rough housing", impact injury: wrestling, etc. |
| 16 Fighting: broke bone/nose, hit in face, shot, stabbed, etc. |
17 Struck by object from other person (intent unknown) |
| 18 Insect sting or bite |
19 Stepped on sharp object, i.e. glass/nails/metal |
| 20 Ran into stationary object (not in home environment) |
22 Ran into stationary object (home environment) |
| 21 Animal bite |
23 Cut by sharp object, i.e. knife/glass/tool |
| 24 Burn, i.e. from heater/cigarette/oven/stove |
25 Jump/fall accident, i.e. off furniture/other object |
| 26 "Temper" injuries, i.e. fell, kicked furniture, etc. |
15 Other (SPECIFY) |
HLTH-7D [M00198.00] | Section: HEALTH |
What specific injury or conditions resulted from the accident just mentioned?
(CODE ALL THAT APPLY)
| 1 Broken or dislocated bones |
| 2 Sprain, strain, or pulled muscle |
| 3 Wound: cuts, scrapes, puncture |
| 4 Head injury, concussion |
| 5 Bruise, contusion, or internal bleeding |
| 6 Burn, scald |
| 7 Illness or effect from poisons, medicines (drugs), etc |
| 15 Other (SPECIFY) |
HLTH-7E [M00200.00] | Section: HEALTH |
Where did the accident or injury happen?
| 1 At home (any, not necessarily the child's) |
| 2 School (including grounds and athletic areas) |
| 3 Day care location (preschool/nursery) |
| 4 Street or highway |
| 5 Public building or space (other than streets or schools) |
| 6 Place of recreation and sports, except school |
| 7 Farm or agricultural area, except farm house |
| 8 Other (SPECIFY) |
HLTH-7G [M00202.00] | Section: HEALTH |
Has [Child First Name] had any other accidents or injuries requiring hospitalization since [ was born/we last interviewed you on ]?
HLTH-7-LOOP-END [] | Section: HEALTH |
UNTIL([ANYMORE HOSPITALIZATIONS?]==0)
HLTH-8 [M00206.00] | Section: HEALTH |
{HLTH-SUB} had any illnesses that required medical attention or treatment?
HLTH-8A [M00207.00] | Section: HEALTH |
How many such illnesses has [Child First Name] had [HLTH-SUB3B]?
HLTH-9 [M00208.00] | Section: HEALTH |
When did [Child First Name] last see a doctor for a routine health checkup?
| 1 Less than 1 month ago |
| 2 1 - 3 months ago |
| 3 4 - 6 months ago |
| 4 7 - 11 months ago |
| 5 1 year - 23 months ago |
| 6 2 or more years ago |
| 7 Never |
HLTH-11-AGECK [M00211.00] | Section: HEALTH |
{CHILDSEX} == 2 && {MSAGE} >= 8 && {CHILDPER}==0
If Answer = 1 Then Go To HLTH-11A
HLTH-11A [M00212.00] | Section: HEALTH |
Has [Child First Name] ever had a menstrual period?
HLTH-11B [M00213.00] | Section: HEALTH |
How old was [Child First Name] when she had her first menstrual period?
(INTERVIEWER: ENTER AGE IN YEARS.)
HLTH-11C [M00214.00] | Section: HEALTH |
In what month and year did she have her first period?
HLTH-12-AGECHK [M00215.00] | Section: HEALTH |
([CHILD AGE (YEARS)]>=2)
COMMENT: Is child age 2 yrs or older?
If Answer = 1 Then Go To HLTH-12A
HLTH-12A [M00216.00] | Section: HEALTH |
Which hand does [Child First Name] use for writing?
IF R VOLUNTEERS "AMBIDEXTROUS","EITHER", OR "BOTH", ENTER EITHER/BOTH AND RECORD EXPLANATION IN COMMENT SCREEN.
IF R SAYS CHILD DOESN'T WRITE YET, ASK WHICH HAND HE/SHE USES MOST OFTEN.
| 1 Left |
| 2 Right |
| 3 Either/both |
HLTH-12B [M00217.00] | Section: HEALTH |
Please think about the hand [Child First Name] uses for activities such as throwing a ball. When [he/she] throws a ball, does [he/she] use [his/her]...
| 1 right hand nearly all of the time? |
| 2 right hand more than half of the time? |
| 3 right and left hands about equally? |
| 4 left hand more than half of the time? |
| 5 left hand nearly all of the time? |
HLTH-12C [M00218.00] | Section: HEALTH |
When [he/she] brushes [his/her] teeth, does [he/she] use [his/her]...
| 1 right hand nearly all of the time? |
| 2 right hand more than half of the time? |
| 3 right and left hands about equally? |
| 4 left hand more than half of the time? |
| 5 left hand nearly all of the time? |
HLTH-13 [M00219.00] | Section: HEALTH |
When did [Child First Name] last see a dentist for a checkup or to have some dental work done?
| 1 Less than 1 month ago |
| 2 1 - 3 months ago |
| 3 4 - 6 months ago |
| 4 7 - 11 months ago |
| 5 1 year - 23 months ago |
| 6 2 or more years ago |
| 7 Never |
HLTH-14 [M00220.00] | Section: HEALTH |
Is [Child First Name]'s health care now covered by health insurance provided either by an employer or by an individual plan that pays part or all of a hospital, doctor's, or surgeon's bill?
(THIS DOES NOT INCLUDE PUBLIC ASSISTANCE HEALTH CARE PROGRAMS.)
HLTH-15 [M00221.00] | Section: HEALTH |
There is a national program called Medicaid that pays for health care for persons in need.
Is [Child First Name]'s health care now covered by Medicaid?
(INTERVIEWER: IF NEEDED, HAND R SHOW CARD "STATE MEDICAID PROGRAMS". IF TELEPHONE INTERVIEW, SHOWCARD MAY BE READ)
HOME-AGECK1 [M00224.00] | Section: The HOME |
([CHILD AGE IN MONTHS]>=0)
COMMENT: IF child meets AGE and YOB/BORNSR19 constraints, then continue. Otherwise skip to HOME-END
If Answer = 1 Then Go To HOME-TITLE
HOME-TITLE [] | Section: The HOME |
**** BEGIN SECTION: The HOME *****
HOME-INTRO [] | Section: The HOME |
INTERVIEWER: THE FOLLOWING SECTION IS A CHILD ASSESSMENT. IT IS VITAL THAT YOU COMPLETE ALL QUESTIONS IN THIS SECTION.
READ TO MOTHER
We are interested in your family's lifestyle and rules.
HOME-AGECK2 [M00227.00] | Section: The HOME |
([CHILD AGE IN MONTHS])
COMMENT: Jump to appropriate HOME section based on months of age.
If Answer >= 0 AND Answer <= 35 Then Go To HOME-A01
If Answer >= 36 AND Answer <= 71 Then Go To HOME-B01
If Answer >= 72 AND Answer <= 119 Then Go To HOME-C01
If Answer >= 120 AND Answer <= 179 Then Go To HOME-D01
HOME-A01 [M00228.00] | Section: The HOME |
About how often does [Child First Name] have a chance to get out of the house?
| 5 Every day |
| 4 4 or more times a week |
| 3 A few times a week |
| 2 About once a week |
| 1 A few times a month or less |
HOME-A02 [M00229.00] | Section: The HOME |
About how many children's books does [Child First Name] have?
| 4 10 or more books |
| 3 3 to 9 books |
| 2 1 or 2 books |
| 1 None |
HOME-A03 [M00230.00] | Section: The HOME |
How often do you get a chance to read stories to [Child First Name]?
| 1 Never |
| 2 Several times a year |
| 3 Several times a month |
| 4 Once a week |
| 5 About 3 times a week |
| 6 Everyday |
HOME-A04 [M00231.00] | Section: The HOME |
About how often do you take [Child First Name] to the grocery store?
| 1 Twice a week or more |
| 2 Once a week |
| 3 Once a month |
| 4 Hardly ever |
HOME-A05 [M00232.00] | Section: The HOME |
About how many, if any, cuddly, soft or role-playing toys (like a doll) does [Child First Name] have? (May be shared with sister or brother.)
ENTER NUMBER OF SOFT TOYS.
HOME-A06 [M00233.00] | Section: The HOME |
About how many, if any, push or pull toys does [Child First Name] have? (May be shared with sister or brother.)
ENTER NUMBER OF PUSH/PULL TOYS.
HOME-A07 [M00234.00] | Section: The HOME |
Some parents spend time teaching their children new skills while other parents believe children learn best on their own. Which of the following most closely describes your attitude?
| 1 Parents should always spend time teaching their children |
| 2 Parents should usually spend time teaching their children |
| 3 Parents should usually allow their children to learn on their own |
| 4 Parents should always allow their children to learn on their own |
HOME-A08 [M00235.00] | Section: The HOME |
Think for a moment about a typical weekday for your family. How much time--either in your home or elsewhere--does [Child First Name] spend watching television on a typical weekday?
INTERVIEWER: ENTER HOURS PER WEEKDAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekday?)
HOME-A09 [M00236.00] | Section: The HOME |
Now, think about a typical weekend day (Saturday or Sunday) for your family. How much time--either in your home or elsewhere--does [Child First Name] spend watching television on a typical weekend day?
INTERVIEWER: ENTER HOURS PER WEEKEND DAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekend day?)
HOME-A10A [M00237.00] | Section: The HOME |
About how many hours is the TV on in your home each day?
INTERVIEWER: ENTER HOURS PER DAY, ROUND TO NEAREST 1/2 HR.
NOTE: LESS THAN 1 HOUR PER DAY = 0. IF R DOES NOT HAVE A TV, ENTER ZERO AND CHANGE CHECK ITEM BELOW.
HOME-A10B [M00238.00] | Section: The HOME |
MARK AS APPROPRIATE
| 1 R HAS A TV |
| 0 R DOES NOT HAVE A TV |
HOME-A-DADCHK1 [M00239.00] | Section: The HOME |
([FATHER IN HOUSEHOLD] == 1)
COMMENT: IF FATHER PRESENT IN MOTHER HOUSEHOLD SKIP TO HOME-A-TXTSUB1
If Answer = 1 Then Go To HOME-A14
HOME-A11 [M00240.00] | Section: The HOME |
Does [Child First Name] ever see [his/her] father, or someone [he/she] considers a father-figure?
HOME-A12 [M00241.00] | Section: The HOME |
Is this person [his/her] biological father, stepfather, or a father-figure?
| 1 BIOLOGICAL FATHER |
| 2 STEPFATHER |
| 3 FATHER-FIGURE |
HOME-A13 [M00242.00] | Section: The HOME |
What is his relationship to you? (Is he your spouse, your partner, your friend, a relative, or someone else?)
| 1 SPOUSE |
| 2 EX-SPOUSE |
| 3 PARTNER |
| 4 EX-PARTNER |
| 5 BOYFRIEND |
| 6 EX-BOYFRIEND |
| 7 FIANCE |
| 8 FRIEND |
| 9 FATHER |
| 10 GRANDFATHER |
| 11 BROTHER |
| 12 UNCLE |
| 13 SOMEONE ELSE (SPECIFY) |
HOME-A14 [M00243.00] | Section: The HOME |
Does [Child First Name] see [his/her] [father/stepfather/father-figure] on a daily basis?
HOME-A15 [M00244.00] | Section: The HOME |
How often does [Child First Name] eat a meal with both you and [his/her] [father/stepfather/father-figure]?
| 1 More than once a day |
| 2 Once a day |
| 3 Several times a week |
| 4 About once a week |
| 5 About once a month |
| 6 Never |
HOME-A16 [M00245.00] | Section: The HOME |
Children seem to demand attention when their parents are busy around the house. How often do you talk to [Child First Name] while you are working?
| 1 Always (talk to your child when working) |
| 2 Often (talk to your child when working) |
| 3 Sometimes (talk to your child when working) |
| 4 Rarely (talk to your child when working) |
| 5 Never (talk to your child when working) |
HOME-A17A [M00246.00] | Section: The HOME |
How close does [Child First Name] feel toward you? Does [he/she] feel...
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-A-DADCHK2 [M00247.00] | Section: The HOME |
([WHODAD])
COMMENT: WHODAD=0 (NO FATHER-FIGURE), SKIP TO HOME-A18;
WHODAD>=1 SKIP TO HOME-A17B.
If Answer = 0 Then Go To HOME-A18
If Answer >= 1 AND Answer <= 3 Then Go To HOME-A17B
HOME-A17B [M00248.00] | Section: The HOME |
How close does [he/she] feel toward [his/her] (biological) father?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
| 5 Does not have this parent |
HOME-A-DADCHK3 [M00249.00] | Section: The HOME |
([WHODAD])
COMMENT: IF father is in HH, don't ask about closeness to stepfather
(WHODAD=1 skip to HOME-A18).
If Answer = 1 Then Go To HOME-A18
HOME-A17D [] | Section: The HOME |
How close does [he/she] feel toward [his/her] [father/stepfather/father-figure]?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-A18 [M00250.00] | Section: The HOME |
Sometimes kids mind pretty well and sometimes they don't.
About how many times, if any, have you had to spank [Child First Name] in the past week?
HOME-B01 [M00251.00] | Section: The HOME |
About how often do you read stories to [Child First Name]?
| 1 Never |
| 2 Several times a year |
| 3 Several times a month |
| 4 Once a week |
| 5 At least 3 times a week |
| 6 Everyday |
HOME-B02 [M00252.00] | Section: The HOME |
About how many children's books does [Child First Name] have?
| 4 10 or more books |
| 3 3 to 9 books |
| 2 1 or 2 books |
| 1 None |
HOME-B03 [M00253.00] | Section: The HOME |
About how many magazines does your family get regularly?
| 1 None |
| 2 One |
| 3 Two |
| 4 Three |
| 5 Four or more |
HOME-B04 [M00254.00] | Section: The HOME |
Does [Child First Name] have the use of a CD player, tape deck, or tape recorder, or record player at home and at least 5 children's records or tapes? (May be shared with sister or brother.)
HOME-B05A [M00255.00] | Section: The HOME |
Please tell me which of the following you (or someone else) have helped [Child First Name] learn at home.
Do you or have you helped with...numbers?
HOME-B05B [M00256.00] | Section: The HOME |
Do you (or someone else) help with...the alphabet?
HOME-B05C [M00257.00] | Section: The HOME |
Do you (or someone else) help with...colors?
HOME-B05D [M00258.00] | Section: The HOME |
Do you (or someone else) help with...shapes and sizes?
HOME-B06 [M00259.00] | Section: The HOME |
How much choice is [Child First Name] allowed in deciding what foods [he/she] eats at breakfast and lunch?
| 1 A great deal of choice |
| 2 Some choice |
| 3 Little choice |
| 4 No choice |
HOME-B07A [M00260.00] | Section: The HOME |
About how many hours is the TV on in your home each day?
INTERVIEWER: ENTER HOURS PER DAY, ROUND TO NEAREST 1/2 HR.
NOTE: LESS THAN 1 HOUR PER DAY = 0. IF R DOES NOT HAVE A TV, ENTER ZERO AND CHANGE CHECK ITEM BELOW.
HOME-B07B [M00261.00] | Section: The HOME |
| 1 R HAS A TV |
| 0 R DOES NOT HAVE A TV |
HOME-B08A [M00262.00] | Section: The HOME |
Most children get angry at their parents from time to time. If [Child First Name] got so angry that [he/she] hit you, what would you do?
INTERVIEWER: ENTER VERBATIM AND MARK ALL THAT APPLY
HOME-B08B [M00263.00] | Section: The HOME |
| 1 Hit him/her back |
| 2 Send him/her to his/her room |
| 3 Spank him/her |
| 4 Talk to him/her |
| 5 Ignore it |
| 6 Give him/her household chore |
| 7 Take away his/her allowance |
| 8 Hold child's hands until he/she was calm |
| 10 Put child in a short 'time out' |
| 9 Other (SPECIFY) |
HOME-B09 [M00264.00] | Section: The HOME |
How often does a family member get a chance to take [Child First Name] on any kind of outing (like shopping, to the park, a picnic, drive-in, and so on)?
| 1 A few times a year or less |
| 2 About once a month |
| 3 About two or three times a month |
| 4 Several times a week |
| 5 About once a day |
HOME-B10 [M00265.00] | Section: The HOME |
How often has a family member taken or arranged to take [Child First Name] to any type of museum (children's, scientific, art, historical, etc.) within the past year?
| 1 Never |
| 2 Once or twice |
| 3 Several times |
| 4 About once a month |
| 5 About once a week or more often |
HOME-B11 [M00266.00] | Section: The HOME |
Think for a moment about a typical weekday for your family. How much time--either in your home or elsewhere--does [Child First Name] spend watching television on a typical weekday?
INTERVIEWER: ENTER HOURS PER WEEKDAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekday?)
HOME-B12 [M00267.00] | Section: The HOME |
Now, think about a typical weekend day (Saturday or Sunday) for your family. How much time--either in your home or elsewhere--does [Child First Name] spend watching television on a typical weekend day?
INTERVIEWER: ENTER HOURS PER WEEKEND DAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekend day?)
HOME-B-DADCHK1 [M00268.00] | Section: The HOME |
([FATHER IN HOUSEHOLD] == 1)
COMMENT: IF FATHER PRESENT IN MOTHER HOUSEHOLD SKIP TO HOME-B-TXTSUB1
If Answer = 1 Then Go To HOME-B16
HOME-B13 [M00269.00] | Section: The HOME |
Does [Child First Name] ever see [his/her] father, or someone [he/she] considers a father-figure?
HOME-B14 [M00270.00] | Section: The HOME |
Is this man [Child First Name]'s biological father, stepfather, or a father-figure?
| 1 BIOLOGICAL FATHER |
| 2 STEPFATHER |
| 3 FATHER-FIGURE |
HOME-B15 [M00271.00] | Section: The HOME |
What is his relationship to you? (Is he your spouse, your partner, your friend, a relative, or someone else?)
| 1 SPOUSE |
| 2 EX-SPOUSE |
| 3 PARTNER |
| 4 EX-PARTNER |
| 5 BOYFRIEND |
| 6 EX-BOYFRIEND |
| 7 FIANCE |
| 8 FRIEND |
| 9 FATHER |
| 10 GRANDFATHER |
| 11 BROTHER |
| 12 UNCLE |
| 13 SOMEONE ELSE (SPECIFY) |
HOME-B16 [M00272.00] | Section: The HOME |
Does [Child First Name] see [his/her] [father/stepfather/father-figure] on a daily basis?
HOME-B17 [M00273.00] | Section: The HOME |
How often does [Child First Name] eat a meal with you and [his/her] [father/stepfather/father-figure]?
| 1 More than once a day |
| 2 Once a day |
| 3 Several times a week |
| 4 About once a week |
| 5 About once a month |
| 6 Never |
HOME-B18A [M00274.00] | Section: The HOME |
How close does [Child First Name] feel toward you? Does [he/she] feel...
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-B-DADCHK2 [M00275.00] | Section: The HOME |
([WHODAD])
COMMENT: WHODAD=0 (NO FATHER-FIGURE), SKIP TO HOME-B19;
WHODAD>=1 SKIP TO HOME-B18B.
If Answer = 0 Then Go To HOME-B19
If Answer >= 1 AND Answer <= 3 Then Go To HOME-B18B
HOME-B18B [M00276.00] | Section: The HOME |
How close does [Child First Name] feel toward [his/her] (biological) father?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
| 5 Does not have this parent |
HOME-B-DADCHK3 [M00277.00] | Section: The HOME |
([WHODAD])
COMMENT: IF father is in HH, don't ask about closeness to stepfather (WHODAD=1 skip to HOME-B19).
If Answer = 1 Then Go To HOME-B19
HOME-B18D [M00278.00] | Section: The HOME |
How close does [Child First Name] feel toward [his/her] [father/stepfather/father-figure]?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-B19 [M00279.00] | Section: The HOME |
Sometimes kids mind pretty well and sometimes they don't. About how many times, if any, have you had to spank [Child First Name] in the past week?
HOME-C01 [M00280.00] | Section: The HOME |
About how many books does [Child First Name] have?
| 1 None |
| 2 1 or 2 books |
| 3 3 to 9 books |
| 4 10 or more books |
HOME-C02 [M00281.00] | Section: The HOME |
About how often do you read aloud to [Child First Name]?
| 1 Never |
| 2 Several times a year |
| 3 Several times a month |
| 4 Once a week |
| 5 At least 3 times a week |
| 6 Everyday |
HOME-C03A [M00282.00] | Section: The HOME |
How often is [Child First Name] expected to make [his/her] own bed?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-C03B [M00283.00] | Section: The HOME |
How often is [Child First Name] expected to clean [his/her] own room?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-C03C [M00284.00] | Section: The HOME |
How often is [Child First Name] expected to clean up after spills?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-C03D [M00285.00] | Section: The HOME |
How often is [Child First Name] expected to bathe [him/her]self?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-C03E [M00286.00] | Section: The HOME |
How often is [Child First Name] expected to pick up after [him/her]self?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-C04 [M00287.00] | Section: The HOME |
Is there a musical instrument (for example, piano, drum, guitar, etc.) that [Child First Name] can use here at home?
HOME-C05 [M00288.00] | Section: The HOME |
Does your family get a daily newspaper?
HOME-C06 [M00289.00] | Section: The HOME |
About how often does [Child First Name] read for enjoyment?
| 1 Every day |
| 2 Several times a week |
| 3 Several times a month |
| 4 Several times a year |
| 5 Never |
HOME-C07 [M00290.00] | Section: The HOME |
Does your family encourage [Child First Name] to start and keep doing hobbies?
HOME-C08 [M00291.00] | Section: The HOME |
Does [Child First Name] get special lessons or belong to any organization that encourages activities such as sports, music, art, dance, drama, etc.?
HOME-C09 [M00292.00] | Section: The HOME |
How often has a family member taken, or arranged to take [Child First Name] to any type of museum (children's, scientific, art, historical, etc.) within the past year?
| 1 Never |
| 2 Once or twice |
| 3 Several times |
| 4 About once a month |
| 5 About once a week or more often |
HOME-C10 [M00293.00] | Section: The HOME |
How often has a family member taken, or arranged to take [Child First Name] to any type of musical or theatrical performance within the past year?
| 1 Never |
| 2 Once or twice |
| 3 Several times |
| 4 About once a month |
| 5 About once a week or more often |
HOME-C11 [M00294.00] | Section: The HOME |
About how often does your whole family get together with relatives or friends?
| 1 Once a year or less |
| 2 A few times a year |
| 3 About once a month |
| 4 Two or three times a month |
| 5 About once a week or more |
HOME-C12 [M00295.00] | Section: The HOME |
Think for a moment about a typical weekday for your family. How much time--either in your home or elsewhere--would you say your child spends watching television on a typical weekday?
INTERVIEWER: ENTER HOURS PER WEEKDAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekday?)
HOME-C13 [M00296.00] | Section: The HOME |
Now, think for a moment about a typical weekend day (Saturday or Sunday) for your family. How much time--either in your home or elsewhere-- would you say [Child First Name] spends watching television on a typical weekend day?
INTERVIEWER: ENTER HOURS PER WEEKEND DAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekend day?)
HOME-C-DADCHK1 [M00297.00] | Section: The HOME |
([FATHER IN HOUSEHOLD] == 1)
COMMENT: IF FATHER PRESENT IN MOTHER HOUSEHOLD SKIP TO HOME-C-TXTSUB1
If Answer = 1 Then Go To HOME-C17
HOME-C14 [M00298.00] | Section: The HOME |
Does [Child First Name] ever see [his/her] father, or someone [he/she] considers a father-figure?
HOME-C15 [M00299.00] | Section: The HOME |
Is this man [his/her] biological father, step father, or a father-figure?
| 1 BIOLOGICAL FATHER |
| 2 STEPFATHER |
| 3 FATHER-FIGURE |
HOME-C16 [M00300.00] | Section: The HOME |
What is his relationship to you? (Is he your spouse, your partner, your friend, a relative, or someone else?)
| 1 SPOUSE |
| 2 EX-SPOUSE |
| 3 PARTNER |
| 4 EX-PARTNER |
| 5 BOYFRIEND |
| 6 EX-BOYFRIEND |
| 7 FIANCE |
| 8 FRIEND |
| 9 FATHER |
| 10 GRANDFATHER |
| 11 BROTHER |
| 12 UNCLE |
| 13 SOMEONE ELSE (SPECIFY) |
HOME-C17 [M00301.00] | Section: The HOME |
About how often does [Child First Name] spend time with [his/her] [father/stepfather/father-figure]?
| 1 Once a day or more often |
| 2 At least 4 times a week |
| 3 About once a week |
| 4 About once a month |
| 5 A few times a year or less |
| 6 Never |
| 7 No father, stepfather, or father-figure |
HOME-C18 [M00302.00] | Section: The HOME |
About how often does [Child First Name] spend time with [his/her] [father/stepfather/father-figure] in outdoor activities?
| 1 Once a day or more often |
| 2 At least 4 times a week |
| 3 About once a week |
| 4 About once a month |
| 5 A few times a year or less |
| 6 Never |
| 7 No father, stepfather, or father-figure |
HOME-C19 [M00303.00] | Section: The HOME |
How often does [Child First Name] eat a meal with both you and [his/her] [father/stepfather/father-figure]?
| 1 More than once a day |
| 2 Once a day |
| 3 Several times a week |
| 4 About once a week |
| 5 About once a month |
| 6 Never |
| 7 No father, stepfather, father-figure |
HOME-C20 [M00304.00] | Section: The HOME |
When your family watches TV together, do you [FATHER-FIGURE PRINT TEXT] discuss TV programs with [him/her]?
| 1 Yes |
| 0 No |
| 2 Do not have a TV |
HOME-C21A [M00305.00] | Section: The HOME |
How close does [Child First Name] feel toward...you? Does [he/she] feel...
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-C-DADCHK2 [M00306.00] | Section: The HOME |
([WHODAD])
COMMENT: WHODAD=0 (NO FATHER-FIGURE), SKIP TO HOME-C22A;
WHODAD>=1 SKIP TO HOME-C21B.
If Answer = 0 Then Go To HOME-C22A
If Answer >= 1 AND Answer <= 3 Then Go To HOME-C21B
HOME-C21B [M00307.00] | Section: The HOME |
How close does [Child First Name] feel toward [his/her] (biological) father?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
| 5 Does not have this parent |
HOME-C-DADCHK3 [M00308.00] | Section: The HOME |
([WHODAD])
COMMENT: IF father is in HH, don't ask about closeness to stepfather/father-figure
(WHODAD=1 skip to HOME-C22A).
If Answer = 1 Then Go To HOME-C22A
HOME-C21D [M00309.00] | Section: The HOME |
How close does [Child First Name] feel toward [his/her] [father/stepfather/father-figure]?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-C22A [M00310.00] | Section: The HOME |
Sometimes children get so angry at their parents that they say things like "I hate you" or swear in a temper tantrum.
What action(s) you would take if this happened?
INTERVIEWER: ENTER VERBATIM AND MARK ALL THAT APPLY.
HOME-C22B [M00311.00] | Section: The HOME |
| 1 Grounding |
| 2 Spanking |
| 3 Talk with child |
| 4 Give him/her a household chore |
| 5 Ignore it |
| 6 Send to room for more than 1 hour |
| 7 Take away his/her allowance |
| 8 Take away TV, phone, or other privileges |
| 10 Put child in a short "time out" |
| 9 Other (SPECIFY) |
HOME-C23A [M00312.00] | Section: The HOME |
If [Child First Name] brought home a report card with grades lower than expected, how likely would you be to contact [his/her] teacher or principal?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23B [M00313.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to lecture [him/her]?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23C [M00314.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to keep a closer eye on [his/her] activities?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23D [M00315.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to punish [him/her]?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23E [M00316.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to talk with [him/her]?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23F [M00317.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to wait and see if [he/she] improves on [his/her] own?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23G [M00318.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to tell [him/her] to spend more time on schoolwork?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23H [M00319.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to spend more time helping [him/her] with schoolwork?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23I [M00320.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to limit or reduce [his/her] non-school activities (such as play, sports, clubs, etc.)?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-C23J [M00321.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...would you do anything else?
HOME-C23JV [M00322.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected...would you do anything else?)
What would that be?
HOME-C24A [M00323.00] | Section: The HOME |
INTERVIEWER: ENTER NUMBER OF TIMES IN PAST WEEK FOR EACH QUESTION
Sometimes kids mind pretty well and sometimes they don't. Sometimes they do things that make you feel good.
How many times in the past week have you...had to spank your child?
HOME-C24B [M00324.00] | Section: The HOME |
How many times in the past week have you...grounded [him/her]?
HOME-C24C [M00325.00] | Section: The HOME |
How many times in the past week have you...taken away TV or other privileges?
HOME-C24D [M00326.00] | Section: The HOME |
How many times (in the past week) have you...praised [Child First Name] for doing something worthwhile?
HOME-C24E [M00327.00] | Section: The HOME |
How many times (in the past week) have you...taken away [his/her] allowance?
HOME-C24F [M00328.00] | Section: The HOME |
How many times (in the past week) have you...shown [him/her] physical affection (kiss, hug, stroke hair, etc.)?
HOME-C24G [M00329.00] | Section: The HOME |
How many times (in the past week) have you...sent [Child First Name] to [his/her] room?
HOME-C24H [M00330.00] | Section: The HOME |
How many times (in the past week) have you...told another adult (spouse, friend, co-worker, visitor, relative) something positive about [Child First Name]?
HOME-D01 [M00331.00] | Section: The HOME |
About how many books does [Child First Name] have?
| 1 None |
| 2 1 to 9 |
| 3 10 to 19 |
| 4 20 or more |
HOME-D02A [M00332.00] | Section: The HOME |
Please tell me how often [Child First Name] is expected to do each of the following:
How often is [Child First Name] expected to make his/her own bed?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-D02B [M00333.00] | Section: The HOME |
How often is [Child First Name] expected to clean his/her own room?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-D02C [M00334.00] | Section: The HOME |
How often is [he/she] expected to pick up after [him/her]self?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-D02D [M00335.00] | Section: The HOME |
How often is [he/she] expected to help keep shared living areas clean and straight?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-D02E [M00336.00] | Section: The HOME |
How often is [he/she] expected to do routine chores such as mow the lawn, help with dinner, wash dishes, etc.?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-D02F [M00337.00] | Section: The HOME |
How often is [Child First Name] expected to help manage [his/her] own time (get up on time, be ready for school, etc.)?
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
HOME-D03 [M00338.00] | Section: The HOME |
Is there a musical instrument (for example, piano, drum, guitar, etc.) that your child can use here at home?
HOME-D04 [M00339.00] | Section: The HOME |
Does your family get a daily newspaper?
HOME-D05 [M00340.00] | Section: The HOME |
About how often does [Child First Name] read for enjoyment?
| 1 Every day |
| 2 Several times a week |
| 3 Several times a month |
| 4 Several times a year |
| 5 Never |
HOME-D06 [M00341.00] | Section: The HOME |
Does your family encourage [Child First Name] to start and keep doing hobbies?
HOME-D07 [M00342.00] | Section: The HOME |
Does [Child First Name] get special lessons or belong to any organization that encourages activities such as sports, music, art, dance, drama, etc.?
HOME-D08 [M00343.00] | Section: The HOME |
How often has any family member taken or arranged to take [Child First Name] to any type of museum (children's, scientific, art, historical, etc.) within the past year?
| 1 Never |
| 2 Once or twice |
| 3 Several times |
| 4 About once a month |
| 5 About once a week or more often |
HOME-D09 [M00344.00] | Section: The HOME |
How often has a family member taken or arranged to take [him/her] to any type of musical or theatrical performance within the past year?
| 1 Never |
| 2 Once or twice |
| 3 Several times |
| 4 About once a month |
| 5 About once a week or more often |
HOME-D10 [M00345.00] | Section: The HOME |
About how often does your whole family get together with relatives or friends?
| 1 Once a year or less |
| 2 A few times a year |
| 3 About once a month |
| 4 Two or three times a month |
| 5 About once a week or more |
HOME-D11 [M00346.00] | Section: The HOME |
Think for a moment about a typical weekday for your family. How much time--either in your home or elsewhere--does [Child First Name] spend watching television on a typical weekday?
INTERVIEWER: ENTER HOURS PER WEEKDAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekday?)
HOME-D12 [M00347.00] | Section: The HOME |
Now, think about a typical weekend day (Saturday or Sunday) for your family. How much time--either in your home or elsewhere--does [Child First Name] spend watching television on a typical weekend day?
INTERVIEWER: ENTER HOURS PER WEEKEND DAY (ROUND TO NEAREST 1/2 HR. "NO" OR "NONE"= 0)
(IF REPLY IS "Do not have a TV" THEN PROMPT: Does [Child First Name] spend any time watching TV outside of your home (for example with a babysitter) on a typical weekend day?)
HOME-D-DADCHK1 [M00348.00] | Section: The HOME |
{FATHINHH} == 1
COMMENT: IF FATHER PRESENT IN MOTHER HOUSEHOLD SKIP TO HOME-D-TXTSUB1
If Answer = 1 Then Go To HOME-D15
HOME-D13 [M00349.00] | Section: The HOME |
Does [Child First Name] ever see [his/her] father, stepfather, or father-figure?
HOME-D14 [M00350.00] | Section: The HOME |
Is this man [his/her] biological father, stepfather, or a father-figure?
| 1 BIOLOGICAL FATHER |
| 2 STEPFATHER |
| 3 FATHER-FIGURE |
HOME-D15 [M00351.00] | Section: The HOME |
What is his relationship to you? (Is he your spouse, your partner, your friend, a relative, or someone else?)
| 1 SPOUSE |
| 2 EX-SPOUSE |
| 3 PARTNER |
| 4 EX-PARTNER |
| 5 BOYFRIEND |
| 6 EX-BOYFRIEND |
| 7 FIANCE |
| 8 FRIEND |
| 9 FATHER |
| 10 GRANDFATHER |
| 11 BROTHER |
| 12 UNCLE |
| 13 SOMEONE ELSE (SPECIFY) |
HOME-D16 [M00352.00] | Section: The HOME |
About how often does [Child First Name] spend time with [his/her] [father/stepfather/father-figure]?
| 1 Once a day or more often |
| 2 At least 4 times a week |
| 3 About once a week |
| 4 About once a month |
| 5 A few times a year or less |
| 6 Never |
| 7 No father, stepfather, or father-figure |
HOME-D17 [M00353.00] | Section: The HOME |
About how often does [he/she] spend time with [his/her] [father/stepfather/father-figure] in outdoor activities?
| 1 Once a day or more often |
| 2 At least 4 times a week |
| 3 About once a week |
| 4 About once a month |
| 5 A few times a year or less |
| 6 Never |
| 7 No father, stepfather, or father-figure |
HOME-D18 [M00354.00] | Section: The HOME |
How often does [Child First Name] eat a meal with both mother and father?
| 1 More than once a day |
| 2 Once a day |
| 3 Several times a week |
| 4 About once a week |
| 5 About once a month |
| 6 Never |
| 7 No father, stepfather, father-figure |
HOME-D19 [M00355.00] | Section: The HOME |
When your family watches TV together, do you [FATHER-FIGURE PRINT TEXT] discuss TV programs with [him/her]?
| 1 Yes |
| 0 No |
| 2 Do not have a TV |
HOME-D20A [M00356.00] | Section: The HOME |
How close does [Child First Name] feel toward you?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
HOME-D-DADCHK2 [M00357.00] | Section: The HOME |
([WHODAD])
COMMENT: WHODAD=0 (NO FATHER-FIGURE), SKIP TO HOME-D21A;
WHODAD>=1 SKIP TO HOME-D20B.
If Answer = 0 Then Go To HOME-D21A
If Answer >= 1 AND Answer <= 3 Then Go To HOME-D20B
HOME-D20B [M00358.00] | Section: The HOME |
How close does [Child First Name] feel toward [his/her] (biological) father?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
| 5 Does not have this parent |
HOME-D-DADCHK3 [M00359.00] | Section: The HOME |
([WHODAD])
COMMENT: IF father is in HH, don't ask about closeness to stepfather (WHODAD=1 skip to HOME-D21A).
If Answer = 1 Then Go To HOME-D21A
HOME-D20D [M00360.00] | Section: The HOME |
How close does [Child First Name] feel toward [his/her] [father/stepfather/father-figure]?
| 1 Extremely close |
| 2 Quite close |
| 3 Fairly close |
| 4 Not at all close |
| 5 Does not have this parent |
HOME-D21A [M00361.00] | Section: The HOME |
Sometimes children get so angry at their parents that they say things like "I hate you" or swear in a temper tantrum.
What action(s) would you take if this happened?
INTERVIEWER: ENTER VERBATIM AND MARK ALL THAT APPLY.
HOME-D21B [M00362.00] | Section: The HOME |
| 1 Grounding |
| 2 Spanking |
| 3 Talk with child |
| 4 Give him/her a household chore |
| 5 Ignore it |
| 6 Send to room for more than 1 hour |
| 7 Take away his/her allowance |
| 8 Take away TV, phone, or other privileges |
| 10 Put child in a short "time out" |
| 9 Other (SPECIFY) |
HOME-D22A [M00363.00] | Section: The HOME |
If [Child First Name] brought home a report card with grades lower than expected, how likely would you be to contact [his/her] teacher or principal?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22B [M00364.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to lecture [him/her]?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22C [M00365.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to keep a closer eye on [his/her] activities?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22D [M00366.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to punish [him/her]?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22E [M00367.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to talk with [him/her]?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22F [M00368.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to wait and see if [he/she] improves on [his/her] own?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22G [M00369.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to tell [him/her] to spend more time on schoolwork?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22H [M00370.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to spend more time helping [him/her] with schoolwork?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22I [M00371.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...how likely would you be to limit or reduce [his/her] non-school activities (such as play, sports, clubs, etc.)?
| 5 Very Likely |
| 4 Somewhat Likely |
| 3 Not Sure How Likely |
| 2 Somewhat Unlikely |
| 1 Not At All Likely |
HOME-D22J [M00372.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected),
...would you do anything else?
HOME-D22JV [M00373.00] | Section: The HOME |
(If [Child First Name] brought home a report card with grades lower than expected...would you do anything else?)
What would that be?
HOME-D23A [M00374.00] | Section: The HOME |
INTERVIEWER: ENTER NUMBER OF TIMES IN PAST WEEK FOR EACH QUESTION
Sometimes kids mind pretty well and sometimes they don't. Sometimes they do things that make you feel good.
How many times in the past week have you...had to spank your child?
HOME-D23B [M00375.00] | Section: The HOME |
How many times in the past week have you...grounded [him/her]?
HOME-D23C [M00376.00] | Section: The HOME |
How many times in the past week have you...taken away TV or other privileges?
HOME-D23D [M00377.00] | Section: The HOME |
How many times (in the past week) have you...praised [Child First Name] for doing something worthwhile?
HOME-D23E [M00378.00] | Section: The HOME |
How many times (in the past week) have you...taken away [his/her] allowance?
HOME-D23F [M00379.00] | Section: The HOME |
How many times (in the past week) have you...shown [him/her] physical affection (kiss, hug, stroke hair, etc.)?
HOME-D23G [M00380.00] | Section: The HOME |
How many times (in the past week) have you...sent [Child First Name] to [his/her] room?
HOME-D23H [M00381.00] | Section: The HOME |
How many times (in the past week) have you...told another adult (spouse, friend, co-worker, visitor, relative) something positive about [Child First Name]?
ACT-AGECK1 [M00384.00] | Section: TEMPERAMENT |
([CHILD AGE IN MONTHS] < 84) && ([MSBORNB4_R19]==1)
COMMENT: If child age is 83 months or younger and meets YOB/BORNSR19 constraints, then continue OTHERWISE goto end of section
If Answer = 1 Then Go To ACT-TITLE
ACT-TITLE [] | Section: TEMPERAMENT |
**** BEGIN SECTION: TEMPERAMENT *****
ACT-INTRO [] | Section: TEMPERAMENT |
INTERVIEWER: THE FOLLOWING SECTION IS A CHILD ASSESSMENT.
IT IS VITAL THAT YOU COMPLETE ALL QUESTIONS IN THIS SECTION.
READ TO MOTHER:
We are interested in how your child normally acts during an average day. Please think about [Child First Name] during the last two weeks.
If [he/she] was not feeling well, think back to the last two-week time period when [he/she] was [his/her] normal self.
ACT-AGECK2 [M00385.00] | Section: TEMPERAMENT |
([CHILD AGE IN MONTHS])
COMMENT: Jump to appropriate section based on months of age.
If Answer >= 0 AND Answer <= 11 Then Go To CASI-AGECHK1
If Answer >= 12 AND Answer <= 23 Then Go To CASI-AGECHK1
If Answer >= 24 AND Answer <= 83 Then Go To ACT-C01
ACT-C01 [M00386.00] | Section: TEMPERAMENT |
(The following questions ask about how often [Child First Name] acted in a certain way.)
When it is mealtime, how often does [Child First Name] eat what you want [him/her] to eat?
Would that be...
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C02 [M00387.00] | Section: TEMPERAMENT |
When [Child First Name] doesn't eat what you want [him/her] to eat and you tell [him/her] to do so, how often does [he/she] obey and eat?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C03 [M00388.00] | Section: TEMPERAMENT |
When it is [Child First Name]'s bedtime, how often does [he/she] protest or resist going to bed?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C04 [M00389.00] | Section: TEMPERAMENT |
When [he/she] does protest and you tell [him/her] again to go to bed, how often does [he/she] do so?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C05 [M00390.00] | Section: TEMPERAMENT |
When you tell [Child First Name] to turn off the TV, how often does [he/she] do so without protest?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C06 [M00391.00] | Section: TEMPERAMENT |
When [he/she] does protest and you tell [him/her] again to turn off the TV, how often does [he/she] do so?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C07 [M00392.00] | Section: TEMPERAMENT |
When [Child First Name] meets a new child about the same age, how often is [he/she] shy at first?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C08 [M00393.00] | Section: TEMPERAMENT |
When [he/she] meets an adult [he/she] does not know, how often is [he/she] shy at first?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C09 [M00394.00] | Section: TEMPERAMENT |
How often does [Child First Name] cry when [he/she] hurts [him/her]self a little bit?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C10 [M00395.00] | Section: TEMPERAMENT |
How often does [he/she] laugh and smile easily (for example, when no one is touching [him/her])?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C11 [M00396.00] | Section: TEMPERAMENT |
When [Child First Name] is with other children [his/her] own age, how often does [he/she] fight, take toys, hit, and so on?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C12 [M00397.00] | Section: TEMPERAMENT |
When [he/she] is with other children [his/her] own age, how often does [he/she] willingly share toys?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C13 [M00398.00] | Section: TEMPERAMENT |
How often do you have trouble soothing or calming [Child First Name] when [he/she] is upset?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C14 [M00399.00] | Section: TEMPERAMENT |
When [Child First Name] is playing, how often does [he/she] stay close to you and make sure that [he/she] can still see you?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C15 [M00400.00] | Section: TEMPERAMENT |
How often does [he/she] try to copy what you do or how you act? (You may not always allow [him/her] to do this.)
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C16 [M00401.00] | Section: TEMPERAMENT |
When you leave the room and leave [Child First Name] alone, how often does [he/she] get upset?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C17 [M00402.00] | Section: TEMPERAMENT |
How often is [Child First Name] demanding and impatient even when you are busy?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C18 [M00403.00] | Section: TEMPERAMENT |
When you get upset about something, how often does [he/she] get worried, or try to help, or make you feel better?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C19 [M00404.00] | Section: TEMPERAMENT |
How often does [Child First Name] want you to help with the things [he/she] is doing?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
ACT-C20 [M00405.00] | Section: TEMPERAMENT |
During the past year, how often has [Child First Name] slept through the night?
(Would that be...)
| 1 Almost never |
| 2 Less than 1/2 of the time |
| 3 1/2 of the time |
| 4 More than 1/2 of the time |
| 5 Almost always |
CASI-AGECHK1 [M00411.00] | Section: MS CASI SECTION |
{msage} < 4
COMMENT: If child is less than 4 years old, skip CASI instructions all together
If Answer = 1 Then Go To BKGN-CASI-AGECK1
CASI-TITLE [] | Section: MS CASI SECTION |
**** BEGIN MOTHER SUPPLEMENT CASI SECTION *****
(TO BE SELF-ADMINISTERED)
CASI-INTRO-A [] | Section: MS CASI SECTION |
INTERVIEWER: MOTHER WILL ENTER RESPONSES FOR THE FOLLOWING SECTION DIRECTLY.
(IF MOTHER REALLY PREFERS, OR HAS DIFFICULTY READING, YOU MAY ADMINISTER THIS SECTION. REMEMBER, HOWEVER, THAT ITEMS IN THIS SECTION ARE MORE SENSITIVE THAN OTHERS.)
CASI-INTRO-B [] | Section: MS CASI SECTION |
INTERVIEWER: IF THIS IS A TELEPHONE INTERVIEW, YOU MAY PROCEED WITH THE INTERVIEW AS USUAL.
CASI-MODE [M00412.00] | Section: MS CASI SECTION |
INTERVIEWER: IS MOTHER COMPLETING THE FOLLOWING SECTION?
| 1 YES |
| 0 NO |
| 2 NO - TELEPHONE INTEVIEW |
CASI-MODECHK [M00413.00] | Section: MS CASI SECTION |
{MOMCASI} ==1
If Answer = 1 Then Go To CASI-INTRO-C
CASI-INTRO-C [] | Section: MS CASI SECTION |
INTERVIEWER: TURN THE COMPUTER AROUND AND INSTRUCT R HOW TO PROCEED BY FOLLOWING THE INSTRUCTIONS ON EACH SCREEN. R HAS FINISHED THIS SHORT CONFIDENTIAL SECTION WHEN SHE IS ON THE SCREEN THANKING HER FOR FILLING OUT THE SECTION.
PLEASE ASSIST R IF ASKED TO DO SO. YOU MAY TURN THE COMPUTER AROUND NOW.
CASI-INSTRUCT1 [] | Section: MS CASI SECTION |
Please read the instructions in the following screens before you begin to answer the questions. Once you have entered your answer, the survey will automatically go to the next question.
Click "Submit and Continue" button to proceed.
CASI-INSTRUCT2 [] | Section: MS CASI SECTION |
To answer a question, simply click on the circle or "radio button" next to your desired answer. When you are satisfied with your answer, click on the "Submit and Continue" button to proceed.
CASI-INSTRUCT3 [] | Section: MS CASI SECTION |
If you do not know an answer or do not wish to answer a question, you can choose Don't Know, or Refuse. These are generally displayed below any other answer choices.
Click on the "Submit and Continue" button to proceed....
CASI-INSTRUCT4 [M00414.00] | Section: MS CASI SECTION |
Most questions in this section are answered in the same way...
EXAMPLE: What did you do most often for entertainment last year?
If the answer is "WENT TO A PLAY" you would simply click on the circle or "radio button" next to "WENT TO A PLAY". Then click on the "Submit and Continue" button to proceed....
.
| 6 Went to a movie |
| 5 Played cards |
| 4 Went to a play |
| 3 Read books |
| 2 Went skiing |
| 1 Went golfing |
CASI-INSTRUCT5 [] | Section: MS CASI SECTION |
Please complete the following section of the questionnaire now on your own. You are free to ask questions at any time.
BKGN-CASI-AGECK1 [M00416.00] | Section: MS CASI SECTION |
{msage} >= 5
COMMENT: If child age is 5 years or OLDER then continue;
Otherwise, skip to BKGN-CASI-END
If Answer = 1 Then Go To BKGN-37
BKGN-37 [M00418.00] | Section: MS CASI SECTION |
{BKGN-SUB1} {cfname} repeated a grade for any reason?
{keyinstruct1} {keyinstruct2} {keyinstruct3}
BKGN-37-LOOP-BEGIN [] | Section: MS CASI SECTION |
REPEAT
BKGN-37A [M00425.00] | Section: MS CASI SECTION |
What was the [most recent/next most recent] grade that [Child First Name] repeated?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 0 PRE-KINDERGARTEN/KINDERGARTEN/PRE-1ST GRADE |
| 1 1ST GRADE |
| 2 2ND GRADE |
| 3 3RD GRADE |
| 4 4TH GRADE |
| 5 5TH GRADE |
| 6 6TH GRADE |
| 7 7TH GRADE |
| 8 8TH GRADE |
| 9 9TH GRADE |
| 10 10TH GRADE |
| 11 11TH GRADE |
| 12 12TH GRADE |
BKGN-37B [M00430.00] | Section: MS CASI SECTION |
What was the main reason [he/she] repeated that grade?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 1 Academic failure or lack of ability |
| 2 Immature; acts too young |
| 3 Frequently absent (excused absence) |
| 4 Truancy (unexcused absence) |
| 5 Health reasons |
| 6 Moved into a more difficult school |
| 7 Other reason (SPECIFY) |
BKGN-37C [M00435.00] | Section: MS CASI SECTION |
Has [Child First Name] repeated any other grades?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
BKGN-37-LOOP-END [] | Section: MS CASI SECTION |
UNTIL([ANY MORE TO REPORT?]==0)
BKGN-38 [M00445.00] | Section: MS CASI SECTION |
Has [Child First Name] ever had any behavior problems at school resulting in your receiving a note or being asked to come in and talk to the teacher or principal?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
BKGN-39 [M00446.00] | Section: MS CASI SECTION |
What grade was [Child First Name] in the first time you received a note, or were asked to come in and talk to the teacher or principal?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 90 NURSERY/PRESCHOOL |
| 0 KINDERGARTEN |
| 1 1ST GRADE |
| 2 2ND GRADE |
| 3 3RD GRADE |
| 4 4TH GRADE |
| 5 5TH GRADE |
| 6 6TH GRADE |
| 7 7TH GRADE |
| 8 8TH GRADE |
| 9 9TH GRADE |
| 10 10TH GRADE |
| 11 11TH GRADE |
| 12 12TH GRADE |
BKGN-40 [M00447.00] | Section: MS CASI SECTION |
Has [Child First Name] ever been suspended or expelled from school?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
BKGN-40A [M00448.00] | Section: MS CASI SECTION |
(Has your child ever been suspended or expelled from school?)
In what grade did this first happen?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 90 NURSERY/PRESCHOOL |
| 0 KINDERGARTEN |
| 1 1ST GRADE |
| 2 2ND GRADE |
| 3 3RD GRADE |
| 4 4TH GRADE |
| 5 5TH GRADE |
| 6 6TH GRADE |
| 7 7TH GRADE |
| 8 8TH GRADE |
| 9 9TH GRADE |
| 10 10TH GRADE |
| 11 11TH GRADE |
| 12 12TH GRADE |
BKGN-41 [M00449.00] | Section: MS CASI SECTION |
{MSINSCHL} == 1
If Answer = 1 Then Go To BKGN-42
BKGN-42 [M00450.00] | Section: MS CASI SECTION |
Is your child one of the best students in class, above the middle, in the middle, below the middle, or near the bottom of the class?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 1 One of the best students in class |
| 2 Above the middle |
| 3 In the middle |
| 4 Below the middle |
| 5 Near the bottom of the class |
BKGN-43A [M00451.00] | Section: MS CASI SECTION |
Please think about how well [Child First Name]'s school does its job.
What grade would you give the school for how much the teachers care about the students?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
BKGN-43B [M00452.00] | Section: MS CASI SECTION |
What grade would you give the school for how effective the principal is as the leader of the school?
BKGN-43C [M00453.00] | Section: MS CASI SECTION |
What grade would you give the school for the skill of the teachers?
BKGN-43D [M00454.00] | Section: MS CASI SECTION |
What grade would you give the school for how safe the school is for the students to attend?
BKGN-43E [M00455.00] | Section: MS CASI SECTION |
What grade would you give the school for letting parents know how their children are doing?
BKGN-43F [M00456.00] | Section: MS CASI SECTION |
What grade would you give the school for letting parents participate in decisions about how the school is run?
BKGN-43G [M00457.00] | Section: MS CASI SECTION |
What grade would you give the school for helping students learn the difference between right and wrong?
BKGN-43H [M00458.00] | Section: MS CASI SECTION |
What grade would you give for maintaining order and discipline?
BKGN-44 [M00459.00] | Section: MS CASI SECTION |
Looking ahead, how far do you think [Child First Name] will go in school? Will [he/she]...
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 1 leave high school before graduation |
| 2 graduate from high school |
| 3 get some college or other training |
| 4 graduate from college |
| 5 take further training after college |
| 6 or something else? (SPECIFY) |
BKGN-45 [M00460.00] | Section: MS CASI SECTION |
In general, how much trouble has [Child First Name] been to bring up?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 1 None |
| 2 Just a little |
| 3 Quite a bit |
| 4 A lot |
BKGN-46A [M00461.00] | Section: MS CASI SECTION |
Think now about how things are going in general in [Child First Name]'s life. Please rate each of the following parts of [his/her] life as either excellent, good, only fair, or poor.
First, how would you rate [Child First Name]'s health?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
| 4 EXCELLENT |
| 3 GOOD |
| 2 FAIR |
| 1 POOR |
BKGN-46B [M00462.00] | Section: MS CASI SECTION |
How would you rate [his/her] friendships?
| 4 EXCELLENT |
| 3 GOOD |
| 2 FAIR |
| 1 POOR |
BKGN-46C [M00463.00] | Section: MS CASI SECTION |
(How would you rate...) [his/her] relationship with you?
| 4 EXCELLENT |
| 3 GOOD |
| 2 FAIR |
| 1 POOR |
BKGN-46D [M00464.00] | Section: MS CASI SECTION |
(How would you rate...) [his/her] feelings about [him/her]self?
| 4 EXCELLENT |
| 3 GOOD |
| 2 FAIR |
| 1 POOR |
BKGN-46E [M00465.00] | Section: MS CASI SECTION |
(How would you rate...) [his/her] prospects for the future?
| 4 EXCELLENT |
| 3 GOOD |
| 2 FAIR |
| 1 POOR |
BKGN-46F [M00466.00] | Section: MS CASI SECTION |
(How would you rate...) [his/her] relationships with brothers, sisters, or other children [he/she] lives with?
| 4 EXCELLENT |
| 3 GOOD |
| 2 FAIR |
| 1 POOR |
| 0 NO OTHER CHILDREN IN HOUSEHOLD |
BPI-AGECK1 [M00469.00] | Section: MS CASI SECTION |
([CHILD AGE (YEARS)] >= 4) && ([MSBORNB4_R19] == 1)
COMMENT: If child age is 4 years or OLDER and meets YOB/BORNSR19 constraints, then continue OTHERWISE skip to BPI-END.
If Answer = 1 Then Go To BPI-INTRO
BPI-INTRO [] | Section: MS CASI SECTION |
The following statements are about behavior problems many children have. For each item, think about [Child First Name]'s behavior over the last three months. Then indicate whether the statement is often true, sometimes true, or not true.
BPI-01 [M00470.00] | Section: MS CASI SECTION |
{cfname}...has sudden changes in mood or feeling.
Is this statement often true, sometimes true, or not true?
{keyinstruct1} {keyinstruct2} {keyinstruct3}
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-02 [M00471.00] | Section: MS CASI SECTION |
{cfname}...feels or complains that no one loves {himher}.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-03 [M00472.00] | Section: MS CASI SECTION |
{cfname}...is rather high strung, tense and nervous.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-04 [M00473.00] | Section: MS CASI SECTION |
{cfname}...cheats or tells lies.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-05 [M00474.00] | Section: MS CASI SECTION |
{cfname}...is too fearful or anxious.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-06 [M00475.00] | Section: MS CASI SECTION |
{cfname} ...argues too much.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-07 [M00476.00] | Section: MS CASI SECTION |
{cfname}...has difficulty concentrating, cannot pay attention for long.
{keyinstruct1} {keyinstruct2} {keyinstruct3}
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-08 [M00477.00] | Section: MS CASI SECTION |
{cfname}...is easily confused, seems to be in a fog.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-09 [M00478.00] | Section: MS CASI SECTION |
{cfname}...bullies or is cruel or mean to others.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-10 [M00479.00] | Section: MS CASI SECTION |
{cfname}...is disobedient at home.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-11 [M00480.00] | Section: MS CASI SECTION |
{cfname} ...does not seem to feel sorry after {heshe} misbehaves.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-12 [M00481.00] | Section: MS CASI SECTION |
{cfname}...has trouble getting along with other children.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-13 [M00482.00] | Section: MS CASI SECTION |
{cfname}...is impulsive, or acts without thinking.
{keyinstruct1} {keyinstruct2} {keyinstruct3}
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-14 [M00483.00] | Section: MS CASI SECTION |
{cfname}...feels worthless or inferior.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-15 [M00484.00] | Section: MS CASI SECTION |
{cfname}...is not liked by other children.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-16 [M00485.00] | Section: MS CASI SECTION |
{cfname}...has a lot of difficulty getting {hisher} mind off certain thoughts (has obsessions).
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-17 [M00486.00] | Section: MS CASI SECTION |
{cfname}...is restless or overly active, cannot sit still.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-18 [M00487.00] | Section: MS CASI SECTION |
{cfname}...is stubborn, sullen, or irritable.
{keyinstruct1} {keyinstruct2} {keyinstruct3}
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-19 [M00488.00] | Section: MS CASI SECTION |
{cfname}...has a very strong temper and loses it easily.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-20 [M00489.00] | Section: MS CASI SECTION |
{cfname}...is unhappy, sad, or depressed.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-21 [M00490.00] | Section: MS CASI SECTION |
{cfname}...is withdrawn, does not get involved with others.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-22 [M00491.00] | Section: MS CASI SECTION |
{cfname}...breaks things on purpose or deliberately destroys {hisher} own or another's things.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-23 [M00492.00] | Section: MS CASI SECTION |
{cfname}...clings to adults.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-24 [M00493.00] | Section: MS CASI SECTION |
{cfname}...cries too much.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-25 [M00494.00] | Section: MS CASI SECTION |
{cfname}...demands a lot of attention.
{keyinstruct1} {keyinstruct2} {keyinstruct3}
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-26 [M00495.00] | Section: MS CASI SECTION |
{cfname}...is too dependent on others.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-27 [M00496.00] | Section: MS CASI SECTION |
{cfname}...feels others are out to get {himher}.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-28 [M00497.00] | Section: MS CASI SECTION |
{cfname}...hangs around with kids who get into trouble.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-29 [M00498.00] | Section: MS CASI SECTION |
{cfname}...is secretive, keeps things to {himher}self.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-30 [M00499.00] | Section: MS CASI SECTION |
{cfname}...worries too much.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
BPI-SCHLCK [M00500.00] | Section: MS CASI SECTION |
([IN SCHOOL] == 1) || ([EVER IN SCHOOL] == 1)
If Answer = 1 Then Go To BPI-31
BPI-31 [M00501.00] | Section: MS CASI SECTION |
Please answer even if school is not in session:
[Child First Name]...is disobedient at school.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
| 4 Never Attended School |
BPI-32 [M00502.00] | Section: MS CASI SECTION |
(Please answer even if school is not in session:)
[Child First Name]...has trouble getting along with teachers.
| 1 Often True |
| 2 Sometimes True |
| 3 Not True |
| 4 Never Attended School |
BPI-END [] | Section: MS CASI SECTION |
End of series. Click on the "Submit and Continue" button to proceed....
COMMENT: ------------END OF BEHAVIOR PROBLEM INDEX ASSESSMENT-------------
HLTH-16 [M00504.00] | Section: MS CASI SECTION |
{msage} < 4
COMMENT: If child's age less than 4 years skip to HLTH-19, OTHERWISE continue
If Answer = 1 Then Go To HLTH-19
HLTH-17 [M00505.00] | Section: MS CASI SECTION |
During the past 12 months has [Child First Name] seen a psychiatrist, psychologist, or counselor about any behavioral, emotional, or mental problem?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
HLTH-17A [M00506.00] | Section: MS CASI SECTION |
What was the problem?
[Using the down arrow and space bar to select your answers, please mark all of the items in the list below that describe the problem(s) / CODE ALL THAT APPLY]
HLTH-17B [M00507.00] | Section: MS CASI SECTION |
You said that the problem was "[BEHAVIOR PROBLEM TEXT ENTRY]".
[keyinstruct5]
| 1 LEARNING PROBLEMS OR DISABILITY, DYSLEXIA, READING OR SPEECH PROBLEMS |
| 11 ATTENTION DEFICIT HYPERACTIVITY DISORDER (ADHD, ADD) |
| 2 BEHAVIOR PROBLEMS IN SCHOOL/PRESCHOOL |
| 3 FAMILY PROBLEMS: LOSS OF PARENT OR SIB, DIVORCE |
| 4 UNMANAGEABLE, TEMPER TANTRUMS, DISRUPTIVE, HYPERACTIVE |
| 5 STRESS, CRIES A LOT |
| 6 LYING |
| 7 EMOTIONAL TRAUMA: MOLESTATION, ABUSE |
| 8 AUTISM |
| 9 SHYNESS |
| 10 NIGHTMARES |
| 15 OTHER (SPECIFY) |
HLTH-18 [M00508.00] | Section: MS CASI SECTION |
Was the cost of the visit to the psychiatrist, psychologist, or counselor covered, at least in part, by any form of insurance or benefit program?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
HLTH-19 [M00509.00] | Section: MS CASI SECTION |
{HLTH-SUB2}, have you felt, or has anyone suggested, that {cfname} needed help for any behavioral, emotional, or mental problem?
{keyinstruct1} {keyinstruct2} {keyinstruct3}
HLTH-20 [M00510.00] | Section: MS CASI SECTION |
Does [Child First Name] regularly take any medicines or prescription drugs to help control [his/her] activity level or behavior?
[ / (PRESS 'DOWN ARROW' TO TURN ON SCREEN AND TO HIGHLIGHT AN ANSWER. THEN PRESS TWICE TO CONTINUE.)] [ / (PRESS FOR DON'T KNOW AND FOR DO NOT WISH TO ANSWER.)] [(Type in your response here) / ENTER VERBATIM AND CODE ALL THAT APPLY ON NEXT SCREEN]
CASI-RESP-CHK [M00512.00] | Section: MS CASI SECTION |
{MOMCASI} == 1
COMMENT: SKIP STOP SCREEN IF MOTHER IS NOT COMPLETING CONFIDENTIAL - CASI ITEMS HERSELF
If Answer = 1 Then Go To CASI-THANKYOU
CASI-OTHERPRES [M00513.00] | Section: MS CASI SECTION |
INTERVIEWER: WAS ANYONE ELSE PRESENT, EXCLUDING THE RESPONDENT AND YOUNG CHILDREN (AGE 3 AND YOUNGER), WHEN YOU ASKED THE QUESTIONS ABOUT [Child First Name]'S HEALTH AND BEHAVIOR?
| 1 YES |
| 0 NO |
| 2 TELEPHONE INTERVIEW |
CASI-THANKYOU [] | Section: MS CASI SECTION |
Please stop here.
You are now finished with this section of the interview. Thank you!
Please turn the screen back toward the interviewer.
MSIR-TITLE [] | Section: MS INTERVIEWER REMARKS |
**** BEGIN SECTION: REMARKS*****
MSIR-CHKQXSTAT [M00515.00] | Section: MS INTERVIEWER REMARKS |
{MSUPSQXCONSNT}==2 || {MS_DOB_REFUSED}==1
If Answer = 1 Then Go To MSIR-REFCONFIRM
MSIR-REFCONFIRM [] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: PLEASE CONFIRM -
IS THIS MOTHER SUPPLEMENT INSTRUMENT BEING REFUSED?
MSIR-NOT-REFUSAL [] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER:
REFUSAL OF THE INSTRUMENT HAS NOT BEEN CONFIRMED.
PLEASE VERIFY:
-IF THE RESPONDENT IS NOW WILLING TO COMPLETE THE INSTRUMENT, PLEASE BACK UP TO THE BEGINNING OF THE INSTRUMENT AND RESUME FROM QUESTION ITEM: MS-STARTSCREEN .
ELSE
-IF THIS INSTRUMENT IS BEING REFUSED, BACK UP TO THE PREVIOUS CHECK ITEM AND CORRECT.
NOTE: NO ACCESSIBLE SCREENS FOLLOW.
MSIR-REF-REASON [] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: BE SURE TO ENTER COMMENTS HERE AND IN CM-FIELD AS TO THE NATURE OF THE REFUSAL. THEN CONTACT YOUR FM ABOUT THE STATUS OF THIS INSTRUMENT.
REASON FOR REFUSAL
MSIR-REF-FMID [] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER - STOP HERE.
EXIT THE CASE AND ASK YOUR FM TO REVIEW THE REFUSAL STATUS OF THIS INSTRUMENT.
DO NOT PROCEED UNTIL THE FM HAS PROVIDED FURTHER INSTRUCTION.
IF FM APPROVES THE REFUSAL:
ENTER THE FM APPROVAL CODE BELOW. THIS MOTHER SUPPLEMENT WILL BE CODED AS A REFUSAL
IF THIS IS A CONVERSION:
IF THE RESPONDENT IS NOW WILLING TO COMPLETE THE INSTRUMENT, PLEASE BACK UP TO THE BEGINNING OF THE INSTRUMENT AND RESUME FROM QUESTION ITEM: MS-STARTSCREEN .
.
FM APPROVAL CODE
MSIR-1 [M00516.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: LIST QUESTIONS WITH SKIP ERRORS, QUESTIONS THAT WERE CONFUSING TO THE RESPONDENT, OR QUESTIONS THAT OTHERWISE DIDN'T WORK.
| 1 SELECT TO ENTER QUESTION ...(Go To MSIR-1A) |
| 0 NO QUESTIONS CAUSED PROBLEMS |
MSIR-1A [M00517.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF FIRST QUESTION THAT CAUSED RESPONDENT PROBLEMS. IF DON'T KNOW SECTION OR QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
MSIR-1B [M00518.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: YOU SAID THE PROBLEM WAS WITH THE ITEM [MSIRPROBLEM1].
PLEASE ENTER A DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN MSIR-1A.
MSIR-1C [M00519.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: WERE THERE ANY OTHER QUESTIONS THAT CAUSED PROBLEMS?
| 1 SELECT TO ENTER QUESTION ...(Go To MSIR-1A2) |
| 0 NO QUESTIONS CAUSED PROBLEMS |
MSIR-1A2 [M00520.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: LIST SECTION AND QUESTION NUMBER OF NEXT QUESTION THAT CAUSED RESPONDENT PROBLEMS. IF DON'T KNOW SECTION OR QUESTION NUMBER, RECORD DESCRIPTION OF QUESTION.
MSIR-1B2 [M00521.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: YOU SAID THE PROBLEM WAS WITH THE ITEM [MSIRPROBLEM2].
PLEASE ENTER A DESCRIPTION OF PROBLEM WITH QUESTION MENTIONED IN MSIR-1A2.
MSIR-EVALCHK [M00522.00] | Section: MS INTERVIEWER REMARKS |
{MSINTMODE}==1
If Answer = 1 Then Go To MSIR-EVAL
MSIR-EVAL [M00523.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: IN GENERAL, WHAT WAS THE MOTHER'S ATTITUDE ABOUT ENTERING HER OWN ANSWERS ON THE COMPUTER? PLEASE DESCRIBE BELOW.
IF NO REACTION, ENTER "NONE".
MSIR-REMINDER [] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: REMINDER - MAKE SURE THAT MOTHER IS PAID. IF IN-PERSON INTERVIEW, BE SURE THAT SHE SIGNS THE RECEIPT. IF YOU HAVE NOT ALREADY THANKED MOTHER FOR HER PARTICIPATION, PLEASE DO SO NOW.
MSIR-IDNUM [M00524.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: PLEASE ENTER YOUR PROJECT ID NUMBER.
MSIR-INTNAME [M00525.00] | Section: MS INTERVIEWER REMARKS |
INTERVIEWER: PLEASE ENTER YOUR NAME ON THE LINE PROVIDED.
THEN CLICK "Submit and Continue " TO END SURVEY.