Now I would like to ask you some questions about your general state of health.

[flag indicating R reported having asthma at the date of last interview]==1

[Since date of last interview, has a doctor, nurse or other health professional/Has a doctor, nurse or other health professional ever] told you that you have asthma?

How old were you when you were [first/most recently] told (by a doctor, nurse, or other health professional) that you had asthma?

(INTERVIEWER: ENTER AGE IN YEARS. IF LESS THEN ONE YEAR, ENTER ZERO.)

[flag indicating R has been asked asthma questions in previous rounds] ==1

COMMENT: Machine Check: Was R ever asked Asthma Questions in a Previous Survey?

Has your biological father ever been told that he has asthma?

Has anyone smoked cigarettes or other tobacco products in your home in the past two weeks?

Have you routinely spent time in a place where you smelled cigarette smoke in the past two weeks?

[flag indicating R reported having asthma at the date of last interview]==1

COMMENT: Machine Check: Did R report ever having asthma at date of last interview?

[flag indicating whether R reported asthma for first time in current survey]==1

COMMENT: MACHINE CHECK: HAS R EVER HAD ASTHMA?

Do you still have asthma?

How old were you when you last had any symptoms of asthma?

(INTERVIEWER: ENTER AGE IN YEARS. IF LESS THEN ONE YEAR, ENTER ZERO.)

[flag indicating whether or not R still has asthma]==-2

During the past 12 months, have you had an episode of asthma or an asthma attack?

During the past 12 months, how many times did you have an unscheduled visit to an emergency room, doctor's office, or urgent care center because of asthma? (Please do not count any visits for routine medical care.)

([flag indicating if R has done any work for pay since date of last interview]==1)&&(([flag indicating if R has been enrolled in school since the date of last interview]==1)||([is R currently enrolled]==1))

COMMENT: MACHINE CHECK: HAS R HAD ANY EMPLOYERS?

[flag indicating if R has done any work for pay since date of last interview]==1

COMMENT: MACHINE CHECK: HAS R HAD ANY EMPLOYERS?

(([flag indicating if R has been enrolled in school since the date of last interview]==1)||([is R currently enrolled]==1))

COMMENT: MACHINE CHECK: HAS R HAD ANY EMPLOYERS?

During the past 12 months, how many days of [work/school/work or school] did you miss due to your asthma?

During the past 12 months, how much did you limit your usual activities due to your asthma? Would you say:

Do you use a daily asthma controller medication to prevent attacks?

(INTERVIEWER, IF NECESSARY ADD: For example Accolate, Advair, Azmacort, Flovent, Fordile, Intal, Oxis, Seretide, Serevent, Singulair, Tilade, or Vanceril.)

Now please think about the last month. In the past 30 days how often did you have any asthma symptoms either during the day or at night?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

In the past 30 days, how often did your asthma symptoms make it difficult for you to stay asleep at night?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

In the past 30 days how often have you used quick relief medicines when you had an asthma attack?

(INTERVIEWER: IF NECESSARY, ADD: For example, Airomir, Asmol, Albuterol, Atrovent, Bricanyl, Predmix, Redipred, Respolin, Maxair, or Ventolin)

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY)

[age of R as of December 31. 2016]==12 || [age of R as of December 31. 2016]==13

COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2016?

[number of previously reported limiting health conditions]>=1

COMMENT: Machine check: Is R on active duty or reported at least one employer in Section 7?

When we last spoke with you, you indicated you had the following health [condition/conditions]:

[list of previous limiting conditions reported by R]

Do you still have [this condition/these conditions] [condition/conditions]?

Besides [list of previous limiting conditions reported by R], do you currently have any other physical, emotional, or mental condition that limits your ability to work or attend school, or requires frequent medical attention, regular use of medication, or the use of special equipment such as a brace, wheelchair, air filter, catheter, and so on?

(Besides [list of previous limiting conditions reported by R],) What is/are your additional health condition(s) or limitation(s)?

(PROBE IF NECESSARY:) What is it called?

(INTERVIEWER: CONDITIONS ARE LISTED IN ALPHABETICAL ORDER. CHOICE NUMBER 34 IS 'OTHER (SPECIFY)'- MAKE SURE TO USE THIS CHOICE IF R'S APPROPRIATE CONDITION IS NOT ON LIST.)

(CODE ALL THAT APPLY WITHOUT READING CATEGORIES.)

Do you have any physical, emotional, or mental conditions that limit your ability to work or attend school?

Do you have any physical, emotional, or mental conditions that require frequent medical attention, regular use of medication, or the use of special equipment such as a brace, wheelchair, air filter, catheter and so on?

[Gender of Respondent]==1

COMMENT: MACHINE CHECK: IF R IS MALE, SKIP PREGNANCY CHECK

[flag indicating if R is pregnant]==1

COMMENT: check if YA is preg from sect 12

Is your limitation entirely due to your current pregnancy?

What is/are your health condition(s) or limitation(s)?

(PROBE IF NECESSARY:) What is it called?

(INTERVIEWER: CONDITIONS ARE LISTED IN ALPHABETICAL ORDER. CHOICE NUMBER 34 IS 'OTHER (SPECIFY)'- MAKE SURE TO USE THIS CHOICE IF R'S APPROPRIATE CONDITION IS NOT ON LIST.)

(CODE ALL THAT APPLY WITHOUT READING CATEGORIES.)

INSELECTION([Q14-8A],-1)

INSELECTION([Q14-8A],-2)

([number of health limitations]==1)

COMMENT: Did R indicate only one health limitation?

Which ONE of these health conditions would you say is the main cause of your limitation?

INTERVIEWER: PROBE IF NECESSARY. CODE DON'T KNOW ONLY IF PROBING IS UNSUCCESSFUL.

How long have you had this limitation, [name of illness]?

INTERVIEWER, PLEASE CHECK TIME FRAME ON THIS PAGE, PRESS SUBMIT AND CONTINUE, AND ENTER NUMERIC ANSWER ON THE NEXT PAGE.

(How long have you had this limitation ([name of illness]) (other than pregnancy)?)

(How long have you had this limitation ([name of illness]) (other than pregnancy)?)

[***]==0

Is anyone in your household [besides you/blank] disabled or chronically ill?

Which household member is this?

(INTERVIEWER: PROBE IF THERE IS MORE THAN ONE HOUSEHOLD MEMBER: "Is there anyone else?")

(INTERVIEWER: IF RESPONDENT SAYS SOMEONE WHO IS NOT ON THE HOUSEHOLD ROSTER, PLEASE ENTER APPROPRIATE INFORMATION IN A COMMENT.)

Do you regularly spend time helping or taking care of [this/these]?

About how many hours per week do you spend doing this?

Do you regularly spend time helping or taking care of a disabled or chronically ill relative or friend who does not live in your household?

About how many hours per week do you spend doing this?

How would you describe your present health? Is it...

Which of the following are you trying to do now about your weight?

In a typical week, how many times do you the following......


(INTERVIEWER: READ ANSWER CATEGORIES FOR FIRST QUESTION, THEN REPEAT ONLY IF NECESSARY)

[age of R as of December 31. 2016]==12 || [age of R as of December 31. 2016]==13

COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2016?

When you buy a food item for the first time, how often would you say you read the nutritional information sometimes listed on the label - would you say always, often, sometimes, rarely or never?

When you buy a food item for the first time, how often would you say you read the ingredient list on the package?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

During a typical week (7 days), how many times on average do you do the following kinds of activities for 30 minutes or more during your free time?


(INTERVIEWER: READ ANSWER CATEGORIES FOR FIRST QUESTION, THEN REPEAT ONLY IF NECESSARY)

In a typical week, how many hours total do you use a computer or mobile device to do activities related to work or school?

In a typical week, how many hours total do you use a computer or mobile device to do any activities NOT related to work or school?

On a typical weeknight, how many hours of sleep do you usually get?

[age of R as of December 31. 2016]==12 || [age of R as of December 31. 2016]==13

COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2016?

During the past 12 months have you had any accidents or injuries that required medical attention?

How many such accidents or injuries requiring medical attention have you had in the past 12 months?

Did any of these accidents or injuries require hospitalization?

REPEAT

COMMENT: start loop about accidents

[loop number]

COMMENT: check to see if this is the first loop through

How many such accidents or injuries requiring hospitalization have you had in the past 12 months?

What was the cause of the [label to differentiate between R's most recent accident and any previous accidents([loop number])] accident or injury?

(INTERVIEWER, IF APPLICABLE ASK:) What injuries did you sustain?

[flag indicating if will R be 21 or over as of December 31, 2012]==1

Where did the accident or injury happen?


(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

UNTIL (([loop number]==[number of accidents or injuries requiring hospitalization]) || ([number of accidents or injuries requiring hospitalization]<=0)||([loop number]==3))

[Gender of Respondent]==1

COMMENT: Check to see if R is male; if so branch over menses

VAREXIST ([flag indicating whether R has previously reported onset of menses])

COMMENT: set symbol for next question

[flag indicating whether R has previously reported onset of menses]==1

COMMENT: Check to see if menses information has already been collected.

Have you ever had a menstrual period?

How old were you when you had your first menstrual period?

(ENTER AGE:)

In what month and year did you have your first period?

(ENTER MONTH AND YEAR:)

(([Residence of Respondent]==19) || ([Residence of Respondent]==20) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]>0) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]==0)) && ([age of young adult]<19)

COMMENT: IS R IN HH WITH BOTH PARENTS OR WITH MOTHER ONLY AND UNDER AGE 19?

[age of young adult]>=21

COMMENT: Machine Check: will R be 21 or over as of December 31, 2014?

Some injuries or illnesses are not treated by a doctor or nurse. During the past 12 months, how many times were you injured or ill so that you missed at least one full day of usual activities such as work or school, but were not treated by a doctor or nurse?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

When you have an illness or injury that requires medical attention, where do you usually go for medical treatment?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

In the past 12 months have you had any illnesses that required medical attention or treatment?

How many such illnesses have you had in the past 12 months?

(ENTER NUMBER OF ILLNESSES:)

When did you last see a doctor for treatment of an illness?


(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

When did you last see a doctor for a routine health check-up?


(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

When did you last see a dentist for a routine dental check-up?


(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

When did you last see an optometrist or ophthalmologist for a routine eye exam?


(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

How tall are you?

(ENTER NUMBER OF FEET:)

How much do you weigh?

(ENTER NUMBER OF POUNDS)

[age of R as of December 31. 2016]==12 || [age of R as of December 31. 2016]==13

COMMENT: Machine Check: Will R be age 12 or 13 on December 31, 2016?

(([Residence of Respondent]==19) || ([Residence of Respondent]==20) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]>0) || ([flag indicating if R's mother lives in R's household]>0 && [flag indicating if R's father resides in R's household]==0)) && ([age of young adult]<19)

COMMENT: IS R IN HH WITH BOTH PARENTS OR WITH MOTHER ONLY AND UNDER AGE 21?

Now we have a couple of questions about health care coverage.

First, there is a national program called Medicaid (or Medi-Cal/Medical Assistance/Welfare/Medical Services) that pays for health care for persons in need. Is your health care now covered by Medicaid (or one of these public assistance health care programs)?

(INTERVIEWER: WE WILL ASK ABOUT OTHER FORMS OF HEALTH INSURANCE IN THE NEXT QUESTION)

Is your health care [also/now] covered by health insurance provided by an employer, the military, a student plan or by an individual plan that pays part or all of a hospital or doctor's bill?

(PROBE IF NECESSARY:) Examples of health and hospitalization insurance plans include Blue Cross, Blue Shield, HMO.

(INTERVIEWER: THIS INCLUDES BEING COVERED BY PARENT'S INSURANCE.)

What is the source of your health plan?

(INTERVIEWER: IF NECESSARY, READ:) Is it your own policy bought directly from a medical insurance company, an employer policy, your parent's policy, or something else?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

[Q14-22]==0&&[Q14-24]==0

COMMENT: Did R indicate having no kind of health care coverage?

Not including single service plans, about how long has it been since you last had health care coverage?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

In the past 12 months, have you ever been without health care coverage?

About how many months were you without coverage?

Which of these are the reasons you [do/did] not have health insurance?

(INTERVIEWER: SELECT ALL THAT APPLY.)

Now we are going to ask you about events that you may have experienced [Since date of last interview./since you were 10 years old.]

Is there anyone that you felt especially close to who has died?

How was the person who died related to you?

(INTERVIEWER: PLEASE SELECT ALL THAT APPLY.)

REPEAT

COMMENT: start loop about deaths of significant people

INSELECTION([Q14-26], [loop number])

COMMENT: CHECK TO DETERMINE IF THIS RELATIONSHIP WAS CHOSEN BY RESPONDENT IN Q14-26

In what month and year did your [relationship to R([loop number])] die?

[month of death([loop number])]==-2 || [month of death([loop number])]==-1

COMMENT: Machine Check: Did R indicate DK or refusal on month of death?

[year of death([loop number])]==-2 || [year of death([loop number])]==-1

COMMENT: Machine Check: Did R indicate DK or refusal on year of death?

About how old were you when your [relationship to R([loop number])] died?

UNTIL ( [loop number]==29)

COMMENT: End loop about deaths of significant people

[Since date of last interview have you/Have you ever] been the victim of a violent crime, for example, physical or sexual assault, robbery or arson?

[Since [date of last interview] have/Have] you been the victim of a violent crime more than once?

How old were you the first time [(since date of last interview)?/?] you were the victim of a violent crime?

How old were you the most recent time you were the victim of a violent crime?

How old were you when you were the victim of a violent crime[(since date of last interview)?/?]

[Since date of last interview,/Since you were 10 years old,] has an adult member of your household (other than yourself), that is someone who was living in the same household as you at the time, been sent to jail or prison?

How was the person who went to jail or prison related to you?

(INTERVIEWER: PLEASE SELECT ALL THAT APPLY.)

REPEAT

COMMENT: start loop about imprisonment of adults in household

INSELECTION([Q14-35], [loop number])

COMMENT: CHECK TO DETERMINE IF THIS RELATIONSHIP WAS CHOSEN BY RESPONDENT IN Q14-35

Was your [relationship to R([loop number])] sent to jail or prison more than once while you were living in the same household?

How old were you the first time [(since date of last interview)?/?] your [relationship to R([loop number])] was sent to jail or prison (while you were living in the same household)?

How old were you the most recent time your [relationship to R([loop number])] was sent to jail or prison (while you living were in the same household)?

How old were you when your [relationship to R([loop number])] was sent to jail or prison[(since date of last interview)?/?]

UNTIL ( [loop number]==18)

COMMENT: End loop about imprisonment of adults in household

[age of R as of December 31. 2016]==29 || [age of R as of December 31. 2016]==30 || [age of R as of December 31. 2016]==41 || [age of R as of December 31. 2016]==42 || [NEEDHEALTHMOD]==1

COMMENT: Check: Does R need to complete additional health module?

Have either of your biological parents or any of your biological brothers or sisters ever been told by a doctor that they have any of the following:

INSELECTION([Q14-41],3)

COMMENT: Did R indicate a family member has diabetes?

You mentioned that a doctor has told someone in your immediate family that they have diabetes. Was that your mother, your father, or a brother or sister?

Have any of your biological grandparents been told by a doctor that they have diabetes?

Which of your grandparents has been told they have diabetes?

INTERVIEWER: IF NECESSARY PROBE TO DETERMINE RELATIONSHIP.

([flag indicating if R's father is deceased]==1) || ([flag indicating if R lives with biological father]==2) || ([flag indicating if R's father is alive]==0)

COMMENT: Is R's father deceased?

What caused your biological father's death?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

How old was he when he died?

([flag indicating that R reported mother deceased in Q2-18]==1) || ([flag indicating that R reported mother deceased in Q2-18]==1) || ([flag indicating that R reported mother deceased in Q2-23b]==15) || ([flag indicating if R's mother is deceased]==1) || ([flag indicating if R lives with biological mother]==2)

COMMENT: Is R's mother deceased?

What caused your biological mother's death?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

How old was she when she died?

[age of young adult] >=40

COMMENT: Check: Does R need to complete additional health module?

Has a doctor ever told you that you have high blood pressure or hypertension?

Do you have high blood pressure or hypertension at the present time?

[flag indicatig R has reported having diabetes]==1

Has a doctor ever told you that you have diabetes or high blood sugar?

Do you have high diabetes or high blood sugar at the present time?

Has a doctor ever told you that you had skin cancer?

Has a doctor ever told you that you had cancer or malignant tumor of any kind except skin cancer?

[flag indicatig R has reported having cancer]==1

[flag indicatig R has reported having skin cancer]==1||[has R reported cancer (other than skin)]==1

Do you currently have any such cancer?

[flag indicatig R has reported having bronchitis]==1

Not including asthma, has a doctor ever told you that you have chronic lung disease such as chronic bronchitis or emphysema?

Has a doctor ever told you that you had a heart attack, coronary heart disease, angina, congestive heart failure, or other heart problems?

Did you have a heart attack or myocardial infarction?

Do you currently have any angina or chest pains due to your heart?

Has a doctor ever told you that you have congestive heart failure?

Has a doctor ever told you that you had a stroke?

[flag indicatig R has reported having depression]==1

Has a doctor ever diagnosed you as suffering from depression?

During the last 12 months, have you suffered from depression?

[flag indicatig R has reported having anxiety]==1||[flag indicatig R has reported having bipolar disorder]==1

Has a doctor ever told you that you had emotional, nervous, or psychiatric problems other than depression?

During the last 12 months, have you had any emotional, nervous, or psychiatric problems?

Have you ever had, or has a doctor ever told you that you have, arthritis or rheumatism?

Do you sometimes have pain, stiffness, or swelling in your joints?

Has a doctor ever told you that you had osteopenia or osteoporosis?

During the past 4 weeks, have you accomplished less than you would like with your work or other regular daily activities as a result of any emotional problems such as feeling depressed or anxious?

IF YES, PROBE: Did you accomplish a lot less or a little less?

During the past 4 weeks, have you accomplished less than you would like with your work or other regular daily activities as a result of your physical health?

IF YES, PROBE: Did you accomplish a lot less or a little less?

[age of young adult] >=40

COMMENT: Check: Does R need to complete additional health module?

During the past 4 weeks, how much did pain interfere with your normal work (including both work outside of the home and housework)?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

How often during the past 4 weeks...

...did you have a lot of energy?

Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?

How often during the past 4 weeks...

...have you felt calm and peaceful?

(Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?)

(How often during the past 4 weeks...)

...have you felt down-hearted and blue?

(Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?)

During the past 4 weeks, how much of the time has your physical health or emotional problems interfered with your social activities (like visiting with friends, family, etc.)?

(Was it all of the time, most of the time, a good bit of the time, some of the time, a little of the time, or none of the time?)

[age of young adult] >=40

COMMENT: Check: Does R need to complete additional health module?

We are interested in how much difficulty people have with various activities because of a health or physical problem. How difficult is it for you to...


(INTERVIEWER: READ ANSWER CATEGORIES FOR FIRST QUESTION, THEN REPEAT ONLY IF NECESSARY)

We are interested in how much difficulty people have with various activities because of a health or physical problem. How difficult is it for you to...



(INTERVIEWER: READ ANSWER CATEGORIES ONLY IF NECESSARY)

During the past 2 years, have you had any of the following medical tests or procedures?

[Gender of Respondent]==2

COMMENT: Is R female?

Have you had a PAP smear in the past 2 years?

[age of young adult] >=40

COMMENT: Check: Does R need to complete additional health module?

Have you had a mammogram in the past 2 years?

During a usual week, how many times a day do you...

....brush your teeth?

(During a usual week, how many times a day do you...)

....use dental floss?

[Since age 30, have you/Have you ever] had a blow to the head or a similar type of head injury that was severe enough to require medical attention, or to cause loss of consciousness or memory loss for a period of time?

[Since age 30, how/How] many times has this happened?

[How old were you at the time?/Now I want you to think about your most recent head injury or trauma. How old were you at the time?]

Did you lose consciousness?

How long were you unconscious?

(INTERVIEWER: READ CATEGORIES ONLY IF NECESSARY.)

Part of this study is concerned with people's memory, and ability to think about things. First, how would you rate your memory at the present time? Would you say it is excellent, very good, good, fair or poor?

Compared to two years ago, would you say your memory is better now, about the same, or worse now than it was then?

[check for proxy interview code from INTRO]==4

I'll read a set of 10 words and ask you to recall as many as you can. We have purposely made the list long so that it will be difficult for anyone to recall all the words. Most people recall just a few. Please listen carefully as I read the set of words because I cannot repeat them. When I finish, I will ask you to recall aloud as many of the words as you can, in any order. Is this clear?

(INTERVIEWER: PROBE AS NEEDED FOR UNDERSTANDING OF TASK. READ ITEMS ON FOLLOWING SCREEN AT A SLOW STEADY RATE, AS THEY FLASH ON THE SCREEN.

IF R REFUSES DURING OR AFTER THE INTRODUCTION AND BEFORE ANY WORDS ARE READ, SELECT "REFUSED WORD LIST" BELOW AND SELECT <SUBMIT AND CONTINUE> TO PROCEED.)

INT(RAND(0)*4)

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: DOUBLE CLICK START ARROW TO START WORD LIST. READ WORDS AS THEY FLASH ON THE SCREEN.

AFTER READING WORDS, ASK:)
Now please tell me the words you can recall.

(INTERVIEWER: PERMIT AS MUCH TIME AS THE R WISHES UP TO ABOUT 2 MINUTES. SELECT "RECALLED" FOR WORDS R RECALLED, AND "NOT RECALLED" FOR WORDS THE R DID NOT RECALL.

SELECT <SUBMIT AND CONTINUE> TO ENTER WRONG WORDS ONTO THE ROSTER ON NEXT SCREEN. BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: ENTER WRONG WORDS "RECALLED" ON ROSTER BELOW BY SELECTING <ADD ROW> AND TYPING THE WORD.)

(INTERVIEWER: PLEASE INDICATE WHETHER ANY OF THE FOLLOWING PROBLEMS OCCURRED IN RELATION TO WORD RECALL.)

(SELECT ALL THAT APPLY.)

For this next question, please try to count backward as quickly as you can from the number I will give you. I will tell you when to stop.

Please start with: 20

(INTERVIEWER: ALLOW R TO START OVER IF S/HE WISHES TO DO SO. SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)

INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS, OR ASKS TO START OVER.

R CAN CORRECTLY COUNT DOWN FROM 19 TO 10 OR FROM 20 TO 11.

You may stop now. Thank you.

(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)

Let's try again.

The number to count backward from is : 20

(INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS YOU READ THE NUMBER.)

INTERVIEWER: SELECT <CONTINUE WITH BACKWARD COUNTING> AS SOON AS R HAS COUNTED 10 NUMBERS, OR STOPS.

You may stop now. Thank you.

(INTERVIEWER: SELECT <CORRECT> IF R COUNTED BACKWARDS FROM 19 TO 10 OR FROM 20 TO 11 WITHOUT ERROR. SELECT <REFUSED> IF R REFUSED TO TRY THE TASK. DON'T KNOW IS NOT AN ACCEPTABLE RESPONSE.)