Start
alspac_98_msdas
MY SON AT SCHOOL
This questionnaire asks about your study child
It should be completed by the chief carer.
All answers are confidential.
THANK YOU FOR YOUR HELP
SECTION A: THE HEALTH OF YOUR STUDY CHILD

How would you assess the health of your child now? in the past month

1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell

How would you assess the health of your child now? in the past year

1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell

Has he had fluoride supplements (tablets or drops) in the past year?

1
Yes
2
No
Has he had any of the following in the past 12 months?
-
diarrhoea
blood in the stools
vomiting
cough
high temperature
snuffles/cold
ear ache
ear discharge (pus not wax)
convulsions/fits
stomach ache(s)
rash
wheezing
breathlessness
episodes of stopping breathing
an accident
urinary infection
headache(s)
constipation
worm infections
head lice
scabies
asthma
eczema
hay fever

Has he had any of the following in the past 12 months? other (please tick and describe)

1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have
Other

Has your child been admitted to hospital in the past year?

1
Yes
2
No
If no, go to A5 on page 4
If yes,
qc_A4_a == 1

how many times?

How many
please describe for each admission:
Age of child (years) Reason for admission No. of nights child stayed in hospital
AgeGeneric textHow many AgeGeneric textHow many AgeGeneric textHow many
1
2
3

How often did you see him while he was in hospital? 1st admission

1
Not at all
2
Quite often
3
Every day
4
Stayed in the hospital with him

How often did you see him while he was in hospital? 2nd admission

1
Not at all
2
Quite often
3
Every day
4
Stayed in the hospital with him

How often did you see him while he was in hospital? 3rd admission

1
Not at all
2
Quite often
3
Every day
4
Stayed in the hospital with him

Has he ever had any of the following operations? hernia repair

1
Yes
If yes,
qc_A5_a == 1

please give type

Generic text

Has he ever had any of the following operations? tonsils out

1
Yes

Has he ever had any of the following operations? adenoids out

1
Yes

Has he ever had any of the following operations? appendicectomy (appendix out)

1
Yes

Has he ever had any of the following operations? tubes (grommets) put in his ears

1
Yes

Has he ever had any of the following operations? squint repair (to put eyes straight)

1
Yes

Has he ever had any of the following operations? teeth pulled out

1
Yes

Has he ever had any of the following operations? circumcision

1
Yes

Has he ever had any of the following operations? other operations (please describe)

1
Yes
Other

In the past year has he had any periods when there was wheezing with whistling on his chest when he breathed?

1
Yes
2
No
If no, go to A6k on page 6
If yes,
qc_A6_a == 1

How many separate times has this happened in the past 12 months?

1
once
2
twice
3
3-4 times
4
5 or more times
9
don't know

How many days altogether would you say he has wheezed in the past 12 months?

1
1 day
2
2-3 days
3
4-9 days
4
10-19 days
5
20 or more days
9
don't know

Was he breathless during any of these times?

1
Yes for all
2
Yes for some
3
No not at all

Did he have a fever during any of these times?

1
Yes for all
2
Yes for some
3
No not at all

How often, on average, has your child's sleep been disturbed due to wheezing in the past 12 months?

1
Never woken with wheezing
2
Less than one night per week
3
One or more nights per week

Has wheezing ever been severe enough to limit your child's speech to only one or two words at a time between breaths in the past 12 months?

1
Yes
2
No

Do you think the wheezing attacks are worse during any particular time of year?

1
yes, worse in spring and/or summer
2
yes, worse in autumn and/or winter
3
not particularly
4
other (please tick & describe)
Other

What do you think brings on the wheezing attacks ? chest infection or bronchitis

1
Yes
2
No

What do you think brings on the wheezing attacks ? being in a smoky room

1
Yes
2
No

What do you think brings on the wheezing attacks ? cold weather

1
Yes
2
No

What do you think brings on the wheezing attacks ? I don't know

1
Yes
2
No

What do you think brings on the wheezing attacks ? other (please tick & describe)

1
Yes
2
No
Other

In the past 12 months has your child's chest sounded wheezy during or after exercise?

1
Yes
2
No

In the past 12 months has your child had a dry cough at night, apart from a cough associated with a cold or chest infection?

1
Yes
2
No

Have any of your other children ever had spells of wheezing with whistling on the chest?

1
Yes
2
No
7
have no other children

Has your child had any itchy, dry skin rash in the joints and creases of his body (e.g. behind the knees, elbows, under the arms) in the past year?

1
Yes
2
No
If no, go to A8a on page 7
If yes,
qc_A7_a == 1

how bad was this?

1
very bad
2
quite bad
3
mild
4
no problem

does he have this sort of rash now?

1
Yes
2
No

did the rash ever become sore and oozy?

1
Yes
2
No

was it made worse by irritants such as bubble bath, soap, wool or nylon clothing?

1
Yes
2
No

Has he had an itchy, dry, rash on his hands in the past year?

1
Yes
2
No

Has he had an itchy, dry rash on his feet in the past year?

1
Yes
2
No
If no, go to A8c below
If yes,
qc_A8_b == 1

please describe which parts of his feet

Generic text

In the past 12 months how often, on average, has your child been kept awake at night by an itchy rash?

1
Never in the past 12 months
2
Less than one night per week
3
One or more nights per week

Does his skin get itchy when he gets sweaty? (e.g. in a hot room or when he has been playing?)

1
Yes
2
No

Has he had a skin reaction in the past year (e.g. redness or itching) which you thought was due to some food that he had eaten?

1
Yes
2
No
If no, go to A10 on page 8
If yes,
qc_A9 == 1

please describe the food(s)

Generic text

how long after the food was eaten did the reaction appear?

Generic text

where was the reaction? (please describe)

1
mouth
2
other part
Generic text
This question is about problems which occur when your child does not have a cold or the flu.

Has your child ever had a problem with sneezing or a runny or blocked nose, when he did not have a cold or the flu?

1
Yes
2
No
If no, go to A11a on page 9
qc_A10_a == 2

Has he had vomiting spells in the past year?

1
Yes
2
No
If no, go to A12a below
If yes,
qc_A11_a == 1

How many times?

1
once
2
twice
3
3-9 times
4
10 or more times

How often have these been associated with: diarrhoea

1
Always
2
Frequently
3
Sometimes
4
Rarely
5
Never

How often have these been associated with: chestiness (wheezing or coughing or grunting)

1
Always
2
Frequently
3
Sometimes
4
Rarely
5
Never

In the past year has he had diarrhoea or gastro-enteritis?

1
Yes
2
No
If no go to A13a on page 10
If yes,
qc_A12_a == 1

how many times in the past 12 months?

How many

how many days did the worst attack last?

How many

Did you: call the doctor to come to your home?

1
Yes
2
No

Did you: go to your doctor?

1
Yes
2
No

Did you: treat it yourself?

1
Yes
2
No

Did you: do something else? (please tick & describe)

1
Yes
2
No
Other

Did he continue to eat as usual?

1
Yes
2
No
If yes, go to (f) below
If no,
qc_A12_e == 2

how long was normal eating disturbed?

1
less than 1 day
2
1 day
3
2 days
4
3-4 days
5
5 or more days

What treatment was given?

Generic text

In the past year has your child ever had a time when he has coughed off and on for at least 2 days?

1
Yes
2
No
If no, go to A14a on page 11
If yes,
qc_A13_a == 1

How many times has this happened in the past year?

1
once
2
twice
3
3-9 times
4
10 or more times

Did he have a fever at any of these times?

1
Yes for all
2
Yes for some
3
No, not at all

Did he have a runny nose during any of these spells?

1
Yes for all
2
Yes for some
3
No, not at all
The following questions are about your child's ears and hearing.

Nowadays, does your child listen to people or to things that happen nearby:

1
Yes always
2
Yes often
3
Sometimes
4
Usually not
5
Never
7
Child unable to hear at all
SECTION B: SLEEPING

Does your child have a regular sleeping routine?

1
Yes
2
No

How many hours sleep does he usually have during the day time?

1
none
2
less than 1 hour
3
1 - 2 hours
4
more than 2 hours
9
don't know

Normally, during term-time what time in the evening does your child go to sleep? school days ... p.m.

Time

Normally, during term-time what time in the evening does your child go to sleep? on Saturdays ... p.m.

Time

During term-time what time does he normally wake up in the morning? school days ... a.m.

Time

During term-time what time does he normally wake up in the morning? weekend days ... a.m.

Time

How often during the night does he usually wake? ... times

How many

How often during a normal day does he have a sleep? ... times

How many

Where does the child usually sleep? When he goes to bed at night

1
in his own room on his own
2
in a room with other children
3
in your bedroom
4
in a room with other adults
5
other place (please tick & describe)
Other

Where does the child usually sleep? When he wakes in the morning

1
in his own room on his own
2
in a room with other children
3
in your bedroom
4
in a room with other adults
5
other place (please tick & describe)
Other

Does the child sleep on his own most nights or does he share a bed? When he goes to bed at night

1
in his own bed
2
in a bed with other children
3
in your bed with you
4
in a bed with other adult
5
other place (please tick & describe)
Other

Does the child sleep on his own most nights or does he share a bed? When he wakes in the morning

1
in his own bed
2
in a bed with other children
3
in your bed with you
4
in a bed with other adult
5
other place (please tick & describe)
Other

How often does he sleep? on his back

1
Always
2
Usually
3
Sometimes
4
Hardly ever

How often does he sleep? on his side

1
Always
2
Usually
3
Sometimes
4
Hardly ever

How often does he sleep? on his front

1
Always
2
Usually
3
Sometimes
4
Hardly ever

Do you feel his sleep pattern is:

1
better than other children of the same age
2
same as other children of the same age
3
worse than other children of the same age
9
don't know
In the room where the child sleeps most of the night:
In Winter In Summer

1 - Yes always

2 - Yes sometimes

3 - No not at all

1 - Yes always

2 - Yes sometimes

3 - No not at all

1 - Yes always

2 - Yes sometimes

3 - No not at all

1 - Yes always

2 - Yes sometimes

3 - No not at all

is the heating on all night?
is the heating on part of the night?
is there a window open at night?
does he sleep with a duvet?
does he have an electric blanket?
does he sleep with a pillow?
In the past year has your child:
-
refused to go to bed
woken very early
had difficulty going to sleep
had nightmares
continued to get up after being put to bed
woken in the night
got up after only a few hours sleep
snored
wet the bed
sleep walked
masturbated

In the past year has your child: other (please tick and describe)

1
Yes, but did not worry me
2
Yes, worried me a bit
3
Yes, worried me greatly
4
No, did not happen
9
Don't know
Other
SECTION C: STRENGTHS AND DIFFICULTIES
Please think how your child has been in the past 6 months

In the last six months: He has been considerate of other people's feelings

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has been restless, overactive, cannot stay still for long

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has often complained of headaches, stomach aches or sickness

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has shared readily with other children (treats, toys, pencils etc.)

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has often had temper trantrums or hot tempers

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is rather solitary, tends to play alone

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is generally obedient, usually does what adults request

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has many worries, often seems worried

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is helpful if someone is hurt, upset or feeling ill

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is constantly fidgeting or squirming

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has at least one good friend

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He often fights with other children or bullies them

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is often unhappy, down-hearted or tearful

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is generally liked by other children

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is easily distracted, his concentration wanders

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is nervous or clingy in new situations, easily loses confidence

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is kind to younger children

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He often lies or cheats

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He is picked on or bullied by other children

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He often volunteers to help others (parents, teachers, other children)

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He thinks things out before acting

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He steals from home, school or elsewhere

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He gets on better with adults than with other children

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He has many fears, is easily scared

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know

In the last six months: He sees tasks through to the end, has good attention span

1
Not true
2
Somewhat true
3
Certainly true
4
Don't know
SECTION D: UPSETTING EVENTS
Below are listed some events that might upset some children. Please state whether any of these has happened since he was 5 years old. **We realise how sensitive and personal some of the following questions are, but it is important to find out how frequently these events happen to children and what, if any, effect they have on them. As you know, answers you put in questionnaires are never linked back to your name and address.
-
He was taken into care*
A pet died
He moved home
He had a shock or fright*
He was physically hurt by someone*
He was sexually abused
Somebody in the family died
He was separated from his mother
He was separated from his father
He acquired a new mother or father
He had a new brother or sister
He was admitted to hospital
He changed care taker (i.e. the person mostly looking after him)
He was separated from someone else that he was close to
He started a new school or kindergarten
He started school
He lost his best friend

Below are listed some events that might upset some children. Please state whether any of these has

happened since he was 5 years old. *We realise how sensitive and personal some of the following questions are, but it is important to find out how frequently these events happen to children and what, if any, effect they have on them. As you know, answers you put in questionnaires are never linked back to your name and address. Something else (please tick and describe)

1
Yes and he was very upset
2
Yes and he was quite upset
3
Yes and he was a bit upset
4
Yes but he wasn't upset
5
No did not happen
Other
If yes, to any items with a *,
qc_D1-D17$*;1,4,5 >= 1 && qc_D1-D17$*;1,4,5 <= 4 || qc_D18 >= 1 && qc_D18 <= 4

please write a description if you feel able to.

Generic text

Space for comments:

Long text
SECTION E: ABILITIES AND DISABILITIES
Children in this study have a range of skills and abilities and some have a number of disabilities. These questions will enable us to get a picture of your child. Please answer each question. If you don't know the answer please ask your child to try the task.
Using his body:

Is he able to walk?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Is he able to stoop down and pick up something from the floor?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Is he able to run?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he jump forward with both feet together?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he walk on tiptoe?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he run on tiptoe?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he hop on one foot for 3 steps?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he walk backwards for 4 steps?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he stand on 1 foot for at least 8 seconds?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he walk upstairs, putting both feet on each step?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he walk upstairs, putting one foot on each step?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he walk downstairs, putting both feet on each step?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he walk downstairs, putting one foot on each step?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he run upstairs?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he run upstairs 2 steps at a time?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he ride a tricycle or a bicycle with stabilisers

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he ride a bicycle?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he swim with waterwings?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he swim without waterwings?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he do a handstand against the wall?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he do a handstand without support?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he skip with a skipping rope?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he stand on his head?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance
Using his hands:

Can he hold a pencil and scribble?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he copy a vertical line with a pencil?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he wiggle his thumb?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he draw a circle (more or less)

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he bang together two objects that he is holding?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he draw (or copy) a cross?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he draw (or copy) a square?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he write his name?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he write the numbers 1 to 9?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

If you ask him to draw a man, what is the result likely to be?

1
just a scribble
2
a head and not much else
3
a head and body
4
a head, body and legs
5
head, body, arms, legs
6
other (please describe)
Other
Pictures, letters and numbers

Does he show interest in pictures in books?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he notice details in pictures and photographs?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he recognise the colours red, yellow and blue?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he recognise orange, brown and purple?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he recognise his name when written?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he know at least 3 letters of the alphabet?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he know at least 10 letters of the alphabet?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he read simple words?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he read a story with less than 10 words a page?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he read a story with more than 10 words a page?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he understand numbers 1 and 2?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he understand numbers 3 and 4?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he understand numbers 5 to 10?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he count up to 20?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he count up to 100?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance
Playing & sharing

Does he share his toys with other children?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he share the toys of other children, understanding that they are not his?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he feel sympathy for someone if they are hurt?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he think of things to do to please you?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he take turns in a game without fuss?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he play card games (e.g. snap)?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he play any board games (e.g. Monopoly, Snakes & Ladders)?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he play chess?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance
Ball skills

Can he kick a large ball?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he throw a small ball underarm?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he throw a small ball overarm?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he throw a ball against a wall and catch it?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance
Social skills

Does he drink from a cup or mug?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he eat skilfully with a spoon?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he eat with fork and spoon in each hand?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he cut his food with a knife?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he sit at a table and cope with a whole meal without help?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he wash and dry his hands on his own?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he brush his teeth on his own?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he get dressed without help?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he get undressed without help?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he do up buttons?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he tie a bow?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he brush and comb his hair?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance
Listening & Singing

Can he listen to a short story from start to finish?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he understand instructions such as: 'Find the jumper that Granny gave you'?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he sing songs (even if the words are not clear)?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he talk clearly?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Does he ask sensible questions?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he carry on a conversation?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he say at least 3 nursery rhymes?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he sing at least 3 songs?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he hum a tune?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance

Can he beat a rhythm by clapping hands in time to the music?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
4
Is unable to try this
5
Has not had the chance
Talking

Does he stumble or get stuck on words or repeat them many times? (e.g. I I I I want a sweet)

1
Never
2
Sometimes
3
Often
4
Always

Is his voice hoarse or husky?

1
Never
2
Sometimes
3
Often
4
Always

Can you understand what he says?

1
Never
2
Sometimes
3
Often
4
Always

Can your family understand what he says?

1
Never
2
Sometimes
3
Often
4
Always

Can visitors to your house understand what he says?

1
Never
2
Sometimes
3
Often
4
Always

Does he prefer to use gestures (pointing or pulling) to get what he wants instead of asking?

1
Yes, still does
2
Yes, did in past, not now
3
No, never did

When he talks nowadays, what are the most words he can put together (e.g. "I want juice" would be 3 words).

1
one word
2
two words
3
3 or 4 words
4
5-8 words
5
9 or more words
6
does not talk at all
Some children enjoy talking and others do not.
-
talk a lot
stay mainly silent
seem to avoid looking at people&#39;s faces when he talks
echo what has just been said to him (e.g. you say; &#39;we are going out now he says: &#39;going out now&#39;.)

Does your son have difficulty in pronouncing certain sounds (e.g. th, sss, t)?

1
Yes
2
No
If yes,
qc_E11_a == 1

please describe

Generic text

Are there any other languages apart from spoken English used in your household, including Sign language for the deaf?

1
Yes
2
No
If no, go to E13a on page 38
If yes,
qc_E12_a == 1

please say which

Generic text

Is English the main language spoken? By mother

1
English is the main language
2
both English and other language used equally
3
other is the main language
7
no such person

Is English the main language spoken? By study child

1
English is the main language
2
both English and other language used equally
3
other is the main language

Is English the main language spoken? By partner

1
English is the main language
2
both English and other language used equally
3
other is the main language
7
no such person

Is English the main language spoken? By other children

1
English is the main language
2
both English and other language used equally
3
other is the main language
7
no such person

Space for comments.

Long text

Do you think he has difficulty recognising how other people feel just by looking at the expression on their faces?

1
Yes, often
2
Yes, sometimes
3
No, not at all
9
Can&#39;t say

Do you think he has difficulty recognising how other people feel just from the tone of their voice?

1
Yes, often
2
Sometimes
3
Rarely/never
9
Can&#39;t say

Which aspects of your child's growth and development are you worried about? (Please tick all that apply)

2
Not worried at all about any respect
If Not worried at all about any respect to question E14 Go to F1 on page 40
qc_E14 == 2
This is confidential information, so we cannot make any response to what you put. If you are worried about your child's development we suggest you contact your family doctor or your health visitor.
SECTION F: THE CHILD'S ACTIVITIES

About how often does your child do the following: How often does he: Go swimming

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all

About how often does your child do the following: How often does he: Play a musical instrument (e.g. piano, recorder) Please tick & describe

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Go to special groups (such as Beavers or Rainbows) Please tick and describe group

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Go to Sunday School

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all

About how often does your child do the following: How often does he: Go to special classes or clubs for some activity (e.g. dancing, judo, sports) Please tick and describe

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Go to special classes because of learning difficulty Please tick and describe

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Classes for foreign languages Please tick and describe

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Singing group Please tick and describe

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Other type of classes or group Please tick and describe

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
Generic text

About how often does your child do the following: How often does he: Have physiotherapy

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all

About how often does your child do the following: How often does he: See his grandparents

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all

About how often does your child do the following: How often does he: Play computer games

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all

About how often does your child do the following: How often does he: Help in the house

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
Rarely
6
Not at all
How often does his mother or other adult female do these activities with the study child?
-
baths (or showers) him
makes things with him
sings to him or with him
reads to him or with him
plays with toys
cuddles him
active play (e.g. ball games, wrestling, hide and seek)
takes him to the park or playground
puts him to bed
takes him swimming, fishing or similar activity
draws or paints with him
prepares food for him
takes him to classes
takes him shopping
takes him to watch sports/football
does homework with him
has conversations with him
helps him prepare things for school

How often does his mother or other adult female do these activities with the study child? Mother or other woman: other (please tick & describe)

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Less than once a week
5
Never
Other
Who are the women involved in any of these activities with the study child? (Please tick all that apply)
-
His mother
His stepmother
His grandmother
His grown-up sister
Another relative
A family friend
A lodger
A baby sitter/nanny

Who are the women involved in any of these activities with the study child? (Please tick all that apply) Other (please tick and describe)

1
Yes
Other
How often does a male adult (e.g. his father/your partner) do these activities with your child?
-
baths (or showers) him
makes things with him
sings to him or with him
reads to him or with him
plays with toys
cuddles him
active play (e.g. ball games, wrestling, hide and seek)
takes him to the park or playground
puts him to bed
takes him swimming, fishing or similar activity
draws or paints with him
prepares food for him
takes him to classes
takes him shopping
takes him to watch sports/football
does homework with him
has conversations with him
helps him prepare things for school

How often does a male adult (e.g. his father/your partner) do these activities with your child? Father or other man: other (please tick and describe )

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Less than once a week
5
Never
Other
Who are the men involved in any of these activities with the study child? (Tick all that apply)
-
His father
His stepfather
His grandfather
His grown-up brother
Another relative
A family friend
A lodger
A baby sitter/nanny

Who are the men involved in any of these activities with the study child? (Tick all that apply) Other (please tick and describe)

1
Yes
Other

Help in the house: Does your son help in the home (cleaning, washing dishes, etc.)?

1
Yes, but only if made to
2
Yes, sometimes offers to and sometimes is made to
3
Yes, always offers to
4
No, refuses to help
5
No, is not allowed to help

Does he have a space in which he can do things on his own?

1
Yes, his own bedroom
2
A corner of a room
3
No, there is no room for this
4
Something else (please tick and describe)
Other

Does he have brothers and/or sisters living at home (include step and half brothers and sisters)?

1
Yes
2
No
If no, go to section G on page 48
If yes,
qc_F6_a == 1

How many? older brothers

How many

How many? older sisters

How many

How many? younger brothers

How many

How many? younger sisters

How many

Please give the age of: oldest brother ... years old

Age

Please give the age of: oldest sister ... years old

Age

Please give the age of: youngest brother ... years old

Age

Please give the age of: youngest sister ... years old

Age
How often does he do the following with them?
-
Play with toys
Read together
Sing together
Make things, draw or paint
Go out together
Talk together
Eat together
Argue with one another
Does he wear clothes that have been handed down free from others? (Please tick all that apply)
-
yes, from his older brothers &amp; sisters
yes, from other relatives
yes, from friends

Does he ever have clothes bought second-hand for him?

1
Yes
2
No
SECTION G: EATING

Some children just have snacks all day while others wait for meals. How would you describe your child?

1
snacks all day, no real meals
2
snacks all day, but also has meals
3
doesn&#39;t snack much, just has meals
4
other (please tick &amp; describe)
Other

How many real meals a day does your child have now?

How many

In the past year have you had difficulties getting him to eat what you wanted him to?

1
Yes, great difficulty
2
Yes, some difficulty
3
Yes, occasional difficulty
4
No, no difficulty
If yes,
qc_G2 == 1 || qc_G2 == 2 || qc_G2 == 3

please describe the problems:

Generic text
In the past year has he at any time:
-
deliberately not eaten a sufficient amount of food
refused to eat the food you think he should eat
been choosy with food
over-eaten
been difficult to get into an eating routine
Meals in School

Does your study child ever have a mid-day meal provided by the school?

1
Yes
2
No
If no, go to G4d below
If yes,
qc_G4_a == 1

How often?

1
Rarely
2
once in 2 weeks
3
once a week
4
2-4 times a week
5
5 times a week
Please ask him how much he usually eats of this school meal:
-
Main part of meal e.g. meat, egg etc.
potatoes
other cooked vegetables
salad
rice/pasta
pudding

Does your study child ever have packed lunch provided by you?

1
Yes
2
No
If no, go to G5 on page 50
If yes,
qc_G4_d == 1

How often?

1
Rarely
2
once in 2 weeks
3
once a week
4
2-4 times a week
5
5 times a week
Please ask him how much he usually eats of this packed lunch:
-
sandwiches (any type)
pies, pastries, pizza etc.
crisps/savoury snacks
fruit (fresh, dried or tinned)
yoghurt etc.
biscuits/cakes
chocolate/sweets
How many times in a usual month does your study child eat meals away from home (not counting school meals)? If none, write 00.
with a relative ... times with friends ... times in a café/restaurant (e.g. McDonalds) ... times other ... times
How manyHow manyHow manyHow many How manyHow manyHow manyHow many How manyHow manyHow manyHow many How manyHow manyHow manyHow many
Term-time
School holidays
Thinking about all the food that you provide which he eats during the day, how often does he eat the following foods? Please answer every question even if he never eats the food (in this case tick "never" or "rarely"). Do not include meals provided by school.
-
Sausages, burgers
Meat pies/pasties (pork pie, steak/meat pie etc.)
Vegetarian Pies/ Pasties (cheese and onion pasties, vegetable samosa, onion bhaji, vegetable grills etc.)
Ham, bacon, pâté and cold meats (e.g. salami, luncheon meat, garlic sausage etc.)
Meat roast, chops, stews and curries etc. (e.g. beef, lamb, pork, mince)
Liver, kidney, heart
Chicken/turkey in crispy coating (e.g. chicken nuggets, turkey burgers, chicken fingers etc.)
Poultry: roast, grilled, fried, boiled, stewed (chicken, turkey etc.)
Shellfish (prawns, crab, cockles, mussels etc.)
White fish in breadcrumbs or batter (e.g. fish fingers/ shapes, chip shop fish, breaded cod etc.)
White fish without coating (eg. grilled fish, cod in parsley sauce etc.)
Tuna
Other fish (pilchards, sardines, mackerel, herring, kippers, trout, salmon etc.)
Eggs, quiche, omelettes, flan etc.
Cheese
Pizza
Oven chips
Fried chips, potato waffles or croquettes, Alphabites etc.
Roast potatoes (cooked in fat or oil)
Boiled, mashed, jacket potatoes
Rice (boiled, or fried, not rice pudding)
Canned pasta (spaghetti rings, ravioli, macaroni cheese etc.) Pot Noodles, Super Noodles etc.
Boiled pasta (e.g. spaghetti, fusilli, lasagna) bulgar wheat and cous-cous.
Fried food (e.g. fried fish, eggs, bacon, chops etc.)

Does he eat the fat on meat?

1
yes, all of it
2
yes, some of it
3
no, always leaves fat
4
no, never given meat with fat
5
never eats meat
How many times nowadays does he eat:
-
Baked beans
Peas, broad beans
Sweetcorn
Cabbage, brussel sprouts, spinach, broccoli and other dark green leafy vegetables
Other green vegetables (cauliflower, runner beans, leeks, courgettes etc.)
Carrots
Other root vegetables (turnip, swede, parsnip etc.)
Tomatoes (cooked or raw)
Salad (lettuce, cucumber, peppers, other raw vegetables etc.)
Pulses and pulse dishes (dahl, lentil soup, falafel, dried peas, beans, chick peas)
Soya &#39;Meat&#39;, TVP, Soya-type Vegeburgers, Bean Curd (Tofu, Miso etc.)
Peanuts, peanut butter
Other nuts (e.g. cashew), nut roast
Fresh citrus fruit (e.g. oranges, grapefruit , satsumas, tangerines etc.)
Other fresh fruit (e.g. apple, banana, pear, bunch of grapes, peach etc.)
Canned fruit
Yoghurt, Fromage Frais
Milk puddings (e.g. rice pudding, semolina), mousse, Angel Delight etc.)
Ice cream, choc ice, chocolate ice cream bar etc.
Ice lollies
Pudding (e.g. fruit pie, crumble, cheesecake, gateaux)
Custard, cream, Elmlea, Tip-Top, evaporated milk etc. on puddings
Cakes or buns (fruit cake, sponge, teacake, doughnut, flapjack, scone, custard tart, cream cake etc.)
Crispbreads (Ryvita, crackerbread etc.)

Does he eat breakfast cereals at all?

1
Yes
2
No
If no, go to G11 on page 57
If yes,
qc_G9_a == 1
What type of breakfast cereal does he eat nowadays?
-
Oat cereals (e.g. porridge, Ready Brek, Muesli, chocolate Ready Brek)
Wholegrain or bran cereals (e.g. All Bran, Bran Flakes, Weetabix, Wheatflakes, Fruit &amp; Fibre, Shreddies, Shredded Wheat, Sugar Puffs)
Other cereals (e.g . Cornflakes, Rice Krispies, Frosties, Special K, Coco Pops)
When he has breakfast cereals

How often are they sugar/honey coated or chocolate flavoured (eg. Frosties, Coco Pops etc.)

1
Always
2
Sometimes
3
Never
If never go to G10c below
qc_G10_a == 3

How many teaspoonfuls of sugar does he have on other types of cereal (ie. plain cereal)?

1
None
2
1/2 teaspoon
3
One teaspoon
4
2 teaspoons
5
More than 2 teaspoons
7
Doesn&#39;t have plain cereal

How many times per week does he have milk on cereal? ... times

How many
How often nowadays does he eat:
-
Crisps, corn snacks (e.g. Wotsits, Quavers, tortilla chips, etc.)
Full-coated chocolate biscuits (e.g. Club, Kit Kat, Penguin, Breakaway etc.)
Other biscuits (e.g. Rich tea, shortcake, digestive and chocolate digestive, Hob Nobs)
Chocolate bars/buttons (milk, plain or white,) Smarties, Mars bars, Milky Way, Creme Eggs, Rolos etc.
Sweets (individual, packets or bars) Cola bottles, penny mix-ups, chews, jelly sweets, flumps, liquorice, sherbert dips, polos, fruit pastilles, refreshers etc.

On days when he has sweets, how many individual sweets does he eat in that day? Count a chew or jelly sweet as one sweet.

1
1-2 sweets
2
3-5 sweets
3
6-10 sweets
4
11-20 sweets
5
more than 20 sweets
7
never has sweets

On days when he has chocolate or chocolate bars (e.g. Mars bars, bag of buttons): What size bar/packet does he have?

1
Usually eats Funsize
2
Usually eats Adult size
3
Never has chocolate
If Never has chocolate to question G13a Go to G14 on page 58
qc_G13_a == 3
How many times a week nowadays does he drink?
-
Fruit juice from a tin (including tomato juice)
Pure fruit juice from a carton or freshly squeezed
Squash, fruit drinks or Ribena
Cola drinks (e.g. Coca Cola, Pepsi etc.)
Other fizzy drinks (e.g. lemonade, fizzy water)
Plain water on its own
Milk on its own (Please include school milk here)
Flavoured milk drinks (e.g. Horlicks, Ovaltine, milkshakes) or yoghurt drinks

When he has soft drinks (e.g. lemonade, cola, squash), how often are they low calorie, diet or reduced sugar drinks?

1
usually
2
sometimes
3
not at all
7
doesn&#39;t drink soft drinks

When he has cola drinks, how often are they decaffeinated?

1
usually
2
sometimes
3
not at all
7
doesn&#39;t have cola
How often does he eat each of these types of bread?
-
white bread
soft grain white bread (e.g. Mighty White)
brown/granary bread
wholemeal bread
chappatis, pitta bread
naan bread

How many slices of bread, rolls or chappatis does he eat on a usual day?

1
less than 1
2
1-2
3
3-4
4
5 or more

How many slices of bread (or rolls) spread with butter or margarine does he eat each day? (include bought sandwiches) ... slices

How many
What sort of fat does he have:
on bread or vegetables for frying

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

Butter, ghee, dripping, lard, solid cooking fat
Polyunsaturated margarine (e.g. Flora, sunflower margarine, Vitalite)
Hard or soft margarine (e.g. Blue Band, Stork, supermarket own brand)
Low-fat spread (e.g. Delight, St Ivel Gold, Flora Xtra Light)
Sunflower oil, corn oil, soya oil
Olive oil, hazelnut oil, rapeseed oil
Other vegetable oil
Other (please tick &amp; describe)

What sort of fat does he have: on bread or vegetables Other (please tick & describe)

Other

What sort of fat does he have: for frying Other (please tick & describe)

Other

What type(s) of milk does he have? Full fat (silver or gold top)

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does he have? Semi-skimmed (red stripe)

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does he have? Skimmed (blue stripe)

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does he have? Dried milk (e.g. Marvel)

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does he have? Goat/sheep milk

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does he have? Soya milk

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does he have? Other (please tick and describe)

1
Yes usually
2
Yes sometimes
3
No not at all
Other

Is this milk usually:

1
Fresh pasteurised
2
Longlife (UHT)
3
Sterilised
4
Other (please describe)
9
Don&#39;t know
Other

Does he drink tea?

1
Yes
2
No
If no, go to G23a below
If yes,
qc_G22_a == 1

How many cups of tea does he drink in a day? (do not include herbal teas) ... cups a day

How many

How many spoons of sugar in each cup? ... spoons

How many

How many of the cups of tea that he drinks are decaffeinated? ... cups a day

How many

Which description best fits the amount of milk in the tea he drinks?

1
no milk
2
a little milk
3
about 1/4 milk
4
about 1/2 milk
5
about 3/4 milk
6
almost all milk

Does he drink coffee?

1
Yes
2
No
If no, go to G24 on page 62
If yes,
qc_G23_a == 1

How many cups of coffee (real, instant or decaffeinated) does he drink? ... cups a day

How many

How many spoons of sugar in each cup? ... spoons

How many

How many of the cups of coffee he drinks are decaffeinated? ... cups a day

How many

How many of the cups of coffee he drinks are made using real coffee (i.e. not instant)? ... cups a day

How many

How many of these are decaffeinated? ... cups a day

How many

Which description best fits the amount of milk in the coffee he drinks?

1
no milk
2
a little milk
3
about 1/4 milk
4
about 1/2 milk
5
about 3/4 milk
6
all milk

Does he drink herbal teas at all?

1
yes, often
2
yes, occasionally
3
no, not at all
If no, go to G25 below
If yes,
qc_G24_a == 1 || qc_G24_a == 2

how many cups/mugs of herbal tea has he drunk in the past week? ... cups a week

How many

Please list the types of herbal teas he has drunk in the past 3 months:

Generic text

Apart from herbal teas, are there any other health foods (whether or not bought from a health food shop) that he often eats or drinks?

1
Yes
2
No

The questionnaire was completed by: (tick all that apply) mother

1
Yes

This questionnaire was completed by: (tick all that apply) father

1
Yes

This questionnaire was completed by: (tick all that apply) other (please describe)

1
Yes
Other

Please give the date on which you completed this questionnaire:

Generic date

Please give the date of birth of your child:

Date of birth
THANK YOU VERY MUCH FOR YOUR HELP

Space for any additional comments you would like to make

Long text
NB Please remember we cannot reply to any comment unless you sign it.
When completed, please return the questionnaire to: Professor Jean Golding Children of the Nineties - ALSPAC Institute of Child Health
End

alspac_98_msdas

MY SON AT SCHOOL
This questionnaire asks about your study child
It should be completed by the chief carer.
All answers are confidential.
THANK YOU FOR YOUR HELP

SECTION A: THE HEALTH OF YOUR STUDY CHILD

How would you assess the health of your child now? in the past month
1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell
How would you assess the health of your child now? in the past year
1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell
Has he had fluoride supplements (tablets or drops) in the past year?
1
Yes
2
No

Has he had any of the following in the past 12 months?

-
diarrhoea
blood in the stools
vomiting
cough
high temperature
snuffles/cold
ear ache
ear discharge (pus not wax)
convulsions/fits
stomach ache(s)
rash
wheezing
breathlessness
episodes of stopping breathing
an accident
urinary infection
headache(s)
constipation
worm infections
head lice
scabies
asthma
eczema
hay fever
Has he had any of the following in the past 12 months? other (please tick and describe)
1
Yes and saw a doctor
2
Yes but did not see doctor
3
No did not have
Other
Has your child been admitted to hospital in the past year?
1
Yes
2
No
If no, go to A5 on page 4
qc_A4_a == 1
how many times?
How many
qc_A4_a == 1

please describe for each admission:

Age of child (years) Reason for admission No. of nights child stayed in hospital
AgeGeneric textHow many AgeGeneric textHow many AgeGeneric textHow many
1
2
3
qc_A4_a == 1
How often did you see him while he was in hospital? 1st admission
1
Not at all
2
Quite often
3
Every day
4
Stayed in the hospital with him
qc_A4_a == 1
How often did you see him while he was in hospital? 2nd admission
1
Not at all
2
Quite often
3
Every day
4
Stayed in the hospital with him
qc_A4_a == 1
How often did you see him while he was in hospital? 3rd admission
1
Not at all
2
Quite often
3
Every day
4
Stayed in the hospital with him
Has he ever had any of the following operations? hernia repair
1
Yes
qc_A5_a == 1
please give type
Generic text
Has he ever had any of the following operations? tonsils out
1
Yes
Has he ever had any of the following operations? adenoids out
1
Yes
Has he ever had any of the following operations? appendicectomy (appendix out)
1
Yes
Has he ever had any of the following operations? tubes (grommets) put in his ears
1
Yes
Has he ever had any of the following operations? squint repair (to put eyes straight)
1
Yes
Has he ever had any of the following operations? teeth pulled out
1
Yes
Has he ever had any of the following operations? circumcision
1
Yes
Has he ever had any of the following operations? other operations (please describe)
1
Yes
Other
In the past year has he had any periods when there was wheezing with whistling on his chest when he breathed?
1
Yes
2
No
If no, go to A6k on page 6
qc_A6_a == 1
How many separate times has this happened in the past 12 months?
1
once
2
twice
3
3-4 times
4
5 or more times
9
don&#39;t know
qc_A6_a == 1
How many days altogether would you say he has wheezed in the past 12 months?
1
1 day
2
2-3 days
3
4-9 days
4
10-19 days
5
20 or more days
9
don&#39;t know
qc_A6_a == 1
Was he breathless during any of these times?
1
Yes for all
2
Yes for some
3
No not at all
qc_A6_a == 1
Did he have a fever during any of these times?
1
Yes for all
2
Yes for some
3
No not at all
qc_A6_a == 1
How often, on average, has your child's sleep been disturbed due to wheezing in the past 12 months?
1
Never woken with wheezing
2
Less than one night per week
3
One or more nights per week
qc_A6_a == 1
Has wheezing ever been severe enough to limit your child's speech to only one or two words at a time between breaths in the past 12 months?
1
Yes
2
No
qc_A6_a == 1
Do you think the wheezing attacks are worse during any particular time of year?
1
yes, worse in spring and/or summer
2
yes, worse in autumn and/or winter
3
not particularly
4
other (please tick &amp; describe)
Other
qc_A6_a == 1
What do you think brings on the wheezing attacks ? chest infection or bronchitis
1
Yes
2
No
qc_A6_a == 1
What do you think brings on the wheezing attacks ? being in a smoky room
1
Yes
2
No
qc_A6_a == 1
What do you think brings on the wheezing attacks ? cold weather
1
Yes
2
No
qc_A6_a == 1
What do you think brings on the wheezing attacks ? I don't know
1
Yes
2
No
qc_A6_a == 1
What do you think brings on the wheezing attacks ? other (please tick & describe)
1
Yes
2
No
Other
In the past 12 months has your child's chest sounded wheezy during or after exercise?
1
Yes
2
No
In the past 12 months has your child had a dry cough at night, apart from a cough associated with a cold or chest infection?
1
Yes
2
No
Have any of your other children ever had spells of wheezing with whistling on the chest?
1
Yes
2
No
7
have no other children
Has your child had any itchy, dry skin rash in the joints and creases of his body (e.g. behind the knees, elbows, under the arms) in the past year?
1
Yes
2
No
If no, go to A8a on page 7
qc_A7_a == 1
how bad was this?
1
very bad
2
quite bad
3
mild
4
no problem
qc_A7_a == 1
does he have this sort of rash now?
1
Yes
2
No
qc_A7_a == 1
did the rash ever become sore and oozy?
1
Yes
2
No
qc_A7_a == 1
was it made worse by irritants such as bubble bath, soap, wool or nylon clothing?
1
Yes
2
No
Has he had an itchy, dry, rash on his hands in the past year?
1
Yes
2
No
Has he had an itchy, dry rash on his feet in the past year?
1
Yes
2
No
If no, go to A8c below
qc_A8_b == 1
please describe which parts of his feet
Generic text
In the past 12 months how often, on average, has your child been kept awake at night by an itchy rash?
1
Never in the past 12 months
2
Less than one night per week
3
One or more nights per week
Does his skin get itchy when he gets sweaty? (e.g. in a hot room or when he has been playing?)
1
Yes
2
No
Has he had a skin reaction in the past year (e.g. redness or itching) which you thought was due to some food that he had eaten?
1
Yes
2
No
If no, go to A10 on page 8
qc_A9 == 1
please describe the food(s)
Generic text
qc_A9 == 1
how long after the food was eaten did the reaction appear?
Generic text
qc_A9 == 1
where was the reaction? (please describe)
1
mouth
2
other part
Generic text
This question is about problems which occur when your child does not have a cold or the flu.
Has your child ever had a problem with sneezing or a runny or blocked nose, when he did not have a cold or the flu?
1
Yes
2
No
Has he had vomiting spells in the past year?
1
Yes
2
No
If no, go to A12a below
qc_A11_a == 1
How many times?
1
once
2
twice
3
3-9 times
4
10 or more times
qc_A11_a == 1
How often have these been associated with: diarrhoea
1
Always
2
Frequently
3
Sometimes
4
Rarely
5
Never
qc_A11_a == 1
How often have these been associated with: chestiness (wheezing or coughing or grunting)
1
Always
2
Frequently
3
Sometimes
4
Rarely
5
Never
In the past year has he had diarrhoea or gastro-enteritis?
1
Yes
2
No
If no go to A13a on page 10
qc_A12_a == 1
how many times in the past 12 months?
How many
qc_A12_a == 1
how many days did the worst attack last?
How many
qc_A12_a == 1
Did you: call the doctor to come to your home?
1
Yes
2
No
qc_A12_a == 1
Did you: go to your doctor?
1
Yes
2
No
qc_A12_a == 1
Did you: treat it yourself?
1
Yes
2
No
qc_A12_a == 1
Did you: do something else? (please tick & describe)
1
Yes
2
No
Other
qc_A12_a == 1
Did he continue to eat as usual?
1
Yes
2
No
qc_A12_a == 1
If yes, go to (f) below
qc_A12_a == 1
qc_A12_e == 2
how long was normal eating disturbed?
1
less than 1 day
2
1 day
3
2 days
4
3-4 days
5
5 or more days
qc_A12_a == 1
What treatment was given?
Generic text
In the past year has your child ever had a time when he has coughed off and on for at least 2 days?
1
Yes
2
No
If no, go to A14a on page 11
qc_A13_a == 1
How many times has this happened in the past year?
1
once
2
twice
3
3-9 times
4
10 or more times
qc_A13_a == 1
Did he have a fever at any of these times?
1
Yes for all
2
Yes for some
3
No, not at all
qc_A13_a == 1
Did he have a runny nose during any of these spells?
1
Yes for all
2
Yes for some
3
No, not at all
The following questions are about your child's ears and hearing.
Nowadays, does your child listen to people or to things that happen nearby:
1
Yes always
2
Yes often
3
Sometimes
4
Usually not
5
Never
7
Child unable to hear at all
Does he turn his head towards sounds?
1
yes usually
2
yes sometimes
3
only to very loud sounds
4
never turns towards sounds
9
don&#39;t know
Does he prefer music or talking to be loud or soft?
1
He hates loud sounds
2
He doesn&#39;t mind if it&#39;s loud or not
3
He loves loud sounds
4
Can&#39;t say
During or after a cold, is his hearing worse than usual?
1
yes much worse
2
yes a little worse
3
no, about the same
9
don&#39;t know
7
has never had a cold
Has pus or sticky mucus (not ear wax) leaked out of his ear in the past year?
1
never
2
once
3
more than once
9
don&#39;t know
Does he breathe through his mouth rather than through his nose? when asleep
1
all the time
2
much of the time
3
sometimes
4
rarely
5
never
9
don&#39;t know
Does he breathe through his mouth rather than through his nose? when awake
1
all the time
2
much of the time
3
sometimes
4
rarely
5
never
9
don&#39;t know
Does he snore for more than a few minutes at a time?
1
most nights
2
quite often
3
sometimes
4
only rarely
5
never
9
don&#39;t know
When he is asleep, does he seem to stop breathing or hold his breath for several seconds at a time?
1
yes, often
2
yes, sometimes
3
no
9
don&#39;t know
Have there been times in the past year when he has had a pain in his stomach?
1
Yes
2
No
If no, go to A16a on page 14
qc_A15_a == 1
How many separate times has this happened in the past year?
1
once
2
twice
3
3-4 times
4
5 or more times
9
don&#39;t know
qc_A15_a == 1
Did he have vomiting or diarrhoea at the same time as the pain?
1
yes every time
2
yes, for some of the times
3
no, not at all
qc_A15_a == 1

What do you think were the causes of his stomach pains? (Tick all that apply)

-
something he ate
an infection
constipation
don&#39;t know
qc_A15_a == 1
What do you think were the causes of his stomach pains? (Tick all that apply) other (please describe)
1
Yes
Other
Does he often have aches and pains in his arms or legs?
1
yes arm(s)
2
yes leg(s)
3
yes both
4
no, not often
If no, go to A17a below
qc_A16_a == 1
does this happen especially when he is tired?
1
Yes
2
No
qc_A16_a == 1
what do you think is the cause ?
Generic text
qc_A16_a == 1
do you find any particular treatment helps ?
1
Yes
2
No
qc_A16_a == 1
qc_A16_a_iii == 1
please describe
Generic text
Since his 5th birthday has he had any form of convulsion, fit, seizure or other turn in which consciousness was lost or any part of the body made an abnormal movement?
1
Yes
2
No
9
Not known
If no, or not known, go to A18 on page 16
qc_A17_a == 1
Please describe the first attack since his 5th birthday:
Generic text
qc_A17_a == 1
Did the child have a high temperature at the time?
1
Yes
2
No
9
Not known
qc_A17_a == 1
How old was he at the time?
1
5 years
2
6 years
qc_A17_a == 1
How many attacks has he had since his 5th birthday?
1
one
2
two
3
3-4
4
5 or more
qc_A17_a == 1

By whom was he seen for these attack(s)? (Tick all that apply)

-
general practitioner at home
general practitioner at surgery
hospital outpatients
admitted to hospital
qc_A17_a == 1
What investigations, if any, have been carried out?
Generic text
qc_A17_a == 1
Did later attacks differ from the first one?
1
yes
2
no
qc_A17_a == 1
If no go to (j) below
qc_A17_a == 1
qc_A17_h == 1
please describe
Generic text
qc_A17_a == 1

What were the attacks thought to be due to? (Tick all that apply)

-
febrile convulsions
fainting and blackouts
epilepsy
breath holding
reaction to immunisation
don&#39;t know
qc_A17_a == 1
What were the attacks thought to be due to? (Tick all that apply) other (please specify)
1
Yes
Other

In the past year, has he had the following infections?

-
measles
chicken pox
mumps
meningitis
cold sores
whooping cough
urinary infection
eye infection
ear infection
chest infection
In the past year, has he had the following infections? In the past year: other infection (please tick & describe)
1
Yes
2
No
Other
Are there any foods or drinks that your child is or has been allergic to?
1
yes definitely
2
yes possibly
3
no, not at all
9
don&#39;t know
If no, or don't know go to A20a on page 19
qc_A19 == 1 || qc_A19 == 2
please describe which foods or drinks
Generic text
qc_A19 == 1 || qc_A19 == 2
was the reaction caused by eating or touching the food or drink?
1
eating/drinking
2
touching
3
both
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) bright red rash
1
Yes
qc_A19 == 1 || qc_A19 == 2
qc_A19_c_i == 1
over what part of body?
Generic text
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) hives (white raised bumps on skin)
1
Yes
qc_A19 == 1 || qc_A19 == 2
qc_A19_c_ii == 1
over what part of body?
Generic text
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) wheezing or whistling in the chest
1
Yes
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) vomiting
1
Yes
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) diarrhoea
1
Yes
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) difficulty breathing
1
Yes
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) stop breathing
1
Yes
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) headache
1
Yes
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) swelling
1
Yes
qc_A19 == 1 || qc_A19 == 2
qc_A19_c_ix == 1
describe where
Generic text
qc_A19 == 1 || qc_A19 == 2
what happens when he does have the reaction? (Tick all that apply) other reaction (please describe )
1
Yes
Other
qc_A19 == 1 || qc_A19 == 2
How long after eating or drinking or touching does this usually happen?
1
less than 1 hr
2
1-2 hrs
3
3-5 hrs
4
6 hrs or more
9
don&#39;t know
qc_A19 == 1 || qc_A19 == 2
How old was he when this first happened? ... years old
Age
qc_A19 == 1 || qc_A19 == 2
How many times has a reaction happened?
1
once
2
2-3 times
3
4-9 times
4
10 or more times
9
don&#39;t know
qc_A19 == 1 || qc_A19 == 2
How old was he the last time a reaction happened? ... years old
Age
qc_A19 == 1 || qc_A19 == 2

What have you done about these reactions? (Tick all that apply)

-
Avoided the foods that caused them
Took to GP to investigate
Investigated in hospital
qc_A19 == 1 || qc_A19 == 2
What have you done about these reactions? (Tick all that apply) Other (please describe)
1
Yes
Other
qc_A19 == 1 || qc_A19 == 2
What advice have you been given?
1
None
2
Yes, some advice
qc_A19 == 1 || qc_A19 == 2
qc_A19_j ==2
Please describe
Generic text
qc_A19 == 1 || qc_A19 == 2
What treatment has your child been given for the problem?
1
None
2
Yes, some treatment
qc_A19 == 1 || qc_A19 == 2
qc_A19_k ==2
Please describe
Generic text
Apart from food and drink are there any other things to which he is allergic?
1
Yes
2
No
If no, go to A21 on page 20
qc_A20_a == 1
What is he allergic to? (Tick all that apply) pollen
1
Yes
qc_A20_a == 1
What is he allergic to? (Tick all that apply) cat
1
Yes
qc_A20_a == 1
What is he allergic to? (Tick all that apply) dog
1
Yes
qc_A20_a == 1
What is he allergic to? (Tick all that apply) bee sting or wasp sting
1
Yes
qc_A20_a == 1
What is he allergic to? (Tick all that apply) house dust
1
Yes
qc_A20_a == 1
What is he allergic to? (Tick all that apply) medicine
1
Yes
qc_A20_a == 1
qc_A20_b_vi == 1
please describe type of medicine
Generic text
qc_A20_a == 1
What is he allergic to? (Tick all that apply) other (please tick and describe)
1
Yes
Other
qc_A20_a == 1
How does he react to these? (Tick all that apply) wheezing
1
Yes
qc_A20_a == 1
How does he react to these? (Tick all that apply) breathlessness
1
Yes
qc_A20_a == 1
How does he react to these? (Tick all that apply) sneezing
1
Yes
qc_A20_a == 1
How does he react to these? (Tick all that apply) rash
1
Yes
qc_A20_a == 1
How does he react to these? (Tick all that apply) other (please tick and describe)
1
Yes
Other
Spring and Summer problems:

Does your child suffer from any of the following symptoms during Spring or Summer?(Please tick all that apply)

-
runny, red or itchy eyes
frequent sneezing bouts
constantly blocked, runny or itchy nose
nettle-like rash without obvious cause
constant cold
none of the above

Does your child take any of the following medication regularly but just during the Spring or Summer months? (Please tick all that apply)

-
Piriton
Loratadine/Clarityn
Flixonase
Nasonex
Antihistamine eye drops
Triludan
Cetirizine/Zirtek
Beconase
Opticrom eye drops
Does your child take any of the following medication regularly but just during the Spring or Summer months? (Please tick all that apply) Other antihistamine (Please tick & describe)
1
Yes
Other

SECTION B: SLEEPING

Does your child have a regular sleeping routine?
1
Yes
2
No
How many hours sleep does he usually have during the day time?
1
none
2
less than 1 hour
3
1 - 2 hours
4
more than 2 hours
9
don&#39;t know
Normally, during term-time what time in the evening does your child go to sleep? school days ... p.m.
Time
Normally, during term-time what time in the evening does your child go to sleep? on Saturdays ... p.m.
Time
During term-time what time does he normally wake up in the morning? school days ... a.m.
Time
During term-time what time does he normally wake up in the morning? weekend days ... a.m.
Time
How often during the night does he usually wake? ... times
How many
How often during a normal day does he have a sleep? ... times
How many
Where does the child usually sleep? When he goes to bed at night
1
in his own room on his own
2
in a room with other children
3
in your bedroom
4
in a room with other adults
5
other place (please tick &amp; describe)
Other
Where does the child usually sleep? When he wakes in the morning
1
in his own room on his own
2
in a room with other children
3
in your bedroom
4
in a room with other adults
5
other place (please tick &amp; describe)
Other
Does the child sleep on his own most nights or does he share a bed? When he goes to bed at night
1
in his own bed
2
in a bed with other children
3
in your bed with you
4
in a bed with other adult
5
other place (please tick &amp; describe)
Other
Does the child sleep on his own most nights or does he share a bed? When he wakes in the morning
1
in his own bed
2
in a bed with other children
3
in your bed with you
4
in a bed with other adult
5
other place (please tick &amp; describe)
Other
How often does he sleep? on his back
1
Always
2
Usually
3
Sometimes
4
Hardly ever
How often does he sleep? on his side
1
Always
2
Usually
3
Sometimes
4
Hardly ever
How often does he sleep? on his front
1
Always
2
Usually
3
Sometimes
4
Hardly ever
Do you feel his sleep pattern is:
1
better than other children of the same age
2
same as other children of the same age
3
worse than other children of the same age
9
don&#39;t know

In the room where the child sleeps most of the night:

In Winter In Summer

1 - Yes always

2 - Yes sometimes

3 - No not at all

1 - Yes always

2 - Yes sometimes

3 - No not at all

1 - Yes always

2 - Yes sometimes

3 - No not at all

1 - Yes always

2 - Yes sometimes

3 - No not at all

is the heating on all night?
is the heating on part of the night?
is there a window open at night?
does he sleep with a duvet?
does he have an electric blanket?
does he sleep with a pillow?

In the past year has your child:

-
refused to go to bed
woken very early
had difficulty going to sleep
had nightmares
continued to get up after being put to bed
woken in the night
got up after only a few hours sleep
snored
wet the bed
sleep walked
masturbated
In the past year has your child: other (please tick and describe)
1
Yes, but did not worry me
2
Yes, worried me a bit
3
Yes, worried me greatly
4
No, did not happen
9
Don&#39;t know
Other

SECTION C: STRENGTHS AND DIFFICULTIES

Please think how your child has been in the past 6 months
In the last six months: He has been considerate of other people's feelings
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He has been restless, overactive, cannot stay still for long
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He has often complained of headaches, stomach aches or sickness
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He has shared readily with other children (treats, toys, pencils etc.)
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He has often had temper trantrums or hot tempers
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is rather solitary, tends to play alone
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is generally obedient, usually does what adults request
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He has many worries, often seems worried
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is helpful if someone is hurt, upset or feeling ill
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is constantly fidgeting or squirming
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He has at least one good friend
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He often fights with other children or bullies them
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is often unhappy, down-hearted or tearful
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is generally liked by other children
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know
In the last six months: He is easily distracted, his concentration wanders
1
Not true
2
Somewhat true
3
Certainly true
4
Don&#39;t know