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alspac_95_dahomsd
DEVELOPMENT AND HEALTH OF MY DAUGHTER
This questionnaire asks some more questions about your study child. We are interested to know about her health and behaviour and how she gets on with other children.
This questionnaire is like the other questionnaires you have received. To answer simply tick the box which best describes your child or your child's situation. Please answer all questions that you can. If you cannot answer any question or if they do not apply to you please put a line through them. There are no right or wrong answers. Please just describe what happens in your situation. Your may make additional comments at the end. All answers are confidential.
Many of the questions ask you to describe what has happened since your child was 3 - by this we mean since her 3rd birthday.
THANK YOU FOR YOUR HELP
SECTION A: YOUR CHILD'S HEALTH

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 she had fluoride supplements (tablets or drops) in the past 2 years?

1
Yes
2
No
3
Not known
If no or not known go to A3a below
If yes,
qc_A2 == 1

for how long did she have them?

1
less than 1 month
2
1-2 months
3
3-5 months
4
6-11 months
5
more than 12 months
9
don't know

How old was she when she last had fluoride supplements? ... years old

(put 6 if she still has them)

Age

Since your child was 3 years old, has the doctor been called to your home because she was unwell?

1
Yes
2
No
If no, go to A4 on page 3
If yes,
qc_A3_a == 1

how many times?

1
once
2
twice
3
3-4 times
4
5 or more times
Has she had any of the following since she was 3 years old?
-

1 - Yes and saw a doctor

2 - Yes but did not see doctor

3 - No did not have

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
lice or scabies

Has she had any of the following since she was 3 years old? 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 since she was 3 years old?

1
Yes
2
No
If no, go to A6 on page 5
If yes,
qc_A5_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
How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many
1.
2.
3.

How often did you see her while she was in hospital? 1st admission

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

How often did you see her while she was in hospital? 2nd admission

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

How often did you see her while she was in hospital? 3rd admission

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

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

Has she ever had any of the following operations? other operations (please tick and describe)

1
Yes
2
No
Other

Since she was 3 years old has she had any periods when there was wheezing with whistling on her chest when she breathed?

1
Yes
2
No
If no, go to A7g on page 7
If yes,
qc_A7_a == 1

How many separate times has this happened since she was 3 years old?

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

How many days altogether would you say she had wheezed since she was 3 years old?

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 she breathless during any of these times?

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

Did she have a fever during any of these times?

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

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No

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

1
Yes
2
No
Other

Have any of your other children 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 her body (e.g. behind the knees, elbows, under the arms) since she was 3 years old?

1
Yes
2
No
If no, go to A9a below
If yes,
qc_A8_a == 1

how bad was this?

1
very bad
2
quite bad
3
mild
4
no problem

does she 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 she had an itchy, dry, rash on her hands since she was 3 years old?

1
Yes
2
No

Has she had an itchy, dry rash on her feet since she was 3 years old?

1
Yes
2
No
If no, go to A9c on page 8
If yes,
qc_A9_b == 1

please describe which parts of her feet

Generic text

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

1
Yes
2
No

Has she ever had a skin reaction (e.g. redness or itching) which you thought was due to some food that she had eaten?

1
Yes
2
No
If no, go to A11a below
If yes,
qc_A10 == 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?

1
mouth
2
other part please say where
Other

Has she had vomiting spells since she was 3 years old?

1
Yes
2
No
If no, go to A12a on page 9
If yes,
qc_A11_a == 1

How many times?

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

With the vomiting attacks, did she also have: diarrhoea

1
Always
2
Frequently
3
Sometimes
4
Rarely
5
Never

With the vomiting attacks, did she also have: chestiness (wheezing or coughing or grunting)

1
Always
2
Frequently
3
Sometimes
4
Rarely
5
Never

Since she was 3 years old has she 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?

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 and describe)

1
Yes
2
No
Other

Did she continue to eat as usual?

1
Yes
2
No
If yes, go to A12f on page 10
If no,
qc_A12_e == 2

how long was normal feeding disturbed?

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

Was she given an oral rehydration solution?

1
Yes
2
No
9
Don't know
If no or don't know, go to A12g below
If yes,
qc_A12_f == 1

give type if known:

Generic text

how long was the solution given?

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

What other treatment was given?

Other

Since she was 3 years old has your child ever had a time when she 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 since she was 3 years old?

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

Did she have a fever at any of these times?

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

Did she 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 or 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 she turn her head towards sounds?

1
yes usually
2
yes sometimes
3
only to very loud sounds
4
never turns towards sounds
9
don't know

During or after a cold, is her hearing worse than usual?

1
yes, much worse
2
yes, a little worse
3
no, about the same
7
has never had a cold
9
don't know

During recent colds, is the dripping (discharge) from her nose:

7
Hasn't had a cold
If Hasn't had a cold to A14d Go to A14b below
qc_A14_d == 7
Else
During recent colds, is the dripping (discharge) from her nose:
-

1 - Yes usually

2 - Yes sometimes

3 - No never

9 - Don't know

clear
slightly white in colour
thick heavy yellow and/or green in colour (catarrh)
very little discharge occurs at all

Has pus or sticky mucus (not ear wax) leaked out of her ear since she was 3 years old?

1
never
2
once
3
more than once
9
don't know

Does she breathe through her mouth rather than through her nose? when asleep

1
all the time
2
much of the time
3
sometimes
4
rarely
5
never
9
don't know

Does she breathe through her mouth rather than through her nose? when awake

1
all the time
2
much of the time
3
sometimes
4
rarely
5
never
9
don't know

Does she 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't know

When she is asleep, does she seem to stop breathing or hold her breath for several seconds at a time?

1
yes, often
2
yes, sometimes
3
no
9
don't know

Have there been times since she was 3 years old when she has had a pain in her stomach?

1
Yes
2
No
If no, go to A16a on page 14
If yes,
qc_A15_a == 1

How many separate times has this happened since she was 3 years old?

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

Did she 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

What do you think are the causes of her stomach pains (tick all that apply)? something she ate

1
Yes

What do you think are the causes of her stomach pains (tick all that apply)? an infection

1
Yes

What do you think are the causes of her stomach pains (tick all that apply)? constipation

1
Yes

What do you think are the causes of her stomach pains (tick all that apply)? other (please describe)

1
Yes
Other

What do you think are the causes of her stomach pains (tick all that apply)? don't know

1
Yes

Does she often have aches and pains in her arms or legs?

1
yes arm(s)
2
yes leg(s)
3
yes both
4
no, not often
If no, go to A17a on page 15
If yes,
qc_A16_a == 1 || qc_A16_a == 2 || qc_A16_a == 3

does this happen especially when she is tired?

1
Yes
2
No

what do you think is the cause ?

Generic text

do you find any particular treatment helps ?

1
Yes
2
No
If yes,
qc_A16_b_iii == 1

please describe

Generic text

Since she was 3 years old has she 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 17
If yes,
qc_A17_a == 1

Please describe the first attack since her 3rd birthday:

Generic text

Did she have a high temperature at the time?

1
Yes
2
No
9
Not known

How old was she at the time?

1
3 years
2
4 years
3
5 years old

How many attacks has she had since her 3rd birthday?

1
one
2
two
3
3-4
4
5 or more
By whom was she seen for these attack(s)? (tick all that apply)
-

1 - Yes

general practitioner (GP) at home
GP at surgery
hospital outpatients
admitted to hospital

What investigations, if any, have been carried out?

Generic text

Did later attacks differ from the first one ?

1
Yes
2
No
If no, go to (j) below
If yes,
qc_A17_h == 1

please describe

Generic text

What were these thought to be due to? (Tick all that apply) febrile convulsions

1
Yes

What were these thought to be due to? (Tick all that apply) fainting and blackouts

1
Yes

What were these thought to be due to? (Tick all that apply) epilepsy

1
Yes

What were these thought to be due to? (Tick all that apply) breath holding

1
Yes

What were these thought to be due to? (Tick all that apply) reaction to immunisation

1
Yes

What were these thought to be due to? (Tick all that apply) other (please specify)

1
Yes
Other

What were these thought to be due to? (Tick all that apply) don't know

1
Yes

Since she was 3 years old, has she had the following infections? measles

1
Yes
2
No

Since she was 3 years old, has she had the following infections? chicken pox

1
Yes
2
No

Since she was 3 years old, has she had the following infections? mumps

1
Yes
2
No

Since she was 3 years old, has she had the following infections? meningitis

1
Yes
2
No

Since she was 3 years old, has she had the following infections? cold sores

1
Yes
2
No

Since she was 3 years old, has she had the following infections? whooping cough

1
Yes
2
No

Since she was 3 years old, has she had the following infections? urinary infection

1
Yes
2
No

Since she was 3 years old, has she had the following infections? eye infection

1
Yes
2
No

Since she was 3 years old, has she had the following infections? ear infection

1
Yes
2
No

Since she was 3 years old, has she had the following infections? chest infection

1
Yes
2
No

Since she was 3 years old, has she had the following infections? other infection (please tick and describe)

1
Yes
2
No
Other

Approximately how many times in the last 12 months has: the family doctor come to your home because your study child was ill ... times

(put 00 if not at all)

How many

Approximately how many times in the last 12 months has: the family doctor seen your study child in his surgery because she was unwell? ... times

(put 00 if not at all)

How many

Approximately how many times in the last 12 months has: a doctor seen your study child for a routine check? ... times

(put 00 if not at all)

How many
SECTION B: SLEEPING

Does your child have a regular sleeping routine?

1
Yes
2
No

How many hours sleep does she 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 what time in the evening does your child go to sleep? ... p.m.

Generic time

What time does she normally wake up in the morning? ... a.m.

Generic time

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

How many

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

How many

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

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

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

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

Does the child sleep on her own most nights or does she share a bed or cot? When she goes to bed at night

1
in her 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 and describe)
Other

Does the child sleep on her own most nights or does she share a bed or cot? When she wakes in the morning

1
in her 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 and describe)
Other

How often does she sleep? on her back

1
Always
2
Usually
3
Sometimes
4
Hardly ever

How often does she sleep? on her side

1
Always
2
Usually
3
Sometimes
4
Hardly ever

How often does she sleep? on her front

1
Always
2
Usually
3
Sometimes
4
Hardly ever
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

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 she sleep with a duvet?
does she have an electric blanket?
does she sleep with a pillow?

Do you feel her 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 past year has your child regularly:
-

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

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

What time in the evening do you (first) put your child to bed? ... p.m.

Generic time
SECTION C: YOU AND YOUR CHILD

Do you ever have a battle of wills with your child?

1
never
2
rarely
3
sometimes
4
frequently
If never, go to C2 below
qc_C1_a == 1
Else

What are they usually about:

Generic text

Who most often wins?

1
me
2
she does
3
about even
4
neither of us

How often does she refuse to go to bed?

1
most of the time
2
often
3
at times
4
rarely
5
never

How often does she have temper tantrums?

1
more than once a day
2
most days
3
at least once a week
4
less than once a week
5
never
If never, go to C4 on page 24
If she has temper tantrums:
qc_C3_a >= 1 && qc_C3_a <= 4
Why do you think they happen? (please tick all that apply)
-

1 - Yes

failure to get what she wants
failure to make herself understood
reaction to being corrected
no particular reason

Why do you think they happen? (please tick all that apply) other (please tick and describe)

1
Yes
Other
When she has temper tantrums how often do you:
-

1 - Often

2 - Sometimes

3 - Never

ignore it, let her get it out of her system
send her away for 'time out' eg. send her to her bedroom
try to hold and cuddle her
try to reason with her
leave it for someone else to cope with
slap or hit her
try to distract her
shout at her

When she has temper tantrums how often do you: other (please tick and describe)

1
Often
2
Sometimes
3
Never
Other

How often does she do the following: repeatedly rocks her head or body for no reason

1
Often
2
Sometimes
3
Never

How often does she do the following: has a tic or twitch

1
Often
2
Sometimes
3
Never

How often does she do the following: has other unusual behaviour (please tick and describe)

1
Often
2
Sometimes
3
Never
Other

About how often does she go to: local shops

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: department store

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: supermarket

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: park or playground

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: visits to friends

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: visits to relatives

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: library

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: places of interest (e.g. Zoo, museum)

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: places of entertainment (e.g. funfair)

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

About how often does she go to: swimming pool or other sporting area

1
Nearly every day
2
2-5 times a week
3
Once a week
4
Once a month
5
A few times per year
6
Never

How much choice do you allow her in deciding what foods she eats at meals? Main meal

1
she can choose from any food available
2
she is given a choice from a few alternatives that an adult chooses
3
an adult decides what she will eat

How much choice do you allow her in deciding what foods she eats at meals? Snacks

1
she can choose from any food available
2
she is given a choice from a few alternatives that an adult chooses
3
an adult decides what she will eat

Do you allow her to choose what clothes she will wear?

1
she always takes part in choosing
2
she has some choice
3
she has no choice in what she will wear

Does your child have: cuddly toys

1
Yes
2
No

Does your child have: construction toys (e.g. lego)

1
Yes
2
No

Does your child have: co-ordination toys (eg. set of blocks, shape posting box, stacking cups)

1
Yes
2
No

Does your child have: jigsaw puzzles

1
Yes
2
No

Does your child have: action dolls (e.g. Barbie, Power Ranger)

1
Yes
2
No

Does your child have: computer games

1
Yes
2
No

Does your child have: toy cars

1
Yes
2
No

About how many books does she have of her own or that she shares with brothers or sisters?

1
none
2
1 - 2 books
3
3 - 9 books
4
10 or more

How often do you talk to her while you do housework or are occupied in some other way?

1
never
2
rarely
3
sometimes
4
often
5
almost always

Do you have a television set?

1
Yes
2
No
If no, go to C12 on page 28
If yes,
qc_C11_a == 1

How often is your child allowed to watch the television or a video?

1
whenever she wants
2
when I decide it is suitable
3
hardly ever
If hardly ever, go to C12 on page 28
qc_C11_b == 3
Else

When do you normally have the television on? Weekdays

1
all day
2
most of the day
3
1/2 the day
4
less than 1/2 the day
5
not at all

When do you normally have the television on? Weekends

1
all day
2
most of the day
3
1/2 the day
4
less than 1/2 the day
5
not at all
Does your child watch television or a video when it is on?
-

1 - Always

2 - Sometimes

3 - Never

yes, but plays at the same time
yes, and pays attention
no, she ignores it
If she does watch TV,
qc_C11_d_i-iii$1;1,2 == 1 || qc_C11_d_i-iii$1;1,2 == 2

what programmes does she see? (tick all that apply)

9
Don't know

what programmes does she see? (tick all that apply) children's programmes

1
Yes

what programmes does she see? (tick all that apply) other programmes

1
Yes

what programmes does she see? (tick all that apply) children's videos

1
Yes

what programmes does she see? (tick all that apply) other videos

1
Yes

About how close to the TV does she usually sit?

1
less than 1 metre
2
about 1 metre
3
more than 1 metre
4
varies

How often does she play with other children (other than brothers or sisters)?

1
every day
2
2 - 6 times a week
3
once a week
4
less than once a week
5
never

When you and your child meet again after being apart for an hour or more, does she tell you what she's been doing?

1
yes, always
2
yes, sometimes
3
hardly ever
4
never
7
we are never apart
Many children have particular types of activities that they prefer or toys they play with.
How often has your daughter played with the following in the past month:
-

1 - Never

2 - Hardly ever

3 - Sometimes

4 - Often

5 - Very often

Guns (or objects used as guns)
Jewellery
Tool set
Dolls
Trains, cars or aeroplanes
Swords (or objects used as swords)
Tea set
How often in the past month has she done the following:
-

1 - Never

2 - Hardly ever

3 - Sometimes

4 - Often

5 - Very often

Played house (e.g. cleaning, cooking)
Played with girls
Pretended to be a female person (e.g. a princess)
Pretended to be a male character (e.g. a soldier)
Played at fighting
Played at being a mother or father
Played ball games
Climbed (fence, tree, climbing frame)
Played at looking after babies
Showed interest in real cars, trains and aeroplanes
Dressed up in girlish clothes
Played with boys

How often does she: Like to explore new surroundings

1
Never
2
Hardly ever
3
Sometimes
4
Often
5
Very often

How often does she: Enjoy rough and tumble play

1
Never
2
Hardly ever
3
Sometimes
4
Often
5
Very often

How often does she: Show interest in spiders, insects or snakes

1
Never
2
Hardly ever
3
Sometimes
4
Often
5
Very often

How often does she: Avoid getting dirty

1
Never
2
Hardly ever
3
Sometimes
4
Often
5
Very often

How often does she: Like pretty things

1
Never
2
Hardly ever
3
Sometimes
4
Often
5
Very often

How often does she: Avoid taking risks

1
Never
2
Hardly ever
3
Sometimes
4
Often
5
Very often

Do you feel that she dominates the household?

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

Do you start by being firm but then give way?

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

Space for comments:

Generic text

How often does your partner do these activities with your child?

7
Have no partner
If Have no partner Go to C19 on page 32,
qc_C18 == 7
Else
How often does your partner do these activities with your child?
-

1 - Often

2 - Sometimes

3 - Rarely

4 - Never

gives her a bath or shower
makes things with her
sings to her
reads to her
plays with toys
cuddles her
active play (eg. ball games, hide and seek)
takes her to a park or playground
puts her to bed
takes her swimming
draws or paints with her
prepares food for her

How often does your partner do these activities with your child? other (please tick and describe)

1
Often
2
Sometimes
3
Rarely
4
Never
Other
How often do you do these activities with your child?
-

1 - Often

2 - Sometimes

3 - Rarely

4 - Never

bath (or shower) her
make things with her
sing to her
read to her
play with toys
cuddle her
active play (eg. ball games, hide and seek)
take her to the park or playground
put her to bed
take her swimming or other activity
draw or paint with her
prepare food for her

How often do you do these activities with your child? other (please describe)

1
Often
2
Sometimes
3
Rarely
4
Never
Other

About how often does your child do the following: Go to a park or playground

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

About how often does your child do the following: Play a musical instrument (e.g. piano, recorder)

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

About how often does your child do the following: Go to a library

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all
Other

About how often does your child do the following: Go to Sunday school

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all
Other

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all
Other

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

About how often does your child do the following: See her grandparents

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

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

1
Every day
2
2 - 6 times a week
3
once a week
4
once a month
5
not at all

Has she had her ears pierced ?

1
Yes
2
No
SECTION D: UPSETTING EVENTS
Below are listed some events that might upset some children. Please state whether any of these has happened since she was 3 years old.

Since her 3rd birthday: She was taken into care*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: A pet died

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She moved home

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She had a shock or fright*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She was physically hurt by someone*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She was sexually abused*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She was separated from her mother*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She was separated from her father*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She acquired a new mother or father*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She had a new brother or sister

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She was admitted to hospital

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She changed care taker (i.e. the person mostly looking after her)

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She was separated from someone else*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She started a new nursery or kindergarten

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: She started school

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen

Since her 3rd birthday: Something else*

1
Yes and she was very upset
2
Yes and she was quite upset
3
Yes and she was a bit upset
4
Yes but she wasn't upset
5
No did not happen
If yes, to any marked *,
qc_D1-D15$*;1,5:9,13,16 >= 1 && qc_D1-D15$*;1,5:9,13,16 <=4

please give details below:

Generic 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 ask your child to do the task.

Is she is able to walk?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Is she 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
7
Is unable to try this

Is she able to run?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she jump forward with both feet together?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she walk on tiptoe?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she run on tiptoe?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she hop on one foot for 3 steps?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she walk backwards for 4 steps?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she run upstairs?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she ride a tricycle?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she ride a bicycle?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she swim with waterwings?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she swim without waterwings?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she do a handstand against the wall?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she skip with a skipping rope?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she stand on her head?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she hold a pencil and scribble?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she copy a vertical line with a pencil?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she wiggle her thumb?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she draw a circle (more or less)?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she bang together two objects that she is holding?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she draw (or copy) a cross?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she draw (or copy) a square?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she write her name?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she write any numbers?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

If you ask her 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

Can she pick up a small object using finger and thumb only?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she turn the pages of a book?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she build a tower putting one object on top of another?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she build a tower of 4 bricks?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she build a tower of 6 bricks?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she build a tower of 8 bricks?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she put bricks together to make a bridge?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she show interest in pictures in books?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she notice details in pictures and photographs?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she recognise the colours red, yellow and blue?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she recognise orange, brown and purple?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she recognise her name when written?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she 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
7
Is unable to try this

Does she 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
7
Is unable to try this

Can she read simple words ?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she 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
7
Is unable to try this

Does she understand numbers 1 and 2?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she understand numbers 3 and 4?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she understand numbers 5 to 10?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she count up to 20?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she count up to 100?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she share her toys with other children?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she share the toys of other children, understanding that they are not hers?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she 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
7
Is unable to try this

Does she 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
7
Is unable to try this

Can she kick a large ball?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she throw a small ball underarm?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she throw a small ball overarm?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she 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
7
Is unable to try this

Does she take turns in a game without fuss?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

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

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she play any board games?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she drink from a cup or mug?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she eat skilfully with a spoon?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she 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
7
Is unable to try this

Does she cut her food with a knife?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she sit at 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
7
Is unable to try this

Can she wash and dry her hands on her own?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she brush her teeth on her own?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she get dressed without help?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she get undressed without help?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she do up buttons?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she tie a bow?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she brush and comb her hair?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she 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
7
Is unable to try this

Can she 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
7
Is unable to try this

Does she talk clearly?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Does she 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
7
Is unable to try this

Does she ask sensible questions?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she carry on a conversation?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she say at least 3 nursery rhymes?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she sing at least 3 songs?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she hum a tune?

1
Yes, can do well
2
Yes, does but not very well
3
Has not yet done
7
Is unable to try this

Can she 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
7
Is unable to try this

Does she 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
7
Always

Is her voice hoarse or husky?

1
Never
2
Sometimes
3
Often
7
Always

Can you understand what she says?

1
Never
2
Sometimes
3
Often
7
Always

Can your family understand what she says?

1
Never
2
Sometimes
3
Often
7
Always

Can visitors to your house understand what she says?

1
Never
2
Sometimes
3
Often
7
Always

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

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

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

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.
-

1 - Always

2 - Sometimes

3 - Never

talk a lot
stay mainly silent
seem to avoid looking at people's faces when she talks
echo what has just been said to her (e.g. you say; 'we are going out now' she says: 'going out now'.)

Does your daughter 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 English spoken in your household?

1
Yes
2
No
If no, go to E13 on page 45
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 spoken
2
both English and other language used equally
3
other is the main language spoken
7
no such person at home

Is English the main language spoken? By study child

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

Is English the main language spoken? By partner

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

Is English the main language spoken? By other children

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

Space for comments.

Long text

Are you worried about any aspects of your child's growth and development? her speech

1
Yes I am worried
2
No I am not worried

Are you worried about any aspects of your child's growth and development? her weight

1
Yes I am worried
2
No I am not worried

Are you worried about any aspects of your child's growth and development? her height

1
Yes I am worried
2
No I am not worried

Are you worried about any aspects of your child's growth and development? her behaviour

1
Yes I am worried
2
No I am not worried

Are you worried about any aspects of your child's growth and development? her general development

1
Yes I am worried
2
No I am not worried

Are you worried about any aspects of your child's growth and development? other

1
Yes I am worried
2
No I am not worried
If yes,
qc_E13_a == 1 || qc_E13_b == 1 || qc_E13_c == 1 || qc_E13_d == 1 || qc_E13_e == 1 || qc_E13_f == 1

to any of these, please describe what worries you:

Generic text
This is confidential information. 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: TEMPERAMENT AND BEHAVIOUR

How often is your child's behaviour like that given below: She tends to be shy

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She cries easily

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She likes to be with people

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is always on the go

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She prefers playing with others rather than alone

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is somewhat emotional

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: When she moves about she moves slowly

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She makes friends easily

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is off and running as soon as she wakes up in the morning

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She finds people more stimulating than anything else

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She fusses and cries

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is very sociable

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is very energetic

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She takes a long time to warm to strangers

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She gets upset easily

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is something of a loner

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She prefers quiet inactive games to more active ones

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: When alone she feels isolated

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She reacts intensely when upset

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is very friendly with strangers

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She bullies other children

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is very restless, hardly ever still.

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is squirmy or fidgety

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She destroys her own things or those belonging to others

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She fights with other children

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is not much liked by other children

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She worries about many things

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She does things on her own. She is rather solitary

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is irritable. Is quick to fly off the handle

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She appears miserable, unhappy, tearful or distressed

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She takes things belonging to others

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She bites her nails or fingers

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is disobedient

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She cannot settle to do anything for more than a few moments

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is afraid of new things or new situations

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She is fussy or over- particular

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She tells lies

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She likes to sit and watch TV rather than play active games

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She laughs a lot

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She smiles when she sees her parent(s)

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She likes a cuddle

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often is your child's behaviour like that given below: She really enjoys life

1
Never
2
Rarely
3
Sometimes
4
Often
5
Always

How often does she join in with others?

1
Never
2
Often
3
Sometimes

How often does she find it hard to wait for her turn in a game?

1
Never
2
Sometimes
3
Often
4
Always

How many children choose to play with her?

1
None
2
1 or 2
3
3 or more

How upset does she get over quite small things? (e.g. breaking things, getting dirty hands, falling over?)

1
Not at all
2
Sometimes
3
Often
4
Nearly always

How easy is it to comfort her when she is upset?

1
Very easy
2
Quite easy
3
Quite hard
4
Very hard

How often will she comfort another child who is upset, or get someone else to help?

1
Never
2
Sometimes
3
Often
4
Always

How often does she tell you things about others that you know are not true to get them into trouble.

1
Never
2
Sometimes
3
Often
4
Always

How often, when you ask her to do something does she do it straight away?.

1
Never
2
Sometimes
3
Often
4
Always

How good would you describe her at sitting still (for a meal or story)?

1
Is very active - doesn't sit still when she should
2
Can usually sit still when she should
3
Can sit still for a long time
4
Is very inactive

How long can she concentrate on a game or task you have given her to do?

1
Up to 2 minutes
2
2-5 minutes
3
5-10 minutes
4
10-15 minutes
5
More than 15 minutes

How often is she too demanding of you? (e.g. asking for help for a task she can do herself)

1
Less than once a month
2
Once a month
3
Once a week
4
Once a day
5
More than once a day

How often, does she whine or moan with little reason?

1
Less than once a month
2
Once a month
3
Once a week
4
Once a day
5
Two or three times a day

How often, is she unhappy for no apparent reason?

1
Less than once a month
2
Once a month
3
Once a week
4
Once a day
5
Two or three times a day

How often, if you leave the room does she want to follow you?

1
Never
2
Sometimes
3
Often
4
Always

Does she ever refuse to do as she's told by other adults (not her parents)?

1
No not at all
2
Yes sometimes
3
Yes often
4
Yes always

Does she interrupt, butt in, when others are talking

1
No not at all
2
Yes sometimes
3
Yes often
4
Yes always

Does she talk far too much?

1
No not at all
2
Yes sometimes
3
Yes often
4
Yes always

How often do you understand what she says?

1
Never
2
Occasionally
3
About half the time
4
Most of the time
5
Always

When you tell her something how often does she try to understand?

1
Never
2
Sometimes
3
Often
4
Always

Does your study child have brothers or sisters?

1
Yes
2
No
If no, go to F63a on page 54
If yes,
qc_F62_a == 1

How often: Is she teased by them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Does she tease them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Is she deliberately provoked by them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Does she deliberately provoke them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Is she willing to share things with them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Is she interrupted by them when she is working or playing?

1
Never
2
Sometimes
3
Often
9
Not sure

Does your study child have contact with other children?

1
Yes
2
No
If no, go to F64 below
If yes,
qc_F63_a == 1

How often: Is she teased by them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Does she tease them

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Is she deliberately provoked by them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Does she deliberately provoke them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Will she share things with them?

1
Never
2
Sometimes
3
Often
9
Not sure

How often: Is she interrupted by them when she is doing somthing?

1
Never
2
Sometimes
3
Often
9
Not sure
Please tick any of the following activities your child willingly undertakes.
-

1 - Yes

Handicraft (e.g. painting, drawing, making things )
Playing on mobile toys (e.g. cycle, scooter, ride on trucks
Music (e.g. listening, singing, dancing)
Climbing on things (e.g. climbing frame, low walls)
Constructive toys (e.g. lego)
Imaginative play (pretend games)
Messy play (e.g. sand, water, mud)
Investigative play (finding out how things work)

Please tick any of the following activities your child willingly undertakes. Other (please tick and describe)

1
Yes
Other

How often does she speak freely when she is with adults? Adults who are family

1
Never
2
Sometimes
3
Often
4
Nearly always
9
Not sure

How often does she speak freely when she is with adults? Other adults

1
Never
2
Sometimes
3
Often
4
Nearly always
9
Not sure

How often does she speak freely when she is with children? Children who are family

1
Never
2
Sometimes
3
Often
4
Nearly always
9
Not sure
7
No such children

How often does she speak freely when she is with children? Other children

1
Never
2
Sometimes
3
Often
4
Nearly always
9
Not sure

How often does she: Deliberately tear things (e.g wallpaper, books)

1
Never
2
Sometimes
3
Often
9
Don't know

How often does she: Deliberately break toys

1
Never
2
Sometimes
3
Often
9
Don't know

How often does she: Wander about aimlessly

1
Never
2
Sometimes
3
Often
9
Don't know

How often does she: Stare into space

1
Never
2
Sometimes
3
Often
9
Don't know

How often does she: Seem to have nothing to do

1
Never
2
Sometimes
3
Often
9
Don't know
When you take her out somewhere, how often does she behave in the ways listed below?

(Please put a tick against EACH listed behaviour)

-

1 - Never

2 - Sometimes

3 - Often

4 - Always

Does what you ask
Runs off
Has a tantrum
Is fun to be with
Is interested in what is going on
Is aware of the reactions of others

When trying to tell you something, does she: Have a stutter or stammer ?

1
Yes
2
No

When trying to tell you something, does she: Have a lisp?

1
Yes
2
No

When trying to tell you something, does she: Say things that do not make sense?

1
Yes
2
No
How often does she do the things listed below to family members? FAMILY
ADULTS CHILDREN

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

Kick them
Hit them
Fight them
Swear at them
Use angry words
As far as you know, how often does she do the things below to people who are not family members? NOT FAMILY
ADULTS CHILDREN

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

1 - Never

2 - Sometimes

3 - Often

Kick them
Hit them
Fight them
Swear at them
Use angry words
Most children have some fears. Is your child ever afraid of:
-

1 - Yes

2 - No

7 - Has not experienced this

Haircut
Using the toilet
Doctors
Hospital
TV programmes
Vacuum cleaner
Being alone
Stories
Dogs
Cats
Other animals
Insects
Thunder/loud noises
The dark
Strangers
Going out
Car, bus, train, tube train
Lift, escalator
Water, the bath
Getting dirty

Most children have some fears. Is your child ever afraid of: Other (please tick and describe)

1
Yes
2
No
7
Has not experienced this
Other
How often does she do the following things?
-

1 - Never

2 - Sometimes

3 - Often

Wet the bed when she is ill
Wet the bed when she is nervous or excited about something
Wet the bed when there is no apparent reason
As far as you know, how often does she take things and keep them without permission?
-

1 - Never

2 - Sometimes

3 - Often

9 - Not sure

Takes from children in the family
Takes from other adults
Takes from adults in the family
Takes from other adults

Does your child show any other behaviours that cause problems?

1
Yes
2
No
If yes,
qc_F75 == 1

please describe

Generic text

Space for you to describe the strong points of her behaviour.

Generic text
SECTION G

This 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 that we cannot respond personally to your comments unless they are signed.
When completed, please return the questionnaire to:
Professor Jean Golding Children of the Nineties - ALSPAC Institute of Child Health
End

alspac_95_dahomsd

DEVELOPMENT AND HEALTH OF MY DAUGHTER
This questionnaire asks some more questions about your study child. We are interested to know about her health and behaviour and how she gets on with other children.
This questionnaire is like the other questionnaires you have received. To answer simply tick the box which best describes your child or your child's situation. Please answer all questions that you can. If you cannot answer any question or if they do not apply to you please put a line through them. There are no right or wrong answers. Please just describe what happens in your situation. Your may make additional comments at the end. All answers are confidential.
Many of the questions ask you to describe what has happened since your child was 3 - by this we mean since her 3rd birthday.
THANK YOU FOR YOUR HELP

SECTION A: YOUR CHILD'S HEALTH

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 she had fluoride supplements (tablets or drops) in the past 2 years?
1
Yes
2
No
3
Not known
If no or not known go to A3a below
for how long did she have them?
1
less than 1 month
2
1-2 months
3
3-5 months
4
6-11 months
5
more than 12 months
9
don't know
How old was she when she last had fluoride supplements? ... years old
Age
Since your child was 3 years old, has the doctor been called to your home because she was unwell?
1
Yes
2
No
If no, go to A4 on page 3
how many times?
1
once
2
twice
3
3-4 times
4
5 or more times

Has she had any of the following since she was 3 years old?

-

1 - Yes and saw a doctor

2 - Yes but did not see doctor

3 - No did not have

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
lice or scabies