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alspac_99_msdw
My Daughter's Well-being
This questionnaire asks about your study child.
It should be completed by the chief carer.
To answer simply tick the box that is most accurate in your opinion.
If you cannot answer certain questions please put a line through them.
All answers are confidential.
THANK YOU FOR YOUR HELP
SECTION A: YOUR CHILD'S HEALTH
The health of your study child is still of great importance to us. We would like to know about any recent illnesses or medical treatment.

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

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

In the past 12 months has the doctor been called to your home because she was unwell?

1
Yes
2
No
If no, go to A3 below
If yes,
qc_A2_a == 1

how many times?

1
once
2
2 times
3
3-4 times
4
5 or more times
Has she 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 she 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 a doctor ever actually said that your study child has asthma?

1
Yes
2
No
In the past 12 months, has she had the following infections?
-
measles
chicken pox
mumps
meningitis
cold sores
whooping cough
urinary infection
eye infection
ear infection
chest infection
tonsillitis or laryngitis
german measles
scarlet fever
influenza (flu)
a cold

In the past 12 months, has she had the following infections? other infection (please tick & describe)

1
Yes
2
No
Other
How many days has she had to take off school for health reasons?
No. of days off school please describe
How manyGeneric text How manyGeneric text
For one or more infections (including colds, cough, flu )
For hospital investigation including admission
For other investigation(s)

How many days has she had to take off school for health reasons? In the past 12 months: For asthma, eczema or hayfever ... No. of days off school

How many
How many days has she had to take off school for health reasons?
No. of days off school
Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child in the last 12 months.
- If yes, please give full names of substances if you can

1 - Never

2 - Yes for 1-2 episodes only

3 - Yes for 3 or more episodes

Generic text

1 - Never

2 - Yes for 1-2 episodes only

3 - Yes for 3 or more episodes

Generic text
cough medicine
antibiotics/penicillin
throat medicine
vitamins
paracetamol/calpol
ointment for skin
eye ointment
diarrhoea mixture or pills
dimotapp/decongestant
ear drops
eye drops
iron
laxative
homeopathic medicine
herbal medicine
asthma medication
vaporiser

Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child in the last 12 months. other (please tick and describe)

2
Yes for 1-2 episodes only
3
Yes for 3 or more episodes
Other
If yes,
qc_A7_r == 2 || qc_A7_r == 3

please give full names of substances if you can

Generic text

Are there any pills, ointments or medicines that she has taken every day or nearly every day for the last 3 months? (Include vitamins, skin cream, inhaler, laxatives as well as antibiotics, homeopathic and herbal remedies etc.)

1
Yes
2
No
If no, go to B1 on page 9
If yes,
qc_A8_a == 1

please describe:

Generic text
SECTION B: USING THE TOILET

When she needs to go to the toilet to urinate (pass water): How often does she show signs (e.g. fidgets) that she needs to go?

1
never
2
sometimes
3
often

When she needs to go to the toilet to urinate (pass water): When she needs to, how often does she go to the toilet without you having to remind her?

1
never
2
sometimes
3
often
4
always

When she needs to go to the toilet to urinate (pass water): Does she have to dash to the toilet quickly when she realises she needs to go?

1
yes, has to go straight away
2
can hold for a short time (less than 5 minutes)
3
can hold for longer than 5 minutes

When she needs to go to the toilet to urinate (pass water): How often does she usually go to the toilet to pass water during the day?

1
less than 5 times a day
2
5-9 times a day
3
10 or more times a day
9
don't know

When she needs to go to the toilet to urinate (pass water): How often does she usually get up to go to the toilet at night?

1
not at all
2
once
3
twice
4
3 or more times
9
don't know

How often usually does your child: dirty her pants during the day

1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day

How often usually does your child: dirty herself at night

1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day

How often usually does your child: wet herself during the day

1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day

How often usually does your child: wet the bed at night

1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day
If she wets at night,
qc_B1_i >= 2 && qc_B1_i <= 6
If she wets at night, how often does she:
-
wake up after wetting
seem to wet soon after going to sleep
seem upset when the bed is wet
Which of the following methods have you tried in the past or are using now to try and help your child stop wetting during the day? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting during the day).
Have used in the past Using now

1 - Yes

1 - Yes

1 - Yes

1 - Yes

taking her to the toilet regularly
encouraging child to &#39;hold on&#39; before using the toilet
drinking more fluids
drinking less fluids
medication
praising for dry pants
showing your displeasure
advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe

Which of the following methods have you tried in the past or are using now to try and help your child stop wetting during the day? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting during the day). advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe

Generic text
Which of the following methods have you tried in the past or are you using now to try and help your child stop wetting the bed? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting the bed).
Have used in the past Using now

1 - Yes

1 - Yes

1 - Yes

1 - Yes

lifting (taking your child out of bed to the toilet)
restricting drinks before bed
getting her to toilet regularly in the day
rewarding for being dry
medication
homeopathy
hypnosis
an alarm that wakes the child when she wets
showing your displeasure
using night-time protection pants or nappies
advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe

Which of the following methods have you tried in the past or are you using now to try and help your child stop wetting the bed? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting the bed). advice from a health worker (e.g. health

visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe

Generic text
SECTION C: SEPARATION ANXIETY
Most children are particularly attached to one person or a few key people, looking to them for security, and turning to them when upset. They can be mum and dad, grandparents, favourite teachers, neighbours etc.

Who would you say your study child is particularly attached to? (tick all that apply)

2
No-one
If no-one to question C1, go to D1 on page 15
qc_C1 == 2
Most children have some worries about being separated from the people they are most attached to. We would like to know how your study child compares with other children of her age. We are interested in how she is usually - not the occasional "clingy day" or "off day".

Overall in the past month, has she been particularly worried about being separated from any of the people ticked in C1 above?

1
Yes
2
No
In the past month, compared with other children of the same age:
-
Has she often worried about something unpleasant happening to these people, or about losing them?
Has she often worried that she might be taken away from any of them, e.g. by being kidnapped, taken to hospital or killed?
Has she often not wanted to go to school in case something nasty happened whilst she was still at school to a person(s) she is attached to? (Do not include reluctance to go to school for other reasons, e.g. fear of bullying or exams)
Has she worried about sleeping alone?
Has she come out of her bedroom at night to check on, or to sleep near any of these people?
Has she worried about sleeping in a strange place?
Has she been afraid of being alone in a room at home without one of the people she is attached to (even if you or they are close by)?
Has she had repeated nightmares or bad dreams about being separated from any of these people?
Has she had headaches, stomach aches or felt sick when she had to leave a person she is attached to, or when she knew it was about to happen?
Has being apart or the thought of being apart from a person she is attached to led to worry, crying, tantrums, clinginess or misery?
below. If not, go to D1 on page 15.
qc_C3_a-j == 3

How long has she had worries about separation?

1
Less than 1 month
2
1-5 months
3
6 months or more

Was she like this before the age of 6?

1
Yes
2
No

How much do you think these worries have upset her?

1
not at all
2
only a little
3
quite a lot
4
a great deal
How much have these worries interfered with her day-to-day life?
-
how well she gets on with you and the rest of the family?
making and keeping friends?
learning or school work?
playing, hobbies, sports or other leisure activities?

Have these problems put a burden on you or the family as a whole?

1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
SECTION D: PARTICULAR FEARS
This section of the questionnaire is about any particular things or situations that your study child is scared of, even though they aren't really a danger to her. How is she usually - not on the occasional "off day"?
How scared is your study child about any of the following?
-
insects, spiders, wasps, bees, mice, snakes, birds or any other creature
storms, thunder, heights or water
blood, injection or injury
dentists or doctors
other specific situations: lifts, tunnels, flying, driving, trains buses, small enclosed spaces
the dark

How scared is your study child about any of the following? She is scared of: any other specific fear? (please tick & describe)

1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
Other

How scared is your study child about any of the following? She is scared of:

1
not particularly scared of anything
If so, go to E1 on page 18
qc_D1_h == 1
SECTION E: SOCIAL FEARS

Overall does your study child particularly fear or avoid situations that involve a lot of people or meeting new people or doing things in front of people? Do not count the occasional "off day" or ordinary shyness.

1
Yes
2
No
Has she been particularly afraid of any of the following situations over the last month?
-
Meeting new people
Meeting a lot of people such as at a party
Speaking in class
Reading out loud in front of others
Writing in front of others
Eating in front of others
If you have ticked 'a lot' to ANY of the answers in E2 above, continue below. If not, go to F1 on page 21.
qc_E2_a-f == 3

Are her fears of being with a lot of people mainly related to her fear of being separated from someone she is attached to, or are the fears still there even when she is with such a person?

1
mainly afraid only when separated from her special people
2
afraid even when with one of her special people

Is your study child just afraid in these situations with adults, or is she also afraid in situations that involve lots of children, or meeting new children?

1
only with adults
2
with both adults and children
3
only with children

Outside of these situations is your study child able to get on well enough with the adults and children she knows best?

1
Yes
2
No

Do you think her dislike of these situations is because she is afraid she will act in a way that will be embarrassing or show her up?

1
Yes, definitely
2
Not sure
3
No

Is it related to speech, reading or writing problems?

1
Yes
2
Not sure
3
No

Why else do you think she dislikes such situations?

Generic text

How long has she had this fear of being with lots of people, or doing things in front of lots of people, or meeting new people?

1
less than one month
2
1-5 months
3
6 months or more

What age did it begin?

1
under 6 years
2
6 years or older

When your study child is in one of these situations she fears, or when she thinks she is about to be in one, how anxious or upset does she usually become?

1
very anxious or upset
2
just a bit
3
not at all
If 'not at all' go to E10 on on page 20
qc_E8 == 3

Does her fear lead to avoiding these situations?

1
yes, a lot
2
a little
3
no
If 'a little' or 'no' go to E10c below
qc_E10_a == 2 || qc_E10_a == 3

Does she recognise that this fear is excessive or unreasonable?

1
no
2
perhaps
3
definitely

Is she upset about having this fear?

1
no
2
perhaps
3
definitely

Has your study child's fear of these situations put a burden on you or the family as a whole?

1
not at all
2
a little
3
quite a lot
4
a great deal

Space for comments

Generic text
SECTION F: DISASTERS AND FRIGHTS

During your study child's lifetime has anything exceptionally stressful happened to her, that would really upset almost anyone, such as being involved in a terrible accident, or being abused or some other sort of disaster?

1
Yes
2
No
If no, go to G1 on page 24
If yes,
qc_F1 == 1

what was it? (please describe)

Generic text

how old was she ? ... years

Age

At the time, was she very distressed or did her behaviour change dramatically?

1
Yes
2
No

At present, is it affecting her behaviour, feelings or concentration?

1
Yes
2
No
Over the last month has your study child:
-
&quot;relived&quot; the event with vivid memories (flashbacks) of it?
had repeated distressing dreams of the event?
got upset if anything happened which reminded her of it?
tried to avoid thinking or talking about anything to do with the event?
tried to avoid activities, places or people that remind her of the event?
blocked out important details of the event from her memory?
shown much less interest in activities she used to enjoy?
expressed a smaller range of feelings than in the past, e.g. no longer able to express loving feelings?
had problems sleeping?
seemed irritable or angry?
had difficulty concentrating?
always been on the alert for possible dangers?
jumped at little noises or been easily startled in other ways?
If you have ticked 'yes, a lot' to ANY answers in F4, continue below. If not, go to G1 on page 24.
qc_F4_a-m == 3

How long after the event did these problems begin?

1
within 6 months
2
more than 6 months after the event

How long has she been having these problems?

1
Less than one month
2
1-2 months
3
3 months or more

How much have these problems upset or distressed her?

1
Not at all
2
only a little
3
quite a lot
4
a great deal
How much have these problems interfered with her day-to-day life?
-
how well she gets on with you and the rest of the family?
making and keeping friends?
learning or school work?
playing, hobbies, sports or other leisure activities?

Have these problems put a burden on you or the family as a whole?

1
Not at all
2
only a little
3
quite a lot
4
a great deal

Space for comments

Long text
SECTION G: COMPULSIONS AND OBSESSIONS
Many children have some habits or superstitions, such as not stepping on the cracks in the pavement, or needing to wear lucky clothes. It is also common for children to go through phases when they seem obsessed by one particular subject or activity. In this section we are interested in whether your study child has rituals or obsessions that go beyond this.

Overall, does she have rituals or obsessions that upset her, waste a lot of her time, or interfere with her ability to get on with everyday life?

1
Yes
2
No
In the past month has your study child been doing any of the following things over and over again even though she has already done them or doesn't need to do them at all?
-
Excessive cleaning e.g. hand washing, baths, showers, toothbrushing etc.
Other special measures to avoid dirt, germs or poisons
Checking things, e.g. doors, locks, oven, gas taps, electric switches
Repeating actions: e.g. going in/out door many times in a row, up/down from chair
Touching things or people in particular ways
Arranging things so they are just so, or exactly symmetrical
Counting to particular lucky numbers or avoiding unlucky numbers

In the past month has your study child been doing any of the following things over and over again even though she has already done them or doesn't need to do them at all? Anything else? (please tick and describe)

1
No
2
Sometimes
3
Often
Other

In the past month, has she been concerned about: dirt, germs or poison

1
No
2
Sometimes
3
Often

In the past month, has she been concerned about: something terrible happening to herself or others e.g. illnesses, accidents, fires etc.

1
No
2
Sometimes
3
Often
If you have ticked 'often' to ANY answers in G2 or G3, continue below. If not, go to H1 on page 27.
qc_G2_a-g == 3 || qc_G2_h == 3 || qc_G3_a == 3 || qc_G3_b == 3
Space for you to describe any of these activities and concerns in more detail:

What does she do?

Generic text

How often does she do them?

Generic text

How long does each episode last?

Generic text

Have these compulsions or obsessions been present on most days for a period of at least two weeks?

1
Yes
2
No

Does she recognise that this behaviour or these thoughts are excessive or unreasonable?

1
Definitely
2
Somewhat
3
No

Does she try not to do them or think about them?

1
Definitely
2
Somewhat
3
No

Does she become upset because she has to do or think these things?

1
No, enjoys them
2
Neither enjoys it nor becomes upset
3
Sometimes a bit upset
4
Upset a great deal

Do these acts or thoughts last at least an hour a day on average?

1
Yes
2
No
Have these acts or thoughts interfered with:
-
how well she gets on with you and the rest of the family
making and keeping friends
learning or school work
playing, hobbies, sports or other leisure activities

Have these problems put a burden on you or the family as a whole?

1
Not at all
2
Only a little
3
Quite a lot
4
A great deal

Space for comments

Generic text
SECTION H: ANXIETY IN GENERAL
Nearly all children have some worries, and these are naturally worse on some days than others, but some children have so many worries for so much of the time that it makes them really upset or interferes with their lives.

Does your study child ever worry?

1
Yes
2
No
If no, go to J1 on page 30
qc_H1 == 2
SECTION J: MOODS

In the past month, have there been times when your study child has been very sad, miserable, unhappy or tearful?

1
Yes
2
No
If no, go to J2 below
If yes,
qc_J1 == 1

Was there a period over this last month when she was really miserable nearly every day?

1
Yes
2
No

During the time when she was miserable, was she really miserable for most of the day?

1
Yes
2
No

How long did that period last?

1
Less than 2 weeks
2
2 weeks or more

Have you any idea what might have caused it?

1
Yes
2
No
If yes,
qc_J1_d == 1

please describe

Generic text

During this period, could she be cheered up?

1
easily
2
with difficulty/only briefly
3
not at all

In the past month, have there been times when your study child has been grumpy or irritable in a way that was out of character for her?

1
Yes
2
No
If no, go to J4 on page 31
If yes,
qc_J2 == 1

Has there been any period over this last month when she has been really grumpy or irritable nearly every day?

1
Yes
2
No

During the time when she was grumpy or irritable, was she really irritable for most of the day?

1
Yes
2
No

How long did that period last?

1
Less than 2 weeks
2
2 weeks or more

Have you any idea what might have caused it?

1
Yes
2
No
If yes,
qc_J3_d == 1

please describe

Generic text

Was the irritability improved by particular activities, friends coming around or anything else?

1
easily
2
with difficulty/only briefly
3
not at all

In the past month, have there been times when your study child lost interest in everything, or nearly everything, she normally enjoys doing?

1
Yes
2
No
If no, go to J5 on page 32
If yes,
qc_J4 == 1

Was there a period in the past month when she lost interest for nearly every day?

1
Yes
2
No

During the days when she had lost interest in things, was she like this for most of the day?

1
Yes
2
No

For how long did she lose interest in things?

1
Less than 2 weeks
2
2 weeks or more

Did this loss of interest happen during the same period when she was really miserable or irritable?

1
Yes
2
No

Just to recap, has she, in the past month been miserable/irritable or lacked interest in things she usually enjoys?

1
Yes
2
No
If no, go to K1 on page 34
If yes in the past month:
qc_J5 == 1

Did she have no energy and seem tired all the time?

1
Yes
2
No
3
Don&#39;t know

Was she eating either much more or much less than usual?

1
Yes
2
No
3
Don&#39;t know

Did she either lose weight or gain a lot of weight?

1
Yes
2
No
3
Don&#39;t know

Did she find it hard to get to sleep?

1
Yes
2
No
3
Don&#39;t know

Did she sleep too much?

1
Yes
2
No
3
Don&#39;t know

Was there any period when she was agitated or restless much of the time?

1
Yes
2
No
3
Don&#39;t know

Was there any period when she felt worthless, or unnecessarily guilty much of the time?

1
Yes
2
No
3
Don&#39;t know

Was there any period when she found it unusually hard to concentrate or to think things out?

1
Yes
2
No
3
Don&#39;t know

Did she think about death a lot?

1
Yes
2
No
3
Don&#39;t know

Did she ever talk about harming herself or killing herself?

1
Yes
2
No
3
Don&#39;t know

Did she ever try to harm herself or kill herself?

1
Yes
2
No
3
Don&#39;t know

Over the whole of her lifetime has she ever tried to harm herself or kill herself?

1
Yes
2
No
3
Don&#39;t know

Overall, how upset and distressed is your study child as a result of feeling miserable/irritable/ or lacking interest?

1
Not at all
2
A little
3
Quite a lot
4
A great deal
How has this interfered with her day-to-day life?
-
how well she gets on with you and the rest of the family
making and keeping friends
learning or school work
playing, hobbies, sports or other leisure activities

Has your study child's feeling miserable/irritable/lacking interest put a burden on you or the family as a whole?

1
Not at all
2
A little
3
Quite a lot
4
A great deal

Space for comments

Long text
SECTION K: ATTENTION AND ACTIVITY
Nearly all children are overactive or lose concentration at times, but how does your study child compare with other children of her age? We are interested in how she is usually - not the occasional "off day".
Over the last 6 months:

Allowing for her age, do you think that your study child definitely has some problems with overactivity or poor concentration?

1
Yes
2
No
Please compare her behaviour in the last 6 months with other children of her age.
-
Does she often fidget?
Is it hard for her to stay sitting down for long?
Does she run or climb about when she shouldn&#39;t?
Does she find it hard to play or take part in other leisure activities without making a noise?
If she is rushing about does she find it hard to calm down when someone asks her to do so ?
In the last 6 months and compared with other children of her own age:
-
Does she often blurt out an answer before she has heard the question properly?
Is it hard for her to wait her turn?
Does she often butt in on other people&#39;s conversation or games?
Does she often go on talking even if she has been asked to stop or no one is listening?
In the last 6 months and compared with other children of her own age:
-
Does she often make careless mistakes or fail to pay attention to what she is supposed to be doing?
Does she often seem to lose interest in what she is doing?
Does she often not listen to what people are saying to her?
Does she often not finish a job properly?
Is it often hard for her to get herself organised to do something?
Does she often try to get out of things she would have to think about, such as homework?
Does she often lose things she needs for school or PE?
Is she easily distracted?
Is she often forgetful?
Has your study child's teacher complained in the last 6 months of problems with:
-
Fidgetiness, restlessness or overactivity
Poor concentration or being easily distracted
Acting without thinking about what she was doing, frequently butting in, or not waiting her turn
If you have ticked 'a lot' to ANY answers in K2-K5, continue below. If not, go to L1 on page 37.
qc_K2_a-e == 3 || qc_K3_a-d == 3 || qc_K4_a-i == 3 || qc_K5_a-c == 3

Have these problems been there for much of her life?

1
Yes
2
No

At what age did they start? ... years

Age

Thinking still of your child's difficulties with activity and attention, how much do you think they have upset or distressed her?

1
Not at all
2
A little
3
Quite a lot
4
A great deal
How have these difficulties interfered with her day-to-day life?
-
how well she gets on with you and the rest of the family
making and keeping friends
learning or school work
playing, hobbies, sports or other leisure activities

Have these problems put a burden on you or the family as a whole?

1
Not at all
2
A little
3
Quite a lot
4
A great deal

Space for comments

Generic text
SECTION L: AWKWARD AND TROUBLESOME BEHAVIOUR
Awkward Behaviour
All children can be awkward and difficult at times - things like not doing as they are told, being irritable, having temper outbursts, or deliberately annoying other people. We are interested in how your study child is usually, and not just on occasional "off days".
In the last 6 months:

Overall, how do you think your study child compares with other children of her age as far as this sort of awkward behaviour is concerned?

1
Less troublesome than average
2
about average
3
more troublesome than average
In the last 6 months and compared with other children of the same age
-
Has she had severe temper tantrums?
Has she argued with grown-ups?
Has she taken no notice of rules, or refused to do as she is told?
Has she seemed to do things to annoy other people on purpose?
Has she blamed others for her own mistakes or bad behaviour?
Has she been touchy and easily annoyed?
Has she been angry and resentful?
Has she been spiteful?
Has she tried to get her own back on people?
If you have ticked 'a lot more than others' to ANY answers in L2, please continue. If not, go to L8 at the bottom of this page.
qc_L2_a-i == 3

Is this behaviour just with one person (e.g. teacher, brother) or with more than one?

1
Just with one person
2
More than one

Has your study child's awkward behaviour been there for much of her life?

1
Yes
2
No

What age did it start ? ... years

Age
Has it interfered with her day-to-day life?
-
how well she gets on with you and the rest of the family?
making and keeping friends?
learning or school work?
playing, hobbies, sports or other leisure activities?

Have these problems put a burden on you or the family as a whole?

1
Not at all
2
A little
3
Quite a lot
4
A great deal

Has her teacher complained over the last 6 months of problems with this same kind of awkward behaviour or disruptiveness in class?

1
No
2
A little
3
A lot
Behaviour That Sometimes Gets Children Into Trouble - including dangerous, aggressive or antisocial behaviour. How has your study child been over the past 12 months? Answer how she is usually, and not just on occasional "off days".

Has she told lies to get things or favours from others, or to get out of things she was supposed to do?

1
No
2
Perhaps
3
Definitely
If definitely,
qc_L9 == 3

has this been going on for the last 6 months?

1
Yes
2
No

Has she often started fights? (other than with brothers and sisters)

1
No
2
Sometimes
3
Often
If often,
qc_L9_b == 3

has this been going on for the last 6 months?

1
Yes
2
No

Has she bullied or threatened people?

1
No
2
Sometimes
3
Often
If often,
qc_L9_c == 3

has this been going on for the last 6 months?

1
Yes
2
No

Has she stayed out much later than she was supposed to?

1
No
2
Sometimes
3
Often
If often,
qc_L9_d == 3

has this been going on for the last 6 months?

1
Yes
2
No

Has she stolen things from the house, or other people's houses or shops or school?

1
No
2
Perhaps
3
Definitely
If definitely,
qc_L9_e == 3

has this happened in the last 6 months?

1
Yes
2
No

Has she run away from home or ever stayed away all night without your permission?

1
No
2
Yes once only
3
Yes, more than once
If yes,
qc_L9_f == 2 || qc_L9_f == 3

has this happened in the last 6 months?

1
Yes
2
No

Has she often played truant (bunked off) from school?

1
No
2
Perhaps
3
Definitely
If definitely,
qc_L9_g == 3

has this happened in the last 6 months?

1
Yes
2
No

Has your study child shown any other worrying behaviour in the past 12 months? (e.g. deliberately started a fire, vandalism, been deliberately cruel to another person, to animals or birds)?

1
Yes
2
No
If yes,
qc_L10 == 1

please describe

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SECTION M: OTHER PROBLEMS
This next section is about a variety of different aspects of your study child's behaviour and development.

In her first 3 years of life, was there anything that seriously worried you about: her speech development?

1
Yes
2
No
If no, go to M1b below
If yes,
qc_M1_a == 1

has this cleared up completely?

1
Some continuing problems
2
completely cleared up

In her first 3 years of life, was there anything that seriously worried you about: how she got on with other people?

1
Yes
2
No
If no, go to M1c below
If yes,
qc_M1_b == 1

has this cleared up completely?

1
Some continuing problems
2
completely cleared up

In her first 3 years of life, was there anything that seriously worried you about: any odd rituals or unusual habits that were very hard to interrupt?

1
Yes
2
No
If no, go to M2 below
If yes,
qc_M1_c == 1

has this cleared up completely?

1
Some continuing problems
2
completely cleared up

Nowadays, does she have any tics or twitches that she can't seem to control?

1
Yes
2
No
How much do the following descriptions apply to your study child?
-
not aware of other people&#39;s feelings
does not realise when others are upset or angry
does not notice the effect of her behaviour on other members of the family
her behaviour often disrupts normal family life
very demanding of other people&#39;s time
difficult to reason with when upset
does not seem to understand social skills e.g. interrupts conversations constantly
does not pick up on body language
does not understand how she should behave when she is out e.g. in shops, or other people&#39;s houses
does not realise that she offends people with her behaviour
does not respond when told to do something
cannot follow a command unless it is carefully worded

Do you have any other comments or concerns?

1
Yes
2
No
(If yes,
qc_M3_m == 1

please tick and describe)

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SECTION N: GOING TO SCHOOL

What type of school does your study child attend?

1
primary school
2
special school
3
private school
4
other (please tick &amp; describe)
Other

Does she have any problems that mean that the school should make (or has made) special arrangements for her (e.g. put her to the front of the class so that she can hear, provide extra teaching or help.)

1
Yes
2
No
If no, go to N4a on page 45
If yes,
qc_N2_a == 1

please describe

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Please indicate below which particular types of problem your child has which mean that special arrangements at school are needed (please tick all that apply).
-
learning difficulty
speech
hearing
eyesight
reading difficulty
emotional or behavioural problem

Please indicate below which particular types of problem your child has which mean that special arrangements at school are needed (please tick all that apply). physical problem please describe

1
Yes
Generic text

Please indicate below which particular types of problem your child has which mean that special arrangements at school are needed (please tick all that apply). other (please tick and describe)

1
Yes
Other

Have you told the school about this?

1
yes, told this school
2
no, but told previous school
3
the school told me
4
no

Who else have you told? (please tick all that apply )

7
no one
If no-one, go to N3a below
qc_N2_d == 7

Have you ever asked the local education authority for an assessment of your child's needs?

1
Yes
2
No
If no, go to N4a below
If yes,
qc_N3_a == 1

Did the local education authority carry out an assessment?

1
Yes
2
No

Has any school or education authority ever said that your study child has Special Educational Needs?

1
Yes
2
No
If no, go to N6a on page 47
If yes,
qc_N4_a == 1

what do they say these needs are?

Generic text

how old was the child when you were first told this ? ... years

Age

Are you happy with the special needs provision that is being made for your child?

1
Yes, very happy
2
yes, quite happy
3
no, not happy
If no,
qc_N4_d == 3

what changes do you want?

Generic text

have you heard of the Special Educational Needs Code of Practice?

1
Yes
2
No

Does your study child have a 'statement' of special educational needs?

1
yes, has a statement
2
no, but is being assessed
3
no, was refused a statement
4
no, has never been considered for a statement
If never considered, go to N6a on page 47
qc_N5_a == 4

Have you ever appealed to the Special Educational Needs Tribunal?

1
Yes
2
No
If no, go to N7 on page 48
If yes,
qc_N6_a == 1

was your appeal heard by the Tribunal?

1
Yes,
2
No, but will be
3
No
If no, go to N7 on page 48
If yes,
qc_N6_b == 1

what was the outcome?

1
waiting for result
2
turned down
3
successful
If successful,
qc_N6_c == 3

when was the hearing?

Generic date

do you think the LEA has carried out the Tribunal's order?

1
Yes
2
No
If no,
qc_N6_c_ii == 2

please say how you think the local education authority has failed to carry out the order:

Generic text

If you think your child has special needs, do you have any suggestions for improvements in the way they have been handled by the special needs system?

1
Yes
2
No
If yes,
qc_N7 == 1

please describe

Generic text

Has your study child ever had speech (or language) therapy?

1
yes
2
no, but is on waiting list
3
no, never
If no, go to N9 below
If yes,
qc_N8_a == 1

do you think her difficulties improved as a result?

1
Yes
2
No

is she still having speech therapy?

1
Yes
2
No

do you think she should still be receiving speech and language therapy?

1
Yes
2
No

How well informed do you feel your child's school keeps you? about her school work

1
Very well informed
2
Quite well informed
3
Not well informed

How well informed do you feel your child's school keeps you? about her behaviour

1
Very well informed
2
Quite well informed
3
Not well informed

How well informed do you feel your child's school keeps you? about other aspects (please tick and describe)

1
Very well informed
2
Quite well informed
3
Not well informed
Other

How does she feel about school? She looks forward to going

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school? She enjoys it

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school? She is stimulated by it

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school? She is frightened by it

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school? She talks about her friends

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school? She seems bored by school

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school? She likes her teacher (s)

1
Always
2
Usually
3
Sometimes
4
Not at all

How much at school do you think she likes: reading

1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do

How much at school do you think she likes: maths

1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do

How much at school do you think she likes: writing

1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do

How much at school do you think she likes: games

1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do

How much at school do you think she likes: discussion

1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do

How much at school do you think she likes: other (please tick and describe)

1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
Other
When she finishes school and returns home:
-
Talk about the events of the day
Ask about what has happened in your day
Read, draw or play quietly by herself
Watch TV
Play with other children
Fall asleep

Does she bring home things that she has done at school (e.g. painting)?

1
Yes
2
No
If no, go to N14 below
If yes,
qc_N13_a == 1

how often are they put so that everyone can see them?

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? excited

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? talkative

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? withdrawn

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? calm

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? very active

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? sleepy

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? angry

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? hungry

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? tearful

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? anxious

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? affectionate

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? tired

1
Always
2
Usually
3
Sometimes
4
Never

When she gets home from school how does she behave? other (please tick and describe)

1
Always
2
Usually
3
Sometimes
4
Never
Other

Are you interested in what your child does at school?

1
Yes very
2
Yes mostly
3
No, not really

Are you happy with the teaching your daughter is getting at school?

1
Yes very
2
Yes mostly
3
No, not really

Are you happy with the progress your daughter is making at school?

1
Yes very
2
Yes mostly
3
No, not really

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) study child

1
Yes

This questionnaire was completed by: (tick all that apply) other (please tick and 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 comment 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
The illustrations in this questionnaire have been reproduced from pictures produced by children who are part of the "Children of the 90s" research initiative.
End

alspac_99_msdw

My Daughter's Well-being
This questionnaire asks about your study child.
It should be completed by the chief carer.
To answer simply tick the box that is most accurate in your opinion.
If you cannot answer certain questions please put a line through them.
All answers are confidential.
THANK YOU FOR YOUR HELP

SECTION A: YOUR CHILD'S HEALTH

The health of your study child is still of great importance to us. We would like to know about any recent illnesses or medical treatment.
How would you assess the health of your child nowadays? 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 nowadays? in the past year
1
very healthy, no problems
2
healthy, but a few minor problems
3
sometimes quite ill
4
almost always unwell
In the past 12 months has the doctor been called to your home because she was unwell?
1
Yes
2
No
If no, go to A3 below
how many times?
1
once
2
2 times
3
3-4 times
4
5 or more times

Has she 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 she 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 a doctor ever actually said that your study child has asthma?
1
Yes
2
No

In the past 12 months, has she had the following infections?

-
measles
chicken pox
mumps
meningitis
cold sores
whooping cough
urinary infection
eye infection
ear infection
chest infection
tonsillitis or laryngitis
german measles
scarlet fever
influenza (flu)
a cold
In the past 12 months, has she had the following infections? other infection (please tick & describe)
1
Yes
2
No
Other

How many days has she had to take off school for health reasons?

No. of days off school please describe
How manyGeneric text How manyGeneric text
For one or more infections (including colds, cough, flu )
For hospital investigation including admission
For other investigation(s)
How many days has she had to take off school for health reasons? In the past 12 months: For asthma, eczema or hayfever ... No. of days off school
How many

How many days has she had to take off school for health reasons?

No. of days off school

Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child in the last 12 months.

- If yes, please give full names of substances if you can

1 - Never

2 - Yes for 1-2 episodes only

3 - Yes for 3 or more episodes

Generic text

1 - Never

2 - Yes for 1-2 episodes only

3 - Yes for 3 or more episodes

Generic text
cough medicine
antibiotics/penicillin
throat medicine
vitamins
paracetamol/calpol
ointment for skin
eye ointment
diarrhoea mixture or pills
dimotapp/decongestant
ear drops
eye drops
iron
laxative
homeopathic medicine
herbal medicine
asthma medication
vaporiser
Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child in the last 12 months. other (please tick and describe)
2
Yes for 1-2 episodes only
3
Yes for 3 or more episodes
Other
please give full names of substances if you can
Generic text
Are there any pills, ointments or medicines that she has taken every day or nearly every day for the last 3 months? (Include vitamins, skin cream, inhaler, laxatives as well as antibiotics, homeopathic and herbal remedies etc.)
1
Yes
2
No
If no, go to B1 on page 9
please describe:
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SECTION B: USING THE TOILET

When she needs to go to the toilet to urinate (pass water): How often does she show signs (e.g. fidgets) that she needs to go?
1
never
2
sometimes
3
often
When she needs to go to the toilet to urinate (pass water): When she needs to, how often does she go to the toilet without you having to remind her?
1
never
2
sometimes
3
often
4
always
When she needs to go to the toilet to urinate (pass water): Does she have to dash to the toilet quickly when she realises she needs to go?
1
yes, has to go straight away
2
can hold for a short time (less than 5 minutes)
3
can hold for longer than 5 minutes
When she needs to go to the toilet to urinate (pass water): How often does she usually go to the toilet to pass water during the day?
1
less than 5 times a day
2
5-9 times a day
3
10 or more times a day
9
don&#39;t know
When she needs to go to the toilet to urinate (pass water): How often does she usually get up to go to the toilet at night?
1
not at all
2
once
3
twice
4
3 or more times
9
don&#39;t know
How often usually does your child: dirty her pants during the day
1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day
How often usually does your child: dirty herself at night
1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day
How often usually does your child: wet herself during the day
1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day
How often usually does your child: wet the bed at night
1
Never
2
Occasional accident but less than once a week
3
About once a week
4
2-5 times a week
5
Nearly every day
6
More than once a day

If she wets at night, how often does she:

-
wake up after wetting
seem to wet soon after going to sleep
seem upset when the bed is wet

Which of the following methods have you tried in the past or are using now to try and help your child stop wetting during the day? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting during the day).

Have used in the past Using now

1 - Yes

1 - Yes

1 - Yes

1 - Yes

taking her to the toilet regularly
encouraging child to &#39;hold on&#39; before using the toilet
drinking more fluids
drinking less fluids
medication
praising for dry pants
showing your displeasure
advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe
Which of the following methods have you tried in the past or are using now to try and help your child stop wetting during the day? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting during the day). advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe
Generic text

Which of the following methods have you tried in the past or are you using now to try and help your child stop wetting the bed? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting the bed).

Have used in the past Using now

1 - Yes

1 - Yes

1 - Yes

1 - Yes

lifting (taking your child out of bed to the toilet)
restricting drinks before bed
getting her to toilet regularly in the day
rewarding for being dry
medication
homeopathy
hypnosis
an alarm that wakes the child when she wets
showing your displeasure
using night-time protection pants or nappies
advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe
Which of the following methods have you tried in the past or are you using now to try and help your child stop wetting the bed? (Please note: this is not a list of ways which are necessarily effective in helping children to stop wetting the bed). advice from a health worker (e.g. health visitor, school nurse, GP, hospital doctor, social worker, psychologist) Please tick and describe
Generic text

SECTION C: SEPARATION ANXIETY

Most children are particularly attached to one person or a few key people, looking to them for security, and turning to them when upset. They can be mum and dad, grandparents, favourite teachers, neighbours etc.
Who would you say your study child is particularly attached to? (tick all that apply)
2
No-one
Most children have some worries about being separated from the people they are most attached to. We would like to know how your study child compares with other children of her age. We are interested in how she is usually - not the occasional "clingy day" or "off day".
Overall in the past month, has she been particularly worried about being separated from any of the people ticked in C1 above?
1
Yes
2
No

In the past month, compared with other children of the same age:

-
Has she often worried about something unpleasant happening to these people, or about losing them?
Has she often worried that she might be taken away from any of them, e.g. by being kidnapped, taken to hospital or killed?
Has she often not wanted to go to school in case something nasty happened whilst she was still at school to a person(s) she is attached to? (Do not include reluctance to go to school for other reasons, e.g. fear of bullying or exams)
Has she worried about sleeping alone?
Has she come out of her bedroom at night to check on, or to sleep near any of these people?
Has she worried about sleeping in a strange place?
Has she been afraid of being alone in a room at home without one of the people she is attached to (even if you or they are close by)?
Has she had repeated nightmares or bad dreams about being separated from any of these people?
Has she had headaches, stomach aches or felt sick when she had to leave a person she is attached to, or when she knew it was about to happen?
Has being apart or the thought of being apart from a person she is attached to led to worry, crying, tantrums, clinginess or misery?
How long has she had worries about separation?
1
Less than 1 month
2
1-5 months
3
6 months or more
Was she like this before the age of 6?
1
Yes
2
No
How much do you think these worries have upset her?
1
not at all
2
only a little
3
quite a lot
4
a great deal

How much have these worries interfered with her day-to-day life?

-
how well she gets on with you and the rest of the family?
making and keeping friends?
learning or school work?
playing, hobbies, sports or other leisure activities?
Have these problems put a burden on you or the family as a whole?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal

SECTION D: PARTICULAR FEARS

This section of the questionnaire is about any particular things or situations that your study child is scared of, even though they aren't really a danger to her. How is she usually - not on the occasional "off day"?

How scared is your study child about any of the following?

-
insects, spiders, wasps, bees, mice, snakes, birds or any other creature
storms, thunder, heights or water
blood, injection or injury
dentists or doctors
other specific situations: lifts, tunnels, flying, driving, trains buses, small enclosed spaces
the dark
How scared is your study child about any of the following? She is scared of: any other specific fear? (please tick & describe)
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
Other
How scared is your study child about any of the following? She is scared of:
1
not particularly scared of anything

SECTION E: SOCIAL FEARS

Overall does your study child particularly fear or avoid situations that involve a lot of people or meeting new people or doing things in front of people? Do not count the occasional "off day" or ordinary shyness.
1
Yes
2
No

Has she been particularly afraid of any of the following situations over the last month?

-
Meeting new people
Meeting a lot of people such as at a party
Speaking in class
Reading out loud in front of others
Writing in front of others
Eating in front of others
Are her fears of being with a lot of people mainly related to her fear of being separated from someone she is attached to, or are the fears still there even when she is with such a person?
1
mainly afraid only when separated from her special people
2
afraid even when with one of her special people
Is your study child just afraid in these situations with adults, or is she also afraid in situations that involve lots of children, or meeting new children?
1
only with adults
2
with both adults and children
3
only with children
Outside of these situations is your study child able to get on well enough with the adults and children she knows best?
1
Yes
2
No
Do you think her dislike of these situations is because she is afraid she will act in a way that will be embarrassing or show her up?
1
Yes, definitely
2
Not sure
3
No
Is it related to speech, reading or writing problems?
1
Yes
2
Not sure
3
No
Why else do you think she dislikes such situations?
Generic text
How long has she had this fear of being with lots of people, or doing things in front of lots of people, or meeting new people?
1
less than one month
2
1-5 months
3
6 months or more
What age did it begin?
1
under 6 years
2
6 years or older
When your study child is in one of these situations she fears, or when she thinks she is about to be in one, how anxious or upset does she usually become?
1
very anxious or upset
2
just a bit
3
not at all
Does her fear lead to avoiding these situations?
1
yes, a lot
2
a little
3
no
Does she recognise that this fear is excessive or unreasonable?
1
no
2
perhaps
3
definitely
Is she upset about having this fear?
1
no
2
perhaps
3
definitely
Has your study child's fear of these situations put a burden on you or the family as a whole?
1
not at all
2
a little
3
quite a lot
4
a great deal
Space for comments
Generic text

SECTION F: DISASTERS AND FRIGHTS

During your study child's lifetime has anything exceptionally stressful happened to her, that would really upset almost anyone, such as being involved in a terrible accident, or being abused or some other sort of disaster?
1
Yes
2
No
If no, go to G1 on page 24
what was it? (please describe)
Generic text
how old was she ? ... years
Age
At the time, was she very distressed or did her behaviour change dramatically?
1
Yes
2
No
At present, is it affecting her behaviour, feelings or concentration?
1
Yes
2
No

Over the last month has your study child:

-
&quot;relived&quot; the event with vivid memories (flashbacks) of it?
had repeated distressing dreams of the event?
got upset if anything happened which reminded her of it?
tried to avoid thinking or talking about anything to do with the event?
tried to avoid activities, places or people that remind her of the event?
blocked out important details of the event from her memory?
shown much less interest in activities she used to enjoy?
expressed a smaller range of feelings than in the past, e.g. no longer able to express loving feelings?
had problems sleeping?
seemed irritable or angry?
had difficulty concentrating?
always been on the alert for possible dangers?
jumped at little noises or been easily startled in other ways?
How long after the event did these problems begin?
1
within 6 months
2
more than 6 months after the event
How long has she been having these problems?
1
Less than one month
2
1-2 months
3
3 months or more
How much have these problems upset or distressed her?
1
Not at all
2
only a little
3
quite a lot
4
a great deal

How much have these problems interfered with her day-to-day life?

-
how well she gets on with you and the rest of the family?
making and keeping friends?
learning or school work?
playing, hobbies, sports or other leisure activities?
Have these problems put a burden on you or the family as a whole?
1
Not at all
2
only a little
3
quite a lot
4
a great deal
Space for comments
Long text

SECTION G: COMPULSIONS AND OBSESSIONS

Many children have some habits or superstitions, such as not stepping on the cracks in the pavement, or needing to wear lucky clothes. It is also common for children to go through phases when they seem obsessed by one particular subject or activity. In this section we are interested in whether your study child has rituals or obsessions that go beyond this.
Overall, does she have rituals or obsessions that upset her, waste a lot of her time, or interfere with her ability to get on with everyday life?
1
Yes
2
No

In the past month has your study child been doing any of the following things over and over again even though she has already done them or doesn't need to do them at all?

-
Excessive cleaning e.g. hand washing, baths, showers, toothbrushing etc.
Other special measures to avoid dirt, germs or poisons
Checking things, e.g. doors, locks, oven, gas taps, electric switches
Repeating actions: e.g. going in/out door many times in a row, up/down from chair
Touching things or people in particular ways
Arranging things so they are just so, or exactly symmetrical
Counting to particular lucky numbers or avoiding unlucky numbers
In the past month has your study child been doing any of the following things over and over again even though she has already done them or doesn't need to do them at all? Anything else? (please tick and describe)
1
No
2
Sometimes
3
Often
Other
In the past month, has she been concerned about: dirt, germs or poison
1
No
2
Sometimes
3
Often
In the past month, has she been concerned about: something terrible happening to herself or others e.g. illnesses, accidents, fires etc.
1
No
2
Sometimes
3
Often
Space for you to describe any of these activities and concerns in more detail:
What does she do?
Generic text
How often does she do them?
Generic text
How long does each episode last?
Generic text
Have these compulsions or obsessions been present on most days for a period of at least two weeks?
1
Yes
2
No
Does she recognise that this behaviour or these thoughts are excessive or unreasonable?
1
Definitely
2
Somewhat
3
No
Does she try not to do them or think about them?
1
Definitely
2
Somewhat
3
No
Does she become upset because she has to do or think these things?
1
No, enjoys them
2
Neither enjoys it nor becomes upset
3
Sometimes a bit upset
4
Upset a great deal
Do these acts or thoughts last at least an hour a day on average?
1
Yes
2
No

Have these acts or thoughts interfered with:

-
how well she gets on with you and the rest of the family
making and keeping friends
learning or school work
playing, hobbies, sports or other leisure activities
Have these problems put a burden on you or the family as a whole?
1
Not at all
2
Only a little
3
Quite a lot
4
A great deal
Space for comments
Generic text

SECTION H: ANXIETY IN GENERAL

Nearly all children have some worries, and these are naturally worse on some days than others, but some children have so many worries for so much of the time that it makes them really upset or interferes with their lives.
Does your study child ever worry?
1
Yes
2
No

SECTION J: MOODS

In the past month, have there been times when your study child has been very sad, miserable, unhappy or tearful?
1
Yes
2
No
If no, go to J2 below
Was there a period over this last month when she was really miserable nearly every day?
1
Yes
2
No
During the time when she was miserable, was she really miserable for most of the day?
1
Yes
2
No
How long did that period last?
1
Less than 2 weeks
2
2 weeks or more
Have you any idea what might have caused it?
1
Yes
2
No
please describe
Generic text
During this period, could she be cheered up?
1
easily
2
with difficulty/only briefly
3
not at all
In the past month, have there been times when your study child has been grumpy or irritable in a way that was out of character for her?
1
Yes
2
No
If no, go to J4 on page 31
Has there been any period over this last month when she has been really grumpy or irritable nearly every day?
1
Yes
2
No
During the time when she was grumpy or irritable, was she really irritable for most of the day?
1
Yes
2
No
How long did that period last?
1
Less than 2 weeks
2
2 weeks or more
Have you any idea what might have caused it?
1
Yes
2
No
please describe
Generic text
Was the irritability improved by particular activities, friends coming around or anything else?
1
easily
2
with difficulty/only briefly
3
not at all
In the past month, have there been times when your study child lost interest in everything, or nearly everything, she normally enjoys doing?
1
Yes
2
No
If no, go to J5 on page 32
Was there a period in the past month when she lost interest for nearly every day?
1
Yes
2
No
During the days when she had lost interest in things, was she like this for most of the day?
1
Yes
2
No
For how long did she lose interest in things?
1
Less than 2 weeks
2
2 weeks or more
Did this loss of interest happen during the same period when she was really miserable or irritable?
1
Yes
2
No
Just to recap, has she, in the past month been miserable/irritable or lacked interest in things she usually enjoys?
1
Yes
2
No
If no, go to K1 on page 34
Did she have no energy and seem tired all the time?
1
Yes
2
No
3
Don&#39;t know
Was she eating either much more or much less than usual?
1
Yes
2
No
3
Don&#39;t know
Did she either lose weight or gain a lot of weight?
1
Yes
2
No
3
Don&#39;t know
Did she find it hard to get to sleep?
1
Yes
2
No
3
Don&#39;t know
Did she sleep too much?
1
Yes
2
No
3
Don&#39;t know
Was there any period when she was agitated or restless much of the time?
1
Yes
2
No
3
Don&#39;t know
Was there any period when she felt worthless, or unnecessarily guilty much of the time?
1
Yes
2
No
3
Don&#39;t know
Was there any period when she found it unusually hard to concentrate or to think things out?
1
Yes
2
No
3
Don&#39;t know
Did she think about death a lot?
1
Yes
2
No
3
Don&#39;t know
Did she ever talk about harming herself or killing herself?
1
Yes
2
No
3
Don&#39;t know
Did she ever try to harm herself or kill herself?
1
Yes
2
No
3
Don&#39;t know
Over the whole of her lifetime has she ever tried to harm herself or kill herself?
1
Yes
2
No
3
Don&#39;t know
Overall, how upset and distressed is your study child as a result of feeling miserable/irritable/ or lacking interest?
1
Not at all
2
A little
3
Quite a lot
4
A great deal

How has this interfered with her day-to-day life?

-
how well she gets on with you and the rest of the family
making and keeping friends
learning or school work
playing, hobbies, sports or other leisure activities
Has your study child's feeling miserable/irritable/lacking interest put a burden on you or the family as a whole?
1
Not at all
2
A little
3
Quite a lot
4
A great deal
Space for comments
Long text

SECTION K: ATTENTION AND ACTIVITY

Nearly all children are overactive or lose concentration at times, but how does your study child compare with other children of her age? We are interested in how she is usually - not the occasional "off day".
Over the last 6 months:
Allowing for her age, do you think that your study child definitely has some problems with overactivity or poor concentration?
1
Yes
2
No

Please compare her behaviour in the last 6 months with other children of her age.

-
Does she often fidget?
Is it hard for her to stay sitting down for long?
Does she run or climb about when she shouldn&#39;t?
Does she find it hard to play or take part in other leisure activities without making a noise?
If she is rushing about does she find it hard to calm down when someone asks her to do so ?

In the last 6 months and compared with other children of her own age:

-
Does she often blurt out an answer before she has heard the question properly?
Is it hard for her to wait her turn?
Does she often butt in on other people&#39;s conversation or games?
Does she often go on talking even if she has been asked to stop or no one is listening?

In the last 6 months and compared with other children of her own age:

-
Does she often make careless mistakes or fail to pay attention to what she is supposed to be doing?
Does she often seem to lose interest in what she is doing?
Does she often not listen to what people are saying to her?
Does she often not finish a job properly?
Is it often hard for her to get herself organised to do something?
Does she often try to get out of things she would have to think about, such as homework?
Does she often lose things she needs for school or PE?
Is she easily distracted?
Is she often forgetful?

Has your study child's teacher complained in the last 6 months of problems with:

-
Fidgetiness, restlessness or overactivity
Poor concentration or being easily distracted
Acting without thinking about what she was doing, frequently butting in, or not waiting her turn
Have these problems been there for much of her life?
1
Yes
2
No
At what age did they start? ... years
Age
Thinking still of your child's difficulties with activity and attention, how much do you think they have upset or distressed her?
1
Not at all
2
A little
3
Quite a lot
4
A great deal

How have these difficulties interfered with her day-to-day life?

-
how well she gets on with you and the rest of the family
making and keeping friends
learning or school work
playing, hobbies, sports or other leisure activities
Have these problems put a burden on you or the family as a whole?
1
Not at all
2
A little
3
Quite a lot
4
A great deal
Space for comments
Generic text

SECTION L: AWKWARD AND TROUBLESOME BEHAVIOUR

Awkward Behaviour
All children can be awkward and difficult at times - things like not doing as they are told, being irritable, having temper outbursts, or deliberately annoying other people. We are interested in how your study child is usually, and not just on occasional "off days".
In the last 6 months:
Overall, how do you think your study child compares with other children of her age as far as this sort of awkward behaviour is concerned?
1
Less troublesome than average
2
about average
3
more troublesome than average

In the last 6 months and compared with other children of the same age

-
Has she had severe temper tantrums?
Has she argued with grown-ups?
Has she taken no notice of rules, or refused to do as she is told?
Has she seemed to do things to annoy other people on purpose?
Has she blamed others for her own mistakes or bad behaviour?
Has she been touchy and easily annoyed?
Has she been angry and resentful?
Has she been spiteful?
Has she tried to get her own back on people?
Is this behaviour just with one person (e.g. teacher, brother) or with more than one?
1
Just with one person
2
More than one
Has your study child's awkward behaviour been there for much of her life?
1
Yes
2
No
What age did it start ? ... years
Age

Has it interfered with her day-to-day life?

-
how well she gets on with you and the rest of the family?
making and keeping friends?
learning or school work?
playing, hobbies, sports or other leisure activities?
Have these problems put a burden on you or the family as a whole?
1
Not at all
2
A little
3
Quite a lot
4
A great deal
Has her teacher complained over the last 6 months of problems with this same kind of awkward behaviour or disruptiveness in class?
1
No
2
A little
3
A lot
Behaviour That Sometimes Gets Children Into Trouble - including dangerous, aggressive or antisocial behaviour. How has your study child been over the past 12 months? Answer how she is usually, and not just on occasional "off days".
Has she told lies to get things or favours from others, or to get out of things she was supposed to do?
1
No
2
Perhaps
3
Definitely
has this been going on for the last 6 months?
1
Yes
2
No
Has she often started fights? (other than with brothers and sisters)
1
No
2
Sometimes
3
Often
has this been going on for the last 6 months?
1
Yes
2
No
Has she bullied or threatened people?
1
No
2
Sometimes
3
Often
has this been going on for the last 6 months?
1
Yes
2
No
Has she stayed out much later than she was supposed to?
1
No
2
Sometimes
3
Often
has this been going on for the last 6 months?
1
Yes
2
No
Has she stolen things from the house, or other people's houses or shops or school?
1
No
2
Perhaps
3
Definitely
has this happened in the last 6 months?
1
Yes
2
No
Has she run away from home or ever stayed away all night without your permission?
1
No
2
Yes once only
3
Yes, more than once
has this happened in the last 6 months?
1
Yes
2
No
Has she often played truant (bunked off) from school?
1
No
2
Perhaps
3
Definitely
has this happened in the last 6 months?
1
Yes
2
No
Has your study child shown any other worrying behaviour in the past 12 months? (e.g. deliberately started a fire, vandalism, been deliberately cruel to another person, to animals or birds)?
1
Yes
2
No
please describe
Generic text

SECTION M: OTHER PROBLEMS

This next section is about a variety of different aspects of your study child's behaviour and development.
In her first 3 years of life, was there anything that seriously worried you about: her speech development?
1
Yes
2
No
If no, go to M1b below
has this cleared up completely?
1
Some continuing problems
2
completely cleared up
In her first 3 years of life, was there anything that seriously worried you about: how she got on with other people?
1
Yes
2
No
If no, go to M1c below
has this cleared up completely?
1
Some continuing problems
2
completely cleared up
In her first 3 years of life, was there anything that seriously worried you about: any odd rituals or unusual habits that were very hard to interrupt?
1
Yes
2
No
If no, go to M2 below
has this cleared up completely?
1
Some continuing problems
2
completely cleared up
Nowadays, does she have any tics or twitches that she can't seem to control?
1
Yes
2
No

How much do the following descriptions apply to your study child?

-
not aware of other people&#39;s feelings
does not realise when others are upset or angry
does not notice the effect of her behaviour on other members of the family
her behaviour often disrupts normal family life
very demanding of other people&#39;s time
difficult to reason with when upset
does not seem to understand social skills e.g. interrupts conversations constantly
does not pick up on body language
does not understand how she should behave when she is out e.g. in shops, or other people&#39;s houses
does not realise that she offends people with her behaviour
does not respond when told to do something
cannot follow a command unless it is carefully worded
Do you have any other comments or concerns?
1
Yes
2
No
please tick and describe)
Generic text

SECTION N: GOING TO SCHOOL

What type of school does your study child attend?
1
primary school
2
special school
3
private school
4
other (please tick &amp; describe)
Other
Does she have any problems that mean that the school should make (or has made) special arrangements for her (e.g. put her to the front of the class so that she can hear, provide extra teaching or help.)
1
Yes
2
No
If no, go to N4a on page 45
please describe
Generic text

Please indicate below which particular types of problem your child has which mean that special arrangements at school are needed (please tick all that apply).

-
learning difficulty
speech
hearing
eyesight
reading difficulty
emotional or behavioural problem
Please indicate below which particular types of problem your child has which mean that special arrangements at school are needed (please tick all that apply). physical problem please describe
1
Yes
Generic text
Please indicate below which particular types of problem your child has which mean that special arrangements at school are needed (please tick all that apply). other (please tick and describe)
1
Yes
Other
Have you told the school about this?
1
yes, told this school
2
no, but told previous school
3
the school told me
4
no
Who else have you told? (please tick all that apply )
7
no one
Have you ever asked the local education authority for an assessment of your child's needs?
1
Yes
2
No
If no, go to N4a below
Did the local education authority carry out an assessment?
1
Yes
2
No
Has any school or education authority ever said that your study child has Special Educational Needs?
1
Yes
2
No
If no, go to N6a on page 47
what do they say these needs are?
Generic text
how old was the child when you were first told this ? ... years
Age
Are you happy with the special needs provision that is being made for your child?
1
Yes, very happy
2
yes, quite happy
3
no, not happy
what changes do you want?
Generic text
have you heard of the Special Educational Needs Code of Practice?
1
Yes
2
No
Does your study child have a 'statement' of special educational needs?
1
yes, has a statement
2
no, but is being assessed
3
no, was refused a statement
4
no, has never been considered for a statement
Have you ever appealed to the Special Educational Needs Tribunal?
1
Yes
2
No
If no, go to N7 on page 48
was your appeal heard by the Tribunal?
1
Yes,
2
No, but will be
3
No
If no, go to N7 on page 48
what was the outcome?
1
waiting for result
2
turned down
3
successful
when was the hearing?
Generic date
do you think the LEA has carried out the Tribunal's order?
1
Yes
2
No
please say how you think the local education authority has failed to carry out the order:
Generic text
If you think your child has special needs, do you have any suggestions for improvements in the way they have been handled by the special needs system?
1
Yes
2
No
please describe
Generic text
Has your study child ever had speech (or language) therapy?
1
yes
2
no, but is on waiting list
3
no, never
If no, go to N9 below
do you think her difficulties improved as a result?
1
Yes
2
No
is she still having speech therapy?
1
Yes
2
No
do you think she should still be receiving speech and language therapy?
1
Yes
2
No
How well informed do you feel your child's school keeps you? about her school work
1
Very well informed
2
Quite well informed
3
Not well informed
How well informed do you feel your child's school keeps you? about her behaviour
1
Very well informed
2
Quite well informed
3
Not well informed
How well informed do you feel your child's school keeps you? about other aspects (please tick and describe)
1
Very well informed
2
Quite well informed
3
Not well informed
Other
How does she feel about school? She looks forward to going
1
Always
2
Usually
3
Sometimes
4
Not at all
How does she feel about school? She enjoys it
1
Always
2
Usually
3
Sometimes
4
Not at all
How does she feel about school? She is stimulated by it
1
Always
2
Usually
3
Sometimes
4
Not at all
How does she feel about school? She is frightened by it
1
Always
2
Usually
3
Sometimes
4
Not at all
How does she feel about school? She talks about her friends
1
Always
2
Usually
3
Sometimes
4
Not at all
How does she feel about school? She seems bored by school
1
Always
2
Usually
3
Sometimes
4
Not at all
How does she feel about school? She likes her teacher (s)
1
Always
2
Usually
3
Sometimes
4
Not at all
How much at school do you think she likes: reading
1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
How much at school do you think she likes: maths
1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
How much at school do you think she likes: writing
1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
How much at school do you think she likes: games
1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
How much at school do you think she likes: discussion
1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
How much at school do you think she likes: other (please tick and describe)
1
She likes it a lot
2
She quite likes it
3
She does not like it
4
Is unable to do
Other

When she finishes school and returns home:

-
Talk about the events of the day
Ask about what has happened in your day
Read, draw or play quietly by herself
Watch TV
Play with other children
Fall asleep
Does she bring home things that she has done at school (e.g. painting)?
1
Yes
2
No
If no, go to N14 below
how often are they put so that everyone can see them?
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? excited
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? talkative
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? withdrawn
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? calm
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? very active
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? sleepy
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? angry
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? hungry
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? tearful
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? anxious
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? affectionate
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? tired
1
Always
2
Usually
3
Sometimes
4
Never
When she gets home from school how does she behave? other (please tick and describe)
1
Always
2
Usually
3
Sometimes
4
Never
Other
Are you interested in what your child does at school?
1
Yes very
2
Yes mostly
3
No, not really
Are you happy with the teaching your daughter is getting at school?
1
Yes very
2
Yes mostly
3
No, not really
Are you happy with the progress your daughter is making at school?
1
Yes very
2
Yes mostly
3
No, not really
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) study child
1
Yes
This questionnaire was completed by: (tick all that apply) other (please tick and describe)
1
Yes
Other
Please give the date on which you completed this questionnaire:
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Please give the date of birth of your child:
Date of birth
THANK YOU VERY MUCH FOR YOUR HELP
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When completed, please return the questionnaire to: Professor Jean Golding Children of the Nineties - ALSPAC Institute of Child Health
The illustrations in this questionnaire have been reproduced from pictures produced by children who are part of the "Children of the 90s" research initiative.
Name

My Son/Daughter's Well-being