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alspac_95_myfyobg
MY YOUNG 4 YEAR OLD GIRL
This questionnaire asks about your child now she is 4 years old. We are interested to know about her health and behaviour and how she gets on with other children. Your answers will help us to understand the developing child and to identify problems that children and their parents have.
This questionaire 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. You may make additional comments at the end. All answers are confidential.
THANK YOU FOR YOUR HELP
SECTION A: ACCIDENTS AND INJURIES
However careful a parent is, most children have accidents at some time or other. Please list on the next pages the times your child has had an accident, whether or not she was injured as a result.

Has she been burnt or scalded since she was 3 years old?

1
Yes
2
No
If no, go to A2a on page 4
If yes,
qc_A1_a == 1

how many times?

How many
For each burn or scald please describe below what happened:
Place accident happened (e.g. kitchen, garden,nursery) What was she burnt with? (e.g. tea, iron, electric fire) Date of accident (month, year) Injuries caused (if no injury write none) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st accident
2nd accident
3rd accident

Please describe how each accident happened: Burn 1

Generic text

Please describe how each accident happened: Burn 2

Generic text

Please describe how each accident happened: Burn 3

Generic text

Has she had a bad fall since she was 3 years old?

1
Yes
2
No
If no, go to A3a on page 5
If yes,
qc_A2_a == 1

how many times?

How many
For each fall please describe below what happened:
Place accident happened (e.g. kitchen, garden,nursery) What did she fall from (e.g. table, wall, climbing frame)? Date of fall (month, year) Injuries caused (if no injury write none) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st fall
2nd fall
3rd fall

Please describe how each accident happened: Fall 1

Generic text

Please describe how each accident happened: Fall 2

Generic text

Please describe how each accident happened: Fall 3

Generic text

Has she swallowed anything she shouldn't have (such as pills, buttons, disinfectant) since she was 3 years old?

1
Yes
2
No
If no, go to A4a on page 6
If yes,
qc_A3_a == 1

how many times?

How many
For each time please describe below what happened:
Place accident happened (e.g. your home, nursery, at friend's) What did she swallow? Date of accident (month, year) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
1st accident
2nd accident
3rd accident

Please describe how each accident happened: Accident 1

Generic text

Please describe how each accident happened: Accident 2

Generic text

Please describe how each accident happened: Accident 3

Generic text

Has she had any other accidents or injuries since she was 3 years old?

1
Yes
2
No
If no, go to A5 on page 7
If yes,
qc_A4_a == 1

how many other accidents?

How many
For each accident or injury please describe below what happened.
Place accident happened (e.g. kitchen, garden, street, nursery) What happened? Date of accident (month, year) Injuries caused (if no injury write none) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st accident
2nd accident
3rd accident

Please describe how each accident happened: Accident 1

Generic text

Please describe how each accident happened: Accident 2

Generic text

Please describe how each accident happened: Accident 3

Generic text

Has she had any of the following happen since she was born? Broken arm/hand

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Broken leg/foot

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Broken/cracked skull

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Other broken bone (please describe)

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all
Other

Has she had any of the following happen since she was born? Unconscious because of a head injury

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Cut(s) requiring stitches

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Burn or scald having a skin graft

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? A road traffic accident

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? An accident in a playground

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? An accident at school, nursery, creche

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Stung by wasp or bee

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Bitten by animal or human please describe

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all
Generic text

Has she had any of the following happen since she was born? Badly sunburnt

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Nearly drowned

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Front tooth (teeth) knocked out

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Front tooth/teeth chipped or injured

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all

Has she had any of the following happen since she was born? Other tooth/teeth knocked out or chipped

1
Yes, aged 0 - 2
2
Yes, since age 3
3
No, not at all
SECTION B: PROBLEMS AND TREATMENT
Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child since she was 3 years old.
- If yes, please give full names of substances if you can

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text

1 - Never

2 - Yes for one episode only

3 - Yes for 2 or more episodes

Generic text

1 - Never

2 - Yes for one episode only

3 - Yes for 2 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
other (please tick and describe )

Children often have accidents or illnesses that need treatment. Please indicate which of the following have been given to your child since she was 3 years old. other (please tick and describe )

Other

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, laxatives as well as antibiotics, homeopathic and herbal remedies etc)

1
Yes
2
No
If no, go to B3a below
If yes,
qc_B2_a == 1

please describe:

Generic text
During the child's early years of life various possible problems are often identified - yet when investigated further they are often found not to be problems at all. In this section we are asking about any possible problems that might have arisen.

Since your study child was 3 years old has she been investigated because it was thought she might have something wrong with her hips, her legs or her feet?

1
Yes
2
No
If no, go to B4a on page 11
If yes,
qc_B3_a == 1

were any problems found?

1
Yes
2
No
9
Don't know
If no, go to B4a on page 11
If yes,
qc_B3_b == 1

please describe:

Generic text

how old was she?

1
3 years old
2
4 years old
3
5 years old

what treatment did she have?

Generic text

Since she was 3 years old has anyone thought there might be a problem with her hearing?

1
Yes
2
No
If no, go to B5a below
qc_B4_a == 2
Else

Has your child been seen at the Hearing Assessment Centre since she was 3?

1
Yes
2
No
If no, go to B5a below
If yes,
qc_B4_b == 1

At what age?

1
3 years old
2
4 years old
3
5 years old

What was decided?

Generic text

Has anyone thought there might be a problem with her eyesight?

1
Yes
2
No
If no, go to B6a on page 12
qc_B5_a == 2
Else

What was thought to be wrong with her eyes?

1
squint (eyes not looking in same direction)
2
something else (please describe)
3
don't know
Other

Has your child been referred to an eye specialist since she was 3?

1
Yes
2
No
If no, go to B6a on page 12
If yes,
qc_B5_c == 1

at what age?

1
3 years old
2
4 years old
3
5 years old

What was decided?

Generic text

What treatment was given?

Generic text

Has anyone thought that there might be a problem with her talking?

1
Yes
2
No
If no, go to B7a on page 13
If yes,
qc_B6_a == 1

who? (tick all that apply): you or your partner

1
Yes

who? (tick all that apply): health visitor

1
Yes

who? (tick all that apply): G.P.

1
Yes

who? (tick all that apply): grandparents

1
Yes

who? (tick all that apply): other (please describe)

1
Yes
Other

Has she ever been seen by a speech therapist?

1
Yes
2
No
If no, go to B7a on page 13
if yes,
qc_B6_g == 1

how old was she? ... years

Age in years

what was decided?

Generic text

Are there still any worries about her talking?

1
Yes
2
No
If yes,
qc_B6_h == 1

please describe

Generic text

Has anyone ever thought there might be a problem with her growth?

1
Yes
2
No
If no, go to B8a on page 14
If yes,
qc_B7_a == 1

who? (tick all that apply): you or your partner

1
Yes

who? (tick all that apply): health visitor

1
Yes

who? (tick all that apply): G.P.

1
Yes

who? (tick all that apply): grandparents

1
Yes

who? (tick all that apply): other (please describe)

1
Yes
Other

Has she ever been seen by a specialist about her growth?

1
Yes
2
No
If no, go to j) below
If yes,
qc_B7_g == 1

how old was she? ... years (If less than 12 months put 0)

Age in years

what was decided?

Generic text

Are there still worries about her growth?

1
Yes
2
No
If yes,
qc_B7_j == 1

please describe

Generic text

Has anyone ever thought there might be a problem with clumsiness or her movement or coordination?

1
Yes
2
No
If no, go to B9a below
If yes,
qc_B8_a == 1

who? (tick all that apply): you or your partner

1
Yes

who? (tick all that apply): health visitor

1
Yes

who? (tick all that apply): G.P.

1
Yes

who? (tick all that apply): grandparents

1
Yes

who? (tick all that apply): other (please describe)

1
Yes
Other

Has she ever been seen by a specialist about this?

1
Yes
2
No
If no, go to j) below
If yes,
qc_B8_g == 1

how old was she? ... years (If less than 12 months put 0)

Age in years

what was decided?

Generic text

Are there still worries about this?

1
Yes
2
No
If yes,
qc_B8_j == 1

please describe

Generic text

Has anyone ever thought there might be a problem with other aspects of her development?

1
Yes
2
No
If no, go to B10a on page 15
If yes,
qc_B9_a == 1

who? (tick all that apply): you or your partner

1
Yes

who? (tick all that apply): health visitor

1
Yes

who? (tick all that apply): G.P.

1
Yes

who? (tick all that apply): grandparents

1
Yes

who? (tick all that apply): other (please describe)

1
Yes
Other

Has she ever been seen by a specialist about this?

1
Yes
2
No
If no, go to j) below
If yes,
qc_B9_g == 1

how old was she? ... years (If less than 12 months put 0)

Age in years

what was decided?

Generic text

Are there still worries about this?

1
Yes
2
No
If yes,
qc_B9_j == 1

please describe

Generic text

Have there been any other problems for which your child saw (or is going to see) a specialist since she was 3 years old?

1
Yes
2
No
If no, go to B11a on page 17
If yes,
qc_B10_a == 1

For how many different problems?

How many
Please list, for each problem, what has happened:
What was thought to be the problem? Have you seen the specialist? What age was she the first time she was seen for this problem ? (put 0 if less than 12 months) ... years What was decided? What treatment was given?
Generic text

1 - Yes

2 - No

Generic textAge in yearsGeneric textGeneric textGeneric textAge in yearsGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

Age in yearsGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAge in yearsGeneric textGeneric text

1 - Yes

2 - No

Generic textAge in years
Generic text

1 - Yes

2 - No

Generic textAge in yearsGeneric textGeneric textGeneric textAge in yearsGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

Age in yearsGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAge in yearsGeneric textGeneric text

1 - Yes

2 - No

Generic textAge in years
Generic text

1 - Yes

2 - No

Generic textAge in yearsGeneric textGeneric textGeneric textAge in yearsGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

Age in yearsGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAge in yearsGeneric textGeneric text

1 - Yes

2 - No

Generic textAge in years
Generic text

1 - Yes

2 - No

Generic textAge in yearsGeneric textGeneric textGeneric textAge in yearsGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

Age in yearsGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAge in yearsGeneric textGeneric text

1 - Yes

2 - No

Generic textAge in years
Generic text

1 - Yes

2 - No

Generic textAge in yearsGeneric textGeneric textGeneric textAge in yearsGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

Age in yearsGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAge in yearsGeneric textGeneric text

1 - Yes

2 - No

Generic textAge in years
Problem No.1
Problem No.2
Problem No.3
If more than 3 problems, continue below or on a separate sheet.

Has she visited the dentist in the last 2 years?

1
yes for treatment
2
yes, for inspection only
3
no, not at all
If yes, for treatment,
qc_B11_a == 1

what has she had (tick all that apply) a filling?

1
Yes

what has she had (tick all that apply) a tooth taken out?

1
Yes
If yes,
qc_B11_a_ii == 1

How many teeth?

How many

Did she have a general anaesthetic for this?

1
Yes
2
No

what has she had (tick all that apply) other treatment?

1
Yes

Please describe

Other

Does she use a toothbrush?

1
yes, adult size brush
2
yes, child size brush
3
no, not at all
If no, go to B11e on page 18
qc_B11_b == 3
Else

How often does she brush her teeth?

1
more than once each day
2
once every day
3
less than once a day
4
not at all

Who brushes her teeth?

1
always brushes herself
2
usually brushes herself
3
always brushed by adult
4
usually brushed by adult
5
sometimes child, sometimes adult
6
other (please describe)
Other

Does she ever have toothpaste?

1
Yes
2
No
If no, go to B11f below
If yes,
qc_B11_e == 1

how much toothpaste does she have on her brush nowadays?

1
brush full
2
half brush
3
less that half a brush
4
none

how many times a day does this happen? ... times

How many

does she usually swallow it or spit it out?

1
swallows it
2
spits it out
3
varies

what type of toothpaste is usually used: (please give exact name and brand)

Generic text

Has she ever had a dental X-ray?

1
Yes
2
No

Have any of her first (milk) teeth fallen out?

1
Yes
2
No
If no, go to B12 below
If yes,
qc_B11_g == 1

how many? ... teeth

How many

Are there any foods or drinks that your child is allergic to?

1
yes definitely
2
yes possibly
3
no, not at all
9
don't know
If no, or don't know go to B13a on page 20
If yes,
qc_B12 == 1 || qc_B12 == 2

please describe which foods or drinks

Generic text

was the reaction caused by eating or touching the food or drink?

1
eating/drinking
2
touching
3
both

what happens when she does have the reaction? (tick all that apply) bright red rash

1
Yes
If yes,
qc_B12_c_i == 1

over what part of body?

Generic text

what happens when she does have the reaction? (tick all that apply) hives (white raised bumps on skin)

1
Yes
If yes,
qc_B12_c_ii == 1

over what part of body?

Generic text

what happens when she does have the reaction? (tick all that apply) wheezing or whistling in the chest

1
Yes

what happens when she does have the reaction? (tick all that apply) vomiting

1
Yes

what happens when she does have the reaction? (tick all that apply) diarrhoea

1
Yes

what happens when she does have the reaction? (tick all that apply) difficulty breathing

1
Yes

what happens when she does have the reaction? (tick all that apply) stop breathing

1
Yes

what happens when she does have the reaction? (tick all that apply) headache

1
Yes

what happens when she does have the reaction? (tick all that apply) swelling

1
Yes
If yes,
qc_B12_c_ix == 1

describe where

Generic text

what happens when she does have the reaction? (tick all that apply) other reaction (please describe )

1
Yes
Other

How long after eating or drinking or touching does this usually happen?

1
less than 1 hr
2
1-2 hrs
3
3-5 hrs
4
6 hrs or more
9
don't know

How old was she when this first happened? ... years old

(put 0 if she was under 12 months )

Age in years

How many times has a reaction happened? ... times

How many

How old was she the last time a reaction happened? ... years old

Age in years

What have you done about these reactions? (tick all that apply) Avoided the foods that caused them

1
Yes

What have you done about these reactions? (tick all that apply) Took to GP to investigate

1
Yes

What have you done about these reactions? (tick all that apply) Investigated in hospital

1
Yes

What have you done about these reactions? (tick all that apply) Other (please describe)

1
Yes
Other

What advice have you been given? (if none, write NONE)

Generic text

What treatment has your child been given for the problem? (if none, write NONE)

Generic text

Apart from food and drink are there any other things to which she is allergic?

1
Yes
2
No
If no, go to Section C on page 22
If yes,
qc_B13_a == 1

What is she allergic to? (tick all that apply) pollen

1
Yes

What is she allergic to? (tick all that apply) cat

1
Yes

What is she allergic to? (tick all that apply) dog

1
Yes

What is she allergic to? (tick all that apply) bee sting

1
Yes

What is she allergic to? (tick all that apply) house dust

1
Yes

What is she allergic to? (tick all that apply) other (please tick and describe)

1
Yes
Other

How does she react to these? (tick all that apply) wheezing

1
Yes

How does she react to these? (tick all that apply) breathlessness

1
Yes

How does she react to these? (tick all that apply) sneezing

1
Yes

How does she react to these? (tick all that apply) rash

1
Yes

How does she react to these? (tick all that apply) other (please tick and describe)

1
Yes
Other

Space for any comments about allergies.

Long text
SECTION C: YOUR CHILD'S ENVIRONMENT
Which animals in either your home or elsewhere does she touch at least once a week?
-

1 - Yes in our home

2 - Yes elsewhere

3 - No, not at all

cat (s)
dog (s)
other furry animal*(s)
birds
other creatures*

Which animals in either your home or elsewhere does she touch at least once a week? (*please tick and describe ...)

Other

All children get dirty. How often in a normal day: is her face washed?

1
not at all
2
1-2 times
3
3-4 times
5
5 or more times

All children get dirty. How often in a normal day: are her hands washed or wiped?

1
not at all
2
1-2 times
3
3-4 times
5
5 or more times

All children get dirty. How often in a normal day: are her hands cleaned before a meal?

1
always
2
usually
3
sometimes
4
occasionally
5
never

How often does she normally: have a bath or shower:

1
more than once a day
2
once every day
3
more than once a week
4
once a week
5
hardly ever

How often does she normally: have her ear holes cleaned:

1
more than once a day
2
once every day
3
more than once a week
4
once a week
5
hardly ever

How often during a day is she in a room or enclosed place where people are smoking: weekdays

1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all

How often during a day is he in a room or enclosed place where people are smoking: weekends

1
all the time
2
more than 5 hours
3
3-5 hours
4
1-2 hours
5
less than 1 hour
6
not at all

How often in a normal week 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
More than once a week
5
Every day

How often in a normal week 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
More than once a week
5
Every day

How often in a normal week 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
More than once a week
5
Every day

How often in a normal week does your child: dirty himself at night

1
Never
2
Occasional accident but less than once a week
3
About once a week
4
More than once a week
5
Every day

In a normal week for how long is she left at home alone or just with other young children (aged less than 12)?* during the day:

1
not at all
2
only for a few minutes
3
for less than an hour
4
for more than an hour

In a normal week for how long is she left at home alone or just with other young children (aged less than 12)?* at night:

1
not at all
2
only for a few minutes
3
for less than an hour
4
for more than an hour
(* by this we mean with no adults or older children at home at all)
How much time on average does she spend each day:
on a weekday on a weekend day

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

1 - Not at all

2 - less than 1 hour

3 - 1-2 hours

4 - 3 or more hours

in a car, bus or other transport
out of doors in summer
out of doors in winter
watching T.V
with other children
drawing, making, constructing things
playing by herself
looking at books
SECTION D: CHILD CARE AND ACTIVITIES
During the time since she was 3 years old, have you and your partner been employed? Please answer for each age:
Mother

1 - Full time

2 - Part time

3 - Not employed

3 years to 3 1/2
3 1/2 to 4th birthday
4th birthday to now

During the time since she was 3 years old, have you and your partner been employed? Please answer for each age:

7
No partner
If No partner to question D1
qc_D1 == 7
Else
During the time since she was 3 years old, have you and your partner been employed? Please answer for each age:
Partner

1 - Full time

2 - Part time

3 - Not employed

3 years to 3 1/2
3 1/2 to 4th birthday
4th birthday to now
Apart from yourself, who has regularly looked after your child when you were not with her? Childcare on weekdays Please list below all regular arrangements for your child during weekdays since she was 3 (if none write NONE).

(Please answer for each person or place, including kindergarden, nursery, playgroup, childminder, neighbour or school) regularly involved?

Age of child when started ... years Age of child when started ... months Person and/or place (eg. childminder-her home; kindergarten etc..) Number of hours per week Age of child when stopped (put 777 if still happening) ... years Age of child when stopped (put 777 if still happening) ... months
Age in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textAge in monthsAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in yearsHow manyAge in yearsAge in monthsAge in yearsAge in monthsHow manyGeneric textAge in monthsAge in yearsAge in yearsAge in monthsAge in monthsHow manyAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in years Age in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textAge in monthsAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in yearsHow manyAge in yearsAge in monthsAge in yearsAge in monthsHow manyGeneric textAge in monthsAge in yearsAge in yearsAge in monthsAge in monthsHow manyAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in years Age in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textAge in monthsAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in yearsHow manyAge in yearsAge in monthsAge in yearsAge in monthsHow manyGeneric textAge in monthsAge in yearsAge in yearsAge in monthsAge in monthsHow manyAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in years Age in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textAge in monthsAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in yearsHow manyAge in yearsAge in monthsAge in yearsAge in monthsHow manyGeneric textAge in monthsAge in yearsAge in yearsAge in monthsAge in monthsHow manyAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in years Age in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textAge in monthsAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in yearsHow manyAge in yearsAge in monthsAge in yearsAge in monthsHow manyGeneric textAge in monthsAge in yearsAge in yearsAge in monthsAge in monthsHow manyAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in years Age in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textAge in monthsAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in yearsHow manyAge in yearsAge in monthsAge in yearsAge in monthsHow manyGeneric textAge in monthsAge in yearsAge in yearsAge in monthsAge in monthsHow manyAge in yearsGeneric textAge in yearsHow manyAge in monthsGeneric textAge in monthsAge in years
1
2
3
4
5
Apart from yourself, who has regularly looked after your child when you were not with her? Weekend childcare Please list below all regular childcare arrangements during the weekend since she was 3 (if none write NONE).

(Please answer for each person or place, including kindergarden, nursery, playgroup, childminder, neighbour or school) regularly involved?

Age of child when started ... years Age of child when started ... months Person and/or place (eg. grandmother-my home) Number of hours per week ... Saturday Number of hours per week ... Sunday Age of child when stopped (put 777 if still happening) ... years Age of child when stopped (put 777 if still happening) ... months
How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many How manyAge in yearsGeneric textAge in monthsAge in monthsHow manyAge in yearsAge in yearsAge in monthsAge in monthsAge in yearsHow manyHow manyGeneric textHow manyGeneric textAge in monthsAge in yearsAge in monthsHow manyAge in yearsHow manyAge in yearsAge in monthsHow manyAge in yearsAge in monthsGeneric textGeneric textAge in yearsHow manyHow manyAge in monthsAge in monthsAge in yearsGeneric textAge in yearsAge in monthsAge in yearsAge in monthsHow manyHow manyHow manyAge in yearsAge in monthsAge in monthsAge in yearsGeneric textHow many
1
2
3
4
Apart from yourself, who has regularly looked after your child when you were not with her? Childcare during holidays of normal carers Please list the arrangements made for each time this happened. (If none write NONE)

(Please answer for each person or place, including kindergarden, nursery, playgroup, childminder, neighbour or school) regularly involved?

Age of child when started ... years Age of child when started ... months Substitute person and/or place Number of weeks this happened
Age in yearsAge in monthsHow manyGeneric textAge in monthsHow manyGeneric textAge in yearsHow manyAge in monthsGeneric textAge in yearsGeneric textAge in monthsAge in yearsHow many Age in yearsAge in monthsHow manyGeneric textAge in monthsHow manyGeneric textAge in yearsHow manyAge in monthsGeneric textAge in yearsGeneric textAge in monthsAge in yearsHow many Age in yearsAge in monthsHow manyGeneric textAge in monthsHow manyGeneric textAge in yearsHow manyAge in monthsGeneric textAge in yearsGeneric textAge in monthsAge in yearsHow many Age in yearsAge in monthsHow manyGeneric textAge in monthsHow manyGeneric textAge in yearsHow manyAge in monthsGeneric textAge in yearsGeneric textAge in monthsAge in yearsHow many
1
2
3
4
5

Does your child nowadays attend (tick all that apply) infant school full-time

1
Yes

Does your child nowadays attend (tick all that apply) infant school part-time

1
Yes

Does your child nowadays attend (tick all that apply) kindergarten

1
Yes

Does your child nowadays attend (tick all that apply) nursery/creche

1
Yes

Does your child nowadays attend (tick all that apply) other (please tick and describe)

1
Yes
Other

Does your child nowadays attend (tick all that apply) none of the above

1
Yes
If no organised school, kindergarten or creche go to Section E on page 32
qc_D3_a != 1 && qc_D3_b != 1 && qc_D3_c != 1 && qc_D3_d != 1
Else
Who takes her to and from school, kindergarten or nursery/creche nowadays (tick all that apply).
Going Coming back

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

I take her
My partner takes her
A grandparent or adult relative
An older child
Childminder
Other person
Goes on her own
How does she get there?
Going Coming back

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

1 - every day

2 - some days

She walks
She goes in a pram/pushchair
By public transport
School bus/coach
By car
Rides bicycle
Other (please tick and describe)

How does she get there? Other (please tick and describe)

Other
We would like to know what happens after school or kindergarten etc.

Does she usually go straight home?

1
No
2
Yes
If yes, go to D7c on page 29
If no,
qc_D7_a == 1

where does she go? to a relative's home

1
Every day
2
Some days
3
Never

where does she go? to a friend's home

1
Every day
2
Some days
3
Never

where does she go? to a childminder

1
Every day
2
Some days
3
Never

where does she go? other (please tick and describe)

1
Every day
2
Some days
3
Never
Other

If she goes straight home are you always there too?

1
yes, always
2
yes, usually
3
yes, sometimes
4
no, hardly ever

When she first arrives home does she have: a meal

1
Yes
2
No

When she first arrives home does she have: a snack

1
Yes
2
No

When she first arrives home does she have: a drink

1
Yes
2
No

How does she feel about school/kindergarten/nursery/creche? She looks forward to going

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school/kindergarten/nursery/creche? She enjoys it

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school/kindergarten/nursery/creche? She is stimulated by it

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school/kindergarten/nursery/creche? She is frightened by it

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school/kindergarten/nursery/creche? She talks about new friends

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school/kindergarten/nursery/creche? She seems bored by school

1
Always
2
Usually
3
Sometimes
4
Not at all

How does she feel about school/kindergarten/nursery/creche? She likes her teacher (s)

1
Always
2
Usually
3
Sometimes
4
Not at all
When she finishes and returns home:
-

1 - Always

2 - Usually

3 - Sometimes

4 - Never

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

How many children in her class did she know before attending this school/kindergarten?

1
None
2
1 child
3
2-3 children
4
more than 3 children

Had she visited the school/kindergarten before her first day?

1
Yes
2
No

Does she bring home things that she has done during the day (e.g. painting)?

1
Yes
2
No
If no, go to D14 on page 31
If yes,
qc_D13_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/kindergarten/nursery/creche how does she behave?
-

1 - Always

2 - Usually

3 - Sometimes

4 - Never

excited
talkative
withdrawn
calm
very active
sleepy
angry
hungry
tearful
anxious
affectionate
tired

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

1
Always
2
Usually
3
Sometimes
4
Never
Other
SECTION E: EATING

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

1
snacks all day, no real meals
2
snacks all day, but also has meals
3
doesn't snack much, just has meals
4
other (please describe)
Other

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

How many

Which meal do you consider is her main meal of the day? on weekdays

1
Breakfast
2
Mid morning
3
Midday
4
Mid afternoon
5
Early evening
6
Late evening
7
Doesn't have a main meal

Which meal do you consider is her main meal of the day? on Saturdays

1
Breakfast
2
Mid morning
3
Midday
4
Mid afternoon
5
Early evening
6
Late evening
7
Doesn't have a main meal

Which meal do you consider is her main meal of the day? on Sundays

1
Breakfast
2
Mid morning
3
Midday
4
Mid afternoon
5
Early evening
6
Late evening
7
Doesn't have a main meal
If no main meal go to E3 on page 33
qc_E2_a_i == 7 && qc_E2_a_ii == 7 && qc_E2_a_iii == 7
Else
On a typical week how often does she eat her main meal in these places?
-

1 - Never

2 - 1-2 days a week

3 - 3-5 days a week

4 - 6-7 days a week

at home
at school
at nursery/kindergarten
at the childminder's

On a typical week how often does she eat her main meal in these places? other (please tick and describe)

1
Never
2
1-2 days a week
3
3-5 days a week
4
6-7 days a week
Other

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

1
Yes, great difficulty
2
Yes, some difficulty
3
Yes, occasional difficulty
4
No, no difficulty
If yes,
qc_E3 == 1 || qc_E3 == 2 || qc_E3 == 3

please describe the problems:

Generic text
In the past year has she at any time:
-

1 - Yes, worried me greatly

2 - Yes, worried me a bit

3 - Yes, but did not worry me

4 - No did not happen

deliberately not eaten sufficient amount of food
refused to eat the food you think she should eat
been choosy with food
over-eaten
been difficult to get into an eating routine
We are interested in your child's diet. We would like to know how often nowadays she eats the following foods. Please answer every question even if she never eats the food (in this case tick "Never or rarely").
-

1 - Never or rarely

2 - Once in 2 weeks

3 - 1-3 times a week

4 - 4-7 times a week

5 - More than once a day

Sausages, Burgers
Meat Pies/Pasties (pork pie, steak/meat pie etc.)
Vegetarian Pies/ Pasties (cheese and onion pastie, vegetable samosa, onion bhaji, vegetable grills etc.)
Ham, bacon, pate and cold meats (eg salami, luncheon meat, garlic sausage etc.)
Meat roast, chops, stews and curries etc. (eg. beef, lamb, pork, mince)
Liver, kidney, heart
Chicken/Turkey in crispy coating (eg. chicken nuggets, turkey burgers, chicken fingers etc.)
Poultry: roast, grilled, fried, boiled, stewed (chicken, turkey etc.)
Shellfish (prawns, crab, cockles, mussels etc.)
White fish in breadcrumbs or batter (eg fish fingers/ shapes, chip shop fish, breaded cod etc.)
White fish without coating (eg. grilled fish, cod in parsley sauce etc.)
Tuna
Other fish (pilchards, sardines, mackerel, herring, kippers, trout, salmon etc.)
Eggs, quiche, omelettes, flan etc.
Cheese
Pizza
Oven chips
Fried chips, potato waffles or croquettes, Alphabites etc, fried plantain
Roast potatoes (cooked in fat or oil)
Boiled, mashed, jacket potatoes, yam
Rice (boiled, or fried, not rice pudding)
Canned pasta (spaghetti rings, ravioli, macaroni cheese etc.) Pot Noodles, Super Noodles etc.
Boiled pasta (eg. spaghetti, fusilli, lasagna) bulgar wheat and cous-cous.

Does she eat the fat on meat?

1
yes, all of it
2
yes, some of it
3
no
4
never eats meat

How often does she have fried food? (eg. fried fish, eggs, bacon, chops etc.)

1
Never or rarely
2
Once in 2 weeks
3
1-3 times a week
4
4-7 times a week
5
More than once a day
How many times nowadays does she eat:
-

1 - Never or rarely

2 - Once in 2 weeks

3 - 1-3 times a week

4 - 4-7 times a week

5 - More than once a day

Baked beans
Peas, broad beans
Sweetcorn
Cabbage, brussel sprouts, spinach, broccoli and other dark green leafy vegetables
Other green vegetables (cauliflower, runner beans, leeks, okra, courgettes etc.)
Carrots, sweet potato
Other root vegetables (turnip, swede, parsnip etc.)
Tomatoes (cooked or raw)
Salad (lettuce, cucumber, peppers, other raw vegetables etc.)
Pulses and pulse dishes(dahl, lentil soup, falafel, dried peas, beans, chick peas)
Soya 'Meat', TVP, Quorn, Soya-type Vegeburgers, Bean Curd (Tofu, Miso etc.)
Peanuts, peanut butter
Other nuts,(eg. cashew), nut roast
Fresh citrus fruit (eg. oranges, grapefruit, satsumas, tangerines etc.)
Other fresh fruit (eg. apple, banana, pear, bunch of grapes, peach etc.)
Canned fruit
Yoghurt, Fromage Frais,
Milk puddings (eg. rice pudding, semolina), mousse, Angel Delight etc.)
Ice cream, choc ice chocolate ice cream bar etc.
Ice lollies
Pudding (eg fruit pie, crumble, cheesecake, gateaux)
Custard, cream, Elmlea, Tip-Top, evaporated milk etc. on puddings
Cakes or buns (fruit cake, sponge, teacake, doughnut, flapjack, scone, custard tart, cream cake etc.)
Crispbreads (Ryvita, crackerbread etc.)

Does she eat breakfast cereals at all?

1
Yes
2
No
If no, go to E10 on page 40
If yes,
qc_E8_a == 1
What type of breakfast cereal does she eat nowadays?
-

1 - Never or rarely

2 - Once in 2 weeks

3 - 1-3 times a week

4 - 4-7 times a week

5 - More than once a day

Oat cereals (e.g. porridge, Ready Brek, Muesli, chocolate Ready Brek)
Wholegrain or bran cereals (eg. All Bran, Bran Flakes, Weetabix, Wheatflakes, Fruit & Fibre, Shreddies, Shredded Wheat, sugar puffs)
Other cereals (e.g. Cornflakes, Rice Krispies, Frosties, Special K, Coco pops)

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

1
Always
2
Sometimes
3
Never
If never go to E9c below
qc_E9_a == 1
Else

When she has breakfast cereals How many teaspoonfuls of sugar does she have on this type of cereal (ie. sugar coated etc.)

1
None
2
1/2 teaspoon
3
One teaspoon
4
2 teaspoons
5
More than 2 teaspoons

When she has breakfast cereals How many teaspoonfuls of sugar does she have on other types of cereal (ie. plain cereal)?

1
None
2
1/2 teaspoon
3
One teaspoon
4
2 teaspoons
5
More than 2 teaspoons

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

How many
How often nowadays does she eat:
-

1 - Never or rarely

2 - Once in 2 weeks

3 - 1-3 times a week

4 - 4-7 times a week

5 - More than once a day

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

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

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

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

1
Usually eats Funsize
2
Usually eats Adult size
3
Never has chocolate
If Never has chocolate Go to E13 on page 42
qc_E12_a == 3
Else

On days when she has chocolate or chocolate bars (e.g. Mars bars, bag of buttons): How many bars or packets of this size does she usually eat in that day?

1
1/2 or less
2
1 in a day
3
2 in a day
4
3 or more in a day
How many times a week nowadays does she drink?
-

1 - Never or rarely

2 - Once in 2 weeks

3 - 1-3 times a week

4 - 4-7 times a week

5 - More than once a day

Fruit juice from a tin (including tomato juice)
Pure fruit juice from a carton or freshly squeezed
Squash, fruit drinks or Ribena
Cola drinks e.g. Coca Cola, Pepsi etc.
Other fizzy drinks e.g. lemonade
Water on its own
Milk on its own
Flavoured milk drinks (eg. Horlicks, Ovaltine, milkshakes) or yoghurt drinks

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

1
usually
2
sometimes
3
not at all
7
doesn't drink soft drinks

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

1
usually
2
sometimes
3
not at all
7
doesn't have cola

What types of bread does she eat? white bread

1
Usually
2
Sometimes
3
Never

What types of bread does she eat? soft grain white bread (Mighty White)

1
Usually
2
Sometimes
3
Never

What types of bread does she eat? brown/granary bread

1
Usually
2
Sometimes
3
Never

What types of bread does she eat? wholemeal bread

1
Usually
2
Sometimes
3
Never

What types of bread does she eat? chappatis, pitta bread

1
Usually
2
Sometimes
3
Never

What types of bread does she eat? naan bread

1
Usually
2
Sometimes
3
Never

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

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

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

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

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

1 - Yes

2 - No

Butter, Ghee, Dripping, Lard, solid cooking fat
Polyunsaturated margarine eg. Flora, sunflower margarine, Vitalite
Hard or soft margarine eg. Blue Band, Stork, supemarket own brand
Low fat spread eg. Delight, St Ivel Gold, Flora Xtra Light
Sunflower oil, corn oil, soya oil
Olive oil, hazelnut oil, rapeseed oil
Other vegetable oil
Other (please describe)

What sort of fat does she have: Other (please describe)

Other

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

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does she have? Semi Skimmed (red stripe)

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does she have? Dried milk (eg. Marvel)

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does she have? Breast milk

1
Yes usually
2
Yes sometimes
3
No not at all

What type(s) of milk does she have? Other (please describe)

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

Is this milk usually

1
Pasteurised
2
Longlife (UHT)
3
Sterilised
4
Other (please describe)
9
Don't know
Other

Does she drink tea?

1
Yes
2
No
If no, go to E23 on page 46
If yes,
qc_E22_a == 1

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

How many

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

How many

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

How many

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

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

Does she drink coffee?

1
Yes
2
No
If no, go to E24a below
If yes,
qc_E23_a == 1

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

How many

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

How many

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

How many

How many of the cups of coffee she drinks are made using real coffee (ie. not instant)? ... cups a day

How many

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

How many

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

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

Does she drink herbal teas at all?

1
yes, often
2
yes, occasionally
3
no, not at all
If no, go to E25 on page 47
If yes,
qc_E24_a == 1 || qc_E24_a == 2

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

How many

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

Generic text

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

1
Yes
2
No
If no, go to E26a below
If yes,
qc_E25 == 1

please describe below:

Generic text

What would you say best describes your child's alcohol drinking:

1
she has a glass of her own containing a normal adult portion
2
she has a glass of her own, but less than an adult portion
3
she just has a taste of other people's drink
4
she has rarely had any alcohol
5
she has never had any alcohol
If she has never had any alcohol to question E26a Go to E27 on page 48
qc_E26_a == 5
Else
How often does she have any of the following:
-

1 - More than once a week

2 - Once a week

3 - Less than once a week

4 - Not at all

wine
beer, lager
spirits (gin, vodka, brandy)

How often does she have any of the following: other alcohol (please tick and describe)

1
More than once a week
2
Once a week
3
Less than once a week
4
Not at all
Other

Is your child at present a vegetarian?

1
Yes
2
No

Is your child at present a vegan (i.e. does not eat meat, poultry, fish, eggs, butter, milk or cheese)?

1
Yes
2
No

Is your child at present on any kind of special diet?

1
Yes
2
No
If no, go to E30 on page 49
If yes,
qc_E29 == 1

please describe below.

Generic text

Does your child have definite likes and dislikes as far as food is concerned?

1
no, will eat almost anything
2
yes, quite choosy
3
yes, very choosy
How often does she suck a dummy or her thumb or finger?
-

1 - most of the time

2 - sometimes

3 - no, never

dummy
thumb of right hand
thumb of left hand
finger(s)

Apart from her finger, thumb or a dummy does she have a special object that she uses for comfort?

1
Yes
2
No
If no, go to E32 below
If yes,
qc_E31_b == 1

what is this?

1
blanket
2
cuddly toy
3
other (please describe)
Other

Does she eat coal, soil, dirt or other non-food substances?

1
yes, every day
2
yes, at least once a week
3
yes, less than once a week
4
no, not at all
If yes,
qc_E32 == 1 || qc_E32 == 2 || qc_E32 == 3

please describe what she eats:

Generic text
SECTION F: HER GROWTH, HER SHOES, HER LOOKS
Please list the dates on which your child was weighed since she was 3 years old and how much she weighed each time. Also add height and head circumferences, if they were measured. If you don't know, please write DK and go to F5, below.
Date Weight Height Head circumference
Generic textGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric text
1
2
3
4

What size shoes does she take?

Shoe size
How often does she wear the following footwear:
Out of doors Indoors

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

1 - Usually

2 - Sometimes

3 - Never

sandals
trainers/ plimpsols
slippers
shoes
other (please tick and describe)

How often does she wear the following footwear: other (please tick and describe)

Other

What colour are her eyes?

1
blue
2
brown
3
grey
4
greenish
5
other (please describe)
Other

What colour is her hair?

1
black
2
dark brown
3
mid-brown
4
light brown
5
golden
6
almost white
7
red
8
other (please describe)
Other

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:

Generic date
THANK YOU VERY MUCH FOR YOUR HELP

Space for any additional comments you would like to make

Long text
Please remember we cannot reply personally to your comments unless they are signed.
End

alspac_95_myfyobg

MY YOUNG 4 YEAR OLD GIRL
This questionnaire asks about your child now she is 4 years old. We are interested to know about her health and behaviour and how she gets on with other children. Your answers will help us to understand the developing child and to identify problems that children and their parents have.
This questionaire 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. You may make additional comments at the end. All answers are confidential.
THANK YOU FOR YOUR HELP

SECTION A: ACCIDENTS AND INJURIES

However careful a parent is, most children have accidents at some time or other. Please list on the next pages the times your child has had an accident, whether or not she was injured as a result.
Has she been burnt or scalded since she was 3 years old?
1
Yes
2
No
If no, go to A2a on page 4
how many times?
How many

For each burn or scald please describe below what happened:

Place accident happened (e.g. kitchen, garden,nursery) What was she burnt with? (e.g. tea, iron, electric fire) Date of accident (month, year) Injuries caused (if no injury write none) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st accident
2nd accident
3rd accident
Please describe how each accident happened: Burn 1
Generic text
Please describe how each accident happened: Burn 2
Generic text
Please describe how each accident happened: Burn 3
Generic text
Has she had a bad fall since she was 3 years old?
1
Yes
2
No
If no, go to A3a on page 5
how many times?
How many

For each fall please describe below what happened:

Place accident happened (e.g. kitchen, garden,nursery) What did she fall from (e.g. table, wall, climbing frame)? Date of fall (month, year) Injuries caused (if no injury write none) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
1st fall
2nd fall
3rd fall
Please describe how each accident happened: Fall 1
Generic text
Please describe how each accident happened: Fall 2
Generic text
Please describe how each accident happened: Fall 3
Generic text
Has she swallowed anything she shouldn't have (such as pills, buttons, disinfectant) since she was 3 years old?
1
Yes
2
No
If no, go to A4a on page 6
how many times?
How many

For each time please describe below what happened:

Place accident happened (e.g. your home, nursery, at friend's) What did she swallow? Date of accident (month, year) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textOtherGeneric textGeneric textGeneric dateOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric dateGeneric textOtherGeneric dateGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
1st accident
2nd accident
3rd accident
Please describe how each accident happened: Accident 1
Generic text
Please describe how each accident happened: Accident 2
Generic text
Please describe how each accident happened: Accident 3
Generic text
Has she had any other accidents or injuries since she was 3 years old?
1
Yes
2
No
If no, go to A5 on page 7
how many other accidents?
How many

For each accident or injury please describe below what happened.

Place accident happened (e.g. kitchen, garden, street, nursery) What happened? Date of accident (month, year) Injuries caused (if no injury write none) Who was with her? What did the person with her do? Other (please describe) What treatment did the person with her give? What other treatment did she have?
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric dateGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric dateGeneric date

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric dateOther

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textGeneric textGeneric textGeneric textOtherGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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1 - Nothing

2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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4 - Took to hospital

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2 - Treated her themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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4 - Took to hospital

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5 - Other (please describe)

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4 - Took to hospital

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4 - Took to hospital

5 - Other (please describe)

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3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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4 - Took to hospital

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3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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Other

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4 - Took to hospital

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4 - Took to hospital

5 - Other (please describe)

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3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

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