








- | |
---|---|
1 - Yes and saw a doctor 2 - Yes but did not see doctor 3 - No did not have |
|
diarrhoea | |
blood in the stools | |
vomiting | |
cough | |
high temperature | |
ear ache | |
ear discharge (pus not wax) | |
convulsions/fits | |
stomach ache(s) | |
rash | |
wheezing | |
breathlessness | |
episodes of stopping breathing | |
an accident | |
headache(s ) | |
constipation | |
worm infection | |
head lice | |
scabies | |
asthma | |
eczema | |
hay fever |

Age of child (years) | Reason for admission | No. of nights child stayed in hospital Write 00 if he did not stay overnight | |
---|---|---|---|
How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many | How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many | How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many | |
1 | |||
2 | |||
3 |











- | |
---|---|
1 - Definitely 2 - Probably 3 - No, not At all |
|
Repeated movements of parts of the face and head (e.g. eye blinking, grimacing, sticking tongue out, licking lips, spitting) | |
Repeated movements of the neck, shoulder or trunk (e.g. twisting around, shoulder shrugging, bending over, nodding) | |
Repeated movements of the arms, hands, legs or feet (e.g. clapping hands, touching himself or others, hopping, kicking) | |
Repeated noises and sounds (e.g. coughing, clearing throat, grunting, gurgling, hissing) | |
Repeated words and phrases |

- | |
---|---|
1 - A lot worse than average 2 - A bit worse than average 3 - About average 4 - A bit better than average 5 - A lot better than average |
|
Able to laugh around with others, e.g. accepting lighthearted teasing and responding appropriately | |
Easy to chat with, even if it isn't on a topic that specially interests him | |
Able to compromise and be flexible | |
Finds the right thing to say or do in order to defuse a tense or embarrassing situation | |
Graceful when he doesn't win or get his own way. A good loser | |
Other people feel at ease around him | |
By reading between the lines of what people say, he can work out what they are really thinking and feeling | |
After doing something wrong, he's able to say sorry and sort it out so that there are no hard feelings. | |
Can take the lead without others feeling they are being bossed about | |
Aware of what is and isn't appropriate in different social situations |





(tick all that apply)





(tick all that apply)
Please choose one of the following for each medicine, that best describes how often, and for how long each time, the side effects happened.
(Tick just one for each medicine)

- | |
---|---|
1 - Is often like this 2 - Is sometimes like this 3 - Is never like this |
|
He goes to extremes to prevent those he loves from leaving him | |
He either loves someone or hates them, with nothing in between | |
He often wonders who he really is | |
He has tried to hurt or kill himself | |
He is a very moody boy | |
He feels his life is dull and meaningless | |
He has difficulty controlling his anger or temper | |
When he gets stressed out, things happen, e.g. he gets paranoid or complains of feeling detached from himself or things around him |
- | |
---|---|
1 - True 2 - Sometimes true 3 - Not true |
|
He felt miserable or unhappy | |
He didn't enjoy anything at all | |
He felt so tired that he just sat around and did nothing | |
He was very restless | |
He felt he was no good any more | |
He cried a lot | |
He found it hard to think properly or concentrate | |
He hated himself | |
He felt he was a bad person | |
He felt lonely | |
He thought nobody really loved him | |
He thought he could never be as good as other kids | |
He felt he did everything wrong |

If a doctor told your study teenager that he needed to put on 5 pounds (2 kilos) for the sake of his health, how would he find this? He may have a physical problem that makes it hard for him to put on weight. Here we are asking if he is willing to try, not whether he can succeed.


- | |
---|---|
1 - Not true 2 - Somewhat true 3 - Certainly true 9 - Don't know |
|
He has been considerate of other people's feelings | |
He has been restless, overactive, cannot stay still for long | |
He has often complained of headaches, stomach aches or sickness | |
He has shared readily with other children and teenagers (treats, toys, pencils etc.) | |
He has often had temper trantrums or hot tempers | |
He is rather solitary, tends to play alone | |
He is generally obedient, usually does what adults request | |
He has many worries, often seems worried | |
He is helpful if someone is hurt, upset or feeling ill | |
He is constantly fidgeting or squirming | |
He has at least one good friend | |
He often fights or bullies other children or teenagers | |
He is often unhappy, down-hearted or tearful | |
He is generally liked by other children | |
He is easily distracted, his concentration wanders | |
He is nervous or clingy in new situations, easily loses confidence | |
He is kind to younger children | |
He often lies or cheats | |
He is picked on or bullied by other children | |
He often volunteers to help others (parents, teachers, other children) | |
He thinks things out before acting | |
He steals from home, school or elsewhere | |
He gets on better with adults than with other teenagers | |
He has many fears, is easily scared | |
He sees tasks through to the end, has good attention span |





- | |
---|---|
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 | |
Green vegetables (e.g. broccoli, cauliflower, cabbage, leeks, Brussels sprouts, courgettes, green beans etc.) | |
Carrots | |
Other root vegetables (turnip, swede, parsnip etc.) | |
Tomatoes (cooked or raw) | |
Salad (lettuce, cucumber, peppers, other raw vegetables etc.) | |
Pulses and pulse dishes (dahl, lentil soup, falafel, dried peas, beans, chick peas) | |
Quorn pieces/mince/ fillets, Quorn sausages or burgers | |
Soya 'Meat', TVP, Soya-type Vegeburgers, Vegebangers, Bean Curd (Tofu, Miso etc.) | |
Peanuts, peanut butter | |
Other nuts (e.g. cashew), nut roast | |
Canned fruit | |
Yoghurt, Fromage Frais | |
Milk puddings (e.g. rice pudding, semolina), mousse, Angel Delight etc. | |
Ice cream, choc ice, chocolate ice cream bar etc. | |
Ice lollies | |
Pudding (e.g. fruit pie, crumble, cheesecake, gateaux) | |
Custard, cream, Elmlea, Tip-Top, evaporated milk etc. on puddings | |
Cakes or buns (fruit cake, sponge, teacake, doughnut, flapjack, scone, custard tart, cream cake etc.) | |
Crispbreads (Ryvita, crackerbread etc.) | |
Ketchup/brown sauce etc. | |
Mayonnaise, salad cream or dressing 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 |
|
Oat cereals (e.g. porridge, Ready Brek, Muesli, chocolate Ready Brek) | |
Wholegrain or bran cereals (e.g. 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) | |
Breakfast cereal bars e.g. Rice Krispies bars, cornflakes bars |

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 | ||
Olive oil margarine | ||
Full-fat polyunsaturated margarine (e.g. Flora, Vitalite, sunflower margarine) | ||
Other full-fat margarine e.g. Stork, Blue Band, supermarket own brand, Clover, Golden Crown, Willow | ||
Low-fat polyunsaturated margarine (e.g. Flora lite, Vitalite Lite, low-fat sunflower margarine) | ||
Other low-fat spread, not polyunsaturated (e.g. Delight, St Ivel Gold) | ||
Sunflower oil, corn oil, soya oil | ||
Olive oil, hazelnut oil, rapeseed oil | ||
Other vegetable oil | ||
Other (please tick describe) |








alspac_04_mtsd
SECTION A: YOUR SON'S HEALTH
Has he had any of the following in the past 12 months?
- | |
---|---|
1 - Yes and saw a doctor 2 - Yes but did not see doctor 3 - No did not have |
|
diarrhoea | |
blood in the stools | |
vomiting | |
cough | |
high temperature | |
ear ache | |
ear discharge (pus not wax) | |
convulsions/fits | |
stomach ache(s) | |
rash | |
wheezing | |
breathlessness | |
episodes of stopping breathing | |
an accident | |
headache(s ) | |
constipation | |
worm infection | |
head lice | |
scabies | |
asthma | |
eczema | |
hay fever |
please describe for each admission:
Age of child (years) | Reason for admission | No. of nights child stayed in hospital Write 00 if he did not stay overnight | |
---|---|---|---|
How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many | How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many | How manyAgeGeneric textHow manyAgeGeneric textAgeGeneric textHow many | |
1 | |||
2 | |||
3 |
What is the main reason he has been feeling tired or lacking in energy? (please tick all that apply)
- | |
---|---|
1 - Yes |
|
Illness | |
Problems with sleep | |
Playing a lot of sport (or other physical exercise) | |
Stress or worry |
SECTION B: SEEING AND HEARING
SECTION C: TICS AND UNINTENDED HABITS
Many teenagers have strange habits that they do not intend and often are not aware of them. Please indicate whether your study teenager has had any of these in the past year.
- | |
---|---|
1 - Definitely 2 - Probably 3 - No, not At all |
|
Repeated movements of parts of the face and head (e.g. eye blinking, grimacing, sticking tongue out, licking lips, spitting) | |
Repeated movements of the neck, shoulder or trunk (e.g. twisting around, shoulder shrugging, bending over, nodding) | |
Repeated movements of the arms, hands, legs or feet (e.g. clapping hands, touching himself or others, hopping, kicking) | |
Repeated noises and sounds (e.g. coughing, clearing throat, grunting, gurgling, hissing) | |
Repeated words and phrases |
SECTION D: SOCIAL SKILLS
How do you feel your study teenager compares with people of his own age in regard to the following:
- | |
---|---|
1 - A lot worse than average 2 - A bit worse than average 3 - About average 4 - A bit better than average 5 - A lot better than average |
|
Able to laugh around with others, e.g. accepting lighthearted teasing and responding appropriately | |
Easy to chat with, even if it isn't on a topic that specially interests him | |
Able to compromise and be flexible | |
Finds the right thing to say or do in order to defuse a tense or embarrassing situation | |
Graceful when he doesn't win or get his own way. A good loser | |
Other people feel at ease around him | |
By reading between the lines of what people say, he can work out what they are really thinking and feeling | |
After doing something wrong, he's able to say sorry and sort it out so that there are no hard feelings. | |
Can take the lead without others feeling they are being bossed about | |
Aware of what is and isn't appropriate in different social situations |
SECTION E: ATTITUDES AND BEHAVIOUR TOWARDS ANIMALS
SECTION F: MEDICINES, PILLS, LOTIONS, CREAMS AND IMMUNISATIONS
what type of medicine was difficult for him to take?
Yes | Please give name(s) of medicines | |
---|---|---|
1 - Yes Generic text1 - Yes Generic text |
1 - Yes Generic text1 - Yes Generic text |
|
tablets | ||
hard capsules (usually contain granules or powder) | ||
soft capsules (may contain a liquid) | ||
liquid medicine |
_medicine < 4
_medicine < 4
Which of the following best describes the reaction or side effects?
- | |
---|---|
1 - Yes |
|
skin rash | |
itching | |
feeling/being sick | |
breathing difficulties | |
effects on digestion e.g. diarrhoea | |
blood disorder | |
bleeding | |
bad headache(s) | |
dizziness/feeling faint | |
blurred vision | |
jaundice | |
severe allergic reaction or anaphylaxis |
SECTION G: MOODS AND FEELINGS
We are interested in studying the patterns of behaviour that children have. Please could you try to describe the kind of person your child is. When answering the questions, think about how he has tended to feel, think, and act over the past several years. Remember that there are no correct answers.
- | |
---|---|
1 - Is often like this 2 - Is sometimes like this 3 - Is never like this |
|
He goes to extremes to prevent those he loves from leaving him | |
He either loves someone or hates them, with nothing in between | |
He often wonders who he really is | |
He has tried to hurt or kill himself | |
He is a very moody boy | |
He feels his life is dull and meaningless | |
He has difficulty controlling his anger or temper | |
When he gets stressed out, things happen, e.g. he gets paranoid or complains of feeling detached from himself or things around him |
As far as you know, has he done things on impulse that can get him into trouble?
- | |
---|---|
1 - Yes 2 - No |
|
Has he gone on eating binges? | |
Has he drunk too much alcohol? | |
Has he taken drugs? | |
Has he spent more money than he has? | |
Has he yelled at people? | |
Has he broken things? | |
Has he hit people? | |
Has he stolen things? |
These questions are about how your teenager may have been feeling or acting recently. For each question, please say how much you think he has felt or acted this way in the past two weeks.
- | |
---|---|
1 - True 2 - Sometimes true 3 - Not true |
|
He felt miserable or unhappy | |
He didn't enjoy anything at all | |
He felt so tired that he just sat around and did nothing | |
He was very restless | |
He felt he was no good any more | |
He cried a lot | |
He found it hard to think properly or concentrate | |
He hated himself | |
He felt he was a bad person | |
He felt lonely | |
He thought nobody really loved him | |
He thought he could never be as good as other kids | |
He felt he did everything wrong |