Start
alspac_94_mtyobg
MA_MY THREE YEAR OLD BOY
This questionnaire asks about your child now he is 3 years old. We are interested to know about his health and behaviour and how he 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 questionnaire is like the other questionnaires you have received. To answer simply tick the box which best describes your child or your child's situation. Again some questions will seem similar but they are not the same. 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: 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 his 2nd birthday.
- 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
teething gel
laxative
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 his 2nd birthday. Since his 2nd birthday: other (please tick and describe)

Generic text

Are there any pills, ointments or medicines that he has taken every day or nearly every day for the last 3 months? (Include vitamins, skin cream, laxatives as well as antibiotics, etc)

1
Yes
2
No
If no, go to A3a below
If yes,
qcA2_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 problem that might have arisen.

Has your toddler ever been investigated because it was thought he might have something wrong with his hips, his legs or his feet?

1
Yes
2
No
If no, go to A4a on page 4
If yes,
qcA3_a == 1

were any problems found?

1
Yes
2
No
9
Don't know
If yes,
qcA3_b == 1

please describe:

Generic text

how old was he?

1
less than 1 year
2
1 year old
3
2 years old
4
3 years old

what treatment did he have?

Generic text
Your child's hearing

Has anyone ever thought there might be a problem with his hearing?

1
Yes
2
No
If no, go to A5 below
If yes,
qcA4_a == 1

Who first suspected a problem?

1
I did
2
my partner did
3
other relative or friend
4
health visitor
5
doctor
6
someone else (please tick and describe)
Other

Has your child been seen at the Hearing Assessment Centre?

1
Yes
2
No
If no, go to A5 below
If yes,
qcA4_c == 1

At what age?

1
less than 1 year
2
1 year old
3
2 years old
4
3 years old

What was decided?

Generic text

What treatment was given (if any)

Generic text
Your child's sight

Has anyone ever thought there might be a problem with his eyesight?

1
Yes
2
No
If no, go to A6 on page 5
If yes,
qcA5_a == 1

Who first suspected a problem?

1
I did
2
my partner did
3
other relative or friend
4
health visitor
5
doctor
6
someone else (please tick and describe)
Other

What was thought to be wrong with his eyes?

1
squint
2
something else (please tick & describe)
9
don't know
Other

Has your child ever been referred to an eye specialist?

1
Yes
2
No
If no, go to A6 below
If yes,
qcA5_d == 1

at what age?

1
less than 1 year
2
1 year old
3
2 years old
4
3 years old

What was decided?

Generic text

What treatment was given?

Generic text
Other problems

Have there been any other problems for which your child saw (or is going to see) a specialist?

1
Yes
2
No
If no, go to A7a on page 6
If yes,
qcA6_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 he the first time he was seen for this problem? (put 0 if less than 12 months) ... years old What was decided? What treatment was given?
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Problem No. 1
Problem No. 2
Problem No. 3

Has he ever visited the dentist?

1
yes for treatment
2
yes, for inspection only
3
no, not at all
If yes, for treatment,
qcA7_a == 1

has he had: a filling

1
Yes
2
No

has he had: a tooth out

1
Yes
2
No

has he had: other treatment (please tick & describe)

1
Yes
2
No
Other

Do you use a toothbrush for the child?

1
yes, every day
2
yes, sometimes
3
no not at all

Does he ever have toothpaste?

1
Yes
2
No
If yes,
qcA7_c == 1

how much do you put on his brush nowadays?

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

how many times a day do you do this? ... times

How many

does he 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 he ever had a dental X-ray?

1
Yes
2
No
SECTION B: 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 SINCE HIS 2ND BIRTHDAY whether or not he was injured as a result.

Has he been burnt or scalded since his 2nd birthday?

1
Yes
2
No
If no, go to B2a on page 9
If yes,
qcB1_a == 1

how many times?

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

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him 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 he been dropped or had a bad fall since his 2nd birthday?

1
Yes
2
No
If no, go to B3a on page 10
If yes,
qcB2_a == 1

how many times?

How many
For each fall please describe below what happened.
Place accident happened (eg. kitchen, garden, creche) What did he fall or drop from (eg. table, baby walker, pram, bed, your arms) Date of fall (month, year) Injuries caused (if no injury write none) Who was with him? What did the person with him do? Other (please describe) What treatment did the person with him give? What other treatment did he have?
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him 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: 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 he swallowed anything he shouldn't have (such as pills, buttons, disinfectant) since his 2nd birthday?

1
Yes
2
No
If no, go to B4a on page 11
If yes,
qcB3_a == 1

how many times?

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

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him 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 he had any other accidents or injuries since his 2nd birthday?

1
Yes
2
No
If no, go to Section C on page 12
If yes,
qcB4_a == 1

how many other accidents?

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

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him 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
SECTION C: YOUR CHILD'S ENVIRONMENT
Which animals in either your home or elsewhere does he touch at least once a week?
-

1 - Yes in our home

2 - Yes elsewhere

4 - No, not at all

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

*please tick & describe

Generic text

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

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

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

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

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

1
always
2
usually
3
sometimes
4
occasionally
5
never

How often does he usually: have a bath:

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

How often does he usually: have his ear holes cleaned:

1
more than once a day
2
once every day
3
several times a week
4
once a week
5
hardly ever
Toilet Training:

Is your child: dry during the day

1
Always
2
Sometimes
3
Never

Is your child: dry during the night

1
Always
2
Sometimes
3
Never

Is your child: clean during the day

1
Always
2
Sometimes
3
Never

Is your child: clean during the night

1
Always
2
Sometimes
3
Never

Does your child tell you when he wants to go to the lavatory?

1
usually
2
sometimes
3
never

How often during a day is he 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 is he left at home alone or just with other young children (i.e. children younger than 12)? during the day:

1
not at all
2
less than 10 minutes
3
less than an hour
4
more than an hour

How often in a normal week is he left at home alone or just with other young children (i.e. children younger than 12)? at night:

1
not at all
2
less than 10 minutes
3
less than an hour
4
more than an hour
SECTION D: CHILDCARE
Apart from yourself, nowadays who regularly looks after your child when you are not there? (Please answer for each person regularly involved).
- If yes, give hours per week

1 - No

2 - Yes

Hours per week

1 - No

2 - Yes

Hours per week

1 - No

2 - Yes

Hours per week

1 - No

2 - Yes

Hours per week
partner
child's grandparent
other relative
friend/neighbour
paid person outside the home (eg. child minder)
paid person in the home (eg. nanny, baby sitter)
day nursery (creche)
other (please describe)

Apart from yourself, nowadays who regularly looks after your child when you are not there? (Please answer for each person regularly involved). other (please describe)

Generic text

What was the main reason for choosing this form of childcare?

1
I had no choice
2
I could afford it
3
It was convenient
4
It was linked to my job
5
I thought it would be beneficial for my child
6
Other (please describe)
Other

How satisfied are you with these arrangements?

1
very satisfied
2
fairly satisfied
3
not at all happy
Since your child was 24 months old, please list below the daytime child care arrangements (other than you or your partner) at each age.
No. of hours/week during the day Person (eg childminder grandmother) Place (eg at home, creche, etc)
Generic textHours per weekGeneric textGeneric textHours per weekGeneric textHours per weekGeneric textGeneric text Generic textHours per weekGeneric textGeneric textHours per weekGeneric textHours per weekGeneric textGeneric text Generic textHours per weekGeneric textGeneric textHours per weekGeneric textHours per weekGeneric textGeneric text
2 years
2 years 3 months
2 years 6 months
2 years 9 months
3 years
now

How many different people other than you or your partner have looked after your child during the day since he was 2 years old (count each nursery or creche as 1 person)

How many

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

7
Have no no partner
If Have no no partner to question D4 Go to D5 on page 16
qcD4 == 7
Else
How often does your partner do these activities with your child?
-

1 - Often

2 - Sometimes

3 - Rarely

4 - Never

baths him
feeds him
sings to him
shows him pictures in books
plays with toys
cuddles him
physical play (eg. clapping, rolling over)
takes him for walks
puts him to bed

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

1
Often
2
Sometimes
3
Rarely
4
Never
Generic text

How often do you do these activities with your child? bath him

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? feed him

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? sing to him

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? show him pictures in books

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? play with toys

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? cuddle him

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? physical play (eg. clapping, rolling over)

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? take him for walks

1
Often
2
Sometimes
3
Rarely
4
Never

How often do you do these activities with your child? put him to bed

1
Often
2
Sometimes
3
Rarely
4
Never

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

1
Often
2
Sometimes
3
Rarely
4
Never
Other

How much time on average does he spend: On most weekdays in a car

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekdays out of doors

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekdays watching T.V.

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekdays with other children

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekend days in a car

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekend days out of doors

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekend days watching T.V.

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day

How much time on average does he spend: On most weekend days with other children

1
not at all
2
less than 1 hour
3
1-2 hours a day
4
more than 2 hours a day
SECTION E: FEEDING

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

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

How many meals a day does your child have now?

How many

For his main meal of the day how often does your child eat:

7
Doesn't have a main meal
If Doesn't have a main meal to question E2 go to E3 below
qcE2 == 7
Else
For his main meal of the day how often does your child eat:
-

1 - Always

2 - Almost always

3 - Sometimes

4 - Almost never

5 - Never

the same food as you
a different meal that you prepare
a ready-prepared meal out of a packet or tin

Do you feel that you have had difficulties feeding him in the past year?

1
Yes, great difficulty
2
Yes, some difficulty
3
Yes, occasional difficulty
4
No, no difficulty
If yes,
qcE3 == 1 || qcE3 == 2 || qcE3 == 3

please describe the problems:

Generic text
In the past year has he 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

not eaten sufficient amount of food
refused to eat the right food
been choosy with food
over-eaten
been difficult to get into an eating routine
How many times nowadays does he 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

Sausages, Burgers
Pies, Pasties (pork pie, steak/meat pie etc.)
Meat (beef, lamb, pork, ham, bacon etc.)
Poultry (chicken, turkey etc)
Liver, liver pate, kidney, heart
Fish fingers
White fish, not fish fingers (cod, haddock, plaice, etc)
Other fish (pilchards, sardines, mackerel, tuna, herring, kippers, trout, salmon etc)
Shellfish (prawns, crab, cockles, mussels etc)
Eggs, quiche
Cheese
Pizza
Chips
Roast potatoes (cooked in fat)
Boiled, mashed, jacket potatoes
Rice (boiled, or fried)
Pot Noodles, cook-in sauces, Ragu etc.
Pasta (eg. spaghetti, lasagna)
Crisps
Fried foods (eg. fried fish, eggs, bacon, chops etc)

Does he eat the fat on meat?

1
yes, all of it
2
yes, some of it
3
no
4
never eats meat
How many times nowadays does he 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, sweetcorn, broad beans
Cabbage, brussel sprouts, kale and other green leafy vegetables
Other green vegetables (cauliflower, runner beans, leeks etc)
Carrots
Other root vegetables (turnip,swede,parsnip etc)
Salad (lettuce, tomato, cucumber etc)
Pulses - dried peas, beans, lentils, chick peas, bean curd, tahini
Nuts, nut roast
Soya 'Meat', T.V.P., Vegeburgers
Fresh fruit (apple, pear, banana, orange, bunch of grapes etc)
Yoghurt, Fromage Frais, milk puddings, mousse
Pudding (eg fruit pie, crumble, cheesecake, gateaux)
Oat cereals (eg porridge, Ready Brek, muesli)
Wholegrain or bran cereals (eg. All Bran, Bran Flakes, Weetabix, Wheatflakes, Fruit & Fibre)
Other cereals (eg Cornflakes, Rice Krispies, Frosties)
Cakes or buns (fruit cake, sponge, teacake, doughnut, flapjack, scone, custard tart, cream cake etc)
Crispbreads (Ryvita, crackerbread etc)
Biscuits (digestive, shortcake, Hob Nobs, Rich Tea, Nice, Marie)
Chocolate biscuits, chocolate fingers, (Penguin, Club, Kit Kat etc)
Chocolate bars (Mars, Twix, Wispa, Bounty, Creme Egg etc)
Chocolate (dairy milk or plain, white chocolate, smarties etc)
Sweets (cola bottles, penny mix-ups, chews, jelly sweets etc)

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

1
1-2
2
3-5
3
6-10
4
11 and over

On the day when he has chocolates or chocolate bars, how much does he eat (give as proportion of Mars bar, bag of buttons, etc)

1
less than a quarter
2
about a quarter
3
about a half
4
about three quarters
5
whole
6
more than one
7
never has chocolates
How many times a week nowadays does he 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 carton/ freshly squeezed
Squash, fruit drink 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/yoghurt drinks, ready made
Flavoured milk drinks (not ready made) hot or cold

When he has soft drinks, how often are they low calorie, diet or reduced sugar drinks?

1
usually
2
sometimes
3
not at all
4
doesn't drink soft drinks

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

1
usually
2
sometimes
3
not at all
4
doesn't have cola

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

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

What types of bread does he eat most days? white bread

1
Yes
2
No

What types of bread does he eat most days? brown/granary bread

1
Yes
2
No

What types of bread does he eat most days? wholemeal bread

1
Yes
2
No

What types of bread does he eat most days? chappatis, nan bread

1
Yes
2
No

What types of bread does he eat most days?

7
doesn't usually eat any bread
What sort of fat does he have?
-

1 - Yes usually

2 - Yes sometimes

3 - No not at all

Butter, Ghee, Dripping Lard, Solid cooking fat
Hard or soft margarine e.g. Blue Band, Stork, Supermarket own brand
Polyunsaturated margarine e.g. Flora, Sunflower, Vitalite
Low fat spread, e.g. Outline, Delight, St.Ivel Gold
Sunflower, soya, corn, olive oil
Other vegetable oil

What sort of fat does he have? Other (please tick & describe)

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

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

How many

How many times in a month does he eat takeaway foods for his main meal?

1
never or rarely
2
1 - 2
3
3 - 4
4
5 - 9
5
10 or more

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

1
Yes usually
2
Yes sometimes
3
No not at all

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

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

How often does he have milk: tea with milk

1
almost every day
2
several times a week
3
at least once a week
4
less than once a week
5
no, not at all

How often does he have milk: coffee with some milk

1
almost every day
2
several times a week
3
at least once a week
4
less than once a week
5
no, not at all

How often does he have milk: milk on breakfast cereal

1
almost every day
2
several times a week
3
at least once a week
4
less than once a week
5
no, not at all

How often does he have milk: a milk pudding (custard, rice)

1
almost every day
2
several times a week
3
at least once a week
4
less than once a week
5
no, not at all

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

How many

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

How many

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

How many

How many cups of coffee does he drink? ... cups a day

How many

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

How many

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

How many

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

How many

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

How many

Does he drink herbal teas at all?

1
yes, often
2
yes, occasionally
3
no, not at all
If no, go to E22a below
If yes,
qcE21_a == 1 || qcE21_a == 2

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

How many

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

Generic text

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

1
he often has a glass of his own
2
he sometimes has a glass of his own
3
he just has a taste of other people's drink
4
he has rarely had any alcohol
5
he has never had any alcohol

How often does he have any of the following: wine

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

How often does he have any of the following: beer, lager

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

How often does he have any of the following: spirits (gin, vodka, brandy)

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

How often does he 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

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

1
Yes
2
No
If yes,
qcE23 == 1

please describe below:

Generic text

What does he usually drink from nowadays? ordinary cup, mug or glass

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

What does he usually drink from nowadays? feeder cup

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

What does he usually drink from nowadays? bottle with teat

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

What does he usually drink from nowadays? can

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

What does he usually drink from nowadays? carton or bottle with a straw

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

How often does he have a bottle of drink which he carries with him and drinks from, over several hours?

1
everyday
2
most days
3
occasionally
4
not at all

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 do you put him down to sleep with a bottle? (whether at night or during the day)

1
always
2
sometimes
3
never

How often does he suck a dummy or his thumb or finger? dummy

1
most of the time
2
sometimes
3
no, never

How often does he suck a dummy or his thumb or finger? thumb/finger

1
most of the time
2
sometimes
3
no, never

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

1
Yes
2
No
If no, go to E29 below
If yes,
qcE28_c == 1

what is this?

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

How often does he eat coal, soil, dirt or other non-nutritious substances?

1
every day
2
at least once a week
3
less than once a week
4
not at all
If yes,
qcE29 == 1 || qcE29 == 2 || qcE29 == 3

please describe what he eats:

Generic text
SECTION F: TEMPERAMENT
Please tick the box which describes how often the child's behaviour is like the behaviour given below:

He tends to be shy

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He cries easily

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He likes to be with people

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He is always on the go

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He prefers playing with others rather than alone

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He tends to be somewhat emotional

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

When he moves about he tends to move slowly

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He makes friends easily

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He is off and running as soon as he wakes up in the morning

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He finds people more stimulating than anything else

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He often fusses and cries

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He is very sociable

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He is very energetic

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He takes a long time to warm up to strangers

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He gets upset easily

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He is something of a loner

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He prefers quiet inactive games to more active ones

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

When alone he feels isolated

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He reacts intensely when upset

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him

He is very friendly with strangers

1
Not at all like him
2
Not much like him
3
Somewhat like him
4
Quite like him
5
Exactly like him
SECTION G: HIS GROWTH

Please list the dates on which your child was weighed since he was 24 months old and how much he weighed each time. Also add height and head circumferences, if they were measured. [f you do not have this information - tick box ... and go to section H]

1
Tick
[f you do not have this information - tick box and go to section H]
qcG_i == 1
Else
Please list the dates on which your child was weighed since he was 24 months old and how much he weighed each time. Also add height and head circumferences, if they were measured.
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
5
6
SECTION H: UNDERSTANDING AND TALKING
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Hello
Don't
Dinner
Call
Turn round
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Dog/Puppy
Bear/Teddy
Chicken
Goose
Animal
Crocodile
Hen
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Nose
Hand
Head
Finger
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Sock
Coat
Pyjamas
Jumper
Tights
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Cheese
Biscuit
Raisin
Pizza
Butter
Chips
(Beef) burger
Peas
Potato
Strawberry
Spaghetti
Lemonade
Nuts
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Door
Window
Settee/sofa
Sink
Bedroom
Washing machine
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Bottle
Box
Fork
Money
Glasses
Plate
Knife
Camera
Heater
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Tree
Rain
Star
House
Snow
Roof
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Mummy
Boy
Clown
Lady
Princess
Person
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Park
Farm
Church
Library
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Down
The
On top of
With
An
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Mine
These
Him
Hers
Us
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Ouch/Ow
Wet
Happy
Hurt
Sleepy
New
Green
Fast
Quiet
Awake
White
First
Angry
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.
He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

More
Some
Any
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

What?
Which?
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Night
Today
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Toy
Bubbles
Football
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Boat
Train
We are interested in the words your child understands and those he SAYS. Please mark the words you have heard your child use or know he understands. If your child uses a different pronunciation of a word (for example, "raffe" instead of "giraffe" or "sketti" for "spaghetti"), mark the word anyway. This is a list of some of the words that may be used by young children. Don't worry if your child doesn't say any of these yet.

(Tick both columns if he says and understands).

He says He understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Kiss
Bite
Help
Comb
Close
Cook
Turn on/off
Fix
Look
Splash
Shake
Pull
Touch
Put
Cover
Drop
Taste
Lie down
Wish
Do
Have to
Are
Were

To talk about more than one thing, we add an "s" to many words. For example, cars, shoes, dogs, and keys. Has your son begun to do this?

1
Not yet
2
Sometimes
3
Often

To talk about ownership, we add an "s", for example, Daddy's key, kitty's dish, and baby's bottle. Has your son begun to do this?

1
Not yet
2
Sometimes
3
Often

To talk about activities, we sometimes add "ing" to verbs. For example, looking, running, and crying. Has your son begun to do this?

1
Not yet
2
Sometimes
3
Often

To talk about things that happened in the past, we often add "ed" to the verb. For example, kissed, opened, and pushed. Has your son begun to do this?

1
Not yet
2
Sometimes
3
Often
Below are some plural words. Please indicate in each column which your son uses and/or understands (if any).
Yes, he says Yes, he understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

children
feet
men
mice
teeth
Next are some words that indicate that something happened in the past; please mark in each column which he says and/or understands.
Yes, he says Yes, he understands

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

ate
blew
bought
broke
came
drank
drove
fell
flew
got
had
heard
held
lost
made
ran
sat
saw
took
went

Has your son begun to combine words yet, such as "nother sweet", or "doggie bite?"

1
Not yet
2
Sometimes
3
Often
If not yet, go to section I on page 37
qcH22 == 1
Else

Please list three of the longest combinations you have heard your child say recently.

Generic text
Generic text 2
Generic text 3

In each of the following, please mark the one that sounds most like the way your child talks right now.

1
two shoe
2
two shoes
1
two feet
2
two foots
3
two foot
1
Daddy car
2
Daddy's car
1
Kitty sleep
2
Kitty sleeping
3
Kitty is asleep
1
I make tower
2
I making tower
3
I am making tower

In each of the following, please mark the one that sounds most like the way your child talks right now. Talking about something that already happened:

1
I fell down
2
I fall down
1
Doggie kiss me
2
Doggie kissed me
1
Daddy pick me up
2
Daddy picked me up
1
John went away
2
John go away

In each of the following, please mark the one that sounds most like the way your child talks right now. Talking about other things:

1
Baby's blanket
2
Baby blanket
1
Dog table
2
Dog on table
1
That's my book
2
That my book
SECTION I: MORE ABOUT TALKING AND LISTENING

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

1
Not yet
2
Sometimes
3
Often

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

1
Not yet
2
Sometimes
3
Often

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

1
Never
2
Sometimes
3
Often

Is his voice hoarse or husky?

1
Never
2
Sometimes
3
Often

Can you understand what he says?

1
Mostly
2
Sometimes
3
Rarely

Can your family understand what he says?

1
Mostly
2
Sometimes
3
Rarely

Can visitors to your house understand what he says?

1
Mostly
2
Sometimes
3
Rarely

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

1
Not yet
2
Sometimes
3
Often

Does he talk but the words are in the wrong order? (e.g. 'me car want').

1
Often
2
Sometimes
3
Never

Does he ask questions?

1
Often
2
Sometimes
3
Never

Children learn to talk in different ways and at different ages. Please indicate which description best describes your son: making babble noises that sound like talking:

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

Children learn to talk in different ways and at different ages. Please indicate which description best describes your son: prefers using gestures (pointing or pulling) to get what he wants:

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

When he talks nowadays, how many words can he put together (e.g. "me want juice" would be 3)?

1
one
2
two
3
3 or 4
4
5 or more
5
does not talk at all
Some children enjoy talking and others do not.
-

1 - Often

2 - Sometimes

3 - Not often

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

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

1
Yes
2
No
If no, go to I13 on page 39.
If yes,
qcI11 == 1

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

1
Yes
2
No

who (tick all that apply): health visitor

1
Yes
2
No

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

1
Yes
2
No

who (tick all that apply): grandparents

1
Yes
2
No

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

1
Yes
2
No
Other

Are there still any worries about his talking?

1
Yes
2
No
If yes,
qcI11_f == 1

please describe

Generic text

Has he ever been seen by a speech therapist?

1
Yes
2
No
If no, go to I13
If yes,
qcI12 == 1

how old was he? ... years

(If less than 1 year put 0)

Age

what was decided?

Generic text

Are there any other languages apart from English spoken in your household?

1
Yes
2
No
If yes,
qcI13 == 1

please say which

Generic text

which language does your son speak?

1
English only
2
English and other
3
Other only

This questionnaire was completed by: mother

1
Yes
2
No

This questionnaire was completed by: father

1
Yes
2
No

This questionnaire was completed by: other (please tick & describe)

1
Yes
2
No
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 to any comment unless you sign it.
When completed, please return the questionnaire to: Dr. Jean Golding, Children of the Nineties - ALSPAC, Institute of Child Health, 24, Tyndall Avenue, Bristol. BS8 1BR. Tel: Bristol 925 6260
End

alspac_94_mtyobg

MA_MY THREE YEAR OLD BOY
This questionnaire asks about your child now he is 3 years old. We are interested to know about his health and behaviour and how he 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 questionnaire is like the other questionnaires you have received. To answer simply tick the box which best describes your child or your child's situation. Again some questions will seem similar but they are not the same. 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: 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 his 2nd birthday.

- 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
teething gel
laxative
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 his 2nd birthday. Since his 2nd birthday: other (please tick and describe)
Generic text
Are there any pills, ointments or medicines that he has taken every day or nearly every day for the last 3 months? (Include vitamins, skin cream, laxatives as well as antibiotics, etc)
1
Yes
2
No
If no, go to A3a below
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 problem that might have arisen.
Has your toddler ever been investigated because it was thought he might have something wrong with his hips, his legs or his feet?
1
Yes
2
No
If no, go to A4a on page 4
were any problems found?
1
Yes
2
No
9
Don't know
please describe:
Generic text
how old was he?
1
less than 1 year
2
1 year old
3
2 years old
4
3 years old
what treatment did he have?
Generic text

Your child's hearing

Has anyone ever thought there might be a problem with his hearing?
1
Yes
2
No
If no, go to A5 below
Who first suspected a problem?
1
I did
2
my partner did
3
other relative or friend
4
health visitor
5
doctor
6
someone else (please tick and describe)
Other
Has your child been seen at the Hearing Assessment Centre?
1
Yes
2
No
If no, go to A5 below
At what age?
1
less than 1 year
2
1 year old
3
2 years old
4
3 years old
What was decided?
Generic text
What treatment was given (if any)
Generic text

Your child's sight

Has anyone ever thought there might be a problem with his eyesight?
1
Yes
2
No
If no, go to A6 on page 5
Who first suspected a problem?
1
I did
2
my partner did
3
other relative or friend
4
health visitor
5
doctor
6
someone else (please tick and describe)
Other
What was thought to be wrong with his eyes?
1
squint
2
something else (please tick & describe)
9
don't know
Other
Has your child ever been referred to an eye specialist?
1
Yes
2
No
If no, go to A6 below
at what age?
1
less than 1 year
2
1 year old
3
2 years old
4
3 years old
What was decided?
Generic text
What treatment was given?
Generic text

Other problems

Have there been any other problems for which your child saw (or is going to see) a specialist?
1
Yes
2
No
If no, go to A7a on page 6
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 he the first time he was seen for this problem? (put 0 if less than 12 months) ... years old What was decided? What treatment was given?
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Generic text

1 - Yes

2 - No

Generic textAgeGeneric textGeneric textGeneric textAgeGeneric text

1 - Yes

2 - No

Generic text

1 - Yes

2 - No

AgeGeneric textGeneric textGeneric text

1 - Yes

2 - No

Generic textGeneric textAgeGeneric textGeneric text

1 - Yes

2 - No

Generic textAge
Problem No. 1
Problem No. 2
Problem No. 3
Has he ever visited the dentist?
1
yes for treatment
2
yes, for inspection only
3
no, not at all
has he had: a filling
1
Yes
2
No
has he had: a tooth out
1
Yes
2
No
has he had: other treatment (please tick & describe)
1
Yes
2
No
Other
Do you use a toothbrush for the child?
1
yes, every day
2
yes, sometimes
3
no not at all
Does he ever have toothpaste?
1
Yes
2
No
how much do you put on his brush nowadays?
1
brush full
2
half brush full
3
less than half a brush full
4
none
how many times a day do you do this? ... times
How many
does he 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 he ever had a dental X-ray?
1
Yes
2
No

SECTION B: 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 SINCE HIS 2ND BIRTHDAY whether or not he was injured as a result.
Has he been burnt or scalded since his 2nd birthday?
1
Yes
2
No
If no, go to B2a on page 9
how many times?
How many

For each burn or scald please describe below what happened:

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

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him 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 he been dropped or had a bad fall since his 2nd birthday?
1
Yes
2
No
If no, go to B3a on page 10
how many times?
How many

For each fall please describe below what happened.

Place accident happened (eg. kitchen, garden, creche) What did he fall or drop from (eg. table, baby walker, pram, bed, your arms) Date of fall (month, year) Injuries caused (if no injury write none) Who was with him? What did the person with him do? Other (please describe) What treatment did the person with him give? What other treatment did he have?
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him 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: 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 he swallowed anything he shouldn't have (such as pills, buttons, disinfectant) since his 2nd birthday?
1
Yes
2
No
If no, go to B4a on page 11
how many times?
How many

For each time please describe below what happened.

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

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic text
Generic textGeneric text

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateOtherGeneric textGeneric textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric textOtherGeneric textGeneric textGeneric text

1 - Nothing

2 - Treated him 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 he had any other accidents or injuries since his 2nd birthday?
1
Yes
2
No
If no, go to Section C on page 12
how many other accidents?
How many

For each accident or injury please describe below what happened.

Place accident happened (eg. kitchen, garden, creche) What happened? Date of accident (month, year) Injuries caused (if no injury write none) Who was with him? What did the person with him do? Other (please describe) What treatment did the person with him give? What other treatment did he have?
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric dateGeneric textGeneric text

1 - Nothing

2 - Treated him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic textGeneric textGeneric textOtherGeneric textGeneric textGeneric date

1 - Nothing

2 - Treated him 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 him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital

5 - Other (please describe)

Generic dateGeneric text
Other

1 - Nothing

2 - Treated him 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 him 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 him themselves

3 - Took to doctor

4 - Took to hospital