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ncds_74_pq

Local Authority Code Number

Local Authority Code Number

Child's Code Number

Child's Code Number
Strictly confidential
NATIONAL CHILDREN'S BUREAU,
Parental interview form
(1958 Cohort)
NATIONAL CHILD DEVELOPMENT STUDY
Sponsors: Institute of Child Health, University of London National Birthday Trust Fund National Foundation for Educational Research in England and Wales
In Collaboration with: Society of Education Officers Society of Community Medicine Association of Directors of Education (Scotland)
Chairman of Consultative Committee: Professor D. V. Donnison BA
Chairman of Steering Commitee: W. D. Wall BA, Ph.D
Executive Co-Directors: Professor N. R. Butler MD, FRCP, DCH Professor R. Davie BA, Ph.D, DIP.ED. Psych Mrs. Mia Kellmer Pringle BA, Ph.D, D.Sc
Co-Directors: M. J. R. Healy BA J.M. Tanner MD, D.Sc, FRCP, FRC.Psych W.D. Wall BA, Ph.D
Senior Research Officer: K.R. Fogleman BA

Child's name (surname)

Generic text

First names (in full)

Generic text

Sex (please ring appropriate number)

1
Boy
2
Girl

Child's Date of Birth

Date of birth

Today's Date

Generic date

Child's present address

Generic text

Child's home address at time of birth

Generic text

Place of birth if different from above (please give address if possible)

Generic text

Child's address at the time of Second Follow-up (in 1969)

Generic text
If born abroad,

please give approximate date child came to live in this country

Generic date

Name of informant (surname)

Generic text

Name of informant (first names)

Generic text

Relationship of informant to the study child

1
Mother
2
Father
3
Other (please specify ...)
Other
Introductory Notes
First of all may we take this chance to thank you for carrying out these interviews on behalf of the National Child Development Study
During the first few months of this year some 16,000 such interviews will be taking place. During the same period the young people themselves will be answering a questionnaire, completing a few tests of their educational attainment and they will be given a full medical examination. We shall also ask their teachers and headteachers about the young people's schools and their educational progress.
If you helped us with earlier follow-ups of these young people, you will know that this is the fourth time that information has been collected.
At birth, information was obtained which cast light on such matters as perinatal mortality, the significance of birthweight, the effect of mothers' smoking in pregnancy and many other important details with consequent improvement in the Maternity Services.
The findings of the follow-up when the children were aged seven have recently been published in From Birth to Seven (Davie, Butler & Goldstein,1972). The overwhelming co-operation received from health visitors, teachers, medical officers, parents and many others enabled this report to present more findings which have been recognised as having important implications for policy and planning decisions for future medical, educational and social services.
A similar follow-up was carried out a 11 years of age and many of the results from this are now being published. A full list of all NCDS books, articles and papers can be obtained from the National Children's Bureau.
Now that the young people in the study are 16 years of age, the opportunity is being taken to extend the study as they reach school leaving age.
The Interview
Ideally the interview should be with the child's mother or mother figure by herself (apart from those few cases where there is none). However, this cannot always be possible and its important to avoid embarrassment and awkwardness that might be caused by asking someone else to leave.
In our preparatory work on the interview form, we have tried to avoid questions which would be resented by the person being interviewed for being too personal. However, it is always possible that people do not want to answer some questions for reasons of this kind. Please stress at the start of the interview that people are free to decline to answer some questions if they choose and do not press for answers where this is the case.
Recording information
The form is designed so that, as far as possible, information can be recorded with the minimum of difficulty and the processing and analysis of the answers can be carried out conveniently. You will find that answers fall into three categories:
Firstly, there are those that require a short, written answer and space is provided to write a few words.
Secondly, there are those questions where a number of alternative answers are offered, each with a number by it. In this case, you should ring the number corresponding to the answer you are given. You will also often find that there is a space provided to be used when the answer does not fall into any of the categories offered.
For the third kind of question the answer is a number. For these the number should be written in the box or boxes provided.
If you feel that any answer needs some qualification or amplification, please add comments at that point on the form.
Thank you again for all your help.
People in the household
A household is a group of people who live together and eat together.
Who normally lives in the study child's household?
Relationship to study child (e.g. father, stepbrother) or status In household (e.g. lodger) Roster cs_q1_X Age Generic text Generic text Generic text Generic text Age Generic text Age Generic text
Study child 1 Name
Study child 1 Sex
Study child 1 Age
Study child 2 Name
Study child 2 Sex
Study child 2 Age
Study child 3 Name
Study child 3 Sex
Study child 3 Age
Study child 4 Name
Study child 4 Sex
Study child 4 Age
Study child 5 Name
Study child 5 Sex
Study child 5 Age
Study child 6 Name
Study child 6 Sex
Study child 6 Age
Study child 7 Name
Study child 7 Sex
Study child 7 Age
Study child 8 Name
Study child 8 Sex
Study child 8 Age
The following questions about brothers and sisters are to be taken as referring to all children who have the same natural mother as the study child. Include in the answers any that you have already listed as being in the household. Do not count a twin of the study child as a younger or older brother or sister, (the twin should have a seperate form).

How many older brothers does the study child have?

How many

How many younger brothers?

How many

How many older sisters?

How many

How many younger sisters?

How many

The relationship to the study child of the person acting as the child's mother is : (Please ring appropriate letter or number)

Y
Natural mother
X
Mother by legal adoption
0
Step-mother
1
Foster-mother
2
Grandmother
3
Elder sister
4
Co-habitee of father
5
Aunt
6
Housemother
7
No regular mother figure
8
Other (please specify ...)
Other
If not natural or legal adoptive mother, please state if possible:
qc_3 != Y || qc_3 != X

Why child is not living with his/her natural or adoptive mother.

Generic text

If child is living with a mother substitute, at what age did he/she first come under her care? Please write age in years in boxes

Age

The relationship to the study child of the person acting as the child's father is: (please ring appropriate letter or number)

Y
Natural father
X
Father by legal adoption
0
Step-father
1
Foster-father
2
Grandfather
3
Elder brother
4
Co-habitee of mother
5
Uncle
6
Housefather
7
No regular father figure
8
Other (please specify ...)
Other
If not natural or legal adoptive father, please state, if possible:
qc_5 != Y || qc_5 != X

Why child is not living with his/her natural or adoptive father

Generic text

If child is living with a father subsitute, at what age did he/she first come under his care? Please write age in years in boxes

Age

Has this child ever been in the care of a Local Authority?

1
Yes, in care now
2
Yes, in care only in the past
3
No, has never been in care
4
Don't know
5
Other reply (give details ...)
Other
If yes,
qc_7_a == 1 || qc_7_a == 2

what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Local Authority? Age

Age

what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Local Authority? Local Authority

Generic text

Has the child ever been in the care of a Voluntary Society?

1
Yes, in care now
2
Yes, in care only in the past
3
No, has never been in care
4
Don't know
5
Other reply (give details ...)
Other
If yes,
qc_7_b == 1 || qc_7_b == 2

what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Voluntary Society? Age

Age

what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Voluntary Society? Voluntary Society

Generic text
Occupation of the child's father or father figure (i.e. present male head of household)

If not working, write 'Not working' below and fill in details of last occupation under a) to e). If no male head, write 'None' below and proceed to question 10.

Generic text
If no male head, write 'None' below and proceed to question 10.
qc_8 == "None"
Else
(In completing this question as much detail as possible should be given to indicate the exact type of work done so that we can classify by skill, qualification or responsibility involved. Terms such as 'electrical worker', 'engineer', 'civil servant', 'clerk' are insufficient and need explaining.)

Actual job

Generic text

Trade, Industry or Profession

Generic text

Is the father paid weekly, monthly or is he self-employed?

1
Weekly
2
Monthly
3
Self-employed
4
Don't know
5
Other (please specify ...)
Other
If self-employed:
qc_8_c == 3

How many people does he employ?

1
None
2
1 - 24
3
25 +
4
Don't know
If not self-employed:
qc_8_c != 3

Does he supervise others? (e.g. foreman, manager, chargehand)

1
Yes
2
No
3
Don't know
If yes, i.e. does supervise others,
qc_8_e_i == 1

approximately how many people does he supervise?

1
1-24
2
25+
3
Don't know

For how many weeks has the father (i.e male head) been out of work in the past 12 months through illness or accident or unemployment. Enter number of weeks in boxes. e.g for 6 weeks put 06 for no weeks put 00. Where no male head leave blank. Number of weeks off work through: Illness or accident

Weeks in past 12 months

For how many weeks has the father (i.e male head) been out of work in the past 12 months through illness or accident or unemployment. Enter number of weeks in boxes. e.g for 6 weeks put 0 6 for no weeks put 00. Where no male head leave blank. Number of weeks off work through: Unemployment

Weeks in past 12 months

Does the mother (or mother figure) do paid work?

1
Yes
2
No
If mother does paid work, please give full details:
qc_10 == 1

Actual job and nature of work (including whether full or part-time)

Generic text

Trade, industry or profession

Generic text

Paid weekly, monthly or self-employed

Generic text

Supervisory status, if any, and how many supervised

Generic text

If self-employed, how many people she employs

How many

At what age did father or father figure leave full-time education?

Age

At what age did mother or mother figure leave full-time education?

Age

Is English the language usually spoken in the child's home?

1
Yes, English only
2
Yes, but other language also used
3
No. Other language usually used
If any other language is spoken in the home
qc_14_a == 1 || qc_14_a == 2

what is it?

Generic text

How many cigarettes each do the mother and father smoke? Mother

1
Does not smoke at all
2
Smokes an occasional cigarette, but less than 1 a day
3
1-5 cigarettes a day
4
6-10
5
11-20
6
21-30
7
31 or more
8
Smokes a pipe or cigars, but not cigarettes

How many cigarettes each do the mother and father smoke? Father

1
Does not smoke at all
2
Smokes an occasional cigarette, but less than 1 a day
3
1-5 cigarettes a day
4
6-10
5
11-20
6
21-30
7
31 or more
8
Smokes a pipe or cigars, but not cigarettes

How often does the study child go out in the evenings?

1
Never or rarely goes out
2
Goes out in the evenings once or twice a week
3
Goes out in the evenings three or four times a week
4
Goes out in the evenings five or more times a week
5
Other answers (please specify ...)
Other

Remind the parent that the study child's year group is the first in which all children have had to stay at school until the age of sixteen. In the study child's case do they wish that he/she had been able to leave school at fifteen?

1
Yes
2
No
3
Don't know/Can't say
Ask parents who would have liked the child to have already left school
qc_17_a == 1

their reasons for this.

Generic text

Which of the following would the parents like the study child to do?

1
Leave at minimum school leaving age (i.e. end of this school year)
2
Stay in full-time education beyond minimum school leaving age, but not beyond 18
3
Continue some form of full-time education beyond the age of 18
4
Uncertain

Which of the following do the parents think the study child is in fact likely to do?

1
Leave at minimum school leaving age (i.e. end of this school year)
2
Stay in full-time education beyond minimum school leaving age, but not beyond 18
3
Continue some form of full-time education beyond the age of 18
4
Uncertain

What type of work would the parents like the study child to do?

Generic text

What type of work do the parents think the study child Is in fact likely to do? (If the answer is the same as to question 20 please write 'as above').

Generic text

Is the study child likely, after leaving school, to be in need of any special provision because of a handicap which could restrict his/her employment opportunities?

1
Yes
2
No
3
Uncertain/Don't know
If yes,
qc_22 == 1

please specify type of handicap

Generic text

Please ask the parent to what extent they have been satisfied with the study child's education in his/her present school.

1
Satisfied
2
Satisfied in some ways but not in others
3
Dissatisfied
4
Uncertain/Don't know
If any dissatisfaction,
qc_23 == 2 || qc_23 == 3

please give reasons

Generic text

Ask the parent how many times during the past twelve months he/she has discussed the study child's school progress with his/her teachers. (Write number in box). If no such discussion write 0 in box. If 9 or more, please write 9.

Discussion

Have the parents at any time in the past 12 months found it necessary to keep the study child off school in order to help at home?

1
Yes
2
No
3
Uncertain/Don't know

How many schools has the study child attended since his/her 11th birthday ? Please list the name and type of schools (secondary modern, comprehensive, etc) below:

Generic text

Please enquire or state from your own knowledge if a) the study child, and b) any other member of the family, has had any contact with any of the following services since the child's eleventh birthday. (Please ring all that apply) Study child

1
Social Services or Social Work Department (including former Children's Department)
2
Educational Welfare Department
3
Careers Officer/Youth Employment Officer
4
Voluntary Social Work Agency (please state which ...)
5
Police or Probation Office
Generic text

Please enquire or state from your own knowledge if a) the study child, and b) any other member of the family, has had any contact with any of the following services since the child's eleventh birthday. (Please ring all that apply) Other person

1
Social Services or Social Work Department (including former Children's Department)
2
Educational Welfare Department
3
Careers Officer/Youth Employment Officer
4
Voluntary Social Work Agency (please state which ...)
5
Police or Probation Office
Generic text
If there has been any such contact,
(qc_27_a_i >= 1 && qc_27_a_i <= 5) || (qc_27_a_ii >= 1 && qc_27_a_ii <= 5)

please state who arranged the contact in the first instance

Generic text

Has the study child ever been taken to court (or a Children's Hearing in Scotland)?

1
Yes
2
No
3
Don't know
If yes,
qc_27_c == 1

please give as many details as you can

Generic text

Does any child of the family recieve free school meals at present?

1
Yes
2
No
3
Don't know
4
Other replies (please specify ...)
Other

Ask the parent whether they have been seriously troubled by financial hardship in the past 12 months.

1
Yes
2
No
3
Uncertain
4
Don't know
5
Other reply (please give details ...)
Other

What have been the sources of income of the household during the past 12 months? (Ring all relevant sources but exclude study child's earnings, if any).

1
Father/ father figure's employment
2
Mother/mother figure's employment
3
Brothers'/sisters' employment
4
Other adult member(s) of household's employment
5
Investments and/or private income
6
Annuities and pensions (other than social security)
Y
Supplementary benefit
X
Unemployment benefit
0
Widow's Pension/Widowed mother's allowances
1
Sickness benefit
2
Retirement Pension
3
Disability Pension
4
Family Allowance
5
Family Income Supplement
6
Any other sources (please specify ...)
Other
Ask the informant(s) to indicate the range in which the members of the household's usual net income falls (i.e after all deductions at source, viz, income-tax, health contributions, pensions, etc, commissions, overtime pay, etc. Include bonuses, commissions, overtime pay, etc. if this is usually recieved). Please show the informant (s) the following section and ask them to indicate the approximate range in which the net income of members of the household falls.
-

Y - £0-4

X - £5-9

0 - £10-14

1 - £15-19

2 - £20-24

3 - £25-29

4 - £30-34

5 - £35-39

6 - £40-44

7 - £45-49

8 - £50-59

9 - £60+

Weekly net pay of father or father figure Please ring the appropriate number
Weekly net pay of mother or mother figure Please ring the appropriate number
Weekly net income from all other sources (e.g. family allowances, earned income of other members of household, investments, private incomes, social security benefits, pensions, Family Income Supplement, etc)
Ask the informant(s) to indicate the range in which the members of the household's usual net income falls (i.e after all deductions at source, viz, income-tax, health contributions, pensions, etc, commissions, overtime pay, etc. Include bonuses, commissions, overtime pay, etc. if this is usually recieved). Please show the informant (s) the following section and ask them to indicate the approximate range in which the net income of members of the household falls.
-

Y - £0-17

X - £18-40

0 - £41-60

1 - £61-80

2 - £81-105

3 - £106-125

4 - £126-145

5 - £146-170

6 - £171-190

7 - £191-210

8 - £211-255

9 - £256+

Monthly net pay of father or father figure Please ring the appropriate number
Monthly net pay of mother or mother figure Please ring the appropriate number
Monthly net income from all other sources (e.g. family allowances, earned income of other members of household, investments, private incomes, social security benefits, pensions, Family Income Supplement, etc.)
If all or part of questions 30 and 31 were not answered,
qc_30 == NULL || (qc_31_i == NULL && qc_31_ii == NULL)

was this because:

1
Informant did not know answer(s)
2
Informant did not want to give answer(s)
3
Uncertain of reason

What accommodation is occupied by this household?

1
Whole house or bungalow
2
Flat/maisonette (self-contained)
3
Room(s)
4
Caravan
5
Other (please specify ...)
Other

is this accommodation:

1
Owned by this household or being bought
2
Rented from Council or New Town Corporation or Commission or Scottish Special Housing Association
3
Privately rented-unfunished
4
Privately rented-furnished
5
Tied to occupation
6
Other (please specify ...)
Other

Does the accommodation have : (ask each item) Bathroom

1
Yes-sole use of one
2
Yes-sole use of two or more
3
Yes-shared use only
4
No bathroom, but permanent fixed bath with own water supply in another room (e.g. kitchen)
5
No bathroom or permanent fixed bath
6
Don't know

Does the accommodation have : (ask each item) Indoor lavatory

1
Yes-sole use of one
2
Yes-sole use of two or more
3
Yes-shared use only
4
No
5
Don't know

Does the accommodation have : (ask each item) Outdoor lavatory

1
Yes-sole use
2
Yes-shared use only
3
No
4
Don't know

Does the accommodation have : (ask each item) Hot water supply

1
Yes-sole use
2
Yes-shared use only
3
No
4
Don't know

How many rooms does the accommodation have? Exclude all kitchens, sculleries and bathrooms. Include rooms used by lodgers and relatives who are members of the household as defined in Question 1. Enter number of rooms in the boxes. e.g. 6 rooms = 06 11 rooms = 11

How many

And now please describe the kitchen; which of the following applies?

1
Kitchen less than 6 feet wide and not used as a living room
2
Kitchen less than 6 feet wide and used as a living room
3
Kitchen more than 6 feet wide and not used as a living room
4
Kitchen more than 6 feet wide and used as a living room
5
No kitchen
6
Don't know

How many other people sleep in the same room as the study child? Please fill in number in box. (if child has own room enter 0; if shares with 1 other, enter 1, etc.)

How many

How many other people sleep in the same bed as the study child? Please fill in number in box. (If child has own bed enter 0; if shares with 1 other, enter 1, etc)

How many

How many floors are there in the building in which the family live? Please enter number in boxes. e.g. 6 floors = 06 12 floors = 12

How many

On what floor is the front door of the home?

1
Below street level
2
At street level/ground floor
3
1st floor
4
2nd floor
5
3rd-4th floor
6
5th-6th floor
7
7th-9th floor
8
10th-12th floor
9
13th floor upwards

Does the household have: (please ring all that apply)

1
TV-black and white
2
TV-colour
3
Refrigerator
4
Deep-freeze
5
Telephone within the accomodation (do not count coin-box phone)
6
2 or more cars
7
1 car
8
Full or partial central heating

For how long has this address been the study child's home?

Y
Since birth
X
Not since birth but over 10 years
0
5-10 years
1
4 years
2
3 years
3
2 years
4
1 year
5
Under 1 year
6
Don't know
7
Other (please specify ...)
Other

How many times has the famliy moved since the study child was born? Enter the number of moves, e.g. 6 moves = 6 If 9 or more, enter 9

Moves
If the answer is not straightforward

give brief details below. (For example, cases where the child has moved home but not the family, or where the child is in a residential home or residential school, etc.)

Generic text
Read to the informant (s) : 'There are many things about which parents and teenagers can disagree. I will now read a list of some of the most common areas. Could you say for each one how often you and the study child argue (if at all) about this subject'. For each topic please ring the appropriate number.
-

1 - Often

2 - Sometimes

3 - Never or hardly ever

His/her choice of friends of the same sex
His/her choice of friends of the opposite sex
His/her dress and/or hairstyle
The time he/she comes in at night, and/or the time he/she goes to bed
The places he/she goes to in his/her own time
Whether or not he/she does his/her homework
Whether or how much he/she smokes
Whether or how much he/she drinks
Below is a list of minor health problems which most children have at some time. Please ask how often each of these happens with the study child. Answers should be given according to how the child has been during the past 12 months.
-

1 - Never

2 - Occasionally but not as often as once per week

3 - At least once per week

Has stomach-ache or vomiting
Wets pants or the bed
Soils or loses control of bowels
Has temper tantrums (that is, complete loss of temper with shouting, angry movements, etc.)
Has tears on arrival at school or refuses to go into the building
Truants from school

Does he/she stammer or stutter?

1
No
2
Yes, mildly
3
Yes, severely

Has he/she any difficulty with speech other than stammering or stuttering?

1
No
2
Yes, mild
3
Yes, severe
If yes,
qc_45_b == 2 || qc_45_b == 3

please describe the difficulty

Generic text

Does he/she ever steal things?

1
No
2
Yes, occasionally
3
Yes, frequently
If yes,
qc_45_c == 2 || qc_45_c == 3

please give a few details if possible

Generic text

Is there any eating difficulty?

1
No
2
Yes, mild
3
Yes, severe
If yes,
qc_45_d == 2 || qc_45_d == 3

is it:

1
Not eating enough
2
Eating too much
3
Faddiness
4
Other (please describe ...)
Other

Does he/she have any sleeping difficulty?

1
No
2
Yes, mild
3
Yes, severe
If yes,
qc_45_e == 2 || qc_45_e == 3

is it :

1
Getting off to sleep
2
Waking during the night
3
Waking early in the morning
4
Bad dreams
5
Night terrors
6
Sleep walking
7
Other (specify ...)
Other
Below are a series of descriptions of behaviour often shown by young people. Please ask the informant(s) about each one and ring the appropriate number to show the degree to which this description is true of the study child.
-

1 - Doesn't apply

2 - Applies somewhat

3 - Certainly applies

Very restless. Has difficulty staying seated for long
Squirmy, fidgety child
Often destroys own or others' property
Frequently fights or is extremely quarrelsome with other children
Not much liked by other children
Often worried, worries about many things
Tends to do things on own-rather solitary
Irritable. Is quick to 'fly off the handle'
Often appears miserable, unhappy, tearful or distressed
Has twitches, mannerisms or tics of the face or body
Frequently sucks thumb or fingers
Frequently bites nails or fingers
Is often disobedient
Cannot settle to anything for more than a few moments
Tends to be fearful or afraid of new things or new situations
Fussy or over-particular
Often tells lies
Bullies other children

Please enquire where the parents were born. Place of birth (town,county and country) Mother

Generic text

Please enquire where the parents were born. Place of birth (town,county and country) Father

Generic text
If not born in Britain,

in which year did parents come to live in this country? Year of arrival : Mother

Generic date

in which year did parents come to live in this country? Year of arrival : Father

Generic date
Medical Causes of School Absence

How much time altogether has the study child missed from school in the past 12 months for reasons of ill-health or emotional disturbance ?

1
None, or less than one week in all
2
Over one week and up to one month in all
3
Over one month and up to three months in all
4
Over three months in all
5
Missed school, but don't know for how long
6
Don't know whether missed school
7
Does not attend school (please state why ...)
Generic text
If absent for more than one week in all during the past 12 months,
qc_48_a >= 2 && qc_48_a <= 4

please indicate reason(s). If not applicable, leave blank; otherwise please ring all appropriate letters or numbers.

Y
Colds, catarrh, sore throats, ear infections or influenza
X
Bronchitis or chest infections, including pneumonia
0
Asthma or wheeziness
1
Headaches
2
Emotional or nervous problems (specify ...)
3
Bilious attacks or diarrhoea
4
Dysmenorrhoea
5
Abdominal pain
6
Infectious diseases (specify ...)
7
Accident or injury (specify ...)
8
Convulsions, fits or turns
9
Other causes (specify ...)
Generic text
Generic text 2
Generic text 3
Other
General Health

Has the study child suffered in the past 12 months from any of the following ? Please ring all appropriate letters or numbers.

Y
Hay fever or allergic rhinitis
X
Recurrent vomiting or bilious attacks
0
Dysmenorrhoea
1
Travel sickness
2
Recurrent abdominal pains
3
Recurrent mouth ulcers
4
Recurrent throat and/or ear infections requiring treatment by a doctor
5
Acne (other than trivial)
6
Eczematous rashes
7
Psoriasis
8
None of the above
Accidents (including burns, scalds, poisoning, near-drowning) requiring hospital admission or accident/casualty department attendance.

Has the study child ever had any accident necessitating admission to hospital or attendance at an accident/casualty department?

1
Yes, one
2
Yes, two
3
Yes, three
4
Yes, four
5
Yes, five
6
Yes, six
7
Yes, seven or more
8
No
9
Don't know
If No or Don't know, please proceed to Question 49
If Yes, please complete b) to f) below.
qc_50_a >= 1 && qc_50_a <= 7
Place where accident occurred Please complete the following table by ringing the appropriate numbers to show where each accident occurred and whether the study child was admitted to hospital or attended an accident/casualty department only. Against (i) to (iv) please enter this information for the four most recent accidents which have occurred, starting with the most recent.
Accident resulting in:

1 - Hospital admission overnight or longer: On the road

2 - Hospital admission overnight or longer: At home

3 - Hospital admission overnight or longer: At school

4 - Hospital admission overnight or longer: Elsewhere

5 - or Accident/casualty department attendance only: On the road

6 - or Accident/casualty department attendance only: At home

7 - or Accident/casualty department attendance only: At school

8 - or Accident/casualty department attendance only: Elsewhere

Most recent accident
Next most recent
Next most recent
Next most recent
Type of injury For each accident recorded in b) above, please show the type of injury which resulted. Ring more than one number against each accident, if necessary.
-

Y - Type of injury not known

X - No injury detected

0 - Unconsciousness

1 - Fracture of skull

2 - Fracture of other bone

3 - Eye injury

4 - Burn or scald

5 - Flesh wound requiring 10+ stitches

6 - Poisoning or suspected poisoning

7 - In danger of drowning

8 - Other injury

Most recent accident
Next most recent
Next most recent
Next most recent
Age(s) at which accident(s) occurred Please enter in the boxes in the margin the age in years at which each accident occurred. (If age less than 1, enter 00).
-
Age
Most recent accident
Next most recent
Next most recent
Next most recent
Below, for each accident, please give any further known details, e.g. circumstances, type of injury, site of fracture, nature of poisoning, etc.
-
Generic text
Most recent accident
Next most recent
Next most recent
Next most recent
If the study child has had more than four accidents please enter details of all earlier accidents in section (f).
qc_50_a >= 5 && qc_50_a <= 7

[Details of all earlier accidents (including burns, scalds or poisoning) if child has had more than four, i.e. where accidents(s) occurred, nature of injury, whether admitted to hospital overnight and child's age.

Generic text
Admission to hospital overnight or longer

Has the study child ever been admitted to a hospital over-night ?

1
Yes, as a result of an accident(s) only
2
Yes, for other reason(s) only
3
Yes, as a result of an accident(s) and for other reason(s)
4
No
5
Don't know
If No, or Don't know, or Yes, accident(s) only, please proceed to Question 50. Otherwise, please complete b) to f) below.
qc_51_a == 4 || qc_51_a == 5 || qc_51_a == 1
Operations Please complete the following table by ringing the appropriate number or letter in each line to show whether the study child has had any of these operations and at what age.
-

Y - No

X - Don't know

0 - Yes, but don't know age

1 - Yes, when aged: under 3 yrs

2 - Yes, when aged: 3 or 4

3 - Yes, when aged: 5 or 6

4 - Yes, when aged: 7 or 8

5 - Yes, when aged: 9 or 10

6 - Yes, when aged: 11

7 - Yes, when aged: 12

8 - Yes, when aged: 13

9 - Yes, when aged: 14+

Tonsillectomy
Appendicectomy
Correction of squint
Circumcision
Hernia repair
Operation on undescended testis(es)

Other operation(s) Has the study chid ever been admitted to hospital overnight for any operation other than the above (please ring as appropriate and give diagnosis).

1
Thoracic
2
Upper respiratory or E.N.T. (other than tonsillectomy and/or adenoidectomy)
3
Orthopaedic
4
Any other operation(s)
Other operation(s) Has the study chid ever been admitted to hospital overnight for any operation other than the above (please ring as appropriate and give diagnosis).
Age Diagnosis
AgeGeneric textAgeGeneric text AgeGeneric textAgeGeneric text
Thoracic
Upper respiratory or E.N.T. (other than tonsillectomy and/or adenoidectomy)
Orthopaedic
Any other operation(s)

Please give name and address of hospital attended for operation(s) mentioned in c) above.

Generic text

All hospital admissions (other than for accidents or operations). Please indicate any conditions (not included in b) or c) above) for which the study child has ever been admitted to hospital overnight by ringing the appropriate number(s) below:

1
No other admission
2
Asthma/Wheezy bronchitis
3
Upper respiratory tract infection(s) (including E.N.T.)
4
Chest infections
5
Urinary tract infections/investigation
6
Other infections
7
Convulsions
8
Heart investigation/treatment
9
Abdominal conditions not requiring operation
Y
Disorders of bones and joints
X
Blood disorders including leukaemia/anaemia
0
Tumours, neoplasms and other malignant conditions
1
Endocrine disorders (diabetes, thyroid, etc.)
2
Skin conditions
3
Eye conditions
4
Problems of nutrition (e.g. over or under weight)
5
Emotional conditions
6
Any other conditions
All hospital admissions (other than for accidents or operations). Please indicate any conditions (not included in b) or c) above) for which the study child has ever been admitted to hospital overnight by ringing the appropriate number(s) below:
Age at first admission Diagnosis
AgeGeneric textAgeGeneric text AgeGeneric textAgeGeneric text
No other admission
Asthma/Wheezy bronchitis
Upper respiratory tract infection(s) (including E.N.T.)
Chest infections
Urinary tract infections/investigation
Other infections
Convulsions
Heart investigation/treatment
Abdominal conditions not requiring operation
Disorders of bones and joints
Blood disorders including leukaemia/anaemia
Tumours, neoplasms and other malignant conditions
Endocrine disorders (diabetes, thyroid, etc.)
Skin conditions
Eye conditions
Problems of nutrition (e.g. over or under weight)
Emotional conditions
Any other conditions

Please give name and address of hospital attended for any condition(s) ringed in e) above:

Generic text
Hospital outpatient attendances

Apart from any accident recorded in Question 48, has the study child ever attended a hospital outpatient department for specialist opinion or investigation?

1
Yes
2
No
3
Don't know
If No, or Don't know, please proceed to Question 51.
If Yes, please complete b) below.
qc_52_a == 1

Please show, by ringing the appropriate number(s), the condition (s) for which investigation(s) was carried out and enter any known details of diagnosis (exclude condtions already entered in Question 49 above) :

1
No outpatient attendance apart from conditions included in Question 49
2
Asthma/Wheezy bronchitis
3
Upper respiratory tract infections (including E.N.T.)
4
Chest infections
5
Urinary tract infections/investigation
6
Other infections
7
Convulsions
8
Heart investigation/treatment
9
Abdominal conditions not requiring operation
Y
Disorders of bones and joints
X
Blood disorders including leukaemia/anaemia
0
Tumours, neoplasms and other malignant conditions
1
Endocrine disorders (diabetes, thyroid, etc.)
2
Skin conditions
3
Eye conditions
4
Problems of nutrition (e.g. over or under weight)
5
Emotional conditions
6
All other conditions
Please show, by ringing the appropriate number(s), the condition (s) for which investigation(s) was carried out and enter any known details of diagnosis (exclude condtions already entered in Question 49 above) :
Age at first attendance Diagnosis
AgeGeneric textAgeGeneric text AgeGeneric textAgeGeneric text
No outpatient attendance apart from conditions included in Question 49
Asthma/Wheezy bronchitis
Upper respiratory tract infections (including E.N.T.)
Chest infections
Urinary tract infections/investigation
Other infections
Convulsions
Heart investigation/treatment
Abdominal conditions not requiring operation
Disorders of bones and joints
Blood disorders including leukaemia/anaemia
Tumours, neoplasms and other malignant conditions
Endocrine disorders (diabetes, thyroid, etc.)
Skin conditions
Eye conditions
Problems of nutrition (e.g. over or under weight)
Emotional conditions
All other conditions
Vision

Please ring the number(s) against all of the following which apply:

1
Study child wears glasses now (or they have been prescribed recently)
2
He/she has seen an oculist or eye specialist in the past 12 months
3
He/she has had a squint in the past but not present now
4
He/she has a squint now
5
None of the above applies
Hearing

Has the study child ever worn a hearing aid?

1
Yes, and still wears it
2
Yes, but no longer wears it
3
No
4
Don't know
If Yes,
qc_54 == 1 || qc_54 == 2

please give reason

Generic text
Speech therapy

Has the study child attended for speech therapy in the past 12 months ?

1
Yes
2
No
3
Don't know
If Yes,
qc_55 == 1

please give reason

Generic text
Convulsions

Has the study child ever had any form of fit or other turn in which consciousness was lost, or any part of the body made abnormal movements (do not include emotional faints)?

1
Yes
2
No
3
Don't know
If No, or Don't know, please proceed to Question 55.
If Yes, please complete b)-d) below.
qc_56_a == 1

Did the first episode occur:

1
Before first birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday
7
Don't know

Did the most recent episode occur:

1
Before 1st birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday but not in the past 12 months
7
In past 12 months
8
Don't know age
If episodes have taken place since the age of 11, please enter details below:
qc_56_b == 6 || qc_56_c == 6 || qc_56_c == 7

Description

Generic text

Frequency

Generic text

Name and address of any hospital attended

Generic text
Asthma/Wheezy bronchitis

Has the study child ever had an attack of asthma or wheezy bronchitis ?

1
Yes
2
No
3
Don't know
If No, or Don't know, please proceed to Question 56.
If Yes, please complete b)-e) below
qc_57_a == 1

Have the attacks ever necessitated investigation/treatment ? (Please ring all that apply)

1
No
2
Don't know
3
Yes, admitted to hospital
4
Yes, by a specialist in a hospital outpatient department/clinic
5
Yes, by a G.P.

Did the first attack occur:

1
Before first birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday
7
Don't know age

Did the most recent attack occur:

1
Before first birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday but not in past 12 months
7
In past 12 months
8
Don't know age
If the child has had asthma or wheezy bronchitis in the past 12 months
qc_57_d == 7

did this occur :

1
At least once a week
2
Usually less than once a week but at least once a month
3
Less than once a month
4
Frequency unknown
Migraine

Has the study child had attacks of migraine or recurrent sick headaches in the past 12 months?

1
No
2
Don't know
3
Yes, but none in the past month
4
Yes, one in the past month
5
Yes, more than one in the past month
6
Yes, but frequency unknown
If Yes,
qc_58 >= 3 && qc_58 <= 6

please specify exact nature of attacks:

Generic text
Bladder control

Has the study child wet the bed at night (more than occasionally) since the age of 5?

1
Yes
2
No
3
Don't know
If No, or Don't know, proceed to Question 58.
If Yes, please complete b) to d) below.
qc_59_a == 1

Has he/she ever received treatment/investigation for this condition (please ring all that apply)?

Y
No
X
Don't know whether received treatment
0
Yes, admitted to hospital
1
Yes, as an outpatient, but no longer attending
2
Yes, as an outpatient and still attending
3
Yes, at a clinic but no longer attending
4
Yes, at a clinic and still attending
5
Yes, by a G.P. but no longer attending
6
Yes, by a G.P. and still attending
7
Yes, but don't know where received treatment/investigation

At what age did he/she most recently wet the bed?

1
Not known when
2
Before 11th birthday
3
Aged 11
4
Aged 12
5
Aged 13
6
Aged 14 or more but not in past 12 months
7
During past 12 months but not in the past month
8
During the past month
If the study child has wet the bed during the past month
qc_59_c == 8

was it:

1
Frequency not known
2
1-3 nights
3
4-10 nights
4
11 or more nights
Psychiatric and behaviour problems

Has the study child ever been seen by a specialist for an emotional or behavioural problem ? (Ring all that apply)

1
No
2
Don't know
3
Yes, as an inpatient in hospital
4
Yes, in a hospital outpatient department
5
Yes, at a child guidance clinic
6
Yes, elsewhere (specify ...)
Other
If Yes,
qc_60 >= 3 && qc_60 <= 6
please give year of attendance, diagnosis and name and address of hospital/clinic attended
Year of attendance Diagnosis Name and address of hospital/clinic attended
Generic textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric text Generic textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric text Generic textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric text
1
2
Dental care

Has the study child been seen by a school dentist during the past 12 months? (Ring all that apply)

1
No
2
Don't know
3
Yes, but don't know reason
4
Yes, for inspection
5
Yes, for fillings and/or extractions
6
Yes, for straightening teeth
7
Yes, other reason (specify ...)
Other

Has he/she been seen by any other dentist during the past 12 months? (Ring all that apply)

Y
No
X
Don't know
0
Yes, but don't know reason
1
Yes, at a surgery for inspection
2
Yes, at a surgery for fillings and/or extractions
3
Yes, at a surgery for straightening teeth
4
Yes, at a surgery for other reason (specify ...)
5
Yes, at a dental hospital for fillings and/or extractions
6
Yes, at a dental hospital for straightening teeth
7
Yes, at a dental hospital for other reason (specify ...)
Other
Other 2

Has the study child lost any second teeth? (Ring all that apply)

1
No
2
Don't know
3
Yes, through decay
4
Yes, through accident
5
Yes, as a procedure for straightening teeth
6
Yes, for other reason (specify ...)
7
Yes, reason not known
Other

Does the study child have any false teeth ? (Ring one number only)

1
No
2
Don't know
3
Yes, to replace teeth lost through decay
4
Yes, to replace teeth lost through accident
5
Yes, to replace teeth lost in both above ways
6
Yes, but reason not known

Has the study child ever worn a brace for straightening his/her teeth ?

1
No
2
Don't know
3
Yes, and wears it now
4
Yes, but does not wear it now
Pubertal development
Girls:
qc_I_b == 2

At what age did she have her first menstrual period?

1
Before 11th birthday
2
When aged 11
3
Aged 12
4
Aged 13
5
Aged 14
6
Aged 15 or more
7
Not yet commenced
8
Commenced, but don't know age
9
Don't know whether commenced
Boys:
qc_I_b == 1

At what age did his voice break ?

1
Before 11th birthday
2
When aged 11
3
Aged 12
4
Aged 13
5
Aged 14
6
Aged 15 or more
7
Not yet broken
8
Voice broken but don't know when
9
Don't know whether voice broken
Chronic ill-health or disability in the household
In answering this question :
(i) include conditions which have been present since the study child's 11th birthday, irrespective of when they commenced
(ii) include only the most severe condition if more than one is affecting the same person
(iii) include parent substitute under 'mother' or 'father'

Has the study child since his/her 11th birthday lived in the same household as anyone suffering from chronic physical or mental ill-health or disability?

1
No
2
Don't know
3
Yes, but not now
4
Yes, and still continues
If No, or Don't know, please proceed to Question 62.
If Yes, please complete b) to d) below.
qc_63_a == 3 || qc_63_a == 4

Indicate, by ringing the appropriate number(s), the member(s) of the household affected

1
Mother
2
Father
3
Other adult (specify ...)
4
Other child
Other
Please give the following details:
Diagnosis Year of onset Duration of illness Present state of condition
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
Mother
Father
Other adult
Other child

Name and address of the study child's General Practitioner

Generic text

Please ask for the study child's National Health Service Number

Generic text
Please thank the parent for his/her assistance in completing this form.
Summary (to be completed after the interview)

Taking into account the information you have obtained during the interview and any other relevant information, do you consider the child has any handicapping condition or disability ?

1
Yes
2
No
3
Don't know
If Yes,
qc_66_a == 1

what is the nature of the child's handicap or disability ? (Please ring all that apply)

1
Congenital malformation
2
Visual defect
3
Hearing defect
4
Mental retardation
5
Muscular dystrophy
6
Other general motor handicap (e.g. cerebral palsy)
7
Epilepsy
8
Psychiatric problem
9
Speech defect
Y
Asthma
X
Other chest condition
0
Alimentary condition
1
Chronic bone or joint disorder
2
Heart condition
3
Disorder of kidney or urinary tract
4
Malignancy (including leukaemia)
5
Diabetes
6
Skin disorder
7
Any other handicap or disability
what is the nature of the child's handicap or disability? (Please ring all that apply)
Please give brief description.
Generic text
Congenital malformation
Visual defect
Hearing defect
Mental retardation
Muscular dystrophy
Other general motor handicap (e.g. cerebral palsy)
Epilepsy
Psychiatric problem
Speech defect
Asthma
Other chest condition
Alimentary condition
Chronic bone or joint disorder
Heart condition
Disorder of kidney or urinary tract
Malignancy (including leukaemia)
Diabetes
Skin disorder
Any other handicap or disability

Are there any remarks or other notes you would wish to add?

Long text
Thank you

If you wish to add any comments on anything in this questionnaire, please use the space below. Like everything else in this questionnaire this will be strictly confidential.

Long text
Thank you. Now please place this form in this special envelope provided and seal it. Then please write your name on the back of the envelope.
End

ncds_74_pq

Local Authority Code Number
Local Authority Code Number
Child's Code Number
Child's Code Number
Strictly confidential
NATIONAL CHILDREN'S BUREAU,
Parental interview form
(1958 Cohort)
NATIONAL CHILD DEVELOPMENT STUDY
Sponsors: Institute of Child Health, University of London National Birthday Trust Fund National Foundation for Educational Research in England and Wales
In Collaboration with: Society of Education Officers Society of Community Medicine Association of Directors of Education (Scotland)
Chairman of Consultative Committee: Professor D. V. Donnison BA
Chairman of Steering Commitee: W. D. Wall BA, Ph.D
Executive Co-Directors: Professor N. R. Butler MD, FRCP, DCH Professor R. Davie BA, Ph.D, DIP.ED. Psych Mrs. Mia Kellmer Pringle BA, Ph.D, D.Sc
Co-Directors: M. J. R. Healy BA J.M. Tanner MD, D.Sc, FRCP, FRC.Psych W.D. Wall BA, Ph.D
Senior Research Officer: K.R. Fogleman BA
Child's name (surname)
Generic text
First names (in full)
Generic text
Sex (please ring appropriate number)
1
Boy
2
Girl
Child's Date of Birth
Date of birth
Today's Date
Generic date
Child's present address
Generic text
Child's home address at time of birth
Generic text
Place of birth if different from above (please give address if possible)
Generic text
Child's address at the time of Second Follow-up (in 1969)
Generic text
please give approximate date child came to live in this country
Generic date
Name of informant (surname)
Generic text
Name of informant (first names)
Generic text
Relationship of informant to the study child
1
Mother
2
Father
3
Other (please specify ...)
Other

Introductory Notes

First of all may we take this chance to thank you for carrying out these interviews on behalf of the National Child Development Study
During the first few months of this year some 16,000 such interviews will be taking place. During the same period the young people themselves will be answering a questionnaire, completing a few tests of their educational attainment and they will be given a full medical examination. We shall also ask their teachers and headteachers about the young people's schools and their educational progress.
If you helped us with earlier follow-ups of these young people, you will know that this is the fourth time that information has been collected.
At birth, information was obtained which cast light on such matters as perinatal mortality, the significance of birthweight, the effect of mothers' smoking in pregnancy and many other important details with consequent improvement in the Maternity Services.
The findings of the follow-up when the children were aged seven have recently been published in From Birth to Seven (Davie, Butler & Goldstein,1972). The overwhelming co-operation received from health visitors, teachers, medical officers, parents and many others enabled this report to present more findings which have been recognised as having important implications for policy and planning decisions for future medical, educational and social services.
A similar follow-up was carried out a 11 years of age and many of the results from this are now being published. A full list of all NCDS books, articles and papers can be obtained from the National Children's Bureau.
Now that the young people in the study are 16 years of age, the opportunity is being taken to extend the study as they reach school leaving age.
Ideally the interview should be with the child's mother or mother figure by herself (apart from those few cases where there is none). However, this cannot always be possible and its important to avoid embarrassment and awkwardness that might be caused by asking someone else to leave.
In our preparatory work on the interview form, we have tried to avoid questions which would be resented by the person being interviewed for being too personal. However, it is always possible that people do not want to answer some questions for reasons of this kind. Please stress at the start of the interview that people are free to decline to answer some questions if they choose and do not press for answers where this is the case.
Recording information
The form is designed so that, as far as possible, information can be recorded with the minimum of difficulty and the processing and analysis of the answers can be carried out conveniently. You will find that answers fall into three categories:
Firstly, there are those that require a short, written answer and space is provided to write a few words.
Secondly, there are those questions where a number of alternative answers are offered, each with a number by it. In this case, you should ring the number corresponding to the answer you are given. You will also often find that there is a space provided to be used when the answer does not fall into any of the categories offered.
For the third kind of question the answer is a number. For these the number should be written in the box or boxes provided.
If you feel that any answer needs some qualification or amplification, please add comments at that point on the form.
Thank you again for all your help.

People in the household

A household is a group of people who live together and eat together.

Who normally lives in the study child's household?

Relationship to study child (e.g. father, stepbrother) or status In household (e.g. lodger) Roster cs_q1_X Age Generic text Generic text Generic text Generic text Age Generic text Age Generic text
Study child 1 Name
Study child 1 Sex
Study child 1 Age
Study child 2 Name
Study child 2 Sex
Study child 2 Age
Study child 3 Name
Study child 3 Sex
Study child 3 Age
Study child 4 Name
Study child 4 Sex
Study child 4 Age
Study child 5 Name
Study child 5 Sex
Study child 5 Age
Study child 6 Name
Study child 6 Sex
Study child 6 Age
Study child 7 Name
Study child 7 Sex
Study child 7 Age
Study child 8 Name
Study child 8 Sex
Study child 8 Age
The following questions about brothers and sisters are to be taken as referring to all children who have the same natural mother as the study child. Include in the answers any that you have already listed as being in the household. Do not count a twin of the study child as a younger or older brother or sister, (the twin should have a seperate form).
How many older brothers does the study child have?
How many
How many younger brothers?
How many
How many older sisters?
How many
How many younger sisters?
How many
The relationship to the study child of the person acting as the child's mother is : (Please ring appropriate letter or number)
Y
Natural mother
X
Mother by legal adoption
0
Step-mother
1
Foster-mother
2
Grandmother
3
Elder sister
4
Co-habitee of father
5
Aunt
6
Housemother
7
No regular mother figure
8
Other (please specify ...)
Other
Why child is not living with his/her natural or adoptive mother.
Generic text
If child is living with a mother substitute, at what age did he/she first come under her care? Please write age in years in boxes
Age
The relationship to the study child of the person acting as the child's father is: (please ring appropriate letter or number)
Y
Natural father
X
Father by legal adoption
0
Step-father
1
Foster-father
2
Grandfather
3
Elder brother
4
Co-habitee of mother
5
Uncle
6
Housefather
7
No regular father figure
8
Other (please specify ...)
Other
Why child is not living with his/her natural or adoptive father
Generic text
If child is living with a father subsitute, at what age did he/she first come under his care? Please write age in years in boxes
Age
Has this child ever been in the care of a Local Authority?
1
Yes, in care now
2
Yes, in care only in the past
3
No, has never been in care
4
Don't know
5
Other reply (give details ...)
Other
what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Local Authority? Age
Age
what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Local Authority? Local Authority
Generic text
Has the child ever been in the care of a Voluntary Society?
1
Yes, in care now
2
Yes, in care only in the past
3
No, has never been in care
4
Don't know
5
Other reply (give details ...)
Other
what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Voluntary Society? Age
Age
what was the child's age at the time of admission to care (or at the last time of admission if more than one) and the name of the Voluntary Society? Voluntary Society
Generic text

Occupation of the child's father or father figure (i.e. present male head of household)

If not working, write 'Not working' below and fill in details of last occupation under a) to e). If no male head, write 'None' below and proceed to question 10.
Generic text
(In completing this question as much detail as possible should be given to indicate the exact type of work done so that we can classify by skill, qualification or responsibility involved. Terms such as 'electrical worker', 'engineer', 'civil servant', 'clerk' are insufficient and need explaining.)
Actual job
Generic text
Trade, Industry or Profession
Generic text
Is the father paid weekly, monthly or is he self-employed?
1
Weekly
2
Monthly
3
Self-employed
4
Don't know
5
Other (please specify ...)
Other
How many people does he employ?
1
None
2
1 - 24
3
25 +
4
Don't know
Does he supervise others? (e.g. foreman, manager, chargehand)
1
Yes
2
No
3
Don't know
approximately how many people does he supervise?
1
1-24
2
25+
3
Don't know
For how many weeks has the father (i.e male head) been out of work in the past 12 months through illness or accident or unemployment. Enter number of weeks in boxes. e.g for 6 weeks put 06 for no weeks put 00. Where no male head leave blank. Number of weeks off work through: Illness or accident
Weeks in past 12 months
For how many weeks has the father (i.e male head) been out of work in the past 12 months through illness or accident or unemployment. Enter number of weeks in boxes. e.g for 6 weeks put 0 6 for no weeks put 00. Where no male head leave blank. Number of weeks off work through: Unemployment
Weeks in past 12 months
Does the mother (or mother figure) do paid work?
1
Yes
2
No
Actual job and nature of work (including whether full or part-time)
Generic text
Trade, industry or profession
Generic text
Paid weekly, monthly or self-employed
Generic text
Supervisory status, if any, and how many supervised
Generic text
If self-employed, how many people she employs
How many
At what age did father or father figure leave full-time education?
Age
At what age did mother or mother figure leave full-time education?
Age
Is English the language usually spoken in the child's home?
1
Yes, English only
2
Yes, but other language also used
3
No. Other language usually used
what is it?
Generic text
How many cigarettes each do the mother and father smoke? Mother
1
Does not smoke at all
2
Smokes an occasional cigarette, but less than 1 a day
3
1-5 cigarettes a day
4
6-10
5
11-20
6
21-30
7
31 or more
8
Smokes a pipe or cigars, but not cigarettes
How many cigarettes each do the mother and father smoke? Father
1
Does not smoke at all
2
Smokes an occasional cigarette, but less than 1 a day
3
1-5 cigarettes a day
4
6-10
5
11-20
6
21-30
7
31 or more
8
Smokes a pipe or cigars, but not cigarettes
How often does the study child go out in the evenings?
1
Never or rarely goes out
2
Goes out in the evenings once or twice a week
3
Goes out in the evenings three or four times a week
4
Goes out in the evenings five or more times a week
5
Other answers (please specify ...)
Other
Remind the parent that the study child's year group is the first in which all children have had to stay at school until the age of sixteen. In the study child's case do they wish that he/she had been able to leave school at fifteen?
1
Yes
2
No
3
Don't know/Can't say
their reasons for this.
Generic text
Which of the following would the parents like the study child to do?
1
Leave at minimum school leaving age (i.e. end of this school year)
2
Stay in full-time education beyond minimum school leaving age, but not beyond 18
3
Continue some form of full-time education beyond the age of 18
4
Uncertain
Which of the following do the parents think the study child is in fact likely to do?
1
Leave at minimum school leaving age (i.e. end of this school year)
2
Stay in full-time education beyond minimum school leaving age, but not beyond 18
3
Continue some form of full-time education beyond the age of 18
4
Uncertain
What type of work would the parents like the study child to do?
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What type of work do the parents think the study child Is in fact likely to do? (If the answer is the same as to question 20 please write 'as above').
Generic text
Is the study child likely, after leaving school, to be in need of any special provision because of a handicap which could restrict his/her employment opportunities?
1
Yes
2
No
3
Uncertain/Don't know
please specify type of handicap
Generic text
Please ask the parent to what extent they have been satisfied with the study child's education in his/her present school.
1
Satisfied
2
Satisfied in some ways but not in others
3
Dissatisfied
4
Uncertain/Don't know
please give reasons
Generic text
Ask the parent how many times during the past twelve months he/she has discussed the study child's school progress with his/her teachers. (Write number in box). If no such discussion write 0 in box. If 9 or more, please write 9.
Discussion
Have the parents at any time in the past 12 months found it necessary to keep the study child off school in order to help at home?
1
Yes
2
No
3
Uncertain/Don't know
How many schools has the study child attended since his/her 11th birthday ? Please list the name and type of schools (secondary modern, comprehensive, etc) below:
Generic text
Please enquire or state from your own knowledge if a) the study child, and b) any other member of the family, has had any contact with any of the following services since the child's eleventh birthday. (Please ring all that apply) Study child
1
Social Services or Social Work Department (including former Children's Department)
2
Educational Welfare Department
3
Careers Officer/Youth Employment Officer
4
Voluntary Social Work Agency (please state which ...)
5
Police or Probation Office
Generic text
Please enquire or state from your own knowledge if a) the study child, and b) any other member of the family, has had any contact with any of the following services since the child's eleventh birthday. (Please ring all that apply) Other person
1
Social Services or Social Work Department (including former Children's Department)
2
Educational Welfare Department
3
Careers Officer/Youth Employment Officer
4
Voluntary Social Work Agency (please state which ...)
5
Police or Probation Office
Generic text
please state who arranged the contact in the first instance
Generic text
Has the study child ever been taken to court (or a Children's Hearing in Scotland)?
1
Yes
2
No
3
Don't know
please give as many details as you can
Generic text
Does any child of the family recieve free school meals at present?
1
Yes
2
No
3
Don't know
4
Other replies (please specify ...)
Other
Ask the parent whether they have been seriously troubled by financial hardship in the past 12 months.
1
Yes
2
No
3
Uncertain
4
Don't know
5
Other reply (please give details ...)
Other
What have been the sources of income of the household during the past 12 months? (Ring all relevant sources but exclude study child's earnings, if any).
1
Father/ father figure's employment
2
Mother/mother figure's employment
3
Brothers'/sisters' employment
4
Other adult member(s) of household's employment
5
Investments and/or private income
6
Annuities and pensions (other than social security)
Y
Supplementary benefit
X
Unemployment benefit
0
Widow's Pension/Widowed mother's allowances
1
Sickness benefit
2
Retirement Pension
3
Disability Pension
4
Family Allowance
5
Family Income Supplement
6
Any other sources (please specify ...)
Other

Ask the informant(s) to indicate the range in which the members of the household's usual net income falls (i.e after all deductions at source, viz, income-tax, health contributions, pensions, etc, commissions, overtime pay, etc. Include bonuses, commissions, overtime pay, etc. if this is usually recieved). Please show the informant (s) the following section and ask them to indicate the approximate range in which the net income of members of the household falls.

-

Y - £0-4

X - £5-9

0 - £10-14

1 - £15-19

2 - £20-24

3 - £25-29

4 - £30-34

5 - £35-39

6 - £40-44

7 - £45-49

8 - £50-59

9 - £60+

Weekly net pay of father or father figure Please ring the appropriate number
Weekly net pay of mother or mother figure Please ring the appropriate number
Weekly net income from all other sources (e.g. family allowances, earned income of other members of household, investments, private incomes, social security benefits, pensions, Family Income Supplement, etc)

Ask the informant(s) to indicate the range in which the members of the household's usual net income falls (i.e after all deductions at source, viz, income-tax, health contributions, pensions, etc, commissions, overtime pay, etc. Include bonuses, commissions, overtime pay, etc. if this is usually recieved). Please show the informant (s) the following section and ask them to indicate the approximate range in which the net income of members of the household falls.

-

Y - £0-17

X - £18-40

0 - £41-60

1 - £61-80

2 - £81-105

3 - £106-125

4 - £126-145

5 - £146-170

6 - £171-190

7 - £191-210

8 - £211-255

9 - £256+

Monthly net pay of father or father figure Please ring the appropriate number
Monthly net pay of mother or mother figure Please ring the appropriate number
Monthly net income from all other sources (e.g. family allowances, earned income of other members of household, investments, private incomes, social security benefits, pensions, Family Income Supplement, etc.)
was this because:
1
Informant did not know answer(s)
2
Informant did not want to give answer(s)
3
Uncertain of reason
What accommodation is occupied by this household?
1
Whole house or bungalow
2
Flat/maisonette (self-contained)
3
Room(s)
4
Caravan
5
Other (please specify ...)
Other
is this accommodation:
1
Owned by this household or being bought
2
Rented from Council or New Town Corporation or Commission or Scottish Special Housing Association
3
Privately rented-unfunished
4
Privately rented-furnished
5
Tied to occupation
6
Other (please specify ...)
Other
Does the accommodation have : (ask each item) Bathroom
1
Yes-sole use of one
2
Yes-sole use of two or more
3
Yes-shared use only
4
No bathroom, but permanent fixed bath with own water supply in another room (e.g. kitchen)
5
No bathroom or permanent fixed bath
6
Don't know
Does the accommodation have : (ask each item) Indoor lavatory
1
Yes-sole use of one
2
Yes-sole use of two or more
3
Yes-shared use only
4
No
5
Don't know
Does the accommodation have : (ask each item) Outdoor lavatory
1
Yes-sole use
2
Yes-shared use only
3
No
4
Don't know
Does the accommodation have : (ask each item) Hot water supply
1
Yes-sole use
2
Yes-shared use only
3
No
4
Don't know
How many rooms does the accommodation have? Exclude all kitchens, sculleries and bathrooms. Include rooms used by lodgers and relatives who are members of the household as defined in Question 1. Enter number of rooms in the boxes. e.g. 6 rooms = 06 11 rooms = 11
How many
And now please describe the kitchen; which of the following applies?
1
Kitchen less than 6 feet wide and not used as a living room
2
Kitchen less than 6 feet wide and used as a living room
3
Kitchen more than 6 feet wide and not used as a living room
4
Kitchen more than 6 feet wide and used as a living room
5
No kitchen
6
Don't know
How many other people sleep in the same room as the study child? Please fill in number in box. (if child has own room enter 0; if shares with 1 other, enter 1, etc.)
How many
How many other people sleep in the same bed as the study child? Please fill in number in box. (If child has own bed enter 0; if shares with 1 other, enter 1, etc)
How many
How many floors are there in the building in which the family live? Please enter number in boxes. e.g. 6 floors = 06 12 floors = 12
How many
On what floor is the front door of the home?
1
Below street level
2
At street level/ground floor
3
1st floor
4
2nd floor
5
3rd-4th floor
6
5th-6th floor
7
7th-9th floor
8
10th-12th floor
9
13th floor upwards
Does the household have: (please ring all that apply)
1
TV-black and white
2
TV-colour
3
Refrigerator
4
Deep-freeze
5
Telephone within the accomodation (do not count coin-box phone)
6
2 or more cars
7
1 car
8
Full or partial central heating
For how long has this address been the study child's home?
Y
Since birth
X
Not since birth but over 10 years
0
5-10 years
1
4 years
2
3 years
3
2 years
4
1 year
5
Under 1 year
6
Don't know
7
Other (please specify ...)
Other
How many times has the famliy moved since the study child was born? Enter the number of moves, e.g. 6 moves = 6 If 9 or more, enter 9
Moves
give brief details below. (For example, cases where the child has moved home but not the family, or where the child is in a residential home or residential school, etc.)
Generic text

Read to the informant (s) : 'There are many things about which parents and teenagers can disagree. I will now read a list of some of the most common areas. Could you say for each one how often you and the study child argue (if at all) about this subject'. For each topic please ring the appropriate number.

-

1 - Often

2 - Sometimes

3 - Never or hardly ever

His/her choice of friends of the same sex
His/her choice of friends of the opposite sex
His/her dress and/or hairstyle
The time he/she comes in at night, and/or the time he/she goes to bed
The places he/she goes to in his/her own time
Whether or not he/she does his/her homework
Whether or how much he/she smokes
Whether or how much he/she drinks

Below is a list of minor health problems which most children have at some time. Please ask how often each of these happens with the study child. Answers should be given according to how the child has been during the past 12 months.

-

1 - Never

2 - Occasionally but not as often as once per week

3 - At least once per week

Has stomach-ache or vomiting
Wets pants or the bed
Soils or loses control of bowels
Has temper tantrums (that is, complete loss of temper with shouting, angry movements, etc.)
Has tears on arrival at school or refuses to go into the building
Truants from school
Does he/she stammer or stutter?
1
No
2
Yes, mildly
3
Yes, severely
Has he/she any difficulty with speech other than stammering or stuttering?
1
No
2
Yes, mild
3
Yes, severe
please describe the difficulty
Generic text
Does he/she ever steal things?
1
No
2
Yes, occasionally
3
Yes, frequently
please give a few details if possible
Generic text
Is there any eating difficulty?
1
No
2
Yes, mild
3
Yes, severe
is it:
1
Not eating enough
2
Eating too much
3
Faddiness
4
Other (please describe ...)
Other
Does he/she have any sleeping difficulty?
1
No
2
Yes, mild
3
Yes, severe
is it :
1
Getting off to sleep
2
Waking during the night
3
Waking early in the morning
4
Bad dreams
5
Night terrors
6
Sleep walking
7
Other (specify ...)
Other

Below are a series of descriptions of behaviour often shown by young people. Please ask the informant(s) about each one and ring the appropriate number to show the degree to which this description is true of the study child.

-

1 - Doesn't apply

2 - Applies somewhat

3 - Certainly applies

Very restless. Has difficulty staying seated for long
Squirmy, fidgety child
Often destroys own or others' property
Frequently fights or is extremely quarrelsome with other children
Not much liked by other children
Often worried, worries about many things
Tends to do things on own-rather solitary
Irritable. Is quick to 'fly off the handle'
Often appears miserable, unhappy, tearful or distressed
Has twitches, mannerisms or tics of the face or body
Frequently sucks thumb or fingers
Frequently bites nails or fingers
Is often disobedient
Cannot settle to anything for more than a few moments
Tends to be fearful or afraid of new things or new situations
Fussy or over-particular
Often tells lies
Bullies other children
Please enquire where the parents were born. Place of birth (town,county and country) Mother
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Please enquire where the parents were born. Place of birth (town,county and country) Father
Generic text
in which year did parents come to live in this country? Year of arrival : Mother
Generic date
in which year did parents come to live in this country? Year of arrival : Father
Generic date

Medical Causes of School Absence

How much time altogether has the study child missed from school in the past 12 months for reasons of ill-health or emotional disturbance ?
1
None, or less than one week in all
2
Over one week and up to one month in all
3
Over one month and up to three months in all
4
Over three months in all
5
Missed school, but don't know for how long
6
Don't know whether missed school
7
Does not attend school (please state why ...)
Generic text
please indicate reason(s). If not applicable, leave blank; otherwise please ring all appropriate letters or numbers.
Y
Colds, catarrh, sore throats, ear infections or influenza
X
Bronchitis or chest infections, including pneumonia
0
Asthma or wheeziness
1
Headaches
2
Emotional or nervous problems (specify ...)
3
Bilious attacks or diarrhoea
4
Dysmenorrhoea
5
Abdominal pain
6
Infectious diseases (specify ...)
7
Accident or injury (specify ...)
8
Convulsions, fits or turns
9
Other causes (specify ...)
Generic text
Generic text 2
Generic text 3
Other

General Health

Has the study child suffered in the past 12 months from any of the following ? Please ring all appropriate letters or numbers.
Y
Hay fever or allergic rhinitis
X
Recurrent vomiting or bilious attacks
0
Dysmenorrhoea
1
Travel sickness
2
Recurrent abdominal pains
3
Recurrent mouth ulcers
4
Recurrent throat and/or ear infections requiring treatment by a doctor
5
Acne (other than trivial)
6
Eczematous rashes
7
Psoriasis
8
None of the above

Accidents (including burns, scalds, poisoning, near-drowning) requiring hospital admission or accident/casualty department attendance.

Has the study child ever had any accident necessitating admission to hospital or attendance at an accident/casualty department?
1
Yes, one
2
Yes, two
3
Yes, three
4
Yes, four
5
Yes, five
6
Yes, six
7
Yes, seven or more
8
No
9
Don't know
If No or Don't know, please proceed to Question 49

Place where accident occurred Please complete the following table by ringing the appropriate numbers to show where each accident occurred and whether the study child was admitted to hospital or attended an accident/casualty department only. Against (i) to (iv) please enter this information for the four most recent accidents which have occurred, starting with the most recent.

Accident resulting in:

1 - Hospital admission overnight or longer: On the road

2 - Hospital admission overnight or longer: At home

3 - Hospital admission overnight or longer: At school

4 - Hospital admission overnight or longer: Elsewhere

5 - or Accident/casualty department attendance only: On the road

6 - or Accident/casualty department attendance only: At home

7 - or Accident/casualty department attendance only: At school

8 - or Accident/casualty department attendance only: Elsewhere

Most recent accident
Next most recent
Next most recent
Next most recent

Type of injury For each accident recorded in b) above, please show the type of injury which resulted. Ring more than one number against each accident, if necessary.

-

Y - Type of injury not known

X - No injury detected

0 - Unconsciousness

1 - Fracture of skull

2 - Fracture of other bone

3 - Eye injury

4 - Burn or scald

5 - Flesh wound requiring 10+ stitches

6 - Poisoning or suspected poisoning

7 - In danger of drowning

8 - Other injury

Most recent accident
Next most recent
Next most recent
Next most recent

Age(s) at which accident(s) occurred Please enter in the boxes in the margin the age in years at which each accident occurred. (If age less than 1, enter 00).

-
Age
Most recent accident
Next most recent
Next most recent
Next most recent

Below, for each accident, please give any further known details, e.g. circumstances, type of injury, site of fracture, nature of poisoning, etc.

-
Generic text
Most recent accident
Next most recent
Next most recent
Next most recent
[Details of all earlier accidents (including burns, scalds or poisoning) if child has had more than four, i.e. where accidents(s) occurred, nature of injury, whether admitted to hospital overnight and child's age.
Generic text

Admission to hospital overnight or longer

Has the study child ever been admitted to a hospital over-night ?
1
Yes, as a result of an accident(s) only
2
Yes, for other reason(s) only
3
Yes, as a result of an accident(s) and for other reason(s)
4
No
5
Don't know

Operations Please complete the following table by ringing the appropriate number or letter in each line to show whether the study child has had any of these operations and at what age.

-

Y - No

X - Don't know

0 - Yes, but don't know age

1 - Yes, when aged: under 3 yrs

2 - Yes, when aged: 3 or 4

3 - Yes, when aged: 5 or 6

4 - Yes, when aged: 7 or 8

5 - Yes, when aged: 9 or 10

6 - Yes, when aged: 11

7 - Yes, when aged: 12

8 - Yes, when aged: 13

9 - Yes, when aged: 14+

Tonsillectomy
Appendicectomy
Correction of squint
Circumcision
Hernia repair
Operation on undescended testis(es)
Other operation(s) Has the study chid ever been admitted to hospital overnight for any operation other than the above (please ring as appropriate and give diagnosis).
1
Thoracic
2
Upper respiratory or E.N.T. (other than tonsillectomy and/or adenoidectomy)
3
Orthopaedic
4
Any other operation(s)

Other operation(s) Has the study chid ever been admitted to hospital overnight for any operation other than the above (please ring as appropriate and give diagnosis).

Age Diagnosis
AgeGeneric textAgeGeneric text AgeGeneric textAgeGeneric text
Thoracic
Upper respiratory or E.N.T. (other than tonsillectomy and/or adenoidectomy)
Orthopaedic
Any other operation(s)
Please give name and address of hospital attended for operation(s) mentioned in c) above.
Generic text
All hospital admissions (other than for accidents or operations). Please indicate any conditions (not included in b) or c) above) for which the study child has ever been admitted to hospital overnight by ringing the appropriate number(s) below:
1
No other admission
2
Asthma/Wheezy bronchitis
3
Upper respiratory tract infection(s) (including E.N.T.)
4
Chest infections
5
Urinary tract infections/investigation
6
Other infections
7
Convulsions
8
Heart investigation/treatment
9
Abdominal conditions not requiring operation
Y
Disorders of bones and joints
X
Blood disorders including leukaemia/anaemia
0
Tumours, neoplasms and other malignant conditions
1
Endocrine disorders (diabetes, thyroid, etc.)
2
Skin conditions
3
Eye conditions
4
Problems of nutrition (e.g. over or under weight)
5
Emotional conditions
6
Any other conditions

All hospital admissions (other than for accidents or operations). Please indicate any conditions (not included in b) or c) above) for which the study child has ever been admitted to hospital overnight by ringing the appropriate number(s) below:

Age at first admission Diagnosis
AgeGeneric textAgeGeneric text AgeGeneric textAgeGeneric text
No other admission
Asthma/Wheezy bronchitis
Upper respiratory tract infection(s) (including E.N.T.)
Chest infections
Urinary tract infections/investigation
Other infections
Convulsions
Heart investigation/treatment
Abdominal conditions not requiring operation
Disorders of bones and joints
Blood disorders including leukaemia/anaemia
Tumours, neoplasms and other malignant conditions
Endocrine disorders (diabetes, thyroid, etc.)
Skin conditions
Eye conditions
Problems of nutrition (e.g. over or under weight)
Emotional conditions
Any other conditions
Please give name and address of hospital attended for any condition(s) ringed in e) above:
Generic text

Hospital outpatient attendances

Apart from any accident recorded in Question 48, has the study child ever attended a hospital outpatient department for specialist opinion or investigation?
1
Yes
2
No
3
Don't know
If No, or Don't know, please proceed to Question 51.
Please show, by ringing the appropriate number(s), the condition (s) for which investigation(s) was carried out and enter any known details of diagnosis (exclude condtions already entered in Question 49 above) :
1
No outpatient attendance apart from conditions included in Question 49
2
Asthma/Wheezy bronchitis
3
Upper respiratory tract infections (including E.N.T.)
4
Chest infections
5
Urinary tract infections/investigation
6
Other infections
7
Convulsions
8
Heart investigation/treatment
9
Abdominal conditions not requiring operation
Y
Disorders of bones and joints
X
Blood disorders including leukaemia/anaemia
0
Tumours, neoplasms and other malignant conditions
1
Endocrine disorders (diabetes, thyroid, etc.)
2
Skin conditions
3
Eye conditions
4
Problems of nutrition (e.g. over or under weight)
5
Emotional conditions
6
All other conditions

Please show, by ringing the appropriate number(s), the condition (s) for which investigation(s) was carried out and enter any known details of diagnosis (exclude condtions already entered in Question 49 above) :

Age at first attendance Diagnosis
AgeGeneric textAgeGeneric text AgeGeneric textAgeGeneric text
No outpatient attendance apart from conditions included in Question 49
Asthma/Wheezy bronchitis
Upper respiratory tract infections (including E.N.T.)
Chest infections
Urinary tract infections/investigation
Other infections
Convulsions
Heart investigation/treatment
Abdominal conditions not requiring operation
Disorders of bones and joints
Blood disorders including leukaemia/anaemia
Tumours, neoplasms and other malignant conditions
Endocrine disorders (diabetes, thyroid, etc.)
Skin conditions
Eye conditions
Problems of nutrition (e.g. over or under weight)
Emotional conditions
All other conditions

Vision

Please ring the number(s) against all of the following which apply:
1
Study child wears glasses now (or they have been prescribed recently)
2
He/she has seen an oculist or eye specialist in the past 12 months
3
He/she has had a squint in the past but not present now
4
He/she has a squint now
5
None of the above applies

Hearing

Has the study child ever worn a hearing aid?
1
Yes, and still wears it
2
Yes, but no longer wears it
3
No
4
Don't know
please give reason
Generic text

Speech therapy

Has the study child attended for speech therapy in the past 12 months ?
1
Yes
2
No
3
Don't know
please give reason
Generic text

Convulsions

Has the study child ever had any form of fit or other turn in which consciousness was lost, or any part of the body made abnormal movements (do not include emotional faints)?
1
Yes
2
No
3
Don't know
If No, or Don't know, please proceed to Question 55.
Did the first episode occur:
1
Before first birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday
7
Don't know
Did the most recent episode occur:
1
Before 1st birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday but not in the past 12 months
7
In past 12 months
8
Don't know age
Description
Generic text
Frequency
Generic text
Name and address of any hospital attended
Generic text

Asthma/Wheezy bronchitis

Has the study child ever had an attack of asthma or wheezy bronchitis ?
1
Yes
2
No
3
Don't know
If No, or Don't know, please proceed to Question 56.
Have the attacks ever necessitated investigation/treatment ? (Please ring all that apply)
1
No
2
Don't know
3
Yes, admitted to hospital
4
Yes, by a specialist in a hospital outpatient department/clinic
5
Yes, by a G.P.
Did the first attack occur:
1
Before first birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday
7
Don't know age
Did the most recent attack occur:
1
Before first birthday
2
Between 1st and 2nd birthdays
3
Between 2nd and 5th birthdays
4
Between 5th and 7th birthdays
5
Between 7th and 11th birthdays
6
Since 11th birthday but not in past 12 months
7
In past 12 months
8
Don't know age
did this occur :
1
At least once a week
2
Usually less than once a week but at least once a month
3
Less than once a month
4
Frequency unknown

Migraine

Has the study child had attacks of migraine or recurrent sick headaches in the past 12 months?
1
No
2
Don't know
3
Yes, but none in the past month
4
Yes, one in the past month
5
Yes, more than one in the past month
6
Yes, but frequency unknown
please specify exact nature of attacks:
Generic text

Bladder control

Has the study child wet the bed at night (more than occasionally) since the age of 5?
1
Yes
2
No
3
Don't know
If No, or Don't know, proceed to Question 58.
Has he/she ever received treatment/investigation for this condition (please ring all that apply)?
Y
No
X
Don't know whether received treatment
0
Yes, admitted to hospital
1
Yes, as an outpatient, but no longer attending
2
Yes, as an outpatient and still attending
3
Yes, at a clinic but no longer attending
4
Yes, at a clinic and still attending
5
Yes, by a G.P. but no longer attending
6
Yes, by a G.P. and still attending
7
Yes, but don't know where received treatment/investigation
At what age did he/she most recently wet the bed?
1
Not known when
2
Before 11th birthday
3
Aged 11
4
Aged 12
5
Aged 13
6
Aged 14 or more but not in past 12 months
7
During past 12 months but not in the past month
8
During the past month
was it:
1
Frequency not known
2
1-3 nights
3
4-10 nights
4
11 or more nights

Psychiatric and behaviour problems

Has the study child ever been seen by a specialist for an emotional or behavioural problem ? (Ring all that apply)
1
No
2
Don't know
3
Yes, as an inpatient in hospital
4
Yes, in a hospital outpatient department
5
Yes, at a child guidance clinic
6
Yes, elsewhere (specify ...)
Other

please give year of attendance, diagnosis and name and address of hospital/clinic attended

Year of attendance Diagnosis Name and address of hospital/clinic attended
Generic textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric text Generic textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric text Generic textGeneric dateGeneric textGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric text
1
2

Dental care

Has the study child been seen by a school dentist during the past 12 months? (Ring all that apply)
1
No
2
Don't know
3
Yes, but don't know reason
4
Yes, for inspection
5
Yes, for fillings and/or extractions
6
Yes, for straightening teeth
7
Yes, other reason (specify ...)
Other
Has he/she been seen by any other dentist during the past 12 months? (Ring all that apply)
Y
No
X
Don't know
0
Yes, but don't know reason
1
Yes, at a surgery for inspection
2
Yes, at a surgery for fillings and/or extractions
3
Yes, at a surgery for straightening teeth
4
Yes, at a surgery for other reason (specify ...)
5
Yes, at a dental hospital for fillings and/or extractions
6
Yes, at a dental hospital for straightening teeth
7
Yes, at a dental hospital for other reason (specify ...)
Other
Other 2
Has the study child lost any second teeth? (Ring all that apply)
1
No
2
Don't know
3
Yes, through decay
4
Yes, through accident
5
Yes, as a procedure for straightening teeth
6
Yes, for other reason (specify ...)
7
Yes, reason not known
Other
Does the study child have any false teeth ? (Ring one number only)
1
No
2
Don't know
3
Yes, to replace teeth lost through decay
4
Yes, to replace teeth lost through accident
5
Yes, to replace teeth lost in both above ways
6
Yes, but reason not known
Has the study child ever worn a brace for straightening his/her teeth ?
1
No
2
Don't know
3
Yes, and wears it now
4
Yes, but does not wear it now

Pubertal development

At what age did she have her first menstrual period?
1
Before 11th birthday
2
When aged 11
3
Aged 12
4
Aged 13
5
Aged 14
6
Aged 15 or more
7
Not yet commenced
8
Commenced, but don't know age
9
Don't know whether commenced
At what age did his voice break ?
1
Before 11th birthday
2
When aged 11
3
Aged 12
4
Aged 13
5
Aged 14
6
Aged 15 or more
7
Not yet broken
8
Voice broken but don't know when
9
Don't know whether voice broken

Chronic ill-health or disability in the household

In answering this question :
(i) include conditions which have been present since the study child's 11th birthday, irrespective of when they commenced
(ii) include only the most severe condition if more than one is affecting the same person
(iii) include parent substitute under 'mother' or 'father'
Has the study child since his/her 11th birthday lived in the same household as anyone suffering from chronic physical or mental ill-health or disability?
1
No
2
Don't know
3
Yes, but not now
4
Yes, and still continues
If No, or Don't know, please proceed to Question 62.
Indicate, by ringing the appropriate number(s), the member(s) of the household affected
1
Mother
2
Father
3
Other adult (specify ...)
4
Other child
Other

Please give the following details:

Diagnosis Year of onset Duration of illness Present state of condition
Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric textGeneric text
Mother
Father
Other adult
Other child
Name and address of the study child's General Practitioner
Generic text
Please ask for the study child's National Health Service Number
Generic text
Please thank the parent for his/her assistance in completing this form.

Summary (to be completed after the interview)

Taking into account the information you have obtained during the interview and any other relevant information, do you consider the child has any handicapping condition or disability ?
1
Yes
2
No
3
Don't know
what is the nature of the child's handicap or disability ? (Please ring all that apply)
1
Congenital malformation
2
Visual defect
3
Hearing defect
4
Mental retardation
5
Muscular dystrophy
6
Other general motor handicap (e.g. cerebral palsy)
7
Epilepsy
8
Psychiatric problem
9
Speech defect
Y
Asthma
X
Other chest condition
0
Alimentary condition
1
Chronic bone or joint disorder
2
Heart condition
3
Disorder of kidney or urinary tract
4
Malignancy (including leukaemia)
5
Diabetes
6
Skin disorder
7
Any other handicap or disability

what is the nature of the child's handicap or disability? (Please ring all that apply)

Please give brief description.
Generic text
Congenital malformation
Visual defect
Hearing defect
Mental retardation
Muscular dystrophy
Other general motor handicap (e.g. cerebral palsy)
Epilepsy
Psychiatric problem
Speech defect
Asthma
Other chest condition
Alimentary condition
Chronic bone or joint disorder
Heart condition
Disorder of kidney or urinary tract
Malignancy (including leukaemia)
Diabetes
Skin disorder
Any other handicap or disability
Are there any remarks or other notes you would wish to add?
Long text
Thank you
If you wish to add any comments on anything in this questionnaire, please use the space below. Like everything else in this questionnaire this will be strictly confidential.
Long text
Thank you. Now please place this form in this special envelope provided and seal it. Then please write your name on the back of the envelope.
Name

NCDS Age 16 Parental Questionnaire