CLOSER Discovery

What is your baby's age now? … months and … weeks old

What does your child look like? His/her hair is:

What does your child look like? His/her eyes are:

What does your child look like? Does she or he remind you of anyone strongly ?

How would you describe your BABY'S ETHNIC ORIGIN?

Has YOUR BABY had any physical health problems since birth which needed medical attention?

Please give details of his/her physical health problems below:

Do you have concerns about your baby's health now?

Please give details of any concerns you have

However careful a parent is, most children have accidents at some time or other. Please tell us on the set of questions below about the times your child has had an accident, at what age and if there was any treatment given. Has your child ever … Been burnt or scalded What did the person with your child do about the accident? (please tick a box) Other...

However careful a parent is, most children have accidents at some time or other. Please tell us on the set of questions below about the times your child has had an accident, at what age and if there was any treatment given. Has your child ever … Been dropped or had a bad fall What did the person with your child do about the accident? (please tick a box) Other...

However careful a parent is, most children have accidents at some time or other. Please tell us on the set of questions below about the times your child has had an accident, at what age and if there was any treatment given. Has your child ever … Swallowed anything he or she shouldn't (e.g., pills, buttons, disinfectant) What did the person with your child do about the accident? (please tick a box) Other..

However careful a parent is, most children have accidents at some time or other. Please tell us on the set of questions below about the times your child has had an accident, at what age and if there was any treatment given. Has your child ever … Had any other accidents or injuries ? What did the person with your child do about the accident? (please tick a box) Other...

Has or does your child's chest ever wheeze or whistle?

Does your child's chest ever wheeze or whistle when he/she does have a cold?

Does your child's chest ever wheeze or whistle when he/she doesn't have a cold?

At what age did the wheezing or whistling start? ... months of age

Please tell us how often during the day your child is in a room or enclosed place where people are smoking? How often... On weekdays?

Please tell us how often during the day your child is in a room or enclosed place where people are smoking? How often... At weekends?

Many families have pet animals at home, which pets is your child in contact with at least once a week either in your home or elsewhere? cat(s)

Many families have pet animals at home, which pets is your child in contact with at least once a week either in your home or elsewhere? dog(s)

Many families have pet animals at home, which pets is your child in contact with at least once a week either in your home or elsewhere? other furry pet*(s)

Many families have pet animals at home, which pets is your child in contact with at least once a week either in your home or elsewhere? other pet*(s)

How well does your child sleep at night? Please place a tick next to each statement that correctly describes your child ...

How often do you find yourself doing each of the following things with your baby now? I stroke my baby's tummy.

How often do you find yourself doing each of the following things with your baby now? I stroke my baby's back.

How often do you find yourself doing each of the following things with your baby now? I stroke my baby's arms or legs

How often do you find yourself doing each of the following things with your baby now? I talk to my baby

How often do you find yourself doing each of the following things with your baby now? I cuddle my baby

How often do you find yourself doing each of the following things with your baby now? I hold my baby

How often do you find yourself doing each of the following things with your baby now? I leave her/him to play alone

How often do you find yourself doing each of the following things with your baby now? I read to my baby

How often do you find yourself doing each of the following things with your baby now? I play with my baby

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Babies should be picked up whenever they cry

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... It is important to develop a regular pattern of feeding and sleeping with a baby

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Babies should be fed whenever they are hungry

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Babies need to be stimulated if they are to develop well

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Babies need quiet secure surroundings and should not be disturbed too much

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Parents need to adapt their lives to the baby's demands

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... A baby should fit into the parent's routine

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Babies should be left to develop naturally

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Talking, to even a very young baby, is important

Below are a number of statements about parents and babies. Please say how much you agree or disagree with each one ... Cuddling a baby is very important

Most children are looked after by more than one person at some time. Apart from yourself, who regularly looks after your baby when you are out of the house or at work? other (please describe)

How satisfied are you with these childcare arrangements?

Any comments about your childcare arrangements:

In a typical week, how much time does your child spend with other young children (not including brothers and sisters)? … hours per week

Over the past year which health and/or support services have been involved with you and your child? Health visitor

Over the past year which health and/or support services have been involved with you and your child? GP

Over the past year which health and/or support services have been involved with you and your child? Social worker

Over the past year which health and/or support services have been involved with you and your child? CPN

Over the past year which health and/or support services have been involved with you and your child? Paediatrician

Over the past year which health and/or support services have been involved with you and your child? Children's centre

Over the past year which health and/or support services have been involved with you and your child? Surestart worker

Over the past year which health and/or support services have been involved with you and your child? CHiCC team

Over the past year which health and/or support services have been involved with you and your child? Family Support Worker

Over the past year which health and/or support services have been involved with you and your child? Other (please say who …)

Who lives with you in your household now?

What type of housing do you live in now?

What is your correct postcode?

Is the place where you live owned or rented by you?

How many bedrooms do you have?

How many rooms in total are there?

How long have you lived there? … years … months

How satisfied are you with your housing?

What do you think of your neighbourhood as a place to live?

What is your employment status now?

Are you currently:

Is this the same as when we spoke to you at your 20 week scan appointment?

Have you had a new partner since your 20 week scan in pregnancy?

What is your approximate annual FAMILY income now?

Are you receiving any benefits now?

Do you have financial problems at the moment?

At the moment, how difficult do you find it to afford any or all of these items? Food

At the moment, how difficult do you find it to afford any or all of these items? Clothing

At the moment, how difficult do you find it to afford any or all of these items? Heating

At the moment, how difficult do you find it to afford any or all of these items? Rent or mortgage

At the moment, how difficult do you find it to afford any or all of these items? Things you need for the baby

Have YOU had any physical health problems since your baby was born which required medical attention?

Please give details

Have YOU had any emotional problems since your baby was born which required help?

Please give details

Since your baby's birth have you taken medicines prescribed by the doctor?

Please give name(s) of these medicines:

Since your baby was born have you taken any of the following sorts of medicines? Sleeping pills

Since your baby was born have you taken any of the following sorts of medicines? Pills to calm anxiety or 'nerves'

Since your baby was born have you taken any of the following sorts of medicines? Pills to treat depression

Do you feel that you are getting enough sleep?

During an average night how many hours sleep do you get?

Since your first baby was born have you become pregnant again?

How many cigarettes do you smoke each day, on average?

Over the past year, have you drunk alcohol?

Which of the recreational drugs below have you taken in the past year? Cannabis/marihuana

Which of the recreational drugs below have you taken in the past year? Amphetamines or other stimulants

Which of the recreational drugs below have you taken in the past year? Heroin, methadone, crack, cocaine

Please circle the response that best fits how you feel now? How satisfied are you with your marriage / relationship?

Please circle the response that best fits how you feel now? How satisfied are you with your husband / partner?

Becoming a parent can be enjoyable and challenging! The following questions ask about the level of help and support you feel you have… I have no one to share my feelings with

Becoming a parent can be enjoyable and challenging! The following questions ask about the level of help and support you feel you have… My partner provides the emotional support I need

Becoming a parent can be enjoyable and challenging! The following questions ask about the level of help and support you feel you have… There are other mothers with whom I can share my experiences

Becoming a parent can be enjoyable and challenging! The following questions ask about the level of help and support you feel you have… There are members of my family who give me emotional support

The following questions are about your partner and the baby. He really enjoys this baby

The following questions are about your partner and the baby. He would really have preferred that we had not had this baby when we did

The following questions are about your partner and the baby. He likes to play with the baby

The following questions are about your partner and the baby. He is confident with the baby

The following questions are about your partner and the baby. He takes great pleasure in watching the baby develop

The following questions are about your partner and the baby. He really cannot bear it when the baby cries

The following questions are about your partner and the baby. He dislikes the mess that surrounds the baby

The following questions are about your partner and the baby. I trust him alone with the baby

The following questions are about your partner and the baby. He takes an active part in bringing up the baby

We would like to know how stressed or worried you have felt during the last 3 months. On the following scale 0 indicates feeling extremely relaxed and 10 indicates feeling extremely stressed or worried. Please circle a number to say how worried and stressed you have been feeling since your baby's birth?

HOW DO YOU FEEL RIGHT NOW..? I feel calm

HOW DO YOU FEEL RIGHT NOW..? I feel secure

HOW DO YOU FEEL RIGHT NOW..? I feel nervous

HOW DO YOU FEEL RIGHT NOW..? I am relaxed

HOW DO YOU FEEL RIGHT NOW..? I am worried

HOW DO YOU FEEL RIGHT NOW..? I feel pleasant

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been able to concentrate on whatever you are doing?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Lost much sleep over worry?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Felt that you are playing a useful part in things?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Felt capable of making decisions about things?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Felt constantly under strain?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Felt you couldn't over come your difficulties?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been able to enjoy your normal day-to-day activities?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been able to face up to your problems?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been feeling unhappy and depressed?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been losing confidence in yourself?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been thinking of your self as a worthless person?

The following questions ask about your health in general. For each statement, please circle the response that comes closest to how you have been feeling over the past few weeks. Have you recently ... Been feeling reasonably happy, all things considered?

In the past seven days I have been able to laugh and see the funny side of things:

In the past seven days I have looked forward with enjoyment to things:

In the past seven days I have blamed myself unnecessarily when things went wrong:

In the past seven days I have been anxious or worried for no good reason:

In the past seven days I have felt scared or panicky for no very good reason:

In the past seven days Things have been getting on top of me:

In the past seven days I have been so unhappy that I have had difficulty sleeping:

In the past seven days I have felt sad or miserable:

In the past seven days I have been so unhappy that I have been crying

In the past seven days The thought of harming myself has occurred to me:

DURING THE PAST WEEK ... Before falling asleep at night, how often did your baby ...show no fussing or crying?

DURING THE PAST WEEK ... How often did your baby ...seem contented when left in the cot?

DURING THE PAST WEEK ... How often did your baby ...cry or fuss before going to sleep for naps?

DURING THE PAST WEEK ... During sleep how often did your baby ...toss about in the cot?

DURING THE PAST WEEK ... After sleeping, how often did your baby ... fuss or cry immediately?

DURING THE PAST WEEK ... After sleeping, how often did your baby ... play quietly in the cot?

DURING THE PAST WEEK ... During feeding how often did the baby ...lie or sit quietly?

DURING THE PAST WEEK ... During feeding how often did the baby ...squirm or kick?

DURING THE PAST WEEK ... When something the baby was playing with had to be removed, how often did s/he ...cry or show distress for a time?

DURING THE PAST WEEK ... When your baby saw a toy he/she wanted, how often did s/he: ...get very excited about getting it?

DURING THE PAST WEEK ... When your baby saw a toy he/she wanted, how often did s/he: ...immediately go after it?

DURING THE PAST WEEK ... When given a new toy, how often did your baby: ...get very excited about getting it?

DURING THE PAST WEEK ... When given a new toy, how often did your baby: ...immediately go after it?

DURING THE PAST WEEK ... How often during the week did your baby ...show a strong desire for something he/she wanted?

DURING THE PAST WEEK ... When the baby wanted something, how often did s/he ...have tantrums (crying, screaming, face red, etc.) when s/he did not get what s/he wanted?

DURING THE PAST WEEK ... How often during the last week did your baby ... protest being placed in a confining place? (e.g., like an infant high chair, play pen, car seat etc)

DURING THE PAST TWO WEEKS When introduced to an unfamiliar adult, how often did your baby: ...cling to a parent?

DURING THE PAST TWO WEEKS When your baby was approached by an unfamiliar person when you and s/he were out (e.g., shopping), how often did your baby: ...show distress?

DURING THE PAST TWO WEEKS When introduced to a dog or cat, how often did your baby ...cry or show distress?

DURING THE PAST TWO WEEKS When visiting a new place, how often did your baby ...get excited about exploring new surroundings?

DURING THE PAST TWO WEEKS When visiting a new place, how often did your baby ...move about actively when s/he is exploring new surroundings?

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Shows pleasure when he/she succeeds (for example, claps for self)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Gets hurt so often that you can't take your eyes off him or her

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Seems nervous, tense, or fearful

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Is restless and can't sit still

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Follows rules

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Wakes up at night and needs help to fall asleep again

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Cries or has tantrums until he or she is exhausted

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Is afraid of certain places, animals, or things. What is he or she afraid of?

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Has less fun than other children

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Looks for you (or other parent) when upset

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Cries or hangs onto you when you try to leave

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Worries a lot or is very serious

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Looks right at you when you say his or her name

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Does not react when hurt

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Is affectionate with loved ones

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Won't touch some objects because of how they feel

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Has trouble falling asleep or staying asleep

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Runs away in public places

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Plays well with other children (not including brother or sister)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Can pay attention for a long time (other than watching TV)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Has trouble adjusting to changes

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Tries to help when someone is hurt (for example, gives a toy)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Often gets very upset

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Gags or chokes on food

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Imitates playful sounds when you ask him or her to

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Refuses to eat

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Hits, shoves, kicks, or bites children (not including brother or sister)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Is destructive. Breaks or ruins things on purpose

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Points to show you something far away

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Hits, bites, or kicks you (or other parent)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Hugs or feeds dolls or stuffed animals

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Seems very unhappy, sad, depressed or withdrawn

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH Purposely tries to hurt you (or other parent)

Please circle the ONE response that best describes your child’s behaviour in the LAST MONTH When upset, gets very still, freezes, or doesn't move

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Puts things in a special order over and over and gets upset if he/she is interrupted

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Repeats the same action or phrase over and over without enjoyment. Please give an example:

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Repeats a particular movement over and over (like rocking, spinning). Please give an example:

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Spaces out. Is totally unaware of what is happening around him or her

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Does not make eye contact

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Avoids physical contact

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Hurts self on purpose. (for example, bangs his or her head). Please give an example:

Please circle the one response that best describes your child’s behaviour in the LAST MONTH Eats or drinks things that are inedible (like paper or paint). Please give an example:

How worried are you about your child's behaviour, emotions, or relationships?

How worried are you about your child's language development?

What were you like when you were younger? I was considerate of other people's feelings

What were you like when you were younger? I was restless and could not sit still for long

What were you like when you were younger? I got a lot of headaches, stomach-aches or sickness

What were you like when you were younger? I usually shared food, toys/games, DVDs etc., with other kids

What were you like when you were younger? I got very angry and often lost my temper

What were you like when you were younger? I was usually on my own. I generally played alone or kept to myself

What were you like when you were younger? I usually did as I was told

What were you like when you were younger? I worried a lot

What were you like when you were younger? I was helpful if someone was hurt, upset, or feeling ill

What were you like when you were younger? I was constantly fidgeting or squirming around

What were you like when you were younger? I had at least one good friend

What were you like when you were younger? I fought a lot

What were you like when you were younger? I was often unhappy, downhearted or tearful

What were you like when you were younger? Other people my age generally liked me

What were you like when you were younger? I was easily distracted and found it difficult to concentrate

What were you like when you were younger? I was nervous in new situations. I easily lost confidence

What were you like when you were younger? I was kind to animals and younger children

What were you like when you were younger? I was often accused of lying or cheating

What were you like when you were younger? Other kids picked on me or bullied me

What were you like when you were younger? I often volunteered to help other people

What were you like when you were younger? I thought things out before acting on them

What were you like when you were younger? I took things that were not mine from home, school or shops

What were you like when you were younger? I got on better with adults than with kids my own age

What were you like when you were younger? I did graffiti or damaged property in other ways

What were you like when you were younger? I had many fears, I was easily scared

What were you like when you were younger? I saw tasks through to the end. My attention was good

What were you like when you were younger? I played truant from school

Overall, when you were younger (up to 16 years old) do you think that you had difficulties in one or more of the following areas: emotions, concentration, behaviour or being able to get on with other people?