|
subjectkey |
GUID |
|
Required |
The NDAR Global Unique Identifier (GUID) for research subject |
NDAR*
|
|
|
|
src_subject_id |
String |
20
|
Required |
Subject ID how it's defined in lab/project |
|
|
|
|
interview_date |
Date |
|
Required |
Date on which the interview/genetic test/sampling/imaging/biospecimen was completed. MM/DD/YYYY |
|
|
|
|
interview_age |
Integer |
|
Required |
Age in months at the time of the interview/test/sampling/imaging. |
0 :: 1260
|
Age is rounded to chronological month. If the research participant is 15-days-old at time of interview, the appropriate value would be 0 months. If the participant is 16-days-old, the value would be 1 month.
|
|
|
sex |
String |
20
|
Required |
Sex of subject at birth |
M;F; O; NR
|
M = Male; F = Female; O=Other; NR = Not reported
|
gender |
Query
|
abdomdistention |
Integer |
|
Recommended |
Abdominal distention |
0::5
|
0=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
|
|
Query
|
abdomenabnormal |
String |
100
|
Recommended |
Abdomen If abnormal briefly describe abnormalities |
|
|
|
Query
|
abdomenlist |
Integer |
|
Recommended |
Abdomen |
0::3
|
1=Normal; 2=G-tube present and normal; 3=Abnormal (not including distention; recorded elsewhere); 0=Not done
|
|
Query
|
actionposttremor |
Integer |
|
Recommended |
Action or postural tremor |
0::4
|
0=Not present; 1=1 cm to <3 cm maximal amplitude; 2=3 cm to 10 cm maximal amplitude; 3=>10 cm maximal amplitude;4= <1 cm maximal amplitude
|
|
Query
|
aggressivebehaviors |
Integer |
|
Recommended |
Aggressive behaviors towards others |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
airswallowing |
Integer |
|
Recommended |
Airswallowing |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
alertness_dx |
Integer |
|
Recommended |
Alertness |
0::4
|
0=Not alert; 1=~25%;2= ~50%; 3=~75%;4= Alert entire visit (>90%)
|
alertness |
Query
|
appendicrigidity |
Integer |
|
Recommended |
Appendicular Rigidity nonvelocity dependent stiffness |
0::5
|
0=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
|
|
Query
|
appendictone |
Integer |
|
Recommended |
Overall tone choose one option onlyAppendicular |
1::4
|
1=Normal; 2=Hypotonic; 3=Hypertonic;4= Mixed
|
|
Query
|
ataxiaapraxia |
Integer |
|
Recommended |
Ataxiaapraxia of gait |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
axialrigidity |
Integer |
|
Recommended |
Axial Rigidity nonvelocity dependent stiffness |
0::5
|
0=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
|
|
Query
|
axialtone |
Integer |
|
Recommended |
Overall tone choose one option onlyAxial |
1::4
|
1=Normal; 2=Hypotonic; 3=Hypertonic;4= Mixed
|
|
Query
|
bmicategorycss |
Integer |
|
Recommended |
BMI category for CSS |
1::5
|
1=26%-50% or higher; 2=11-25%; 3=5-10%; 4=<5%; 5=<<5%
|
|
Query
|
babinskinotpresent |
Integer |
|
Recommended |
BabinskiNotpresent |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
birthmarkslocationsize |
String |
150
|
Recommended |
Birth marks location and size |
|
|
|
Query
|
bradykinesia |
Integer |
|
Recommended |
Bradykinesia |
0::4
|
0=Not present; 1=Deliberate movements with minimal slowness (<10% of time); 2=Mild paucity of movement or mild slowness (<50% of time); 3=Moderate paucity of movement with moderate slowness (50-90% of time); 4=Rarely moves or movements extremely slow (95-100% of time)
|
|
Query
|
breasttannerstage |
Integer |
|
Recommended |
Breast Tanner stage for males indicate not done |
0::5
|
1=I - no glandular tissue; areola follows the skin contours of the chest; 2=II - breast bud forms, with small area of surrounding glandular tissue; areola begins to widen; 3=III - breast more elevated, extends beyond areola border, areola continues to widen (in contour with breast); 4=IV - increased breast size and elevation; areola and papilla form a secondary mound; 5=V - breast final adult size; areola returns to contour of surrounding breast; projecting central papilla; 0=not done
|
|
Query
|
breathholding |
Integer |
|
Recommended |
Breathholding of time of visit Hyperventilation and Breathholding cannot be 100 |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
breathholdingcyanosis |
Integer |
|
Recommended |
If breathholding present level of cyanosis |
0::3
|
0=No cyanosis; 1=Mild, peri-oral or acrocyanosis; 2=Moderate cyanosis; 3=Severe cyanosis with alteration of consciousness
|
|
Query
|
breathholdingdisrupt |
Integer |
|
Recommended |
If breathholding present level of disruption |
0::5
|
0=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
|
|
Query
|
bruxism_dx |
Integer |
|
Recommended |
Bruxism |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
bruxism |
Query
|
cardiacabcomment |
String |
100
|
Recommended |
Cardiac soundsComments if abnormal |
|
|
|
Query
|
cardiacsounds |
Integer |
|
Recommended |
Cardiac sounds |
0::2
|
1=Normal; 2=Abnormal; 0=Not Done
|
|
Query
|
chorea |
Integer |
|
Recommended |
Chorea |
0::4
|
0=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
|
|
Query
|
comestosit |
Integer |
|
Recommended |
Comes to sitting |
0::3
|
1=On own; 2=With minimal assistance; 3=With maximal assistance; 0=No attempt
|
|
Query
|
comestostand |
Integer |
|
Recommended |
Comes to standing |
0::3
|
1=On own; 2=With minimal assistance; 3=With maximal assistance; 0=No attempt
|
|
Query
|
commgenexam |
String |
250
|
Recommended |
Optional comments on general exam |
|
|
|
Query
|
commnonverblang |
String |
400
|
Recommended |
Optional comments on expressive nonverbal language |
|
|
|
Query
|
commentsreflex |
String |
200
|
Recommended |
Optional comments on reflexes or pathological reflexes present |
|
|
|
Query
|
contractures_ankle |
Integer |
|
Recommended |
Contractures: Ankle |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
contractures_elbow |
Integer |
|
Recommended |
Contractures: Elbow |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
contractures_fingers |
Integer |
|
Recommended |
Contractures: Fingers |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
contractures_hip |
Integer |
|
Recommended |
Contractures: Hip |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
contractures_knee |
Integer |
|
Recommended |
Contractures: Knee |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
contractures_none |
Integer |
|
Recommended |
Contractures: None |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
contractures_wrist |
Integer |
|
Recommended |
Contractures: Wrist |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
pe_9 |
Integer |
|
Recommended |
Cranial Nerves |
0::2
|
1=Normal;2=Abnormal; 0=Not done
|
cranialnerves |
Query
|
degreehyperreflexia |
Integer |
|
Recommended |
Degree of Hyperreflexia |
1::5
|
1=4+ with spread or clonus; 2=4+ with spread and clonus; 3=Normal; 4=4+ ankles or knees; 5=4+ ankles and knees
|
|
Query
|
descriptabnormalother |
String |
150
|
Recommended |
Description of abnormalityIf other please specify |
|
|
|
Query
|
da_doesnotalerttos |
Integer |
|
Recommended |
DescriptAbnormal: Does not alert to sounds |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_doesnotalerttos |
Query
|
da_doesnotfixvisua |
Integer |
|
Recommended |
DescriptAbnormal: Does not fix visually |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_doesnotfixvisua |
Query
|
da_doesnotfollowok |
Integer |
|
Recommended |
DescriptAbnormal: Does not follow OKN tape/test |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_doesnotfollowok |
Query
|
da_doesnotfollowvi |
Integer |
|
Recommended |
DescriptAbnormal: Does not follow visually |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_doesnotfollowvi |
Query
|
da_dysconjugategaz |
Integer |
|
Recommended |
DescriptAbnormal: Dysconjugate gaze |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_dysconjugategaz |
Query
|
da_facialnervepals |
Integer |
|
Recommended |
DescriptAbnormal: Facial nerve palsy, peripheral or central |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_facialnervepals |
Query
|
da_lateralgazepals |
Integer |
|
Recommended |
DescriptAbnormal: Lateral gaze palsy |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_lateralgazepals |
Query
|
da_nystagmus |
Integer |
|
Recommended |
DescriptAbnormal: Nystagmus |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_nystagmus |
Query
|
da_other |
Integer |
|
Recommended |
DescriptAbnormal: Other |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_other |
Query
|
da_sialorrhea |
Integer |
|
Recommended |
DescriptAbnormal: Sialorrhea |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_sialorrhea |
Query
|
da_verticalgazepal |
Integer |
|
Recommended |
DescriptAbnormal: Vertical gaze palsy |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptabnormal_verticalgazepal |
Query
|
da_appearsanxiousorf |
Integer |
|
Recommended |
Descript Affect: Appears anxious or fearful |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptaffect_appearsanxiousorf |
Query
|
descriptaffect_calm |
Integer |
|
Recommended |
Descript Affect: Calm |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
descriptaffect_crying |
Integer |
|
Recommended |
Descript Affect: Crying |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
descriptaffect_frowningorsad |
Integer |
|
Recommended |
Descript Affect: Frowning or sad |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
descriptaffect_irritable |
Integer |
|
Recommended |
Descript Affect: Irritable |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
da_laughingorgigglin |
Integer |
|
Recommended |
Descript Affect: Laughing or giggling |
0;1
|
0 = unchecked box; 1 = checked box
|
descriptaffect_laughingorgigglin |
Query
|
descriptaffect_screaming |
Integer |
|
Recommended |
Descript Affect: Screaming |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
descriptaffect_smiling |
Integer |
|
Recommended |
Descript Affect: Smiling |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
drooling_dx |
Integer |
|
Recommended |
Drooling of time of visit Drooling and PuffingBlowing Raspberries cant be 100 |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
drooling |
Query
|
durationeyecont |
Integer |
|
Recommended |
Duration of eye contact |
0::4
|
1=Preserved and propositive; 2=Good eye contact (>30 seconds); 3=Intermittent eye contact (5 to <30 seconds); 4=Infrequent eye contact (<5 seconds); 0=None
|
|
Query
|
dysmextremother |
String |
150
|
Recommended |
Dysmorphic features of extremitiesIf other please specify |
|
|
|
Query
|
d_abnormalnailbeds |
Integer |
|
Recommended |
DysmExtrem: abnormal nail beds |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmextrem_abnormalnailbeds |
Query
|
de_none |
Integer |
|
Recommended |
DysmExtrem: none |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmextrem_none |
Query
|
de_other |
Integer |
|
Recommended |
DysmExtrem: other |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmextrem_other |
Query
|
d_polydactyly |
Integer |
|
Recommended |
DysmExtrem: polydactyly |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmextrem_polydactyly |
Query
|
d_syndactyly |
Integer |
|
Recommended |
DysmExtrem: syndactyly |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmextrem_syndactyly |
Query
|
d_antevertednares |
Integer |
|
Recommended |
DysmorphicCB: anteverted nares |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_antevertednares |
Query
|
d_archedeyebrows |
Integer |
|
Recommended |
DysmorphicCB: arched eyebrows |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_archedeyebrows |
Query
|
d_broadforehead |
Integer |
|
Recommended |
DysmorphicCB: broad forehead |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_broadforehead |
Query
|
d_broadnasalbridge |
Integer |
|
Recommended |
DysmorphicCB: broad nasal bridge |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_broadnasalbridge |
Query
|
d_bulbousnose |
Integer |
|
Recommended |
DysmorphicCB: bulbous nose |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_bulbousnose |
Query
|
d_deepseteyes |
Integer |
|
Recommended |
DysmorphicCB: deep-set eyes |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_deepseteyes |
Query
|
d_depressednasalbridg |
Integer |
|
Recommended |
DysmorphicCB: depressed nasal bridge |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_depressednasalbridg |
Query
|
d_downslantingpalpebr |
Integer |
|
Recommended |
DysmorphicCB: downslanting palpebral fissues |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_downslantingpalpebr |
Query
|
d_epicanthalfolds |
Integer |
|
Recommended |
DysmorphicCB: epicanthal folds |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_epicanthalfolds |
Query
|
d_higharchedpalate |
Integer |
|
Recommended |
DysmorphicCB: high arched palate |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_higharchedpalate |
Query
|
d_highforehead |
Integer |
|
Recommended |
DysmorphicCB: high forehead |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_highforehead |
Query
|
d_highfrontalhairline |
Integer |
|
Recommended |
DysmorphicCB: high frontal hairline |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_highfrontalhairline |
Query
|
d_hypertelorism |
Integer |
|
Recommended |
DysmorphicCB: hypertelorism |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_hypertelorism |
Query
|
d_hypotelorism |
Integer |
|
Recommended |
DysmorphicCB: hypotelorism |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_hypotelorism |
Query
|
d_largemouth |
Integer |
|
Recommended |
DysmorphicCB: large mouth |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_largemouth |
Query
|
d_longeyelashes |
Integer |
|
Recommended |
DysmorphicCB: long eyelashes |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_longeyelashes |
Query
|
d_lowsetears |
Integer |
|
Recommended |
DysmorphicCB: low set ears |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_lowsetears |
Query
|
d_micrognathia |
Integer |
|
Recommended |
DysmorphicCB: micrognathia |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_micrognathia |
Query
|
dy_none |
Integer |
|
Recommended |
DysmorphicCB: none |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_none |
Query
|
dy_other |
Integer |
|
Recommended |
DysmorphicCB: other |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_other |
Query
|
d_pointedchin |
Integer |
|
Recommended |
DysmorphicCB: pointed chin |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_pointedchin |
Query
|
d_posteriorlyrotatede |
Integer |
|
Recommended |
DysmorphicCB: posteriorly rotated ears |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_posteriorlyrotatede |
Query
|
d_retrognathia |
Integer |
|
Recommended |
DysmorphicCB: retrognathia |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_retrognathia |
Query
|
d_smoothphiltrum |
Integer |
|
Recommended |
DysmorphicCB: smooth philtrum |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_smoothphiltrum |
Query
|
d_synophrys |
Integer |
|
Recommended |
DysmorphicCB: synophrys |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_synophrys |
Query
|
d_thinupperlip |
Integer |
|
Recommended |
DysmorphicCB: thin upper lip |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_thinupperlip |
Query
|
d_triangularface |
Integer |
|
Recommended |
DysmorphicCB: triangular face |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_triangularface |
Query
|
d_upslantingpalpebral |
Integer |
|
Recommended |
DysmorphicCB: upslanting palpebral fissures |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_upslantingpalpebral |
Query
|
d_widelyspacedteeth |
Integer |
|
Recommended |
DysmorphicCB: widely spaced teeth |
0;1
|
0 = unchecked box; 1 = checked box
|
dysmorphiccb_widelyspacedteeth |
Query
|
dysmorphicother |
String |
200
|
Recommended |
Dysmorphic featuresIf other please specify |
|
|
|
Query
|
dystonia |
Integer |
|
Recommended |
Dystonia |
0::5
|
0=None; 1=Focal dystonia (more than one joint); 2=Segmental dystonia (two extremities); 3=Generalized dystonia (>2 extremities); 4=None; 5=Focal dystonia (one joint)
|
|
Query
|
facialflush |
Integer |
|
Recommended |
Facial flushing |
0;1
|
0=Absent; 1=Present
|
|
Query
|
fathercircumnotdone |
Integer |
|
Recommended |
Birth Fathers head circumference not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
pda_s2q3_percentile_head_fa |
Float |
|
Recommended |
Bio father head circumference percentile |
|
|
fathercircumpercent |
|
pda_s2q3_head_circumference_fa |
String |
50
|
Recommended |
Bio father head circumference (cm) |
|
|
fatherheadcircum |
Query
|
feetcb |
Integer |
|
Recommended |
Feet choose one from each column |
1::4
|
1=Pink; 2=Mottled; 3=Cyanotic; 4=Red
|
|
Query
|
freqhandmouthing |
Integer |
|
Recommended |
Frequency of hand mouthing hands or objects |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
freqhandstereotypies |
Integer |
|
Recommended |
Frequency of hand stereotypies |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
gp_broadbased |
Integer |
|
Recommended |
GaitPattern: Broad based |
0;1
|
0 = unchecked box; 1 = checked box
|
gaitpattern_broadbased |
Query
|
gp_dyspraxic |
Integer |
|
Recommended |
GaitPattern: Dyspraxic |
0;1
|
0 = unchecked box; 1 = checked box
|
gaitpattern_dyspraxic |
Query
|
gp_normal |
Integer |
|
Recommended |
GaitPattern: Normal |
0;1
|
0 = unchecked box; 1 = checked box
|
gaitpattern_normal |
Query
|
gp_retropulsion |
Integer |
|
Recommended |
GaitPattern: Retropulsion |
0;1
|
0 = unchecked box; 1 = checked box
|
gaitpattern_retropulsion |
Query
|
gp_rockingsidetoside |
Integer |
|
Recommended |
GaitPattern: Rocking side-to-side |
0;1
|
0 = unchecked box; 1 = checked box
|
gaitpattern_rockingsidetoside |
Query
|
gp_toewalking |
Integer |
|
Recommended |
GaitPattern: Toe walking |
0;1
|
0 = unchecked box; 1 = checked box
|
gaitpattern_toewalking |
Query
|
gesturevisualcue |
Integer |
|
Recommended |
Place toyfood on table and after participant is distracted using only a gesture or visual cue eg pointing and looking at item indicate the toy food and record response |
0::5
|
1=Looks at item immediately; 2=After a delay of greater than 5 seconds, looks at item; 3=Turns and looks somewhere else; 4=Regards examiner but does not perform any action; 5=Ignores examiner completely; 0=Unable to perform
|
|
Query
|
gaother |
String |
150
|
Recommended |
If participant cannot walk independently describe some of the ways heshe gets aroundIf other specify |
|
|
getsaroundother |
Query
|
ga_crawls |
Integer |
|
Recommended |
GetsAround: Crawls |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_crawls |
Query
|
ga_creepsonbellypullssel |
Integer |
|
Recommended |
GetsAround: Creeps on belly (pulls self) |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_creepsonbellypullssel |
Query
|
ga_other |
Integer |
|
Recommended |
GetsAround: Other |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_other |
Query
|
ga_rolls |
Integer |
|
Recommended |
GetsAround: Rolls |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_rolls |
Query
|
ga_scootsonbottom |
Integer |
|
Recommended |
GetsAround: Scoots on bottom |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_scootsonbottom |
Query
|
ga_unabletogetaround |
Integer |
|
Recommended |
GetsAround: Unable to get around |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_unabletogetaround |
Query
|
ga_walkswithassistance |
Integer |
|
Recommended |
GetsAround: Walks with assistance |
0;1
|
0 = unchecked box; 1 = checked box
|
getsaround_walkswithassistance |
Query
|
grimace |
Integer |
|
Recommended |
Grimace or sharp contortion of face |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
handdominance |
Integer |
|
Recommended |
Hand Dominance |
1::4
|
1=Left; 2=Variable; 3=Right; 4=Unable to determine
|
|
Query
|
handuseimpression |
Integer |
|
Recommended |
Hand use Impression |
1::6
|
1=Holds object when placed in hand; 2=Normal; 3=Plays with toys or activates switches purposefully; 4=Uses utensils; 5=Finger feeds only or picks up toys; 6=No purposeful hand use
|
|
Query
|
handscb |
Integer |
|
Recommended |
Hands choose one from each column |
1::4
|
1=Pink; 2=Mottled; 3=Cyanotic; 4=Red
|
|
Query
|
headcircumnotdone |
Integer |
|
Recommended |
Head circumference not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
pda_s3q4_headcirc_percentile |
Float |
|
Recommended |
Head circumference percentile |
|
|
headcircumpercent |
Query
|
head_circum |
Float |
|
Recommended |
Head Circumference (in cm) |
|
-1 = Not known
|
headcircumference |
Query
|
heightmeasurement |
Integer |
|
Recommended |
Height measurement way |
1::4
|
1=Standing; 2=Recumbent; 3=Segmental; 4=Calculated
|
|
Query
|
heightnotdone |
Integer |
|
Recommended |
Height not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
neuro_007_height_cm |
Float |
|
Recommended |
Neurological Exam (4:6+ y:m): Measured height (cm) |
|
|
heighttextbox |
Query
|
hyperactivity |
Integer |
|
Recommended |
Hyperactivity of time of visit Hypo and Hyperactivity cant be 100 |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
hyperventleveldisrupt |
Integer |
|
Recommended |
If hyperventilation present level of disruption |
0::5
|
0=None; 1=Very Mild; 2=Mild; 3=Moderate; 4=Severe; 5=Very Severe
|
|
Query
|
hyperventilation |
Integer |
|
Recommended |
Hyperventilation of time of visit Hyperventilation and Breathholding cannot be 100 |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
hypoactivity |
Integer |
|
Recommended |
Hypoactivity of time of visit Hypo and Hyperactivity cant be 100 |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
interaction |
Integer |
|
Recommended |
Interaction with examiner |
1::5
|
1=~25%; 2=Not interactive; 3=Interactive entire visit (>90%); 4=~75%; 5=~50%
|
|
Query
|
irritability_dx |
Integer |
|
Recommended |
Irritability |
0::4
|
0=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
|
irritability |
Query
|
lefthandother |
String |
100
|
Recommended |
Hand use mark all observedLeft hand if other specify |
|
|
|
Query
|
lh_copiescircle |
Integer |
|
Recommended |
LeftHandUse: Copies circle |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_copiescircle |
Query
|
lh_copiesdrawnlineverti |
Integer |
|
Recommended |
LeftHandUse: Copies drawn line vertically |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_copiesdrawnlineverti |
Query
|
lh_copieslinedrawnhoriz |
Integer |
|
Recommended |
LeftHandUse: Copies line drawn horizontally |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_copieslinedrawnhoriz |
Query
|
lh_drawsonpaperwithoutc |
Integer |
|
Recommended |
LeftHandUse: Draws on paper without copying |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_drawsonpaperwithoutc |
Query
|
lh_foldspaperinhalf |
Integer |
|
Recommended |
LeftHandUse: Folds paper in half |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_foldspaperinhalf |
Query
|
lh_graspstoyfoodwpinche |
Integer |
|
Recommended |
LeftHandUse: Grasps toy/food w/pincher |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_graspstoyfoodwpinche |
Query
|
lh_holdscup |
Integer |
|
Recommended |
LeftHandUse: Holds cup |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_holdscup |
Query
|
lh_holdsobject |
Integer |
|
Recommended |
LeftHandUse: Holds object |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_holdsobject |
Query
|
lh_manipulatesobject |
Integer |
|
Recommended |
LeftHandUse: Manipulates object |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_manipulatesobject |
Query
|
lh_noneobserved |
Integer |
|
Recommended |
LeftHandUse: None observed |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_noneobserved |
Query
|
lh_other |
Integer |
|
Recommended |
LeftHandUse: Other |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_other |
Query
|
lh_reachesfortoyfood |
Integer |
|
Recommended |
LeftHandUse: Reaches for toy/food |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_reachesfortoyfood |
Query
|
lh_throwsobject |
Integer |
|
Recommended |
LeftHandUse: Throws object |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_throwsobject |
Query
|
lh_transfersobject |
Integer |
|
Recommended |
LeftHandUse: Transfers object |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_transfersobject |
Query
|
lh_turnspageinbook |
Integer |
|
Recommended |
LeftHandUse: Turns page in book |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_turnspageinbook |
Query
|
lh_usesutensilmaybeadap |
Integer |
|
Recommended |
LeftHandUse: Uses utensil (may be adaptive) |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_usesutensilmaybeadap |
Query
|
lh_writesletters |
Integer |
|
Recommended |
LeftHandUse: Writes letters |
0;1
|
0 = unchecked box; 1 = checked box
|
lefthanduse_writesletters |
Query
|
lighttouch |
Integer |
|
Recommended |
Light touch |
1::3
|
1=Normal or apparently normal; 2=No clear response to light touch in specific region; 3=No clear response to light touch throughout
|
|
Query
|
lsa_banginghead |
Integer |
|
Recommended |
ListSelfAbusive: Banging head |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_banginghead |
Query
|
lsa_bitingchewingsel |
Integer |
|
Recommended |
ListSelfAbusive: Biting/chewing self |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_bitingchewingsel |
Query
|
lsa_hittingslapping1 |
Integer |
|
Recommended |
ListSelfAbusive: Hitting/slapping other parts of head |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_hittingslapping1 |
Query
|
lsa_hittingslapping2 |
Integer |
|
Recommended |
ListSelfAbusive: Hitting/slapping other body parts |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_hittingslapping2 |
Query
|
lsa_none |
Integer |
|
Recommended |
ListSelfAbusive: None |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_none |
Query
|
lsa_pickingself |
Integer |
|
Recommended |
ListSelfAbusive: Picking self |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_pickingself |
Query
|
lsa_pullinghair |
Integer |
|
Recommended |
ListSelfAbusive: Pulling hair |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_pullinghair |
Query
|
lsa_rubbingorpinchin |
Integer |
|
Recommended |
ListSelfAbusive: Rubbing or pinching self |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_rubbingorpinchin |
Query
|
lsa_scratchingdiggin |
Integer |
|
Recommended |
ListSelfAbusive: Scratching/digging self |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_scratchingdiggin |
Query
|
lsa_slappingface |
Integer |
|
Recommended |
ListSelfAbusive: Slapping face |
0;1
|
0 = unchecked box; 1 = checked box
|
listselfabusive_slappingface |
Query
|
miduppercircnotdone |
Integer |
|
Recommended |
Midupper arm circ not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
mothercircumnotdone |
Integer |
|
Recommended |
Birth Mothers head circumference not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
|
pda_s2q2_head_circumference |
String |
50
|
Recommended |
Bio mother Head circumference (cm) |
|
|
motherheadcircum |
|
pda_s2q2_percentile_head_mthr |
String |
50
|
Recommended |
Bio mother Head circumference percentile |
|
|
mothercircumpercent |
Query
|
musclemass |
Integer |
|
Recommended |
Muscle mass |
1;2
|
1=Normal to increased; 2=Decreased
|
|
Query
|
neuroexamcomm |
String |
300
|
Recommended |
Optional comments on general neurological exam |
|
|
|
Query
|
nonvclearmeaning |
Integer |
|
Recommended |
When using nonverbal communication how clear is meaning without coaching |
1::6
|
1=Meaning is always clear; 2=Meaning is clear most of the time (>90%);3= Meaning is clear more than half the time (50-90%); 4=Meaning is clear less than half the time (10-<50%); 5=Meaning is rarely clear (<10% of time); 6=No communication (0%)
|
|
|
nonverbattemptsgest |
String |
100
|
Recommended |
List all nonverbal ways child attempts to communicateIf hand gestures example |
|
|
|
|
nonverbattemptsother |
String |
150
|
Recommended |
List all nonverbal ways child attempts to communicateIf other example |
|
|
|
Query
|
nonverbattemptssign |
String |
75
|
Recommended |
List all nonverbal ways child attempts to communicateIf sign language example |
|
|
|
Query
|
nva_expressionofange |
Integer |
|
Recommended |
NonverbAttempts: Expression of anger |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_expressionofange |
Query
|
nva_expressionoffear |
Integer |
|
Recommended |
NonverbAttempts: Expression of fear or anxiety |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_expressionoffear |
Query
|
nva_expressionofsadn |
Integer |
|
Recommended |
NonverbAttempts: Expression of sadness |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_expressionofsadn |
Query
|
nva_expressionofsurp |
Integer |
|
Recommended |
NonverbAttempts: Expression of surprise |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_expressionofsurp |
Query
|
nva_frowning |
Integer |
|
Recommended |
NonverbAttempts: Frowning |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_frowning |
Query
|
nva_handgestures |
Integer |
|
Recommended |
NonverbAttempts: Hand gestures |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_handgestures |
Query
|
nva_noattempt |
Integer |
|
Recommended |
NonverbAttempts: No attempt |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_noattempt |
Query
|
nva_othercues |
Integer |
|
Recommended |
NonverbAttempts: Other cues |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_othercues |
Query
|
nva_pointing |
Integer |
|
Recommended |
NonverbAttempts: Pointing |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_pointing |
Query
|
nva_signlanguage |
Integer |
|
Recommended |
NonverbAttempts: Sign Language |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_signlanguage |
Query
|
nva_smilingsocially |
Integer |
|
Recommended |
NonverbAttempts: Smiling (socially) |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_smilingsocially |
Query
|
nva_waving |
Integer |
|
Recommended |
NonverbAttempts: Waving |
0;1
|
0 = unchecked box; 1 = checked box
|
nonverbattempts_waving |
Query
|
nonverbchoice |
Integer |
|
Recommended |
When shown 2 items use favorite toys if present or food items how does participant choose nonverbally If participant indicated want clearly verbally to provoke nonverbal response ask participant to show me which one |
0::5
|
1=Points with a single finger to the item she/he wants; 2=Gestures with several fingers or hand to the item she/he wants; 3=Indicates want using other gesture; 4=Turns towards the item she/he wants but does not gesture; 5=Does not indicate want nonverbally; 0=Unable to perform
|
|
Query
|
nystagmustype |
Integer |
|
Recommended |
Description of abnormalityIf Nystagmus what type |
1::3
|
1=Vertical; 2=Horizontal; 3=Rotator
|
|
Query
|
oromotordyskinesia |
Integer |
|
Recommended |
Oromotor dyskinesia tongue protrusion smacking lips sidetoside jaw movements |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
othermovements |
Integer |
|
Recommended |
Other movements mark all that apply |
0::4
|
0=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
|
|
Query
|
or_babinskipresent |
Integer |
|
Recommended |
OtherReflexes: Babinski present |
0;1
|
0 = unchecked box; 1 = checked box
|
otherreflexes_babinskipresent |
Query
|
otherreflexes_none |
Integer |
|
Recommended |
OtherReflexes: None |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
or_palmomentalpresent |
Integer |
|
Recommended |
OtherReflexes: Palmomental present |
0;1
|
0 = unchecked box; 1 = checked box
|
otherreflexes_palmomentalpresent |
Query
|
ors_snoutpresent |
Integer |
|
Recommended |
OtherReflexes: Snout present |
0;1
|
0 = unchecked box; 1 = checked box
|
otherreflexes_snoutpresent |
Query
|
overallhypertonia |
Integer |
|
Recommended |
Overall hypertonia choose one option only |
0::4
|
0=None; 1=Ankle hypertonia; 2=Upper or lower limb hypertonia; 3=Generalized no contractures; 4=Generalized with contractures
|
|
Query
|
overallreflexes |
Integer |
|
Recommended |
Overall reflexes choose one option only |
1::3
|
1=Normal throughout (include hyporeflexia); 2=Some Hyperreflexia; 3=Global Hyperreflexia
|
|
Query
|
painfulstimulation |
Integer |
|
Recommended |
Painful stimulation apply firm pressure to base of finger nail bed using pen or examiners nail for 5 seconds |
0::3
|
1=Immediate withdrawal and change in facial expression; 2=Immediate withdrawal without grimace or clear recognition; 3=Delayed withdrawal; 0=No response during 5 seconds of pressure
|
|
Query
|
palmomentalnotpresent |
Integer |
|
Recommended |
Palmomental Not present |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
predominantaffect |
Integer |
|
Recommended |
Description of affect Choose all that apply and choose one predominant affect |
1::8
|
1=Calm; 2=Smiling; 3=Laughing or giggling; 4=Appears anxious or fearful; 5=Frowning or sad; 6=Crying; 7=Irritable; 8=Screaming
|
|
Query
|
pubictannerstage |
Integer |
|
Recommended |
Pubic Tanner stage |
0::5
|
1=I - No pubic hair; 2=II - Females: small amount of long, downy hair, slight pigmentation on labia majora; 3=III - Hair becomes more coarse and curly, and begins to extend laterally; 4=IV - Adult-like hair quality, extending across pubis but sparing medial thighs; 5=V - Hair extends to medial surface of the thighs; 0=Not done
|
|
Query
|
puffblowrasp |
Integer |
|
Recommended |
Puffingblowing raspberries of time of visit Drooling and PuffingBlowing Raspberries cant be 100 |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
pulmexam |
Integer |
|
Recommended |
Pulmonary exam |
0::2
|
1=Normal; 2=Abnormal; 0=Not Done
|
|
Query
|
pulmexamabcom |
String |
100
|
Recommended |
Pulmonary examComments if abnormal |
|
|
|
Query
|
rm_chewinglicki |
Integer |
|
Recommended |
RepetitiveMovements: Chewing/licking |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_chewinglicki |
Query
|
rm_clapping |
Integer |
|
Recommended |
RepetitiveMovements: Clapping |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_clapping |
Query
|
rm_clasping |
Integer |
|
Recommended |
RepetitiveMovements: Clasping |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_clasping |
Query
|
rm_fingerrubbin |
Integer |
|
Recommended |
RepetitiveMovements: Finger rubbing |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_fingerrubbin |
Query
|
rm_flappinginfr |
Integer |
|
Recommended |
RepetitiveMovements: Flapping in front of body |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_flappinginfr |
Query
|
rm_flappingnext |
Integer |
|
Recommended |
RepetitiveMovements: Flapping next to body |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_flappingnext |
Query
|
rm_flickingfing |
Integer |
|
Recommended |
RepetitiveMovements: Flicking (fingers, lips, etc.) |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_flickingfing |
Query
|
rm_flippingpage |
Integer |
|
Recommended |
RepetitiveMovements: Flipping (pages, hands, objects) |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_flippingpage |
Query
|
rm_hairtwirling |
Integer |
|
Recommended |
RepetitiveMovements: Hair twirling/pulling |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_hairtwirling |
Query
|
rm_handmouthing |
Integer |
|
Recommended |
RepetitiveMovements: Hand mouthing |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_handmouthing |
Query
|
rm_handwringing |
Integer |
|
Recommended |
RepetitiveMovements: Hand wringing/washing |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_handwringing |
Query
|
rm_knittingtwis |
Integer |
|
Recommended |
RepetitiveMovements: Knitting/twisting fingers |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_knittingtwis |
Query
|
rm_none |
Integer |
|
Recommended |
RepetitiveMovements: None |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_none |
Query
|
rm_pickingcloth |
Integer |
|
Recommended |
RepetitiveMovements: Picking (clothes, body, arms, etc.) |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_pickingcloth |
Query
|
rm_pullinghair |
Integer |
|
Recommended |
RepetitiveMovements: Pulling hair |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_pullinghair |
Query
|
rm_rubbing |
Integer |
|
Recommended |
RepetitiveMovements: Rubbing |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_rubbing |
Query
|
rm_scratching |
Integer |
|
Recommended |
RepetitiveMovements: Scratching |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_scratching |
Query
|
rm_squeezinghan |
Integer |
|
Recommended |
RepetitiveMovements: Squeezing (hands, body, object) |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_squeezinghan |
Query
|
rm_tappinghitti |
Integer |
|
Recommended |
RepetitiveMovements: Tapping/hitting (hands, surfaces) |
0;1
|
0 = unchecked box; 1 = checked box
|
repetitivemovements_tappinghitti |
Query
|
resptospoken |
Integer |
|
Recommended |
Response to spoken word |
0::4
|
0=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
|
|
Query
|
restingtremor |
Integer |
|
Recommended |
Resting tremor |
0::4
|
0=Not present; 1=<1 cm maximal amplitude; 2=1 cm to <2 cm maximal amplitude; 3=2 cm to 3 cm maximal amplitude;4= >3 cm maximal amplitude
|
|
Query
|
righthandother |
String |
150
|
Recommended |
Hand use mark all observedRight hand if other specify |
|
|
|
Query
|
rh_copiescircle |
Integer |
|
Recommended |
RightHandUse: Copies circle |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_copiescircle |
Query
|
rh_copiesdrawnlinevert |
Integer |
|
Recommended |
RightHandUse: Copies drawn line vertically |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_copiesdrawnlinevert |
Query
|
rh_copieslinedrawnhori |
Integer |
|
Recommended |
RightHandUse: Copies line drawn horizontally |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_copieslinedrawnhori |
Query
|
rh_drawsonpaperwithout |
Integer |
|
Recommended |
RightHandUse: Draws on paper without copying |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_drawsonpaperwithout |
Query
|
rh_foldspaperinhalf |
Integer |
|
Recommended |
RightHandUse: Folds paper in half |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_foldspaperinhalf |
Query
|
rh_graspstoyfoodwpinch |
Integer |
|
Recommended |
RightHandUse: Grasps toy/food w/pincher |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_graspstoyfoodwpinch |
Query
|
rh_holdscup |
Integer |
|
Recommended |
RightHandUse: Holds cup |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_holdscup |
Query
|
rh_holdsobject |
Integer |
|
Recommended |
RightHandUse: Holds object |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_holdsobject |
Query
|
rh_manipulatesobject |
Integer |
|
Recommended |
RightHandUse: Manipulates object |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_manipulatesobject |
Query
|
rh_noneobserved |
Integer |
|
Recommended |
RightHandUse: None observed |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_noneobserved |
Query
|
rh_other |
Integer |
|
Recommended |
RightHandUse: Other |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_other |
Query
|
rh_reachesfortoyfood |
Integer |
|
Recommended |
RightHandUse: Reaches for toy/food |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_reachesfortoyfood |
Query
|
rh_throwsobject |
Integer |
|
Recommended |
RightHandUse: Throws object |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_throwsobject |
Query
|
rh_transfersobject |
Integer |
|
Recommended |
RightHandUse: Transfers object |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_transfersobject |
Query
|
rh_turnspageinbook |
Integer |
|
Recommended |
RightHandUse: Turns page in book |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_turnspageinbook |
Query
|
rh_usesutensilmaybeada |
Integer |
|
Recommended |
RightHandUse: Uses utensil (may be adaptive) |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_usesutensilmaybeada |
Query
|
rh_writesletters |
Integer |
|
Recommended |
RightHandUse: Writes letters |
0;1
|
0 = unchecked box; 1 = checked box
|
righthanduse_writesletters |
Query
|
scoliosis_dx |
Integer |
|
Recommended |
Scoliosis choose only one option |
0::5
|
0=None; 1=< 10 degrees; 2=10-<20 degrees; 3=20-<40 degrees; 4=40-<60 degrees; 5=60 degrees or greater
|
scoliosis |
Query
|
scoliosissurgyn |
Integer |
|
Recommended |
Scoliosis surgery performed |
0;1
|
1=Yes; 0=No
|
|
Query
|
selfabusive |
Integer |
|
Recommended |
Selfabusive behaviors |
1::5
|
1=Absent 0%; 2=Rare ~25%; 3=Occasional ~50%; 4=Frequent ~75%; 5=Almost constant >90%
|
|
Query
|
sitting |
Integer |
|
Recommended |
Sitting |
1::4
|
1=Sits unaided; 2=Sits with minimal support; 3=Sits with maximal support; 4=Unable to sit
|
|
Query
|
sittingduration |
Integer |
|
Recommended |
SittingIf sits unaided duration |
1::3
|
1=5-30 seconds; 2=>5 seconds; 3=>30 seconds
|
|
Query
|
sea_birthmarks |
Integer |
|
Recommended |
SkinExamAbnormal: Birth marks |
0;1
|
0 = unchecked box; 1 = checked box
|
skinexamabnormal_birthmarks |
Query
|
sea_cracksanderythe |
Integer |
|
Recommended |
SkinExamAbnormal: Cracks and erythema on hands |
0;1
|
0 = unchecked box; 1 = checked box
|
skinexamabnormal_cracksanderythe |
Query
|
sea_erythemaonhands |
Integer |
|
Recommended |
SkinExamAbnormal: Erythema on hands |
0;1
|
0 = unchecked box; 1 = checked box
|
skinexamabnormal_erythemaonhands |
Query
|
sea_other |
Integer |
|
Recommended |
SkinExamAbnormal: Other |
0;1
|
0 = unchecked box; 1 = checked box
|
skinexamabnormal_other |
Query
|
sea_skinbreakdownon |
Integer |
|
Recommended |
SkinExamAbnormal: Skin breakdown on hands |
0;1
|
0 = unchecked box; 1 = checked box
|
skinexamabnormal_skinbreakdownon |
Query
|
skin |
Integer |
|
Recommended |
Skin exam |
0::5
|
1=Wide range of normal variability; 2=Abnormal by exam; 3=Abnormal by history only; 0=Not done; 4=Normal; 5=Abnormal
|
skinexamlist |
|
skinexamother |
String |
300
|
Recommended |
Skin examIf other please specify |
|
|
|
Query
|
snoutnotpresent |
Integer |
|
Recommended |
Snout Not present |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
socialreaction |
Integer |
|
Recommended |
Social reaction when examiner engages with them mark single most characteristic |
1::5
|
1=Responds normally (100%); 2=Regards examiner for most of the time (75%); 3=Regards examiner for some of the time (50%); 4=Regards examiner for a little of the time (25%); 5=Ignores examiner completely (0%)
|
|
Query
|
standing |
Integer |
|
Recommended |
Standing |
1::4
|
1=Stands unaided; 2=Stands (minimal support); 3=Stands (maximal support); 4=Unable to stand
|
|
Query
|
standingduration |
Integer |
|
Recommended |
StandingIf stands unaided duration |
1::3
|
1=5-30 seconds; 2=>5 seconds; 3=>30 seconds
|
|
Query
|
strength |
Integer |
|
Recommended |
Strength |
1;2
|
1=Normal throughout; 2=Any weakness
|
|
Query
|
totalclinicexp |
Integer |
|
Recommended |
Considering your total clinical experience with this population how impaired is participant now USE CGIS SCALE BELOW |
1::7
|
1=Normal, not at all impaired; 2=Borderline impaired; 3=Mildly impaired; 4=Moderately impaired; 5=Markedly impaired; 6=Severely impaired; 7=The most impaired
|
|
Query
|
tricepfoldcircumnotdone |
Integer |
|
Recommended |
Tricep skin fold not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
truncalrocking |
Integer |
|
Recommended |
Truncal rocking voluntary |
0::4
|
0=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
|
|
Query
|
truncaltitubation |
Integer |
|
Recommended |
Truncal titubation |
0::4
|
0=None; 1=25% of time; 2=50% of time; 3=75% of time; 4=100% of time
|
|
Query
|
verbclearmeaning |
Integer |
|
Recommended |
When using vocal or verbal communication how clear is meaning without coaching from parents |
1::6
|
1=Meaning is always clear; 2=Meaning is clear most of the time (>90%); 3=Meaning is clear more than half the time (>50%); 4=Meaning is clear less than half the time (<50%); 5=Vocalizes or verbalizes, but meaning is never clear; 6=Never vocalizes or verbalizes
|
|
Query
|
verblangnumbsent |
Integer |
|
Recommended |
Verbal language output during visitIf uses complete sentences estimate total number of sentences used during visit |
1::6
|
1; 2; 3; 4; 5; 6=>6
|
|
Query
|
verblangnumbwords |
Integer |
|
Recommended |
Verbal language output during visitIf uses single words estimate total number of words used during visit |
1::6
|
1=1; 2=2; 3=3 to 5; 4=6-10; 5=11-20; 6=>20
|
|
Query
|
verblangoutput |
Integer |
|
Recommended |
Verbal language output during visit best function |
0::8
|
0=None, except crying, screaming; 1=Babbles/vocalizes; 2=Uses sounds that have meaning ( I need the bathroom ); 3 =;Echoes words; 4=Uses single words that have meaning 5=; Use phrases (>2 words, but not complete sentence); 6=Uses isolated sentences (>2 words; subject and verb are present); 7=Uses complete sentences linked together in context; 8=Fluent, normal speech (may include occasional errors.)
|
|
Query
|
verbalchoice |
Integer |
|
Recommended |
When shown 2 items use favorite toys if present or food how does participant choose vocally or verbally If participant indicated want clearly nonverbally to provoke verbal response ask participant to tell me which one |
1::4
|
1=Names the item she/he wants; 2=Indicates want using words ('that') but does not name item; 3=Indicates want using non-specific verbalization; 4=Does not indicate want verbally
|
|
Query
|
c_waist |
Float |
|
Recommended |
Waist (cm) |
|
|
waistcircum |
Query
|
waistcircumnotdone |
Integer |
|
Recommended |
Waist circumference not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
walkstamina |
Integer |
|
Recommended |
Walking stamina |
1::5
|
1=Walks distance from waiting room to interview room (>10 feet) easily; 2=Walks distance from waiting room to interview room (>10 feet) with difficulty; 3=Walks across room; 4=Takes a few steps; 5=Stands but does not walk
|
|
Query
|
walking |
Integer |
|
Recommended |
Walking |
1::5
|
1=Walks unaided at normal pace for age; 2=Walks unaided at reduced pace for age; 3=Walks with minimal support; 4=Walks with maximum support; 5=Unable to walk
|
|
Query
|
weightnotdone |
Integer |
|
Recommended |
Weight not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
weight_met |
Float |
|
Recommended |
Weight - Metric Unit |
|
999 = Missing
|
weighttextbox |
Query
|
wristcircumnotdone |
Integer |
|
Recommended |
Wrist circumference not done |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
u5211cababinskinottested |
Integer |
|
Recommended |
Babinski not tested |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
u5211cafeetgroup2 |
Integer |
|
Recommended |
Feet Column 2 |
1::4
|
1=Warm; 2=Cool; 3=Cold; 4=Hot
|
|
Query
|
u5211cafeetgroup3 |
Integer |
|
Recommended |
Feet Column 3 |
1;2
|
1=Dry;2= Sweaty
|
|
Query
|
u5211cahandsgroup2 |
Integer |
|
Recommended |
Hands Column 2 |
1::4
|
1=Warm; 2=Cool; 3=Cold; 4=Hot
|
|
Query
|
u5211cahandsgroup3 |
Integer |
|
Recommended |
Hands Column 3 |
1;2
|
1=Dry;2= Sweaty
|
|
Query
|
u5211capalmomentalint |
Integer |
|
Recommended |
Palmomentali Not Tested |
0;1
|
0 = unchecked box; 1 = checked box
|
u5211capalmomentalinottested |
|
u5211caresponsetlt |
String |
50
|
Recommended |
Specify response to light touch |
|
|
u5211caresponsetolighttouch |
Query
|
u5211casnoutnottested |
Integer |
|
Recommended |
Snout Not Tested |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
mostsevereabusive |
Integer |
|
Recommended |
List all selfabusive behaviors and fill in O next to the single most severeproblematic of these movements |
0::9
|
1=Slapping face; 2=Biting/chewing self; 3=Banging head; 4=Pulling hair; 5=Picking self; 6=Hitting/slapping other parts of head; 7=Hitting/slapping other body parts; 8=Scratching/digging self;9= Rubbing or pinching self; 0=None
|
|
Query
|
mostsevererepmove |
Integer |
|
Recommended |
List all repetitive movements and fill in O next to the single most severeproblematic of these movements |
0::18
|
1=Clasping; 2=Hand wringing/washing; 3=Clapping; 4=Tapping/hitting (hands, surfaces); 5=Squeezing (hands, body, object); 6=Flicking (fingers, lips, etc.); 7=Scratching; 8=Hand mouthing; 9=Pulling hair; 10=Finger rubbing; 11=Picking (clothes, body, arms, etc.); 12=Hair twirling/pulling;13= Knitting/twisting fingers;14= Flipping (pages, hands, objects); 15=Rubbing; 16=Chewing/licking;17= Flapping next to body; 18=Flapping in front of body; 0=None
|
|
Query
|
u5211caemaffectpr |
Integer |
|
Recommended |
D1 Description of Affect Predominant |
1::8
|
1=Calm; 2=Smiling; 3=Laughing or giggling; 4=Appears anxious or fearful; 5=Frowning or sad; 6=Crying; 7=Irritable; 8=Screaming
|
u5211caemotionalaffectpredomin |
Query
|
midupperarmcircum |
Float |
|
Recommended |
Midupper arm circ cm |
|
|
|
Query
|
tricepfoldcircum |
Float |
|
Recommended |
Tricep skin fold mm |
|
|
|
Query
|
wristcircum |
Float |
|
Recommended |
Wrist circumference cm |
|
|
|
Query
|
bmibycalc |
Float |
|
Recommended |
BMI by calculation |
|
|
|
Query
|
nystagmustype_horizontal |
Integer |
|
Recommended |
If Mystagmus selected, specify type: horizontal |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
nystagmustype_rotator |
Integer |
|
Recommended |
If Mystagmus selected, specify type: rotator |
0;1
|
0 = unchecked box; 1 = checked box
|
|
Query
|
nystagmustype_vertical |
Integer |
|
Recommended |
If Mystagmus selected, specify type: vertical |
0;1
|
0 = unchecked box; 1 = checked box
|
|