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NIMH Data Archive
NDA ABCD CCF OAI NIAAADA AMP SCZ HEAL

Child's Medical History

0 Shared Subjects

N/A
Clinical Assessments
Med History
12/02/2019
child_med01
07/05/2022
View Change History
01
Definition
Submission Template
Query Element Name Data Type Size Required Description Value Range Notes Aliases
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::1440 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
cg_unknown Integer Recommended Conception/gestation unknown (child adopted/fostered/etc.) 0;1 0= No; = Yes
cg_q1_ivf Integer Recommended Was conception via in vitro fertilization (IVF)?
1::5
1 = Yes, Legal mother's egg/legal father's sperm; 2 = Yes, Legal mother's egg/donated sperm; 3 = Yes, Donated egg/legal father's sperm; 4 = Yes, Donated egg/donated sperm; 5 = No
cg_q2_surrogate Integer Recommended Was the pregnancy carried by a surrogate mother?
1::5
1 = Yes, Legal mother's egg/legal father's sperm; 2 = Yes, Legal mother's egg/donated sperm; 3 = Yes, Surrogate's egg/legal father's sperm; 4 = Yes, Surrogate's egg/donated sperm; 5 = No
cg_q3_multi_preg Integer Recommended Was the pregnancy a multiple pregnancy? 0::4;97 0 = No; 1 = Yes, Identical Twins; 2 = Yes, Fraternal Twins; 3 = Yes, Identical Triplets; 4 = Yes, Fraternal Triplets; 97 = Yes, Other (please specify):
cg_q3_multi_preg_oth_desc String 100 Recommended Specify other type of multiple pregnancy
cg_q4_other_desc String 500 Recommended Please include any other unique details about conception and/or gestation:
ph_unknown Integer Recommended Prenatal history unknown (child adopted/fostered/etc) 0;1 0= No; = Yes
ph1a_stress Integer Recommended Did the mother experience: a high level of stress during pregnancy 0;1 0= No; = Yes
devhx_10j3_p Integer Recommended During the pregnancy with this child, did you/biological mother have any of the following conditions? Pregnancy-related high blood pressure? /¿Presión arterial alta relacionada con el embarazo? 1 ; 0 ; 999 1 = Yes /Sí; 0 = No /No; 999 = Don't know/ No lo sé ph1b_bp
devhx_10g3_p Integer Recommended During the pregnancy with this child, did you/biological mother have any of the following conditions? Severe anemia?/¿Anemia grave? 1 ; 0 ; 999 1 = Yes /Sí; 0 = No /No; 999 = Don't know/ No lo sé ph1c_anemia
preg_bleeding String 50 Recommended Did mother experience excessive bleeding during pregnancy?
Yes; No;999
ph1d_bleeding
devhx_10h3_p Integer Recommended During the pregnancy with this child, did you/biological mother have any of the following conditions? Urinary tract infections? /¿Infecciones de vías urinarias? 1 ; 0 ; 999 1 = Yes /Sí; 0 = No /No; 999 = Don't know/ No lo sé ph1e_uti
ph1f_toxemia Integer Recommended Did the mother experience: toxemia 0;1 0= No; = Yes
preg_eclampsia String 50 Recommended Did mother experience eclampsia during pregnancy?
Yes; No;999
ph1g_eclampsia
ph1h_injury Integer Recommended Did the mother experience: accidental injury that caused bleeding or loss of consciousness 0;1 0= No; = Yes
ph1i_poisoning Integer Recommended Did the mother experience: carbon monoxide or lead poisoning 0;1 0= No; = Yes
ph1j_seizures Integer Recommended Did the mother experience: seizures 0;1 0= No; = Yes
ph1k_diabetes Integer Recommended Did the mother experience: diabetes 0;1 0= No; = Yes
ph1l_other Integer Recommended Did the mother experience: any other medical problems 0;1 0= No; = Yes
ph1l_other_desc String 100 Recommended Describe any other medical problems experienced during pregnancy
ph2a_psych_meds Integer Recommended Did the Mother: take any type of prescription for a psychiatric condition during pregnancy 0;1 0= No; = Yes
ph2a_psych_meds_desc String 100 Recommended Describe type of prescription for a psychiatric condition during pregnancy
ph2b_other_meds Integer Recommended Did the Mother: take any prescription meds for any other disease/illness during pregnancy 0;1 0= No; = Yes
ph2b_other_meds_desc String 100 Recommended Describe prescription meds for any other disease/illness during pregnancy
matern_cigs Integer Recommended Did you smoke cigarettes during your pregnancy (including before you knew you were pregnant)? 0;1 0 = No; 1 = Yes ph2c_cigs
mca1b Integer Recommended On average, how many cigarettes per day did she smoke during her pregnancy with this child? 0=Only occasional smoking ph2c_cigs_amt
ph2d_alcohol Integer Recommended Did the Mother: drink alcoholic beverages during pregnancy 0;1 0= No; = Yes
ph2d_alcohol_amt String 100 Recommended How many alcholic beverages consumed by mother during pregnancy
ph2d_alcohol_freq Integer Recommended How often were alcoholic beverages consumed by the mother during pregnancy 1::3 1= Daily; 2= Weekly; 3= Monthly
matern_caff Integer Recommended Did you drink any caffeinated beverages (coffee, tea or soda with caffeine) during your pregnancy (including before you knew you were pregnant)? 0;1 0 = No; 1 = Yes ph2e_caffeine
ph2e_caffeine_amt String 100 Recommended How much caffeine was consumed by the mother during pregnancy?
ph2e_caffeine_freq Integer Recommended How often were caffeinated beverages consumed by the mother during pregnancy 1::3 1= Daily; 2= Weekly; 3= Monthly
matern_marij Integer Recommended Did you smoke (or ingest) marijuana during your pregnancy (including before you knew you were pregnant) ? 0;1 0 = No; 1 = Yes ph2f_marijuana
ph2f_marijuana_amt String 100 Recommended How much marijuana was smoked by the mother during pregnancy?
ph2f_marijuana_freq Integer Recommended How often did the mother smoke marijuana during pregnancy? 1::3 1= Daily; 2= Weekly; 3= Monthly
ph2g_drugs Integer Recommended Did the Mother: use any other illegal drugs during pregnancy 0;1 0= No; = Yes
ph2g_drugs_cz String 100 Recommended How much was other illegal drugs used by the mother during pregnancy?
ph2g_drugs_freq Integer Recommended How often were other illegal drugs used by the mother during pregnancy 1::3 1= Daily; 2= Weekly; 3= Monthly
bh_unknown Integer Recommended Birth history unknown (child adopted/fostered/etc.) 0;1 0= No; = Yes
preg_age_mom Integer Recommended Age of mother at the time of birth In years; 999=Unknown bh1_mothers_age
bh2_full_term Integer Recommended Was the pregnancy considered "full term? 0;1 0= No; = Yes
bh2_duration String 100 Recommended If not a full term pregnancy, what was the duration?
bh3_rh_factor Integer Recommended Was there Rh factor incompatibility 0;1;-9 0= No; = Yes; -9 Don't know
bh4_labor_length String 100 Recommended How long was labor? (initial labor pains to childbirth)
bh5_delivery Integer Recommended How was the baby delivered 1::3 1 = Vaginal; 2 = Planned C-Section; 3 = Emergency C-Section
bh6_instrument Integer Recommended Were instruments used 0;1 0= No; = Yes
bh6_instrument_type Integer Recommended If yes, what type of instruments were used during delivery 1;2 1= Forceps; 2= Suction
bh7_breech Integer Recommended Did the baby present in the breech position? 0;1 0= No; = Yes
bh8_fetal_distress Integer Recommended Was there fetal distress (variable heart rate with contraction)? 0;1 0= No; = Yes
ldnb_cordarndneck String 50 Recommended Was the babys umbilical cord wrapped around its neck
No;Yes;Don't Know
bh9_wrapped_cord
bh10_meconium Integer Recommended Did the baby ingest meconium 0;1 0= No; = Yes
matern_brth_wt String 25 Recommended What was your child's birth weight (lbs, oz)? bh11_weight_lbs
bh12_color_pblm Integer Recommended Were there any problems with the baby's color at birth 0;1 0= No; = Yes
bh12_color_type Integer Recommended Color Type at birth 1;2 1 = Blue? (cyanotic); 2 = Yellow? (jaundice)
bh13_breath_difficult Integer Recommended Did the baby have any difficulty beginning to breathe 0;1 0= No; = Yes
bhs_5b Integer Recommended Baby's problems during birth and hospital stay: Cardiac/heart problem 0;1;-9 0=No; 1=Yes; -9=Unknown bh14_heart_pblm
seizure Integer Recommended Baby's problems during birth and hospital stay: seizures 1;2 1=No; 2=Yes bh15_seizures
bh16_infection Integer Recommended Did the baby develop any type of infection in the hospital 0;1 0= No; = Yes
bh16_infection_desc String 100 Recommended Describe infection at birth
bh17_nicu Integer Recommended Did the baby require treatment in the NICU for any reason 0;1 0= No; = Yes
bh17_nicu_desc String 200 Recommended If yes, for what and what type of treatment
bh18_hospital_stay String 50 Recommended How long did the baby remain in the hospital before release
in_unknown String 100 Recommended Infancy unknown (child adopted/fostered/etc.)
in1_breast_fed Integer Recommended Was the baby breast-fed? 0;1 0= No; = Yes
in1_breast_fed_length String 100 Recommended If yes, how long was baby breast-fed?
in1_breast_fed_difficult Integer Recommended If yes, were there difficulties tolerating breast milk 0;1 0= No; = Yes
in1_breast_fed_difficult_desc String 200 Recommended If yes, please describe difficulties in tolerating breast milk
in2_formula Integer Recommended Was the baby fed formula after birth 0;1 0= No; = Yes
in2_formula_type Integer Recommended What type of formula? 1::3 1 = Milk-based; 2 = Soy-based; 3 = Rice-based
in2_formula_difficult Integer Recommended If yes, were there difficulties tolerating formula 0;1 0= No; = Yes
in2_formula_difficult_desc String 100 Recommended If yes, please describe problems tolerating formula
in3_illness_3mo Integer Recommended Did the baby contract any type of illness or develop any medical condition during the first three months after birth 0;1 0= No; = Yes
in3_illness_3mo_desc String 100 Recommended If yes, please describe illness or medical condition during the first three months
dev_overall_05 Integer Recommended Was/is your child from ages 0-5 1::3 1 = easy; 2 = average; 3 = difficult
dev_overall_612 Integer Recommended Was/is your child from ages 6-12 1::3 1 = easy; 2 = average; 3 = difficult
dev_late_walk Integer Recommended Was/is your child from ages 0-5: Late Walking 0;1 0= No; = Yes
dev_late_talk Integer Recommended Was/is your child from ages 0-5: Late Talking 0;1 0= No; = Yes
dev_speech_05 Integer Recommended Was/is your child from ages 0-5: hard to understand? 0;1 0= No; = Yes
dev_speech_612 Integer Recommended Was/is your child from ages 6-12: hard to understand? 0;1 0= No; = Yes
dev_clumsy_05 Integer Recommended Was/is your child from ages 0-5: awkward or clumsy? 0;1 0= No; = Yes
dev_clumsy_612 Integer Recommended Was/is your child from ages 6-12: awkward or clumsy? 0;1 0= No; = Yes
dev_delay_05 Integer Recommended Was/is your child from ages 0-5: said to be slow, delayed, or retarded? 0;1 0= No; = Yes
dev_delay_612 Integer Recommended Was/is your child from ages 6-12: said to be slow, delayed, or retarded? 0;1 0= No; = Yes
dev_toilet Integer Recommended Was/is your child from ages 0-5: difficult to toilet train 0;1 0= No; = Yes
dev_upset_05 Integer Recommended Was/is your child from ages 0-5: often very upset (explosive) over little frustrations? 0;1 0= No; = Yes
dev_upset_612 Integer Recommended Was/is your child from ages 6-12: often very upset (explosive) over little frustrations? 0;1 0= No; = Yes
dev_play_well_05 Integer Recommended Was/is your child from ages 0-5: unable to play well with other children? 0;1 0= No; = Yes
dev_play_well_612 Integer Recommended Was/is your child from ages 6-12: unable to play well with other children? 0;1 0= No; = Yes
dev_int_play_05 Integer Recommended Was/is your child from ages 0-5: uninterested in playing with other children? 0;1 0= No; = Yes
dev_int_play_612 Integer Recommended Was/is your child from ages 6-12: uninterested in playing with other children? 0;1 0= No; = Yes
dev_preschool_05 Integer Recommended Was/is your child from ages 0-5: unable to get along well in preschool or kindergarten 0;1 0= No; = Yes
dev_preschool_612 Integer Recommended Was/is your child from ages 6-12: unable to get along well in preschool or kindergarten 0;1;98 0= No; 1= Yes; 98= N/A
dev_fam_chng_05 Integer Recommended Was/is your child from ages 0-5: having trouble w/ family changes(new baby, a move, etc.)? 0;1 0= No; = Yes
dev_fam_chng_612 Integer Recommended Was/is your child from ages 6-12: having trouble w/ family changes(new baby, a move, etc.)? 0;1 0= No; = Yes
dev_sep_anx_05 Integer Recommended Was/is your child from ages 0-5: very upset/resistant to being away from home or family? 0;1 0= No; = Yes
dev_sep_anx_612 Integer Recommended Was/is your child from ages 6-12: very upset/resistant to being away from home or family? 0;1 0= No; = Yes
dev_eating_05 Integer Recommended Was/is your child from ages 0-5: having frequent difficulties with eating? 0;1 0= No; = Yes
dev_eating_612 Integer Recommended Was/is your child from ages 6-12: having frequent difficulties with eating? 0;1 0= No; = Yes
dev_fam_mem_05 Integer Recommended Was/is your child from ages 0-5: having trouble getting along with family members? 0;1 0= No; = Yes
dev_fam_mem_612 Integer Recommended Was/is your child from ages 6-12: having trouble getting along with family members? 0;1 0= No; = Yes
dev_friends_05 Integer Recommended Was/is your child from ages 0-5: having trouble making or keeping friends? 0;1 0= No; = Yes
dev_friends_612 Integer Recommended Was/is your child from ages 6-12: having trouble making or keeping friends? 0;1 0= No; = Yes
dev_peers_05 Integer Recommended Was/is your child from ages 0-5: uninterested in being with peers? 0;1 0= No; = Yes
dev_peers_612 Integer Recommended Was/is your child from ages 6-12: uninterested in being with peers? 0;1 0= No; = Yes
dev_sch_lrn_05 Integer Recommended Was/is your child from ages 0-5: having problems in school with learning/achievement 0;1 0= No; = Yes
dev_sch_lrn_612 Integer Recommended Was/is your child from ages 6-12: having problems in school with learning/achievement 0;1 0= No; = Yes
dev_sch_beh_05 Integer Recommended Was/is your child from ages 0-5: having problems in school with behavior 0;1 0= No; = Yes
dev_sch_beh_612 Integer Recommended Was/is your child from ages 6-12: having problems in school with behavior 0;1 0= No; = Yes
dev_sch_atnd_05 Integer Recommended Was/is your child from ages 0-5: having problems in school with attendance 0;1 0= No; = Yes
dev_sch_atnd_612 Integer Recommended Was/is your child from ages 6-12: having problems in school with attendance 0;1 0= No; = Yes
dev_beh_def_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: defiance 0;1 0= No; = Yes
dev_beh_def_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: defiance 0;1 0= No; = Yes
dev_beh_des_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: destructive 0;1 0= No; = Yes
dev_beh_des_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: destructive 0;1 0= No; = Yes
dev_beh_lie_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: lying 0;1 0= No; = Yes
dev_beh_lie_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: lying 0;1 0= No; = Yes
dev_beh_steal_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: stealing 0;1 0= No; = Yes
dev_beh_steal_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: stealing 0;1 0= No; = Yes
dev_beh_fight_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: fighting 0;1 0= No; = Yes
dev_beh_fight_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: fighting 0;1 0= No; = Yes
dev_beh_etoh_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: alcohol use 0;1 0= No; = Yes
dev_beh_etoh_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: alcohol use 0;1 0= No; = Yes
dev_beh_drug_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: drug use 0;1 0= No; = Yes
dev_beh_drug_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: drug use 0;1 0= No; = Yes
dev_beh_cruel_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: cruelty to people/animals 0;1 0= No; = Yes
dev_beh_cruel_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: cruelty to people/animals 0;1 0= No; = Yes
dev_beh_death_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: death threats 0;1 0= No; = Yes
dev_beh_death_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: death threats 0;1 0= No; = Yes
dev_beh_oth_05 Integer Recommended Was/is your child from ages 0-5 having behavior problems: other 0;1 0= No; = Yes
dev_beh_oth_612 Integer Recommended Was/is your child from ages 6-12 having behavior problems: other 0;1 0= No; = Yes
dev_mood_dep_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: depressed 0;1 0= No; = Yes
dev_mood_dep_612 Integer Recommended Was/is your child from ages 6-12 having mood problems:depressed 0;1 0= No; = Yes
dev_mood_thrt_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: suicide threats 0;1 0= No; = Yes
dev_mood_thrt_612 Integer Recommended Was/is your child from ages 6-12 having mood problems:suicide threats 0;1 0= No; = Yes
dev_mood_att_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: suicide attempts 0;1 0= No; = Yes
dev_mood_att_612 Integer Recommended Was/is your child from ages 6-12 having mood problems: suicide attempts 0;1 0= No; = Yes
dev_mood_shy_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: very shy 0;1 0= No; = Yes
dev_mood_shy_612 Integer Recommended Was/is your child from ages 6-12 having mood problems: very shy 0;1 0= No; = Yes
dev_mood_nerv_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: very nervous 0;1 0= No; = Yes
dev_mood_nerv_612 Integer Recommended Was/is your child from ages 6-12 having mood problems: very nervous 0;1 0= No; = Yes
dev_mood_happy_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: way too happy 0;1 0= No; = Yes
dev_mood_happy_612 Integer Recommended Was/is your child from ages 6-12 having mood problems:way too happy 0;1 0= No; = Yes
dev_mood_angry_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: way too angry 0;1 0= No; = Yes
dev_mood_angry_612 Integer Recommended Was/is your child from ages 6-12 having mood problems: way too angry 0;1 0= No; = Yes
dev_mood_panic_05 Integer Recommended Was/is your child from ages 0-5 having mood problems: panic attacks 0;1 0= No; = Yes
dev_mood_panic_612 Integer Recommended Was/is your child from ages 6-12 having mood problems: panic attacks 0;1 0= No; = Yes
ch1_ear_infection String 100 Recommended How many ear infections per year in the first five years of life?
ch1_tubes Integer Recommended Were tubes inserted 0;1 0= No; = Yes
ch1_tonsils Integer Recommended Were tonsils surgically removed 0;1 0= No; = Yes
ch1_adenoids Integer Recommended Were adenoids surgically removed 0;1 0= No; = Yes
ch2_vaccine_se Integer Recommended Did child experience any significant side effects following any immunization/vaccination 0;1;98 0= No; 1= Yes; 98= N/A
ch2_vaccine_se_desc String 100 Recommended Description of any significant side effects following immunization
ch3_toxic_swallow Integer Recommended Did the child ever swallow a toxic substance 0;1 0= No; = Yes
ch3_toxic_swallow_desc String 100 Recommended Description of when child swallowed a toxic substance
ch4_toxic_vapors Integer Recommended Did the child ever become ill from exposure to toxic vapors (e.g. carbon monoxide)? 0;1 0= No; = Yes
ch4_toxic_vapors_desc String 100 Recommended Description of when child became ill from exposure to toxic vapors (e.g. carbon monoxide)?
ch5_strep String 100 Recommended How many strep infections per year during the first five years of life?
ch6_allergy_air Integer Recommended Is the child allergic to anything in the air? 0;1 0= No; = Yes
ch6_allergy_air_desc String 100 Recommended Description of airbone allergy of child
ch7_allergy_food Integer Recommended Is the child allergic to any food? 0;1 0= No; = Yes
ch7_allergy_food_desc String 200 Recommended Description of food allergy of child
ch8_high_fever Integer Recommended Has child ever had a fever high enough to cause loss of consciousness or seizure? 0;1 0= No; = Yes
ch9_head_injury Integer Recommended Has the child ever had an injury to the head sufficient to cause nausea, vomiting, or loss of consciousness? 0;1 0= No; = Yes
ch10_seizure Integer Recommended Has the child ever experienced a seizure for reasons other than a fever? 0;1 0= No; = Yes
fu_q20_hearing_tested String 25 Recommended Has your child's hearing been tested?
Yes;No
ch11_hearing_tested
ch11_hear_exam String 100 Recommended If so, when was his/her most recent hearing exam
ch11_hear_loss Integer Recommended Was there any evidence of hearing loss? 0;1 0= No; = Yes
ch11_hear_loss_desc String 100 Recommended Describe any hearing loss of child
ch11_audiologist Integer Recommended Has the child ever been tested by an audiologist in order to evaluate auditory 0;1 0= No; = Yes
ch11_apd Integer Recommended Was a central auditory processing disorder identified? 0;1 0= No; = Yes
ch12_vision_tested Integer Recommended Has your child's vision ever been tested? Y 0;1 0= No; = Yes
ch12_vision_exam String 100 Recommended If so, when was his/her most recent vision exam
ch12_vision_loss Integer Recommended Was there any evidence of visual impairment 0;1 0= No; = Yes
ch12_vision_loss_desc String 100 Recommended Description of vision loss of child
ch12_lenses Integer Recommended Were corrective lenses prescribed 0;1 0= No; = Yes
ch12_convergence Integer Recommended Has the child ever been tested by an optometrist or ophthalmologist in order to evaluate impairment of visual tracking or eyes working together 0;1 0= No; = Yes
ch13_med_tx Integer Recommended Aside from "colds" and common infections, has the child required medical treatment for any other disease or medical condition 0;1 0= No; = Yes
ch13_med_tx_desc String 100 Recommended Describe medical treatment for other diseases or medical conditions
me_anemia Integer Recommended Has the child's physician ever ordered laboratory tests for: anemia 0;1 0= No; = Yes
me_zinc Integer Recommended Has the child's physician ever ordered laboratory tests for: Zinc Deficiency 0;1 0= No; = Yes
me_iron Integer Recommended Has the child's physician ever ordered laboratory tests for: Iron Deficiency 0;1 0= No; = Yes
me_hypoglcemia Integer Recommended Has the child's physician ever ordered laboratory tests for: Hypoglycemia 0;1 0= No; = Yes
me_estrogen Integer Recommended Has the child's physician ever ordered laboratory tests for: Estrogen 0;1 0= No; = Yes
me_amino_acids Integer Recommended Has the child's physician ever ordered laboratory tests for: Amino Acids 0;1 0= No; = Yes
me_illegal_drugs Integer Recommended Has the child's physician ever ordered laboratory tests for: llegal Drugs 0;1 0= No; = Yes
me_thyroid_disorder Integer Recommended Has the child's physician ever ordered laboratory tests for: Thyroid Disorder 0;1 0= No; = Yes
me_magnesium Integer Recommended Has the child's physician ever ordered laboratory tests for: Magnesium Deficiency 0;1 0= No; = Yes
me_vitamin_b Integer Recommended Has the child's physician ever ordered laboratory tests for: Vitamin B Deficiency 0;1 0= No; = Yes
me_vitamin_d Integer Recommended Has the child's physician ever ordered laboratory tests for: Vitamin D Deficiency 0;1 0= No; = Yes
me_diabetes Integer Recommended Has the child's physician ever ordered laboratory tests for: Diabetes 0;1 0= No; = Yes
me_progesterone Integer Recommended Has the child's physician ever ordered laboratory tests for: Progesterone 0;1 0= No; = Yes
me_celiac Integer Recommended Has the child's physician ever ordered laboratory tests for: Celiac Disease 0;1 0= No; = Yes
me_growth_hormones Integer Recommended Has the child's physician ever ordered laboratory tests for: Growth Hormones 0;1 0= No; = Yes
me_other_tests String 100 Recommended Did the doctor order any other medical tests for your child?
me_other_test_results String 200 Recommended Any significant results from those medical tests?
diet1_bfast1 String 200 Recommended Most common breakfast
diet1_bfast1_days Integer Recommended How many days/week eating: Most common breakfast
diet1_bfast2 String 50 Recommended 2nd most common breakfast:
diet1_bfast2_days Integer Recommended How many days/week eating: 2nd most common breakfast
diet1_bfast3 String 500 Recommended 3rd most common breakfast
diet1_bfast3_days Integer Recommended How many days/week eating: 3rd most common breakfast
diet2_lunch1 String 50 Recommended Most common lunch
diet2_lunch1_days Integer Recommended How many days/week eating: Most common lunch
diet2_lunch2 String 50 Recommended 2nd most common lunch
diet2_lunch2_days Integer Recommended How many days/week eating: 2nd most common lunch
diet2_lunch3 String 200 Recommended 3rd most common lunch
diet2_lunch3_days Integer Recommended How many days/week eating: 3rd most common lunch
diet3_evening1 String 50 Recommended Most common dinner
diet3_evening1_days Integer Recommended How many days/week eating: Most common dinner
diet3_evening2 String 50 Recommended 2nd most common dinner
diet3_evening2_days Integer Recommended How many days/week eating: 2nd most common dinner
diet3_evening3 String 200 Recommended 3rd most common dinner
diet3_evening3_days Integer Recommended How many days/week eating: 3rd most common dinner
diet_snacks String 50 Recommended What kind of snacks does your child eat?
diet_snacks_days Integer Recommended How many days/week eating: Snacks
bisq4 String 20 Recommended What time do you usually put your child to bed at night? (time of turning out the light.) sleep1_bedtime
sleep2_asleep_hrs Integer Recommended How long does it usually take for the child to fall asleep? Hours
parent_sleep2 Float Recommended During the past month, how long (in minutes) has it usually taken your child to fall asleep each night? sleep2_asleep_mins
sleep3_night_wake Integer Recommended Does the child wake during the night? 0;1 0= No; = Yes
sleep3_night_wake_freq String 50 Recommended how often does your child wake up during the night
sleep4_move_sleep Integer Recommended Does the child move excessively while sleeping 0;1 0= No; = Yes
sleep5_sleepwalk Integer Recommended Does the child sleepwalk? 0;1 0= No; = Yes
sleep6_apnea Integer Recommended Has the child ever been evaluated for sleep apnea 0;1 0= No; = Yes
sleep6_apnea_desc String 50 Recommended describe results of sleep apnea evaluation
sleep6_snore Integer Recommended Does the child snore loudly 0;1 0= No; = Yes
sleep36 Integer Recommended Do you have difficulty breathing during sleep or stop breathing during sleep? 0;1 0= No; 1= Yes sleep6_stop_breath
sleep6_gasp Integer Recommended Does the child snort and/or gasp during sleep? 0;1 0= No; = Yes
csh_20_b Integer Recommended Child is restless and moves a lot during sleep. Is it a problem? 0;1; 3 0=No; 1=Yes; 3=NA sleep7_restless
p_health_2 String 10 Recommended When did your child wake up this morning (e.g. 12:00PM)? HH:MM(AM/PM) sleep8_wake_time
sleep9_fatigue Integer Recommended At waking, does the child feel fatigued? 0;1 0= No; = Yes
sleep_time String 50 Recommended Calculated time asleep
exercise1_days Integer Recommended How many days per week does the child engage in at least 30 minutes of exercise?
exercise2_desc String 50 Recommended What types of exercise does the child do?
exercise3_pain Integer Recommended Does the child experience shortness of breath or chest pains when exercising? 0;1 0= No; = Yes
caffeine_daily String 50 Recommended Caffeine (tea, coffee, soda) use per day
caffeine_weekly String 50 Recommended Caffeine (tea, coffee, soda) use per week
comments_misc String 4,000 Recommended Miscellaneous comments on study, interview, methodology relevant to this form data
session Integer Recommended Session
validity String 13 Recommended Validity rating Yes;No;Questionnable
site String 101 Recommended Site Study Site
resp_source Integer Recommended Respondent Source 1::6 1= subject; 2= parent; 3= clinician; 4= teacher; 5= trainer; 6= fidelity reviewer source
med_frequency_1 String 20 Recommended med1 - Frequency Frequency
med_frequency_4_3mo String 20 Recommended med4 - Frequency Frequency
med_condition_4_3mo String 500 Recommended med4 - Condition Reason
med_recent_changes_4_3mo String 500 Recommended med4 - Recent Changes Report Any Changes
med_medication_5_3mo String 100 Recommended med5 - Medication Name of Medication
med_dose_5_3mo String 20 Recommended med5 - Dose Dosage
med_frequency_5_3mo String 20 Recommended med5 - Frequency Frequency
med_condition_5_3mo String 500 Recommended med5 - Condition Reason
med_recent_changes_5_3mo String 500 Recommended med5 - Recent Changes Report Any Changes
med_illness_3mo_yn Integer Recommended Has your child had any illnesses over the past 3 months? 0;1 0= No; 1= Yes
med_past_what_diagnosis_1_3mo String 100 Recommended illness1 - What (Diagnosis) Name of Diagnosis
med_condition_1 String 500 Recommended med1 - Condition Reason
med_past_date_1_3mo Date Recommended illness1 - Date MM/DD/YYYY
med_past_treatment_1_3mo String 500 Recommended illness1 - Treatment Treatment Name
med_past_resolved_1_3mo String 500 Recommended illness1 - Resolved Resolved
med_past_what_diagnosis_2_3mo String 100 Recommended illness2 - What (Diagnosis) Name of Diagnosis
med_past_date_2_3mo Date Recommended illness2 - Date MM/DD/YYYY
med_past_treatment_2_3mo String 500 Recommended illness2 - Treatment Treatment Name
med_past_resolved_2_3mo String 500 Recommended illness2 - Resolved Resolved
med_past_what_diagnosis_3_3mo String 100 Recommended illness3 - What (Diagnosis) Name of Diagnosis
med_past_date_3_3mo Date Recommended illness3 - Date MM/DD/YYYY
med_past_treatment_3_3mo String 500 Recommended illness3 - Treatment Treatment Name
med_recent_changes_1 String 500 Recommended med1 - Recent Changes Report Any Changes
med_past_resolved_3_3mo String 500 Recommended illness3 - Resolved Resolved
med_past_what_diagnosis_4_3mo String 100 Recommended illness4 - What (Diagnosis) Name of Diagnosis
med_past_date_4_3mo Date Recommended illness4 - Date MM/DD/YYYY
med_past_treatment_4_3mo String 500 Recommended illness4 - Treatment Treatment Name
med_past_resolved_4_3mo String 500 Recommended illness4 - Resolved Resolved
med_past_what_diagnosis_5_3mo String 100 Recommended illness5 - What (Diagnosis) Name of Diagnosis
med_past_date_5_3mo Date Recommended illness5 - Date MM/DD/YYYY
med_past_treatment_5_3mo String 500 Recommended illness5 - Treatment Treatment Name
med_past_resolved_5_3mo String 500 Recommended illness5 - Resolved Resolved
med_surg_3mo_yn Integer Recommended Has your child had any medical events over the past 3 months? 0;1 0= No; 1= Yes
med_medication_2yn Integer Recommended med2 - Is your child taking another medication? 0;1 0= No; 1= Yes
med_surg_what_1_3mo String 100 Recommended event1 - What Specify
med_surg_date_1_3mo Date Recommended event1 - Date MM/DD/YYYY
med_surg_treatment_1_3mo String 500 Recommended event1 - Treatment Treatment Name
med_surg_what_2_3mo String 100 Recommended event2 - What Specify
med_surg_date_2_3mo Date Recommended event2 - Date MM/DD/YYYY
med_surg_treatment_2_3mo String 500 Recommended event2 - Treatment Treatment Name
med_surg_what_3_3mo String 100 Recommended event3 - What Specify
med_surg_date_3_3mo Date Recommended event3 - Date MM/DD/YYYY
med_surg_treatment_3_3mo String 500 Recommended event3 - Treatment Treatment Name
med_surg_what_4_3mo String 100 Recommended event4 - What Specify
med_medication_2 String 100 Recommended med2 - Medication Name of Medication
med_surg_date_4_3mo Date Recommended event4 - Date MM/DD/YYYY
med_surg_treatment_4_3mo String 500 Recommended event4 - Treatment Treatment Name
med_other_tx_3mo_yn Integer Recommended Has your child started any new treatment, such as CBIT or another therapy over the past 3 months? 0;1 0= No; 1= Yes
med_other_tx_3mo String 4,000 Recommended Describe treatment
med_surg_ortho Integer Recommended Does your child currently have any type of metal orthodontia, such as braces, lingual braces, permanent metal retainers or MARA appliance? 0;1 0= No; 1= Yes
med_surg_ortho_future Integer Recommended Do you anticipate your child getting any type of metal orthodontia? 0;1 0= No; 1= Yes
med_surg_ortho_date Date Recommended When will or did he/she get metal orthodontia? Date: MM/DD/YYYY
med_surg_ortho_type String 100 Recommended Type of orthodontia:
med_surg_ortho_removal String 100 Recommended How long will the [med_surg_ortho_type] be kept on for?
med_dose_2 String 20 Recommended med2 - Dose Dosage
med_frequency_2 String 20 Recommended med2 - Frequency Frequency
med_condition_2 String 500 Recommended med2 - Condition Reason
med_recent_changes_2 String 500 Recommended med2 - Recent Changes Report Any Changes
med_medication_3yn Integer Recommended med3 - Is your child taking another medication? 0;1 0= No; 1= Yes
med_medication_3 String 100 Recommended med3 - Medication Name of Medication
med_dose_3 String 20 Recommended med3 - Dose Dosage
med_frequency_3 String 20 Recommended med3 - Frequency Frequency
med_condition_3 String 500 Recommended med3 - Condition Reason
med_recent_changes_3 String 100 Recommended med3 - Recent Changes
med_medication_4yn Integer Recommended med4 - Is your child taking another medication? 0;1 0= No; 1= Yes
med_medication_4 String 100 Recommended med4 - Medication Name of Medication
med_dose_4 String 20 Recommended med4 - Dose Dosage
med_frequency_4 String 20 Recommended med4 - Frequency Frequency
med_condition_4 String 500 Recommended med4 - Condition Reason
med_completed_by String 10 Recommended Completed by Mother; Father; Grandma; Grandpa; Aunt; Uncle; Guardian; Sister; Brother; any relative
med_recent_changes_4 String 100 Recommended med4 - Recent Changes
med_medication_5yn Integer Recommended med5 - Is your child taking another medication? 0;1 0= No; 1= Yes
med_medication_5 String 100 Recommended med5 - Medication Name of Medication
med_dose_5 String 20 Recommended med5 - Dose Dosage
med_frequency_5 String 20 Recommended med5 - Frequency Frequency
med_condition_5 String 500 Recommended med5 - Condition Reason
med_recent_changes_5 String 100 Recommended med5 - Recent Changes
med_past_dx1_yn Integer Recommended illness1 - Has your child had any medical illnesses during their lifetime? 0;1 0= No; 1= Yes
med_past_what_dx_1 String 100 Recommended illness1 - What (Diagnosis) Name of Diagnosis
med_past_date_1 Date Recommended illness1 - Date MM/DD/YYYY
med_allergies Integer Recommended Does your child have any known allergies? 0;1 0= No; 1= Yes
med_past_treatment_1 String 500 Recommended illness1 - Treatment Treatment Name
med_past_resolved_1 Integer Recommended illness1 - Resolved 1 1 = Yes
med_past_dx2_yn Integer Recommended illness2 - Has you child had any other medical illnesses during their lifetime? 0;1 0= No; 1= Yes
med_past_what_dx_2 String 100 Recommended illness2 - What (Diagnosis) Name of Diagnosis
med_past_date_2 Date Recommended illness2 - Date MM/DD/YYYY
med_past_treatment_2 String 500 Recommended illness2 - Treatment Treatment Name
med_past_resolved_2 Integer Recommended illness2 - Resolved 1 1 = Yes
med_past_dx3_yn Integer Recommended illness3 - Has you child had any other medical illnesses during their lifetime? 0;1 0= No; 1= Yes
med_past_what_dx_3 String 100 Recommended illness3 - What (Diagnosis) Name of Diagnosis
med_past_date_3 Date Recommended illness3 - Date MM/DD/YYYY
med_allergies_list String 500 Recommended List all known allergies
med_past_treatment_3 String 500 Recommended illness3 - Treatment Treatment Name
med_past_resolved_3 Integer Recommended illness3 - Resolved 1 1 = Yes
med_past_dx4_yn Integer Recommended illness4 - Has you child had any other medical illnesses during their lifetime? 0;1 0= No; 1= Yes
med_past_what_dx_4 String 100 Recommended illness4 - What (Diagnosis) Name of Diagnosis
med_past_date_4 Date Recommended illness4 - Date MM/DD/YYYY
med_past_treatment_4 String 500 Recommended illness4 - Treatment Treatment Name
med_past_resolved_4 Integer Recommended illness4 - Resolved 1 1 = Yes
med_past_dx5_yn Integer Recommended illness5 - Has you child had any other medical illnesses during their lifetime? 0;1 0= No; 1= Yes
med_past_what_dx_5 String 100 Recommended illness5 - What (Diagnosis) Name of Diagnosis
med_past_date_5 String 100 Recommended illness5 - Date
med_health_past_weeks String 300 Recommended How has your health been over the past few weeks?
med_past_treatment_5 String 500 Recommended illness5 - Treatment Treatment Name
med_past_resolved_5 Integer Recommended illness5 - Resolved 1 1 = Yes
med_surg_1yn Integer Recommended event1 - Has your child had any surgeries or hospitalizations during their lifetime? 0;1 0= No; 1= Yes
med_surg_what_1 String 100 Recommended event1 - What Specify
med_surg_date_1 Date Recommended event1 - Date MM/DD/YYYY
med_surg_treatment_1 String 500 Recommended event1 - Treatment Treatment Name
med_surg_2yn Integer Recommended event2 - Has your child had any other surgeries or hospitalizations during their lifetime? 0;1 0= No; 1= Yes
med_surg_what_2 String 100 Recommended event2 - What Specify
med_surg_date_2 Date Recommended event2 - Date MM/DD/YYYY
med_surg_treatment_2 String 500 Recommended event2 - Treatment Treatment Name
med_medication_1yn Integer Recommended med1 - Is your child currently taking any medications? 0;1 0= No; 1= Yes
med_surg_3yn Integer Recommended event3 - Has your child had any other surgeries or hospitalizations during their lifetime? 0;1 0= No; 1= Yes
med_surg_what_3 String 100 Recommended event3 - What Specify
med_surg_date_3 Date Recommended event3 - Date MM/DD/YYYY
med_surg_treatment_3 String 500 Recommended event3 - Treatment Treatment Name
med_surg_4yn Integer Recommended event4 - Has your child had any other surgeries or hospitalizations during their lifetime? 0;1 0= No; 1= Yes
med_surg_what_4 String 100 Recommended event4 - What Specify
med_surg_date_4 Date Recommended event4 - Date MM/DD/YYYY
med_surg_treatment_4 String 500 Recommended event4 - Treatment Treatment Name
med_surg_color_blind Integer Recommended Does your child have any type of color blindness? 0;1 0= No; 1= Yes
med_surg_cb_descript String 500 Recommended If yes, provide type and/or description:
med_medication_1 String 100 Recommended med1 - Medication Name of Medication
med_health_past_weeks_3mo String 4,000 Recommended How has your child's health been over the past 3 months?
med_current_meds_3mo Integer Recommended Is your child currently taking any medications? 0;1 0= No; 1= Yes
med_changes_3mo_yn Integer Recommended Have there been any changes to your child's medications over the past 3 months? 0;1 0= No; 1= Yes
med_medication_1_3mo String 100 Recommended med1 - Medication Name of Medication
med_dose_1_3mo String 20 Recommended med1 - Dose Dosage
med_frequency_1_3mo String 20 Recommended med1 - Frequency Frequency
med_condition_1_3mo String 500 Recommended med1 - Condition Reason
med_recent_changes_1_3mo String 500 Recommended med1 - Recent Changes Report Any Changes
med_medication_2_3mo String 100 Recommended med2 - Medication Name of Medication
med_dose_2_3mo String 20 Recommended med2 - Dose Dosage
med_dose_1 String 20 Recommended med1 - Dose Dosage
med_frequency_2_3mo String 20 Recommended med2 - Frequency Frequency
med_condition_2_3mo String 500 Recommended med2 - Condition Reason
med_recent_changes_2_3mo String 500 Recommended med2 - Recent Changes Report Any Changes
med_medication_3_3mo String 100 Recommended med3 - Medication Name of Medication
med_dose_3_3mo String 20 Recommended med3 - Dose Dosage
med_frequency_3_3mo String 20 Recommended med3 - Frequency Frequency
med_condition_3_3mo String 500 Recommended med3 - Condition Reason
med_recent_changes_3_3mo String 500 Recommended med3 - Recent Changes Report Any Changes
med_medication_4_3mo String 100 Recommended med4 - Medication Name of Medication
med_dose_4_3mo String 20 Recommended med4 - Dose Dosage
Data Structure

This page displays the data structure defined for the measure identified in the title and structure short name. The table below displays a list of data elements in this structure (also called variables) and the following information:

  • Element Name: This is the standard element name
  • Data Type: Which type of data this element is, e.g. String, Float, File location.
  • Size: If applicable, the character limit of this element
  • Required: This column displays whether the element is Required for valid submissions, Recommended for valid submissions, Conditional on other elements, or Optional
  • Description: A basic description
  • Value Range: Which values can appear validly in this element (case sensitive for strings)
  • Notes: Expanded description or notes on coding of values
  • Aliases: A list of currently supported Aliases (alternate element names)
  • For valid elements with shared data, on the far left is a Filter button you can use to view a summary of shared data for that element and apply a query filter to your Cart based on selected value ranges

At the top of this page you can also:

  • Use the search bar to filter the elements displayed. This will not filter on the Size of Required columns
  • Download a copy of this definition in CSV format
  • Download a blank CSV submission template prepopulated with the correct structure header rows ready to fill with subject records and upload

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