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Early Development Questionnaire

694 Shared Subjects

The Modified Checklist for Autism in Toddlers
Clinical Assessments
Questionnaire
01/06/2012
edq01
01/06/2012
View Change History
01
Early_Development_Questionnaire_reformatted.pdf PDF file icon
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 Required field
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 the subject M;F M = Male; F = Female gender
Query regression_age Integer Recommended If your child experienced a regression before 18 months of age only rate his or her behavior up to the point of the regression. Specify age in months. 0 :: 18
rel_child_spfy String 250 Recommended If other please specify
Query look_social Integer Recommended My child looked at others during social interactions 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_1
Query repetitive_behavior Integer Recommended My child engaged in repetitive motor behavior 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_2
Query choice_answer Integer Recommended When given a choice between two items my child clearly let me know which one he or she wanted. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember
Query smile_back Integer Recommended My child smiled back at me when I smiled at him or her. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_4
Query child_non_interests Integer Recommended My child rarely noticed or seemed interested in new objects or toys in his or her environment. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_5
Query attention_book Integer Recommended My child could listen and pay attention to a book for at least 5 minutes. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_6
Query arms_up Integer Recommended My child put his/her arms up when he or she wanted to be picked up. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_7
Query part_toy Integer Recommended My child was more interested in playing with a certain part of a toy (e.g. spinning the wheels of a car) than playing with the whole toy. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_8
Query understandable_speech Integer Recommended My child's speech at whatever level acquired was easy to understand. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_9
Query brought_interested Integer Recommended My child showed or brought me things that interested him or her. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_10
Query routine_change Integer Recommended My child became upset if there was a minor change in his or her routine or environment. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_11
Query meaningful_phrases Integer Recommended My child put 2 or 3 words together into meaningful phrases. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_12
Query name_look Integer Recommended When I called my child's name he or she looked at me right away. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_13
Query stare_objects Integer Recommended My child stared at lights or visually inspected objects at close range for extended periods of time. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_14
Query baby_talk Integer Recommended Before my child used words his or her babbling or baby talk was clearly directed toward me. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_15
Query request_things Integer Recommended If my child wanted something he or she would point to request it. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_16
Query ear_cover Integer Recommended My child covered his or her ears in response to certain sounds (e.g. vacuum cleaner traffic). 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_17
Query follow_command Integer Recommended My child followed simple verbal instructions 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_18
Query point_look Integer Recommended If I pointed or looked toward something my child would look at it too. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_19
Query child_held Integer Recommended When held my child cuddled or molded into my body. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_20
Query child_push_hand Integer Recommended When my child wanted something he or she used my hand as a tool or pushed my body or arm to get help from me. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_21
Query initiated_game Integer Recommended My child initiated interactive games such as peek-a-boo or hide-andseek with me. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_22
Query lined_toys Integer Recommended My child enjoyed lining up toys or other objects. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_23
Query spontaneous_five_word Integer Recommended My child spontaneously used 5 or more words other than mama or dada on a daily basis. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_24
Query imitated_actions Integer Recommended My child imitated things I did such as clapping waving goodbye or blowing a kiss. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_25
Query unusual_object Integer Recommended My child was attached to an unusual object and insisted on carrying it around with him or her. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_26
Query understand_me Integer Recommended My child seemed to understand what I said to him or her even if he or she couldn't respond back verbally. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_27
Query play_others Integer Recommended My child preferred to play with others than to play alone. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_28
Query smell_texture Integer Recommended My child seemed particularly interested in the smell or texture of things. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_29
Query babble_speech Integer Recommended My child babbled or used word approximations to get my attention. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_30
Query child_point Integer Recommended If my child saw something that interested him or her he or she would point to it and then look at me to see if I was looking at it too. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_31
Query child_rocked Integer Recommended My child rocked in his or her crib or play pen for extended periods of time. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_32
Query head_shake Integer Recommended My child shook his or her head to mean No. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_33
Query pretend_activities Integer Recommended My child engaged in simple pretend play activities 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_34
Query one_toy Integer Recommended My child played with one toy or object over and over again to an unusual degree. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_35
Query head_nod Integer Recommended My child nodded his or her head to mean Yes. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_36
Query interested_children Integer Recommended My child seemed interested in other children. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_37
Query child_mouthed Integer Recommended My child mouthed objects to an unusual degree. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_38
Query like_smile Integer Recommended When my child really liked something he or she would let me know by smiling or making noises that were clearly directed toward me. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_39
Query hurt_self Integer Recommended My child injured him/herself deliberately (biting self or banging head). 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_40
Query imitated_words Integer Recommended My child imitated sounds I made or words I said after hearing them. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_41
Query people_preference Integer Recommended My child showed a clear preference for me over less familiar people. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_42
Query body_part Integer Recommended My child accurately indicated one or more body parts when asked. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_43
Query spontaneous_ten_word Integer Recommended My child spontaneously and regularly used 10 or more meaningful words. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_44
Query interupt_activity Integer Recommended My child became upset if his or her activity was interrupted and would insist on starting it over again from the beginning. 0 :: 4 0 = Never; 1 = Rarely; 2 = Occasionally; 3 = Often; 4 = Don't know or can't remember EDQ_45
Query roll_over Integer Recommended At what age (in months) did your child first learn to roll over EDQ_RO
Query crawl Integer Recommended At what age (in months) did your child first learn to crawl EDQ_CL
Query sit_alone Integer Recommended At what age (in months) did your child first learn to sit alone unsupported EDQ_SA
Query single_words_use Integer Recommended At what age (in months) did your child use single words EDQ_SW
Query single_word_use_lt String 250 Recommended Please list a few of his/her first words EDQ_FW
Query speak_phrases Integer Recommended At what age (in months) did your child speak in phrases EDQ_SP
Query speak_phrases_lt String 250 Recommended Please list some of the first phrases your child used EDQ_FP
Query phrase_lost Integer Recommended Did your child lose all words or phrases (e.g. requesting food or other needs addressing parents greeting replying when called by name or labeling familiar objects or animals) 0 :: 1 0 = No; 1 = Yes EDQ_3A1
Query phrase_lost_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3A1_L
Query meaning_phrase_lost Integer Recommended Did your child lose most meaningful words or phrases although may have retained a few 0 :: 1 0 = No; 1 = Yes EDQ_3A2
Query meaning_phrase_lost_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3A2_L
Query gesture_lost Integer Recommended Did your child lose gestures or imitative behaviors such as pointing clapping waving goodbye 0 :: 1 0 = No; 1 = Yes EDQ_3A3
Query gesture_lost_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3A3_L
Query understand_lang_lost Integer Recommended Did your child lose ability to understand language spoken by others 0 :: 1 0 = No; 1 = Yes EDQ_3A4
Query understand_lang_lost_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3A4_L
Query fam_interest_loss Integer Recommended Did your child lose interest in parents siblings relative or peers 0 :: 1 0 = No; 1 = Yes EDQ_3B1
Query fam_interest_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3B1_L
Query smile_response_loss Integer Recommended Did your child lose smiling in response to another person's smile 0 :: 1 0 = No; 1 = Yes EDQ_3B2
Query smile_response_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3B2_L
Query reach_parent_loss Integer Recommended Did your child lose reaching for caregiver (e.g. putting arms up to be lifted) 0 :: 1 0 = No; 1 = Yes EDQ_3B3
Query reach_parent_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3B3_L
Query eye_contact_loss Integer Recommended Did your child lose direct eye contact during communication 0 :: 1 0 = No; 1 = Yes EDQ_3B4
Query eye_contact_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3B4_L
Query game_interest_loss Integer Recommended Did your child lose interest in interactive games such as Peek-a-boo 0 :: 1 0 = No; 1 = Yes EDQ_3B5
Query game_interest_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3B5_L
Query pretend_play_loss Integer Recommended Did your child lose pretend or imaginative play 0 :: 1 0 = No; 1 = Yes EDQ_3B6
Query pretend_play_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3B6_L
Query feed_self_loss Integer Recommended Did your child lose ability to feed self at whatever level acquired 0 :: 1 0 = No; 1 = Yes EDQ_3C1
Query feed_self_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3C1_L
Query dress_self_loss Integer Recommended Did your child lose ability to dress oneself at whatever level acquired 0 :: 1 0 = No; 1 = Yes EDQ_3C2
Query dress_self_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3C2_L
Query toilet_skills_loss Integer Recommended Did your child lose toileting skills at whatever level acquired 0 :: 1 0 = No; 1 = Yes EDQ_3C3
Query toilet_skills_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3C3_L
Query motor_small_obj_loss Integer Recommended Did your child lose ability to manipulate small objects such as legos or stack blocks 0 :: 1 0 = No; 1 = Yes EDQ_3D1
Query motor_small_obj_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3D1_L
Query carry_ball_loss Integer Recommended Did your child lose ability to carry throw or kick a ball or climb onto furniture 0 :: 1 0 = No; 1 = Yes EDQ_3D2
Query carry_ball_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3D2_L
Query able_phys_loss Integer Recommended Did your child lose ability to physically move about independently 0 :: 1 0 = No; 1 = Yes EDQ_3D3
Query able_phys_loss_lgth Integer Recommended Length of loss in months 1 :: 4 1 = <3 months; 2 = 3-6 months; 3 = >6 months; 4 = Don't know EDQ_3D3_L
Query skill_loss_age Integer Recommended At what age (in months) did your child begin to lose any of the skills EDQ_4_1
Query skill_loss_stop_age Integer Recommended At what age (in months) did the loss of skills appear to stop? EDQ_4_2
Query concern_development Integer Recommended Did you have any concerns about your child development before the regression? 0 :: 1 0 = No; 1 = Yes
concern_development_lt String 250 Recommended Please describe your concerns (and your child age at the time). EDQ_4_3
Query skills_loss Integer Required Was your child's loss of skills gradual or sudden? 1;2;9 1 = Gradual; 2 = Sudden; 9 = Don't know/NA EDQ_4_4
Query lost_language Integer Recommended If your child lost language skills. did he/she lose some or all words? 1 :: 2 1 = Some words; 2 = All words EDQ_4_5
Query before_loss_words Integer Recommended About how many words (maximum) did your child use before the loss? EDQ_4_6
Query after_loss_words Integer Recommended About how many words (maximum) does he/she use now? EDQ_4_7
Query illness_spfy Integer Recommended Was there any suggestion that the loss of skills was associated with a physical illness such as a high fever encephalitis or seizure activity or with an immunization? 0 :: 1 0 = No; 1 = Yes EDQ_4_8
Query illness_spfy_lt String 250 Recommended If there was any suggestion that the loss of skills was associated with a physical illness please describe EDQ_4_8B
Query loss_skills_stressors Integer Recommended Was there any suggestion that the loss of skills was associated with other stressors such as birth of a sibling death in the family moving or other environmental events/factors? 0 :: 1 0 = No; 1 = Yes EDQ_4_9
Query loss_skills_stressors_lt String 250 Recommended If there was any suggestion that the loss of skills was associated with other stressors please describe EDQ_4_9B
Query adaptive_losses Integer Recommended The number of yes responses between the elements feed_self_loss, dress_self_loss and toilets_kills_loss 0::3
Query communication_losses Integer Recommended The number of yes responses between the elements phrase_lost, meaning_phrase_lost, gesture_lost and understand_lang_lost 0::4
Query communications_scale Integer Recommended Communications Scale for EDQ
Query early_develop_summ_score Integer Recommended Social Total + Communication Total 0 :: 90
Query motor_losses Integer Recommended The number of yes responses between the elements motor_small_obj_loss, carry_ball_loss and able_phys_loss 0 ;1;2;3
Query regression_summ_score Integer Recommended Total losses in Social and Communication losses 1 :: 10
Query repetitive_behavior_scale Integer Recommended Repetitive Behavior Scale for EDQ
Query social_losses Integer Recommended The number of yes responses between the elements fam_interest_loss, smile_response_loss, reach_parent_loss, eye_contact_loss, game_interest_loss and pretend_play_loss 0::6
Query social_scale Integer Recommended Social Scale for EDQ
Query ethnicity String 30 Required Ethnicity of participant
Hispanic or Latino; Not Hispanic or Latino; Unknown
Query respondent String 20 Required Respondent
Mother;Father;Both; Child; Other; Parent
Query phenotype String 200 Required Phenotype/diagnosis for the subject
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