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Domain | CMI Question | CMI Response | Frequency |
---|---|---|---|
Sleep Behavior | About what time did your child go to bed last night? | Subject Input (include "Do Not Know") | 1x, Morning |
About what time did your child wake up? | Subject Input (include "Do Not Know") | 1x, Morning | |
Did your child take sleeping pills or anything else to help their sleep last night? | No/Yes/Do Not Know | 1x, Morning | |
Context of Assessment | Has your child taken off their activity monitor today? | No/Yes/Do Not Know | 1x, evening |
CONDITIONAL, Yes: | 1x, evening | ||
When did they take it off? | Subject input | 1x, evening | |
When did they put it back on? | Subject input | 1x, evening | |
Emotional and Physical States (Mood Circumplex) | How happy versus sad did your child seem today? | Very cheerful/happy --> Very sad/depressed/unhappy (1-7) | 1x, evening |
How relaxed versus anxious did your child seem today? | Very relaxed/calm --> Very nervous/anxious (1-7) | 1x, evening | |
How calm versus excited did your child seem today? | Very calm/quiet --> Very excited/aroused (1-7) | 1x, evening | |
How tired versus energetic did your child seem today? | Very tired/sluggish --> Very energetic/ lively (1-7) | 1x, evening | |
How well did your child's concentration or focus seem today? | Very focused/attentive --> Very unfocused/distracted (1-7) | 1x, evening | |
How irritable or easily angered did your child seem today? | Not at all irritable/angry --> Very irritable/angry (1-7) | 1x, evening | |
Did your child seem worried today? | Not at all worried --> Very worried (1-7) | 1x, evening | |
Do your child seem guilty today? | Not at all guilty --> Very guilty (1-7) | 1x, evening | |
Did your child seem capable of making decisions today? | Not at all/Very indecisive --> Very well/Very decisive (1-7) | 1x, evening | |
Did your child seem like a quick thinker today? | Very quick/lots of ideas --> Slow/cannot think of things (1-7) | 1x, evening | |
Did your child seem like they enjoyed the day? | Really enjoying things --> No pleasure or enjoyment (1-7) | 1x, evening | |
Did your child seem fidgety or restless today compared to their usual self? | Not at all restless --> Very restless/fidgety/cannot sit still (1-7) | 1x, evening | |
Did your child seem hungrier than normal today? | Not at all hungry/full --> Extremely hungry | 1x, evening | |
Did your child seem more tired than normal today? | Not at all sleepy --> very sleepy (1-7) | 1x, evening | |
Activity | Please select the level of activities your child completed today. | Multichoice Vigorous activities (e.g. running, fast cycling, heavy lifting or digging), Moderate activities (e.g. tennis, bicycling, carrying light loads), Light activities (e.g. walking, climbing stairs, routine household chores) | 1x, evening |
Stress | How stressful do you think your child's day was today? | No stress experienced --> extreme stress experienced (1-7) | 1x, evening |
Choose the source(s) of your child's stress today: | None, Physical health, school, relationship with friends, relationships with family, interaction with strangers, Other | 1x, evening | |
Life Events | CONTEXT: Please think of the ONE event that may have affected your child the most today (positively or negatively), no matter how slightly. | 1x, evening | |
Which of the following categories best describes the area of your child's life in which the event occurred? | School, After school program or job, Family or friend relationships, Interactions with classmates, Interactions with strangers, Event at home, Exercise or sport, Health, Traveling or commuting, Other | 1x, evening | |
To what degree did this event have a positive impact on your child? | 1=No positive impact --> 7=Extremely positive | 1x, evening | |
To what degree did this event have a negative impact on your child? | 1=No negative impact --> 7=Extremely negative | 1x, evening | |
Did more than one event occur that significantly influenced your child? | No/yes | 1x, evening | |
CONDITIONAL, Yes: | 1x, evening | ||
To what degree did this other event have a positive impact on your child? | 1=No positive impact --> 7=Extremely positive | 1x, evening | |
To what degree did this other event have a negative impact on your child? | 1=No negative impact --> 7=Extremely negative | 1x, evening | |
Physical Health | Did your child experience any kind of pain today? | No/Yes/Do Not Know | 1x, evening |
CONDITIONAL, Yes: | 1x, evening | ||
Where did your child experience pain today? | Headache, Joint/muscle,back or neck, Stomach/bowel, Other | 1x, evening | |
How severe is your child's pain right now? | 1=Very minor pain --> 7=Extreme pain | 1x, evening | |
How was your child's physical health today? | Very poor --> Very good/excellent (1-7) | 1x, evening | |
Did your child take any over-the-counter medications today? | No/Yes/Do Not Know | 1x, evening | |
CONDITIONAL, Yes: | 1x, evening | ||
Did your child take them for: | Multichoice Pain (Headache, muscle or joint pain, etc.), Allergies/cold (, Fever/acute illness, Headache, Sleep problems, Other | 1x, evening | |
Did your child take any prescription medications today? | No/Yes/Do Not Know | 1x, evening | |
CONDITIONAL, Yes: | 1x, evening | ||
For which of the following conditions? | Multichoice Thyroid/metabolic, Sleep, Anxiety/depression, Attention/hyperactivity, Asthma/allergies/breathing problems, Joint or back pain, Headache, Other | 1x, evening | |
Medications | What daily medications does your child take (include name and dosage)? | Subject Input | Only Once |