DDI_NPL_2013-2014_ICTECD_v01_M_WB Development Economics Data Group 2020-07-17 NADA Version 01 (July 2020) The Role of Information and Cash Transfers on Early Childhood Development 2013-2014 Evidence from Nepal RICTECD 2013-2014 NPL_2013-2014_ICTECD_v01_M Gayatri Acharya Michael Levere Prashant Bharadwaj NADA The Strategic Impact Evaluation Fund Gayatri Acharya Alreena Renita Pinto Socio-Economic/Monitoring Survey [hh/sems] While substantial progress has been made in combating malnutrition at a global level, chronic maternal and child malnutrition remains a serious problem in many parts of the developing world. In this paper, using a randomized control trial design in Nepal, we evaluate a program that provided information on best practices about maternal and child health and nutrition, and cash to families in extremely poor areas with pregnant mothers and/or children below the age of 2. We find significant and sizable impacts of the information plus cash intervention on maternal knowledge, behavior, child development, and nutrition. The size of these impacts along some measures of knowledge and development are significantly different from the information only intervention group suggesting a potential role for providing a short term cash safety net along with information to tackle the problem of malnutrition. Nepal The intervention was implemented in four food insecure districts in Nepal - Sarlahi, Rautahat, Sindhuli, and Ramechaap - Household - Individual Sample survey data [ssd] Detailed description of the experimental design is available in "The Role of Information and Cash Transfers on Early Childhood Development: Evidence from Nepal", pp4-7 Computer Assisted Personal Interview [capi] The baseline, midline, and endline surveys were nearly identical, and each included three separate modules to measure information on the household, the eligible mother, and the eligible infant. The household component of the survey was intended to be answered by either the household head or eligible mother, and measured a household’s composition, assets, annual income, monthly expenditures, and daily food intake. The mother then answered questions about herself and her children, which measured her knowledge of maternal health and nutritional best practices and her actual behaviors with her youngest child while pregnant and breastfeeding. The survey concluded with anthropometric measurements of the child and a measure of cognitive development as measured by the Ages and Stages Questionnaire (ASQ). Baseline data collection occurred in August-October 2013, prior to the start of the intervention. One fourth of counties were randomly assigned to be surveyed at midline in August-September 2014, with the remaining three-fourths surveyed at endline in November-December 2014. A total of 4,228 women and 3,695 children under two years old were surveyed at baseline. Of these, 3,152 women and 2,783 children were in the counties surveyed at endline, which will be primarily used in the analysis. After attrition and trimming outliers, the primary sample consists of 2,338 women and 1,953 children. Use of the dataset must be acknowledged using a citation which would include: - the Identification of the Primary Investigator - the title of the survey (including country, acronym and year of implementation) - the survey reference number - the source and date of download. Example: Gayatri Acharya (The World Bank Group), Michael Levere (Mathematica Policy Research), Prashant Bharadwaj (University of California, San Diego). Nepal - The Role of Information and Cash Transfers on Early Childhood Development 2013-2014 (ICTECD 2013-2014). Ref : NPL_2013-2014_ICTECD_v01_M. Downloaded from (url) on (date). The user of the data acknowledges that the original collector of the data, the authorized distributor of the data, and the relevant funding agency bear no responsibility for use of the data or for interpretations or inferences based upon such uses. SEC01.dta Nepal 2013 data on survey information - Baseline data 4723 14 SEC02.dta Nepal 2013 data on household identification - Baseline data 4723 25 SEC03.dta Nepal 2013 household roster data - Baseline data 36945 15 SEC04A.dta Nepal 2013 housing condition and physical assets data - Baseline 4723 22 SEC04B.dta Nepal 2013 housing condition and physical assets data (Land) - Baseline 7516 7 SEC04C.dta Nepal 2013 housing condition and physical assets data (Vegetables and Livestock) - Baseline 4723 5 SEC05A.dta Nepal 2013 household expenditures data for the past 30 days - Baseline 74458 4 SEC05B1.dta Nepal 2013 household income data in the past 12 months - Baseline 51213 4 SEC05B2.dta Nepal 2013 household loans and borrowing data - Baseline 4723 5 SEC05C.dta Nepal 2013 food consumption data - Baseline 162789 5 SEC05D.dta Nepal 2013 household shocks data - Baseline 46564 6 SEC06A.dta Nepal 2013 health data - Baseline 4229 5 SEC06B.dta Nepal 2013 health data - Baseline 3166 8 SEC07A.dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for under 2 children 4229 5 SEC07B.dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for under 2 children 67664 5 SEC07C.dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for under 2 children and nutrition for women 4229 11 SEC07D.dta Nepal 2013 data on the knowledge on maternal and child nutrition for Baseline - nutrition for women 59206 5 SEC07E.dta Nepal 2013 data on the knowledge of maternal and child nutrition, specifically on health, tobacco and alcohol consumption - Baseline 33832 5 SEC07F.dta Nepal 2013 data on the knowledge of maternal and child nutrition, specifically on health, tobacco and alcohol consumption - Baseline 4229 5 SEC08A.dta Nepal 2013 maternal heatlh data - antenatal care - Baseline 4229 13 SEC08B.dta Nepal 2013 maternal heatlh data - antenatal care - Baseline 17412 5 SEC08C.dta Nepal 2013 maternal heatlh data - antenatal and postnatal care - Baseline 4229 10 SEC09A.dta Nepal 2013 breastfeeding data - Baseline 3882 7 SEC09B.dta Nepal 2013 breastfeeding data - Baseline 20496 5 SEC09C.dta Nepal 2013 breastfeeding data - Baseline 3882 8 SEC09D.dta Nepal 2013 breastfeeding data - Baseline 1308 5 SEC09E.dta Nepal 2013 breastfeeding data - Baseline 3882 4 SEC09F.dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline 84312 5 SEC09G.dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline 3882 4 SEC09H.dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline 39720 5 SEC09I.dta Nepal 2013 Child Nutrition (0-24 month children) data - Baseline 3882 6 SEC10A.dta Nepal 2013 anthropometric measures data - Baseline 4229 13 SEC10B.dta Nepal 2013 anthropometric measures data - Baseline 4194 15 SEC11.dta Nepal 2013 data on child's development - Baseline data 3993 165 SEC00.dta Nepal 2014 Endline Wave 1 data 4155 17 SEC01.dta Nepal 2014 survey information data for Endline Wave 1 1190 17 SEC02.dta Nepal 2014 household identification data for Endline Wave 1 1190 18 SEC03.dta Nepal 2014 household roster data for Endline Wave 1 9170 16 SEC04A.dta Nepal 2014 housing condition and physical assets data for Endline wave 1 1190 23 SEC04B.dta Nepal 2014 housing condition and physical assets data for Endline wave 1, specifically data on land. 1989 8 SEC04C.dta Nepal 2014 housing condition and physical assets data for Endline wave 1, specifically data on vegetables and livestock 1190 6 SEC05A.dta Nepal 2014 household expenditures in the past 30 days data for Endline wave 1. 19830 5 SEC05B1.dta Nepal 2014 household income in the past 12 months data for Endline wave 1 14005 5 SEC05B2.dta Nepal 2014 household loans and borrowing data for Endline wave 1 1190 5 SEC05C.dta Nepal 2014 food consumption data for Endline wave 1 40800 6 SEC05D.dta Nepal 2014 data on household shocks for Endline wave 1 11675 7 SEC06A.dta Nepal 2014 health data for Endline wave 1 1314 6 SEC06B.dta Nepal 2014 health data for Endline wave 1 1148 9 SEC07A.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for under 2 children 1128 6 SEC07B.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for under 2 children 18048 6 SEC07C.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for under 2 children and nutrition for women 1128 12 SEC07D.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - nutrition for women 15792 6 SEC07E.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - health, tobacco and alcohol consumption 9024 6 SEC07F.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 1 - health, tobacco and alcohol consumption 1128 13 SEC08A.dta Nepal 2014 maternal health data for Endline wave 1 - antenatal care 1128 14 SEC08B.dta Nepal 2014 maternal health data for Endline wave 1 - antenatal care 6447 6 SEC08C.dta Nepal 2014 maternal health data for Endline wave 1 - antenatal and postnatal care 1128 11 SEC09A.dta Nepal 2014 breastfeeding data for Endline wave 1 1106 8 SEC09B.dta Nepal 2014 breastfeeding data for Endline wave 1 2928 6 SEC09C.dta Nepal 2014 breastfeeding data for Endline wave 1 1106 9 SEC09D.dta Nepal 2014 breastfeeding data for Endline wave 1 329 6 SEC09E.dta Nepal 2014 breastfeeding data for Endline wave 1 1106 5 SEC09F.dta Nepal 2014 child nutrition data for Endline wave 1 19320 6 SEC09G.dta Nepal 2014 child nutrition data for Endline wave 1 1106 5 SEC09H.dta Nepal 2014 child nutrition data for Endline wave 1 10245 6 SEC09I.dta Nepal 2014 child nutrition data for Endline wave 1 1106 7 SEC10A.dta Nepal 2014 anthropometric measures data for Endline wave 1 1314 16 SEC10B.dta Nepal 2014 female respondent and child anthropometric measures data for Endline wave 1 1410 16 SEC11.dta Nepal 2014 data on child's development - Endline wave 1 data 1410 213 SEC00.dta Endline Wave 2 data 14577 16 SEC01.dta Nepal 2014 survey information data for Endline Wave 2 4246 17 SEC02.dta Nepal 2014 household identification data for Endline Wave 2 4246 18 SEC03.dta Nepal 2014 household roster data for Endline Wave 2 31429 16 SEC04A.dta Nepal 2014 housing condition and physical assets data for Endline wave 2 4246 23 SEC04B.dta Nepal 2014 housing condition and physical assets data for Endline wave 2, specifically data on land. 7018 8 SEC04C.dta Nepal 2014 housing condition and physical assets data for Endline wave 2, specifically data on vegetables and livestock 4246 6 SEC05A.dta Nepal 2014 household expenditures in the past 30 days data for Endline wave 2. 69974 5 SEC05B1.dta Nepal 2014 household income in the past 12 months data for Endline wave 2 49434 5 SEC05B2.dta Nepal 2014 household loans and borrowing data for Endline wave 2 4246 5 SEC05C.dta Nepal 2014 food consumption data for Endline wave 2 143918 6 SEC05D.dta Nepal 2014 data on household shocks for Endline wave 2 41218 7 SEC06A.dta Nepal 2014 health data for Endline wave 2 4668 6 SEC06B.dta Nepal 2014 health data for Endline wave 2 2483 9 SEC07A.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - nutrition for under 2 children 3907 6 SEC07B.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 -nutrition for under 2 children 62512 6 SEC07C.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - nutrition for under 2 children and nutrition for women 3907 12 SEC07D.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - nutrition for women 54698 6 SEC07E.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - health, tobacco and alcohol consumption 31256 6 SEC07F.dta Nepal 2014 knowledge on maternal and child nutrition data for Endline wave 2 - health, tobacco and alcohol consumption 3907 13 SEC08A.dta Nepal 2014 maternal health data for Endline wave 2 - antenatal care 3907 14 SEC08B.dta Nepal 2014 maternal health data for Endline wave 2 - antenatal care 21315 6 SEC08C.dta Nepal 2014 maternal health data for Endline wave 2 - antenatal and postnatal care 3907 11 SEC09A.dta Nepal 2014 breastfeeding data for Endline wave 2 3724 8 SEC09B.dta Nepal 2014 breastfeeding data for Endline wave 2 11196 6 SEC09C.dta Nepal 2014 breastfeeding data for Endline wave 2 3724 9 SEC09D.dta Nepal 2014 breastfeeding data for Endline wave 2 623 6 SEC09E.dta Nepal 2014 breastfeeding data for Endline wave 2 3724 5 SEC09F.dta Nepal 2014 child nutrition data for Endline wave 2 61968 6 SEC09G.dta Nepal 2014 child nutrition data for Endline wave 2 3724 5 SEC09H.dta Nepal 2014 child nutrition data for Endline wave 2 29175 6 SEC09I.dta Nepal 2014 child nutrition data for Endline wave 2 3724 7 SEC10A.dta Nepal 2014 anthropometric measures data for Endline wave 2 4668 16 SEC10B.dta Nepal 2014 female respondent and child anthropometric measures data for Endline wave 2 4728 16 SEC11.dta Nepal 2014 data on child's development - Endline wave 2 data 4728 213 CO code CO code CO code CO code CO code 4723 1 600 Household number Household number Household number Household number Household number Household number 4723 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 101. Round Number 101. Round Number 101. Round Number 101. Round Number 101. Round Number Round Number 4723 1 1 1 103. CO Code No 103. CO Code No 103. CO Code No 103. CO Code No 103. CO Code No CO Code No (see the code sheet) 4723 1 600 104. House Serial No 104. House Serial No 104. House Serial No 104. House Serial No 104. House Serial No House Serial No (Copy from Q5 of Listing Form) 4723 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman SN eligible woman (From listing form) 4723 7 1 2 3 4 7 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman Interviewed eligible woman 4723 4 1 2 3 4 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD Date of Interview - Day 4723 1 31 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM Date of Interview - Month 4723 5 7 5 6 7 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY Date of Interview - Year 4723 2070 2070 2070 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name Name of enumerator 4723 1 49 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name Name of supervisor 4723 1 47 1 4 7 10 13 16 19 22 26 29 32 36 40 44 45 47 110. Editor's name 110. Editor's name 110. Editor's name 110. Editor's name 110. Editor's name Name of Editor 4723 1 8 1 2 3 4 5 6 7 8 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator Name of data entry operator 4723 1 9 1 2 3 4 5 6 7 8 9 CO code CO code CO code CO code CO code CO Code 4723 1 600 Household number Household number Household number Household number Household number Household number 4723 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 201. District 201. District 201. District 201. District 201. District District: 4723 1 4 1 Ramechhap 2 Sindhuli 3 Sarlahi 4 Rautahat 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? Is this a VDC or a Municipality? 4723 1 2 1 VDC 2 Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality Name and Code of VDC/Municipality (see code sheet) 4723 1 185 204. Ward Number 204. Ward Number 204. Ward Number 204. Ward Number 204. Ward Number Ward Number 4723 1 9 1 2 3 4 5 6 7 8 9 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent Name of the respondents and Identity number (HH Roster): - Name of the Main Respondent 4723 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 99 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent Name of the respondents and Identity number (HH Roster): - Name of the Second Respondent 4723 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 22 98 99 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head Name of the Household Head and code - ID Code 4723 1 1 1 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head Caste/ethnicity of HH head 4723 1 103 1 Chhetri 2 Bhamhin - Hill 3 Magar 4 Tharu 5 Tamang 6 Newar 7 Muslim 8 Kami 9 Yadav 10 Rai 11 Gurung 12 Damai/dholi 13 Limbu 14 Thakuri 15 Sarki 16 Teli 17 Chamar/harijan/ram 18 Koiri 19 Kurmi 20 Sanyasi 21 Dhanuk 22 Musahar 23 Dusadh/paswan/pasi 24 Sherpa 25 Sonar 26 Kewat 27 Bramhin - Terai 28 Baniya 29 Gharti/bhujel 30 Mallah 31 Kalwar 32 Kumal 33 Hajam/thakur 34 Kanu 35 Rajbansi 36 Sunuwar 37 Sudhi 38 Lohar 39 Tatma 40 Khatwe 41 Dhobi 42 Majhi 43 Niniya 44 Kumhar 45 Danuwar 46 Chepang/praja 47 Haluwai 48 Rajput 49 Kayastha 50 Badhae 51 Marwadi 52 Santhal/satar 53 Jhangad 54 Bantar 55 Barae 56 Kahar 57 Gangai 58 Lodha 59 Rajbhar 60 Thami 61 Dhimal 62 Bhote 63 Bing/bida 64 Bhediyar/gaderi 65 Nurang 66 Yakha 67 Darai 68 Tajpuriya 69 Thakali 70 Chidimar 71 Pahari 72 Mali 73 Bangali 74 Chhantyal 75 Dom 76 Kamar 77 Bote 78 Baramu 79 Gaine 80 Jirel 81 Adibasi/janajati 82 Dura 83 Churoute 84 Badi 85 Meche 86 Lepcha 87 Halkhor 88 Panjabi/sikh 89 Kisan 90 Raji 91 Byasi 92 Hayu 93 Koche 94 Dhniya 95 Walung 96 Jaine 97 Munda 98 Raute 99 Yholmo 100 Pattharkatta/kuswadiya 101 Kusunda 102 Other caste 103 Unidentified caste 212. Result of Interview: A. HH Questionnaire (Section 1-5) 212. Result of Interview: A. HH Questionnaire (Section 1-5) 212. Result of Interview: A. HH Questionnaire (Section 1-5) 212. Result of Interview: A. HH Questionnaire (Section 1-5) 212. Result of Interview: A. HH Questionnaire (Section 1-5) Result of Interview: - HH Questionnaire (Section 1-5) 4723 1 2 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 212. Result of Interview: B. Women Sections (Section 6-10) ? 1st set 212. Result of Interview: B. Women Sections (Section 6-10) ? 1st set 212. Result of Interview: B. Women Sections (Section 6-10) ? 1st set 212. Result of Interview: B. Women Sections (Section 6-10) ? 1st set 212. Result of Interview: B. Women Sections (Section 6-10) ? 1st set Result of Interview: - Women Sections (Section 6-10) – 1st set 4649 74 1 5 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled Sysmiss 212. Result of Interview: C. Women Sections (Section 6-10) ? 2nd set 212. Result of Interview: C. Women Sections (Section 6-10) ? 2nd set 212. Result of Interview: C. Women Sections (Section 6-10) ? 2nd set 212. Result of Interview: C. Women Sections (Section 6-10) ? 2nd set 212. Result of Interview: C. Women Sections (Section 6-10) ? 2nd set Result of Interview: - Women Sections (Section 6-10) – 2nd set (if no, write "X") 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: D. Women Sections (Section 6-10) ? 3rd set 212. Result of Interview: D. Women Sections (Section 6-10) ? 3rd set 212. Result of Interview: D. Women Sections (Section 6-10) ? 3rd set 212. Result of Interview: D. Women Sections (Section 6-10) ? 3rd set 212. Result of Interview: D. Women Sections (Section 6-10) ? 3rd set Result of Interview: - Women Sections (Section 6-10) ? 3rd set 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: E. Women Sections (Section 6-10) ? 4th set 212. Result of Interview: E. Women Sections (Section 6-10) ? 4th set 212. Result of Interview: E. Women Sections (Section 6-10) ? 4th set 212. Result of Interview: E. Women Sections (Section 6-10) ? 4th set 212. Result of Interview: E. Women Sections (Section 6-10) ? 4th set Result of Interview: - Women Sections (Section 6-10) – 4th set 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: F. Women Sections (Section 6-10) ? 5th set 212. Result of Interview: F. Women Sections (Section 6-10) ? 5th set 212. Result of Interview: F. Women Sections (Section 6-10) ? 5th set 212. Result of Interview: F. Women Sections (Section 6-10) ? 5th set 212. Result of Interview: F. Women Sections (Section 6-10) ? 5th set Result of Interview: - Women Sections (Section 6-10) ? 5th set 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: G. ASQ (Woman and Child Section 11) ? 1st set 212. Result of Interview: G. ASQ (Woman and Child Section 11) ? 1st set 212. Result of Interview: G. ASQ (Woman and Child Section 11) ? 1st set 212. Result of Interview: G. ASQ (Woman and Child Section 11) ? 1st set 212. Result of Interview: G. ASQ (Woman and Child Section 11) ? 1st set Result of Interview: - ASQ (Woman and Child Section 11) – 1st set 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: H. ASQ (Woman and Child Section 11) ? 2st set 212. Result of Interview: H. ASQ (Woman and Child Section 11) ? 2st set 212. Result of Interview: H. ASQ (Woman and Child Section 11) ? 2st set 212. Result of Interview: H. ASQ (Woman and Child Section 11) ? 2st set 212. Result of Interview: H. ASQ (Woman and Child Section 11) ? 2st set Result of Interview: - ASQ (Woman and Child Section 11) – 2nd set (if no, write "X") 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: I. ASQ (Woman and Child Section 11) ? 3rd set 212. Result of Interview: I. ASQ (Woman and Child Section 11) ? 3rd set 212. Result of Interview: I. ASQ (Woman and Child Section 11) ? 3rd set 212. Result of Interview: I. ASQ (Woman and Child Section 11) ? 3rd set 212. Result of Interview: I. ASQ (Woman and Child Section 11) ? 3rd set Result of Interview: - ASQ (Woman and Child Section 11) – 3rd set (if no, write "X") 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: J. ASQ (Woman and Child Section 11) ? 4th set 212. Result of Interview: J. ASQ (Woman and Child Section 11) ? 4th set 212. Result of Interview: J. ASQ (Woman and Child Section 11) ? 4th set 212. Result of Interview: J. ASQ (Woman and Child Section 11) ? 4th set 212. Result of Interview: J. ASQ (Woman and Child Section 11) ? 4th set Result of Interview: - ASQ (Woman and Child Section 11) – 4th set (if no, write "X") 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: K. ASQ (Woman and Child Section 11) ? 5th set 212. Result of Interview: K. ASQ (Woman and Child Section 11) ? 5th set 212. Result of Interview: K. ASQ (Woman and Child Section 11) ? 5th set 212. Result of Interview: K. ASQ (Woman and Child Section 11) ? 5th set 212. Result of Interview: K. ASQ (Woman and Child Section 11) ? 5th set Result of Interview: - ASQ (Woman and Child Section 11) – 5th set (if no, write "X") 4649 74 2 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 212. Result of Interview: L. ASQ (Woman and Child Section 11) ? 6th set 212. Result of Interview: L. ASQ (Woman and Child Section 11) ? 6th set 212. Result of Interview: L. ASQ (Woman and Child Section 11) ? 6th set 212. Result of Interview: L. ASQ (Woman and Child Section 11) ? 6th set 212. Result of Interview: L. ASQ (Woman and Child Section 11) ? 6th set Result of Interview: - ASQ (Woman and Child Section 11) – 6th set (if no, write "X") 4649 74 1 9 1 Completed 2 HH head, spouse, or eligible woman or other adult not at home 3 Refused 4 Dwelling not found/family migrated 5 Eligible woman is sick 6 Eligible womwn is disabled 9 No more set Sysmiss 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? Which religion do you follow mainly in your household? 4649 74 1 8 1 Hindu 2 Bouddha 3 Islam 4 Kirat 5 Jain 6 Christian 7 Shikh 8 Other Sysmiss 214. Total family number 214. Total family number 214. Total family number 214. Total family number 214. Total family number Total family number 4649 74 2 32 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 27 28 32 Sysmiss VDC Treatment Group VDC Treatment Group VDC Treatment Group VDC Treatment Group VDC Treatment Group VDC Treatment Group 4723 1 3 1 Control 2 Info Only 3 Info + Cash CO code CO code CO code CO code CO code CO Code 36945 1 600 Household number Household number Household number Household number Household number Household number 36945 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID CODE ID CODE ID CODE ID CODE ID CODE ID CODE 36871 74 1 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 99 SKIP Sysmiss 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head Relationship to HH head 36871 74 1 14 1 Head 2 Spouse 3 Son/Daughter 4 Grandchild 5 Parent 6 Brother/Sister 7 Nephew/Niece 8 Son/Daughter-in-law 9 Brother/Sister-in-law 10 Parent-in-law 11 Other relative (grandparents etc) 12 Domestic helper 13 Adopted/foster child 14 Other not related Sysmiss 303. Sex 303. Sex 303. Sex 303. Sex 303. Sex Sex 36871 74 1 2 1 Male 2 Female Sysmiss 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year Age (Completed)? - Year 36871 74 99 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month Age (Completed)? - Month 36871 74 11 1 2 3 4 5 6 7 8 9 10 11 Sysmiss 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? Ask only to those who are aged 5 years and older Can [NAME] read and write a letter in any one language? 29537 7408 1 3 1 Read only 2 Read and write 3 None Sysmiss 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? Ask only to those who are aged 5 years and older Has [NAME] ever attended formal school/ college? 29537 7408 1 2 1 Yes 2 No Sysmiss 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? Ask only to those who are aged 5 years and older What is the highest grade [NAME] completed 14094 22851 98 CLASS 1 NOT PASSED 1 CLASS 1 2 CLASS 2 3 CLASS 3 4 CLASS 4 5 CLASS 5 6 CLASS 6 7 CLASS 7 8 CLASS 8 9 CLASS 9 10 CLASS 10 11 SLC 12 CLASS 11 13 CLASS 12 OR INTERMEDIATE 14 BACHELOR LEVEL 15 MASTER LEVEL/PH.D 98 DON'T KNOW Sysmiss 308. Marital status 308. Marital status 308. Marital status 308. Marital status 308. Marital status Ask only to those who are aged 5 years and older Marital status 29537 7408 1 6 1 Unmarried 2 Currently married 3 Divorced 4 Separated 5 Widowed 6 Deserted Sysmiss 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Primary 29537 7408 1 36 1 Self-agri 2 Self-livestock 3 Agri (other) 4 Self/other agri 5 Self-trade/service 6 Self-small/cottage industry 7 Self-middle/big industry 8 Self-construction 9 Self-transportation 10 Self-other 11 Wage-agri 12 Wage-construction skill labour 13 Wage-construction unskilled labour 14 Wage-manufacturing skill labour 15 Wage-manufacturing unskilled labour 16 Wage-other skilled labour 17 Wage-other unskilled labour 18 Labour of transport sector 19 Goverment employee (NIJAMATI) 20 Security force 21 Employee on corporation sector 22 Employee on financial sector 23 Employee of education sector 24 Employee of healthe service 25 Lawer 26 Employee of NGOs/CBOs 27 Student 28 Household duties/child care 29 Retired/old age 30 Disable, can work 31 Disable, can not work 32 Unemployed/seeking work 33 Small age (too young) 35 Foreign employee 36 Other Sysmiss 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Secondary 29537 7408 1 36 1 Self-agri 2 Self-livestock 3 Agri (other) 4 Self/other agri 5 Self-trade/service 6 Self-small/cottage industry 7 Self-middle/big industry 8 Self-construction 9 Self-transportation 10 Self-other 11 Wage-agri 12 Wage-construction skill labour 13 Wage-construction unskilled labour 14 Wage-manufacturing skill labour 15 Wage-manufacturing unskilled labour 16 Wage-other skilled labour 17 Wage-other unskilled labour 18 Labour of transport sector 19 Goverment employee (NIJAMATI) 20 Security force 21 Employee on corporation sector 22 Employee on financial sector 23 Employee of education sector 24 Employee of healthe service 25 Lawer 26 Employee of NGOs/CBOs 27 Student 28 Household duties/child care 29 Retired/old age 30 Disable, can work 31 Disable, can not work 32 Unemployed/seeking work 33 Small age (too young) 34 No secondary occupation 35 Foreign employee 36 Other Sysmiss 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? Is [name] currently residing in this HH? 36871 74 1 2 1 Yes 2 No Sysmiss 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? Is this child or mother eligible for interview? 32619 4326 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 4723 1 600 Household number Household number Household number Household number Household number Household number 4723 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? would like to know more about your housing units used by your household or currently residing. Is this dwelling unit occupied by your household only? 4649 74 1 2 1 Yes 2 No Sysmiss 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? What is the ownership status of the dwelling that your household residing? 4649 74 1 5 1 Own house (Male ownership) 2 Own house (Female ownership) 3 Own house (Joint ownership) 4 No ownership 5 Rented Sysmiss 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? How many rooms are used by your household? 4649 74 14 1 2 3 4 5 6 7 8 9 10 11 12 14 Sysmiss 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? How many stories are there in your household? 4649 74 4 1 2 3 4 Sysmiss 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? Has your household used separate room as a kitchen? 4649 74 1 2 1 Yes 2 No Sysmiss 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? What is the main flooring material of the house that your family using? 4649 74 1 5 1 Earth/mud 2 Wood/Planks 3 Stone/Brick 4 Cement 5 Other Sysmiss 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? What is the main construction material of the outside wall of the house? (What is the main binding material of the house?) 4649 74 1 9 1 Bamboo/Wood/Cement mix (centre wall) 2 Cement bonded Stones/Bricks/Concrete 3 Mud bonded Stones/Bricks 4 Wood 5 Unbaked Bricks 6 Bamboo and mud 7 Clay, Husk, Mud, Straw, Hay 8 Other 9 No outside walls Sysmiss 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? What is the main construction material of the roof of the house? 4649 74 1 7 1 Hay/Straw 2 Earth/Mud 3 Wood 4 Galvanized iron 5 Concrete/Cement 6 Tiles/Slates/Stone 7 Other Sysmiss 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity Does your household have regular electricity or a power generator or Solar Power? - Regular electricity 4649 74 1 2 1 Yes 2 No Sysmiss 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator Does your household have regular electricity or a power generator or Solar Power? - Power generator 4649 74 1 2 1 Yes 2 No Sysmiss 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power Does your household have regular electricity or a power generator or Solar Power? - Solar power 4649 74 1 2 1 Yes 2 No Sysmiss 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? What is the main source of drinking water? 4649 74 1 12 1 Piped water directly to the household/compound 2 Piped water from a public water tap 3 Private Hand-pump (Shallow) 4 Public Hand-pump (Shallow) 5 Private Hand-pump (Deep) 6 Public Hand-pump (Deep) 7 Covered Well 8 Open Well 9 Stored Rain Water 10 Stone tape 11 River, Pond, Stream, or other open water bodies 12 Neighbour's tube-well Sysmiss 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? How many minutes does it take to fetch water? 4649 74 240 1 2 3 4 5 6 7 8 9 10 12 15 16 20 25 30 32 35 40 45 50 55 60 65 90 120 150 180 240 Sysmiss 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main What types of fuel does your household commonly use for cooking and heating? (Main Three) - Third 4649 74 1 10 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) Sysmiss 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second What types of fuel does your household commonly use for cooking and heating? (Main Three) - Third 4649 74 1 99 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) 99 No 2nd/3rd answer Sysmiss 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third What types of fuel does your household commonly use for cooking and heating? (Main Three) - Third 4649 74 1 99 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) 99 No 2nd/3rd answer Sysmiss 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? How many minutes do you walk/bicycle to get one bhari of firewood? Fill out only if one of the answers in Q412 is 01. 3607 1116 999 2 3 4 5 8 9 10 15 16 20 25 30 35 40 45 48 55 60 61 65 70 72 75 80 90 100 110 120 121 125 130 135 140 150 160 165 170 180 190 200 210 220 230 240 250 260 270 280 300 310 320 330 340 350 360 400 420 430 440 442 450 480 540 600 660 720 999 Not fetching water Sysmiss 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? What type of toilet does your household use? 4649 74 1 6 1 Flush toilet 2 Covered Pit/Pan within Household Compound 3 Open Pit within Household Compound 4 Community Latrine 5 Other type of Latrine (Specify) 6 No Toilet/Open Defecation Sysmiss 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? How many minutes does it take to get to the nearest market to your house? 4649 74 960 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? Does your household own land? If No, go to Q418 4649 74 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code 7516 1 600 Household number Household number Household number Household number Household number Household number 7516 1 47 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type Type of land 7516 1 4 1 Household land 2 Farm land 3 Bari/Pakho 4 Baran/forest/etc. 99 SKIP 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit Units 7516 1 2 1 Ropani 2 Bigha 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) Area: - Ropani/ Bigha 7516 90 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 20 21 22 23 24 25 26 27 28 29 30 32 38 40 47 50 53 60 90 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) Area: - Ana/ Kattha 7516 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) Area: - Paisa/ Dhur 7516 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 CO code CO code CO code CO code CO code CO Code 4723 1 600 Household number Household number Household number Household number Household number Household number 4723 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? Does your household have a garden where you grow vegetables? If No, go to 420 4649 74 1 2 1 Yes 2 No Sysmiss 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? For what purpose, do you grow vegetables? 2064 2659 1 3 1 Household consumption 2 Selling 3 Both Sysmiss 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? Has your household owned any livestock? 4649 74 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 74458 1 600 Household number Household number Household number Household number Household number Household number 74458 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item List the particulars of the expenditure that your family made to the following items during the past 30 days. A. Item 74384 74 1 16 1 Fuel (Wood, Kerosene, LPG, etc.) 2 Clothes, Apparel 3 Personal care items (Soap, Comb, Shampoo, cosmetics, etc.) 4 Transportation (Horse, Mule, Bus, Taxi, Rickshaw, etc) 5 Entertainment/Excursion (Movies, picnics, melas, etc) 6 Newspapers, Books, Copies, etc. 7 Educational and Professional Services 8 Medicines and Health Services 9 Legal Expenses and Insurance 10 Repair/Maintenance of House and Household Effects and electrician, plumber, etc. 11 Religious, Marriage, Funeral, etc. expenses 12 Donations/gifts 13 Electricity, Water, etc. 14 Household goods 15 Agri. related goods 16 Ornaments, land, livestock etc. purchase Sysmiss 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) List the particulars of the expenditure that your family made to the following items during the past 30 days. A. Amount 74384 74 400000 CO code CO code CO code CO code CO code CO Code 51213 1 600 Household number Household number Household number Household number Household number Household number 51213 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income List the particulars of the income of your family during the past 12 months. A. Particulars of Income 51139 74 1 11 1 Agriculture (Agriculture, NTFP, Livestock, etc) 2 Non-Agriculture Enterprise 3 From within the home town 4 Inside the country 5 Outside the country 6 Old age pension/allowances 7 Widow pension/Allowances 8 Disability allowances 9 Other social protection program payments 10 Income from interest, bonus, profit, commission, fees, royalties, etc 11 Prize Sysmiss 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) List the particulars of the income of your family during the past 12 months. B. Annual Income (Rupees) 51139 74 2500000 CO code CO code CO code CO code CO code CO Code 4723 1 600 Household number Household number Household number Household number Household number Household number 4723 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? How many borrowed loans does your household have over the past 12 months? If None go to 505 4649 74 16 None 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 Sysmiss 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed What was or is the annual rate of interest of the most recent loan borrowed? 4007 716 75 0.400000005960464 0.5 1 1.20000004768372 1.5 2 2.5 3 4 5 6 8 9 10 11.3999996185303 12 14 15 16 17 18 19 19.5 20 21 22 23 24 25 28 30 36 38 40 42 48 54 60 72 75 Sysmiss 505. Has your household lent any loans to anyone over the past 12 months? 505. Has your household lent any loans to anyone over the past 12 months? 505. Has your household lent any loans to anyone over the past 12 months? 505. Has your household lent any loans to anyone over the past 12 months? 505. Has your household lent any loans to anyone over the past 12 months? Has your household lent any loans to anyone over the past 12 months? 4649 74 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 162789 1 600 Household number Household number Household number Household number Household number Household number 162789 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - Food items 162715 74 1 35 1 Rice 2 Beaten rice 3 Maize 4 Wheat 5 Barley/Oat/Sorghum 6 Millet/ Buckwheat 7 Pulses 8 Gram/Pea 9 Other beans 10 Fish 11 Meat 12 Egg 13 Milk 14 Curd/Whey etc. 15 Baby/Powder milk 16 Ghee 17 Honey 18 Vegetable ghee 19 Oil (Mustard, Soyabean, etc.) 20 Potato/Colocasia 21 Onion 22 Green leafy vegetables 23 Other vergetables (cauliflower, okra, etc) 24 Fruits/nuts 25 Salt 26 Other Spices (scumin seed, marich, garlic, ginger, chillies, etc.) 27 Sugar 28 Sakhar/Gud/Khudo 29 Sweets 30 Tea/Coffee 31 Alcoholic beverages (Jand, Wine, Beer, etc.) 32 Non-alcoholic beverages (Coke, Frooti, Sarbat, etc.) 33 Tobacco and tobacco products 34 Noodles and Biscuits 35 Other Foods Sysmiss 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - How much [QUANTITY] did you consume [FOOD] in in the previous 24 hours? - Quantity (If none, write 0 and ➔Next item) 162715 74 900 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - How much [QUANTITY] did you consume [FOOD] in in the previous 24 hours? - Unit (If none, write 0 and ➔Next item) 52032 110757 1 10 1 Kilogram 2 Gram 3 Litre 4 Ml 5 Pathi 6 Mana 7 Kuruwa 8 Number 9 Dozen 10 Spoons Sysmiss CO code CO code CO code CO code CO code CO Code 46564 1 600 Household number Household number Household number Household number Household number Household number 46564 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Type of shock 46490 74 1 10 1 Getting a new job of any kind 2 Inheritance 3 Death of HH member 4 Accidental or Violent injury 5 Loss of employment of any kind 6 Failure/loss of business 7 Livestock died 8 Crop disease/pests 9 Theft/robbery/burglary/assault 10 Drought/floods Sysmiss 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Has the household experienced the shock? No, go to Next item 46490 74 1 2 1 Yes 2 No Sysmiss 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Who did this shock affect? 3480 43084 1 3 1 Just this household 2 Several HHs in the village 3 All HHs in the village Sysmiss 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - What was the strength of this shock? 3480 43084 1 5 1 Not important 2 Mild 3 Average 4 Quite strong 5 Very strong Sysmiss CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 601. Were you or any of your children who are younger than 36 months sick in the 601. Were you or any of your children who are younger than 36 months sick in the 601. Were you or any of your children who are younger than 36 months sick in the 601. Were you or any of your children who are younger than 36 months sick in the 601. Were you or any of your children who are younger than 36 months sick in the Were you or any of your children who are younger than 36 months sick in the last 30 days? No, go to Section 7 4229 1 2 1 Yes 2 No ***** Number person that was sick (Sec 06) ***** Number person that was sick (Sec 06) ***** Number person that was sick (Sec 06) ***** Number person that was sick (Sec 06) ***** Number person that was sick (Sec 06) Number person that was sick 2522 1707 3 1 2 3 Sysmiss CO code CO code CO code CO code CO code CO Code 3166 1 600 Household number Household number Household number Household number Household number Household number 3166 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3166 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 27 ID Code ID Code ID Code ID Code ID Code ID CODE (Enter from section 3) 3166 1 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 28 99 SKIP 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d What type of illness does [NAME] suffer from last time during the past 30 days? 3166 1 17 1 Diarrhoea 2 Dysentry 3 Pneumonia/Cough 4 Malaria 5 Other fever 6 Skin disease 7 TB 8 Measles 9 Jaundice 10 Parasites 11 Injury 12 Pregnancy related complications 13 Stomach-ache 14 STDs/STIs 15 Eye-ache 16 Head-ache 17 Orthopedic 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q Where did [NAME] go for the first consultation of the illness reported in Q.603? Not consulted → 606 3166 1 12 1 SHP 2 HP 3 PHC 4 Govt. hospital 5 Mobile clinic 6 Ayurvedic centre 7 Pharmacy/Clinic 8 Pvt. hospital 9 Health worker's home 10 Traditional healer 11 GHUMTI SIBIR 12 Not consulted 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? Whom did [NAME] first consult with of the illness reported in Q.603? → Go To Next Member 2959 207 1 6 1 Doctor 2 Paramedic (HA,SAHW, AHW, ANM) 3 Kaviraj/Vaidya 4 Untrained Pharmacist 5 Traditional Healer 6 Other Sysmiss 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? Why didn't you consult for the illness? 207 2959 1 7 1 No money 2 Illness not serious 3 Health worker far 4 No good health worker 5 Treatment expensive 6 Don't know about health institution 7 Pregnant Sysmiss CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? Now I’d like to ask you some questions about the nutrition for under 2 children In your opinion, what should be done with the first milk (colostrums)? 4229 1 8 1 Given to baby 2 Thrown away 3 Other 8 Do not know 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but In your opinion, for how long should a newborn infant be given nothing but breast milk? 4229 1 8 1 Less than 6 months 2 6 months 3 More than 6 months 8 Do not know CO code CO code CO code CO code CO code CO Code 67664 1 600 Household number Household number Household number Household number Household number Household number 67664 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 67664 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item In your opinion, what foods are best to feed children aged 6-24 months 30 days in addition to breast milk? - Item 67664 1 16 1 Porridge that is not enriched with other foods 2 Porridge that is enriched with other foods/sarbottam pitho 3 Yellow, orange and green vegetables 4 Fruits 5 Eggs 6 Milk or yogurt 7 Chicken or meat including liver 8 Ghee, butter, or oil 9 Lentils/pulses 10 Biscuit 11 Cerelac 12 Hoslicks 13 Noodles 14 Vitamin 15 Bread 16 Others 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? In your opinion, what foods are best to feed children aged 6-24 months 30 days in addition to breast milk? - Mentioned/Not mentioned 67664 1 2 1 Mentioned 2 Not mentioned CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition How many times a day should a 6-11 month old baby be fed a meal in addition to breast milk? 4229 98 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 27 28 29 30 50 98 Do not know 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to How many snacks a day should a 12-24 month old baby be given in addition to breast milk? 4229 98 1 2 3 4 5 6 7 8 9 10 11 12 14 15 20 98 Do not know 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha In your opinion, should you breastfeed your baby less, the same or more than usual during an episode of diarrhea? 4229 1 8 1 Less than usual 2 Same as usual 3 More than usual 8 Do not know 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for Now I’d like to ask you some questions about the nutrition for women. In your opinion, at least how many times should a pregnant mother visit for ANC check up, 1, 2, 3, 4 or more? 4229 8 1 2 3 4 5 6 7 8 Do not know 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? When should a pregnant woman start iron supplementation (in months)? 4229 8 1 2 3 4 5 6 7 8 Do not know 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? When should a pregnant woman take deworming tablets (in months)? 4229 8 1 2 3 4 5 6 7 8 Do not know 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within When should a recently delivered woman take Vitamin A capsule (within days of delivery)? 4229 98 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 20 21 22 24 25 28 29 30 32 35 36 40 42 43 44 45 46 48 50 60 80 90 98 Do not know 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same In your opinion, is it best for a pregnant woman to eat less food, the same amount or more food than she ate before becoming pregnant? 4229 1 8 1 More than usual 2 Same as usual 3 Less than usual 8 Do not know CO code CO code CO code CO code CO code CO Code 59206 1 600 Household number Household number Household number Household number Household number Household number 59206 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 59206 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item In your opinion, what are good foods for a woman to eat during her pregnancy? - Item 59206 1 14 1 Yellow, orange and green vegetables 2 Fruit 3 Eggs 4 Milk or yogurt 5 Meat 6 Beans/pulses 7 Rice 8 Bread 9 Horlicks 10 Vitamin 11 Noodles 12 Biscuit 13 HALUWA 14 Others 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? In your opinion, what are good foods for a woman to eat during her pregnancy? - Mentioned/Not mentioned 59206 1 2 1 Mentioned 2 Not Mentioned CO code CO code CO code CO code CO code CO Code 33832 1 600 Household number Household number Household number Household number Household number Household number 33832 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 33832 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice With whom do you usually seek advice on maternal and child health issues? - People giving advice 33832 1 8 1 FCHV 2 AAMA Mothers group 3 MCHW/VHW 4 Other Health Workers 5 Local private pharmacy 6 Traditional healers 7 Family members 8 Other 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? With whom do you usually seek advice on maternal and child health issues? - Yes/No 33832 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? What kind of salt do you normally use in your house? 4229 1 2 1 Aayunoon/Two child logo salt 2 Other salt 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? Are you smoking, chewing tobacco and drinking alcohol regularly? 4229 1 4 1 Yes smoking and taking tobacco 2 Yes drinking alcohol 3 Yes taking both 4 No, taking nothing CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? How old were you when you got married? 4229 10 40 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 33 40 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? Was the marriage arranged? 4229 1 2 1 Yes 2 No 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? Are you currently pregnant? No, go to 806 4229 1 2 1 Yes 2 No 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? How long have you been pregnant for? 1083 3146 9 1 2 3 4 5 6 7 8 9 Sysmiss 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? Is this your first pregnancy? 1) Yes, go to Section 10 2) No, and other kid(s) died, go to Section 10 1083 3146 1 3 1 Yes 2 No, and have kids who are alive 3 No, and other kid(s) died Sysmiss 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece During your pregnancy with your youngest child (name:___________), how many times did you receive antenatal care? 3882 347 36 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 18 36 Sysmiss 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? Did you receive TT injection at any time during this pregnancy (with name)? 3882 347 1 2 1 Yes 2 No Sysmiss 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv While pregnant with (name of youngest child), how many times did you receive such an injection? 3392 837 9 1 2 3 4 5 6 9 Sysmiss 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron When you were pregnant with (name of youngest child), did you receive iron tablets? No, go to 812 3882 347 1 2 1 Yes 2 No Sysmiss 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? How many days during your pregnancy did you take the iron tablets? - Number of days 2902 1327 1 540 CO code CO code CO code CO code CO code CO Code 17412 1 600 Household number Household number Household number Household number Household number Household number 17412 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 17412 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 25 27 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken If yes, from where? (Choose all that apply, ask open-ended) - Place where the tablets were taken 17412 1 6 1 FCHV 2 Health Facility 3 Clinic/pharmacy 4 Hospital 5 NGOs/INGOs 6 Privat nursing home 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? If yes, from where? (Choose all that apply, ask open-ended) - Yes/No 17412 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? During your last pregnancy, (with name) did you take de-worming tablet? 3882 347 1 2 1 Yes 2 No Sysmiss 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? Did you suffer from night blindness or ratandho in your last pregnancy? 3882 347 1 2 1 Yes 2 No Sysmiss 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? Where did you give birth in your most recent delivery? 3882 347 1 6 1 Home 2 Government hospital 3 PHC/HP/SHP 4 Private hospital/nursing home 5 Field/jungle 6 Road/Vehicle Sysmiss 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? Who assisted with your most recent delivery? 3882 347 1 9 1 Doctor 2 Staff nurse/ANM 3 HA/AHW 4 MCHW 5 FCHV 6 TBA 7 Untrained household member/neighbor 8 Other 9 No one Sysmiss 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? In the first 42 days after delivery, did you take Vitamin A capsules? 3882 347 1 2 1 Yes 2 No Sysmiss 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? If yes, from where did you receive? 1757 2472 1 3 1 FCHV 2 Health workers 3 Shop/Medical Sysmiss 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? Are you or your husband currently using any family planning method? 3882 347 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 3882 1 600 Household number Household number Household number Household number Household number Household number 3882 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? Did you ever breastfeed to your youngest child (name of child)? No, go to 904 3882 1 2 1 Yes 2 No 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast How long after giving birth did you first put (name of child) to the breast? 3844 38 360 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid During the first three days after delivery, did you give (name) the liquid that came from your breasts? 3844 38 1 2 1 Yes 2 No Sysmiss 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink In the first three days after delivery, was (name) given anything to drink other than breast milk? No, go to 906 3882 1 2 1 Yes 2 No CO code CO code CO code CO code CO code Code 20496 2 600 Household number Household number Household number Household number Household number Household number 20496 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 40 46 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 20496 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food What was (name) given to drink during that time? Anything else? - Liquid Food 20496 1 12 1 Milk (other than breast milk) 2 Other mother milk 3 Plain water 4 Sugar or glucose water 5 Gripe water 6 Sugar-salt-water solution 7 Fruit juice 8 Infant formula 9 Honey 10 Ghee 11 Milk pouder 12 Others 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? What was (name) given to drink during that time? Anything else? - Fed/Not fed 20496 1 2 1 Fed 2 Not fed CO code CO code CO code CO code CO code CO Code 3882 1 600 Household number Household number Household number Household number Household number Household number 3882 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Woman] Name and ID Code of Respondent -HH Roster 3882 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? For how many months did you exclusively breastfeed (name)? 3882 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 22 23 24 99 Still breastfeeding 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? For how many months did you breastfeed (name)? 3882 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 36 37 38 39 40 42 44 46 48 60 99 Still breastfeeding 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? ENUMERATOR: Is [name] younger than 24 months or older? Older than 24 m 30 d, go to Section 10 3882 1 2 1 Younger than 24 m 30 d 2 Older than 24 m 30 d 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? Are you still breastfeeding (name)? No, go to 911 3513 369 1 2 1 Yes 2 No Sysmiss 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 How often did you breastfeed your child (name) day and night during last 24 hours? 1) Number of times go to 912 2) (Go to Q911 if answer is 0, if more than that go to Q912) 3299 583 40 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 32 35 36 40 Sysmiss CO code CO code CO code CO code CO code CO Code 1308 25 596 Household number Household number Household number Household number Household number Household number 1308 1 45 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 29 30 31 32 33 35 37 45 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1308 1 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding If not breastfeeding, why not? - Reasons for not breastfeeding 1308 1 6 1 No milking 2 Inadequacy of breastmilks 3 Work load/lack of time 4 Child ill 5 Pregnant 6 Mother is/was sick 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? If not breastfeeding, why not? - Yes/No 1308 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 3882 1 600 Household number Household number Household number Household number Household number Household number 3882 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste Did (name) drink anything milk or liquidy from a bottle with a nipple yesterday or last night? 3513 369 1 8 1 Yes 2 Nothing 8 Do not know Sysmiss CO code CO code CO code CO code CO code CO Code 84312 1 600 Household number Household number Household number Household number Household number Household number 84312 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 84312 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 27 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item Now I would like to ask you about (other) liquids or foods that (name) may have had yesterday during the day or at night.. (Ask all items one after another) Did (name) drink/eat:? - Item 84312 1 24 1 Breast milk 2 Plain water 3 Milk such as commercially produced infant formula 4 Any fortified, commercially available infant and young child food 5 Any other porridge or gruel 6 Fresh animal milk 7 Yogurt or other milk products 8 Rice, chapattis other foods made from grains such as millet, maize, lito 9 White potatoes or other [roots] tubers 10 Pupmkin, carrots, or other yellow or orange vegetables 11 Ripe mangoes, papaya, or other yellow or orange fruits 12 Any dark green leafy vegetables 13 Other fruits such as banana, orange, apple 14 Eggs 15 Any meat such as goat, lamb, chicken, pork, ducks 16 Any organ meat such as liver, kidney 17 Fresh or dried fish or shellfish/dried meat 18 Snails or other small protein foods 19 Lentils, beans, peas, or nuts 20 Any oils, fats or foods made with any of these foods 21 Tea 22 Sugary foods such as sweets, chocolate 23 Processed foods such as biscuits, noodles 24 Any other solid or soft foods/JAAND 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? Now I would like to ask you about (other) liquids or foods that (name) may have had yesterday during the day or at night.. (Ask all items one after another) Did (name) drink/eat:? - Code 84312 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 3882 1 600 Household number Household number Household number Household number Household number Household number 3882 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo How many times did (name) youngest child eat solid, semi-solid, or soft food other than liquids yesterday during the day or at night? 3513 369 98 1 2 3 4 5 6 7 8 9 10 12 15 16 20 98 Do not know Sysmiss CO code CO code CO code CO code CO code CO Code 39720 1 600 Household number Household number Household number Household number Household number Household number 39720 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 39720 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 27 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food What type of food consistency is usually given to the child? - Type of food 39720 1 15 1 Solid (Dal Bhat Vegetable) 2 Semi-solid (Jaulo/Porridge) 3 Mashed/pureed 4 Liquidy 5 Milk 6 Biscuit 7 Horlicks 8 Cerelac 9 HALUWA 10 Noodles 11 Egg 12 Meat 13 Bread 14 Fruits 15 Others 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given What type of food consistency is usually given to the child? - Given/Not given 39720 1 2 1 Given 2 Not given CO code CO code CO code CO code CO code CO Code 3882 1 600 Household number Household number Household number Household number Household number Household number 3882 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3882 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? Did the child receive vitamin A capsule within the last 6 months? 3513 369 1 3 1 Yes 2 No 3 Child below 6 months old Sysmiss 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d How many hours were you away from your child due to work or other reasons during the past 24 hours? 3513 369 15 1 2 3 4 5 6 7 8 9 10 11 12 13 15 Sysmiss 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the Did you say you would feed the baby later when he/she (name) expressed the desire for it (within the last 24 hours)? 1015 2867 1 2 1 I did 2 I did not Sysmiss CO code CO code CO code CO code CO code CO Code 4229 1 600 Household number Household number Household number Household number Household number Household number 4229 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Respondent -HH Roster 4229 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 25 27 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) Now, I would like to talk to you about your physical feature and request for measuring weight and height Weight of the female respondent (in kilograms) 4229 27.2000007629395 998 998 Could not weigh 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) Height of the female respondent (in centimeters) 4229 120 998 998 Could not measure 1003. How many children under 3 years of age in your household from the eligible 1003. How many children under 3 years of age in your household from the eligible 1003. How many children under 3 years of age in your household from the eligible 1003. How many children under 3 years of age in your household from the eligible 1003. How many children under 3 years of age in your household from the eligible How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? [If this is 0, it is the end of the interview.] 4229 3 1 2 3 ***** Interviewed children under 3 years of age (for Section 11)? ***** Interviewed children under 3 years of age (for Section 11)? ***** Interviewed children under 3 years of age (for Section 11)? ***** Interviewed children under 3 years of age (for Section 11)? ***** Interviewed children under 3 years of age (for Section 11)? Interviewed children under 3 years of age (for Section 11)? 3644 585 3 1 2 3 Sysmiss 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. 2) If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #1 (kilograms) 3644 585 31.1000003814697 999 998 Could not weigh 999 NA (no >25 months child) Sysmiss 1004. ID CODE OF CHILD 1 1004. ID CODE OF CHILD 1 1004. ID CODE OF CHILD 1 1004. ID CODE OF CHILD 1 1004. ID CODE OF CHILD 1 ID CODE OF CHILD 1 (HH Roster) 3503 726 3 28 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 28 Sysmiss 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) Weight of mother holding child #2 (kilograms) 539 3690 36.0999984741211 999 998 Could not weigh 999 NA (no >25 months child) Sysmiss 1005. ID CODE OF CHILD 2 1005. ID CODE OF CHILD 2 1005. ID CODE OF CHILD 2 1005. ID CODE OF CHILD 2 1005. ID CODE OF CHILD 2 ID CODE OF CHILD 2 (HH Roster) 232 3997 3 20 3 4 5 6 7 8 9 10 11 12 13 14 15 16 19 20 Sysmiss 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) Weight of mother holding child #3 (kilograms) 11 4218 41.7999992370605 999 41.7999992370605 48.7000007629395 52.5 998 Could not weigh 999 NA (no >25 months child) Sysmiss 1006. ID CODE OF CHILD 3 1006. ID CODE OF CHILD 3 1006. ID CODE OF CHILD 3 1006. ID CODE OF CHILD 3 1006. ID CODE OF CHILD 3 ID CODE OF CHILD 3 (HH Roster) 4 4225 7 11 7 9 11 Sysmiss CO code CO code CO code CO code CO code CO Code 4194 1 600 Household number Household number Household number Household number Household number Household number 4194 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4194 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 27 ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child ID CODE of Children 4194 3 28 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 28 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD Date of Birth of Child - DD 4194 1 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM Date of Birth of Child - MM 4194 1 12 1 2 3 4 5 6 7 8 9 10 11 12 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY Date of Birth of Child - YY 4194 2067 2070 2067 2068 2069 2070 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? Was there any problem at delivery of this child (delivery complications)? 4194 1 2 1 Yes 2 No 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? How long was the child breastfed? 4194 99 Not breastfed 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 99 Currently breastfeeding 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? Has child been occulated? 4194 1 3 1 Fully occulated 2 Being fully occulated 3 Not occulated 1011. Height of Child 1011. Height of Child 1011. Height of Child 1011. Height of Child 1011. Height of Child Height of Child (to nearest 0.5 cm) 4194 37 999 999 Not measured 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing Height is measured laying or standing 4106 88 1 2 1 Laying 2 Standing Sysmiss 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child Weight of Child If weight not measured record 999 and go to Q1015 4194 1.5 999 999 Not measured 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? Was child weighed with the mother or alone? With mon → Go To Next Member 4145 49 1 2 1 Alone 2 With mum Sysmiss 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight Reason for not taking Height/Weight (If you filled out 999 for question 1011 or 1013) 49 4145 1 4 1 Child not at home 2 Child was sick 3 Not allowed to take Height/Weight 4 Refused to measure Sysmiss CO code CO code CO code CO code CO code 3993 1 600 Household number Household number Household number Household number Household number 3993 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 40 41 45 46 47 48 50 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) 3993 1 27 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 27 ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child 3993 3 28 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 28 Age of chid (month) Age of chid (month) Age of chid (month) Age of chid (month) Age of chid (month) 3993 1 36 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun Does your baby sometimes make throaty or gurgling sounds? 253 3740 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, Does your baby make cooing sounds such as “ooo,” “gah,” and “aah”? 253 3740 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back When you speak to your baby, does she make sounds back to you? 253 3740 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? Does your baby smile when you talk to him? 497 3496 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? Does your baby chuckle softly? 497 3496 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile After you have been out of sight, does your baby smile or get excited when she sees you? 497 3496 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? Does your baby make high-pitched squeals? 487 3506 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo Does your baby make sounds when looking at toys or people? 754 3239 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does If you call your baby when you are out of sight, does she look in the direction of your voice? 754 3239 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w When a loud noise occurs, does your baby turn to see where the sound came from? 510 3483 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby If you copy the sounds your baby makes, does your baby repeat the same sounds back to you? 821 3172 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s Does your baby respond to the tone of your voice and stop his activity at least briefly when you say “no-no” to him? 821 3172 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? Does your baby make two similar sounds like “ba-ba,” “da-da,” or “ga-ga”? (The sounds do not need to mean anything.) 954 3039 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur If you ask your baby to, does he play at least one nursery game even if you don’t show him the activity yourself (such as “bye-bye,” “Peeka- boo,” “clap your hands,” “So Big”)? 687 3306 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com Does your baby follow one simple command, such as “Come here,” “Give it to me,” or “Put it back,” without your using gestures? 972 3021 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, Does your baby say three words, such as “Mama,” “Dada,” and “Baba”? (A “word” is a sound or sounds your baby says consistently to mean someone or something.) 687 3306 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po When your baby wants something, does he tell you by pointing to it? 1194 2799 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y Does your baby shake his head when he means “no” or “yes”? 661 3332 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur Does your baby point to, pat, or try to pick up pictures in a book? 523 3470 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? Does your baby say four or more words in addition to “Mama” and “Dada”? 818 3175 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro When you ask her to, does your baby go into another room to find a fa- miliar toy or object? (You might ask, “Where is your ball?” or say, “Bring me your coat,” or “Go get your blanket.”) 818 3175 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat,” “Daddy play,” “Go home,” or “What’s this?” does your child say both words back to you? (Mark “yes” even if her words are difficult to understand.) 801 3192 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the Without your showing him, does your child point to the correct picture when you say, “Show me the kitty,” or ask, “Where is the dog?” (He needs to identify only one picture correctly.) 1525 2468 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent Does your child say two or three words that represent different ideas together, such as “See dog,” “Mommy come home,” or “Kitty gone”? (Don’t count word combinations that express one idea, such as “bye- bye,” “all gone,” “all right,” and “What’s that?”) 1287 2706 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, “What is this?” does your child correctly name at least one picture? 1122 2871 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges Without your giving him clues by pointing or using gestures, can your child carry out at least three of these kinds of directions? A) "Put the toy on the table" B) "Close the door" C) "Bring me a towel" D) "Find your coat" E) "Take my hand" F) "Get your book” 1481 2512 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha When you ask your child to point to her nose, eyes, hair, feet, ears, and so forth, does she correctly point to at least seven body parts? (She can point to parts of herself, you, or a doll. Mark “sometimes” if she cor- rectly points to at least three different body parts.) 1481 2512 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like Does your child correctly use at least two words like “me,” “I,” “mine,” and “you”? 854 3139 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four Does your child make sentences that are three or four words long? Please give an example: 489 3504 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge Without giving your child help by pointing or using gestures, ask him to “put the book on the table” and “put the shoe under the chair.” Does your child carry out both of these directions correctly? 489 3504 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y When looking at a picture book, does your child tell you what is hap- pening or what action is taking place in the picture (for example, “bark- ing,” “running,” “eating,” or “crying”)? You may ask, “What is the dog (or boy) doing?” 359 3634 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say When you ask, “What is your name?” does your child say his first name or nickname? 359 3634 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an Fill the code in the blank cell: YES=1; NO = 2] While your baby is on his back, does he wave his arms and legs, wiggle, and squirm? 253 3740 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to When your baby is on her tummy does she turn her head to the side? 253 3740 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up longer than a few seconds? 253 3740 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? When your baby is on her back, does she kick her legs? 497 3496 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b After holding her head up while on her tummy does your baby lay her head down on the floor, rather than let it drop or fall forward? 497 3496 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up so that his chin is about 3 inches from the floor for at least 15 seconds? 497 3496 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s When your baby is on her tummy, does she hold her head straight up, looking around? 244 3749 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby When you hold him in a sitting position, does your baby hold his head steady? 487 3506 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his While your baby is on his back, does your baby lift his legs high enough to see his feet? 487 3506 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting Does your baby roll from his back to his tummy, getting both arms out from under him? 510 3483 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he When you put your baby on the floor, does she lean on her hands while sitting? (If she already sits up straight without leaning on her hands, mark “yes” for this item.) 510 3483 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he support his own weight while standing? 821 3172 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u Does your baby get into a crawling position by getting up on her hands and knees? 821 3172 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support? 578 3415 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support? 954 3039 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi Does your baby walk beside furniture while holding on with only one hand? 687 3306 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he take several steps without tripping or falling? (If your baby already walks alone, mark “yes” for this item.) 972 3021 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s When you hold one hand just to balance your baby, does she take several steps forward? (If your baby already walks alone, mark “yes” for this item.) 661 3332 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi Does your baby stand up in the middle of the floor by himself and take several steps forward? 899 3094 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f Does your baby bend over or squat to pick up an object from the floor and then stand up again without any support? 899 3094 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr Does your baby move around by walking, rather than by crawling on his hands and knees? 818 3175 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? Does your child walk well and seldom fall? 801 3192 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re Does your child climb on an object such as a chair to reach something he wants (for example, to get a toy on a counter or to “help” you in the kitchen)? 1086 2907 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of Does your child walk down stairs if you hold onto one of her hands? She may also hold onto the railing or wall. (You can look for this at a store, on a playground, or at home.) 1193 2800 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does When you show your child how to kick a large ball, does he try to kick the ball by moving his leg forward or by walking into it? (If your child already kicks a ball, mark “yes” for this item.) 1287 2706 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou Does your child run fairly well, stopping herself without bumping into things or falling? 1649 2344 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step Does your child walk either up or down at least two steps by himself? He may also hold onto the railing or wall. 1238 2755 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at Does your child jump with both feet leaving the floor at the same time? 1213 2780 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi Without holding onto anything for support, does your child kick a ball by swinging his leg forward? 1213 2780 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e Does your child walk up stairs, using only one foot on each stair? (The left foot is on one step, and the right foot is on the next.) She may hold onto the railing or wall. 821 3172 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit Does your child stand on one foot for about 1 second without holding onto anything? 489 3504 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by While standing, does your child throw a ball overhand by raising his arm to shoulder height and throwing the ball forward? (Dropping the ball or throwing the ball underhand should be scored as “not yet.”) 243 3750 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both Does your child jump forward at least 6 inches with both feet leaving the ground at the same time? 127 3866 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o Does your baby grasp your finger if you touch the palm of her hand? 253 3740 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i When you put a toy in his hand, does your baby hold it in his hand briefly? 497 3496 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? Does your baby touch her face with her hands? 253 3740 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h Does your baby hold his hands open or partly open when he is awake (rather than in fists, as they were when he was a newborn)? 253 3740 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? Does your baby grab or scratch at her clothes? 497 3496 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a When you put a toy in her hand, does your baby wave it about, at least briefly? 497 3496 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto When you put a toy in her hand, does your baby hold onto it for about 1 minute while looking at it, waving it about, or trying to chew it? 244 3749 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she When you hold your baby in a sitting position, does she reach for a toy on a table close by, even though her hand may not touch it? 487 3506 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave Does your baby grab a toy you offer and look at it, wave it about, or chew on it for about 1 minute? 487 3506 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands Does your baby reach for or grasp a toy using both hands at once? 510 3483 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it Does your baby reach for a crumb or Cheerio and touch it with his finger or hand? (If he already picks up a small object the size of a pea, mark “yes” for this item.) 510 3483 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce Does your baby pick up a small toy, holding it in the center of her hand with her fingers around it? 510 3483 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? Does your baby pick up a small toy with only one hand? 821 3172 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion? (If he already picks up a crumb or Cheerio, mark “yes” for this item.) 578 3415 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o After one or two tries, does your baby pick up a piece of string with her first finger and thumb? (The string may be attached to a toy.) 954 3039 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it Does your baby put a small toy down, without dropping it, and then take her hand off the toy? 972 3021 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? Does your baby help turn the pages of a book? (You may lift a page for him to grasp.) 1210 2783 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot Does your baby throw a small ball with a forward arm motion? (If he simply drops the ball, mark “not yet” for this item.) 1505 2488 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot Does your baby stack a small block or toy on top of another one? (You could also use spools of thread, small boxes, or toys that are about 1 inch in size.) 1854 2139 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of Does your baby make a mark on the paper with the tip of a crayon (or pencil or pen) when trying to draw? 2186 1807 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? Does your child turn the pages of a book by himself? (He may turn more than one page at a time.) 1940 2053 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up Does your child get a spoon into her mouth right side up so that the food usually doesn’t spill? 1655 2338 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while Does your child use a turning motion with her hand while trying to turn doorknobs, wind up toys, twist tops, or screw lids on and off jars? 1533 2460 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron Can your child string small items such as beads, macaroni, or pasta “wagon wheels” onto a string or shoelace? 1481 2512 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? 821 3172 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h After your child watches you draw a line from one side of the paper to the other side, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a horizontal direction? 489 3504 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y After your child watches you draw a single circle, ask him to make a circle like yours. Do not let him trace your circle. Does your child copy you by drawing a circle? 359 3634 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time Does your child turn pages in a book, one page at a time? 359 3634 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or When drawing, does your child hold a pencil, crayon, or pen between her fingers and thumb like an adult does? 243 3750 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches Fill the code in the blank cell: YES=1; NO = 2] Does your baby look at objects that are 8–10 inches away? 253 3740 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit When you move around, does your baby follow you with his eyes? 253 3740 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro When you move a toy slowly from side to side in front of your baby’s face (about 10 inches away), does your baby follow the toy with her eyes, sometimes turning her head? 497 3496 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro When you move a small toy up and down slowly in front of your baby’s face (about 10 inches away), does your baby follow the toy with his eyes? 497 3496 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does When you hold your baby in a sitting position, does she look at a toy (about the size of a cup or rattle) that you place on the table or floor in front of her? 497 3496 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l When you dangle a toy above your baby while he is lying on his back, does he wave his arms toward the toy? 497 3496 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look When you put a toy in her hand, does your baby look at it? 244 3749 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put When you put a toy in his hand, does your baby put the toy in his mouth? 487 3506 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach When a toy is in front of your baby, does she reach for it with both hands? 243 3750 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get When your baby is on her back, does she try to get a toy she has dropped if she can see it? 510 3483 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout Does your baby pick up a toy and put it in his mouth? 510 3483 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on Does your baby play by banging a toy up and down on the floor or table? 821 3172 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute? 821 3172 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang When holding a toy in his hand, does your baby bang it against another toy on the table? 954 3039 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b While holding a small toy in each hand, does your baby clap the toys together (like “Pat-a-cake”)? 954 3039 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o After watching you hide a small toy under a piece of paper or cloth, does your baby find it? (Be sure the toy is completely hidden.) 972 3021 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you If you put a small toy into a bowl or box, does your baby copy you by putting in a toy, although she may not let go of it? (If she already lets go of the toy into a bowl or box, mark “yes” for this item.) 972 3021 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c After you scribble back and forth on paper with a crayon (or a pencil or pen), does your baby copy you by scribbling? (If she already scribbles on her own, mark “yes” for this item.) 899 3094 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o Does your baby drop two small toys, one after the other, into a container like a bowl or box? (You may show him how to do it.) 1194 2799 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to After you have shown your baby how, does he try to get a small toy that is slightly out of reach by using a spoon, stick, or similar tool? 1086 2907 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib Without your showing him how, does your child scribble back and forth when you give him a crayon (or pencil or pen)? 1478 2515 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? (You may show her how.) (You can use a soda-pop bottle or a baby bottle.) 533 3460 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? (Mark “not yet” if your child scribbles back and forth.) 1525 2468 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u If you give your child a bottle, spoon, or pencil upside down, does she turn it right side up so that she can use it properly? 1287 2706 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does If your child wants something he cannot reach, does he find a chair or box to stand on to reach it (for example, to get a toy on a counter or to “help” you in the kitchen)? 1122 2871 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? Does your child pretend objects are something else? For example, does your child hold a cup to his ear, pretending it is a telephone? Does he put a box on his head, pretending it is a hat? Does he use a block or small toy to stir food? 1354 2639 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? Does your child put things away where they belong? For example, does he know his toys belong on the toy shelf, his blanket goes on his bed, and dishes go in the kitchen? 1213 2780 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? When looking in the mirror, ask “Where is _______?” (Use your child’s name.) Does your child point to his image in the mirror? 821 3172 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W When you point to the figure and ask your child, “What is this?” does your child say a word that means a person or something similar? (Mark “yes” for responses like “snowman,” “boy,” “man,” “girl,” “Daddy,” “spaceman,” and “monkey.”) Please write your child’s response here:_______________ 489 3504 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child When you say, “Say ‘seven three,’” does your child repeat just the two numbers in the same order? Do not repeat the numbers. If necessary, try another pair of numbers and say, “Say ‘eight two.’” Your child must repeat just one series of two numbers for you to answer “yes” to this question 489 3504 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s After your child draws a “picture,” even a simple scribble, does she tell you what she drew? (You may say, “Tell me about your picture,” or ask, “What is this?” to prompt her.) 359 3634 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c When you say, “Say ‘five eight three,’” does your child repeat just the three numbers in the same order? Do not repeat the numbers. If neces- sary, try another series of numbers and say, “Say ‘six nine two.’” (Your child must repeat just one series of three numbers for you to answer “yes” to this question.) 127 3866 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o Fill the code in the blank cell: YES=1; NO = 2] Does your baby cry when he is hungry, wet, tired, or wants to be held? 253 3740 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? When you smile at your baby, does she smile back? 253 3740 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? Does your baby watch his hands? 253 3740 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she When your baby sees the breast or bottle, does she seem to know she is about to be fed? 497 3496 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla When your baby has her hands together, does she play with her fingers? 497 3496 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands Does your baby help hold the bottle with both hands at once, or when nursing, does she hold the breast with her free hand? 497 3496 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi When in front of a large mirror, does your baby smile or coo at herself? 487 3506 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha Does your baby act differently toward strangers than he does with you and other familiar people? (Reactions to strangers may include staring, frowning, withdrawing, or crying.) 487 3506 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra While lying on her back, does your baby play by grab- bing her foot? 754 3239 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea When in front of a large mirror, does your baby reach out to pat the mirror? 510 3483 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac Does your baby try to get a toy that is out of reach? (She may roll, pivot on her tummy, or crawl to get it.) 510 3483 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from Does your baby drink water, juice, or formula from a cup while you hold it? 821 3172 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? Does your baby feed himself a cracker or a cookie? 578 3415 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby offer it to you even if she doesn’t let go of it? (If she already lets go of the toy into your hand, mark “yes” for this item.) 954 3039 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby let go of it into your hand? 687 3306 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo When you dress your baby, does she lift her foot for her shoe, sock, or pant leg? 687 3306 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro When you dress your baby, does he push his arm through a sleeve once his arm is started in the hole of the sleeve? 972 3021 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so Does your baby roll or throw a ball back to you so that you can return it to him? 661 3332 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b Does your baby play with a doll or stuffed animal by hugging it? 899 3094 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c Does your baby help undress himself by taking off clothes like socks, hat, shoes, or mittens? 1086 2907 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo Does your baby get your attention or try to show you something by pulling on your hand or clothes? 818 3175 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c While looking at himself in the mirror, does your child offer a toy to his own image? 533 3460 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su Does your child come to you when she needs help, such as with wind- ing up a toy or unscrewing a lid from a jar? 1478 2515 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting Does your child drink from a cup or glass, putting it down again with little spilling? 1193 2800 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as Does your child copy the activities you do, such as wipe up a spill, sweep, shave, or comb hair? 1287 2706 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? Does your child eat (with a fork) well? 1481 2512 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your If you do any of the following gestures, does your child copy at least one of them? A) "Open and close your mouth" B) "Blink your eyes" C) "Pull on your earlobe" D) "Pat your cheek" 1481 2512 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o Does your child push a little wagon, stroller, or other toy on wheels, steering it around objects and backing out of corners if she cannot turn? 854 3139 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often Does your child call herself “I” or “me” more often than her own name? For example, “I do it,” more often than “Juanita do it.” 578 3415 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by Does your child put on a coat, jacket, or shirt by himself? 821 3172 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee After you put on loose-fitting pants around her feet, does your child pull them completely up to her waist? 362 3631 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, When your child is looking in a mirror and you ask, “Who is in the mir- ror?” does he say either “me” or his own name? 359 3634 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a Using these exact words, ask your child, “Are you a girl or a boy?” Does your child answer correctly? 243 3750 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another Does your child take turns by waiting while another child or adult takes a turn? 127 3866 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 4155 1 600 Household number Household number Household number Household number Household number Household number 4155 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4155 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4130 25 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 22 23 99 Sysmiss ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child ID Code of Child (See HH Roster) 2965 1190 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19 20 21 22 27 28 99 Sysmiss 02. Women or children? 02. Women or children? 02. Women or children? 02. Women or children? 02. Women or children? 02. Women or children? 2959 1196 1 2 1 Women 2 Children Sysmiss 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? 1321 2834 1 2 1 Yes 2 No Sysmiss 04. Current status 04. Current status 04. Current status 04. Current status 04. Current status 04. Current status 1321 2834 1 2 1 Pregnant 2 Mother Sysmiss 05. ID code of mother 05. ID code of mother 05. ID code of mother 05. ID code of mother 05. ID code of mother ID code of mother 1638 2517 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 Sysmiss 06A. Date of birth: YY 06A. Date of birth: YY 06A. Date of birth: YY 06A. Date of birth: YY 06A. Date of birth: YY Date of birth: - YY 1638 2517 2067 2071 2067 2068 2069 2070 2071 Sysmiss 06A. Date of birth: MM 06A. Date of birth: MM 06A. Date of birth: MM 06A. Date of birth: MM 06A. Date of birth: MM Date of birth: - MM 1638 2517 1 12 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss 06A. Date of birth: DD 06A. Date of birth: DD 06A. Date of birth: DD 06A. Date of birth: DD 06A. Date of birth: DD Date of birth: - DD 1638 2517 1 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Sysmiss 06B. Age: Year 06B. Age: Year 06B. Age: Year 06B. Age: Year 06B. Age: Year Age: Year 1638 2517 5 1 2 3 4 5 Sysmiss 06B. Age: Month 06B. Age: Month 06B. Age: Month 06B. Age: Month 06B. Age: Month Age: Month 1638 2517 11 1 2 3 4 5 6 7 8 9 10 11 Sysmiss 06B. Age: Day 06B. Age: Day 06B. Age: Day 06B. Age: Day 06B. Age: Day Age: Day 1638 2517 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 Sysmiss 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 2959 1196 1 7 1 Completed 3 Separated 4 Out of home 5 Dead 6 Refused to answer 7 Other Sysmiss 4155 1 3 1 master only (1) 2 using only (2) 3 matched (3) 4 missing updated (4) 5 nonmissing conflict (5) CO code CO code CO code CO code CO code CO Code 1190 1 600 Household number Household number Household number Household number Household number Household number 1190 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1190 3 1 2 3 101. Round Number 101. Round Number 101. Round Number 101. Round Number 101. Round Number Round Number 1190 2 2 2 103. CO Code No 103. CO Code No 103. CO Code No 103. CO Code No 103. CO Code No CO Code No (see the code sheet) 1190 1 600 104. House Serial No 104. House Serial No 104. House Serial No 104. House Serial No 104. House Serial No House Serial No (Copy from Q5 of Listing Form) 1190 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 104. Household sub-number (if separated) 104. Household sub-number (if separated) 104. Household sub-number (if separated) 104. Household sub-number (if separated) 104. Household sub-number (if separated) House Serial No (Copy from Q5 of Listing Form) - sub-number (if any) 1190 3 1 2 3 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman SN eligible woman (From listing form) - Number 1190 4 1 2 3 4 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman SN eligible woman (From listing form) - Interviewed 1190 4 1 2 3 4 106B. Is this hh in baseline? 106B. Is this hh in baseline? 106B. Is this hh in baseline? 106B. Is this hh in baseline? 106B. Is this hh in baseline? Name of CO Member in Selected HH - Is this household in baseline? 1190 1 1 1 Yes 2 No 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD Date of Interview: - Day 1190 1 31 1 2 3 4 5 6 7 8 9 10 25 26 27 28 29 30 31 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM Date of Interview: - Month 1190 5 6 5 6 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY Date of Interview: - Year 1190 2071 2071 2071 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name Name of enumerator 1190 1 71 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 71 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name Name of supervisor 1190 36 1 4 5 6 7 9 10 13 16 17 19 22 23 24 26 28 29 32 34 35 36 110. Editor's name 110. Editor's name 110. Editor's name 110. Editor's name 110. Editor's name Name of Editor 1190 24 1 2 3 4 5 22 24 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator Name of data entry operator 1190 1 10 100 2 3 4 5 6 69 7 a p q CO code CO code CO code CO code CO code CO Code 1190 1 600 Household number Household number Household number Household number Household number Household number 1190 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 201. District 201. District 201. District 201. District 201. District District 1190 1 4 1 Ramechhap 2 Sindhuli 3 Sarlahi 4 Rautahat 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? Is this a VDC or a Municipality? 1190 1 1 1 VDC 2 Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality Name and Code of VDC/Municipality (see code sheet) 1190 1 179 1 7 9 10 11 15 19 32 37 38 42 51 53 60 62 67 69 70 71 74 75 79 85 88 89 97 107 113 114 115 119 126 135 139 141 148 155 161 163 166 172 174 176 177 178 179 1190 1 1 1190 1 1 1190 1 1 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1190 3 1 2 3 204. Ward Number 204. Ward Number 204. Ward Number 204. Ward Number 204. Ward Number Ward Number 1190 1 9 1 2 3 4 5 6 7 8 9 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent Name of the respondents and Identity number (HH Roster): - Name of the Main Respondent 1190 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 99 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent Name of the respondents and Identity number (HH Roster): - Name of the Second Respondent 1190 99 1 2 3 4 5 6 7 8 9 10 11 12 14 15 16 99 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head Name of the Household Head and code: - ID code 1190 1 1 1 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head Caste/ethnicity of HH head 1190 1 99 1 Chhetri 2 Bhamhin - Hill 3 Magar 4 Tharu 5 Tamang 6 Newar 7 Muslim 8 Kami 9 Yadav 10 Rai 11 Gurung 12 Damai/dholi 13 Limbu 14 Thakuri 15 Sarki 16 Teli 17 Chamar/harijan/ram 18 Koiri 19 Kurmi 20 Sanyasi 21 Dhanuk 22 Musahar 23 Dusadh/paswan/pasi 24 Sherpa 25 Sonar 26 Kewat 27 Bramhin - Terai 28 Baniya 29 Gharti/bhujel 30 Mallah 31 Kalwar 32 Kumal 33 Hajam/thakur 34 Kanu 35 Rajbansi 36 Sunuwar 37 Sudhi 38 Lohar 39 Tatma 40 Khatwe 41 Dhobi 42 Majhi 43 Niniya 44 Kumhar 45 Danuwar 46 Chepang/praja 47 Haluwai 48 Rajput 49 Kayastha 50 Badhae 51 Marwadi 52 Santhal/satar 53 Jhangad 54 Bantar 55 Barae 56 Kahar 57 Gangai 58 Lodha 59 Rajbhar 60 Thami 61 Dhimal 62 Bhote 63 Bing/bida 64 Bhediyar/gaderi 65 Nurang 66 Yakha 67 Darai 68 Tajpuriya 69 Thakali 70 Chidimar 71 Pahari 72 Mali 73 Bangali 74 Chhantyal 75 Dom 76 Kamar 77 Bote 78 Baramu 79 Gaine 80 Jirel 81 Adibasi/janajati 82 Dura 83 Churoute 84 Badi 85 Meche 86 Lepcha 87 Halkhor 88 Panjabi/sikh 89 Kisan 90 Raji 91 Byasi 92 Hayu 93 Koche 94 Dhniya 95 Walung 96 Jaine 97 Munda 98 Raute 99 Yholmo 100 Pattharkatta/kuswadiya 101 Kusunda 102 Other caste 103 Unidentified caste 212. Result of Interview 212. Result of Interview 212. Result of Interview 212. Result of Interview 212. Result of Interview Result of Interview: 1190 1 2 1 Completed 2 Not completed 3 MIgrated 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? Which religion do you follow mainly in your household? 1165 25 1 8 1 Hindu 2 Bouddha 3 Islam 4 Kirat 5 Jain 6 Christian 7 Shikh 8 Other Sysmiss 214. Total family number 214. Total family number 214. Total family number 214. Total family number 214. Total family number Total family number 1165 25 3 23 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 23 Sysmiss 1190 1 3 1 Control 2 Info Only 3 Info + Cash CO code CO code CO code CO code CO code CO Code 9170 1 600 Household number Household number Household number Household number Household number Household number 9170 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 9170 3 1 2 3 ID CODE ID CODE ID CODE ID CODE ID CODE ID Code 9145 25 1 23 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 99 SKIP Sysmiss 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head Relationship to HH head 9145 25 1 14 1 Head 2 Spouse 3 Son/Daughter 4 Grandchild 5 Parent 6 Brother/Sister 7 Nephew/Niece 8 Son/Daughter-in-law 9 Brother/Sister-in-law 10 Parent-in-law 11 Other relative (grandparents etc) 12 Domestic helper 13 Adopted/foster child 14 Other not related Sysmiss 303. Sex 303. Sex 303. Sex 303. Sex 303. Sex Sex 9145 25 1 2 1 Male 2 Female Sysmiss 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year Age (Completed)? - Year 9145 25 99 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month Age (Completed)? - Month 9145 25 11 1 2 3 4 5 6 7 8 9 10 11 Sysmiss 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? Ask only to those who are aged 5 years and older Can [NAME] read and write a letter in any one language? 7350 1820 1 2 1 Can read/write 2 Can't read/write Sysmiss 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? Ask only to those who are aged 5 years and older Has [NAME] ever attended formal school/ college? No, go to Q308 7350 1820 1 2 1 Yes 2 No Sysmiss 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? Ask only to those who are aged 5 years and older What is the highest grade [NAME] completed 3337 5833 98 CLASS 1 NOT PASSED 1 CLASS 1 2 CLASS 2 3 CLASS 3 4 CLASS 4 5 CLASS 5 6 CLASS 6 7 CLASS 7 8 CLASS 8 9 CLASS 9 10 CLASS 10 11 SLC 12 CLASS 11 13 CLASS 12 OR INTERMEDIATE 14 BACHELOR LEVEL 15 MASTER LEVEL/PH.D 98 DON'T KNOW Sysmiss 308. Marital status 308. Marital status 308. Marital status 308. Marital status 308. Marital status Ask only to those who are aged 5 years and older Marital status 7350 1820 1 4 1 Unmarried 2 Married 3 Divorced/separated 4 Widow/er Sysmiss 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Primary 7350 1820 1 36 1 Self-agri 2 Self-livestock 3 Agri (other) 4 Self/other agri 5 Self-trade/service 6 Self-small/cottage industry 7 Self-middle/big industry 8 Self-construction 9 Self-transportation 10 Self-other 11 Wage-agri 12 Wage-construction skill labour 13 Wage-construction unskilled labour 14 Wage-manufacturing skill labour 15 Wage-manufacturing unskilled labour 16 Wage-other skilled labour 17 Wage-other unskilled labour 18 Labour of transport sector 19 Goverment employee (NIJAMATI) 20 Security force 21 Employee on corporation sector 22 Employee on financial sector 23 Employee of education sector 24 Employee of healthe service 25 Lawer 26 Employee of NGOs/CBOs 27 Student 28 Household duties/child care 29 Retired/old age 30 Disable, can work 31 Disable, can not work 32 Unemployed/seeking work 33 Small age (too young) 35 Foreign employee 36 Other Sysmiss 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Secondary 7350 1820 1 36 1 Self-agri 2 Self-livestock 3 Agri (other) 4 Self/other agri 5 Self-trade/service 6 Self-small/cottage industry 7 Self-middle/big industry 8 Self-construction 9 Self-transportation 10 Self-other 11 Wage-agri 12 Wage-construction skill labour 13 Wage-construction unskilled labour 14 Wage-manufacturing skill labour 15 Wage-manufacturing unskilled labour 16 Wage-other skilled labour 17 Wage-other unskilled labour 18 Labour of transport sector 19 Goverment employee (NIJAMATI) 20 Security force 21 Employee on corporation sector 22 Employee on financial sector 23 Employee of education sector 24 Employee of healthe service 25 Lawer 26 Employee of NGOs/CBOs 27 Student 28 Household duties/child care 29 Retired/old age 30 Disable, can work 31 Disable, can not work 32 Unemployed/seeking work 33 Small age (too young) 34 No secondary occupation 35 Foreign employee 36 Other Sysmiss 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? Is [name] currently residing in this HH? No, go to another 9145 25 1 2 1 Yes 2 No Sysmiss 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? Is this child or mother eligible for interview? 8057 1113 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 1190 1 600 Household number Household number Household number Household number Household number Household number 1190 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1190 3 1 2 3 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? I would like to know more about your housing units used by your household or currently residing. Is this dwelling unit occupied by your household only? 1165 25 1 2 1 Yes 2 No Sysmiss 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? What is the ownership status of the dwelling that your household residing? 1165 25 1 5 1 Own house (Male ownership) 2 Own house (Female ownership) 3 Own house (Joint ownership) 4 No ownership 5 Rented Sysmiss 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? How many rooms are used by your household? 1165 25 10 1 2 3 4 5 6 7 8 9 10 Sysmiss 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? How many stories are there in your household? 1165 25 10 1 2 3 4 6 10 Sysmiss 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? Has your household used separate room as a kitchen? 1165 25 1 2 1 Yes 2 No Sysmiss 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? What is the main flooring material of the house that your family using? 1165 25 1 4 1 Earth/mud 2 Wood/Planks 3 Stone/Brick 4 Cement 5 Other Sysmiss 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? What is the main construction material of the outside wall of the house? (What is the main binding material of the house?) 1165 25 1 9 1 Bamboo/Wood/Cement mix (centre wall) 2 Cement bonded Stones/Bricks/Concrete 3 Mud bonded Stones/Bricks 4 Wood 5 Unbaked Bricks 6 Bamboo and mud 7 Clay, Husk, Mud, Straw, Hay 8 Other 9 No outside walls Sysmiss 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? What is the main construction material of the roof of the house? 1165 25 1 7 1 Hay/Straw 2 Earth/Mud 3 Wood 4 Galvanized iron 5 Concrete/Cement 6 Tiles/Slates/Stone 7 Other Sysmiss 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity Does your household have regular electricity or a power generator or Solar Power? - Regular electricity 1165 25 1 2 1 Yes 2 No Sysmiss 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator Does your household have regular electricity or a power generator or Solar Power? - Power generator 1165 25 1 2 1 Yes 2 No Sysmiss 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power Does your household have regular electricity or a power generator or Solar Power? - Solar power 1165 25 1 2 1 Yes 2 No Sysmiss 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? What is the main source of drinking water? 1165 25 1 12 1 Piped water directly to the household/compound 2 Piped water from a public water tap 3 Private Hand-pump (Shallow) 4 Public Hand-pump (Shallow) 5 Private Hand-pump (Deep) 6 Public Hand-pump (Deep) 7 Covered Well 8 Open Well 9 Stored Rain Water 10 Stone tape 11 River, Pond, Stream, or other open water bodies 12 Neighbour's tube-well 13 Other Sysmiss 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? How many minutes does it take to fetch water? 1165 25 240 1 2 3 4 5 6 7 8 10 12 15 16 20 25 30 60 90 115 120 240 Sysmiss 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main What types of fuel does your household commonly use for cooking and heating? (Main Three) - Main (If none of A, B, or C is 01 go to question 414) 1165 25 1 10 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) Sysmiss 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second What types of fuel does your household commonly use for cooking and heating? (Main Three) - Second (If none of A, B, or C is 01 go to question 414) 1165 25 1 99 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) 99 No 2nd/3rd answer Sysmiss 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third What types of fuel does your household commonly use for cooking and heating? (Main Three) - Third (If none of A, B, or C is 01 go to question 414) 1165 25 1 99 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) 99 No 2nd/3rd answer Sysmiss 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? How many minutes do you walk/bicycle to get one bhari of firewood? 873 317 999 2 4 5 8 9 10 12 15 20 30 40 45 50 60 65 75 90 95 108 118 120 125 140 150 160 170 180 190 192 200 210 220 240 245 280 300 310 320 350 360 420 480 540 660 720 999 Not fetching water Sysmiss 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? What type of toilet does your household use? 1165 25 1 6 1 Flush toilet 2 Covered Pit/Pan within Household Compound 3 Open Pit within Household Compound 4 Community Latrine 5 Other type of Latrine (Specify) 6 No Toilet/Open Defecation Sysmiss 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? How many minutes does it take to get to the nearest market to your house? 1165 25 480 1 2 3 5 7 10 12 15 20 25 30 35 38 40 45 50 60 65 70 75 80 90 120 130 150 160 180 200 210 240 300 360 420 480 Sysmiss 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? Does your household own land? No, go to Q418 1165 25 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 1989 1 600 Household number Household number Household number Household number Household number Household number 1989 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1989 2 1 2 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type Type of land 1989 1 4 1 Household land 2 Farm land 3 Bari/Pakho 4 Baran/forest/etc. 99 SKIP 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit Units 1989 1 2 1 Ropani 2 Bigha 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) Area - Ropani/ Bigha 1989 75 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 17 18 19 20 22 25 40 50 58 74 75 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) Area - Ana/ Kattha 1989 18 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) Area - Paisa/ Dhur 1989 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 20 CO code CO code CO code CO code CO code CO Code 1190 1 600 Household number Household number Household number Household number Household number Household number 1190 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1190 3 1 2 3 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? Does your household have a garden where you grow vegetables? No, go to 420 1165 25 1 2 1 Yes 2 No Sysmiss 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? For what purpose, do you grow vegetables? 473 717 1 3 1 Household consumption 2 Selling 3 Both Sysmiss 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? Has your household owned any livestock? 1165 25 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 19830 1 600 Household number Household number Household number Household number Household number Household number 19830 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 19830 3 1 2 3 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item List the particulars of the expenditure that your family made to the following items during the past 30 days. - Item 19805 25 1 17 1 Fuel (Wood, Kerosene, LPG, etc.) 2 Clothes, Apparel 3 Personal care items (Soap, Comb, Shampoo, cosmetics, etc.) 4 Transportation (Horse, Mule, Bus, Taxi, Rickshaw, etc) 5 Entertainment/Excursion (Movies, picnics, melas, etc) 6 Newspapers, Books, Copies, etc. 7 Educational and Professional Services 8 Medicines and Health Services 9 Legal Expenses and Insurance 10 Repair/Maintenance of House and Household Effects and electrician, plumber, etc. 11 Religious, Marriage, Funeral, etc. expenses 12 Donations/gifts 13 Electricity, Water, etc. 14 Household goods 15 Agri. related goods 16 Ornaments, land, livestock etc. purchase 17 Other Sysmiss 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) List the particulars of the expenditure that your family made to the following items during the past 30 days. - Amount (Rupees) 19805 25 600000 CO code CO code CO code CO code CO code CO Code 14005 1 600 Household number Household number Household number Household number Household number Household number 14005 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 14005 3 1 2 3 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income List the particulars of the income of your family during the past 12 months. - Particulars of Income 13980 25 1 12 1 Agriculture (Agriculture, NTFP, Livestock, etc) 2 Non-Agriculture Enterprise 3 From within the home town 4 Inside the country 5 Outside the country 6 Old age pension/allowances 7 Widow pension/Allowances 8 Disability allowances 9 Other social protection program payments 10 Income from interest, bonus, profit, commission, fees, royalties, etc 11 Prize 12 Other Sysmiss 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) List the particulars of the income of your family during the past 12 months. - Annual Income (Rupees) 13980 25 1800000 CO code CO code CO code CO code CO code CO Code 1190 1 600 352.824369747899 164.694447295456 Household number Household number Household number Household number Household number Household number 1190 1 46 12.4260504201681 8.42914326683102 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1190 3 0.0201680672268908 0.191308113444256 1 2 3 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? How many borrowed loans does your household have over the past 12 months? None ➔ 505 1165 25 12 2.01030042918455 1.73697321239926 None 1 2 3 4 5 6 7 8 9 10 12 Sysmiss 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed What was or is the annual rate of interest of the most recent loan borrowed? 955 235 96 32.2376963350785 14.7681431936373 4 5 6 7.5 8 9 10 12 12.5 15 16 17 18 20 24 25 30 34 36 46 48 50 56 60 72 96 Sysmiss CO code CO code CO code CO code CO code CO Code 40800 1 600 Household number Household number Household number Household number Household number Household number 40800 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 40800 3 1 2 3 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - Food items 40775 25 1 35 1 Rice 2 Beaten rice 3 Maize 4 Wheat 5 Barley/Oat/Sorghum 6 Millet/ Buckwheat 7 Pulses 8 Gram/Pea 9 Other beans 10 Fish 11 Meat 12 Egg 13 Milk 14 Curd/Whey etc. 15 Baby/Powder milk 16 Ghee 17 Honey 18 Vegetable ghee 19 Oil (Mustard, Soyabean, etc.) 20 Potato/Colocasia 21 Onion 22 Green leafy vegetables 23 Other vergetables (cauliflower, okra, etc) 24 Fruits/nuts 25 Salt 26 Other Spices (scumin seed, marich, garlic, ginger, chillies, etc.) 27 Sugar 28 Sakhar/Gud/Khudo 29 Sweets 30 Tea/Coffee 31 Alcoholic beverages (Jand, Wine, Beer, etc.) 32 Non-alcoholic beverages (Coke, Frooti, Sarbat, etc.) 33 Tobacco and tobacco products 34 Noodles and Biscuits 35 Other Foods Sysmiss 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - How much [QUANTITY] did you consume [FOOD] in in the previous 24 hours? - Quantity (If none, write 0 and ➔Next item) 40775 25 800 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - How much [QUANTITY] did you consume [FOOD] in in the previous 24 hours? - Unit (If none, write 0 and ➔Next item) 14182 26618 1 10 1 Kilogram 2 Gram 3 Litre 4 Ml 5 Pathi 6 Mana 7 Kuruwa 8 Number 9 Dozen 10 Spoons Sysmiss CO code CO code CO code CO code CO code CO Code 11675 1 600 Household number Household number Household number Household number Household number Household number 11675 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 11675 3 1 2 3 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Type of shock 11650 25 1 10 1 Getting a new job of any kind 2 Inheritance 3 Death of HH member 4 Accidental or Violent injury 5 Loss of employment of any kind 6 Failure/loss of business 7 Livestock died 8 Crop disease/pests 9 Theft/robbery/burglary/assault 10 Drought/floods Sysmiss 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Has the household experienced the shock? No, go to Next item 11650 25 1 2 1 Yes 2 No Sysmiss 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Who did this shock affect? 970 10705 1 3 1 Just this household 2 Several HHs in the village 3 All HHs in the village Sysmiss 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - What was the strength of this shock? 970 10705 1 5 1 Not important 2 Mild 3 Average 4 Quite strong 5 Very strong Sysmiss CO code CO code CO code CO code CO code CO Code 1314 1 600 Household number Household number Household number Household number Household number Household number 1314 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1314 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1314 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the Were you or any of your children who are younger than 36 months sick in the last 30 days? No, go to Section 7 1314 1 2 1 Yes 2 No ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) CHECK: Number person that was sick (Sec 06) 847 467 4 1 2 3 4 Sysmiss CO code CO code CO code CO code CO code CO Code 1148 1 600 Household number Household number Household number Household number Household number Household number 1148 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1148 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1148 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 ID Code ID Code ID Code ID Code ID Code ID CODE (Enter from section 3) 1148 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 99 SKIP 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d What type of illness does [NAME] suffer from last time during the past 30 days? 1148 1 18 1 Diarrhoea 2 Dysentry 3 Pneumonia/Cough 4 Malaria 5 Other fever 6 Skin disease 7 TB 8 Measles 9 Jaundice 10 Parasites 11 Injury 12 Pregnancy related complications 13 Stomach-ache 14 STDs/STIs 15 Eye-ache 16 Head-ache 17 Orthopedic 18 Other 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q Where did [NAME] go for the first consultation of the illness reported in Q.603? Not consulted, go to 606 1148 1 12 1 SHP 2 HP 3 PHC 4 Govt. hospital 5 Mobile clinic 6 Ayurvedic centre 7 Pharmacy/Clinic 8 Pvt. hospital 9 Health worker's home 10 Traditional healer 11 GHUMTI SIBIR 12 Not consulted 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? Whom did [NAME] first consult with of the illness reported in Q.603? → Go To Next Member 1060 88 1 5 1 Doctor 2 Paramedic (HA,SAHW, AHW, ANM) 3 Kaviraj/Vaidya 4 Untrained Pharmacist 5 Traditional Healer 6 Other Sysmiss 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? Why didn't you consult for the illness? 88 1060 1 7 1 No money 2 Illness not serious 3 Health worker far 4 No good health worker 5 Treatment expensive 6 Don't know about health institution 7 Pregnant Sysmiss CO code CO code CO code CO code CO code CO Code 1128 1 600 Household number Household number Household number Household number Household number Household number 1128 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1128 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? Now I’d like to ask you some questions about the nutrition for under 2 children. In your opinion, what should be done with the first milk (colostrums)? 1128 1 8 1 Given to baby 2 Thrown away 3 Other 8 Do not know 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but In your opinion, for how long should a newborn infant be given nothing but breast milk? 1128 1 8 1 Less than 6 months 2 6 months 3 More than 6 months 8 Do not know CO code CO code CO code CO code CO code CO Code 18048 1 600 Household number Household number Household number Household number Household number Household number 18048 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 18048 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 18048 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item In your opinion, what foods are best to feed children aged 6-24 months 30 days in addition to breast milk? - Item 18048 1 16 1 Porridge that is not enriched with other foods 2 Porridge that is enriched with other foods/sarbottam pitho 3 Yellow, orange and green vegetables 4 Fruits 5 Eggs 6 Milk or yogurt 7 Chicken or meat including liver 8 Ghee, butter, or oil 9 Lentils/pulses 10 Biscuit 11 Cerelac 12 Horlicks 13 Noodles 14 Vitamin 15 Bread 16 Others 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? In your opinion, what foods are best to feed children aged 6-24 months 30 days in addition to breast milk? - Mentioned/Not mentioned 18048 1 2 1 Mentioned 2 Not mentioned CO code CO code CO code CO code CO code CO Code 1128 1 600 Household number Household number Household number Household number Household number Household number 1128 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1128 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition How many times a day should a 6-11 month old baby be fed a meal in addition to breast milk? 1128 1 98 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 25 98 Do not know 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to How many snacks a day should a 12-24 month old baby be given in addition to breast milk? 1128 2 98 2 3 4 5 6 7 8 9 10 11 12 14 15 16 20 98 Do not know 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha In your opinion, should you breastfeed your baby less, the same or more than usual during an episode of diarrhea? 1128 1 8 1 Less than usual 2 Same as usual 3 More than usual 8 Do not know 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for Now I’d like to ask you some questions about the nutrition for women. In your opinion, at least how many times should a pregnant mother visit for ANC check up, 1, 2, 3, 4 or more? 1128 98 1 2 3 4 5 6 7 8 9 10 98 Do not know 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? When should a pregnant woman start iron supplementation (in months)? 1128 1 98 1 2 3 4 5 6 7 8 98 Do not know 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? When should a pregnant woman take deworming tablets (in months)? 1128 98 1 2 3 4 5 6 7 8 9 98 Do not know 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within When should a recently delivered woman take Vitamin A capsule (within days of delivery)? 1128 1 98 1 2 3 4 5 6 7 8 9 10 12 13 15 17 20 21 22 25 27 30 35 36 40 42 45 50 60 90 98 Do not know 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same In your opinion, is it best for a pregnant woman to eat less food, the same amount or more food than she ate before becoming pregnant? 1128 1 8 1 More than usual 2 Same as usual 3 Less than usual 8 Do not know CO code CO code CO code CO code CO code CO Code 15792 1 600 Household number Household number Household number Household number Household number Household number 15792 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 15792 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 15792 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item In your opinion, what are good foods for a woman to eat during her pregnancy? - Item 15792 1 14 1 Yellow, orange and green vegetables 2 Fruit 3 Eggs 4 Milk or yogurt 5 Meat 6 Beans/pulses 7 Rice 8 Bread 9 Horlicks 10 Vitamin 11 Noodles 12 Biscuit 13 HALUWA 14 Others 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? In your opinion, what are good foods for a woman to eat during her pregnancy? - Mentioned/Not mentioned 15792 1 2 1 Mentioned 2 Not Mentioned CO code CO code CO code CO code CO code CO Code 9024 1 600 Household number Household number Household number Household number Household number Household number 9024 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 9024 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 9024 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice Now I would like to ask you about health, tobacco and alcohol consumption With whom do you usually seek advice on maternal and child health issues? - People giving advice 9024 1 8 1 FCHV 2 AAMA Mothers group 3 MCHW/VHW 4 Other Health Workers 5 Local private pharmacy 6 Traditional healers 7 Family members 8 Other 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? With whom do you usually seek advice on maternal and child health issues? - Yes/No 9024 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 1128 1 600 Household number Household number Household number Household number Household number Household number 1128 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1128 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? What kind of salt do you normally use in your house? 1128 1 2 1 Aayunoon/Two child logo salt 2 Other salt 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? Are you smoking, chewing tobacco and drinking alcohol regularly? 1128 1 4 1 Yes smoking and taking tobacco 2 Yes drinking alcohol 3 Yes taking both 4 No, taking nothing 716. Rank the most important: A. Health 716. Rank the most important: A. Health 716. Rank the most important: A. Health 716. Rank the most important: A. Health 716. Rank the most important: A. Health Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Health - Rank 1128 1 4 1 2 3 4 716. Rank the most important: B. Food 716. Rank the most important: B. Food 716. Rank the most important: B. Food 716. Rank the most important: B. Food 716. Rank the most important: B. Food Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Food - Rank 1128 1 4 1 2 3 4 716. Rank the most important: C. Education 716. Rank the most important: C. Education 716. Rank the most important: C. Education 716. Rank the most important: C. Education 716. Rank the most important: C. Education Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Education - Rank 1128 1 4 1 2 3 4 716. Rank the most important: D. Security 716. Rank the most important: D. Security 716. Rank the most important: D. Security 716. Rank the most important: D. Security 716. Rank the most important: D. Security Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Security - Rank 1128 1 4 1 2 3 4 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai What is the highest level of education that you think your child will obtain? 1128 98 CLASS 1 NOT PASSED 1 CLASS 1 2 CLASS 2 3 CLASS 3 4 CLASS 4 5 CLASS 5 6 CLASS 6 7 CLASS 7 8 CLASS 8 9 CLASS 9 10 CLASS 10 11 SLC 12 CLASS 11 13 CLASS 12 OR INTERMEDIATE 14 BACHELOR LEVEL 15 MASTER LEVEL/PH.D 98 DON'T KNOW 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? In the past month, have you been to a CO meeting? 1128 1 2 1 Yes 2 No 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? Do you think your child will work in agriculture or industry? 1128 1 5 1 Agriculture 2 Industry 3 Foreign employee 4 Service 5 Other CO code CO code CO code CO code CO code CO Code 1128 1 600 Household number Household number Household number Household number Household number Household number 1128 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1128 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? How old were you when you got married? 1128 10 30 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 27 28 29 30 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? Was the marriage arranged? 1128 1 2 1 Yes 2 No 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? Are you currently pregnant? No, go to 806 1128 1 2 1 Yes 2 No 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? How long have you been pregnant for? 151 977 9 1 2 3 4 5 6 7 8 9 Sysmiss 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? Is this your first pregnancy? 1) Yes, go to Section 10 2) No, and other kid(s) died, go to Section 10 151 977 1 3 1 Yes 2 No, and have kids who are alive 3 No, and other kid(s) died Sysmiss 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece During your pregnancy with your youngest child (name:___________), how many times did you receive antenatal care? 1106 22 15 1 2 3 4 5 6 7 8 9 10 15 Sysmiss 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? Did you receive TT injection at any time during this pregnancy (with name)? No, go to 809 1106 22 1 2 1 Yes 2 No Sysmiss 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv While pregnant with (name of youngest child), how many times did you receive such an injection? 1012 116 1 9 1 2 3 4 5 9 Sysmiss 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron When you were pregnant with (name of youngest child), did you receive iron tablets? No, go to 812 1106 22 1 2 1 Yes 2 No Sysmiss 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? How many days during your pregnancy did you take the iron tablets? 921 207 1 999 CO code CO code CO code CO code CO code CO Code 6447 1 600 Household number Household number Household number Household number Household number Household number 6447 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 6447 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 6447 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken If yes, from where? - Place where the tablets were taken 6447 1 7 1 FCHV 2 Health Facility 3 Clinic/pharmacy 4 Hospital 5 NGOs/INGOs 6 Privat nursing home 7 Other 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? If yes, from where? - Yes/No 6447 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 1128 1 600 Household number Household number Household number Household number Household number Household number 1128 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1128 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1128 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? During your last pregnancy, (with name) did you take de-worming tablet? 1106 22 1 2 1 Yes 2 No Sysmiss 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? Did you suffer from night blindness or ratandho in your last pregnancy? 1106 22 1 2 1 Yes 2 No Sysmiss 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? Where did you give birth in your most recent delivery? 1106 22 1 6 1 Home 2 Government hospital 3 PHC/HP/SHP 4 Private hospital/nursing home 5 Field/jungle 6 Road/Vehicle Sysmiss 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? Who assisted with your most recent delivery? 1106 22 1 9 1 Doctor 2 Staff nurse/ANM 3 HA/AHW 4 MCHW 5 FCHV 6 TBA 7 Untrained household member/neighbor 8 Other 9 No one Sysmiss 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? In the first 42 days after delivery, did you take Vitamin A capsules? No, go to 818 1106 22 1 2 1 Yes 2 No Sysmiss 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? If yes, from where did you receive? 642 486 1 3 1 FCHV 2 Health workers 3 Shop/Medical 4 Other Sysmiss 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? Are you or your husband currently using any family planning method? 1106 22 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 1106 1 600 Household number Household number Household number Household number Household number Household number 1106 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1106 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? Did you ever breastfeed to your youngest child (name of child)? 1106 1 2 1 Yes 2 No 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast How long after giving birth did you first put (name of child) to the breast? 1096 10 720 1 2 3 4 5 6 7 8 9 10 12 15 16 20 23 24 30 35 36 48 50 52 55 60 70 72 90 96 120 130 144 240 720 Sysmiss 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid During the first three days after delivery, did you give (name) the liquid that came from your breasts? 1096 10 1 2 1 Yes 2 No Sysmiss 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink In the first three days after delivery, was (name) given anything to drink other than breast milk? No, go to 906 1106 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 2928 6 600 Household number Household number Household number Household number Household number Household number 2928 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 32 35 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 2928 2 1 2 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 2928 1 15 1 2 3 4 5 6 7 8 9 10 12 13 14 15 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food What was (name) given to drink during that time? Anything else? - Liquid Food 2928 1 12 1 Milk (other than breast milk) 2 Other mother milk 3 Plain water 4 Sugar or glucose water 5 Gripe water 6 Sugar-salt-water solution 7 Fruit juice 8 Infant formula 9 Honey 10 Ghee 11 Milk pouder 12 Others 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? What was (name) given to drink during that time? Anything else? - Fed/Not fed 2928 1 2 1 Fed 2 Not fed CO code CO code CO code CO code CO code CO Code 1106 1 600 Household number Household number Household number Household number Household number Household number 1106 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1106 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? For how many months did you exclusively breastfeed (name)? 1106 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 24 25 99 Still breastfeeding 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? For how many months did you breastfeed (name)? 1106 99 3 4 6 7 8 9 10 11 12 14 15 16 17 18 20 22 24 25 26 28 30 34 35 36 48 52 99 Still breastfeeding 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? ENUMERATOR: Is [name] younger than 24 months or older? 1106 1 3 1 Younger than 24 m 30 d 2 Older than 24 m 30 d 3 Child dead 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? Are you still breastfeeding (name)? No, go to 911 805 301 1 2 1 Yes 2 No Sysmiss 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 How often did you breastfeed your child (name) day and night during last 24 hours? Go to Q911 if answer is 0, if more than that go to Q912 760 346 35 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 28 30 35 Sysmiss CO code CO code CO code CO code CO code CO Code 329 25 596 25 34 163 179 204 210 239 253 256 262 287 345 408 420 422 427 461 462 463 464 465 472 474 475 503 507 512 514 582 584 595 596 Household number Household number Household number Household number Household number Household number 329 1 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 20 24 29 30 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 329 2 2 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 329 1 14 1 2 3 4 6 7 8 9 14 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding If not breastfeeding, why not? - Reasons for not breastfeeding 329 1 7 1 No milking 2 Inadequacy of breastmilks 3 Work load/lack of time 4 Child ill 5 Pregnant 6 Mother is/was sick 7 Other 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? If not breastfeeding, why not? - Yes/No 329 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 1106 1 600 Household number Household number Household number Household number Household number Household number 1106 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1106 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste Did (name) drink anything milk or liquidy from a bottle with a nipple yesterday or last night? 805 301 1 8 1 Yes 2 Nothing 8 Do not know Sysmiss CO code CO code CO code CO code CO code CO Code 19320 2 600 Household number Household number Household number Household number Household number Household number 19320 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 36 37 39 41 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 19320 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 19320 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item Now I would like to ask you about (other) liquids or foods that (name) may have had yesterday during the day or at night. (Ask all items one after another) Did (name) drink/eat:? - Item 19320 1 24 1 Breast milk 2 Plain water 3 Milk such as commercially produced infant formula 4 Any fortified, commercially available infant and young child food 5 Any other porridge or gruel 6 Fresh animal milk 7 Yogurt or other milk products 8 Rice, chapattis other foods made from grains such as millet, maize, lito 9 White potatoes or other [roots] tubers 10 Pupmkin, carrots, or other yellow or orange vegetables 11 Ripe mangoes, papaya, or other yellow or orange fruits 12 Any dark green leafy vegetables 13 Other fruits such as banana, orange, apple 14 Eggs 15 Any meat such as goat, lamb, chicken, pork, ducks 16 Any organ meat such as liver, kidney 17 Fresh or dried fish or shellfish/dried meat 18 Snails or other small protein foods 19 Lentils, beans, peas, or nuts 20 Any oils, fats or foods made with any of these foods 21 Tea 22 Sugary foods such as sweets, chocolate 23 Processed foods such as biscuits, noodles 24 Any other solid or soft foods/JAAND 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? Now I would like to ask you about (other) liquids or foods that (name) may have had yesterday during the day or at night. (Ask all items one after another) Did (name) drink/eat:? - Code 19320 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 1106 1 600 Household number Household number Household number Household number Household number Household number 1106 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1106 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo How many times did (name) youngest child eat solid, semi-solid, or soft food other than liquids yesterday during the day or at night? 805 301 98 1 2 3 4 5 6 7 8 9 10 12 14 15 98 Do not know Sysmiss CO code CO code CO code CO code CO code CO Code 10245 2 600 361.803806734993 161.120547094923 Household number Household number Household number Household number Household number Household number 10245 1 46 12.1244509516837 8.35951693187491 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 36 37 39 41 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 10245 3 0.0248901903367496 0.218406470417431 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 10245 1 16 3.76573938506589 2.67491883932387 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food What type of food consistency is usually given to the child? - Type of food 10245 1 15 8 4.32070467302899 1 Solid (Dal Bhat Vegetable) 2 Semi-solid (Jaulo/Porridge) 3 Mashed/pureed 4 Liquidy 5 Milk 6 Biscuit 7 Horlicks 8 Cerelac 9 HALUWA 10 Noodles 11 Egg 12 Meat 13 Bread 14 Fruits 15 Others 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given What type of food consistency is usually given to the child? - Given/Not given 10245 1 2 1.67847730600293 0.467083660846072 1 Given 2 Not given CO code CO code CO code CO code CO code CO Code 1106 1 600 Household number Household number Household number Household number Household number Household number 1106 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1106 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1106 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? Did the child receive vitamin A capsule within the last 6 months? 805 301 1 3 1 Yes 2 No 3 Child below 6 months old Sysmiss 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d How many hours were you away from your child due to work or other reasons during the past 24 hours? 805 301 10 1 2 3 4 5 6 7 8 9 10 Sysmiss 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the Did you say you would feed the baby later when he/she (name) expressed the desire for it (within the last 24 hours)? 187 919 1 2 1 I did 2 I did not Sysmiss CO code CO code CO code CO code CO code CO Code 1314 1 600 Household number Household number Household number Household number Household number Household number 1314 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1314 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Eligible Woman -HH Roster 1314 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 21 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) Now, I would like to talk to you about your physical feature and request for measuring weight and height Weight of the female respondent (in kilograms) 1128 186 27.1000003814697 86 998 Could not weigh Sysmiss 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) Height of the female respondent (in centimeters) 1128 186 130.5 170 998 Could not measure Sysmiss 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? [If this is 0, it is the end of the interview.] 1314 4 1 2 3 4 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? - Interviewed 1262 52 4 1 2 3 4 Sysmiss 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) Weight of mother holding child #1 (kilograms) 1262 52 30.5 999 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 ID CODE OF CHILD 1 (HH Roster) 784 530 3 22 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 22 Sysmiss 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) Weight of mother holding child #2 (kilograms) 353 961 33.5999984741211 999 33.5999984741211 40.9000015258789 41 41.5999984741211 42 42.0999984741211 43 43.2999992370605 43.5 44.0999984741211 44.2999992370605 44.7000007629395 45 45.5999984741211 46.7000007629395 48 48.2000007629395 48.2999992370605 48.4000015258789 48.5 48.5999984741211 49 49.0999984741211 49.5 49.7999992370605 50 51 51.5999984741211 51.7999992370605 52 52.5 52.5999984741211 52.7999992370605 52.9000015258789 53 53.4000015258789 54 54.7999992370605 54.9000015258789 55 55.5 55.7999992370605 57.7999992370605 58.2000007629395 58.5 58.7000007629395 60.7000007629395 63 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 ID CODE OF CHILD 2 (HH Roster) 63 1251 4 23 4 5 6 7 8 9 10 11 13 15 23 Sysmiss 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) Weight of mother holding child #3 (kilograms) 17 1297 42.5 999 42.5 49.4000015258789 50 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 ID CODE OF CHILD 3 (HH Roster) 3 1311 5 9 5 8 9 Sysmiss 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) Weight of mother holding child #4 (kilograms) 5 1309 999 999 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 ID CODE OF CHILD 4 (HH Roster) 1314 * Sysmiss CO code CO code CO code CO code CO code CO Code 1410 1 600 Household number Household number Household number Household number Household number Household number 1410 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1410 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 1410 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child ID CODE of Children 1410 3 23 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 22 23 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD Date of Birth of Child - Day 1410 1 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM Date of Birth of Child - Month 1410 1 12 1 2 3 4 5 6 7 8 9 10 11 12 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY Date of Birth of Child - Year 1410 2067 2071 2067 2068 2069 2070 2071 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? Was there any problem at delivery of this child (delivery complications)? 1410 1 2 1 Yes 2 No 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? How long was the child breastfed? 1410 99 Not breastfed 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 23 24 25 26 27 28 30 34 36 99 Currently breastfeeding 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? Has child been occulated? 1410 1 3 1 Fully occulated 2 Being fully occulated 3 Not occulated 1011. Height of Child 1011. Height of Child 1011. Height of Child 1011. Height of Child 1011. Height of Child Height of Child If height not measured record 999 and go to Q1013 1410 40 999 999 Not measured 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing Height is measured laying or standing 1381 29 1 2 1 Laying 2 Standing Sysmiss 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child Weight of Child If weight not measured record 999 and go to Q1015 1410 1.89999997615814 999 999 Not measured 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? Was child weighed with the mother or alone? → Go To Next Member 1388 22 1 2 1 Alone 2 With mum Sysmiss 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight Reason for not taking Height/Weight (If you filled out 999 for question 1011 or 1013) 22 1388 1 3 1 Child not at home 2 Child was sick 3 Not allowed to take Height/Weight Sysmiss CO code CO code CO code CO code CO code CO Code 1410 1 600 Household number Household number Household number Household number Household number Household number 1410 1 46 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 39 41 45 46 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 1410 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Respondent -HH Roster 1410 1 21 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 21 ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child ID Code of Child (See HH Roster) 1410 3 23 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 22 23 Age of chid (month) Age of chid (month) Age of chid (month) Age of chid (month) Age of chid (month) Age of Child 1410 1 52 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun Does your baby sometimes make throaty or gurgling sounds? 45 1365 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, Does your baby make cooing sounds such as “ooo,” “gah,” and “aah”? 45 1365 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back When you speak to your baby, does she make sounds back to you? 45 1365 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? Does your baby smile when you talk to him? 72 1338 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? Does your baby chuckle softly? 72 1338 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile After you have been out of sight, does your baby smile or get excited when she sees you? 72 1338 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? Does your baby make high-pitched squeals? 85 1325 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo Does your baby make sounds when looking at toys or people? 149 1261 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does If you call your baby when you are out of sight, does she look in the direction of your voice? 149 1261 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w When a loud noise occurs, does your baby turn to see where the sound came from? 122 1288 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby If you copy the sounds your baby makes, does your baby repeat the same sounds back to you? 221 1189 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s Does your baby respond to the tone of your voice and stop his activity at least briefly when you say “no-no” to him? 221 1189 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? Does your baby make two similar sounds like “ba-ba,” “da-da,” or “ga-ga”? (The sounds do not need to mean anything.) 247 1163 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur If you ask your baby to, does he play at least one nursery game even if you don’t show him the activity yourself (such as “bye-bye,” “Peeka- boo,” “clap your hands,” “So Big”)? 183 1227 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com Does your baby follow one simple command, such as “Come here,” “Give it to me,” or “Put it back,” without your using gestures? 267 1143 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, Does your baby say three words, such as “Mama,” “Dada,” and “Baba”? (A “word” is a sound or sounds your baby says consistently to mean someone or something.) 183 1227 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po When your baby wants something, does he tell you by pointing to it? 278 1132 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y Does your baby shake his head when he means “no” or “yes”? 168 1242 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur Does your baby point to, pat, or try to pick up pictures in a book? 138 1272 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? Does your baby say four or more words in addition to “Mama” and “Dada”? 194 1216 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro When you ask her to, does your baby go into another room to find a fa- miliar toy or object? (You might ask, “Where is your ball?” or say, “Bring me your coat,” or “Go get your blanket.”) 194 1216 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat,” “Daddy play,” “Go home,” or “What’s this?” does your child say both words back to you? (Mark “yes” even if her words are difficult to understand.) 178 1232 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the Without your showing him, does your child point to the correct picture when you say, “Show me the kitty,” or ask, “Where is the dog?” (He needs to identify only one picture correctly.) 351 1059 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent Does your child say two or three words that represent different ideas together, such as “See dog,” “Mommy come home,” or “Kitty gone”? (Don’t count word combinations that express one idea, such as “bye- bye,” “all gone,” “all right,” and “What’s that?”) 297 1113 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, “What is this?” does your child correctly name at least one picture? 345 1065 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges Without your giving him clues by pointing or using gestures, can your child carry out at least three of these kinds of directions? A) "Put the toy on the table" B) "Close the door" C) "Bring me a towel" D) "Find your coat" E) "Take my hand" F) "Get your book” 678 732 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha When you ask your child to point to her nose, eyes, hair, feet, ears, and so forth, does she correctly point to at least seven body parts? (She can point to parts of herself, you, or a doll. Mark “sometimes” if she cor- rectly points to at least three different body parts.) 678 732 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like Does your child correctly use at least two words like “me,” “I,” “mine,” and “you”? 277 1133 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four Does your child make sentences that are three or four words long? Please give an example: 437 973 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge Without giving your child help by pointing or using gestures, ask him to “put the book on the table” and “put the shoe under the chair.” Does your child carry out both of these directions correctly? 437 973 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y When looking at a picture book, does your child tell you what is hap- pening or what action is taking place in the picture (for example, “bark- ing,” “running,” “eating,” or “crying”)? You may ask, “What is the dog (or boy) doing?” 333 1077 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say When you ask, “What is your name?” does your child say his first name or nickname? 333 1077 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire Without your giving help by pointing or repeating directions, does your child follow three directions that are unrelated to one another? Give all three directions before your child starts. For example, you may ask your child, “Clap your hands, walk to the door, and sit down,” or “Give me the pen, open the book, and stand up.” 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to Does your child use all of the words in a sentence (for example, “a,” “the,” “am,” “is,” and “are”) to make complete sentences, such as “I am going to the park,” or “Is there a toy to play with?” or “Are you coming, too?” 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo Does your child name at least three items from a common category? For example, if you say to your child, “Tell me some things that you can eat,” does your child answer with something like “cookies, eggs, and cereal”? Or if you say, “Tell me the names of some animals,” does your child answer with something like “cow, dog, and elephant”? 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? Does your child answer the following questions? 1. “What do you do when you are hungry?” (Acceptable answers include “get food,” “eat,” “ask for something to eat,” and “have a snack.”) 2. “What do you do when you are tired?” (Acceptable answers include “take a nap,” “rest,” “go to sleep,” “go to bed,” “lie down,” and “sit down.”) 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com Does your child tell you at least two things about common objects? For example, if you say to your child, “Tell me about your ball,” does she say something like, “It’s round. I throw it. It’s big”? 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- Does your child use endings of words, such as “-s,” “-ed,” and “-ing”? For example, does your child say things like, “I see two cats,” “I am playing,” or “I kicked the ball”? 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For Does your child use four- and five-word sentences? For example, does your child say, “I want the car”? 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do When talking about something that already happened, does your child use words that end in “-ed,” such as “walked,” “jumped,” or “played”? Ask your child questions, such as “How did you get to the store?” (“We walked.”) “What did you do at your friend’s house?” (“We played.”) 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier Does your child use comparison words, such as “heavier,” “stronger,” or “shorter”? Ask your child questions, such as “A car is big, but a bus is _____” (bigger); “A cat is heavy, but a man is _____” (heavier); “A TV is small, but a book is _____” (smaller). 1410 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back Does your child repeat the sentences shown below back to you, with- out any mistakes? (Read the sentences one at a time. You may repeat each sentence one time.) Jane hides her shoes for Maria to find. Al read the blue book under his bed. 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an While your baby is on his back, does he wave his arms and legs, wiggle, and squirm? 45 1365 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to When your baby is on her tummy does she turn her head to the side? 45 1365 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up longer than a few seconds? 45 1365 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? When your baby is on her back, does she kick her legs? 72 1338 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b After holding her head up while on her tummy does your baby lay her head down on the floor, rather than let it drop or fall forward? 72 1338 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up so that his chin is about 3 inches from the floor for at least 15 seconds? 72 1338 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s When your baby is on her tummy, does she hold her head straight up, looking around? 27 1383 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby When you hold him in a sitting position, does your baby hold his head steady? 85 1325 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his While your baby is on his back, does your baby lift his legs high enough to see his feet? 85 1325 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting Does your baby roll from his back to his tummy, getting both arms out from under him? 122 1288 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he When you put your baby on the floor, does she lean on her hands while sitting? (If she already sits up straight without leaning on her hands, mark “yes” for this item.) 122 1288 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he support his own weight while standing? 221 1189 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u Does your baby get into a crawling position by getting up on her hands and knees? 221 1189 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support? 163 1247 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support? 247 1163 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi Does your baby walk beside furniture while holding on with only one hand? 183 1227 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he take several steps without tripping or falling? (If your baby already walks alone, mark “yes” for this item.) 267 1143 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s When you hold one hand just to balance your baby, does she take several steps forward? (If your baby already walks alone, mark “yes” for this item.) 168 1242 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi Does your baby stand up in the middle of the floor by himself and take several steps forward? 222 1188 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f Does your baby bend over or squat to pick up an object from the floor and then stand up again without any support? 222 1188 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr Does your baby move around by walking, rather than by crawling on his hands and knees? 194 1216 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? Does your child walk well and seldom fall? 178 1232 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re Does your child climb on an object such as a chair to reach something he wants (for example, to get a toy on a counter or to “help” you in the kitchen)? 262 1148 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of Does your child walk down stairs if you hold onto one of her hands? She may also hold onto the railing or wall. (You can look for this at a store, on a playground, or at home.) 257 1153 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does When you show your child how to kick a large ball, does he try to kick the ball by moving his leg forward or by walking into it? (If your child already kicks a ball, mark “yes” for this item.) 297 1113 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou Does your child run fairly well, stopping herself without bumping into things or falling? 610 800 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step Does your child walk either up or down at least two steps by himself? He may also hold onto the railing or wall. 453 957 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at Does your child jump with both feet leaving the floor at the same time? 610 800 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi Without holding onto anything for support, does your child kick a ball by swinging his leg forward? 610 800 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e Does your child walk up stairs, using only one foot on each stair? (The left foot is on one step, and the right foot is on the next.) She may hold onto the railing or wall. 531 879 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit Does your child stand on one foot for about 1 second without holding onto anything? 437 973 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by While standing, does your child throw a ball overhand by raising his arm to shoulder height and throwing the ball forward? (Dropping the ball or throwing the ball underhand should be scored as “not yet.”) 225 1185 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both Does your child jump forward at least 6 inches with both feet leaving the ground at the same time? 124 1286 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? Does your child catch a large ball with both hands? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro Does your child climb the rungs of a ladder of a playground slide and slide down without help? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l Does your child hop up and down on either the right or left foot at least one time without losing her balance or falling? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro Does your child jump forward a distance of 20 inches from a standing position, starting with his feet together? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on Without holding onto anything, does your child stand on one foot for at least 5 seconds without losing her balance and putting her foot down? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t Does your child walk on his tiptoes for 15 feet (about the length of a large car)? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o Does your child hop forward on one foot for a distance of 4–6 feet without putting down the other foot? 1410 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? Does your child skip using alternating feet? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o Does your baby grasp your finger if you touch the palm of her hand? 45 1365 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i When you put a toy in his hand, does your baby hold it in his hand briefly? 72 1338 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? Does your baby touch her face with her hands? 45 1365 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h Does your baby hold his hands open or partly open when he is awake (rather than in fists, as they were when he was a newborn)? 45 1365 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? Does your baby grab or scratch at her clothes? 72 1338 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a When you put a toy in her hand, does your baby wave it about, at least briefly? 72 1338 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto When you put a toy in her hand, does your baby hold onto it for about 1 minute while looking at it, waving it about, or trying to chew it? 27 1383 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she When you hold your baby in a sitting position, does she reach for a toy on a table close by, even though her hand may not touch it? 85 1325 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave Does your baby grab a toy you offer and look at it, wave it about, or chew on it for about 1 minute? 85 1325 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands Does your baby reach for or grasp a toy using both hands at once? 122 1288 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it Does your baby reach for a crumb or Cheerio and touch it with his finger or hand? 122 1288 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce Does your baby pick up a small toy, holding it in the center of her hand with her fingers around it? 122 1288 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? Does your baby pick up a small toy with only one hand? 221 1189 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion? 163 1247 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o After one or two tries, does your baby pick up a piece of string with her first finger and thumb? (The string may be attached to a toy.) 247 1163 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it Does your baby put a small toy down, without dropping it, and then take her hand off the toy? 267 1143 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? Does your baby help turn the pages of a book? 321 1089 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot Does your baby throw a small ball with a forward arm motion? 377 1033 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot Does your baby stack a small block or toy on top of another one? 425 985 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of Does your baby make a mark on the paper with the tip of a crayon (or pencil or pen) when trying to draw? 519 891 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? Does your child turn the pages of a book by himself? (He may turn more than one page at a time.) 539 871 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up Does your child get a spoon into her mouth right side up so that the food usually doesn’t spill? 455 955 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while Does your child use a turning motion with her hand while trying to turn doorknobs, wind up toys, twist tops, or screw lids on and off jars? 509 901 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron Can your child string small items such as beads, macaroni, or pasta “wagon wheels” onto a string or shoelace? 678 732 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? 531 879 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h After your child watches you draw a line from one side of the paper to the other side, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a horizontal direction? 437 973 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y After your child watches you draw a single circle, ask him to make a circle like yours. Do not let him trace your circle. Does your child copy you by drawing a circle? 333 1077 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time Does your child turn pages in a book, one page at a time? 333 1077 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or When drawing, does your child hold a pencil, crayon, or pen between her fingers and thumb like an adult does? 225 1185 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte Does your child put together a five- to seven-piece interlocking puzzle? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop Using the shape at right to look at, does your child copy it onto a large piece of paper using a pencil, crayon, or pen, without tracing? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy at least three shapes onto a large piece of paper using a pencil, crayon, or pen, without tracing? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? Does your child unbutton one or more buttons? (Your child may use his own clothing or a doll’s clothing.) 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea Does your child draw pictures of people that have at least three of the following features: head, eyes, nose, mouth, neck, hair, trunk, arms, hands, legs, or feet? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color Does your child color mostly within the lines in a coloring book or within the lines of a 2-inch circle that you draw? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the Ask your child to trace on the line below with a pencil. Does your child trace on the line without going off the line more than two times? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank Ask your child to draw a picture of a person on a blank sheet of paper. You may ask your child, “Draw a picture of a girl or a boy.” If your child draws a person with head, body, arms, and legs, mark “yes.” If your child draws a person with three or fewer parts (head, body, arms, or legs), mark “not yet.” 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy the shapes in the space below without tracing? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy Using the letters below to look at, does your child copy the letters without tracing? 1410 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l Print your child’s first name. Can your child copy the letters? The letters may be large, backward, or reversed. 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches Does your baby look at objects that are 8–10 inches away? 45 1365 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit When you move around, does your baby follow you with his eyes? 45 1365 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro When you move a toy slowly from side to side in front of your baby’s face (about 10 inches away), does your baby follow the toy with her eyes, sometimes turning her head? 72 1338 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro When you move a small toy up and down slowly in front of your baby’s face (about 10 inches away), does your baby follow the toy with his eyes? 72 1338 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does When you hold your baby in a sitting position, does she look at a toy (about the size of a cup or rattle) that you place on the table or floor in front of her? 72 1338 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l When you dangle a toy above your baby while he is lying on his back, does he wave his arms toward the toy? 72 1338 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look When you put a toy in her hand, does your baby look at it? 27 1383 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put When you put a toy in his hand, does your baby put the toy in his mouth? 85 1325 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach When a toy is in front of your baby, does she reach for it with both hands? 58 1352 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get When your baby is on her back, does she try to get a toy she has dropped if she can see it? 122 1288 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout Does your baby pick up a toy and put it in his mouth? 122 1288 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on Does your baby play by banging a toy up and down on the floor or table? 221 1189 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute? 221 1189 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang When holding a toy in his hand, does your baby bang it against another toy on the table? 247 1163 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b While holding a small toy in each hand, does your baby clap the toys together (like “Pat-a-cake”)? 247 1163 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o After watching you hide a small toy under a piece of paper or cloth, does your baby find it? 267 1143 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you If you put a small toy into a bowl or box, does your baby copy you by putting in a toy, although she may not let go of it? 267 1143 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c After you scribble back and forth on paper with a crayon (or a pencil or pen), does your baby copy you by scribbling? 222 1188 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o Does your baby drop two small toys, one after the other, into a container like a bowl or box? 278 1132 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to After you have shown your baby how, does he try to get a small toy that is slightly out of reach by using a spoon, stick, or similar tool? 262 1148 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib Without your showing him how, does your child scribble back and forth when you give him a crayon (or pencil or pen)? 341 1069 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? 110 1300 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? 351 1059 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u If you give your child a bottle, spoon, or pencil upside down, does she turn it right side up so that she can use it properly? 297 1113 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does If your child wants something he cannot reach, does he find a chair or box to stand on to reach it (for example, to get a toy on a counter or to “help” you in the kitchen)? 345 1065 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? Does your child pretend objects are something else? For example, does your child hold a cup to his ear, pretending it is a telephone? Does he put a box on his head, pretending it is a hat? Does he use a block or small toy to stir food? 554 856 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? Does your child put things away where they belong? For example, does he know his toys belong on the toy shelf, his blanket goes on his bed, and dishes go in the kitchen? 610 800 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? When looking in the mirror, ask “Where is _______?” (Use your child’s name.) Does your child point to his image in the mirror? 531 879 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W When you point to the figure and ask your child, “What is this?” does your child say a word that means a person or something similar? (Mark “yes” for responses like “snowman,” “boy,” “man,” “girl,” “Daddy,” “spaceman,” and “monkey.”) Please write your child’s response here:_______________ 437 973 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child When you say, “Say ‘seven three,’” does your child repeat just the two numbers in the same order? Do not repeat the numbers. If necessary, try another pair of numbers and say, “Say ‘eight two.’” Your child must repeat just one series of two numbers for you to answer “yes” to this question 437 973 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s After your child draws a “picture,” even a simple scribble, does she tell you what she drew? (You may say, “Tell me about your picture,” or ask, “What is this?” to prompt her.) 333 1077 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c When you say, “Say ‘five eight three,’” does your child repeat just the three numbers in the same order? 124 1286 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo When asked, “Which circle is the smallest?” does your child point to the smallest circle? 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending Does your child dress up and “play-act,” pretending to be someone or something else? For example, your child may dress up in different clothes and pretend to be a mommy, daddy, brother or sister, or an imaginary animal or figure. 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi Without your giving help by pointing, does your child follow three different directions using the words “under,” “between,” and “middle”? For example, ask your child to put the shoe “under the couch.” Then ask her to put the ball “between the chairs” and the book “in the middle of the table.” 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? When shown objects and asked, “What color is this?” does your child name five different colors, like red, blue, yellow, orange, black, white, or pink? 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c If you place five objects in front of your child, can he count them by saying, “one, two, three, four, five,” in order? 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista Does your child count up to 15 without making mistakes? 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num Does your child know the names of the following numbers? 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin Does your child finish the following sentences using a word that means the opposite of the word that is italicized? For example: “A rock is hard, and a pillow is soft.” A) "A cow is big, and a mouse is ______", B) "Ice is cold, and fire is ______", C) "We see the stars at night, and we see the sun during the ______", D) "When I throw the ball up, it comes ______" 1410 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n Does your child name at least four letters in her name? Point to the letters and ask, “What letter is this?” 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o Does your baby cry when he is hungry, wet, tired, or wants to be held? 45 1365 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? When you smile at your baby, does she smile back? 45 1365 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? Does your baby watch his hands? 45 1365 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she When your baby sees the breast or bottle, does she seem to know she is about to be fed? 72 1338 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla When your baby has her hands together, does she play with her fingers? 72 1338 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands Does your baby help hold the bottle with both hands at once, or when nursing, does she hold the breast with her free hand? 72 1338 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi When in front of a large mirror, does your baby smile or coo at herself? 85 1325 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha Does your baby act differently toward strangers than he does with you and other familiar people? (Reactions to strangers may include staring, frowning, withdrawing, or crying.) 85 1325 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra While lying on her back, does your baby play by grabbing her foot? 149 1261 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea When in front of a large mirror, does your baby reach out to pat the mirror? 122 1288 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac Does your baby try to get a toy that is out of reach? (She may roll, pivot on her tummy, or crawl to get it.) 122 1288 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from Does your baby drink water, juice, or formula from a cup while you hold it? 221 1189 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? Does your baby feed himself a cracker or a cookie? 163 1247 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby offer it to you even if she doesn’t let go of it? 247 1163 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby let go of it into your hand? 183 1227 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo When you dress your baby, does she lift her foot for her shoe, sock, or pant leg? 183 1227 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro When you dress your baby, does he push his arm through a sleeve once his arm is started in the hole of the sleeve? 267 1143 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so Does your baby roll or throw a ball back to you so that you can return it to him? 168 1242 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b Does your baby play with a doll or stuffed animal by hugging it? 222 1188 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c Does your baby help undress himself by taking off clothes like socks, hat, shoes, or mittens? 262 1148 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo Does your baby get your attention or try to show you something by pulling on your hand or clothes? 194 1216 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c While looking at himself in the mirror, does your child offer a toy to his own image? 110 1300 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su Does your child come to you when she needs help, such as with wind- ing up a toy or unscrewing a lid from a jar? 341 1069 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting Does your child drink from a cup or glass, putting it down again with little spilling? 257 1153 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as Does your child copy the activities you do, such as wipe up a spill, sweep, shave, or comb hair? 297 1113 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? Does your child eat (with a fork) well? 678 732 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your If you do any of the following gestures, does your child copy at least one of them? A) "Open and close your mouth" B) "Blink your eyes" C) "Pull on your earlobe" D) "Pat your cheek" 678 732 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o Does your child push a little wagon, stroller, or other toy on wheels, steering it around objects and backing out of corners if she cannot turn? 277 1133 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often Does your child call herself “I” or “me” more often than her own name? For example, “I do it,” more often than “Juanita do it.” 306 1104 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by Does your child put on a coat, jacket, or shirt by himself? 531 879 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee After you put on loose-fitting pants around her feet, does your child pull them completely up to her waist? 313 1097 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, When your child is looking in a mirror and you ask, “Who is in the mir- ror?” does he say either “me” or his own name? 333 1077 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a Using these exact words, ask your child, “Are you a girl or a boy?” Does your child answer correctly? 225 1185 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another Does your child take turns by waiting while another child or adult takes a turn? 124 1286 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one Does your child serve himself, taking food from one container to an- other using utensils? For example, does your child use a large spoon to scoop applesauce from a jar into a bowl? 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate Does your child wash his hands using soap and water and dry off with a towel without help? 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo Does your child tell you at least four of the following? Please mark the items your child knows. A) "First name" B) "Age" C) "City she lives in" D) "Last name" E) "Boy or girl" F) "Telephone number" 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p Does your child tell you the names of two or more playmates, not including brothers and sisters? 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas Does your child brush her teeth by putting toothpaste on the toothbrush and brushing all of her teeth without help? (You may still need to check and rebrush your child’s teeth.) 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he Does your child dress or undress himself without help (except for snaps, buttons, and zippers)? 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin Does your child dress and undress herself, including buttoning medium-size buttons and zipping front zippers? 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? Does your child use the toilet by herself? (She goes to the bathroom, sits on the toilet, wipes, and flushes.) Mark “yes” even if she does this after you remind her. 1410 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o Does your child usually take turns and share with other children? 1410 * 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 14577 8 593 Household number Household number Household number Household number Household number Household number 14577 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 14577 3 1 2 3 ID CODE of eligible women/children ID CODE of eligible women/children ID CODE of eligible women/children ID CODE of eligible women/children ID CODE of eligible women/children [Respondent: Eligible Women and Child] Name and ID Code of Eligible Woman/children -HH Roster 14439 138 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 28 99 SKIP Sysmiss 01A. ID CODE in 2013 survey (from rosster) 01A. ID CODE in 2013 survey (from rosster) 01A. ID CODE in 2013 survey (from rosster) 01A. ID CODE in 2013 survey (from rosster) 01A. ID CODE in 2013 survey (from rosster) ID CODE in 2013 survey (from rosster) 10331 4246 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 99 New member for 2014 Sysmiss 02. Women or children? 02. Women or children? 02. Women or children? 02. Women or children? 02. Women or children? Women or children 10331 4246 1 2 1 Women 2 Children Sysmiss 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? 03. If women, is she new? If women, is she new? 4674 9903 1 2 1 Yes 2 No Sysmiss 04. Current status 04. Current status 04. Current status 04. Current status 04. Current status Current status 4674 9903 1 2 1 Pregnant 2 Mother 3 Dead mother Sysmiss 05. ID code of mother 05. ID code of mother 05. ID code of mother 05. ID code of mother 05. ID code of mother ID code of mother 5657 8920 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 24 25 Sysmiss 06A. Date of birth: YY 06A. Date of birth: YY 06A. Date of birth: YY 06A. Date of birth: YY 06A. Date of birth: YY Date of birth: YY 5657 8920 2067 2071 2067 2068 2069 2070 2071 Sysmiss 06A. Date of birth: MM 06A. Date of birth: MM 06A. Date of birth: MM 06A. Date of birth: MM 06A. Date of birth: MM Date of birth: MM 5657 8920 1 12 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss 06A. Date of birth: DD 06A. Date of birth: DD 06A. Date of birth: DD 06A. Date of birth: DD 06A. Date of birth: DD Date of birth: DD 5657 8920 1 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 Sysmiss 06B. Age: Year 06B. Age: Year 06B. Age: Year 06B. Age: Year 06B. Age: Year Age: Year 5657 8920 4 1 2 3 4 Sysmiss 06B. Age: Month 06B. Age: Month 06B. Age: Month 06B. Age: Month 06B. Age: Month Age: Month 5657 8920 11 1 2 3 4 5 6 7 8 9 10 11 Sysmiss 06B. Age: Day 06B. Age: Day 06B. Age: Day 06B. Age: Day 06B. Age: Day Age: Day 5657 8920 33 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 33 Sysmiss 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) 07. Interview result (of eligible women/children) Interview result (of eligible women/children) 10331 4246 1 7 1 Completed 3 Separated 4 Out of home 5 Dead 6 Refused to answer 7 Other Sysmiss CO code CO code CO code CO code CO code CO Code 4246 8 593 Household number Household number Household number Household number Household number Household number 4246 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4246 3 1 2 3 101. Round Number 101. Round Number 101. Round Number 101. Round Number 101. Round Number Round Number 4246 3 3 3 103. CO Code No 103. CO Code No 103. CO Code No 103. CO Code No 103. CO Code No CO Code No (see the code sheet) 4246 8 593 104. House Serial No 104. House Serial No 104. House Serial No 104. House Serial No 104. House Serial No House Serial No (Copy from Q5 of Listing Form) 4246 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 104. Household sub-number (if separated) 104. Household sub-number (if separated) 104. Household sub-number (if separated) 104. Household sub-number (if separated) 104. Household sub-number (if separated) Household sub-number (if separated) 4246 3 1 2 3 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman 105A. Number of eligible woman SN eligible woman (From listing form) 4246 5 1 2 3 4 5 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman 105B. Interviewed eligible woman SN eligible woman (From listing form) - Interviewed 4246 5 1 2 3 4 5 106B. Is this hh in baseline? 106B. Is this hh in baseline? 106B. Is this hh in baseline? 106B. Is this hh in baseline? 106B. Is this hh in baseline? Name of CO Member in Selected HH - Is this household in baseline 4246 1 2 1 Yes 2 No 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD 107. Date of Interview: DD Date of Interview: - DD 4246 1 30 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM 107. Date of Interview: MM Date of Interview: - MM 4246 1 12 1 2 3 4 5 6 7 8 9 12 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY 107. Date of Interview: YY Date of Interview: - YY 4246 2071 2071 2071 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name 108. Interviewer's name Name of enumerator 4246 71 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 58 60 69 71 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name 109. Supervisor's name Name of supervisor 4246 1 99 1 2 3 4 6 7 8 9 10 11 12 13 14 15 16 19 20 21 22 23 24 25 26 28 29 30 31 32 33 34 35 36 99 110. Editor's name 110. Editor's name 110. Editor's name 110. Editor's name 110. Editor's name Name of Editor 4246 99 1 2 3 4 5 6 7 12 19 21 22 23 47 58 63 99 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator 111. Name of data entry operator Name of data entry operator 4246 . .3 ``` 1 10 11 12 132 2 2. 21 24 28 3 4 5 6 7 7+ 8 83 9 adm CO code CO code CO code CO code CO code CO Code 4246 8 593 Household number Household number Household number Household number Household number Household number 4246 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 201. District 201. District 201. District 201. District 201. District District: 4246 1 4 1 Ramechhap 2 Sindhuli 3 Sarlahi 4 Rautahat 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? 202. Is this a VDC or a Municipality? Is this a VDC or a Municipality? 4246 1 2 1 VDC 2 Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality 203. Code of VDC/Municipality Name and Code of VDC/Municipality (see code sheet) 4246 2 185 4246 1 1 4246 1 1 4246 1 1 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4246 3 1 2 3 204. Ward Number 204. Ward Number 204. Ward Number 204. Ward Number 204. Ward Number Ward Number 4246 1 9 1 2 3 4 5 6 7 8 9 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent 206A. ID code of the Main Respondent Name of the respondents and Identity number (HH Roster): - Name of the Main Respondent - ID CODE 4246 1 34 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19 23 34 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent 206B. ID code of the second Respondent Name of the respondents and Identity number (HH Roster): - Name of the Second Respondent - ID CODE 4246 1 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 19 23 99 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head 207B. ID code of the Household Head Name of the Household Head and code: 4246 1 1 1 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head 208. Caste/ethnicity of HH head Caste/ethnicity of HH head 4246 1 102 1 Chhetri 2 Bhamhin - Hill 3 Magar 4 Tharu 5 Tamang 6 Newar 7 Muslim 8 Kami 9 Yadav 10 Rai 11 Gurung 12 Damai/dholi 13 Limbu 14 Thakuri 15 Sarki 16 Teli 17 Chamar/harijan/ram 18 Koiri 19 Kurmi 20 Sanyasi 21 Dhanuk 22 Musahar 23 Dusadh/paswan/pasi 24 Sherpa 25 Sonar 26 Kewat 27 Bramhin - Terai 28 Baniya 29 Gharti/bhujel 30 Mallah 31 Kalwar 32 Kumal 33 Hajam/thakur 34 Kanu 35 Rajbansi 36 Sunuwar 37 Sudhi 38 Lohar 39 Tatma 40 Khatwe 41 Dhobi 42 Majhi 43 Niniya 44 Kumhar 45 Danuwar 46 Chepang/praja 47 Haluwai 48 Rajput 49 Kayastha 50 Badhae 51 Marwadi 52 Santhal/satar 53 Jhangad 54 Bantar 55 Barae 56 Kahar 57 Gangai 58 Lodha 59 Rajbhar 60 Thami 61 Dhimal 62 Bhote 63 Bing/bida 64 Bhediyar/gaderi 65 Nurang 66 Yakha 67 Darai 68 Tajpuriya 69 Thakali 70 Chidimar 71 Pahari 72 Mali 73 Bangali 74 Chhantyal 75 Dom 76 Kamar 77 Bote 78 Baramu 79 Gaine 80 Jirel 81 Adibasi/janajati 82 Dura 83 Churoute 84 Badi 85 Meche 86 Lepcha 87 Halkhor 88 Panjabi/sikh 89 Kisan 90 Raji 91 Byasi 92 Hayu 93 Koche 94 Dhniya 95 Walung 96 Jaine 97 Munda 98 Raute 99 Yholmo 100 Pattharkatta/kuswadiya 101 Kusunda 102 Other caste 103 Unidentified caste 212. Result of Interview 212. Result of Interview 212. Result of Interview 212. Result of Interview 212. Result of Interview Result of Interview 4246 1 2 1 Completed 2 Not completed 3 MIgrated 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? 213. Which religion do you follow mainly in your household? Which religion do you follow mainly in your household? 4108 138 1 8 1 Hindu 2 Bouddha 3 Islam 4 Kirat 5 Jain 6 Christian 7 Shikh 8 Other Sysmiss 214. Total family number 214. Total family number 214. Total family number 214. Total family number 214. Total family number Total family number 4108 138 2 28 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 Sysmiss 4246 1 3 1 Control 2 Info Only 3 Info + Cash CO code CO code CO code CO code CO code CO Code 31429 8 593 Household number Household number Household number Household number Household number Household number 31429 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 31429 3 1 2 3 ID CODE ID CODE ID CODE ID CODE ID CODE ID Code 31291 138 1 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 99 SKIP Sysmiss 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head 302. Relationship to HH head Relationship to HH head 31291 138 1 99 1 Head 2 Spouse 3 Son/Daughter 4 Grandchild 5 Parent 6 Brother/Sister 7 Nephew/Niece 8 Son/Daughter-in-law 9 Brother/Sister-in-law 10 Parent-in-law 11 Other relative (grandparents etc) 12 Domestic helper 13 Adopted/foster child 14 Other not related 99 Dead mother Sysmiss 303. Sex 303. Sex 303. Sex 303. Sex 303. Sex Sex 31291 138 1 2 1 Male 2 Female Sysmiss 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year 304. Age (Completed): A. Year Age (Completed)? - Year 31291 138 99 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month 304. Age (Completed): B. Month Age (Completed)? - Month 31291 138 11 1 2 3 4 5 6 7 8 9 10 11 Sysmiss 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? 305. Can [NAME] read and write a letter in any one language? Ask only to those who are aged 5 years and older Can [NAME] read and write a letter in any one language? 25139 6290 1 2 1 Can read/write 2 Can't read/write Sysmiss 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? 306. Has [NAME] ever attended formal school/ college? Ask only to those who are aged 5 years and older Has [NAME] ever attended formal school/ college? No, go to Q308 25139 6290 1 2 1 Yes 2 No Sysmiss 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? 307. What is the highest grade [NAME] completed? Ask only to those who are aged 5 years and older What is the highest grade [NAME] completed? 12606 18823 98 CLASS 1 NOT PASSED 1 CLASS 1 2 CLASS 2 3 CLASS 3 4 CLASS 4 5 CLASS 5 6 CLASS 6 7 CLASS 7 8 CLASS 8 9 CLASS 9 10 CLASS 10 11 SLC 12 CLASS 11 13 CLASS 12 OR INTERMEDIATE 14 BACHELOR LEVEL 15 MASTER LEVEL/PH.D 98 DON'T KNOW Sysmiss 308. Marital status 308. Marital status 308. Marital status 308. Marital status 308. Marital status Ask only to those who are aged 5 years and older Marital status 25143 6286 1 4 1 Unmarried 2 Married 3 Divorced/separated 4 Widow/er Sysmiss 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation 309. Occupation: A. Main occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Primary 25139 6290 1 36 1 Self-agri 2 Self-livestock 3 Agri (other) 4 Self/other agri 5 Self-trade/service 6 Self-small/cottage industry 7 Self-middle/big industry 8 Self-construction 9 Self-transportation 10 Self-other 11 Wage-agri 12 Wage-construction skill labour 13 Wage-construction unskilled labour 14 Wage-manufacturing skill labour 15 Wage-manufacturing unskilled labour 16 Wage-other skilled labour 17 Wage-other unskilled labour 18 Labour of transport sector 19 Goverment employee (NIJAMATI) 20 Security force 21 Employee on corporation sector 22 Employee on financial sector 23 Employee of education sector 24 Employee of healthe service 25 Lawer 26 Employee of NGOs/CBOs 27 Student 28 Household duties/child care 29 Retired/old age 30 Disable, can work 31 Disable, can not work 32 Unemployed/seeking work 33 Small age (too young) 35 Foreign employee 36 Other Sysmiss 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation 309. Occupation: B. Secondary occupation Ask only to those who are aged 5 years and older What is [NAME’s] main and secondary occupation? - Secondary 25139 6290 1 36 1 Self-agri 2 Self-livestock 3 Agri (other) 4 Self/other agri 5 Self-trade/service 6 Self-small/cottage industry 7 Self-middle/big industry 8 Self-construction 9 Self-transportation 10 Self-other 11 Wage-agri 12 Wage-construction skill labour 13 Wage-construction unskilled labour 14 Wage-manufacturing skill labour 15 Wage-manufacturing unskilled labour 16 Wage-other skilled labour 17 Wage-other unskilled labour 18 Labour of transport sector 19 Goverment employee (NIJAMATI) 20 Security force 21 Employee on corporation sector 22 Employee on financial sector 23 Employee of education sector 24 Employee of healthe service 25 Lawer 26 Employee of NGOs/CBOs 27 Student 28 Household duties/child care 29 Retired/old age 30 Disable, can work 31 Disable, can not work 32 Unemployed/seeking work 33 Small age (too young) 34 No secondary occupation 35 Foreign employee 36 Other Sysmiss 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? 310. Is [name] currently residing in this HH? Is [name] currently residing in this HH? No, go to another 31291 138 1 3 1 Yes 2 No 3 Dead Sysmiss 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? 311. Is this child or mother eligible for interview? Is this child or mother eligible for interview? 27822 3607 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 4246 8 593 Household number Household number Household number Household number Household number Household number 4246 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4246 3 1 2 3 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? 401. Is this dwelling unit occupied by your household only? I would like to know more about your housing units used by your household or currently residing. Is this dwelling unit occupied by your household only? 4108 138 1 2 1 Yes 2 No Sysmiss 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? 402. What is the ownership status of the dwelling that your household residing? What is the ownership status of the dwelling that your household residing? 4108 138 1 5 1 Own house (Male ownership) 2 Own house (Female ownership) 3 Own house (Joint ownership) 4 No ownership 5 Rented Sysmiss 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? 403. How many rooms are used by your household? How many rooms are used by your household? 4108 138 1 12 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? 404. How many stories are there in your household? How many stories are there in your household? 4108 138 1 4 1 2 3 4 Sysmiss 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? 405. Has your household used separate room as a kitchen? Has your household used separate room as a kitchen? 4108 138 1 2 1 Yes 2 No Sysmiss 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? 406. What is the main flooring material of the house that your family using? What is the main flooring material of the house that your family using? 4108 138 1 5 1 Earth/mud 2 Wood/Planks 3 Stone/Brick 4 Cement 5 Other Sysmiss 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? 407. What is the main construction material of the outside wall of the house? What is the main construction material of the outside wall of the house? (What is the main binding material of the house?) 4108 138 1 8 1 Bamboo/Wood/Cement mix (centre wall) 2 Cement bonded Stones/Bricks/Concrete 3 Mud bonded Stones/Bricks 4 Wood 5 Unbaked Bricks 6 Bamboo and mud 7 Clay, Husk, Mud, Straw, Hay 8 Other 9 No outside walls Sysmiss 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? 408. What is the main construction material of the roof of the house? What is the main construction material of the roof of the house? 4108 138 1 7 1 Hay/Straw 2 Earth/Mud 3 Wood 4 Galvanized iron 5 Concrete/Cement 6 Tiles/Slates/Stone 7 Other Sysmiss 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity 409. Does your household: A. Regular electricity Does your household have regular electricity or a power generator or Solar Power? - Regular electricity 4108 138 1 2 1 Yes 2 No Sysmiss 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator 409. Does your household: B. Power generator Does your household have regular electricity or a power generator or Solar Power? - Power generator 4108 138 1 2 1 Yes 2 No Sysmiss 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power 409. Does your household: C. Solar power Does your household have regular electricity or a power generator or Solar Power? - Solar power 4108 138 1 2 1 Yes 2 No Sysmiss 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? 410. What is the main source of drinking water? What is the main source of drinking water? 4108 138 1 13 1 Piped water directly to the household/compound 2 Piped water from a public water tap 3 Private Hand-pump (Shallow) 4 Public Hand-pump (Shallow) 5 Private Hand-pump (Deep) 6 Public Hand-pump (Deep) 7 Covered Well 8 Open Well 9 Stored Rain Water 10 Stone tape 11 River, Pond, Stream, or other open water bodies 12 Neighbour's tube-well 13 Other Sysmiss 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? 411. How many minutes does it take to fetch water? How many minutes does it take to fetch water? 4108 138 999 1 2 3 4 5 6 7 8 9 10 12 15 16 20 25 30 40 45 50 60 90 110 120 130 180 240 300 999 Sysmiss 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main 412. Fuel used for cooking and heating - A. Main What types of fuel does your household commonly use for cooking and heating? Main three - Third 4108 138 1 10 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) Sysmiss 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second 412. Fuel used for cooking and heating - B. Second What types of fuel does your household commonly use for cooking and heating? Main three - Third 4108 138 1 99 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) 99 No 2nd/3rd answer Sysmiss 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third 412. Fuel used for cooking and heating - C. Third What types of fuel does your household commonly use for cooking and heating? Main three - Third 4108 138 1 99 1 Wood 2 Crop residues (Husk/Straw) 3 Dung cakes 4 Charcoal 5 Coal/cake 6 Kerosene 7 Electricity 8 Liquid Petroleum Gas 9 Bio Gas 10 Other (Specify) 99 No 2nd/3rd answer Sysmiss 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? 413. How many minutes do you walk/bicycle to get one bhari of firewood? Fill out only if one of the answers in Q412 is 01. 2796 1450 10 999 10 20 25 30 35 40 45 60 75 80 90 100 110 120 130 140 150 160 170 180 190 200 208 210 220 230 240 242 250 260 280 300 320 340 350 360 370 380 420 430 480 500 600 620 630 670 720 900 999 Not fetching water Sysmiss 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? 414. What type of toilet does your household use? What type of toilet does your household use? 4108 138 1 6 1 Flush toilet 2 Covered Pit/Pan within Household Compound 3 Open Pit within Household Compound 4 Community Latrine 5 Other type of Latrine (Specify) 6 No Toilet/Open Defecation Sysmiss 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? 415. How many minutes does it take to get to the nearest market to your house? How many minutes does it take to get to the nearest market to your house? 4108 138 690 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? 416. Does your household own land? Does your household own land? No, go to Q418 4108 138 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 7018 8 593 Household number Household number Household number Household number Household number Household number 7018 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 7018 3 1 2 3 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type 417. Land - A. Type Type of land 7018 1 4 1 Household land 2 Farm land 3 Bari/Pakho 4 Baran/forest/etc. 99 SKIP 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit 417. Land - B. Unit Units 7018 1 2 1 Ropani 2 Bigha 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) 417. Land - C. Area (ropani/bigha) Area - Ropani/ Bigha 7018 60 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 24 25 26 27 28 30 32 40 45 50 60 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) 417. Land - D. Area (aana/kattha) Area - Ana/ Kattha 7018 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 20 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) 417. Land - C. Area (dhur/paisa) Area - Paisa/ Dhur 7018 20 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 CO code CO code CO code CO code CO code CO Code 4246 8 593 Household number Household number Household number Household number Household number Household number 4246 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4246 3 1 2 3 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? 418. Does your household have a garden where you grow vegetables? Does your household have a garden where you grow vegetables? No, go to 420 4108 138 1 2 1 Yes 2 No Sysmiss 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? 419. For what purpose, do you grow vegetables? For what purpose, do you grow vegetables? 1786 2460 1 3 1 Household consumption 2 Selling 3 Both Sysmiss 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? 420. Has your household owned any livestock? Has your household owned any livestock? 4108 138 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 69974 8 593 Household number Household number Household number Household number Household number Household number 69974 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 69974 3 1 2 3 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item 501. Expenditure: A. Item List the particulars of the expenditure that your family made to the following items during the past 30 days. - Item 69836 138 1 17 1 Fuel (Wood, Kerosene, LPG, etc.) 2 Clothes, Apparel 3 Personal care items (Soap, Comb, Shampoo, cosmetics, etc.) 4 Transportation (Horse, Mule, Bus, Taxi, Rickshaw, etc) 5 Entertainment/Excursion (Movies, picnics, melas, etc) 6 Newspapers, Books, Copies, etc. 7 Educational and Professional Services 8 Medicines and Health Services 9 Legal Expenses and Insurance 10 Repair/Maintenance of House and Household Effects and electrician, plumber, etc. 11 Religious, Marriage, Funeral, etc. expenses 12 Donations/gifts 13 Electricity, Water, etc. 14 Household goods 15 Agri. related goods 16 Ornaments, land, livestock etc. purchase 17 Other Sysmiss 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) 501. Expenditure: B. Amount (NRs.) List the particulars of the expenditure that your family made to the following items during the past 30 days. - Amount (Rupees) 69836 138 1500000 CO code CO code CO code CO code CO code CO C 49434 8 593 Household number Household number Household number Household number Household number Household number 49434 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 49434 3 1 2 3 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income 502. Income: A. Particulars of Income List the particulars of the income of your family during the past 12 months. - Item 49296 138 1 12 1 Agriculture (Agriculture, NTFP, Livestock, etc) 2 Non-Agriculture Enterprise 3 From within the home town 4 Inside the country 5 Outside the country 6 Old age pension/allowances 7 Widow pension/Allowances 8 Disability allowances 9 Other social protection program payments 10 Income from interest, bonus, profit, commission, fees, royalties, etc 11 Prize 12 Other Sysmiss 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) 502. Income: B. Annual income (NRs.) List the particulars of the income of your family during the past 12 months. - Annual Income (Rupees) 49296 138 1900000 CO code CO code CO code CO code CO code CO Code 4246 8 593 Household number Household number Household number Household number Household number Household number 4246 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4246 3 1 2 3 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? 503. How many borrowed loans does your household have over the past 12 months? How many borrowed loans does your household have over the past 12 months? None (➔505) 4108 138 20 None 1 2 3 4 5 6 7 8 9 10 11 12 20 Sysmiss 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed 504. What was or is the annual rate of interest of the most recent loan borrowed What was or is the annual rate of interest of the most recent loan borrowed? 3259 987 1 72 1 2 3 3.5 4 5 6 8 9 10 11 12 12.5 14 15 16 17 18 20 22 24 25 30 34 36 40 48 50 60 61 72 Sysmiss CO code CO code CO code CO code CO code CO Code 143918 8 593 Household number Household number Household number Household number Household number Household number 143918 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 143918 3 1 2 3 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item 506. Consumption: A. Food item Particulars of your food consumption in the past 24 hours (e.g., breakfast, lunch, mid-day snacks, dinner, etc.) - Food items 143780 138 1 35 1 Rice 2 Beaten rice 3 Maize 4 Wheat 5 Barley/Oat/Sorghum 6 Millet/ Buckwheat 7 Pulses 8 Gram/Pea 9 Other beans 10 Fish 11 Meat 12 Egg 13 Milk 14 Curd/Whey etc. 15 Baby/Powder milk 16 Ghee 17 Honey 18 Vegetable ghee 19 Oil (Mustard, Soyabean, etc.) 20 Potato/Colocasia 21 Onion 22 Green leafy vegetables 23 Other vergetables (cauliflower, okra, etc) 24 Fruits/nuts 25 Salt 26 Other Spices (scumin seed, marich, garlic, ginger, chillies, etc.) 27 Sugar 28 Sakhar/Gud/Khudo 29 Sweets 30 Tea/Coffee 31 Alcoholic beverages (Jand, Wine, Beer, etc.) 32 Non-alcoholic beverages (Coke, Frooti, Sarbat, etc.) 33 Tobacco and tobacco products 34 Noodles and Biscuits 35 Other Foods Sysmiss 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity 506. Consumption: B. Quantity How much [QUANTITY] did you consume [FOOD] in in the previous 24 hours? - Quantity (If none, write 0 and ➔Next item) 143780 138 900 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit 506. Consumption: B. Unit How much [QUANTITY] did you consume [FOOD] in in the previous 24 hours? - Unit (If none, write 0 and ➔Next item) 46839 97079 1 10 1 Kilogram 2 Gram 3 Litre 4 Ml 5 Pathi 6 Mana 7 Kuruwa 8 Number 9 Dozen 10 Spoons Sysmiss CO code CO code CO code CO code CO code CO Code 41218 8 593 Household number Household number Household number Household number Household number Household number 41218 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 41218 3 1 2 3 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock 507. Unexpected events - A. Type of shock Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Type of shock 41080 138 1 10 1 Getting a new job of any kind 2 Inheritance 3 Death of HH member 4 Accidental or Violent injury 5 Loss of employment of any kind 6 Failure/loss of business 7 Livestock died 8 Crop disease/pests 9 Theft/robbery/burglary/assault 10 Drought/floods Sysmiss 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? 507. Unexpected events - B. Has the household experienced? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Has the household experienced the shock? No, go to Next item 41080 138 1 2 1 Yes 2 No Sysmiss 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? 507. Unexpected events - C. Who did this shock affect? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - Who did this shock affect? 2023 39195 1 3 1 Just this household 2 Several HHs in the village 3 All HHs in the village Sysmiss 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? 507. Unexpected events - D. What was the strength of this shock? Which of the following unexpected events has this household experienced in the last twelve months (incidents that were unexpected and affected an individual, family, and the society)? - What was the strength of this shock? 2023 39195 1 5 1 Not important 2 Mild 3 Average 4 Quite strong 5 Very strong Sysmiss CO code CO code CO code CO code CO code CO Code 4668 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 4668 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4668 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4668 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 24 25 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the 601. Were you or any of your children who are younger than 60 months sick in the Were you or any of your children who are younger than 36 months sick in the last 30 days? No, go to Section 7 4668 1 2 1 Yes 2 No ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) ***** CHECK: Number person that was sick (Sec 06) CHECK: Number person that was sick (Sec 06) 2063 2605 4 1 2 3 4 Sysmiss CO code CO code CO code CO code CO code CO Code 2483 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 2483 1 48 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 2483 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 2483 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 25 ID Code ID Code ID Code ID Code ID Code ID Code (Enter from section 3) 2483 1 28 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 24 28 99 SKIP 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d 603. What type of illness does [NAME] suffer from last time during the past 30 d What type of illness does [NAME] suffer from last time during the past 30 days? 2483 1 18 1 Diarrhoea 2 Dysentry 3 Pneumonia/Cough 4 Malaria 5 Other fever 6 Skin disease 7 TB 8 Measles 9 Jaundice 10 Parasites 11 Injury 12 Pregnancy related complications 13 Stomach-ache 14 STDs/STIs 15 Eye-ache 16 Head-ache 17 Orthopedic 18 Other 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q 604. Where did [NAME] go for the first consultation of the illness reported in Q Where did [NAME] go for the first consultation of the illness reported in Q.603? Not consulted, go to 606 2483 1 12 1 SHP 2 HP 3 PHC 4 Govt. hospital 5 Mobile clinic 6 Ayurvedic centre 7 Pharmacy/Clinic 8 Pvt. hospital 9 Health worker's home 10 Traditional healer 11 GHUMTI SIBIR 12 Not consulted 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? 605. Whom did [NAME] first consult with of the illness reported in Q.603? Whom did [NAME] first consult with of the illness reported in Q.603? → Go To Next Member 2324 159 1 5 1 Doctor 2 Paramedic (HA,SAHW, AHW, ANM) 3 Kaviraj/Vaidya 4 Untrained Pharmacist 5 Traditional Healer 6 Other Sysmiss 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? 606. Why didn't you consult for the illness? Why didn't you consult for the illness? 159 2324 1 7 1 No money 2 Illness not serious 3 Health worker far 4 No good health worker 5 Treatment expensive 6 Don't know about health institution 7 Pregnant Sysmiss CO code CO code CO code CO code CO code CO Code 3907 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 3907 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3907 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? 701. In your opinion, what should be done with the first milk (colostrums)? Now I’d like to ask you some questions about the nutrition for under 2 children In your opinion, what should be done with the first milk (colostrums)? 3907 1 8 1 Given to baby 2 Thrown away 3 Other 8 Do not know 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but 702. In your opinion, for how long should a newborn infant be given nothing but In your opinion, for how long should a newborn infant be given nothing but breast milk? 3907 1 8 1 Less than 6 months 2 6 months 3 More than 6 months 8 Do not know CO code CO code CO code CO code CO code CO Code 62512 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 62512 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 62512 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 62512 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item 703. What foods are best? - A. Item In your opinion, what foods are best to feed children aged 6-24 months 30 days in addition to breast milk? - Item 62512 1 16 1 Porridge that is not enriched with other foods 2 Porridge that is enriched with other foods/sarbottam pitho 3 Yellow, orange and green vegetables 4 Fruits 5 Eggs 6 Milk or yogurt 7 Chicken or meat including liver 8 Ghee, butter, or oil 9 Lentils/pulses 10 Biscuit 11 Cerelac 12 Horlicks 13 Noodles 14 Vitamin 15 Bread 16 Others 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? 703. What foods are best? - B. Mentioned/Not Mentioned? In your opinion, what foods are best to feed children aged 6-24 months 30 days in addition to breast milk? - Mentioned/Not mentioned 62512 1 2 1 Mentioned 2 Not mentioned CO code CO code CO code CO code CO code CO Code 3907 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 3907 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3907 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition 704. How many times a day should a 6-11 month old baby be fed a meal in addition How many times a day should a 6-11 month old baby be fed a meal in addition to breast milk? 3907 98 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 28 29 30 40 98 Do not know 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to 705. How many snacks a day should a 12-24 month old baby be given in addition to How many snacks a day should a 12-24 month old baby be given in addition to breast milk? 3907 98 1 2 3 4 5 6 7 8 9 10 11 12 13 15 16 18 20 98 Do not know 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha 706. In your opinion, should you breastfeed your baby less, the same or more tha In your opinion, should you breastfeed your baby less, the same or more than usual during an episode of diarrhea? 3907 1 8 1 Less than usual 2 Same as usual 3 More than usual 8 Do not know 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for 707. In your opinion, at least how many times should a pregnant mother visit for Now I’d like to ask you some questions about the nutrition for women. In your opinion, at least how many times should a pregnant mother visit for ANC check up, 1, 2, 3, 4 or more? 3907 98 1 2 3 4 5 6 7 8 9 10 12 98 Do not know 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? 708. When should a pregnant woman start iron supplementation (in months)? When should a pregnant woman start iron supplementation (in months)? 3907 98 1 2 3 4 5 6 7 8 9 98 Do not know 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? 709. When should a pregnant woman take deworming tablets (in months)? When should a pregnant woman take deworming tablets (in months)? 3907 1 98 1 2 3 4 5 6 7 8 9 98 Do not know 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within 710. When should a recently delivered woman take Vitamin A capsule (within When should a recently delivered woman take Vitamin A capsule (within days of delivery)? 3907 98 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 28 30 35 36 39 40 42 43 45 48 50 60 90 98 Do not know 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same 711. In your opinion, is it best for a pregnant woman to eat less food, the same In your opinion, is it best for a pregnant woman to eat less food, the same amount or more food than she ate before becoming pregnant? 3907 1 8 1 More than usual 2 Same as usual 3 Less than usual 8 Do not know CO code CO code CO code CO code CO code CO Code 54698 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 54698 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 54698 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 54698 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item 712. Good foods for a woman - A. Item In your opinion, what are good foods for a woman to eat during her pregnancy? - Item 54698 1 14 1 Yellow, orange and green vegetables 2 Fruit 3 Eggs 4 Milk or yogurt 5 Meat 6 Beans/pulses 7 Rice 8 Bread 9 Horlicks 10 Vitamin 11 Noodles 12 Biscuit 13 HALUWA 14 Others 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? 712. Good foods for a woman - B. Mentioned/Not Mentioned? In your opinion, what are good foods for a woman to eat during her pregnancy? - Mentioned/Not mentioned 54698 1 2 1 Mentioned 2 Not Mentioned CO code CO code CO code CO code CO code CO Code 31256 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 31256 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 31256 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 31256 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice 713. With whom do you usually seek advice? - A. People giving advice Now I would like to ask you about health, tobacco and alcohol consumption. With whom do you usually seek advice on maternal and child health issues? - People giving advice 31256 1 8 1 FCHV 2 AAMA Mothers group 3 MCHW/VHW 4 Other Health Workers 5 Local private pharmacy 6 Traditional healers 7 Family members 8 Other 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? 713. With whom do you usually seek advice? - B. Yes/No? With whom do you usually seek advice on maternal and child health issues? - Yes/No 31256 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 3907 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 3907 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3907 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? 714. What kind of salt do you normally use in your house? What kind of salt do you normally use in your house? 3907 1 2 1 Aayunoon/Two child logo salt 2 Other salt 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? 715. Are you smoking, chewing tobacco and drinking alcohol regularly? Are you smoking, chewing tobacco and drinking alcohol regularly? 3907 1 4 1 Yes smoking and taking tobacco 2 Yes drinking alcohol 3 Yes taking both 4 No, taking nothing 716. Rank the most important: A. Health 716. Rank the most important: A. Health 716. Rank the most important: A. Health 716. Rank the most important: A. Health 716. Rank the most important: A. Health Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Health - Rank 3907 1 4 1 2 3 4 716. Rank the most important: B. Food 716. Rank the most important: B. Food 716. Rank the most important: B. Food 716. Rank the most important: B. Food 716. Rank the most important: B. Food Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Food - Rank 3907 1 4 1 2 3 4 716. Rank the most important: C. Education 716. Rank the most important: C. Education 716. Rank the most important: C. Education 716. Rank the most important: C. Education 716. Rank the most important: C. Education Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Education - Rank 3907 1 4 1 2 3 4 716. Rank the most important: D. Security 716. Rank the most important: D. Security 716. Rank the most important: D. Security 716. Rank the most important: D. Security 716. Rank the most important: D. Security Please rank, in order from 1 through 4, with 1 being the most important and 4 being the least important, the following priorities for your children. - Security - Rank 3907 1 4 1 2 3 4 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai 717. What is the highest level of education that you think your child will obtai What is the highest level of education that you think your child will obtain? 3907 98 CLASS 1 NOT PASSED 1 CLASS 1 2 CLASS 2 3 CLASS 3 4 CLASS 4 5 CLASS 5 6 CLASS 6 7 CLASS 7 8 CLASS 8 9 CLASS 9 10 CLASS 10 11 SLC 12 CLASS 11 13 CLASS 12 OR INTERMEDIATE 14 BACHELOR LEVEL 15 MASTER LEVEL/PH.D 98 DON'T KNOW 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? 718. In the past month, have you been to a CO meeting? In the past month, have you been to a CO meeting? 3907 1 2 1 Yes 2 No 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? 719. Do you think your child will work in agriculture or industry? Do you think your child will work in agriculture or industry? 3907 1 5 1 Agriculture 2 Industry 3 Foreign employee 4 Service 5 Other CO code CO code CO code CO code CO code CO Code 3907 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 3907 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3907 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? 801. How old were you when you got married? How old were you when you got married? 3907 10 42 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 33 42 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? 802. Was the marriage arranged? Was the marriage arranged? 3907 1 2 1 Yes 2 No 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? 803. Are you currently pregnant? Are you currently pregnant? No, go to 806 3907 1 2 1 Yes 2 No 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? 804. How long have you been pregnant for? How long have you been pregnant for? 593 3314 9 1 2 3 4 5 6 7 8 9 Sysmiss 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? 805. Is this your first pregnancy? Is this your first pregnancy? 1) Yes, go to Section 10 2) No, and other kid(s) died, go to Section 10 593 3314 1 3 1 Yes 2 No, and have kids who are alive 3 No, and other kid(s) died Sysmiss 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece 806. During your pregnancy with your youngest child, how many times did you rece During your pregnancy with your youngest child (name:___________), how many times did you receive antenatal care? 3724 183 98 1 2 3 4 5 6 7 8 9 10 12 14 15 31 60 64 98 Sysmiss 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? 807. Did you receive TT injection at any time during this pregnancy (with name)? Did you receive TT injection at any time during this pregnancy (with name)? No, go to 809 3724 183 1 2 1 Yes 2 No Sysmiss 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv 808. While pregnant with (name of youngest child), how many times did you receiv While pregnant with (name of youngest child), how many times did you receive such an injection? 3340 567 1 6 1 2 3 4 5 6 Sysmiss 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron 809. When you were pregnant with (name of youngest child), did you receive iron When you were pregnant with (name of youngest child), did you receive iron tablets? No, go to 812 3724 183 1 2 1 Yes 2 No Sysmiss 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? 810. How many days during your pregnancy did you take the iron tablets? How many days during your pregnancy did you take the iron tablets? 3045 862 660 CO code CO code CO code CO code CO code CO Code 21315 8 593 Household number Household number Household number Household number Household number Household No. (copy from Q104) 21315 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 21315 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) Name and ID Code of Respondent -HH Roster 21315 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 25 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken 811. From where? - A. Place where the tablets were taken If yes, from where? - Place where the tablets were taken 21315 1 7 1 FCHV 2 Health Facility 3 Clinic/pharmacy 4 Hospital 5 NGOs/INGOs 6 Privat nursing home 7 Other 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? 811. From where? - B. Yes/No? If yes, from where? - Yes/No 21315 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 3907 8 593 Household number Household number Household number Household number Household number Household No. 3907 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3907 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3907 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? 812. During your last pregnancy, (with name) did you take de-worming tablet? During your last pregnancy, (with name) did you take de-worming tablet? 3724 183 1 2 1 Yes 2 No Sysmiss 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? 813. Did you suffer from night blindness or ratandho in your last pregnancy? Did you suffer from night blindness or ratandho in your last pregnancy? 3724 183 1 2 1 Yes 2 No Sysmiss 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? 814. Where did you give birth in your most recent delivery? Where did you give birth in your most recent delivery? 3724 183 1 6 1 Home 2 Government hospital 3 PHC/HP/SHP 4 Private hospital/nursing home 5 Field/jungle 6 Road/Vehicle Sysmiss 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? 815. Who assisted with your most recent delivery? Who assisted with your most recent delivery? 3724 183 1 9 1 Doctor 2 Staff nurse/ANM 3 HA/AHW 4 MCHW 5 FCHV 6 TBA 7 Untrained household member/neighbor 8 Other 9 No one Sysmiss 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? 816. In the first 42 days after delivery, did you take Vitamin A capsules? In the first 42 days after delivery, did you take Vitamin A capsules? 3724 183 1 2 1 Yes 2 No Sysmiss 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? 817. If yes, from where did you receive? If yes, from where did you receive? 2095 1812 1 4 1 FCHV 2 Health workers 3 Shop/Medical 4 Other Sysmiss 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? 818. Are you or your husband currently using any family planning method? Are you or your husband currently using any family planning method? 3724 183 1 2 1 Yes 2 No Sysmiss CO code CO code CO code CO code CO code CO Code 3724 8 593 Household number Household number Household number Household number Household number Household No. 3724 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3724 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? 901. Did you ever breastfeed to your youngest child (name of child)? Did you ever breastfeed to your youngest child (name of child)? No…, go to 904 3724 1 2 1 Yes 2 No 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast 902. How long after giving birth did you first put (name of child) to the breast How long after giving birth did you first put (name of child) to the breast? 3707 17 360 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid 903. During the first three days after delivery, did you give (name) the liquid During the first three days after delivery, did you give (name) the liquid that came from your breasts? 3707 17 1 2 1 Yes 2 No Sysmiss 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink 904. In the first three days after delivery, was (name) given anything to drink In the first three days after delivery, was (name) given anything to drink other than breast milk? No, go to 906 3724 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 11196 8 593 Household number Household number Household number Household number Household number Household No. 11196 1 43 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 11196 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 11196 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 18 19 25 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food 905. What was (name) given to drink? - A. Liquid Food What was (name) given to drink during that time? Anything else? - Liquid food 11196 1 12 1 Milk (other than breast milk) 2 Other mother milk 3 Plain water 4 Sugar or glucose water 5 Gripe water 6 Sugar-salt-water solution 7 Fruit juice 8 Infant formula 9 Honey 10 Ghee 11 Milk pouder 12 Others 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? 905. What was (name) given to drink? - B. Fed/not fed? What was (name) given to drink during that time? Anything else? - Fed/Not fed 11196 1 2 1 Fed 2 Not fed CO code CO code CO code CO code CO code CO Code 3724 8 593 Household number Household number Household number Household number Household number Household No. 3724 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3724 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? 906. For how many months did you exclusively breastfeed (name)? For how many months did you exclusively breastfeed (name)? 3724 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 17 18 24 30 99 Still breastfeeding 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? 907. For how many months did you breastfeed (name)? For how many months did you breastfeed (name)? 3724 99 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 34 35 36 39 42 48 50 60 90 99 Still breastfeeding 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? 908. ENUMERATOR: Is [name] younger than 24 months or older? ENUMERATOR: Is [name] younger than 24 months or older? Older than 24 m 30 d, go to Section 10 3724 1 3 1 Younger than 24 m 30 d 2 Older than 24 m 30 d 3 Child dead 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? 909. Are you still breastfeeding (name)? Are you still breastfeeding (name)? No, go to 911 2582 1142 1 2 1 Yes 2 No Sysmiss 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 910. How often did you breastfeed your child (name) day and night during last 24 How often did you breastfeed your child (name) day and night during last 24 hours? (Go to Q911 if answer is 0, if more than that go to Q912) 2494 1230 80 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 28 30 32 60 80 Sysmiss CO code CO code CO code CO code CO code CO Code 623 13 578 Household number Household number Household number Household number Household number Household No. 623 1 40 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 26 27 28 32 33 36 37 40 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 623 3 1 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 623 1 16 1 2 3 4 7 8 9 10 12 14 16 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding 911. Why not? - A. Reasons for not breastfeeding If not breastfeeding, why not? - Reasons for not breastfeeding 623 1 7 1 No milking 2 Inadequacy of breastmilks 3 Work load/lack of time 4 Child ill 5 Pregnant 6 Mother is/was sick 7 Other 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? 911. Why not? - B. Yes/No? If not breastfeeding, why not? - Yes/No 623 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 3724 8 593 Household number Household number Household number Household number Household number Household No. 3724 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3724 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste 912. Did (name) drink anything milk or liquidy from a bottle with a nipple yeste Did (name) drink anything milk or liquidy from a bottle with a nipple yesterday or last night? 2582 1142 1 8 1 Yes 2 Nothing 8 Do not know Sysmiss CO code CO code CO code CO code CO code CO Code 61968 8 593 Household number Household number Household number Household number Household number Household No. 61968 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 61968 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 61968 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item 913. liquids or foods - A. Item Now I would like to ask you about (other) liquids or foods that (name) may have had yesterday during the day or at night.. (Ask all items one after another) Did (name) drink/eat:? - Item 61968 1 24 1 Breast milk 2 Plain water 3 Milk such as commercially produced infant formula 4 Any fortified, commercially available infant and young child food 5 Any other porridge or gruel 6 Fresh animal milk 7 Yogurt or other milk products 8 Rice, chapattis other foods made from grains such as millet, maize, lito 9 White potatoes or other [roots] tubers 10 Pupmkin, carrots, or other yellow or orange vegetables 11 Ripe mangoes, papaya, or other yellow or orange fruits 12 Any dark green leafy vegetables 13 Other fruits such as banana, orange, apple 14 Eggs 15 Any meat such as goat, lamb, chicken, pork, ducks 16 Any organ meat such as liver, kidney 17 Fresh or dried fish or shellfish/dried meat 18 Snails or other small protein foods 19 Lentils, beans, peas, or nuts 20 Any oils, fats or foods made with any of these foods 21 Tea 22 Sugary foods such as sweets, chocolate 23 Processed foods such as biscuits, noodles 24 Any other solid or soft foods/JAAND 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? 913. liquids or foods - B. Yes/No? Now I would like to ask you about (other) liquids or foods that (name) may have had yesterday during the day or at night.. (Ask all items one after another) Did (name) drink/eat:? - Code 61968 1 2 1 Yes 2 No CO code CO code CO code CO code CO code CO Code 3724 8 593 Household number Household number Household number Household number Household number Household No. 3724 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3724 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo 914. How many times did (name) youngest child eat solid, semi-solid, or soft foo How many times did (name) youngest child eat solid, semi-solid, or soft food other than liquids yesterday during the day or at night? 2582 1142 98 1 2 3 4 5 6 7 8 9 10 12 14 98 Do not know Sysmiss CO code CO code CO code CO code CO code CO Code 29175 8 593 Household number Household number Household number Household number Household number Household No. 29175 1 47 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 29175 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 29175 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 21 23 25 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food 915. Food usually given to the child - A. Type of food What type of food consistency is usually given to the child? - Type of food 29175 1 15 1 Solid (Dal Bhat Vegetable) 2 Semi-solid (Jaulo/Porridge) 3 Mashed/pureed 4 Liquidy 5 Milk 6 Biscuit 7 Horlicks 8 Cerelac 9 HALUWA 10 Noodles 11 Egg 12 Meat 13 Bread 14 Fruits 15 Others 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given 915. Food usually given to the child - B. Given/not given What type of food consistency is usually given to the child? - Given/Not given 29175 1 2 1 Given 2 Not given CO code CO code CO code CO code CO code CO Code 3724 8 593 Household number Household number Household number Household number Household number Household No. 3724 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 3724 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 3724 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? 916. Did the child receive vitamin A capsule within the last 6 months? Did the child receive vitamin A capsule within the last 6 months? 2582 1142 1 3 1 Yes 2 No 3 Child below 6 months old Sysmiss 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d 917. How many hours were you away from your child due to work or other reasons d How many hours were you away from your child due to work or other reasons during the past 24 hours? (If answer is no or less than 1 hour, record 00) 2582 1142 12 1 2 3 4 5 6 7 8 9 10 11 12 Sysmiss 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the 918. Did you say you would feed the baby later when he/she (name) expressed the Did you say you would feed the baby later when he/she (name) expressed the desire for it (within the last 24 hours)? 591 3133 1 2 1 I did 2 I did not Sysmiss CO code CO code CO code CO code CO code CO Code 4668 8 593 Household number Household number Household number Household number Household number Household No. 4668 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4668 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4668 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 24 25 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) 1001. Weight of the female respondent (in kilograms) Now, I would like to talk to you about your physical feature and request for measuring weight and height Weight of the female respondent (in kilograms). 3907 761 26.5 998 998 Could not weigh Sysmiss 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) 1002. Height of the female respondent (in centimeters) Height of the female respondent (in centimeters) 3907 761 115 998 998 Could not measure Sysmiss 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl 1003A. How many children under 5 years of age in your household from the eligibl How many children under 3 years (0-36 months or up to 36 months 30 days) of age in your household from the eligible woman? [If this is 0, it is the end of the interview.] 4668 4 1 2 3 4 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? 1003B. Interviewed children under 5 years of age (for Section 11)? Interviewed children under 5 years of age (for Section 11)? 4326 342 4 1 2 3 4 Sysmiss 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) 1004. Weight of mother holding child #1 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #1 (kilograms) 4326 342 31.5 999 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 1004. ID CODE OF CHILD #1 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 1 (HH Roster) 2513 2155 3 28 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 24 25 28 Sysmiss 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) 1005. Weight of mother holding child #2 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #2 (kilograms) 1264 3404 37.4000015258789 999 37.4000015258789 38.5 39.4000015258789 40.2000007629395 41 41.2000007629395 41.4000015258789 41.7000007629395 42.2999992370605 42.7000007629395 42.7999992370605 43.5999984741211 44 44.7999992370605 45.4000015258789 45.5 45.5999984741211 45.7000007629395 46 46.0999984741211 46.4000015258789 46.5 47.0999984741211 47.2000007629395 47.5 47.7999992370605 48.2000007629395 48.2999992370605 48.5999984741211 48.7000007629395 48.9000015258789 49 49.4000015258789 49.5999984741211 49.7000007629395 50 50.2999992370605 50.4000015258789 50.7000007629395 50.7999992370605 51.2000007629395 51.2999992370605 51.5999984741211 51.7999992370605 51.9000015258789 52 52.2999992370605 52.4000015258789 52.5999984741211 52.7999992370605 53 53.0999984741211 53.4000015258789 53.5999984741211 53.7000007629395 54 54.2999992370605 54.5 54.7000007629395 55 55.2000007629395 55.4000015258789 55.5999984741211 56 56.2000007629395 56.2999992370605 56.4000015258789 56.5999984741211 56.7000007629395 56.7999992370605 57 57.4000015258789 57.7999992370605 57.9000015258789 58 58.2999992370605 59.0999984741211 59.2000007629395 59.9000015258789 61 61.7999992370605 62.2000007629395 62.5 63.7999992370605 63.9000015258789 64 64.0999984741211 65.5999984741211 70.1999969482422 71.0999984741211 73 73.6999969482422 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 1005. ID CODE OF CHILD #2 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 2 (HH Roster) 131 4537 3 20 3 4 5 6 7 8 9 10 11 12 13 15 16 20 Sysmiss 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) 1006. Weight of mother holding child #3 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #3 (kilograms) 58 4610 48.5 999 48.5 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 1006. ID CODE OF CHILD #3 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 3 (HH Roster) 1 4667 5 5 5 Sysmiss 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) 1006A. Weight of mother holding child #4 (kilograms) If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. Weight of mother holding child #4 (kilograms) 2 4666 999 999 998 Could not weigh 999 NA (>=25 months child) Sysmiss 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 1006A. ID CODE OF CHILD #4 If child is below 24 months 30 days, ask the mother to hold the child, weigh both mother and child. If the child is 25 months or older, do not fill out Q1004-1006. ID CODE OF CHILD 4 (HH Roster) 4668 * Sysmiss CO code CO code CO code CO code CO code CO Code 4728 8 593 Household number Household number Household number Household number Household number Household No. 4728 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4728 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women] Name and ID Code of Respondent -HH Roster 4728 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child According to Q1003, ask the following questions about children under 3 years (0-36 months) of age and measure weight and height of those children. If the child is below 24 m 30 d ask the mother to hold the child and take measurements of both together, and then calculate the child’s weight deducting that of the mother’s. ID CODE of Children 4728 2 28 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 24 25 28 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD 1007. Date of Birth of Child - DD Date of Birth of Child - DD 4728 1 32 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM 1007. Date of Birth of Child - MM Date of Birth of Child - MM 4728 1 12 1 2 3 4 5 6 7 8 9 10 11 12 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY 1007. Date of Birth of Child - YY Date of Birth of Child - YY 4728 2067 2071 2067 2068 2069 2070 2071 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? 1008. Was there any problem at delivery of this child (delivery complications)? Was there any problem at delivery of this child (delivery complications)? 4728 1 2 1 Yes 2 No 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? 1009. How long was the child breastfed? How long was the child breastfed? 4728 99 Not breastfed 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 34 35 36 37 39 99 Currently breastfeeding 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? 1010. Has child been occulated? Has child been occulated? [BCG(1); DPT(3); Polio(3); Measles(1)] 4728 1 3 1 Fully occulated 2 Being fully occulated 3 Not occulated 1011. Height of Child 1011. Height of Child 1011. Height of Child 1011. Height of Child 1011. Height of Child Height of Child (to nearest 0.5 cm) If height not measured record 999 and go to Q1013 4728 39 999 999 Not measured 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing 1012. Height is measured laying or standing Height is measured laying or standing 4585 143 1 2 1 Laying 2 Standing Sysmiss 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child 1013. Weight of Child Weight of Child If weight not measured record 999 and go to Q1015 4728 1.89999997615814 999 999 Not measured 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? 1014. Was child weighed with the mother or alone? Was child weighed with the mother or alone? → Go To Next Member 4592 136 1 2 1 Alone 2 With mum Sysmiss 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight 1015. Reason for not taking Height/Weight Reason for not taking Height/Weight (If you filled out 999 for question 1011 or 1013) 136 4592 1 3 1 Child not at home 2 Child was sick 3 Not allowed to take Height/Weight Sysmiss CO code CO code CO code CO code CO code CO Code 4728 8 593 Household number Household number Household number Household number Household number Household No. 4728 1 50 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 50 Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) Household sub-number (if separated) 4728 3 1 2 3 ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) ID Code of Eligible Woman/respondent (Sec 06) [Respondent: Eligible Women and Child] Name and ID Code of Respondent -HH Roster 4728 1 25 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 21 23 25 ID Code of child ID Code of child ID Code of child ID Code of child ID Code of child ID Code of Child 4728 2 28 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 22 24 25 28 Age of chid (month) Age of chid (month) Age of chid (month) Age of chid (month) Age of chid (month) How old is/are your child(ren)? - Age of child (month) 4728 1 58 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun 1101A. COMMUNICATION: 01. Does your baby sometimes make throaty or gurgling soun Does your baby sometimes make throaty or gurgling sounds? 207 4521 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, 1101A. COMMUNICATION: 02. Does your baby make cooing sounds such as ?ooo,? ?gah, Does your baby make cooing sounds such as “ooo,” “gah,” and “aah”? 207 4521 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back 1101A. COMMUNICATION: 03. When you speak to your baby, does she make sounds back When you speak to your baby, does she make sounds back to you? 207 4521 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? 1101A. COMMUNICATION: 04. Does your baby smile when you talk to him? Does your baby smile when you talk to him? 439 4289 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? 1101A. COMMUNICATION: 05. Does your baby chuckle softly? Does your baby chuckle softly? 439 4289 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile 1101A. COMMUNICATION: 06. After you have been out of sight, does your baby smile After you have been out of sight, does your baby smile or get excited when she sees you? 439 4289 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? 1101A. COMMUNICATION: 07. Does your baby make high-pitched squeals? Does your baby make high-pitched squeals? 384 4344 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo 1101A. COMMUNICATION: 08. Does your baby make sounds when looking at toys or peo Does your baby make sounds when looking at toys or people? 529 4199 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does 1101A. COMMUNICATION: 09. If you call your baby when you are out of sight, does If you call your baby when you are out of sight, does she look in the direction of your voice? 529 4199 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w 1101A. COMMUNICATION: 10. When a loud noise occurs, does your baby turn to see w When a loud noise occurs, does your baby turn to see where the sound came from? 297 4431 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby 1101A. COMMUNICATION: 11. If you copy the sounds your baby makes, does your baby If you copy the sounds your baby makes, does your baby repeat the same sounds back to you? 506 4222 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s 1101A. COMMUNICATION: 12. Does your baby respond to the tone of your voice and s Does your baby respond to the tone of your voice and stop his activity at least briefly when you say “no-no” to him? 506 4222 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? 1101A. COMMUNICATION: 13. Does your baby make two similar sounds like ?ba-ba,? ? Does your baby make two similar sounds like “ba-ba,” “da-da,” or “ga-ga”? (The sounds do not need to mean anything.) 589 4139 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur 1101A. COMMUNICATION: 14. If you ask your baby to, does he play at least one nur If you ask your baby to, does he play at least one nursery game even if you don’t show him the activity yourself (such as “bye-bye,” “Peeka- boo,” “clap your hands,” “So Big”)? 444 4284 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com 1101A. COMMUNICATION: 15. Does your baby follow one simple command, such as ?Com Does your baby follow one simple command, such as “Come here,” “Give it to me,” or “Put it back,” without your using gestures? 742 3986 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, 1101A. COMMUNICATION: 16. Does your baby say three words, such as ?Mama,? ?Dada, Does your baby say three words, such as “Mama,” “Dada,” and “Baba”? (A “word” is a sound or sounds your baby says consistently to mean someone or something.) 444 4284 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po 1101A. COMMUNICATION: 17. When your baby wants something, does he tell you by po When your baby wants something, does he tell you by pointing to it? 1058 3670 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y 1101A. COMMUNICATION: 18. Does your baby shake his head when he means ?no? or ?y Does your baby shake his head when he means “no” or “yes”? 533 4195 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur 1101A. COMMUNICATION: 19. Does your baby point to, pat, or try to pick up pictur Does your baby point to, pat, or try to pick up pictures in a book? 598 4130 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? 1101A. COMMUNICATION: 20. Does your baby say four or more words in addition to ? Does your baby say four or more words in addition to “Mama” and “Dada”? 823 3905 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro 1101A. COMMUNICATION: 21. When you ask her to, does your baby go into another ro When you ask her to, does your baby go into another room to find a familiar toy or object? (You might ask, “Where is your ball?” or say, “Bring me your coat,” or “Go get your blanket.”) 823 3905 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp 1101A. COMMUNICATION: 22. Does your child imitate a two-word sentence? For examp Does your child imitate a two-word sentence? For example, when you say a two-word phrase, such as “Mama eat,” “Daddy play,” “Go home,” or “What’s this?” does your child say both words back to you? 679 4049 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the 1101A. COMMUNICATION: 23. Without your showing him, does your child point to the Without your showing him, does your child point to the correct picture when you say, “Show me the kitty,” or ask, “Where is the dog?” (He needs to identify only one picture correctly.) 1131 3597 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent 1101A. COMMUNICATION: 24. Does your child say two or three words that represent Does your child say two or three words that represent different ideas together, such as “See dog,” “Mommy come home,” or “Kitty gone”? 831 3897 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, 1101A. COMMUNICATION: 25. If you point to a picture of a ball (kitty, cup, hat, If you point to a picture of a ball (kitty, cup, hat, etc.) and ask your child, “What is this?” does your child correctly name at least one picture? 1042 3686 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges 1101A. COMMUNICATION: 26. Without your giving him clues by pointing or using ges Without your giving him clues by pointing or using gestures, can your child carry out at least three of these kinds of directions? A) "Put the toy on the table" B) "Close the door" C) "Bring me a towel" D) "Find your coat" E) "Take my hand" F) "Get your book” 1953 2775 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha 1101A. COMMUNICATION: 27. When you ask your child to point to her nose, eyes, ha When you ask your child to point to her nose, eyes, hair, feet, ears, and so forth, does she correctly point to at least seven body parts? 1953 2775 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like 1101A. COMMUNICATION: 28. Does your child correctly use at least two words like Does your child correctly use at least two words like “me,” “I,” “mine,” and “you”? 888 3840 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four 1101A. COMMUNICATION: 29. Does your child make sentences that are three or four Does your child make sentences that are three or four words long? Please give an example: 1347 3381 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge 1101A. COMMUNICATION: 30. Without giving your child help by pointing or using ge Without giving your child help by pointing or using gestures, ask him to “put the book on the table” and “put the shoe under the chair.” Does your child carry out both of these directions correctly? 1347 3381 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y 1101A. COMMUNICATION: 31. When looking at a picture book, does your child tell y When looking at a picture book, does your child tell you what is hap- pening or what action is taking place in the picture (for example, “bark- ing,” “running,” “eating,” or “crying”)? You may ask, “What is the dog (or boy) doing?” 911 3817 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say 1101A. COMMUNICATION: 32. When you ask, ?What is your name?? does your child say When you ask, “What is your name?” does your child say his first name or nickname? 911 3817 1 2 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire 1101A. COMMUNICATION: 33. Without your giving help by pointing or repeating dire Without your giving help by pointing or repeating directions, does your child follow three directions that are unrelated to one another? Give all three directions before your child starts. For example, you may ask your child, “Clap your hands, walk to the door, and sit down,” or “Give me the pen, open the book, and stand up.” 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to 1101A. COMMUNICATION: 34. Does your child use all of the words in a sentence to Does your child use all of the words in a sentence (for example, “a,” “the,” “am,” “is,” and “are”) to make complete sentences, such as “I am going to the park,” or “Is there a toy to play with?” or “Are you coming, too?” 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo 1101A. COMMUNICATION: 35. Does your child name at least three items from a commo Does your child name at least three items from a common category? For example, if you say to your child, “Tell me some things that you can eat,” does your child answer with something like “cookies, eggs, and cereal”? Or if you say, “Tell me the names of some animals,” does your child answer with something like “cow, dog, and elephant”? 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? 1101A. COMMUNICATION: 36. Does your child answer the following questions? - 1. ? Does your child answer the following questions? 1. “What do you do when you are hungry?” (Acceptable answers include “get food,” “eat,” “ask for something to eat,” and “have a snack.”) 2. “What do you do when you are tired?” (Acceptable answers include “take a nap,” “rest,” “go to sleep,” “go to bed,” “lie down,” and “sit down.”) 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com 1101A. COMMUNICATION: 37. Does your child tell you at least two things about com Does your child tell you at least two things about common objects? For example, if you say to your child, “Tell me about your ball,” does she say something like, “It’s round. I throw it. It’s big”? 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- 1101A. COMMUNICATION: 38. Does your child use endings of words, such as ?-s,? ?- Does your child use endings of words, such as “-s,” “-ed,” and “-ing”? For example, does your child say things like, “I see two cats,” “I am playing,” or “I kicked the ball”? 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For 1101A. COMMUNICATION: 39. Does your child use four- and five-word sentences? For Does your child use four- and five-word sentences? For example, does your child say, “I want the car”? 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do 1101A. COMMUNICATION: 40. When talking about something that already happened, do When talking about something that already happened, does your child use words that end in “-ed,” such as “walked,” “jumped,” or “played”? Ask your child questions, such as “How did you get to the store?” (“We walked.”) “What did you do at your friend’s house?” (“We played.”) 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier 1101A. COMMUNICATION: 41. Does your child use comparison words, such as ?heavier Does your child use comparison words, such as “heavier,” “stronger,” or “shorter”? Ask your child questions, such as “A car is big, but a bus is _____” (bigger); “A cat is heavy, but a man is _____” (heavier); “A TV is small, but a book is _____” (smaller). 4728 * 1 Yes 2 No Sysmiss 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back 1101A. COMMUNICATION: 42. Does your child repeat the sentences shown below back Does your child repeat the sentences shown below back to you, without any mistakes? (Read the sentences one at a time. You may repeat each sentence one time.) Jane hides her shoes for Maria to find. Al read the blue book under his bed. 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an 1101B. GROSS MOTOR: 01. While your baby is on his back, does he wave his arms an While your baby is on his back, does he wave his arms and legs, wiggle, and squirm? 207 4521 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to 1101B. GROSS MOTOR: 02. When your baby is on her tummy does she turn her head to When your baby is on her tummy does she turn her head to the side? 207 4521 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 03. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up longer than a few seconds? 207 4521 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? 1101B. GROSS MOTOR: 04. When your baby is on her back, does she kick her legs? When your baby is on her back, does she kick her legs? 439 4289 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b 1101B. GROSS MOTOR: 05. After holding her head up while on her tummy does your b After holding her head up while on her tummy does your baby lay her head down on the floor, rather than let it drop or fall forward? 439 4289 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up 1101B. GROSS MOTOR: 06. When your baby is on his tummy, does he hold his head up When your baby is on his tummy, does he hold his head up so that his chin is about 3 inches from the floor for at least 15 seconds? 439 4289 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s 1101B. GROSS MOTOR: 07. When your baby is on her tummy, does she hold her head s When your baby is on her tummy, does she hold her head straight up, looking around? 232 4496 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby 1101B. GROSS MOTOR: 08. When you hold him in a sitting position, does your baby When you hold him in a sitting position, does your baby hold his head steady? 384 4344 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his 1101B. GROSS MOTOR: 09. While your baby is on his back, does your baby lift his While your baby is on his back, does your baby lift his legs high enough to see his feet? 384 4344 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting 1101B. GROSS MOTOR: 10. Does your baby roll from his back to his tummy, getting Does your baby roll from his back to his tummy, getting both arms out from under him? 297 4431 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he 1101B. GROSS MOTOR: 11. When you put your baby on the floor, does she lean on he When you put your baby on the floor, does she lean on her hands while sitting? 297 4431 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 12. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he support his own weight while standing? 506 4222 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u 1101B. GROSS MOTOR: 13. Does your baby get into a crawling position by getting u Does your baby get into a crawling position by getting up on her hands and knees? 506 4222 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh 1101B. GROSS MOTOR: 14. When sitting on the floor, does your baby sit up straigh When sitting on the floor, does your baby sit up straight for several minutes without using her hands for support? 354 4374 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r 1101B. GROSS MOTOR: 15. When you stand your baby next to furniture or the crib r When you stand your baby next to furniture or the crib rail, does he hold on without leaning his chest against the furniture for support? 589 4139 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi 1101B. GROSS MOTOR: 16. Does your baby walk beside furniture while holding on wi Does your baby walk beside furniture while holding on with only one hand? 444 4284 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h 1101B. GROSS MOTOR: 17. If you hold both hands just to balance your baby, does h If you hold both hands just to balance your baby, does he take several steps without tripping or falling? 742 3986 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s 1101B. GROSS MOTOR: 18. When you hold one hand just to balance your baby, does s When you hold one hand just to balance your baby, does she take several steps forward? 533 4195 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi 1101B. GROSS MOTOR: 19. Does your baby stand up in the middle of the floor by hi Does your baby stand up in the middle of the floor by himself and take several steps forward? 833 3895 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f 1101B. GROSS MOTOR: 20. Does your baby bend over or squat to pick up an object f Does your baby bend over or squat to pick up an object from the floor and then stand up again without any support? 833 3895 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr 1101B. GROSS MOTOR: 21. Does your baby move around by walking, rather than by cr Does your baby move around by walking, rather than by crawling on his hands and knees? 823 3905 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? 1101B. GROSS MOTOR: 22. Does your child walk well and seldom fall? Does your child walk well and seldom fall? 679 4049 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re 1101B. GROSS MOTOR: 23. Does your child climb on an object such as a chair to re Does your child climb on an object such as a chair to reach something he wants (for example, to get a toy on a counter or to “help” you in the kitchen)? 977 3751 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of 1101B. GROSS MOTOR: 24. Does your child walk down stairs if you hold onto one of Does your child walk down stairs if you hold onto one of her hands? She may also hold onto the railing or wall. (You can look for this at a store, on a playground, or at home.) 899 3829 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does 1101B. GROSS MOTOR: 25. When you show your child how to kick a large ball, does When you show your child how to kick a large ball, does he try to kick the ball by moving his leg forward or by walking into it? 831 3897 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou 1101B. GROSS MOTOR: 26. Does your child run fairly well, stopping herself withou Does your child run fairly well, stopping herself without bumping into things or falling? 1844 2884 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step 1101B. GROSS MOTOR: 27. Does your child walk either up or down at least two step Does your child walk either up or down at least two steps by himself? He may also hold onto the railing or wall. 1350 3378 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at 1101B. GROSS MOTOR: 28. Does your child jump with both feet leaving the floor at Does your child jump with both feet leaving the floor at the same time? 1799 2929 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi 1101B. GROSS MOTOR: 29. Without holding onto anything for support, does your chi Without holding onto anything for support, does your child kick a ball by swinging his leg forward? 1799 2929 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e 1101B. GROSS MOTOR: 30. Does your child walk up stairs, using only one foot on e Does your child walk up stairs, using only one foot on each stair? (The left foot is on one step, and the right foot is on the next.) She may hold onto the railing or wall. 1579 3149 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit 1101B. GROSS MOTOR: 31. Does your child stand on one foot for about 1 second wit Does your child stand on one foot for about 1 second without holding onto anything? 1347 3381 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by 1101B. GROSS MOTOR: 32. While standing, does your child throw a ball overhand by While standing, does your child throw a ball overhand by raising his arm to shoulder height and throwing the ball forward? 603 4125 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both 1101B. GROSS MOTOR: 33. Does your child jump forward at least 6 inches with both Does your child jump forward at least 6 inches with both feet leaving the ground at the same time? 334 4394 1 2 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? 1101B. GROSS MOTOR: 34. Does your child catch a large ball with both hands? Does your child catch a large ball with both hands? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro 1101B. GROSS MOTOR: 35. Does your child climb the rungs of a ladder of a playgro Does your child climb the rungs of a ladder of a playground slide and slide down without help? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l 1101B. GROSS MOTOR: 36. Does your child hop up and down on either the right or l Does your child hop up and down on either the right or left foot at least one time without losing her balance or falling? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro 1101B. GROSS MOTOR: 37. Does your child jump forward a distance of 20 inches fro Does your child jump forward a distance of 20 inches from a standing position, starting with his feet together? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on 1101B. GROSS MOTOR: 38. Without holding onto anything, does your child stand on Without holding onto anything, does your child stand on one foot for at least 5 seconds without losing her balance and putting her foot down? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t 1101B. GROSS MOTOR: 39. Does your child walk on his tiptoes for 15 feet (about t Does your child walk on his tiptoes for 15 feet (about the length of a large car)? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o 1101B. GROSS MOTOR: 40. Does your child hop forward on one foot for a distance o Does your child hop forward on one foot for a distance of 4–6 feet without putting down the other foot? 4728 * 1 Yes 2 No Sysmiss 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? 1101B. GROSS MOTOR: 41. Does your child skip using alternating feet? Does your child skip using alternating feet? 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o 1101C. FINE MOTOR : 01. Does your baby grasp your finger if you touch the palm o Does your baby grasp your finger if you touch the palm of her hand? 207 4521 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i 1101C. FINE MOTOR : 02. When you put a toy in his hand, does your baby hold it i When you put a toy in his hand, does your baby hold it in his hand briefly? 439 4289 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? 1101C. FINE MOTOR : 03. Does your baby touch her face with her hands? Does your baby touch her face with her hands? 207 4521 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h 1101C. FINE MOTOR : 04. Does your baby hold his hands open or partly open when h Does your baby hold his hands open or partly open when he is awake (rather than in fists, as they were when he was a newborn)? 207 4521 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? 1101C. FINE MOTOR : 05. Does your baby grab or scratch at her clothes? Does your baby grab or scratch at her clothes? 439 4289 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a 1101C. FINE MOTOR : 06. When you put a toy in her hand, does your baby wave it a When you put a toy in her hand, does your baby wave it about, at least briefly? 439 4289 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto 1101C. FINE MOTOR : 07. When you put a toy in her hand, does your baby hold onto When you put a toy in her hand, does your baby hold onto it for about 1 minute while looking at it, waving it about, or trying to chew it? 232 4496 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she 1101C. FINE MOTOR : 08. When you hold your baby in a sitting position, does she When you hold your baby in a sitting position, does she reach for a toy on a table close by, even though her hand may not touch it? 384 4344 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave 1101C. FINE MOTOR : 09. Does your baby grab a toy you offer and look at it, wave Does your baby grab a toy you offer and look at it, wave it about, or chew on it for about 1 minute? 384 4344 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands 1101C. FINE MOTOR : 10. Does your baby reach for or grasp a toy using both hands Does your baby reach for or grasp a toy using both hands at once? 297 4431 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it 1101C. FINE MOTOR : 11. Does your baby reach for a crumb or Cheerio and touch it Does your baby reach for a crumb or Cheerio and touch it with his finger or hand? 297 4431 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce 1101C. FINE MOTOR : 12. Does your baby pick up a small toy, holding it in the ce Does your baby pick up a small toy, holding it in the center of her hand with her fingers around it? 297 4431 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? 1101C. FINE MOTOR : 13. Does your baby pick up a small toy with only one hand? Does your baby pick up a small toy with only one hand? 506 4222 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b 1101C. FINE MOTOR : 14. Does your baby successfully pick up a crumb or Cheerio b Does your baby successfully pick up a crumb or Cheerio by using his thumb and all of his fingers in a raking motion? 354 4374 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o 1101C. FINE MOTOR : 15. After one or two tries, does your baby pick up a piece o After one or two tries, does your baby pick up a piece of string with her first finger and thumb? (The string may be attached to a toy.) 589 4139 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it 1101C. FINE MOTOR : 16. Does your baby put a small toy down, without dropping it Does your baby put a small toy down, without dropping it, and then take her hand off the toy? 742 3986 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? 1101C. FINE MOTOR : 17. Does your baby help turn the pages of a book? Does your baby help turn the pages of a book? 1042 3686 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot 1101C. FINE MOTOR : 18. Does your baby throw a small ball with a forward arm mot Does your baby throw a small ball with a forward arm motion? 1267 3461 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot 1101C. FINE MOTOR : 19. Does your baby stack a small block or toy on top of anot Does your baby stack a small block or toy on top of another one? (You could also use spools of thread, small boxes, or toys that are about 1 inch in size.) 1432 3296 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of 1101C. FINE MOTOR : 20. Does your baby make a mark on the paper with the tip of Does your baby make a mark on the paper with the tip of a crayon (or pencil or pen) when trying to draw? 1664 3064 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? 1101C. FINE MOTOR : 21. Does your child turn the pages of a book by himself? Does your child turn the pages of a book by himself? (He may turn more than one page at a time.) 1865 2863 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up 1101C. FINE MOTOR : 22. Does your child get a spoon into her mouth right side up Does your child get a spoon into her mouth right side up so that the food usually doesn’t spill? 1567 3161 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while 1101C. FINE MOTOR : 23. Does your child use a turning motion with her hand while Does your child use a turning motion with her hand while trying to turn doorknobs, wind up toys, twist tops, or screw lids on and off jars? 1575 3153 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron 1101C. FINE MOTOR : 24. Can your child string small items such as beads, macaron Can your child string small items such as beads, macaroni, or pasta “wagon wheels” onto a string or shoelace? 1953 2775 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v 1101C. FINE MOTOR : 25. Does your child copy you by drawing a single line in a v After your child watches you draw a line from the top of the paper to the bottom with a pencil, crayon, or pen, ask him to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a vertical direction? 1579 3149 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h 1101C. FINE MOTOR : 26. Does your child copy you by drawing a single line in a h After your child watches you draw a line from one side of the paper to the other side, ask her to make a line like yours. Do not let your child trace your line. Does your child copy you by drawing a single line in a horizontal direction? 1347 3381 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y 1101C. FINE MOTOR : 27. Do not let him trace your circle. Does your child copy y After your child watches you draw a single circle, ask him to make a circle like yours. Do not let him trace your circle. Does your child copy you by drawing a circle? 911 3817 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time 1101C. FINE MOTOR : 28. Does your child turn pages in a book, one page at a time Does your child turn pages in a book, one page at a time? 911 3817 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or 1101C. FINE MOTOR : 29. When drawing, does your child hold a pencil, crayon, or When drawing, does your child hold a pencil, crayon, or pen between her fingers and thumb like an adult does? 603 4125 1 2 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte 1101C. FINE MOTOR : 30. Does your child put together a five- to seven-piece inte Does your child put together a five- to seven-piece interlocking puzzle? 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop 1101C. FINE MOTOR : 31. Using the shape at right to look at, does your child cop Using the shape at right to look at, does your child copy it onto a large piece of paper using a pencil, crayon, or pen, without tracing? (Your child’s drawing should look like the design of the shape, except it may be different in size.) 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 32. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy at least three shapes onto a large piece of paper using a pencil, crayon, or pen, without tracing? (Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.) 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? 1101C. FINE MOTOR : 33. Does your child unbutton one or more buttons? Does your child unbutton one or more buttons? (Your child may use his own clothing or a doll’s clothing.) 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea 1101C. FINE MOTOR : 34. Does your child draw pictures of people that have at lea Does your child draw pictures of people that have at least three of the following features: head, eyes, nose, mouth, neck, hair, trunk, arms, hands, legs, or feet? 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color 1101C. FINE MOTOR : 35. Does your child color mostly within the lines in a color Does your child color mostly within the lines in a coloring book or within the lines of a 2-inch circle that you draw? (Your child should not go more than 1/4 inch outside the lines on most of the picture.) 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the 1101C. FINE MOTOR : 36. Does your child trace on the line without going off the Ask your child to trace on the line below with a pencil. Does your child trace on the line without going off the line more than two times? 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank 1101C. FINE MOTOR : 37. Ask your child to draw a picture of a person on a blank Ask your child to draw a picture of a person on a blank sheet of paper. You may ask your child, “Draw a picture of a girl or a boy.” If your child draws a person with head, body, arms, and legs, mark “yes.” If your child draws a person with three or fewer parts (head, body, arms, or legs), mark “not yet.” 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy 1101C. FINE MOTOR : 38. Using the shapes below to look at, does your child copy Using the shapes below to look at, does your child copy the shapes in the space below without tracing? (Your child’s drawings should look similar to the design of the shapes below, but they may be different in size.) 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy 1101C. FINE MOTOR : 39. Using the letters below to look at, does your child copy Using the letters below to look at, does your child copy the letters without tracing? 4728 * 1 Yes 2 No Sysmiss 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l 1101C. FINE MOTOR : 40. Print your child?s first name. Can your child copy the l Print your child’s first name. Can your child copy the letters? The letters may be large, backward, or reversed. 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches 1101D. PROBLEM SOLVING : 01. Does your baby look at objects that are 8?10 inches Does your baby look at objects that are 8–10 inches away? 207 4521 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit 1101D. PROBLEM SOLVING : 02. When you move around, does your baby follow you wit When you move around, does your baby follow you with his eyes? 207 4521 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro 1101D. PROBLEM SOLVING : 03. When you move a toy slowly from side to side in fro When you move a toy slowly from side to side in front of your baby’s face (about 10 inches away), does your baby follow the toy with her eyes, sometimes turning her head? 439 4289 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro 1101D. PROBLEM SOLVING : 04. When you move a small toy up and down slowly in fro When you move a small toy up and down slowly in front of your baby’s face (about 10 inches away), does your baby follow the toy with his eyes? 439 4289 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does 1101D. PROBLEM SOLVING : 05. When you hold your baby in a sitting position, does When you hold your baby in a sitting position, does she look at a toy (about the size of a cup or rattle) that you place on the table or floor in front of her? 439 4289 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l 1101D. PROBLEM SOLVING : 06. When you dangle a toy above your baby while he is l When you dangle a toy above your baby while he is lying on his back, does he wave his arms toward the toy? 439 4289 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look 1101D. PROBLEM SOLVING : 07. When you put a toy in her hand, does your baby look When you put a toy in her hand, does your baby look at it? 232 4496 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put 1101D. PROBLEM SOLVING : 08. When you put a toy in his hand, does your baby put When you put a toy in his hand, does your baby put the toy in his mouth? 384 4344 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach 1101D. PROBLEM SOLVING : 09. When a toy is in front of your baby, does she reach When a toy is in front of your baby, does she reach for it with both hands? 152 4576 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get 1101D. PROBLEM SOLVING : 10. When your baby is on her back, does she try to get When your baby is on her back, does she try to get a toy she has dropped if she can see it? 297 4431 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout 1101D. PROBLEM SOLVING : 11. Does your baby pick up a toy and put it in his mout Does your baby pick up a toy and put it in his mouth? 297 4431 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on 1101D. PROBLEM SOLVING : 12. Does your baby play by banging a toy up and down on Does your baby play by banging a toy up and down on the floor or table? 506 4222 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h 1101D. PROBLEM SOLVING : 13.Does your baby pick up two small toys, one in each h Does your baby pick up two small toys, one in each hand, and hold onto them for about 1 minute? 506 4222 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang 1101D. PROBLEM SOLVING : 14. When holding a toy in his hand, does your baby bang When holding a toy in his hand, does your baby bang it against another toy on the table? 589 4139 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b 1101D. PROBLEM SOLVING : 15. While holding a small toy in each hand, does your b While holding a small toy in each hand, does your baby clap the toys together (like “Pat-a-cake”)? 589 4139 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o 1101D. PROBLEM SOLVING : 16. After watching you hide a small toy under a piece o After watching you hide a small toy under a piece of paper or cloth, does your baby find it? (Be sure the toy is completely hidden.) 742 3986 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you 1101D. PROBLEM SOLVING : 17. If you put a small toy into a bowl or box, does you If you put a small toy into a bowl or box, does your baby copy you by putting in a toy, although she may not let go of it? 742 3986 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c 1101D. PROBLEM SOLVING : 18. After you scribble back and forth on paper with a c After you scribble back and forth on paper with a crayon (or a pencil or pen), does your baby copy you by scribbling? 833 3895 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o 1101D. PROBLEM SOLVING : 19. Does your baby drop two small toys, one after the o Does your baby drop two small toys, one after the other, into a container like a bowl or box? (You may show him how to do it.) 1058 3670 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to 1101D. PROBLEM SOLVING : 20. After you have shown your baby how, does he try to After you have shown your baby how, does he try to get a small toy that is slightly out of reach by using a spoon, stick, or similar tool? 977 3751 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib 1101D. PROBLEM SOLVING : 21. Without your showing him how, does your child scrib Without your showing him how, does your child scribble back and forth when you give him a crayon (or pencil or pen)? 1197 3531 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c 1101D. PROBLEM SOLVING : 22. After a crumb or Cheerio is dropped into a small, c After a crumb or Cheerio is dropped into a small, clear bottle, does your child turn the bottle upside down to dump it out? 525 4203 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o 1101D. PROBLEM SOLVING : 23. Does your child copy you by drawing a single line o After watching you draw a line from the top of the paper to the bottom with a crayon (or pencil or pen), does your child copy you by drawing a single line on the paper in any direction? 1131 3597 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u 1101D. PROBLEM SOLVING : 24. If you give your child a bottle, spoon, or pencil u If you give your child a bottle, spoon, or pencil upside down, does she turn it right side up so that she can use it properly? 831 3897 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does 1101D. PROBLEM SOLVING : 25. If your child wants something he cannot reach, does If your child wants something he cannot reach, does he find a chair or box to stand on to reach it (for example, to get a toy on a counter or to “help” you in the kitchen)? 1042 3686 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? 1101D. PROBLEM SOLVING : 26. Does your child pretend objects are something else? Does your child pretend objects are something else? For example, does your child hold a cup to his ear, pretending it is a telephone? Does he put a box on his head, pretending it is a hat? Does he use a block or small toy to stir food? 1619 3109 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? 1101D. PROBLEM SOLVING : 27. Does your child put things away where they belong? Does your child put things away where they belong? For example, does he know his toys belong on the toy shelf, his blanket goes on his bed, and dishes go in the kitchen? 1799 2929 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? 1101D. PROBLEM SOLVING : 28. When looking in the mirror, ask ?Where is _______?? When looking in the mirror, ask “Where is _______?” (Use your child’s name.) Does your child point to his image in the mirror? 1579 3149 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W 1101D. PROBLEM SOLVING : 29. When you point to the figure and ask your child, ?W When you point to the figure and ask your child, “What is this?” does your child say a word that means a person or something similar? (Mark “yes” for responses like “snowman,” “boy,” “man,” “girl,” “Daddy,” “spaceman,” and “monkey.”) Please write your child’s response here:_______________ 1347 3381 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child 1101D. PROBLEM SOLVING : 30. When you say, ?Say ?seven three,?? does your child When you say, “Say ‘seven three,’” does your child repeat just the two numbers in the same order? Do not repeat the numbers. If necessary, try another pair of numbers and say, “Say ‘eight two.’” Your child must repeat just one series of two numbers for you to answer “yes” to this question 1347 3381 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s 1101D. PROBLEM SOLVING : 31. After your child draws a ?picture,? even a simple s After your child draws a “picture,” even a simple scribble, does she tell you what she drew? (You may say, “Tell me about your picture,” or ask, “What is this?” to prompt her.) 911 3817 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c 1101D. PROBLEM SOLVING : 32. When you say, ?Say ?five eight three,?? does your c When you say, “Say ‘five eight three,’” does your child repeat just the three numbers in the same order? Do not repeat the numbers. If neces- sary, try another series of numbers and say, “Say ‘six nine two.’ 334 4394 1 2 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo 1101D. PROBLEM SOLVING : 33. When asked, ?Which circle is the smallest?? does yo When asked, “Which circle is the smallest?” does your child point to the smallest circle? 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending 1101D. PROBLEM SOLVING : 34. Does your child dress up and ?play-act,? pretending Does your child dress up and “play-act,” pretending to be someone or something else? For example, your child may dress up in different clothes and pretend to be a mommy, daddy, brother or sister, or an imaginary animal or figure. 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi 1101D. PROBLEM SOLVING : 35. Without your giving help by pointing, does your chi Without your giving help by pointing, does your child follow three different directions using the words “under,” “between,” and “middle”? For example, ask your child to put the shoe “under the couch.” Then ask her to put the ball “between the chairs” and the book “in the middle of the table.” 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? 1101D. PROBLEM SOLVING : 36. When shown objects and asked, ?What color is this?? When shown objects and asked, “What color is this?” does your child name five different colors, like red, blue, yellow, orange, black, white, or pink? 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c 1101D. PROBLEM SOLVING : 37. If you place five objects in front of your child, c If you place five objects in front of your child, can he count them by saying, “one, two, three, four, five,” in order? 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista 1101D. PROBLEM SOLVING : 38. Does your child count up to 15 without making mista Does your child count up to 15 without making mistakes? 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num 1101D. PROBLEM SOLVING : 39. Does your child know the names of the following num Does your child know the names of the following numbers? 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin 1101D. PROBLEM SOLVING : 40. Does your child finish the following sentences usin Does your child finish the following sentences using a word that means the opposite of the word that is italicized? For example: “A rock is hard, and a pillow is soft.” A) "A cow is big, and a mouse is ______", B) "Ice is cold, and fire is ______", C) "We see the stars at night, and we see the sun during the ______", D) "When I throw the ball up, it comes ______" 4728 * 1 Yes 2 No Sysmiss 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n 1101D. PROBLEM SOLVING : 41. Does your child name at least four letters in her n Does your child name at least four letters in her name? Point to the letters and ask, “What letter is this?” 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o 1101E. PERSONAL SOCIAL : 01. Does your baby cry when he is hungry, wet, tired, o Does your baby cry when he is hungry, wet, tired, or wants to be held? 207 4521 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? 1101E. PERSONAL SOCIAL : 02. When you smile at your baby, does she smile back? When you smile at your baby, does she smile back? 207 4521 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? 1101E. PERSONAL SOCIAL : 03. Does your baby watch his hands? Does your baby watch his hands? 207 4521 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she 1101E. PERSONAL SOCIAL : 04. When your baby sees the breast or bottle, does she When your baby sees the breast or bottle, does she seem to know she is about to be fed? 439 4289 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla 1101E. PERSONAL SOCIAL : 05. When your baby has her hands together, does she pla When your baby has her hands together, does she play with her fingers? 439 4289 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands 1101E. PERSONAL SOCIAL : 06. Does your baby help hold the bottle with both hands Does your baby help hold the bottle with both hands at once, or when nursing, does she hold the breast with her free hand? 439 4289 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi 1101E. PERSONAL SOCIAL : 07. When in front of a large mirror, does your baby smi When in front of a large mirror, does your baby smile or coo at herself? 384 4344 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha 1101E. PERSONAL SOCIAL : 08. Does your baby act differently toward strangers tha Does your baby act differently toward strangers than he does with you and other familiar people? (Reactions to strangers may include staring, frowning, withdrawing, or crying.) 384 4344 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra 1101E. PERSONAL SOCIAL : 09. While lying on her back, does your baby play by gra While lying on her back, does your baby play by grabbing her foot? 529 4199 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea 1101E. PERSONAL SOCIAL : 10. When in front of a large mirror, does your baby rea When in front of a large mirror, does your baby reach out to pat the mirror? 297 4431 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac 1101E. PERSONAL SOCIAL : 11. Does your baby try to get a toy that is out of reac Does your baby try to get a toy that is out of reach? (She may roll, pivot on her tummy, or crawl to get it.) 297 4431 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from 1101E. PERSONAL SOCIAL : 12. Does your baby drink water, juice, or formula from Does your baby drink water, juice, or formula from a cup while you hold it? 506 4222 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? 1101E. PERSONAL SOCIAL : 13. Does your baby feed himself a cracker or a cookie? Does your baby feed himself a cracker or a cookie? 354 4374 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 14. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby offer it to you even if she doesn’t let go of it? 589 4139 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do 1101E. PERSONAL SOCIAL : 15. When you hold out your hand and ask for her toy, do When you hold out your hand and ask for her toy, does your baby let go of it into your hand? 444 4284 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo 1101E. PERSONAL SOCIAL : 16. When you dress your baby, does she lift her foot fo When you dress your baby, does she lift her foot for her shoe, sock, or pant leg? 444 4284 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro 1101E. PERSONAL SOCIAL : 17. When you dress your baby, does he push his arm thro When you dress your baby, does he push his arm through a sleeve once his arm is started in the hole of the sleeve? 742 3986 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so 1101E. PERSONAL SOCIAL : 18. Does your baby roll or throw a ball back to you so Does your baby roll or throw a ball back to you so that you can return it to him? 533 4195 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b 1101E. PERSONAL SOCIAL : 19. Does your baby play with a doll or stuffed animal b Does your baby play with a doll or stuffed animal by hugging it? 833 3895 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c 1101E. PERSONAL SOCIAL : 20. Does your baby help undress himself by taking off c Does your baby help undress himself by taking off clothes like socks, hat, shoes, or mittens? 977 3751 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo 1101E. PERSONAL SOCIAL : 21. Does your baby get your attention or try to show yo Does your baby get your attention or try to show you something by pulling on your hand or clothes? 823 3905 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c 1101E. PERSONAL SOCIAL : 22. While looking at himself in the mirror, does your c While looking at himself in the mirror, does your child offer a toy to his own image? 525 4203 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su 1101E. PERSONAL SOCIAL : 23. Does your child come to you when she needs help, su Does your child come to you when she needs help, such as with wind- ing up a toy or unscrewing a lid from a jar? 1197 3531 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting 1101E. PERSONAL SOCIAL : 24. Does your child drink from a cup or glass, putting Does your child drink from a cup or glass, putting it down again with little spilling? 899 3829 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as 1101E. PERSONAL SOCIAL : 25. Does your child copy the activities you do, such as Does your child copy the activities you do, such as wipe up a spill, sweep, shave, or comb hair? 831 3897 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? 1101E. PERSONAL SOCIAL : 26. Does your child eat (with a fork) well? Does your child eat (with a fork) well? 1953 2775 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your 1101E. PERSONAL SOCIAL : 27. If you do any of the following gestures, does your If you do any of the following gestures, does your child copy at least one of them? A) "Open and close your mouth" B) "Blink your eyes" C) "Pull on your earlobe" D) "Pat your cheek" 1953 2775 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o 1101E. PERSONAL SOCIAL : 28. Does your child push a little wagon, stroller, or o Does your child push a little wagon, stroller, or other toy on wheels, steering it around objects and backing out of corners if she cannot turn? 888 3840 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often 1101E. PERSONAL SOCIAL : 29. Does your child call herself ?I? or ?me? more often Does your child call herself “I” or “me” more often than her own name? For example, “I do it,” more often than “Juanita do it.” 976 3752 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by 1101E. PERSONAL SOCIAL : 30. Does your child put on a coat, jacket, or shirt by Does your child put on a coat, jacket, or shirt by himself? 1579 3149 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee 1101E. PERSONAL SOCIAL : 31. After you put on loose-fitting pants around her fee After you put on loose-fitting pants around her feet, does your child pull them completely up to her waist? 1013 3715 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, 1101E. PERSONAL SOCIAL : 32. When your child is looking in a mirror and you ask, When your child is looking in a mirror and you ask, “Who is in the mirror?” does he say either “me” or his own name? 911 3817 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a 1101E. PERSONAL SOCIAL : 33. Using these exact words, ask your child, ?Are you a Using these exact words, ask your child, “Are you a girl or a boy?” Does your child answer correctly? 603 4125 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another 1101E. PERSONAL SOCIAL : 34. Does your child take turns by waiting while another Does your child take turns by waiting while another child or adult takes a turn? 334 4394 1 2 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one 1101E. PERSONAL SOCIAL : 35. Does your child serve himself, taking food from one Does your child serve himself, taking food from one container to an- other using utensils? For example, does your child use a large spoon to scoop applesauce from a jar into a bowl? 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate 1101E. PERSONAL SOCIAL : 36. Does your child wash his hands using soap and wate Does your child wash his hands using soap and water and dry off with a towel without help? 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo 1101E. PERSONAL SOCIAL : 37. Does your child tell you at least four of the follo Does your child tell you at least four of the following? Please mark the items your child knows. A) "First name" B) "Age" C) "City she lives in" D) "Last name" E) "Boy or girl" F) "Telephone number" 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p 1101E. PERSONAL SOCIAL : 38. Does your child tell you the names of two or more p Does your child tell you the names of two or more playmates, not including brothers and sisters? 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas 1101E. PERSONAL SOCIAL : 39. Does your child brush her teeth by putting toothpas Does your child brush her teeth by putting toothpaste on the toothbrush and brushing all of her teeth without help? (You may still need to check and rebrush your child’s teeth.) 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he 1101E. PERSONAL SOCIAL : 40. Does your child dress or undress himself without he Does your child dress or undress himself without help (except for snaps, buttons, and zippers)? 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin 1101E. PERSONAL SOCIAL : 41. Does your child dress and undress herself, includin Does your child dress and undress herself, including buttoning medium-size buttons and zipping front zippers? 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? 1101E. PERSONAL SOCIAL : 42. Does your child use the toilet by herself? Does your child use the toilet by herself? (She goes to the bathroom, sits on the toilet, wipes, and flushes.) Mark “yes” even if she does this after you remind her. 4728 * 1 Yes 2 No Sysmiss 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o 1101E. PERSONAL SOCIAL : 43. Does your child usually take turns and share with o Does your child usually take turns and share with other children? 4728 * 1 Yes 2 No Sysmiss