Information Collection Request

The National Centers for Autism and Developmental Disabilities Research and Epidemiology (CADDRE) Study

ICR 200702-0920-001 · OMB 0920-0741 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Appendix U CADDRE Analysis and Pub Guidelines.doc Supplementary Document Uploaded 2007-06-05 Available
CADDRE Supporting Statement to OMB 6-4-2007.doc Supporting Statement B Uploaded 2007-06-05 Available
Appendix Q Vineland Follow Up call.doc Supplementary Document Uploaded 2007-01-10 Available
Appendix J SCQ.pdf Supplementary Document Uploaded 2007-01-10 Available
Appendix E.21 Buccal Transmittal Form.doc Supplementary Document Uploaded 2007-01-10 Repair queued
Appendix E.5 Caregiver Interview Prep Guide.doc Supplementary Document Uploaded 2007-01-10 Available
Appendix E.4 Clinic Visit Prep Guide.doc Supplementary Document Uploaded 2007-01-10 Available
Appendix E.2 Cover Sheet Yellow Folder Instructions.doc Supplementary Document Uploaded 2007-01-10 Available
Appendix E.1 Enrollment Packet Cover letters .doc Supplementary Document Uploaded 2007-01-10 Available
OMBappendices (2).doc Supplementary Document Uploaded 2007-01-10 Available
Appendix T Hypotheses 6-4-2007.doc Supplementary Document Uploaded 2007-06-05 Available
Appendix S.5 Pediatric MR Form.DOC Supplementary Document Uploaded 2007-01-05 Available
Appendix S.4 Neonatal MR Form.DOC Supplementary Document Uploaded 2007-01-05 Available
Appendix S.3 L&D MR Form.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix S.2 PRENATAL MR Form.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix S.1 Medical Record Request Script & Fax.doc Supplementary Document Uploaded 2007-01-05 Repair queued
Appendix R.1 Shipping and Handling of Biosamples.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix O.2 Reminder call script.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix O.1 follow-up telephone script.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix L ICD DSM Code Lists .xls Supplementary Document Uploaded 2007-06-05 Available
Appendix K site specific ascert.doc Supplementary Document Uploaded 2007-06-05 Available
Appendix I CDC IRB Approval Letter.doc Supplementary Document Uploaded 2007-06-05 Repair queued
Appendix E.22 case cohort picture story.pdf Supplementary Document Uploaded 2007-01-05 Available
Appendix E.20 Buccal IC bioDad.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix E.18 HIPAA release form.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix E.8 Study Bill of Rights.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix E.7 Biosample FAQs.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix E.6 Medical Glossary.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix E.3 Informed Consent Docs.doc Supplementary Document Uploaded 2007-01-05 Available
Appendix D.4 Research Domains by DC Activity 2007 05.doc Supplementary Document Uploaded 2007-06-05 Available
Appendix D.3 DC Instrument Summary Table.doc Supplementary Document Uploaded 2007-06-05 Available
Appendix D.2 Data Collect Process Outline .doc Supplementary Document Uploaded 2007-01-05 Available
Appendix D.1 study Flow 2007 05.pdf Supplementary Document Uploaded 2007-06-05 Available
Appendix C.2 Public Comment.doc Supplementary Document Uploaded 2007-06-05 Available
Appendix C.1 60-Day Federal Registry Notice.pdf Supplementary Document Uploaded 2007-06-05 Available
Appendix B 1 Caregiver Interview Tel Script.doc Supplementary Document Uploaded 2007-01-05 Repair queued
Appendix A Authorizing Legislation.pdf Supplementary Document Uploaded 2007-06-05 Available
CADDRE Supporting Statement to OMB 6-4-2007.doc Supporting Statement A Uploaded 2007-06-05 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
180497 Follow-Up Telephone Calls Other-First Follow-Up Phone Call New
178556 Biosamples Other-Cheek Swab Sample Record Sheet New
178555 Clinic Visit - Case Child Other-Mullen Scales of Early Learning New
178554 Clinic Visit- Control Children Other-Mullen Scales of Early Learning New
178553 Clinic Visit- Control Parent Other-Written Informed Consent New
178552 Clinic Visit - Case Parent Other-Written Informed Consent Form New
178551 Caregiver Interview Other-Primary Caregiver Interview New
178550 Medical Record Abstraction Other-Medical Record Request Script and Fax Letter New
178540 Questionaire Packets Other-Self Administered Consent New
178539 Invitation Telephone Call Other-Other New
178538 Mailed Invitation Packet Other-Response Card New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
06/30/2010 36 Months From Approved
146,278 0 0
50,448 0 0
0 0 0





table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 146,278 0 0 146,278 0 0
Annual Time Burden (Hours) 50,448 0 0 50,448 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No