Clinic Visit - Case Child

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

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-0741 can be found here:

Documents and Forms

Document Name Document Type
Appendix G.1 ADOS.pdf Other-ADOS
Appendix G.2 Mullen.pdf Other-Mullen Scales of Early Learnin
appendix P Dysmorphology Exam.doc Other-Dysmorphology Exam Data Collec
appendix P Dysmorphology Exam.doc Dysmorphology Exam Protocol IC Document

Information Collection (IC) Details

IC Title:	Clinic Visit - Case Child	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Other-Mullen Scales of Early Learning	Appendix G.2 Mullen.pdf	Yes	Yes	Printable Only
Other-ADOS	Appendix G.1 ADOS.pdf	Yes	Yes	Printable Only
Other-Dysmorphology Exam Data Collection Form	appendix P Dysmorphology Exam.doc	Yes	Yes	Printable Only

Line of Business: Health

Subfunction: Public Health Monitoring

Privacy Act System of Records
Title: 09-20-0136 Epidemiologic Studies and Surveillance of Disease Problems	FR Citation: 57 FR 62812

Number of Respondents: 810	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,430	2,430
Annual IC Time Burden (Hours)	1,351	1,351
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Dysmorphology Exam Protocol	appendix P Dysmorphology Exam.doc	06/05/2007

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.