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pdf0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
START NEW CARD
DUP COL 1 - 10
MOD.
I
1
[11 - 12]
CARD NO. 0
1
b
[13 - 14]
[15]
INTRODUCTION/TIMELINES
(INTRODUCTION TO DIAGNOSTIC SECTIONS)
INTRO 1
This interview is made up mostly of questions about the kinds of things ________ has
been doing and feeling in the past year – that is, from last [spring/summer/fall/winter]
up until today.
Asking all the questions should take about an hour, or maybe a little longer. Will that
be all right?
a:
IF SCHEDULING CONFLICT, RESOLVE AT THIS POINT
If you want to take a break for a while, just let me know, that will be fine.
b:
INTRODUCE STUDY-SPECIFIC CONFIDENTIALITY
WORDING AT THIS POINT
NOTE 1:
RECORD TODAY’S DATE (MM,DD,YY)
NOTE 2:
INTERVIEWER, CODE THE FOLLOWING VARIABLE
WITHOUT ASKING:
|____ ____|____ ____|____ ____|[16-21]
GENDER OF CHILD (SUBJECT):
Male ................................................................................................
Female .............................................................................................
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 1
1
2
[22]
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
Okay, let’s start with a few simple questions about ________ and [his/her] family.
1.
What is your relationship to ________?
Both parents ....................................................................................
Biological/Adoptive mother ...........................................................
Biological/Adoptive father .............................................................
Grandmother ...................................................................................
Grandfather .....................................................................................
Adult sister ......................................................................................
Adult brother ...................................................................................
Step mother .....................................................................................
Step father .......................................................................................
Foster mother ..................................................................................
Foster father ....................................................................................
Aunt ................................................................................................
Uncle ...............................................................................................
Other ...............................................................................................
Some combination of above ...........................................................
Don’t know .....................................................................................
2.
[23-24]
|____ ____| YRS.
[25-26]
|____ ____|____ ____|
[27-30]
How old is ________ ?
CODE CURRENT AGE -------------------------------------------------------------->
NOTE 3:
3.
01
02
03
04
05
06
07
08
09
10
11
12
13
14
15
99
IF UNCLEAR, ASK: Is that how old [he/she] is right now?
When is [his/her] birthday?
CODE MONTH AND DAY ---------------------------------------------------------->
A. Was that when [he/she] turned [NAME AGE FROM Q 2]?
0
2
7
9
[31]
IF NO, B. How old is [he/she] now?
4.
ENTER AGE HERE ---------------------------------->
|____ ____| YRS.
CALCULATE BIRTHDATE HERE -------------->
(MM,DD,YY)
|____ ____|____ ____|____ ____|[34-39]
[32-33]
Does ________ have any brothers or sisters that [he/she] lives with?
0
2
7
9
[40]
IF NO, A. In the last year, has [he/she] had brothers or sisters that [he/she] lived
with?
0
2
7
9
[41]
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 2
[10/24/03]
0=NO
5.
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
Does ________ go to school?
0
2
7
9
[42]
IF NO, A. Did [he/she] go to school in the last year?
0
2
7
9
[43]
0
2
7
9
[44]
0
2
7
9
[45]
IF NO, GO TO E
IF YES, B. In the last month?
IF NO, C. Is that because [he/she] is on vacation?
D. When did [he/she] stop going to school?
CODE MONTH ------------------------>
|____ ____|
[46-47]
GO TO Q 6
IF NO, E. Has ________ ever gone to school?
0
2
7
9
[48]
IF NO, GO TO INSTRUCTION BOX “d”
IF YES, F. When [he/she] stopped going to school,
how old was [he/she]?
CODE AGE ----------------------------->
|____ ____| YRS.
[49-50]
|____ ____| GRADE
[51-52]
|____ ____|
[53-54]
|____ ____|
[55-56]
G. What grade was that?
CODE GRADE ------------------------->
(44 = PRE-K,
55 = KINDERGARTEN)
GO TO Q 7
6.
What grade is ________ in now? (IF SUMMER VACATION OR NOT IN
SCHOOL: What grade did [he/she] just complete?)
CODE GRADE ------------------------------------------------------------------------->
(44 = PRE-K, 55 = KINDERGARTEN, 13 = FRESHMAN IN COLLEGE,
14 = SOPHOMORE, 15 = JUNIOR, 16 = SENIOR, 17 = POST BA)
A. When did [he/she] start school this year?
CODE MONTH -------------------------------------------------------->
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 3
[10/24/03]
0=NO
7.
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
Has ________ ever repeated a grade?
0
2
7
9
[57]
IF YES, A. Has [he/she] repeated a grade more than once?
0
2
7
9
[58]
IF YES, B. How many times has [he/she] repeated a grade?
1 grade repeated ........................................................
2 grades repeated .......................................................
3 grades repeated .......................................................
4 grades repeated .......................................................
Refuse to answer .......................................................
Don’t know ................................................................
1
2
3
4
7
9
[59]
C. Which one(s) did [he/she] repeat?
8.
CODE GRADE --------------------------------------------------------->
(44 = PRE-K, 55 = KINDERGARTEN)
|____ ____|
[60-61]
CODE GRADE --------------------------------------------------------->
|____ ____|
[62-63]
CODE GRADE --------------------------------------------------------->
|____ ____|
[64-65]
CODE GRADE --------------------------------------------------------->
|____ ____|
[66-67]
Did ________ go to kindergarten?
0
2
7
9
[68]
IF YES, A. How old was [he/she] then?
CODE AGE -------------------------------------------------------------->
|____ ____|YRS.
[69-70]
|____ ____|YRS.
[71-72]
|____ ____| GRADE
[73-74]
IF NO, B. How old was ________ when [he/she] started school?
CODE AGE -------------------------------------------------------------->
C. What grade was that?
CODE GRADE ----------------------------------------->
(44 = PRE-K, 55 = KINDERGARTEN)
c:
AT THIS POINT, INTERVIEWER SHOULD FILL IN AGE,
GRADE, AND SCHOOLS FOR EACH AGE ON LIFE CHART,
ASKING ADDITIONAL QUESTIONS AS NECESSARY
START NEW CARD
DUP COL 1 - 12
CARD NO. 0
d:
2
b
[13 - 14]
[15]
IF CHILD’S CURRENT AGE
IS LESS THAN 12, GO TO Q 10
ALL OTHERS, CONTINUE
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 4
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0=NO
9.
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
Does ________ have a job?
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
0
2
7
9
[16]
0
2
7
9
[17]
0
2
7
9
[18]
0
2
7
9
[19]
0
2
7
9
[20]
IF YES, A. What does [he/she] do?
B. When did [he/she] start that job? (Enter year or month on charts)
IF NO, C. Has ________ had a job in the last year?
IF YES, D. Has [he/she] had a job in the last month?
IF NO, E. When did [he/she] last have a job? (Enter
month on chart)
F. When did [he/she] start that job? (Enter
year or month on charts)
G. What did [he/she] do?
IF NO, H. Has [he/she] ever had a job?
IF YES, I. When was that? (Enter year or month on
charts)
J. What did [he/she] do?
10. Has [he/she] always lived in the same house (or apartment)?
IF NO, A. When did [he/she] move [here/there]? (Enter year or month on
charts)
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 5
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
11. Does ________ live with both of [his/her] parents?
8, 88=NOT APPLICABLE
0
2
0
0
0
0
0
0
0
0
0
0
0
0
0
2
2
2
2
2
2
2
2
2
2
2
2
2
7
9, 99=DON’T KNOW
9
[21]
12. Which adults whom [he/she] has lived with, have taken care of [him/her] in the last
year? (Circle all that apply)
Biological/Adoptive mother ...........................................................
Biological/Adoptive father .............................................................
Grandmother ...................................................................................
Grandfather .....................................................................................
Adult sister ......................................................................................
Adult brother ...................................................................................
Step mother .....................................................................................
Step father .......................................................................................
Foster mother ..................................................................................
Foster father ....................................................................................
Aunt ................................................................................................
Uncle ...............................................................................................
Other ...............................................................................................
[22]
[23]
[24]
[25]
[26]
[27]
[28]
[29]
[30]
[31]
[32]
[33]
[34]
(SPECIFY “OTHER”):
|____ ____|
[35-36]
01
02
03
04
05
06
07
08
09
10
11
12
13
14
99
[37-38]
|____ ____|
[39-40]
IF MORE THAN ONE ADULT IN Q 12, ASK:
A. Which of these adults does [he/she] feel closest to?
Biological/Adoptive mother ......................................
Biological/Adoptive father ........................................
Grandmother .............................................................
Grandfather ...............................................................
Adult sister ................................................................
Adult brother .............................................................
Step mother ...............................................................
Step father .................................................................
Foster mother ............................................................
Foster father ..............................................................
Aunt ...........................................................................
Uncle .........................................................................
Other ..........................................................................
Some combination of above ......................................
Don’t know ................................................................
IF 12 A CODED 14 OR 99, ASK:
B. Which of these people took care of
[him/her] the most in the last twelve
months?
e:
THIS IS CHILD’S
“ATTACHMENT
FIGURE”
NOTE: IF RESPONDENT
GIVES MORE THAN ONE
PERSON, ENTER LOWEST
CODE FROM ABOVE.
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 6
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
(INTRODUCTION TO TIMELINE)
INTRO 2
When you answer some of the questions I am going to ask you later, I am going to ask
you to do something that is really hard. That is to remember when different things
happened.
One way of making this type of question easier is by asking you if things have happened
since some special time that you may remember.
[INTERVIEWER: Enter months and the following dates
(if known from previous sections) into timelines.]
• Date of child’s birth at top of life chart
• Child’s last birthday into one year line
• Year child started current and previous schools (if not already done)
• Date of child’s starting current academic year (current year chart)
• Start of child’s last summer vacation (current year chart)
• Year or month child started current job
• Year when child started living at present address
• Christmas and other holidays (current year)
I’d like you to tell me when some important events have happened in the past year to
[CHILD] or your family. The reason I’ll be asking about when these things happened is
to help you remember things that happened in the last month and last year.
INTRO 2B
Here we are today in [MONTH] of
RESPONDENT)
. (SHOW CURRENT TIMELINE TO
(INTERVIEWER: IF THE CHRISTMAS HOLIDAYS WERE [FOUR WEEKS/SIX
MONTHS/TWELVE MONTHS] AGO, SAY: And the Christmas holidays were here in
December, which was [four weeks/six months/twelve months] ago. POINT TO DECEMBER AND WRITE “CHRISTMAS HOLIDAYS” ON TIMELINE.)
Okay, [his/her] last birthday was here in [MONTH OF BIRTHDAY]. (INTERVIEWER:
IF APPLICABLE, SAY: Which was _____ months ago.)
f:
Only probe for times that don’t already have an associated event.
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 7
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
CURRENT YEAR TIMELINE:
12 MONTHS AGO:
13. Now I want you to think hard and try and remember if there was anything that
happened around this time one year ago, that is in [NAME CURRENT MONTH]
of last year that really sticks out in your mind.
Can you think of something that happened to ________ or [his/her] family during
[NAME CURRENT MONTH] of last year?
IF YES, A. What happened?
IF NO, B. Did ________ begin to do something new … like joining a team or
playing a sport or starting some other program or special activity?
IF YES, ASK “What happened?”
IF NO, CONTINUE
C. Did anyone move into [your/his/her] home or move out of [your/his/
her] home in [NAME CURRENT MONTH] of last year?
IF YES, ASK “What happened?”
IF NO, CONTINUE
D. Did [he/she] take any trips or vacations during [NAME CURRENT
MONTH] of last year?
IF YES, ASK “What happened?”
IF NO, CONTINUE
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 8
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
6 MONTHS AGO:
14. What about six months ago, that is, in [NAME MONTH]? Is there something that
happened that you can really remember?
IF YES, A. What happened?
IF NO, B. Did ________ begin to do something new … like joining a team or
playing a sport or starting some other program or special activity?
IF YES, ASK “What happened?”
IF NO, CONTINUE
C. Did anyone move into [your/his/her] home or move out of [your/his/
her] home in [NAME MONTH]?
IF YES, ASK “What happened?”
IF NO, CONTINUE
D. Did [he/she] take any trips or vacations during [NAME MONTH]?
IF YES, ASK “What happened?”
IF NO, CONTINUE
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 9
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
4 WEEKS AGO:
15. Now, what about four weeks ago, say the [beginning/middle/end] of [LAST
MONTH]. Is there anything that happened then that really sticks out in your mind?
IF YES, A. What happened?
IF NO, B. Did ________ begin to do something new … like joining a team or
playing a sport or starting some other program or special activity?
IF YES, ASK “What happened?”
IF NO, CONTINUE
C. Did anyone move into [your/his/her] home or move out of [your/his/
her] home four weeks ago?
IF YES, ASK “What happened?”
IF NO, CONTINUE
D. Did [he/she] take any trips or vacations at the [beginning/middle/end]
of [LAST MONTH]?
IF YES, ASK “What happened?”
IF NO, CONTINUE
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 10
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
(TIMELINE COMPLETION)
INTRO 3
Now I’m going to [write/copy] these things down and give you a kind of calendar to help
you with the rest of the questions.
g:
IF WHOLE LIFE CHART IS SPARSE, ASK ABOUT
ADDITIONAL SIGNIFICANT LIFE EVENTS TO FLESH
IT OUT, E.G., HOUSEHOLD MOVES, BIRTH OF SIBLINGS,
MEMORABLE VACATIONS, TEAM SPORTS, ETC.,
AS NECESSARY.
h:
REVIEW THE TIMELINE AND WHOLE LIFE CHART WITH
THE INFORMANT.
BE SURE TO POINT OUT ALL THE KEY EVENTS.
INTRO 4
During the next part of the interview, you can answer most questions by saying “yes” or
“no.” If you’re not sure about an answer, take some time to think about it. Only say “don’t
know” if you really have no idea at all. If I ask you a question you don’t understand, just
tell me.
If you want to tell me more than “yes” or “no” about something, let me know and I’ll write
it down so we can talk about it later.
I ask everyone the same kinds of questions. Just because I ask whether your child has
done something, that doesn’t mean I think [he/she] has.
Please answer each question the best you can. The best answer is a true answer.
INTRO 5
Okay, let’s go over these things again – to make sure that I explained everything clearly.
I’m mainly going to ask you to answer with “yes” or “no.” What should you do if you
want to tell me more than that about something?
i:
IF RESPONDENT DOESN’T KNOW OR IS UNSURE, SAY:
“Tell me so that I can write it down and we can talk about it later.”
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 11
[10/24/03]
0=NO
1=SOMETIMES/SOMEWHAT
2=YES
7, 77=REFUSE TO ANSWER
8, 88=NOT APPLICABLE
9, 99=DON’T KNOW
What should you do if you aren’t sure about whether to answer “yes” or “no”?
j:
IF RESPONDENT DOESN’T KNOW OR IS UNSURE, SAY:
“Well, if you need time to remember something, just say so and I’ll
wait. Or, if you don’t understand a question, just tell me.”
INTRO 6
It’s important that you notice that not all the questions are about the same time period.
Most of the questions about the past year. When I say “in the past year,” I want you to
think about all of the time from [MONTH] a year ago (when [EVENT ON TIMELINE
FOR ONE YEAR AGO]) right up until today (DRAW HORIZONTAL LINE ACROSS
SPAN OF “LAST YEAR” ON TIMELINE).
A few questions will be about the past six months. When I say “in the past six months,”
I want you to think about all of the time from [MONTH] six months ago (when [EVENT
ON TIMELINE FOR SIX MONTHS AGO]) right up until today (DRAW HORIZONTAL LINE ACROSS SPAN OF “LAST SIX MONTHS” ON TIMELINE).
Some questions will be about the past four weeks. When I say “in the past four weeks,”
I want you to think about the time from [the [BEGINNING/MIDDLE/END] OF
MONTH] four weeks ago (when [EVENT ON TIMELINE FOR FOUR WEEKS AGO])
up to and including today (DRAW PARALLEL HORIZONTAL LINE ACROSS SPAN
OF “LAST FOUR WEEKS” ON TIMELINE).
INTRO 7
Finally, some of the questions ask about things that may have happened in [CHILD]’s
whole life.
The time period covered by each question is stated in the question, so please listen for
it.
Do you have any questions about any of this?
k:
INTERVIEWER MAY ANSWER QUESTIONS ABOUT THE
TIMELINE IN OWN WORDS
INTRODUCTION TO DIAGNOSTIC SECTIONS:
Now we are going to start with the yes/no questions about how ________ has been
feeling and acting.
INTERVIEWER:
POINT TO EVENTS ON CURRENT TIMELINE
AND MAKE SURE THAT INFORMANT UNDERSTANDS
THE TIMEFRAME OF THE INTERVIEW.
Introduction and Timeline (Interviewer assist)
DISC IV-P, past year
Page 12
[10/24/03]
| File Type | application/pdf |
| File Title | P-intro/time past yr 072998.pm7 |
| Subject | P-intro/time past yr 072998.pm7 |
| Author | Emerson |
| File Modified | 2003-10-24 |
| File Created | 2003-10-24 |