Attachment List Justification ADHD follow up extension 20100127

Longitudinal Follow-up of Youth with Attention-Deficit/Hyperactivity Disorder Identified in Community Settings: Examining Health Status, Correlates, and Effects Associated with Treatment for ADHD

Revision of 0920-0747

List of Attachments (A-G)

Attachment A. Copies of applicable sections of laws or regulations

A1. Public Health Service Act

A2. Child Health Act, 2000

Attachment B. 60 day Federal Register notice

Attachment C. Data collection instruments

Attachment C1. Instrument Table

Attachment C2. Instrument Description

C3. Parent ADHD Communication and Knowledge

C4a. Parent ADHD Treatment, Cost, and Client Satisfaction Questionnaire

C4b. Parent ADHD Treatment Quarterly Update

C5. Parent Brief Impairment Scale

C6. Parent Critical School Events (elementary, middle)

C7. Parent Critical School Events (high school)

C8. Parent Demographic Survey

C9. Parent Health Risk Behavior Survey Middle (11-13 years)

C10. Parent Health Risk Behavior Survey High School (14+ years)

C11. Parent Child Relationship Inventory

C12. Parents’ Questionnaire (Mental Health)

C13. Parent Quarterly Update

C14. Parent Social Isolation/Support

C15. Parent Strengths and Difficulties Questionnaire

C16. Parent Vanderbilt Rating Scale

C17. Child Brief Sensation Seeking Scale

C18. Child Conflict in Adolescent Dating Relationships Inventory (16+years)

C19. Child Health Risk Behavior Survey Middle (11-13 years)

C20. Child Health Risk Behavior Survey High School (14+ years)

C21. Child MARSH – Self Description Questionnaire v I (7-12 years)

C22. Child MARSH – Self Description Questionnaire v II (13-15 years)

C23. Child MARSH – Self Description Questionnaire v III (16+ years)

C24. Child Social Inventory (High School 14+ years)

C25. Child Olweus Bullying Questionnaire (High School 14+ years)

C26. Child Pediatric Quality of Life (8-12 years)

C27. Child Pediatric Quality of Life (13+ years)

C28. Child Youth Demographic Survey (16+ years)

C29. Teacher Survey

C30. DISC interview (Clinical Diagnostic Tool; exempt from OMB Burden Table requirements)

Attachment D. Consent forms

Attachment D1 SC Parent Consent form (age 9-17)

Attachment D2 SC Child Assent form (middle school)

Attachment D3 SC Youth Consent (High School +)

Attachment E. IRB approval notice

Attachment E1. CDC IRB approval notice

Attachment E2. SC IRB approval notice

Attachment E3. CDC IRB reliance on SC IRB notice

Attachment F. Sample

Attachment F1. Sample Description

Attachment F2. Respondent Age Group Break Down Tables

Attachment G. Triage Protocol

ICRAS Forms:

ICRAS Part I

ICRAS Part II.C3. Parent ADHD Communication and Knowledge

ICRAS Part II C4a. Parent ADHD Treatment, Cost, and Client Satisfaction Questionnaire

ICRAS Part II C4b. Parent ADHD Treatment Quarterly Update

ICRAS Part II C5. Parent Brief Impairment Scale

ICRAS Part II C6. Parent Critical School Events (elementary, middle)

ICRAS Part II C7. Parent Critical School Events (high school)

ICRAS Part II C8. Parent Demographic Survey

ICRAS Part II C9. Parent Health Risk Behavior Survey Middle (11-13 years)

ICRAS Part II C10. Parent Health Risk Behavior Survey High School (14+ years)

ICRAS Part II C11. Parent Child Relationship Inventory

ICRAS Part II C12. Parents’ Questionnaire (Mental Health)

ICRAS Part II C13. Parent Quarterly Update

ICRAS Part II C14. Parent Social Isolation/Support

ICRAS Part II C15. Parent Strengths and Difficulties Questionnaire

ICRAS Part II C16. Parent Vanderbilt Rating Scale

ICRAS Part II C17. Child Brief Sensation Seeking Scale

ICRAS Part II C18. Child Conflict in Adolescent Dating Relationships Inventory (16+years)

ICRAS Part II C19. Child Health Risk Behavior Survey Middle (11-13 years)

ICRAS Part II C20. Child Health Risk Behavior Survey High School (14+ years)

ICRAS Part II C21. Child MARSH – Self Description Questionnaire v I (7-12 years)

ICRAS Part II C22. Child MARSH – Self Description Questionnaire v II (13-15 years)

ICRAS Part II C23. Child MARSH – Self Description Questionnaire v III (16+ years)

ICRAS Part II C24. Child Social Inventory (High School 14+ years)

ICRAS Part II C25. Child Olweus Bullying Questionnaire (High School 14+ years)

ICRAS Part II C26. Child Pediatric Quality of Life (8-12 years)

ICRAS Part II C27. Child Pediatric Quality of Life (13+ years)

ICRAS Part II C28. Child Youth Demographic Survey (16+ years)

ICRAS Part II C29. Teacher Survey