24-Month Interview (PB, EH, TT-HI, TT-LI, PBS)

Provider-Based Sampling Feasibility Study for the Vanguard (Pilot) Study and Data Collection Updates for the National Children's Study (NICHD)

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0925-0593 can be found here:

Documents and Forms

Document Name Document Type
Form 24.4 24-Month Interview (PB, EH, TT-HI, TT-LI, PBS) Form and Instruction
24.1 Survey 24 MO Interview 20120413.docx Form and Instruction
24.2 Survey Modified Checklist for Autism in Toddlers SAQ 20120413.docx Form and Instruction
24.3 Survey - Placeholder for copyrighted material 24 MO ASQ-3.docx Form and Instruction
24.4 Survey - Placeholder for copyrighted material 27 MO ASQ-3.docx Form and Instruction
24.5 Survey - Placeholder for copyrighted material 30 MO ASQ-3.docx Form and Instruction
Note to File - 24 Month -- Administration of Ages and Stages 3 Questionnaire.docx Note to File - 24-Month ASQ Administration IC Document

Information Collection (IC) Details

IC Title:	24-Month Interview (PB, EH, TT-HI, TT-LI, PBS)	Agency IC Tracking Number:

Is this a Common Form? No		IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	24.4	Survey - Placeholder for copyrighted material	27 MO ASQ-3.docx	Yes	Yes	Paper Only
Form and Instruction	24.5	Survey - Placeholder for copyrighted material	30 MO ASQ-3.docx	Yes	Yes	Paper Only
Form and Instruction	24.1	Survey	24 MO Interview 20120413.docx	Yes	Yes	Paper Only
Form and Instruction	24.2	Survey	Modified Checklist for Autism in Toddlers SAQ 20120413.docx	Yes	Yes	Paper Only
Form and Instruction	24.3	Survey - Placeholder for copyrighted material	24 MO ASQ-3.docx	Yes	Yes	Paper Only

Line of Business: General Science and Innovation

Subfunction: Scientific and Technological Research and Innovation

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,251	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	Previously Approved
Annual Number of Responses for this IC	1,251	-884	2,135
Annual IC Time Burden (Hours)	730	-338	1,068
Annual IC Cost Burden (Dollars)	0	0	0

Documents for IC

Title	Document	Date Uploaded
Note to File - 24-Month ASQ Administration	Note to File - 24 Month -- Administration of Ages and Stages 3 Questionnaire.docx	04/16/2012

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