30M_InfantToddlerSensoryProfilePhoneInstructions

OMB #: 0925-0593

OMB Expiration Date: 08/31/2014

Neuro-Psychosocial Infant/Toddler Sensory Profile Instructions: Telephone, Phase 2g

The National Children’s Study

Infant/Toddler Sensory Profile™ Instructions

Telephone Questionnaire

Thank you for agreeing to participate in the National Children’s Study (NCS) and completing the Infant/Toddler Sensory Profile™. This telephone questionnaire will take about 15 minutes to complete. It includes questions about how children react to physical sensations, such as touch, sounds, tastes, smells, movement. If you have more than one child in the NCS, the telephone interviewer will ask you about each child separately.

Your answers are important to us. We will keep everything that you tell us confidential.

Listed below are several points that you may find helpful in answering these questions:

• Please refer to the hardcopy questionnaire that you received in the mail recently. Information in the questionnaire will help you respond to the questions.

• Please keep this questionnaire handy so you will have it available when an NCS staff member calls you on the phone to ask you about your child’s behavior.

• Refer to the key on the first page of the questionnaire for a description of how to answer: Almost Always, Frequently, Occasionally, Seldom, or Almost Never.

• The Infant/Toddler Sensory Profile™ consists of a list of descriptions of children’s behaviors in different areas such as hearing, vision, and touch.

• Listen to each item carefully and then choose the answer that best describes your child’s typical behaviors.

If you have any questions, please call the local contact number located on the next page.

Thank you for taking the time to complete this questionnaire!

For Office Use Only:

Instructions for returning the questionnaire to the Regional Operations Center (ROC):

{Local instructions inserted by ROC. If the visit is done by phone, the ROC will provide information about returning it to the ROC.}

Insert ROC contact information label here.

NEU Infant/Toddler Sensory Profile™ Instructions: Telephone, MDES 4.0, V2.0 1