Assessment of Executive Function for the National Children's Study

Neuropsychosocial Measures Formative Research Methodology Studies for the National Childrens Study (NICHD)

OMB: 0925-0661

IC ID: 212511

Documents and Forms
Document Name
Document Type
Form and Instruction
Other-Consent
Other-Consent
Other-Assent
Other-Consent 2
Other-Consent 2
Other-Consent 2
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
Form and Instruction
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
IC Document
Information Collection (IC) Details

View Information Collection (IC)

Assessment of Executive Function for the National Children's Study
 
Unchanged
 
Voluntary
 

Document Type Form No. Form Name Instrument File URL Available Electronically? Can Be Submitted Electronically? Electronic Capability
Form and Instruction 1 Recruitment Screening Interview Attach 15 Recruitment Screening Script.docx Yes Yes Fillable Fileable
Other-Consent Attach 17 Consent Form Delve with no 2nd session.docx Yes Yes Fillable Fileable Signable
Other-Consent Attach 19 Consent Form UofM with no 2nd session.docx Yes Yes Fillable Fileable Signable
Other-Assent Attach 26 Child Assent Form.docx Yes Yes Fillable Fileable Signable
Form and Instruction 2 Family Demographic Questionnaire Attach 9 Family Demographic Questionnaire_FINAL.docx Yes Yes Fillable Fileable
Form and Instruction 3 CBQ-VSF+EF Attach 10 CBQ-VSF+EF.docx Yes Yes Fillable Fileable
Form and Instruction 4 Ages and Stages Social Emotional Questionnaire Attach 11 Ages and Stages Social Emotional Questionanaire.docx Yes Yes Fillable Fileable
Form and Instruction 5 Strengths and Difficulties Questionnaire Attach 12 Strengths and Difficulties Questionnaire.docx Yes Yes Fillable Fileable
Form and Instruction 6 Q-ABC Attach 13 Q-ABC.docx Yes Yes Fillable Fileable
Form and Instruction 7 Touch Screen Tutorial Attach 1 Touch Screen Tutorial.docx Yes Yes Fillable Fileable
Form and Instruction 8 Dimensional Change Card Sort Test Attach 2 Dimensional Change Card Sort Test.docx Yes Yes Fillable Fileable
Form and Instruction 9 Flanker Inhibitory Control and Attention Test Attach 3 Flanker Inhibitory Control and Attention Test.docx Yes Yes Fillable Fileable
Form and Instruction 10 Picture Vocabulary Test Attach 4 Picture Vocabulary Test.docx Yes Yes Fillable Fileable
Form and Instruction 11 Picture Sequence Memory Test Attach 5 Picture Sequence Memory Test.docx Yes Yes Fillable Fileable
Form and Instruction 12 Peg Tapping Attach 6 Peg Tapping.docx Yes Yes Fillable Fileable
Form and Instruction 13 WPPSI-IV Block Design Attach 7 WPPSI-IV Block Design.docx Yes Yes Fillable Fileable
Form and Instruction 12 Woodcock-Johnson III Tests of Achievement Attach 8 Woodcock Johnson III.docx Yes Yes Fillable Fileable
Other-Consent 2 Attach 16 Consent Form Delve with 2nd session.docx Yes Yes Fillable Fileable Signable
Other-Consent 2 Attach 18 Consent Form UofM with 2nd session.docx Yes Yes Fillable Fileable Signable
Other-Consent 2 Attach 26 Child Assent Form.docx Yes Yes Fillable Fileable Signable

Health Health Care Services

 

792 0
   
Individuals or Households
 
   90 %

  Requested Program Change Due to New Statute Program Change Due to Agency Discretion Change Due to Adjustment in Agency Estimate Change Due to Potential Violation of the PRA Previously Approved
Annual Number of Responses for this IC 792 0 0 0 0 792
Annual IC Time Burden (Hours) 814 0 0 0 0 814
Annual IC Cost Burden (Dollars) 0 0 0 0 0 0

Title Document Date Uploaded
Letter of Invitation Attach 14 Letter of Invitation.docx 07/29/2014
Univ of Minnesota IRB Original Application 01052011 Attach 20 Univ of Minnesota IRB Original Application 01052011.pdf 07/29/2014
Univ of Minnesota IRB Annual Renewal Approval 03062014 Attach 21 Univ of Minnesota IRB Annual Renewal Approval 03062014.pdf 07/29/2014
Univ of Minnesota IRB Change in Protocol Request 11062013 Attach 22 Univ of Minnesota IRB Change in Protocol Request 11062013.docx 07/29/2014
Univ of Minnesota IRB Change in Protocol Approval 11132013 Attach 23 Univ of Minnesota IRB Change in Protocol Approval 11132013.pdf 07/29/2014
Delve IRB Letter Attach 24 Delve IRB Letter.pdf 07/29/2014
Northwestern Univ IRB Letter Attach 25 Northwestern Univ IRB Letter.pdf 07/29/2014
Univ of Minnesota IRB Change in Protocol Approval 06062014 Attach 27 Univ of Minnesota IRB Change in Protocol Approval 06062014.pdf 07/29/2014
OMB Request Template Executive_Function_LOI2-QUEX-6_OIRA_Template_FINAL Nov 2014.docx 11/12/2014
            Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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