CDE Detailed Report

Disease: Spinal Cord Injury
Sub-Domain: Quality of Life/Patient Reported Outcomes
CRF: Child and Adolescent Scale of Participation (CASP)

Displaying 1 - 30 of 30
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C06005 Data collected date and time DataCollDateTime Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date (and time, if applicable and known) the data were collected. This may be the date/time a particular examination or procedure was performed. Date you completed survey Date or Date & Time "Adapted from: Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Core 3.00 2013-07-24 21:00:23.88 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Free-Form Entry

C51994 Child and Adolescent Scale of Participation (CASP) - School social play scale CASPSocialSchoolScl Scale to rate level of participation in social, play and recreational activities with other children at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in social, play and recreational activities with other children at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in social, play and recreational activities with other children at school (eg, 'hanging out,' sports, clubs, hobbies, creative arts, lunchtime or recess activities)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52011 Child and Adolescent Scale of Participation (CASP) - Change made home community school for child indicator CASPChngHouseCommSchoolInd Indicates any changes made to home, community or school (or work) setting to help child participate, as part of the Child and Adolescent Scale of Participation (CASP). Indicates any changes made to home, community or school (or work) setting to help child participate, as part of the Child and Adolescent Scale of Participation (CASP). Have any changes been made to your home, community or the school (or work) setting to help your child participate (e.g., rearranging furniture and materials, adjusting lighting or noise levels, building a ramp or other physical structures)? 0;1 No;Yes Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:47:39.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51973 Child and Adolescent Scale of Participation (CASP) - Neighborhood movement scale CASPNeighborMovmntScl Scale to rate level of participation in moving around the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation - Community Participation (CASP) Scale to rate level of participation in moving around the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation - Community Participation (CASP) Compared to other children your child's age, what was (his/her) level of participation before the injury in moving around the neighborhood and community (eg, public buildings, parks, restaurants, movies) [Please consider your child's primary way of moving around, NOT his or her use of transportation]? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:04:52.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51995 Child and Adolescent Scale of Participation (CASP) - Things help child participate text CASPThingHelpKidPrtpTxt Text describing the types of things that help child participate in the above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP) Text describing the types of things that help child participate in the above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP) Please describe the type of things that help your child participate in the above-mentioned activities (e.g., things that your child does, or that others such as family, friends or education and rehabilitation professionals do to help your child) Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 4000

Free-Form Entry

C52013 Child and Adolescent Scale of Participation (CASP) - Social play with friends scale CASPSocialFriendsScl Scale to rate level of participation in social, play or leisure activities with friends at home (can include conversations on the phone or internet), compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in social, play or leisure activities with friends at home (can include conversations on the phone or internet), compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in social, play or leisure activities with friends at home (can include conversations on the phone or internet)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51977 Child and Adolescent Scale of Participation (CASP) - Communication with children and adults at home scale CASPCommHomeScl Scale to rate level of participation in communicating with other children and adults at home, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in communicating with other children and adults at home, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in communicating with other children and adults at home? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51996 Child and Adolescent Scale of Participation (CASP) - Assistive device equipment used text CASPUseAssistDevEquipTxt Text describing the assistive devices or equipment used to help child participate in the above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP). Text describing the assistive devices or equipment used to help child participate in the above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP). If Yes, please identify: Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 4000

Free-Form Entry

C52016 Child and Adolescent Scale of Participation (CASP) - Self-care activity scale CASPSelfCareScl Scale to rate level of participation in self-care activities, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in self-care activities, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in self-care activities (eg, eating, dressing, bathing, combing or brushing hair, using the toilet)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51980 Child and Adolescent Scale of Participation (CASP) - Shop manage money scale CASPShopMoneyManagScl Scale to rate level of participation in shopping and managing money, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in shopping and managing money, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in shopping and managing money (eg, shopping at stores, figuring out correct change)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51999 Child and Adolescent Scale of Participation (CASP) - Social play with family scale CASPSocialFamilyScl Scale to rate level of participation in social, play or leisure activities with family members at home, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in social, play or leisure activities with family members at home, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in social, play or leisure activities with family members at home (eg, games, hobbies, 'hanging out')? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Adapted from: Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52017 Child and Adolescent Scale of Participation (CASP) - House movement scale CASPHouseMovmntScl Scale to rate level of participation in moving about in and around the home, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in moving about in and around the home, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in moving about in and around the home? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51981 Child and Adolescent Scale of Participation (CASP) - Academic activity scale CASPAcademicActScl Scale to rate level of participation in educational (academic) activities with other children in his or her classroom at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in educational (academic) activities with other children in his or her classroom at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in educational (academic) activities with other children in his or her classroom at school? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52000 Child and Adolescent Scale of Participation (CASP) - Household activity scale CASPHouseActScl Scale to rate level of participation in household activities, compared to other children their age, as part of Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in household activities, compared to other children their age, as part of Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in household activities (eg, preparing some meals, doing laundry, washing dishes)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52020 Child and Adolescent Scale of Participation (CASP) - Assistive device or equipment used indicator CASPUseAssistDevEquipInd Indicates the use of assistive device or equipment to help child participate in above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP). Indicates the use of assistive device or equipment to help child participate in above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP). Does your child currently use any assistive devices or equipment to help him or her participate (e.g., adapted eating utensils, shower chair, note-taker for school, daily planner, computer)? 0;1 No;Yes Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:47:39.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51984 Child and Adolescent Scale of Participation (CASP) - Manage daily schedule scale CASPScheduleManagScl Scale to rate level of participation in managing daily schedule, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in managing daily schedule, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in managing daily schedule (eg, doing and completing daily activities on time; organizing and adjusting time and schedule when needed)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52001 Child and Adolescent Scale of Participation (CASP) - Communication children adults at school scale CASPCommSchoolScl Scale to rate level of participation in communicating with other children and adults at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in communicating with other children and adults at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in communicating with other children and adults at school? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52022 Child and Adolescent Scale of Participation (CASP) - Child name CASPChildName Name of subject/participant, as part of the Child and Adolescent Scale of Participation (CASP). Name of subject/participant, as part of the Child and Adolescent Scale of Participation (CASP). Child's name Alphanumeric "Adapted from: Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Core 1.00 2016-12-20 14:52:55.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 100

Free-Form Entry

C51985 Child and Adolescent Scale of Participation (CASP) - Neighborhood activity scale CASPNeighborActScl Scale to rate level of participation in structured events and activities in the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in structured events and activities in the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in structured events and activities in the neighborhood and community (eg, team sports, clubs, holiday or religious events, concerts, parades and fairs)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52002 Child and Adolescent Scale of Participation (CASP) - Household responsibility scale CASPHouseResponsibilityScl Scale to rate level of participation in family chores, responsibilities and decisions at home compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in family chores, responsibilities and decisions at home compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in family chores, responsibilities and decisions at home (For younger children this may be getting things or putting things away when asked or helping with small parts of household chores; For older children this may be more involvement in household chores and decisions about family activities and plans)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52023 Child and Adolescent Scale of Participation (CASP) - Relative name CASPRelName Name of participant/subject's relative, or the person filling out the scale, as part of the Child and Adolescent Scale of Participation (CASP). Name of participant/subject's relative, or the person filling out the scale, as part of the Child and Adolescent Scale of Participation (CASP). Your name Alphanumeric "Adapted from: Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Core 1.00 2016-07-26 11:14:59.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 100

Free-Form Entry

C51987 Child and Adolescent Scale of Participation (CASP) - Work responsibility scale CASPWorkRespScl Scale to rate level of participation in work activities and responsibilities, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in work activities and responsibilities, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). "Compared to other children your child's age, what is your child's current level of participation in work activities and responsibilities (eg, completion of work tasks, punctuality, attendance and getting along with supervisors and co-workers)?
"
1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52003 Child and Adolescent Scale of Participation (CASP) -Educational material use scale CASPEduMaterialUseScl Scale to rate level of participation in using educational materials and equipment that are available to other children or that have been modified, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in using educational materials and equipment that are available to other children or that have been modified, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in using educational materials and equipment that are available to other children in his or her classroom(s) or that have been modified for your child (eg, books, computers, chairs and desks)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Adult;Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52024 Child and Adolescent Scale of Participation (CASP) - Relationship text CASPRelateTxt Text describing your relationship to the participant/subject, as part of the Child and Adolescent Scale of Participation (CASP). Text describing your relationship to the participant/subject, as part of the Child and Adolescent Scale of Participation (CASP). Your relationship to child Alphanumeric "Adapted from: Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Core 1.00 2016-07-26 11:15:52.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 100

Free-Form Entry

C51990 Child and Adolescent Scale of Participation (CASP) - Communication with children and adult in neighborhood scale CASPCommNeighborScl Scale to rate level of participation in communicating with other children and adults in the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in communicating with other children and adults in the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in communicating with other children and adults in the neighborhood and community? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52004 Child and Adolescent Scale of Participation (CASP) -Change made to home community school for child text CASPChngHouseCommSchoolTxt Text describing changes made to home, community or school (or work) setting to help child participate, as part of the Child and Adolescent Scale of Participation (CASP). Text describing changes made to home, community or school (or work) setting to help child participate, as part of the Child and Adolescent Scale of Participation (CASP). If Yes, please describe: Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 4000

Free-Form Entry

C51992 Child and Adolescent Scale of Participation (CASP) - Neighborhood social play scale CASPSocialNeighborScl Scale to rate level of participation in social, play, or leisure activities with friends in the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in social, play, or leisure activities with friends in the neighborhood and community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in social, play, or leisure activities with friends in the neighborhood and community (eg, casual games, 'hanging out,' going to public places like a movie theater, park or restaurant)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 12:17:02.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C52007 Child and Adolescent Scale of Participation (CASP) - Transportation use scale CASPTrsptUseScl Scale to rate level of participation in using transportation to get around in the community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in using transportation to get around in the community, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in using transportation to get around in the community (eg, to and from school, work, social or leisure activities) [Driving vehicle or using public transportation]? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

C51993 Child and Adolescent Scale of Participation (CASP) - Things interfere child participate text CASPThingsInterfereKidPrtpTxt Text describing the types of things that interfere child participate in the above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP). Text describing the types of things that interfere child participate in the above-mentioned activities, as part of the Child and Adolescent Scale of Participation (CASP). Please describe the type of things that interfere your child participate in the above-mentioned activities (e.g., things that your child does, or that others such as family, friends or education and rehabilitation professionals do to help your child) Alphanumeric "Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points 4000

Free-Form Entry

C52008 Child and Adolescent Scale of Participation (CASP) - School movement scale CASPSchoolMovmntScl Scale to rate level of participation in moving around at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Scale to rate level of participation in moving around at school, compared to other children their age, as part of the Child and Adolescent Scale of Participation (CASP). Compared to other children your child's age, what is your child's current level of participation in moving around at school (eg, to get to and use bathroom, playground, cafeteria, library or other rooms and things that are available to other children his or her age)? 1;2;3;4;Not applicable Unable, your child can not participate in the activities, although other children his or her age do participate.;Very limited, your child participates in the activities much less than other children his or her age [Your child may also need a lot of supervision or assistance];Somewhat limited, your child participates in the activities somewhat less than other children his or her age [Your child may also need occasional supervision or assistance];Age expected (Full participation), your child participates in the activities the same as or more than other children his or her age [With or without assistive devices or equipment];Not applicable, other children your child's age would not be expected to participate in the activities. Alphanumeric

We are interested in finding out about the activities that you participate in at home, school, and in the community. You will be asked about your current level of participation with activities as compared to other children your age.

"Bedell, G. (2004). Child and Adolescent Scale of Participation. Medford: Tufts University. Survey copyright by Gary Bedell. Retrieved from the Tufts University website: http://sites.tufts.edu/garybedell/files/2012/07/CASP-Administration-Scoring-Guidelines-8-19-11.pdf " Pediatric Supplemental 1.00 2016-12-20 13:24:12.0 Child and Adolescent Scale of Participation (CASP) Quality of Life/Patient Reported Outcomes Outcomes and End Points

Single Pre-Defined Value Selected

CSV